“Juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under the age of 16.

Juvenile idiopathic arthritis occurs when the body’s immune system attacks its own cells and tissues. It’s not known why this happens, but both heredity and environment seem to play a role. Some forms of juvenile idiopathic arthritis are more common in girls.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082)”

How Juvenile Arthritis (JIA) is Diagnosis:

Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms.

1. Blood tests

Some of the most common blood tests for suspected cases include:

• Erythrocyte sedimentation rate (ESR). The sedimentation rate is the speed at which your red blood cells settle to the bottom of a tube of blood. An elevated rate can indicate inflammation. Measuring the ESR is primarily used to determine the degree of inflammation.
• C-reactive protein. This blood test also measures levels of general inflammation in the body but on a different scale than the ESR.
• Antinuclear antibody. Antinuclear antibodies are proteins commonly produced by the immune systems of people with certain autoimmune diseases, including arthritis. They are a marker for an increased chance of eye inflammation.
• Rheumatoid factor. This antibody is occasionally found in the blood of children who have juvenile idiopathic arthritis and may mean there’s a higher risk of damage from arthritis.
• Cyclic citrullinated peptide (CCP). Like the rheumatoid factor, the CCP is another antibody that may be found in the blood of children with juvenile idiopathic arthritis and may indicate a higher risk of damage.

In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests.

2. Imaging scans

X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects.

Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage.

Juvenile Arthritis (JIA) Treatment:

Treatment for juvenile idiopathic arthritis focuses on helping your child maintain a normal level of physical and social activity. To accomplish this, doctors may use a combination of strategies to relieve pain and swelling, maintain full movement and strength, and prevent complications.

1. Medications

The medications used to help children with juvenile idiopathic arthritis are chosen to decrease pain, improve function and minimize potential joint damage.

Typical medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications, such as ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve), reduce pain and swelling. Side effects include stomach upset and, much less often, kidney and liver problems.
• Disease-modifying antirheumatic drugs (DMARDs). Doctors use these medications when NSAIDs alone fail to relieve symptoms of joint pain and swelling or if there is a high risk of damage in the future.DMARDs may be taken in combination with NSAIDs and are used to slow the progress of juvenile idiopathic arthritis. The most commonly used DMARD for children is methotrexate (Trexall, Xatmep, others). Side effects of methotrexate may include nausea, low blood counts, liver problems and a mild increased risk of infection.
• Biologic agents. Also known as biologic response modifiers, this newer class of drugs includes tumor necrosis factor (TNF) blockers, such as etanercept (Enbrel, Erelzi, Eticovo), adalimumab (Humira), golimumab (Simponi) and infliximab (Remicade, Inflectra, others). These medications can help reduce systemic inflammation and prevent joint damage. They may be used with DMARDs and other medications.Other biologic agents work to suppress the immune system in slightly different ways, including abatacept (Orencia), rituximab (Rituxan, Truxima, Ruxience), anakinra (Kineret) and tocilizumab (Actemra). All biologics can increase the risk of infection.
• Corticosteroids. Medications such as prednisone may be used to control symptoms until another medication takes effect. They are also used to treat inflammation when it is not in the joints, such as inflammation of the sac around the heart.These drugs can interfere with normal growth and increase susceptibility to infection, so they generally should be used for the shortest possible duration.

2. Therapies

Your doctor may recommend that your child work with a physical therapist to help keep joints flexible and maintain range of motion and muscle tone.

A physical therapist or an occupational therapist may make additional recommendations regarding the best exercise and protective equipment for your child.

A physical or occupational therapist may also recommend that your child make use of joint supports or splints to help protect joints and keep them in a good functional position.

3. Surgery

In very severe cases, surgery may be needed to improve joint function.

***Parents or caregivers help limit the arthritis in your children by doing the following:

• Getting regular exercise. Exercise is important because it promotes both muscle strength and joint flexibility. Swimming is an excellent choice because it places minimal stress on joints.
• Applying cold or heat. Stiffness affects many children with juvenile idiopathic arthritis, particularly in the morning. Some children respond well to cold packs, particularly after activity. However, most children prefer warmth, such as a hot pack or a hot bath or shower, especially in the morning
•  Eating Well. Some children with arthritis have poor appetites. Others may gain excess weight due to medications or physical inactivity. A healthy diet can help maintain an appropriate body weight.Know adequate calcium in the diet is important because children with juvenile idiopathic arthritis are at risk of developing weak bones due to the disease, the use of corticosteroids, and decreased physical activity and weight bearing.

“Arthritis affects persons of all ages; little is known about arthritis prevalence among children and adolescents aged <18 years.

Approximately 220,000 children and adolescents had arthritis during 2017–2021. Prevalence increased with age and was highest among those aged 12–17 years, non-Hispanic Black or African American children and adolescents, children and adolescents with anxiety or depression, those who were physically inactive, had overweight or a heart condition, or lived in a food-insecure or smoking household.

Arthritis affects persons of all ages, including younger adults, adolescents, and children; however, recent arthritis prevalence estimates among children and adolescents aged <18 years are not available. Previous prevalence estimates among U.S. children and adolescents aged <18 years ranged from 21 to 403 per 100,000 population depending upon the case definition used. CDC analyzed aggregated 2017–2021 National Survey of Children’s Health data to estimate the national prevalence of parent-reported arthritis diagnosed among children and adolescents aged <18 years. An estimated 220,000 (95% CI = 187,000–260,000) U.S. children and adolescents aged <18 years (305 per 100,000) had diagnosed arthritis. Arthritis prevalence among non-Hispanic Black or African American children and adolescents was twice that of non-Hispanic White children and adolescents.”

Center for Disease Control and Prevention – CDC (Arthritis Among Children and Adolescents Aged 18 Years — United States, 2017–2021 | MMWR)

While 4th of July is a time for barbecues and parties, it can also increase the risk for accidents and injuries.  A recent survey found that unsafe fireworks displays and drunk driving are two of the biggest concerns for the upcoming holiday. Planning ahead – and prioritizing safety – are the keys to a safe and fun holiday.  Fourth of July is right around the corner, and there’s no better time to start preparing for barbecues, trips, and celebrations.

The survey findings highlighted some of the biggest safety risks that pop up around this time of year:

• Nearly 60% of respondents said they’ve seen unsafe fireworks use during 4th of July

• About 33% of Gen Z and Millennial respondents said they’ve been pressured into risky behavior

• Nearly 70% of respondents said they’ve seen someone try to drive drunk on 4th of July

• Under 30% of respondents said they trust other Americans to celebrate responsibly

“Stick with people and activities you are familiar with,” Steadman said. “Don’t take unnecessary risks or get caught up in a crowd of unruly people. Be cognizant of children and others who may need extra looking after.

“The 4th of July is a time for celebration of America and freedom. By taking the necessary precautions and avoiding risky behavior, everyone can enjoy the day. Stay vigilant and be prepared for if things go south, and always make sure you are practicing safe behavior with both fireworks and alcohol.”

Always keep a first aid kit nearby!”

Consumer Affairs (How to stay safe for 4th of July)

The Fourth of July is a time to celebrate with friends and family the vast opportunities our country has given us. While we reach the end of the COVID-19 pandemic, many Independence Day traditions and celebrations are a go, but that may not be the case everywhere. Be sure to check your local restrictions before hosting barbeques. If your state is fully opened and you plan to attend an event, be vigilant about your safety and that of your belongings. Here are a few other tips to help you get through the festivities.

WAYS TO STAY SAFE ON THE FOURTH OF JULY

1. Stay cool and hydrated especially in areas very hot!

July is one of the hottest times of the year and it’s easy to fall victim to sun or heat stroke. Stay cool by being a shade-seeker: bringing an umbrella with you, wearing a hat, or staying under the covered portion of a porch or patio. It’s equally as important to wear sunscreen as well as light and loose clothing.

Finally, don’t forget the water. Many times, we get caught up in festive food and drink options and forget to add in water. Aim for eight cups or more per day, depending on how hot it is outside or how much sweet or salty food you are consuming.

2. Consider the safety of your food

The heat not only has an impact on you but your food as well.  Having a BBQ and thinking of throwing all the meat on one platter outside awaiting the grill? Think again. Keep raw meat and seafood cold until it’s ready to be cooked. Once it’s ready, keep it hot until it’s consumed, then put in the fridge once everyone is done, meaning, don’t let it sit out. Contaminated food or items that have sat out too long can lead to food poisoning of some sickness, like infection.

3. Be mindful at events

Summer and celebrations mean concerts, BBQs, and state or county fairs. But it’s important to always be aware of your surroundings. Don’t leave your food, bag, or belongings unattended, and if the event is happening at night, be sure to stick with a friend. Fireworks are prime for theft as they are loud with those watching focused on the show.

4. Prevent eye injury

Prevent Blindness Texas has declared June 28th through July 4th as Fireworks Safety Awareness Week. Fireworks can damage your eyes, too. Contusions and lacerations are the most frequent injuries to eyes, which include foreign bodies in the eye.

If you do encounter an eye emergency, follow these steps to save your sight.

In the event of an eye emergency:

1. Do not rub the eye. Rubbing the eye may increase bleeding or make the injury worse.
2. Do not attempt to rinse out the eye. This can be even more damaging than rubbing.
3. Do not apply pressure to the eye itself. Holding or taping a foam cup or the bottom of a juice carton to the eye are just two tips. Protecting the eye from further contact with any item, including your hand, is the goal.
4. Do not stop for medicine! Over-the-counter pain relievers will not do much to relieve pain. Aspirin (should never be given to children) and Ibuprofen can thin the blood and increase bleeding. Go to the emergency room at once – this is more important than stopping for a pain reliever.
5. Do not apply ointment. Ointment, which may not be sterile, makes the area around the eye slippery and harder for the doctor to examine.

Overall, the best way to prevent eye or other injuries is to not play with fireworks and do not let your child play with fireworks, even if their friends are.

“If your holiday plans include fun in the water, make sure every member of your family is water smart ─ has swimming skills and knows how to help others in an emergency.

The American Red Cross offers these tips to help keep you and your loved ones safe during the upcoming 4th of July holidaay:

FIREWORKS SAFETY The safest way to enjoy fireworks is to attend a public fireworks show put on by professionals. Many states outlaw most fireworks, so consider celebrating with glow sticks, noise makers or silly string instead. If you choose to set fireworks off at home, follow these safety steps:

• Never give fireworks to small children, and never throw or point a firework toward people, animals, vehicles, structures or flammable materials.
• Always follow the instructions on the packaging.
• Keep a supply of water close by.
• Make sure the person lighting fireworks always wears eye protection.
• Light only one firework at a time and never attempt to relight “a dud.”
• Store fireworks in a cool, dry place away from children and pets.
• Never use fireworks around pets, keep pets indoors. Exposure to lit fireworks can potentially result in severe burns or trauma, and many pets are also fearful of loud noises and can become lost, scared or disoriented.

WATER SAFETY If your holiday plans include fun in the water, make sure every member of your family is water smart ─ has swimming skills and knows how to help others in an emergency.

• Everyone should learn to swim. Classes are available for both children and adults.
• Prevent unsupervised access to water. Always designate a “water watcher” to keep a close, constant eye on everyone in and around the water until the next water watcher takes over.
• Avoid distractions when supervising children. If a child is missing, check the water first. Drowning behavior is typically fast and silent. Unless rescued, a drowning person will last only 20 to 60 seconds before submerging.
• Reach or throw, don’t go! In the event of an emergency, reach or throw an object out to the person in trouble and tell them to grab on. Don’t go in! You could become a victim yourself. Without putting yourself in danger, rescue and remove the person from the water. Have someone call 911 if needed.”

American Red Cross (Have a Safe 4th of July)

Were saying to celebrate the 4th of July but what we are saying is be SAFE, SAFE, SAFE!

The Fourth of July is a time for America to commemorate the passage of the Declaration of Independence and often celebrated with parades, concerts, firework shows, family road trips, barbeques, and parties where participants toast to the nation.

Sadly, these holiday festivities can lead to potentially deadly consequences on the roads, especially when alcohol is thrown into the mix. According to the National Highway Traffic and Safety Administration, 812 people died in motor vehicle crashes involving drunk drivers during the July 4^th holiday period from 2014-2018.

“Many of our service members and their families will take to the roads in hopes of celebrating our nation’s birthday someplace special,” said Michael Ballard, chief of occupational safety, Air Force Safety Center. “I urge leadership at all levels to take time to engage with Airmen and Guardians about having a plan to reduce the risks associated with their holiday weekend activities.”

On average, 10,200 home fires are started by a grill each year, with gas grills contributing to a higher number of fires than charcoal grills, according to the National Fire Protection Association.

The USFA reported that almost half (49%) of grill fires on residential properties occur between 5 and 8 p.m., with more than half (57%) occurring between May and August.

Nearly a third (32%) of grill fires on residential properties start on patios, terraces, screened-in porches or courtyards, while an additional 24% start on exterior balconies and unenclosed porches.

The leading power source of grill fires is “gas fuels,” with fires primarily being fueled by propane, according to the USFA.

The leading factors contributing to the ignition of these fires are mechanical failures or malfunctions, misuse of materials and operational deficiencies.

The Office of the Illinois State Fire Marshal advises everyone to take the following steps to help ensure safe grilling:

• Propane and charcoal grills should be used only outdoors.
• The grill should be placed away from the home or deck railing, and out from under the eaves of your home and overhanging tree branches.
• Keep children and pets at least three feet away from the grilling area.
• Keep your grill clean by removing grease or fat buildup from the grills and in the trays below the grill.
• Never leave your grill unattended.
• Always make sure gas grill lids are open before lighting it.
• Check the gas tank on your propane grills and hoses for leaks each time before using.
• If you smell gas while grilling, immediately get away from the grill and call the fire department.
• Make sure charcoal grill coals are cool before disposing of them in a metal container.
• Always have a fire extinguisher, bucket of water or garden hose nearby or know where you can access one quickly.
• Campfires need to be built at least 25 feet way from tents, shrubs and anything that can burn. Make sure fires are allowed in the area where you are camping.
• Use of chimneys, outdoor fireplaces and fire pits need to be at least 10 feet away from your home or anything that can burn.

You can find an easy-to-follow grill safety guide published by the USFA here.

According to the Insurance Institute for Highway Safety (IIHS), July 4th is historically the deadliest day of the year for traffic fatalities in the United States. This is primarily due to a combination of increased travel and alcohol consumption. The National Safety Council (NSC) projects that in 2025 alone, as many as 599 people could die in motor vehicle crashes during the holiday weekend.

What makes this time so hazardous? For one, over 43 million Americans are expected to travel during the holiday period, the majority of them by car. Heavy traffic, long travel times, and drivers unfamiliar with their routes create an environment ripe for accidents. Add alcohol into the mix, and the risks escalate dramatically.

In fact, over 40% of July 4th crash fatalities involve alcohol impairment. Drivers aged 21 to 34 are the highest risk group, who account for nearly half of all alcohol-related crash deaths during this period.

How to stay safe on the road:

• Always wear your seatbelt. Seat belts reduce fatal injury risk by 45%.
• Don’t drive under the influence of alcohol or drugs.
• Plan your route ahead of time to avoid getting lost or fatigued.
• Avoid driving late at night when impaired drivers are more likely to be on the road.
• If you’re going out drinking, use a designated driver, rideshare app, or public transportation.
• Never use your phone while driving.

Come on back for part II tomorrow on continuing with facts and safety tips!

“Question  Does acetaminophen use during pregnancy increase children’s risk of neurodevelopmental disorders?

Findings  In this population-based study, models without sibling controls identified marginally increased risks of autism and attention-deficit/hyperactivity disorder (ADHD) associated with acetaminophen use during pregnancy. However, analyses of matched full sibling pairs found no evidence of increased risk of autism (hazard ratio, 0.98), ADHD (hazard ratio, 0.98), or intellectual disability (hazard ratio, 1.01) associated with acetaminophen use.

Meaning  Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analyses. This suggests that associations observed in other models may have been attributable to confounding.”

Journal of American Medical Association – JAMA

(Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability | Attention Deficit/Hyperactivity Disorders | JAMA | JAMA Network)