It’s my own question, this time, and throws up lots of annoying little things. The problem is straightforward: I’m a paediatric oncologist in my spare time, and was asked about the use of LifeMel honey to prevent infections. Now, being both an EBMer and a Physician, I said I didn’t know, but didn’t think it […]
Category: therapy
Q: CPAP for Bronchiolitis?
It’s simple really – Autumn is approaching and most paediatricians are gathering their Virally Protective Hankies to ward off the germs they know they’ll be assaulted by. There’s heavy training in many departments for the new docs — “if it’s bronchiolitis clinically, don’t X-ray them, don’t bleed them, don’t IV them and don’t give them […]
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, […]
Leave appendiceal masses alone.
A 5 year old boy was admitted to a rural New Zealand hospital with 10 day history of abdominal pain. The pain was localised to the RIF with guarding and examination revealed a palpable mass in the RIF. He had previously presented with a 1 day history of severe abdominal pain and fever and had […]
No dental antibiotic prophylaxis for VP shunts.
During a routine clinic follow-up, a patient with an indwelling ventriculo-peritoneal shunt enquires whether prophylactic antibiotics are necessary prior to routine dental hygiene work. He produces a letter from his dentist enquiring the same. Dr Max Nathan of Morriston Hospital, Swansea, UK has had this happen … has it happened to you? And what did […]
Question: Melatonin for ADHD?
Does melatonin improve sleep pattern in children with Attention Deficit Hyperactivity Disorder? Adam is an 8 year old boy with Attention Deficit Hyperactivity Disorder (ADHD) who you see with his mother in your paediatric outpatient clinic. She explains that life is being made increasingly stressful for the whole family as Adam is having difficulty getting […]
Question: ECMO – any benefit for neonates?
Does extra-corporeal membrane oxygenation improve survival for severely unwell neonates with Congenital Diaphragmatic Hernia? A neonate on the intensive care unit with an isolated congenital diaphragmatic hernia is failing on conventional ventilation. There are no exclusion criteria for extra-corporeal membrane oxygenation (ECMO). Should the neonate be transferred for ECMO? […]
Question: How to diagnose and treat pyelonephritis
In children suspected of having a UTI, what clinical and radiological features diagnoses pylonephritis, and what mode of antibiotic treatment is necessary to produce clinical improvement and avoid chronic renal impairment? With the publication of the NICE guidance in the UK on the management of UTI in childhood, many paediatricians have been spurred to review […]
Azithromycin for chest infections in severe CP?
Is the frequency of recurrent chest infections, in children with chronic neurological problems, reduced by prophylactic Azithromycin? You see Jonny, an 8 yr old boy with severe dystonic CP as a result of his premature birth at 26 wks gestation with another chest infection. He is mainly gastrostomy fed and had a Nissen’s fundoplication 5 […]
GnRH analogues to prevent ovarian failure?
Should gonadotropin releasing hormone analogue be administered to prevent premature ovarian failure in young women with systemic lupus erythematosus on cyclophosphamide therapy? A 15 year old girl with acute renal failure was found to have class IV systemic lupus erythematosus (SLE) nephritis on renal biopsy. A decision was taken to start her on the routine […]