Separating Fact from Fiction in Pediatric Medicine: Nocturnal Enuresis
Nocturnal enuresis, more commonly known as bedwetting, is a normal problem that resolves on its own for most children. Chiropractors claim they can treat it. They can't, but they will take the credit for kids doing it themselves.
Should the Incidental Discovery of Nonparentage be Disclosed?
The July issue of Pediatrics, the official journal of the American Academy of Pediatrics, contains an extremely thought provoking article discussing the risks and benefits of disclosing an incidental finding of nonparentage during pediatric genetic testing. Nonparentage occurs when one, or very rarely both, of the social parents did not serve as source code for a child’s genetic programming, so to speak....
The Buzzy: Revolutionary Acute Pain Management or Simple Distraction…
I’ve written about the management of acute pain in children in the past, and unfortunately my feelings haven’t changed in the interim. Acute pain, particularly pain related to procedures such as venipuncture for blood sampling and intravenous access, and intramuscular administration of medications such as antibiotics and vaccines, is commonly undertreated, downplayed and even ignored altogether by medical professionals and even caregivers....
Is There a Role for the Art of Medicine in Science-Based Practice?
The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. The practice of medicine is an art, based on science. -Sir William Osler, AEQUANIMITAS The truth is that many of us have some kind of “extraordinary gift.” For a few of us, that gift...
Separating Fact from Fiction in Pediatric Medicine: Infant Gastroesophageal Reflux
By now, regular SBM readers should be aware of the Choosing Wisely initiative. Just in case, Choosing Wisely is a campaign developed by the ABIM Foundation to bring together experts from a variety of medical specialties in order to identify common practices that should be questioned by patients and providers, if not outright discontinued. Their ultimate goal was not to establish treatment...
Separating Fact from Fiction in the Not-So-Normal Newborn Nursery: Newborn Jaundice
By far the most common medical problem in newborn infants is jaundice, typically appreciated as a yellowish discoloration of the skin caused by increased blood levels of a pigment called bilirubin. In my role as a newborn hospitalist, I manage jaundice every day. If I am not treating jaundice, in every single baby I see I am at least determining the risk...
The 2014 Ohio Mumps Outbreak
As I write this post, a large outbreak of mumps is ongoing in Columbus, Ohio. The city, which on average sees a single case each year, has seen over 250 since February. To put things in further perspective, only about 440 cases are normally diagnosed in the entire United States annually. The outbreak began on the campus of Ohio State University, where...
An Update on Water Immersion During Labor and Delivery
Science Based Medicine last covered the increasingly common practice of laboring while immersed in water, in many cases followed by delivering the baby while still submerged, a little over four years ago. In that post, Dr. Amy Tuteur focused primarily on the contamination of the water with a variety of potentially pathogenic bacteria and the associated risk of infection. She also touched...
Nightmares, Night Terrors and Potential Implications for Pediatric Mental Health…..
Earlier this month, the typical media outlets were abuzz (“Childhood nightmares may point to looming health issues“) with the results of a newly published study linking early childhood nightmares and night terrors with future psychotic experiences. Expressing little in the way of skepticism, most reports simply regurgitated the University of Warwick press release. The research, published in the quite legitimate journal Sleep,...
The Pollyanna Phenomenon and Non-Inferiority: How Our Experience (and Research) Can Lead to Poor Treatment Choices
Pollyanna, a popular children’s book written in 1913 by Eleanor H. Porter, introduced the world to one of the most optimistic fictional characters ever created. She always saw the good in people and her approach to life frequently involved playing “The Glad Game”, where she attempted to find something to appreciate in every situation no matter how unfortunate. She was glad about...