… and other Bohemian aphorisms … There is a quite brilliant paper from the under-advertised PLoS One which shows how, in the are of incubation periods for respiratory disease, Truth By Citation is quite strikingly different than the reality of the evidence. The networks of citations demonstrate how repetition, sometime but not always with a […]
Category: archimedes
LP post-seizure – do white cells indicate infection?
Obviously, I’m excluding the rather large proportion of my workload where the presence of white cells in the CSF indicate metastatic disease … but in normal children, if you did an LP on a child after a seizure and got a total white cell count of 19, would you be treating for meningitis? […]
Do neonates produce CO2?
Well, I know that they do to some extent, but do they do it enough to make those expensive little burp-detector kits turn yellow when you intubate correctly? They do in grown ups, and in proper children with big breaths, but what about teeny tiny children? […]
What’s a normal CSF opening pressure?
Bob has kindly let one or two of us into his Archimedes blog to write about some of the papers we’ve consider for Picket in E&P This letter in the NEJM (Avery RA, Shah SS, Licht DJ, et al. Reference range for cerebrospinal fluid opening pressure in children. N Engl J Med 2010;363:891-3.) gives us, potentially, […]
Confident in predicting? Meta analysis models step two.
So, in a previous post I made a foray into the dangerous world of statistical models of meta-analysis. Now, I’ll try hard to explain why we need to start doubting random effects meta-analysis more than we often have done. […]
It’s how mixed up? Meta analysis models step one.
Well, I have to start with an apology. In one of these columns, I foolishly claimed that the difference between a Peto OR fixed effect meta-analysis and a DerSimonian-Laird random effects meta-analysis was pointlessly academic. It’s not. Now, this might start getting all statistical, but there is a clear and important difference. Meta-analysis comes in […]
I can’t intubate .. can I have a mask?
Not to obscure your deeply shamed face (I know, I’ve had it happen …) but a laryngeal mask, one of those disturbing bits of equipment anesthetists use when the operations’s not long enough to enjoy a nice cup of tea during an operation. Can an LMA be a reasonable choice in neonatal resuscitation? […]
Clean your hands! And wash your stethoscope while you’re at it.
It’s now been some years since I’ve felt comfortable working with the feel of soft cotton on my elbows. Even when not in a designated clinical zone, its sort of wrong. Anyway, after the success of ‘wash your hands’ decade in making millions of people have cracked, sore skin, there’s a thrust to the obsessive […]
Why the obsession with Vitamin D?
So, in the dark and cold climes of an early Northern Spring, Archi has been assailed by questions of vitamin D. There are, it is claimed, near-miraculous things from Vitamin D sufficiency – less cancer, less heart disease, less rickets. Well, I’ll buy the last one, but the others? And does any child really need […]
Hurtful or helpful?
When you’re thinking about applying the results of a clinical trial, its’ often difficult to get a meaningful handle on the balance that should be made between the beneficial and adverse effects of a treatment. If the medicine gives pain relief from your laparotomy to 1 extra patient in every three that take it (NNT=3), […]