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 […]
Category: side effects
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), […]
Q: Who’s still prescribing 0.45% saline for rehydration?
Me … well, actually I don’t anymore, but that’s mainly because I don’t do rehydration. I tend to do hyperhydration to stop the methotrexate causing any more damage than I know it’s going to. BUT if I did prescribe any fluids for a dried up sprogling, I’d reach for 0.45% saline with a sniff of […]
Motherhood, apple pie, psychosis and anaphylaxis
I’ve been worrying about this for some time now. How should we, as health professionals, address the deeply held beliefs of our patients when they aren’t true? Especially when they may harm others, although in a fairly obscure or indirect way? […]
Q: Spandex on prescription?
Fast drying, figure hugging and a joy to not iron, lycra (R) has revolutionised my laundry life. There are potentially even greater benefits though, with the use of lycra suits being promoted for children with cerebral palsies. […]
Q: Midazolam or Ketamine
You have a 7 year old in the ED that needs sutures to a wound inflected when he and his twin were playing Pirates of the Caribbean with kitchen knives … he’s not the sort of chap that will lie still while you stitch him up … so what would you use to keep him […]
Q: Portacath or Hickman Line, madam?
A 6 year old girl with Acute Lymphoblastic Leukaemia presents with another episode of febrile neutropenia with positive blood culture from her Hickman line. On a ward round, her parents discuss that they would like her to have a Portacath device inserted so that she can go swimming and is more comfortable around her friends. […]
Q: How long do you wait to clamp a cord?
When I was doing neonates, it was considered good practice to get little babies spliced away from their Mother, given oxygen to breathe and wrapped up warm, all pretty damn quickly. I keep hearing rumours from my neonatally biased friends that perhaps there are other, better ways of doing things. So – how long do […]
Does atomoxetine aggravate mood problems?
A 13 year old boy with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) comes to the clinic with his mother for a review. He was started on atomoxetine 6 weeks prior to this visit for hyperactive/impulsive symptoms and poor concentration. The boy was admitted in the hospital one week ago for changed behaviour, disorientation, […]