Have We Lost our CommonSense?

Schools are quite paranoid about giving any medication on their watch.  The liability for giving sunscreen when you don’t need it?  Zero.  This is very similar to the use of epinephrine in a school aged child with food allergy.  You certainly don’t want to withhold epi and risk anaphylaxis or death, when the risk of giving the EpiPen is negligible even if you don’t need the drug.  Maybe our policies in schools will change after a large malpractice case gets media attention for NOT giving epinephrine at the appropriate time for peanut allergy. 

http://www.usatoday.com/news/health/story/2012-06-27/sunscreen-policies/55877080/1

Are We Beating a Dead Horse?

Ok, another study about the dangers of food allergy (yesterday in USA Today).  You would think the occurrence of food allergy to KNOWN allergens (peanut & milk) would decrease given all the attention given to accidental ingestion.  Evidently, this is not the case.  Explanations?  Maybe we’re afraid of giving epinephrine.  In my personal experience, giving epinephrine is analogous to “waving the white flag.”  It doesn’t have to be nor should it be when treating children with suspected food allergy.  As I tell my nurses, “give the epi, then call the doctor!” 

http://www.usatoday.com/news/health/story/2012-06-25/kids-food-allergies/55797696/1

Wedding Ring allergy

Think you can be allergic to your spouse? Just this week in the clinic, a middle-aged woman presents with a rash found only when she wears her wedding ring.  No other jewellery gives her problems except for the ring when worn > 2-3 days.  Although nickel allergy can cause this scenario, this woman probably has occlusion dermatitis or “wedding ring allergy.”  Any accumulation of soap and water underneath the ring will cause this type of dermatitis in sensitive individuals.  Want to learn more? 

http://www.medicinenet.com/script/main/art.asp?articlekey=107570

Are CT scans dangerous?

Research does demonstrate that in children, CT scans can lead to a small, but measurable increase in the risk of cancer.  How does one protect your child, yet obtain the x-rays that will give the proper diagnosis and are clinically indicated?

  1. I am of course referring to a CT (coronal) scan of sinuses used to diagnosis infection or anatomical nasal obstruction.  Many patients need CT of sinuses because the underlying cause of their runny nose has never been identified.
  2. Fortunately, coronal CT of sinuses exposes children to very little radiation because the area that is examined is very small (just the face)
  3. Coronal CT of sinuses does not require repeated examinations.  Once is usually enough!
  4. Usefulness of a plain sinus x-ray is questionable.  False negative rates (study is normal, but wrong) can be as high as 30-40% with a plain radiograph.  Take home message: benefit isn’t worth the risk.

Read the article below, but you probably don’t need to worry about CTs of the sinuses. 

http://www.usatoday.com/news/health/story/2012-06-07/childrens-ct-scans-cancer/55439406/1

Some Kids are Just Over the Top!

I always wonder about the emotional maturity of such “brainiacs”.  Is this perhaps me wanting to compensate for intelligence that only a few have?

http://content.usatoday.com/communities/ondeadline/post/2012/06/child-prodigy-sho-yano-earns-medical-doctorate-at-age-21/1?csp=hf&loc=interstitialskip

Improvement in survival without new drugs!

Truly remarkable how cancer survival has improved in children WITHOUT the addition of new drugs.  There is so much more to health than just taking more medication!  Allergy operates in the same way–good avoidance is first, followed by other aggressive medications.

http://www.usatoday.com/news/health/story/2012-06-04/childhood-cancer-progress/55333892/1

A Cultural and Historical Examination of the Cough Drop

What’s medicine and what’s just candy!  Read on to find out.  My own personal thought is many patients with vocal cord dysfunction (VCD) respond to vocal hydration which can occur while sucking on a cough drop/candy.  Maybe we’ve been treating VCD all along with HALLs!  Stranger things have happened.

A Cultural and Historical Examination of the Cough Drop.

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