“I am concerned about this approach, which is increasingly common in Romanian communication”, says doctor Mihai Craiu, who sounds the alarm about the ‘radicalization’ of the doctor-patient dialogue in Romania today.
Dr. Mihai Craiu has issued an alarm signal regarding the “fanatical” approach that some people take in the doctor-patient relationship in Romania today, and especially regarding the treatment applied to children during periods of cold or flu.
“The fanatics make me sick the most. Those who state without blinking an eye “you must eat X food every day” or “it is absolutely forbidden to ever eat Y food”, or “it is mandatory to do this analysis before treatment Z”…
I am worried about this approach, which is increasingly common in Romanian communication.
Whether it comes from non-medical influencers or bloggers, or from Dr. X, with reputation or seniority in the profession, the “fanatic” approach to a health or disease prevention issue is just as wrong as the myoritic version with “let it go as it is”.
Certainly each child is different (I speak only as a pediatrician) and each may react in a specific way to a therapeutic or prophylactic intervention… As the English say “one size doesn’t fit all”.
Let me return to “verdicts” and “labels”, with an example of the flu that is now circulating very intensively in all European countries.
Various say “the flu is treated preventively with antibiotics, so that bacterial superinfections do not occur”… Others say “no specific medication is ever given for the flu, because it goes away on its own, like all colds”… And some vehemently state “only with antivirals your child can be cured”…
These statements are wrong if we apply them to all possible scenarios of child flu.
Yes, there are some children who develop a bacterial superinfection as a complication of the flu (statistically speaking, about a quarter of respiratory viruses in children could evolve into bacterial respiratory superinfections, especially in the scenario of a fragile child – premature babies, those with chronic heart diseases or pulmonary diseases, those with malnutrition, those with extreme obesity and the unvaccinated). But this does not mean that we give antibiotics “preventively” to a child with the flu. We will treat 75% of those diagnosed unnecessarily and with adverse effects.
Influenza is a serious condition and needs treatment if the disease has already set in. We can’t wait for her to pass on her own, especially in the high-risk group of children mentioned earlier.
BUT
We cannot administer specific antivirals (by the way, the various magic potions or decoctions, assiduously promoted by various quacks who loudly claim that “all cases of influenza” will be cured if we drink, swallow or inhale … something are not “antiviral” by the way “special”, possibly sold for a lot of money) anytime.
In influenza, the antiviral authorized for human use (oseltamivir/Tamiflu) can only be administered at the beginning of the disease. In the first days of illness, or as prophylaxis, after significant contact with a patient with proven flu. This medicine will have no effect on the prolonged course or complications of the disease occurring more than one week after the onset of influenza.
Why?
Because oseltamivir does not work miracles, it only prevents the spread of the virus in the body. This prevention mechanism works only in the first 2-3 days after the onset. The faster the more effective.
If we look at the images below we will understand why we only have a small window of opportunity. Oseltamivir blocks neuraminidase.
Neuraminidase works like a scissor, which cuts the connection between the viral copies (produced by the flu virus inside the infected cell and brought to its surface, like mushrooms appearing after the rain) and the corresponding cell of the airway lining.
If we don’t block this scissor by using superglue, the flu virus spreads throughout the body. Tamiflu is a neuraminidase blocker that works like a very strong glue, binding only to this enzyme specifically. If we do not block the scissors, from the surface of each cell infected with the influenza virus, many copies of this virus will be released. And these copies will spread to the rest of the healthy cells, diverting them from their normal function of protecting the airways, to the production of copies of the flu virus.
The faster we act with the glue stick, the less viruses will leave for the rest of the healthy cells. And the sick cells will die and be “recycled” by the body’s defense mechanism, through some cells called macrophages.
The glue ONLY works until too many copies of the flu virus have gone for a walk. After 5 or 7 days it’s too late…
Take home messages
1. No child will always react the same way to the disease and not all children will be able to be treated with the same medicines.
2. As for the flu, it’s easier to prevent it (with good hygiene, frequent ventilation, correct diet for age, lots of outdoor exercise and vaccination for those eligible) than to treat it.
3. And if it is proven flu, antiviral treatment does not always work, but only at the beginning of the disease. Be healthy”, writes doctor Mihai Craiu on the page of Facebook Virtual Hospital for Children.
2024-01-14 20:36:00
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