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Dr_Rosario_Trifiletti

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  1. Do you do any telephone consulations, using Visa or Mastercard? Also, if a doctor from the U.S. prescribes antibiotics to a child who lives in Canada, will pharmacists honour the prescription? Do they accept written ones or ones that are phoned in to the pharmacy, or only from Canadian doctors, or doctors from Ontario?

  2. Very important observation! Many kids with PITANDS have unexplained low ferritin levels! Low ferritin levels usually serve as a red flag to doctors for iron deficiency. In that case --- iron deficiency >> low ferritin levels. But, these kids are not iron deficient! - there are many markers of iron deficiency - low MCV, low hematocrit, high total iron binding capacity ... these kids are not iron deficient I have another idea -- what if the low ferritin is not a consequence of iron deficiency, but the primary problem? In that case low ferritin >> relative iron
  3. I've known Dr. Legido for many years. He is Catalan, from the Barcelona region of Spain., speaks perfect English. He's very smart (many papers published) and very kind. I think you will like him very much as a doctor and person. I'm not sure what his views on PANDAS are. But if you do see him and he has any questions about PANDAS, please tell him that his old friend Dr. Trifiletti said hello and I would be happy to help him with any questions he might have.
  4. I said I wouldn't post but I felt I had to for sake of safety NEVER GIVE YOUR CHILD HYDROGEN PEROXIDE NEVER NEVER This is not the way to treat mycoplasma! email me Fixit ... D r. T
  5. Disorders of the thyroid, and endocrine disorders in general (notable exception is Type 1 diabetes) are usually fairly slow moving clinically. The symptoms generally creep up on you and when diagnosed have been going on for a long time. Thyroid levels certainly affect one's moods and behavior. In fact, The syllable "Thy" usually refers to mood (dys-thy-mia, cyclo-thy-mia, etc). In general - very general- terms : low thyroid is associated with depression, high thyroid is associated excitation, mania I usually measure a thyroid panel (T3, T4, TSH) in every new patient and ask carefully f
  6. If I could choose (and I can't) I would present 4 stories - 15 min each - with 4 or so specialists adding commentaries, along with parents 1. An otherwise healthy child who gets a sudden onset of a tic (like Lauren) 2. An otherwise healthy child who develops OCD 3. A child with autism who develops a marked worsening of symptoms 4. A child who develops severe PANDAS and the "exorcist syndrome" I think this would really show the range of this condition. Keep the "does PANDAS exist" controversy out of it .... By the end of the show, that should be self-evident Dr.
  7. Zazuk2010 You are absolutely right. PANDAS has 100x the name recognition of PITANDS. We have to find a way to not abandon PANDAS .... Maybe just PANDAS-PITANDS or "PANDAS-like ILLNESSES" Also, this classification is really more for doctors, ICD9 codes and the like. And to organize one's thoughts. I thought this would be a good time to talk about PITANDS criteria with the new forum name this week .... It's much better to "ThinkPANDAS" even if you don't "GotStrep" LOL Dr. T
  8. Zazuk2010 You are absolutely right. PANDAS has 100x the name recognition of PITANDS. We have to find a way to not abandon PANDAS .... Maybe just PANDAS-PITANDS or "PANDAS-like ILLNESSES" Also, this classification is really more for doctors, ICD9 codes and the like. And to organize one's thoughts. I thought this would be a good time to talk about PITANDS criteria with the new forum name this week .... It's much better to "ThinkPANDAS" even if you don't "GotStrep" LOL Dr. T
  9. I spent all last year asking about stomach aches. From what I figured out, lots of PANDAS kids seem to have migraine type things going on. We finally decided my son had abdominal migraines. Once he started taking magnesium supplements they decreased in frequency and severity. He will still get them (just not as severe) if he gets dehydrated, too hungry, or spends too much time in front of a movie or TV screen, especially if it is a fast action movie and he sits too close. If I catch it quick a dose of ibuprofen will do the trick. If not, I usually give him a dose of magnesium, ibuprofen
  10. This is an amazing and unusual case for the disparity between ASO and anti-DNAase B. Although these are the highest anti-DNAase B values I've ever seen, remember, most labs report what I call "TILT" values (from the old slot machines), i.e >1:2720 or something like that ... I'm guessing that this is not Group A strep, perhaps C or G ... (C and G have SO but levels of DB may be relatively higher) There is also something called anti-streptolysin S which I will not abbreviate for obvious reasons. LOL Dr. T P.S. I'd be happy to talk with you further offline. PM me wit
  11. Proposal for a working definition and classification of PITANDS Working definition of PITANDS 1. First onset of symptoms in Pediatric age group 0-18 years 2. Acute or persistent onset of neuropsychiatric symptoms, characteristically, but not limited to tics or OCD 3. Usually, but not always, in association with an acute or persistent identified infectious triggers (GABHS, mycoplasma, others) 4. Rapid improvement of symptoms with anti-infective agents, usually antibiotics Notice these criteria are much broader than the Swedo PANDAS criteria, still verifiable, but s
  12. We have recently found almost all children with PANDAS-like illnesses harbor anti-flagellin (p41 on Lyme Western blots) antibodies, indicating chronic infection with flagellated bacteria. This association is very strong, much higher than the association with either strep or mycoplasma. This could, in fact, be the infection that sets the stage for trouble, even before strep arrives on the scene. There are many gut active bacteria - including Helicobacter, Campylobacter, etc - that are flagellated. This is a natural explanation for association of PANDAS with a chronic GI infections - th
  13. This is very detailed, but might be of interest to some http://www.ncbi.nlm.nih.gov/pmc/articles/P...pdf/0068-03.pdf One interesting thing that this article states is that mycoplasma outbreaks peak every 5-7 years. I certainly sense there is a difference from one year to another with respect to PANDAS-like illnesses. I wonder if this has anything to do with it
  14. Interestingly, bad mycoplasma infections seem to occur in every 5-7 year epidemics .... almost predictable. More on this soon, Dr. T
  15. I missed it, working really long hours these days ... will try to look at it soon and get back to you. We need a similar 1 hr show - maybe FRONTLINE on PBS - devoted to PANDAS .... Dr. T
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