Health

Ubiq -“Do you have any data to support, that which has been debunked over and over”

Stop with the liberal lies!
In Saudi Arabia they execute people for crimes, eg. Murder, Drug pushings, etc.
From a UK newspaper online:
“In 2014 they executed 153 criminals.”
From one of the commentors:
“I spent 10 years there, and about the only good thing to be said for the place is that it is basically free of violent crime.”

iacisrmma: -“shmerel: you would rather have a communist like Sanders?”

Did it ever occur to you that some posters here, believe in Communism?!?

Crazykanoiy -“Health, You can support Trump and still criticise him when critiscm is due. Why must you support and defend every disgusting and obnoxious thing he says.”

I support him when I feel he is right!

“His comments on Charlottesville were wrong and indefensible.”

I think his comments was very in the middle. If I would comment – they’d be much more on the right!

“Trump is not a great oheiv yisrael but rather a deeply flawed man who plays to peoples base instincts. Even Conservative hero Ben Shapiro criticized Trump at CPAC over his repulsive comments on Charlottesville”

Who’s B. Shapiro?!?
Did this guy also support Cruz or the guy from Florida? The real conservatives voted for Trump! We don’t want candidates that you libs can live with!!!

Ubiq -“so think about it, how long does it take?”

Ok. Trump is right! Your assumption that e/o at that rally has to be a sympathyzer for Nazis is absurd!
Maybe these guys came to demonstrate first. Do you say the same thing about e/o at the left opposition rally – that they are all Commies or Commie sympathyzers?!?

Midwest2 -“They also called on lawmakers to “stop” (presumely) sale of guns to those under 21,…”

To all you emotional guys reaction to the Parkland School Shooting:
Let’s see – what do you want to accomplish? If it’s just to stop school shootings – then fine. But school shootings are far & inbetween in the US. The main issue is gun murder!
Now let’s take the murder capital in the US – it’s E. St. Louis, Ill. I’m sure a lot of their murders are from guns. And a lot of them are perps under 21. So would your idea of Gun Control stop most killings in the USA?!? LIBERALS – Stop Dreaming!!!

Ubiq -“Well you arent a “very fine person””

Your so far on the liberal left – it’s hard to respond!
Trump was being nice by saying there were fine people on both sides.
There weren’t! And the worse side was the BLM & their left buddies. They were there for violence only.
And why did the town agree in the first place to remove the statue?!? This country doesn’t have any GUTS anymore!

crazykanoi -“I guess your silly definition of a “true” oheiv yisrael is a man who said neo-Nazi marchers are fine people.”

I’ll repeat from the first page –
“STOP Spouting the so-called “Jewish” Leftist Agenda!”

Takes2-2tango -“name can the Nazis ym be from amalek?”

This I don’t know, but the Megillah prophesized the outcome of the Nuremberg trial.
J. Streicher knew this also when the second before hanging – he screamed “PurimFest 1946”!
I googled that word and there is a book from France called “Code of Esther”.

laskern -“Doesn’t white supremacy include anti-semitism?”

STOP Spouting the so-called “Jewish” Leftist Agenda!
From WikiPedia:
“Breitbart News was described by the Anti-Defamation League as “the premier website of the alt-right” representing “white nationalists and unabashed anti-Semites and racists.”[69] The Zionist Organization of America rejected accusations of anti-semitism, saying that Breitbart News instead “bravely fights against anti-Semitism” and called for the ADL to apologize.[70][71] An article in Jewish Daily Forward argued that Bannon and Andrew Breitbart are anti-Semitic.[72] An article by Rabbi Shmuley Boteach in The Hill disputed the allegations, arguing that Breitbart defends Israel against antisemitism.[73] Alexander Marlow denies that Breitbart is a “hate-site”, stating “that we’re consistently called anti-Semitic despite the fact that we are overwhelmingly staffed with Jews and are pro-Israel and pro-Jewish. That is fake news”

Ubiq -“though I’m not sure which question you are referring to”

This question:
“What do you agree with? That a lot of guns should be made illegal?!?”

Ubiq – “Dont look in the mirror, but so do you.
and I quote: “I agree with Trump about making gun ownership more regulated””

This is what I agree with – Trump tweeted this:
“I will be strongly pushing Comprehensive Background Checks with an emphasis on Mental Health. Raise age to 21 and end sale of Bump Stocks!”
What do you agree with? That a lot of guns should be made illegal?!?

Ubiq -“Your posts are hard to follow and jump from topic to topic making any chain of logic (if there is one) difficult to follow. I’m tired of always having t o help things out and get things on track for you.”

Funny NOT one other poster has trouble following my posts!

“You make it even harder by not addressing direct questions.
We are talking about shootings and that it is “impossible to believe that there is no other solution,” I dont see how “yes but they have terrorism” (im paraphrasing) has anything to do with anything”

OK. Again for those that didn’t get it the first time!
To protect against School Shootings – make them like courts, with armed guards & metal detectors.
I agree with Trump about making gun ownership more regulated.

Yidd23 -“I wouldn’t move to Europe, but not because of safety, but because I don’t speak the languages and can’t stand the accents.”

Stop being Dishonest!
How can you claim “not because of safety”, when you could learn the language of that country?!?
Once you learn the language & it becomes your primary language, you will have the same accents that you can’t stand NOW!

Ubiq – “But it is impossible to believe that there is no other solution, when throughout the civilized world there is no need for schools to be protected that way”

Stop dreaming that the US can be some sort of utopia!
There is no country in the world as big as the US & as safe!
Even the small countries in Europe, with all their Gun Control, have a bigger problem with Terrorism than the US.

Meno -“I’m pretty sure I read that the shooter entered the school through a back entrance. What good is an armed guard if there are other ways to get in?”
100% CORRECT!
My previous posts compared that schools should be like courts. In every court building, no matter how many entrances there are, e/o must go through security! That means metal detectors & armed guards.

Ubiq -“Oops wrong again. The school in question had an armed security card, as you may know it dint stop the attack”

You have to read my whole post before commenting! I wrote -“All you need is one armed security guard & a metal detector.” The word “and” is not instead of “or”!

“Mass shootings are not a part of life in other countries as they are here. There has to be a way to be more like them in this regard”

Your obsession with Gun control didn’t let you begin to understand my point!
We don’t need to be like Europe with their liberalism to the Nth degree!
Go visit a court house and try to bring in a weapon.
Every school should be like courts with their tight security!

edited

Goldilocks – Why don’t you use wine? I once made a punch like that.

WtP – ” quite offended that you call me a hypochondriac”

The reason is you should Trust in Hashem that the antibiotics will get rid of the PANDAS; if indeed it’s there. That’s the reason of my labeling.
In my opinion, this case would benefit from CBT & at least SSRI’s!

WtP -“Health, yes.”
OK, That’s what I thought. This isn’t a freebie anymore – find me a Shidduch.
You are a hypochondriac. It does’t matter if it’s PANDAS or not!
Btw, I feel bad for DrMamaBear, but you aren’t HER!
From above -“initial first-line agent (oral penicillin, benzathine penicillin, or a first-generation cephalosporin) is reasonable. When multiple recurrences are believed to be due to GABHS infection, clindamycin or amoxicillin/clavulanic acid is indicated. [1]”
In practice, the majority of children with recent-onset PANDAS experience a reduction in neuropsychiatric symptoms within days or weeks after antimicrobial treatment active against acute GAS infection”
Azithromycin is NOT recommended!
Also, all family members should be tested to see if they are carriers.

DY -“Healrh, WTP is in touch with “a practitioner who is up on the latest research- who actually is part of the latest research”, and you insist on copy/pasting from a website?”

Your post is laughable if not for the issue of life & death!
I’m sorry that you never heard of Emedicine from Medscape.
Here’s from the actual guys who made decisions about PANDAS:
From the PANS/PANDAS Consortium:
“Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Protocol
Throat swab
A throat swab for GAS is recommended during the initial diagnostic evaluation for PANS, particularly if the child is not already receiving antistreptococcal treatment. Testing for GAS is recommended regardless of the presence of clinical pharyngitis or the severity of neuropsychiatric symptoms at that time. A throat swab should also be performed both during exacerbations of neuropsychiatric symptoms and during episodes of pharyngitis, particularly in children not receiving an appropriate antibiotic, or if adherence to the prophylactic regimen is in doubt. Perineal and other extra-oral sites should be inspected routinely, with cultures obtained from suspected infection sites.
The throat of asymptomatic family members and other intimate contacts should also be swabbed, if possible, at the time of initial diagnosis, and at any time they have pharyngitis symptoms. When patients have PANS exacerbations, untreated close contacts should be questioned about symptoms of pharyngitis or dermatitis, and cultured and treated if positive.
Management of Streptococcal Infections in PANDAS
Primary antimicrobial treatment of acute streptococcal infections
Primary antimicrobial treatment for all patients with pharyngeal GAS is indicated, with oral or intramuscular penicillin as a first choice (Gerber et al. 2009). In current practice, amoxicillin is often used in suspension form for younger children due to its enhanced palatability (American Academy of Pediatrics 2015a). Injectable antibiotic therapy is considered the most reliable, although in practice it is usually reserved for children failing or unable to accept oral therapy. The objective of antimicrobial therapy of acute streptococcal infection is to eradicate the current GAS infection to minimize non-suppurative sequelae such as rheumatic fever (Shulman et al. 2012).
For children allergic to, or intolerant of, penicillin, cephalexin, cefadroxil, clindamycin, azithromycin, or clarithromycin are recommended according to the IDSA 2012 guideline for the treatment of acute GAS pharyngitis (Shulman et al. 2012) (Table 2). Children with persistent or rapidly relapsing pharyngitis may also be treated with these agents, which may be more effective clinically than penicillin or amoxicillin (Casey et al. 2008).
Table 2. Antimicrobial Treatment of Acute Streptococcal Pharyngitis
The use of azithromycin as an alternative for the treatment of pharyngeal GAS infection may be less efficacious, due to regional GAS resistance rates as high as 5%–10% or more (Silva-Costa et al. 2015) with an associated potential for the development of sequelae (Logan et al. 2012). Theoretical advantages of azithromycin include its ease of administration, its activity against most Mycoplasma pneumoniae, and its potential immunomodulatory (Obregon et al. 2012) activities. Disadvantages include its potential to promote azithromycin resistance of both GAS and M. pneumoniae. The U.S. Food and Drug Administration recommends that it be used with caution in patients with a prolonged QT interval on the electrocardiogram, and may be contraindicated in patients receiving medications that prolong the QT interval, which includes some of the selective serotonin receptor inhibitors (SSRIs), as well as anti-psychotic medications and other psychoactive drugs.
The use of oral clindamycin suspension may be problematic in children due to its unfavorable taste. Recent data suggest that clindamycin resistance may also be emerging, albeit at a lower frequency than azithromycin, in North America and worldwide (Villaseñor-Sierra et al. 2012; O’Dwyer et al. 2013), notably appearing in localized outbreaks of specific GAS emm types (Smit et al. 2015). Also of concern, clindamycin appears to disturb the protective throat and fecal microbiome to a much greater and a more prolonged degree than other commonly used oral antimicrobial agents (Zaura et al. 2015).
For children allergic or intolerant to the penicillins, the Consortium preference favors cephalexin (bid or tid) or cefadroxil (once daily), in the absence of immediate-type hypersensitivity to penicillin. Among patients with confirmed amoxicillin hypersensitivity, there is a particular cross-allergenicity with cefadroxil, which, unlike cephalexin, shares an identical R side chain with amoxicillin (Miranda et al. 1996; Sastre et al. 1996); cephalexin may, therefore, be preferred in this setting. Some investigators provide this initial treatment for 3 weeks, awaiting resolution of neuropsychiatric symptoms.
Treatment of GAS in children with PANS or PANDAS
With a new diagnosis of PANS, it has been our practice to provide an initial course of antimicrobial treatment for acute streptococcal infection as described earlier, regardless of whether or not GAS is identified at the time of diagnosis, similar to recommendations for the initial management of rheumatic fever (Gerber et al. 2009). Although data from controlled clinical trials are lacking, aggressive diagnosis and treatment of GAS infection seems prudent as a means of mitigating risk for neuronal injury. In practice, the majority of children with recent-onset PANDAS experience a reduction in neuropsychiatric symptoms within days or weeks after antimicrobial treatment active against acute GAS infection (Murphy and Pichichero 2002; Murphy et al. 2004; Snider et al. 2005; Falcini et al. 2013).
Table 3. Management of Infection in PANDAS
Secondary antimicrobial prophylaxis for children with PANDAS
There is currently insufficient evidence to support long-term streptococcal prophylaxis for children with PANDAS. To this end, members of the Consortium commonly institute long-term streptococcal prophylaxis for the most severely affected children, and for those with multiple GAS-associated neuropsychiatric exacerbations. The rationale for using secondary prophylactic measures is to prevent recurrences of intolerable, debilitating symptoms, as well as to minimize the possible risk of long-term sequelae or chronic symptoms. Weighing these theoretical benefits against the known risks of long-term antibiotic administration requires a careful consideration of the patient’s history and clinical status. We believe that the decision to institute long-term antimicrobial prophylaxis may best be made in consultation with a pediatric infectious diseases specialist, or a member of the PANS/PANDAS Clinical Research Consortium. When secondary GAS prevention is chosen, the antimicrobial regimens should be based on guidelines developed for the prevention of rheumatic fever.”

WtP – “The issue is how long to continue the antibiotics- the protocol I got from a practitioner who is up on the latest research- who actually is part of the latest research – is to continue until symptoms subside and then slowly taper the dose.”

BALONEY!!!
This is from Emedicine about Pharyngitis due to Strep.:
“Circumstances dictating that a choice other than penicillin V should be used
Compliance: Oral penicillin requires multiple daily doses and a 10-day course. In patients unlikely to adhere to this regimen, one dose of intramuscular benzathine penicillin provides a depot that releases medication over the course. Recent reports have supported the use of once-daily amoxicillin and verified its noninferiority to twice-daily penicillin [44] or twice-daily amoxicillin. [45] Azithromycin, cefdinir, and cefpodoxime may all be given in 5-day courses, although none of these medications should not be considered a first-line agent given their extended spectrum and risk for promoting antibiotic resistance. [1, 48, 49] Furthermore, although no differences in treatment outcomes have been found between macrolides and penicillin, children experienced more adverse events with macrolides. [47]
Palatability: Some young children find oral penicillin unpalatable. Taste tests and many doctors’ experiences have shown amoxicillin to be much better tolerated. [50] Amoxicillin’s similar spectrum and low cost make it a reasonable substitute.

Recurrence: Test of cure is not indicated when pharyngitis symptoms have resolved following treatment. In patients with recurrent symptoms, retreatment with an initial first-line agent (oral penicillin, benzathine penicillin, or a first-generation cephalosporin) is reasonable. Worth noting is the difficulty in differentiating between viral pharyngitis with GABHS carriage and actual GABHS pharyngitis. This becomes even more of an issue in patients with multiple recurrences. Between 5% and 15% of children are asymptomatic carriers during seasons when GABHS pharyngitis is most prevalent. [55] A positive test result during a time of wellness may indicate GABHS carriage. When multiple recurrences are believed to be due to GABHS infection, clindamycin or amoxicillin/clavulanic acid is indicated. [1]”