Tuesday, October 18, 2016

Is It Time to Dump the Ibuprofen From Your Medicine Cabinet?

Past studies have danced around the notion that nonsteroidal anti-inflammatory drug use might carry risks when utilized in certain infections. This most recent study is well-designed and performed, but what do we do with the results?

Source: LeBourgeois J, Ferroni A, Leruez-Ville M, et al. Nonsteroidal Anti-Inflammatory Drug without Antibiotics for Acute Viral Infection Increases the Empyema Risk in Children:A Matched Case-Control Study. J Pediatr 2016;175:47-53; doi:10.1016/j.jpeds.2016.05.025. See AAP Grand Rounds commentary by Dr. Daniel Lesser (subscription required).

Tuesday, October 11, 2016

Can Mothers Alter Their Children's Risk for Developing Celiac Disease?

The short answer to that question is a qualified "no," but this study raises some interesting questions about an increasingly commonly diagnosed disorder.

Source: Namatovu F, Olsson C, Lindkvist M, et al. Maternal and perinatal conditions and the risk of developing celiac disease during childhood. BMC Pediatrics. 2016;16(1):77; doi:10.1186/s12887-016-0613-y. See AAP Grand Rounds commentary by Dr. Philip Rosenthal (subscription required).

Tuesday, October 4, 2016

Are Teen-Tot Services Better Than Traditional Primary Care for Teen Mothers and Their Infants?

This study, looking at health care delivery for teenage mothers and their infants, suggests that the combined teen-tot program is a good idea. But, we should all read carefully before accepting the authors' conclusions.

Source: Lewin A. Mitchell S, Beers L, et al. Improved contraceptive use among teen mothers in a patient-centered medical home. J Adol Health. 2016;59(2):171-176; doi:10.1016/j.jadohealth.2016.04.007. See AAP Grand Rounds commentary by Dr. Charlene Wong (subscription required).

Saturday, October 1, 2016

Welcome to October's Evidence eMended

In between dusting off those Halloween decorations and trying to decide what costumes your kids (or you!) will look least foolish in, take some time to browse Evidence eMended, where I'll again try to expand on takes from the October issue of AAP Grand Rounds. Those of you fortunate enough to subscribe to AAP Grand Rounds can read about recent studies of treatment delay of UTI, human papillomavirus-associated cancer rates, use of pubertal development and prepubertal growth rates to predict future height and BMI, exposure of children to tobacco product promotion, and many more.

Over the next 4 Tuesdays, I'll be providing commentary on a possible association of NSAIDs with empyema risk (maybe), association of labor induction and autism (not), a novel approach to improving contraceptive use in teen mothers, and risk factors for celiac disease. Please join me in the tricks and treats!

Tuesday, September 27, 2016

The Molecular Autopsy - Beneficial in Sudden Cardiac Death

Rates of autopsies have declined significantly in most hospitals in the US and abroad, but lessons still can be learned, especially in the era of molecular medicine.

Source: Bagnall RD, Weintraub RG, Ingles J, et al. A prospective study of sudden cardiac death among children and young adults. N Engl J Med. 2016;374:2441-2452; doi:10.1056/NEJMoa1510687. See AAP Grand Rounds commentary by Dr. David Spar (subscription required).

Tuesday, September 20, 2016

More Sports Injury Myths Debunked - Children Can Have Successful ACL Repair and Return to Sports

Randomized controlled trials are great for (relatively) quickly finding a better treatment, but retrospective case series, supported by good record-keeping and effective follow up, sometimes can validate newer methods of management.

Source: Chicorelli AM, Micheli LJ, Kelly M, et al. Return to sport after anterior cruciate ligament reconstruction in the skeletally immature athlete. Clin J Sport Med. 2016;26(4):266-271; doi:10.1097/JSM.0000000000000275. See AAP Grand Rounds commentary by Dr. William Hennrikus (subscription required).

Tuesday, September 13, 2016

MMR Vaccine at 12 Months of Age: Is It Safe and Effective?

This study offers some reassurance about immunizing children with MMR at 12 months of age, and it also demonstrates some key take-home points for translating this type of information into clinical practice.

Source: Kontio M, Palmu AA, Syrjänen RK, et al. Similar antibody levels in 3-year-old children vaccinated against measles, mumps, and rubella at the age of 12 months or 18 months. J Infect Dis. 2016;213(12): 2005-2013; doi:10.1093/infdis/jiw058.

Tuesday, September 6, 2016

Lead Poisoning in Flint, Michigan - The Saga Continues

This whole story really saddens me. I suspect most pediatricians have been following this in the lay press, but of course there wasn't much detail in those reports. In the past few months, a clearer picture is emerging.

Source: Kennedy C, Yard E, Dignam T, et al. Blood lead levels among children aged less than 6 years - Flint, Michigan, 2013-1016. MMWR. 2016;65(25):650-654; doi:10.15585/mmwr.mm6525e1.

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