Thursday, December 1, 2016

December's AAP Grand Rounds

Hello folks, and welcome to a new month of AAP Grand Rounds. In this final issue of 2016, you can read about a variety of topics, including new molecular approaches to diagnosing infections in febrile infants, diarrhea causes in developing countries, accidental marijuana ingestions in the new era of legalized marijuana use, and clinical presentations of childhood leukemia, among others.

For my Tuesday postings this month, we'll discuss causes of enteritis from recreational water exposure, MRI use during pregnancy, evaluation of neonatal sacral dimples, and tools for measuring doses of liquid medications. Please join me!

Tuesday, November 29, 2016

The Dominant Science of Medical Education?

Any guesses on what this author was referring to? Well, if you're paying attention to my blog topics, you know the answer is evidence-based medicine. But is this claim a bit of a stretch? Read on.

Hanemaayer A. Evidence-based medicine: a genealogy of the dominant science of medical education. J Med Humanit 2016; 37:449-473. doi 10.1007/s10912-016-9398-0.

Tuesday, November 22, 2016

Miles to Go Before We Sleep - Missing the Mark on Infant Sleeping Habits

Last September I was hiking in Robert Frost country in Vermont, hardly close to a snowy evening at that time, but reading this new study reminded me of one of his best-known poems. The study shows us once again the gaps that arise when trying to implement results of research studies.

Source: Batra EK, Teti DM, Schaefer EW, et al. Nocturnal video assessment of infant sleep environments. Pediatrics. 2016;138(3):e20161533; doi:10.1542/peds.2016-1533. See AAP Grand Rounds commentary by Dr. Carrie Phillipi (subscription required).

Tuesday, November 15, 2016

A Useful Blood Pressure Guide for Children

One of the biggest problems with evidence-based medicine is translating that evidence into everyday practice. This article is a nice example of making it easier for child healthcare providers to identify children with blood pressure problems.

Source: Banker A, Bell C, Gupta-Malhotra M, et al. Blood pressure percentile charts to identify
high or low blood pressure in children. BMC Pediatr. 2016;16:98; doi:10.1186/s12887-016-0633-7. See AAP Grand Rounds commentary by Dr. Pamela Singer (subscription required).

Tuesday, November 8, 2016

More Data on Choice of Fever Medications

This very complex study should become a model for study by epidemiologists, statisticians, and clinicians looking to understand study design and reporting. I found at least 6 separate items for comment but had to settle on just 2.

Source: Sheehan WJ, Mauger DT, Paul IM, et al. Acetaminophen versus ibuprofen in young children with mild persistent asthma. N Engl J Med. 2016;375(7):619-630; doi:10.1056/NEJMoa1515990. See AAP Grand Rounds commentary by Dr. Mike Dubik (subscription required).

Tuesday, November 1, 2016

Transcutaneous Bilirubin - A Nice Idea, Maybe Not So Accurate

Transcutaneous bilirubin measurements are convenient, but how much accuracy are you willing to give up for convenience?

Source: Olusanya BO, Imosemi DO, and Emokpae AA. Differences between transcutaneous
and serum bilirubin measurements in black African neonate. Pediatrics. 2016;138(3):e20160907; doi:10.1542/peds.2016-0907. See AAP Grand Rounds commentary by Dr. Jonathan Mintzer (subscription required).


Welcome to November's Evidence eMended

This is a big month with the elections coming up, but if you're looking to get away from the endless hype and debate, try retreating to the warm confines of AAP Grand Rounds and Evidence eMended. This month's publication of AAP Grand Rounds has thoughtful discussions of risks/benefits of asthma treatments, migraine and functional abdominal pain associations, sudden cardiac death in non-athletes, and hospitalization of medically complex children, among other topics.

For Evidence eMended the first 4 Tuesdays of November, I'll be commenting on the acetaminophen/asthma link, variations in transcutaneous bilirubin determinations associated with infant skin color, compliance with "Back to Sleep" in infants, and a simplified chart for normal blood pressures in children. Also, November is one of those fifth Tuesday months, so check out my "wild card" post on November 29!

And, whatever else you are up to, please make sure to vote on November 8.

Tuesday, October 25, 2016

More on Labor Induction and Risk for Autism

I forgive readers if they don't remember the last time I commented on an association between induced labor and development of autism spectrum disorders in children; I had forgotten about it myself, until I saw this month's article in AAP Grand Rounds. The loop surrounding this possible association is coming to a close.

Source: Oberg AS, D’Onofrio BM, Rickert ME, et al. Association of labor induction with offspring risk of autism spectrum disorders. JAMA Pediatrics 2016; 170(9):e160965. doi:10.1001/jamapediatrics.2016.0965. See AAP Grand Rounds commentary by Dr. Daniel Doherty (subscription required).


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