Why do pediatricians work when sick?
November 1st 2015A survey of 280 physicians and 256 advanced practice clinicians at The Children’s Hospital of Philadelphia found that the vast majority worked while sick at least once in the preceding year and would expect to work with symptoms of contagion, including fever, diarrhea, and acute respiratory tract symptoms.
Early warning system is valuable for identifying who is at risk in the PICU
November 1st 2015A pediatric early warning score (PEWS) predicts patient deterioration after transfer to a pediatric intensive care unit (PICU), according to a retrospective review of patients who were transferred to the PICU at a large children’s hospital during an 8-month period.
Secondhand smoke exposure during pregnancy reduces gross motor development
November 1st 2015Maternal exposure to secondhand smoke (SHS) during pregnancy, even at low levels, is associated with a decrease in gross motor function among young children, a study in 175 nonsmoking mothers and their infants showed.
Rash on boy’s trunk and extremities after upper respiratory infection
November 1st 2015Parents of a 6-year-old boy bring him to your office for urgent consultation for a rash that blossomed on his trunk and extremities 2 weeks ago following an upper respiratory infection and that shows no sign of improving. What’s the diagnosis?
Fever, rash, and pain in the extremities of returning pediatric travelers
November 1st 2015Two siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.
What’s new in “connected” medical devices?
November 1st 2015Physicians and parents are using a variety of health-related gadgets and gizmos that communicate with our smartphones and tablets. These range from fitness devices that monitor daily exercise, to glucometers used by diabetics to monitor sugar levels, to sphygmomanometers used to measure blood pressure.
‘Itch-Scratch-Itch’… What a dilemma!
October 28th 2015‘Itch-scratch-itch’….is a typical chief complaint for many children who present to the pediatric primary care office. The infant is irritable and the mother wants the infant to stop being irritable; the child, or adolescent wants to stop ‘feeling itchy’; and their parents want medications that will immediately return the skin to normal. What a dilemma!
Managing risk from uncooperative parents
October 28th 2015Parents who decline or are non-compliant with medical recommendations are not only putting their child at risk, but also the pediatrician, said James P Scibilia, MD, a private practitioner in Beaver, Pennsylvania, and member of the American Academy of Pediatrics Committee on Medical Liability and Risk Management.
Dueling lipid screening recommendations
October 27th 2015Evidence-based recommendations on selective and universal lipid screening in childhood released by the National Heart, Lung, and Blood Institute (NHLBI) in 2011 were endorsed by the American Academy of Pediatrics (AAP) and are integrated in the Bright Futures guidelines on pediatric health maintenance.
Is “breast milk jaundice” the correct diagnosis?
October 27th 2015Clinicians should refrain from making a diagnosis of “breast milk jaundice” because it is often inappropriate, results in unnecessary discontinuation of breastfeeding, and by delaying accurate identification of the etiology for the symptom, may expose the child to undue risk of severe neonatal hyperbilirubinemia.
Does every outburst need medication?
October 26th 2015Many of the prescriptions written for management of children’s behavioral/mental health issues stem from situations in which families, practitioners, or both feel that medication is the only practical solution to a child’s chronic or acute needs. Nonmedication-based solutions, however, are more practical than they may seem, said Lawrence Wissow, MD, MPH, professor of health, behavior, and society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Prioritizing safe sleep practices
October 26th 2015Sudden infant death syndrome (SIDS) remains an important public health issue as it ranks as the third leading cause of infant mortality, but co-sleeping is a reality. A session discusses how to effectively communicate safe sleeping practices with adults.
Avoiding overdiagnosis pitfalls
October 25th 2015The issue of overdiagnosis in medicine has been brought to center stage by recent and proposed changes to screening guidelines for prostate and breast cancer. Overdiagnosis, however, is also a problem in the pediatric population, cautioned Eric Coon, MD, assistant clinical professor of pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
Optimizing care for children with constipation
October 25th 2015There is no question that pediatricians are experienced in managing constipation considering its prevalence among children. Research shows, however, that the majority of pediatricians are not aware of recently released evidence-based recommendations for both the diagnostic evaluation of children with constipation and the treatment of functional constipation, said Samuel Nurko, MD, MPH, associate professor of pediatrics, Harvard Medical School, Boston, Massachusetts.
Is the IQ-increasing power of breastfeeding overexagerrated?
October 22nd 2015Breastfeeding may not make smarter babies, according to a new report from the UK, but CDC says it still makes healthier babies overall and hospitals have more work to do in order to provide optimal support for nursing mothers.
Hepatitis B vaccination in high-risk infants
October 21st 2015The CDC now recommends that high-risk infants undergo postvaccination serologic testing between 9 and 12 months, updated from 9-18 months. The new vaccination interval can better cover at risk infants from HBV infection and also help ensure a higher adherence to the immunoprophylaxis protocol.