Tuesday, June 27, 2017

Can Routine Asthma Treatment Result in Serious Adrenal Suppression?

According to this study from our friends up north, the answer is yes.

Source: Goldbloom EB, Mokashi A, Cummings EA, et al. Symptomatic adrenal suppression among children in Canada. Arch Dis Child. 2017;102(4):338-345; doi:10.1136/archdischild-2016-311223. See AAP Grand Rounds commentary by Dr. Patricia Fechner (subscription required).

Tuesday, June 20, 2017

Asthma Quality Improvement versus Research - Both Valuable

A group at a children's hospital wanted to improve their asthma management protocols, but the report of this intervention seems not to know whether it's a quality improvement or a research study. Does it matter?

Source: Wong J, Agus MS, Graham DA, et al. A critical asthma standardized clinical and management plan reduces duration of critical asthma therapy. Hosp Pediatr. 2017;7(2):79-87; doi:10.1542/hpeds.2016-0087. See AAP Grand Rounds commentary by Dr. Jeffrey Winer (subscription required).

Tuesday, June 13, 2017

Reducing CT Scans for Child Head Injury

This is the first of 2 quality improvement projects I'll be mentioning this month. The authors here apparently used their work to get credit for Maintenance of Certification from the American Board of Pediatrics, an added bonus!

Source: Jennings RM, Burtner JJ, Pellicer JF, et al. Reducing head CT use for children with head injuries in a community emergency department. Pediatrics. 2017; 139:e20161349. doi:10.1542/peds.2016-1349. See AAP Grand Rounds commentary by Dr. Michelle Stevenson (subscription required).

Tuesday, June 6, 2017

Mumps - The Times They Are A-Changing

Actually, the times have already changed, but not everyone realizes it. This article is a nice, concise report of a 2014 mumps outbreak at a college that confirms prior observations on diagnosis of mumps in the current era, as well as providing very important lessons for primary care providers.

Source: Patel LN, Arciuolo RJ, Fu J, et al. Mumps outbreak among a highly vaccinated university community-New York City, January-April 2014. Clin Infect Dis. 2017;64(4):408-412; doi:10.1093/cid/ciw762. See AAP Grand Rounds commentary by Dr. Rebecca Brady (subscription required).

Thursday, June 1, 2017

What's Up for June in Evidence eMended?

Another edition of AAP Grand Rounds is out, and I'm back reading my Ross Macdonald novel (see last Tuesday's post), so all is right with the world!

This month's AAP Grand Rounds contains commentary on another interesting set of articles: nonoperative treatment of appendicitis, cardiac murmurs in asymptomatic children, parental refusal of vitamin K treatment for their newborns, cancer risk after growth hormone therapy, and more.

The next 4 Tuesdays I'll be posting about diverse topics, including symptomatic adrenal suppression following steroid therapy (this one surprised me), mumps in college students, head CT utilization in community emergency departments, and standardizing care for critical asthma. Please join me, and don't forget to curl up with a few good books this summer!

Tuesday, May 30, 2017

Are Biomedical Research Practices Making Us Sicker?

May is a month with 5 Tuesdays, again unleashing me from my usual commentary of AAP Grand Rounds articles. This time, I chose to do a book report on a recent publication that is highly thought-provoking.

Harris R. (2017). Rigor mortis: How sloppy science creates worthless cures, crushes hope, and wastes billions. Philadelphia, PA: Basic Books.

Tuesday, May 23, 2017

Too Many Echocardiograms, or Too Many Cardiologists?

I'm always a bit skeptical when I come across an article suggesting that increased referrals to subspecialists is a good thing, especially when the authors are the subspecialists themselves. Here's a retrospective study, conducted by pediatric cardiologists, concluding that referral to a pediatric cardiologist can save money.

Source: Lang SM, Bolin E, Hardy S, et al. Diagnostic yield of outpatient pediatric echocardiograms: impact of indications and specialty. Pediatr Cardiol. 2017;38(1):162-169; doi:10.1007/s00246-016-1497-1. See AAP Grand Rounds commentary by Dr. David Spar (subscription required).

Tuesday, May 16, 2017

Bronchiolitis Confusion Redux: Beware of Biocreep!

Last week we discussed an article showing no great benefit to high flow warm humidified air delivery, compared to low-flow nasal cannula, in time to weaning off oxygen in infants with bronchiolitis. Now, we have another bronchiolitis randomized controlled trial, this time comparing high flow nasal cannula to nasal continuous positive airway pressure. Are we any closer to a definitive answer?

Source: Mil├ęsi C, Essouri S, Pouyau R, et al. High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study). Intensive Care Med. 2017;43(2):209-216; doi:10.1007/s00134-016-4617-8. See AAP Grand Rounds commentary by Dr. Mike Dubik (subscription required).

  © Blogger template Shush by Ourblogtemplates.com 2009

Back to TOP