Tuesday, August 15, 2017

Charlotte's Web Finally Comes Through for Seizure Treatment

If you want to find out what my literary allusion has to do with seizures, go back to one of my postings from 3 years ago. This randomized controlled trial of cannabidiol for seizure management in Dravet syndrome also shows a few different ways of how medication benefits might be explained to patients and families.

Source: Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med. 2017;376(21):2011-2020; doi:10.1056/NEJMoa1611618. See AAP Grand Rounds commentary by Dr. David Urion (subscription required).

Tuesday, August 8, 2017

More Evidence Supporting Pertussis Immunization of Pregnant Moms

It's shocking to me that we still see pertussis deaths in children in the United States. While the factors contributing to the current picture are complex, it is becoming very clear how we can prevent such deaths in the future.

Source: Baxter R, Bartlett J, Fireman B, et al. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics. 2017;139(5):e20164091: doi:10.1542/peds.2016-4091. See AAP Grand Rounds commentary by Dr. Rebecca Brady (subscription required).

Tuesday, August 1, 2017

Should Children with Parapneumonic Effusions Receive Steroids?

The short answer is no, but it takes some careful consideration of this randomized, placebo controlled, double-blind study to come to that conclusion.

Source: Tagarro A, Otheo E, Baquero-Artigao F, et al. Dexamethasone for parapneumonic pleural effusion: a randomized, double-blind, clinical trial. J Pediatr. 2017; 185:117-23. doi:10.1016/j.jpeds.2017.02.043. See AAP Grand Rounds commentary by Dr. Daniel Lesser (subscription required).

Welcome to August, 2017 Evidence eMended

Hello everyone. I'm enjoying some relatively cooler August weather in DC now, appropriate for the cool articles this month. In the August edition of AAP Grand Rounds, you'll see reviews on topics including hyponatremia in children with bronchiolitis, CSF cultures in term infants, a possible association of increased leptin in slipped capital femoral epiphysis patients, and more.

This month, my weekly blog will cover steroid therapy for parapneumonic effusion, pertussis immunization of pregnant women, use of cannabidiol for a severe seizure disorder, and some interesting news about early preventive dental care effectiveness. Plus, this month contains the infamous 5th Tuesday, allowing me an opportunity to rant about a special topic of my choice.

Stay tuned, and have a safe summer!

Tuesday, July 25, 2017

Serious Infections in Children with Lupus: Uncommon But Important

This administrative database study has some important caveats for primary care providers, in spite of the limitations in study design.

Source: Hiraki LT, Feldman CH, Marty FM, et al. Serious infection rates among children with systemic lupus erythematosus enrolled in Medicaid [published online ahead of print February 19, 2017]. Arthritis Care Res. doi:10.1002/acr.23219. See AAP Grand Rounds commentary by Dr. Gloria Higgins (subscription required).

Tuesday, July 18, 2017

A Crystal Ball for Pediatric Septic Shock

Well, not quite a crystal ball. However, if clinicians could reliably identify children at high risk of mortality at the time of admission to an ICU, newer management modalities could be targeted specifically for his group of children.

Source: Schlapbach LJ, MacLaren G, Festa M, et al. Prediction of pediatric sepsis mortality within 1 h of intensive care admission. Intensive Care Med. 2017; 43:1085-1096. doi: 10.1007/s00134-017-4701-8. See AAP Grand Rounds commentary by Dr. Susan Bratton (subscription required).

Tuesday, July 11, 2017

Towards Less Imaging for Febrile Infants with Urinary Tract Infection

This study suggests guidance for which infants with febrile urinary tract infection need voiding cystourethrography. Is the evidence good enough to implement now?

Source: Pauchard J-Y, Chehade H, Kies CZ, et al. Avoidance of voiding cystourethrography in infants younger than 3 months with Escherichia coli urinary tract infection and normal renal ultrasound [published online ahead of print April 13, 2017]. Arch Dis Child. doi:10.1136/archdischild-2016-311587. See AAP Grand Rounds commentary by Dr. Pamela Singer (subscription required).

Tuesday, July 4, 2017

Burns in Children: Is There a Profile for Those at Risk?

I guess it's a sad commentary on my state of life to acknowledge that the first thing that pops into my mind when I hear Fourth of July is that children are experiencing injuries from fireworks. This study deals with burns rather than fireworks but offers some interesting food for thought.

Source: Emond A, Sheahan C, Mytton J, et al. Developmental and behavioural associations of burns and scalds in children: a prospective population-based study. Arch Dis Child. 2017;102(5):428-433. doi: 10.1136/archdischild-2016-311644. See AAP Grand Rounds commentary by Dr. Carrie Phillipi (subscription required).

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