Dr. David Hill

Do you remember The Karate Kid? Not the one that came out a few years back starring Jaden Smith and Jackie Chan, but the real one, with Ralph Macchio as the bullied teen Daniel who learns to defend himself with the aid of the late Noriyuki “Pat” Morita’s ancient, surprisingly skilled handyman, Mr. Miyagi. Brace yourself: Ralph Macchio is now the same age Pat Morita was when he filmed the first movie. I just hope Daniel eventually grew up and got a real job. He’d make a great esthetician: “Wax on....”

Hemera

Something to sneeze at

According to an abstract at this year’s American Academy of Allergy and Immunology (AAAAI) meeting, your tired, poor, huddled masses may want to emigrate to some other country if they’re yearning to breathe free. Dr. Jonathan Silverberg of St. Luke's-Roosevelt Hospital Center in New York presented data showing that children who move to the United States become progressively more likely to develop allergic disease the longer they live here, although he could not say which of our treasured freedoms might be to blame.

Kids who had lived in the U.S. for 10 years had three times the rate of allergic disease as those who had only been here 2 years, according to the 2007-2008 National Survey of Children’s Health. Researchers have known for a while that children in Mexico, China, and many other countries suffer fewer allergies and less asthma and eczema than did their American counterparts, but this study further suggests that there’s something about living here that actually causes atopy. Determining whether the source is some uniquely American toxin like, say, country music, or simply that we keep everything too darned clean will require more study. I’m just looking forward to the next Karate Kid sequel, in which the now-aged Daniel teaches a meek youngster from Okinawa how to properly use his inhaler.

Atlas hugged

As my daughter approaches high school, I like to remind her of all the good reasons to get involved in some sort of volunteer project. For example, it will look good on her college applications. Also, there might be cute boys there. A new study from Canada suggests volunteering could even improve her health! At least that’s what happened to 52 Vancouver 10th graders who participated in a 2-month long mentoring program at local elementary schools. Compared with matched controls, the volunteers saw improvements in body mass index, interleukin-6 levels, and cholesterol measurements. There was even a dose-response curve, with those subjects who showed the greatest increases in altruism also seeing the biggest improvements in cardiac risk factors. Researchers did not report on differences in college acceptance rates or romantic entanglements.

Like all intriguing studies, this one bears repetition and elaboration. For example, would the intervention work in other countries, or did it only succeed because Canadians are so darned nice? Would volunteering at a dog shelter or a soup kitchen be equally effective, or are elementary school students naturally cardioprotective? I mean if the effect generalized, shouldn’t Mr. Miyagi have lived to be 115?

Zit true?

Is it just me, or in the last year, has sugar come to be the new Agent Orange? It seems like excessive consumption of sucrose, fructose, and simple carbohydrates has been linked to every ill known to befall humankind except for one, at least until the March issue of the Journal of the Academy of Nutrition and Dietetics hit news stands. Now, the rumor they told us was just a myth has been resurrected and elevated to the status of an almost-fact: Eating sugar worsens acne.

I’m glad I didn’t know this as a teenager, although honestly as bad as my acne was the word “worsen” couldn’t really apply. But there it is: Based on a review of 27 studies published between 1960 and 2012, registered dietician Jennifer Burns and her colleagues at New York University determined that while pizza and milk may not have deserved their complexion-ruining reputations, dietary sugar has been the secret culprit all along. This gives me an idea for the name of my new karate dojo for evil bullies: “High Fructose Corn Syrup Kai.” Sweep the leg, then stir gently.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

Do you remember The Karate Kid? Not the one that came out a few years back starring Jaden Smith and Jackie Chan, but the real one, with Ralph Macchio as the bullied teen Daniel who learns to defend himself with the aid of the late Noriyuki “Pat” Morita’s ancient, surprisingly skilled handyman, Mr. Miyagi. Brace yourself: Ralph Macchio is now the same age Pat Morita was when he filmed the first movie. I just hope Daniel eventually grew up and got a real job. He’d make a great esthetician: “Wax on....”

Hemera

Something to sneeze at

According to an abstract at this year’s American Academy of Allergy and Immunology (AAAAI) meeting, your tired, poor, huddled masses may want to emigrate to some other country if they’re yearning to breathe free. Dr. Jonathan Silverberg of St. Luke's-Roosevelt Hospital Center in New York presented data showing that children who move to the United States become progressively more likely to develop allergic disease the longer they live here, although he could not say which of our treasured freedoms might be to blame.

Kids who had lived in the U.S. for 10 years had three times the rate of allergic disease as those who had only been here 2 years, according to the 2007-2008 National Survey of Children’s Health. Researchers have known for a while that children in Mexico, China, and many other countries suffer fewer allergies and less asthma and eczema than did their American counterparts, but this study further suggests that there’s something about living here that actually causes atopy. Determining whether the source is some uniquely American toxin like, say, country music, or simply that we keep everything too darned clean will require more study. I’m just looking forward to the next Karate Kid sequel, in which the now-aged Daniel teaches a meek youngster from Okinawa how to properly use his inhaler.

Atlas hugged

As my daughter approaches high school, I like to remind her of all the good reasons to get involved in some sort of volunteer project. For example, it will look good on her college applications. Also, there might be cute boys there. A new study from Canada suggests volunteering could even improve her health! At least that’s what happened to 52 Vancouver 10th graders who participated in a 2-month long mentoring program at local elementary schools. Compared with matched controls, the volunteers saw improvements in body mass index, interleukin-6 levels, and cholesterol measurements. There was even a dose-response curve, with those subjects who showed the greatest increases in altruism also seeing the biggest improvements in cardiac risk factors. Researchers did not report on differences in college acceptance rates or romantic entanglements.

Like all intriguing studies, this one bears repetition and elaboration. For example, would the intervention work in other countries, or did it only succeed because Canadians are so darned nice? Would volunteering at a dog shelter or a soup kitchen be equally effective, or are elementary school students naturally cardioprotective? I mean if the effect generalized, shouldn’t Mr. Miyagi have lived to be 115?

Zit true?

Is it just me, or in the last year, has sugar come to be the new Agent Orange? It seems like excessive consumption of sucrose, fructose, and simple carbohydrates has been linked to every ill known to befall humankind except for one, at least until the March issue of the Journal of the Academy of Nutrition and Dietetics hit news stands. Now, the rumor they told us was just a myth has been resurrected and elevated to the status of an almost-fact: Eating sugar worsens acne.

I’m glad I didn’t know this as a teenager, although honestly as bad as my acne was the word “worsen” couldn’t really apply. But there it is: Based on a review of 27 studies published between 1960 and 2012, registered dietician Jennifer Burns and her colleagues at New York University determined that while pizza and milk may not have deserved their complexion-ruining reputations, dietary sugar has been the secret culprit all along. This gives me an idea for the name of my new karate dojo for evil bullies: “High Fructose Corn Syrup Kai.” Sweep the leg, then stir gently.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

Do you remember The Karate Kid? Not the one that came out a few years back starring Jaden Smith and Jackie Chan, but the real one, with Ralph Macchio as the bullied teen Daniel who learns to defend himself with the aid of the late Noriyuki “Pat” Morita’s ancient, surprisingly skilled handyman, Mr. Miyagi. Brace yourself: Ralph Macchio is now the same age Pat Morita was when he filmed the first movie. I just hope Daniel eventually grew up and got a real job. He’d make a great esthetician: “Wax on....”

Hemera

Something to sneeze at

According to an abstract at this year’s American Academy of Allergy and Immunology (AAAAI) meeting, your tired, poor, huddled masses may want to emigrate to some other country if they’re yearning to breathe free. Dr. Jonathan Silverberg of St. Luke's-Roosevelt Hospital Center in New York presented data showing that children who move to the United States become progressively more likely to develop allergic disease the longer they live here, although he could not say which of our treasured freedoms might be to blame.

Kids who had lived in the U.S. for 10 years had three times the rate of allergic disease as those who had only been here 2 years, according to the 2007-2008 National Survey of Children’s Health. Researchers have known for a while that children in Mexico, China, and many other countries suffer fewer allergies and less asthma and eczema than did their American counterparts, but this study further suggests that there’s something about living here that actually causes atopy. Determining whether the source is some uniquely American toxin like, say, country music, or simply that we keep everything too darned clean will require more study. I’m just looking forward to the next Karate Kid sequel, in which the now-aged Daniel teaches a meek youngster from Okinawa how to properly use his inhaler.

Atlas hugged

As my daughter approaches high school, I like to remind her of all the good reasons to get involved in some sort of volunteer project. For example, it will look good on her college applications. Also, there might be cute boys there. A new study from Canada suggests volunteering could even improve her health! At least that’s what happened to 52 Vancouver 10th graders who participated in a 2-month long mentoring program at local elementary schools. Compared with matched controls, the volunteers saw improvements in body mass index, interleukin-6 levels, and cholesterol measurements. There was even a dose-response curve, with those subjects who showed the greatest increases in altruism also seeing the biggest improvements in cardiac risk factors. Researchers did not report on differences in college acceptance rates or romantic entanglements.

Like all intriguing studies, this one bears repetition and elaboration. For example, would the intervention work in other countries, or did it only succeed because Canadians are so darned nice? Would volunteering at a dog shelter or a soup kitchen be equally effective, or are elementary school students naturally cardioprotective? I mean if the effect generalized, shouldn’t Mr. Miyagi have lived to be 115?

Zit true?

Is it just me, or in the last year, has sugar come to be the new Agent Orange? It seems like excessive consumption of sucrose, fructose, and simple carbohydrates has been linked to every ill known to befall humankind except for one, at least until the March issue of the Journal of the Academy of Nutrition and Dietetics hit news stands. Now, the rumor they told us was just a myth has been resurrected and elevated to the status of an almost-fact: Eating sugar worsens acne.

I’m glad I didn’t know this as a teenager, although honestly as bad as my acne was the word “worsen” couldn’t really apply. But there it is: Based on a review of 27 studies published between 1960 and 2012, registered dietician Jennifer Burns and her colleagues at New York University determined that while pizza and milk may not have deserved their complexion-ruining reputations, dietary sugar has been the secret culprit all along. This gives me an idea for the name of my new karate dojo for evil bullies: “High Fructose Corn Syrup Kai.” Sweep the leg, then stir gently.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

The Oscars generated plenty of moments worthy of commentary, from Jennifer Lawrence’s struggles with stairs to Seth MacFarlane’s struggles with taste. But those of us in the pediatric community know what was most impressive about this year’s Oscars. I mean, second most impressive was that a 9-year old girl was up for Best Actress. But most impressive was that Elton John and David Furnish managed to get a 2-year-old boy into a tuxedo in time for the after-party. I was lucky to get my 2-year-olds into onesies, much less a suit that makes it totally reasonable for a man to employ a valet. Tomorrow morning, when my 11-year-old son is getting ready for school, I swear I’m going to show him the video of that little boy and say, “If he can do that, then by God you can find your other shoe!”

Hemera

Otitis news media

Does it seem like just a few years since the American Academy of Pediatrics came out with revised guidelines for the diagnosis and treatment of acute otitis media (AOM)? Yet, it was way back in 2004, in an era before anyone had envisioned the iPhone, a sequestration crisis, or a 2-year-old in a tuxedo. With all that’s changed in the world, the AAP decided this week to release newly revised guidelines for AOM, which could be downloaded to an iPhone by any formally dressed preschooler whose Head Start program just got defunded.

The new guidelines clarify some things. For example, if a child is in pain from an ear infection, we should...wait for it...treat the pain. Yep, got it: no needless suffering. Gone are the provisions for treating ear infections when you just can’t see the ear drum. It’s 2013, people! If you can’t see the tympanic membrane, use your x-ray vision! Most revolutionary, however, may be the provision for treating mild, unilateral, uncomplicated AOM in children aged 6-24 months with watchful waiting. (For those of you who haven’t tried this, it’s like regular waiting, but with eye strain.)

What impresses me most is that the authors bothered to put what was clearly a huge amount of effort into crafting a new guideline when they freely acknowledge right in the text that no one paid any attention to the last one. Ideally, these publications would help doctors curb unnecessary prescribing, which would give us hope that in 10 years, there may still be some bacteria that at least act a little scared when they see an antibiotic. I think the next time they rewrite these recommendations, the team should include Seth MacFarlane. Sure, the guidelines will offend more than half the readers, but the ratings would be great!

Under pressure

Is there any bigger buzz-kill out there right now than the U.S. Preventive Services Task Force (USPSTF)? Name any good, common-sense idea to improve people’s health and increase health care utilization, and suddenly there they are, all like, “What’s your evidence that it works?” And then, when you’re all like, “Well, I don’t really have any, you know, evidence exactly,” they’re all like, “Then, we can’t recommend this.” I’m willing to bet you every last member of the USPSTF is a parent.

Most recently, the USPSTF threw a wet blanket on universal childhood screening for high blood pressure, pointing out that there was no evidence that detecting asymptomatic hypertension in childhood decreases the rates of adult disease related to elevated blood pressure. Reviewing the studies they cite, I have to admit they may have a point. But could they not have published this thing before I spent $1.99 on an iPhone app to determine whether a given blood pressure exceeds the 95th percentile for a child of a given sex, age, and height? I could have used that money to download an episode of Family Guy!

Very special effects

The Oscars celebrate the people who create vivid imaginary worlds for us, but in focusing just on movies, I feel like they leave out other people who craft alternate realities like drug dealers, members of Congress, and now employees of tanning salons. That’s right, a statewide survey of randomly selected tanning facilities in Missouri found that the people who answered the phones there were living in a world that makes Pandora look like a strip mall. In their universe, it’s perfectly fine for children as young as ten to tan (see, they’re only one vowel apart!). About 80% told callers that tanning would prevent future sunburns, and 43% claimed there were absolutely no risks associated with indoor tanning. I hope their industry has some sort of awards show to celebrate these flights of fancy. And I’m betting there’s a newly unemployed host they can hire cheap.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

The Oscars generated plenty of moments worthy of commentary, from Jennifer Lawrence’s struggles with stairs to Seth MacFarlane’s struggles with taste. But those of us in the pediatric community know what was most impressive about this year’s Oscars. I mean, second most impressive was that a 9-year old girl was up for Best Actress. But most impressive was that Elton John and David Furnish managed to get a 2-year-old boy into a tuxedo in time for the after-party. I was lucky to get my 2-year-olds into onesies, much less a suit that makes it totally reasonable for a man to employ a valet. Tomorrow morning, when my 11-year-old son is getting ready for school, I swear I’m going to show him the video of that little boy and say, “If he can do that, then by God you can find your other shoe!”

Hemera

Otitis news media

Does it seem like just a few years since the American Academy of Pediatrics came out with revised guidelines for the diagnosis and treatment of acute otitis media (AOM)? Yet, it was way back in 2004, in an era before anyone had envisioned the iPhone, a sequestration crisis, or a 2-year-old in a tuxedo. With all that’s changed in the world, the AAP decided this week to release newly revised guidelines for AOM, which could be downloaded to an iPhone by any formally dressed preschooler whose Head Start program just got defunded.

The new guidelines clarify some things. For example, if a child is in pain from an ear infection, we should...wait for it...treat the pain. Yep, got it: no needless suffering. Gone are the provisions for treating ear infections when you just can’t see the ear drum. It’s 2013, people! If you can’t see the tympanic membrane, use your x-ray vision! Most revolutionary, however, may be the provision for treating mild, unilateral, uncomplicated AOM in children aged 6-24 months with watchful waiting. (For those of you who haven’t tried this, it’s like regular waiting, but with eye strain.)

What impresses me most is that the authors bothered to put what was clearly a huge amount of effort into crafting a new guideline when they freely acknowledge right in the text that no one paid any attention to the last one. Ideally, these publications would help doctors curb unnecessary prescribing, which would give us hope that in 10 years, there may still be some bacteria that at least act a little scared when they see an antibiotic. I think the next time they rewrite these recommendations, the team should include Seth MacFarlane. Sure, the guidelines will offend more than half the readers, but the ratings would be great!

Under pressure

Is there any bigger buzz-kill out there right now than the U.S. Preventive Services Task Force (USPSTF)? Name any good, common-sense idea to improve people’s health and increase health care utilization, and suddenly there they are, all like, “What’s your evidence that it works?” And then, when you’re all like, “Well, I don’t really have any, you know, evidence exactly,” they’re all like, “Then, we can’t recommend this.” I’m willing to bet you every last member of the USPSTF is a parent.

Most recently, the USPSTF threw a wet blanket on universal childhood screening for high blood pressure, pointing out that there was no evidence that detecting asymptomatic hypertension in childhood decreases the rates of adult disease related to elevated blood pressure. Reviewing the studies they cite, I have to admit they may have a point. But could they not have published this thing before I spent $1.99 on an iPhone app to determine whether a given blood pressure exceeds the 95th percentile for a child of a given sex, age, and height? I could have used that money to download an episode of Family Guy!

Very special effects

The Oscars celebrate the people who create vivid imaginary worlds for us, but in focusing just on movies, I feel like they leave out other people who craft alternate realities like drug dealers, members of Congress, and now employees of tanning salons. That’s right, a statewide survey of randomly selected tanning facilities in Missouri found that the people who answered the phones there were living in a world that makes Pandora look like a strip mall. In their universe, it’s perfectly fine for children as young as ten to tan (see, they’re only one vowel apart!). About 80% told callers that tanning would prevent future sunburns, and 43% claimed there were absolutely no risks associated with indoor tanning. I hope their industry has some sort of awards show to celebrate these flights of fancy. And I’m betting there’s a newly unemployed host they can hire cheap.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

The Oscars generated plenty of moments worthy of commentary, from Jennifer Lawrence’s struggles with stairs to Seth MacFarlane’s struggles with taste. But those of us in the pediatric community know what was most impressive about this year’s Oscars. I mean, second most impressive was that a 9-year old girl was up for Best Actress. But most impressive was that Elton John and David Furnish managed to get a 2-year-old boy into a tuxedo in time for the after-party. I was lucky to get my 2-year-olds into onesies, much less a suit that makes it totally reasonable for a man to employ a valet. Tomorrow morning, when my 11-year-old son is getting ready for school, I swear I’m going to show him the video of that little boy and say, “If he can do that, then by God you can find your other shoe!”

Hemera

Otitis news media

Does it seem like just a few years since the American Academy of Pediatrics came out with revised guidelines for the diagnosis and treatment of acute otitis media (AOM)? Yet, it was way back in 2004, in an era before anyone had envisioned the iPhone, a sequestration crisis, or a 2-year-old in a tuxedo. With all that’s changed in the world, the AAP decided this week to release newly revised guidelines for AOM, which could be downloaded to an iPhone by any formally dressed preschooler whose Head Start program just got defunded.

The new guidelines clarify some things. For example, if a child is in pain from an ear infection, we should...wait for it...treat the pain. Yep, got it: no needless suffering. Gone are the provisions for treating ear infections when you just can’t see the ear drum. It’s 2013, people! If you can’t see the tympanic membrane, use your x-ray vision! Most revolutionary, however, may be the provision for treating mild, unilateral, uncomplicated AOM in children aged 6-24 months with watchful waiting. (For those of you who haven’t tried this, it’s like regular waiting, but with eye strain.)

What impresses me most is that the authors bothered to put what was clearly a huge amount of effort into crafting a new guideline when they freely acknowledge right in the text that no one paid any attention to the last one. Ideally, these publications would help doctors curb unnecessary prescribing, which would give us hope that in 10 years, there may still be some bacteria that at least act a little scared when they see an antibiotic. I think the next time they rewrite these recommendations, the team should include Seth MacFarlane. Sure, the guidelines will offend more than half the readers, but the ratings would be great!

Under pressure

Is there any bigger buzz-kill out there right now than the U.S. Preventive Services Task Force (USPSTF)? Name any good, common-sense idea to improve people’s health and increase health care utilization, and suddenly there they are, all like, “What’s your evidence that it works?” And then, when you’re all like, “Well, I don’t really have any, you know, evidence exactly,” they’re all like, “Then, we can’t recommend this.” I’m willing to bet you every last member of the USPSTF is a parent.

Most recently, the USPSTF threw a wet blanket on universal childhood screening for high blood pressure, pointing out that there was no evidence that detecting asymptomatic hypertension in childhood decreases the rates of adult disease related to elevated blood pressure. Reviewing the studies they cite, I have to admit they may have a point. But could they not have published this thing before I spent $1.99 on an iPhone app to determine whether a given blood pressure exceeds the 95th percentile for a child of a given sex, age, and height? I could have used that money to download an episode of Family Guy!

Very special effects

The Oscars celebrate the people who create vivid imaginary worlds for us, but in focusing just on movies, I feel like they leave out other people who craft alternate realities like drug dealers, members of Congress, and now employees of tanning salons. That’s right, a statewide survey of randomly selected tanning facilities in Missouri found that the people who answered the phones there were living in a world that makes Pandora look like a strip mall. In their universe, it’s perfectly fine for children as young as ten to tan (see, they’re only one vowel apart!). About 80% told callers that tanning would prevent future sunburns, and 43% claimed there were absolutely no risks associated with indoor tanning. I hope their industry has some sort of awards show to celebrate these flights of fancy. And I’m betting there’s a newly unemployed host they can hire cheap.

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

Last weekend, Seattle police hosted a gun buy-back program that netted 348 pistols, 364 rifles, three “street sweepers” (shotguns capable of holding twelve 12-gauge shells), and one Stinger surface-to-air missile launcher, slightly used. Personally, I won’t feel my kids are safe until every school in the nation is protected by personnel armed with, at minimum, anti-tank weapons, mortars, and rocket-propelled grenades. After all, the only thing that stops a bad guy with a missile launcher is a good guy with a missile launcher.

Hemera

Urine Trouble

By now, I should no longer be surprised when something I always thought was true turns out to be all wrong. Pluto is a planet! No, it’s just an conceited asteroid. Lance Armstrong is the world’s greatest cyclist! Nope, but he’s still an exceptionally talented amateur pharmacist. Infants and toddlers with unexplained fevers must be tested and treated for occult urinary tract infections or their kidneys will become so scarred that even Lance Armstrong can’t save them! Now a comprehensive literature review in Annals Of Emergency Medicine suggests that this theory should follow the dinosaurs in Walt Disney’s Fantasia, you know, the ones who perished in the desert heat?

A team of authors from Mt. Sinai and Columbia dismembered the American Academy of Pediatrics 2011 guidelines on the diagnosis and treatment of urinary tract infections in children aged 2 -24 months like a Thanksgiving turkey (Dr. Daniel Runde won the wishbone pull). How compelling was their analysis? Let’s just say that after I finished the article I composed a hand-written note of apology to every febrile toddler I’ve ever catheterized. Their argument boils down to two words:"scarring, schmarring!" Febrile urinary tract infections may only rarely represent pyelonephritis, early treatment of pyelonephritis doesn’t appear to prevent renal scarring better than later treatment, and when renal scarring does occur, it doesn’t seem to cause impaired renal function or hypertension. I’m looking forward to reading the forthcoming letters to the editor from pediatric urologists, but in the meantime, I’m wondering if the mandatory catheterized urinalysis for febrile toddlers is the next Brontosaurus.

Simple Minds

Do you have anyone in your life whose advice always starts with the words, “Why don’t you just...?” Because when you hear that clause you know that whatever comes next is going to waste your time. Overweight and obese kids must hate these words even more, since they hear them so often. “Why don’t you just eat less? Why don’t you just exercise more? Why do you look so angry?” An Australian study in Pediatrics this month drives home the point that managing childhood obesity is a lot more complicated than just adding a little exercise.

The study examined 182 overweight and obese children in Melbourne over 3 years, tracking their activity levels for a week at a time using body-mounted accelerometers. Activity levels were not completely divorced from weight outcomes, but the relationship, like hospital coffee, was disappointingly weak. Kids who increased the time they spent in moderate to vigorous activity were less likely than others to see their BMIs actually worsen. But even large increases in physical activity led to only marginal drops in children’s BMIs, results less impressive than Carly Rae Jepsen’s follow-up to “Call Me Maybe.” So next time you hear someone suggest that a kid wouldn’t be overweight if he would just add a bit of exercise, you can say, “Why don’t you just learn a little more about this subject?”

Dry, but...

I can’t wait to see how over-protective parents cope with a new study in Developmental Science. Psychologists at New York University evaluated 30 toddlers at 13 and 19 months of age to see how often they fell down while walking in cloth diapers, disposable diapers, or no diapers at all. Naked children, allowed a completely natural gait, fell rarely. Toddlers wearing thin disposable diapers fell more often, and those in cloth diapers fell the most. The authors attributed the increased number of falls to the shorter, wider steps toddlers were forced to take in order to accommodate the bulk of their nappies.

Parents interested in providing their children with the most natural possible environments will now be forced to consider whether they should allow their toddlers to roam the house naked or, alternately, buy twice as many cloth diapers, one for the child’s bottom and another to protect her head. If these results lead parents to start bringing their children out in public exposed, I suppose we’ll have to legislate some new health codes to cover the situation, which could only be called, “unconcealed carry laws.”

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

Last weekend, Seattle police hosted a gun buy-back program that netted 348 pistols, 364 rifles, three “street sweepers” (shotguns capable of holding twelve 12-gauge shells), and one Stinger surface-to-air missile launcher, slightly used. Personally, I won’t feel my kids are safe until every school in the nation is protected by personnel armed with, at minimum, anti-tank weapons, mortars, and rocket-propelled grenades. After all, the only thing that stops a bad guy with a missile launcher is a good guy with a missile launcher.

Hemera

Urine Trouble

By now, I should no longer be surprised when something I always thought was true turns out to be all wrong. Pluto is a planet! No, it’s just an conceited asteroid. Lance Armstrong is the world’s greatest cyclist! Nope, but he’s still an exceptionally talented amateur pharmacist. Infants and toddlers with unexplained fevers must be tested and treated for occult urinary tract infections or their kidneys will become so scarred that even Lance Armstrong can’t save them! Now a comprehensive literature review in Annals Of Emergency Medicine suggests that this theory should follow the dinosaurs in Walt Disney’s Fantasia, you know, the ones who perished in the desert heat?

A team of authors from Mt. Sinai and Columbia dismembered the American Academy of Pediatrics 2011 guidelines on the diagnosis and treatment of urinary tract infections in children aged 2 -24 months like a Thanksgiving turkey (Dr. Daniel Runde won the wishbone pull). How compelling was their analysis? Let’s just say that after I finished the article I composed a hand-written note of apology to every febrile toddler I’ve ever catheterized. Their argument boils down to two words:"scarring, schmarring!" Febrile urinary tract infections may only rarely represent pyelonephritis, early treatment of pyelonephritis doesn’t appear to prevent renal scarring better than later treatment, and when renal scarring does occur, it doesn’t seem to cause impaired renal function or hypertension. I’m looking forward to reading the forthcoming letters to the editor from pediatric urologists, but in the meantime, I’m wondering if the mandatory catheterized urinalysis for febrile toddlers is the next Brontosaurus.

Simple Minds

Do you have anyone in your life whose advice always starts with the words, “Why don’t you just...?” Because when you hear that clause you know that whatever comes next is going to waste your time. Overweight and obese kids must hate these words even more, since they hear them so often. “Why don’t you just eat less? Why don’t you just exercise more? Why do you look so angry?” An Australian study in Pediatrics this month drives home the point that managing childhood obesity is a lot more complicated than just adding a little exercise.

The study examined 182 overweight and obese children in Melbourne over 3 years, tracking their activity levels for a week at a time using body-mounted accelerometers. Activity levels were not completely divorced from weight outcomes, but the relationship, like hospital coffee, was disappointingly weak. Kids who increased the time they spent in moderate to vigorous activity were less likely than others to see their BMIs actually worsen. But even large increases in physical activity led to only marginal drops in children’s BMIs, results less impressive than Carly Rae Jepsen’s follow-up to “Call Me Maybe.” So next time you hear someone suggest that a kid wouldn’t be overweight if he would just add a bit of exercise, you can say, “Why don’t you just learn a little more about this subject?”

Dry, but...

I can’t wait to see how over-protective parents cope with a new study in Developmental Science. Psychologists at New York University evaluated 30 toddlers at 13 and 19 months of age to see how often they fell down while walking in cloth diapers, disposable diapers, or no diapers at all. Naked children, allowed a completely natural gait, fell rarely. Toddlers wearing thin disposable diapers fell more often, and those in cloth diapers fell the most. The authors attributed the increased number of falls to the shorter, wider steps toddlers were forced to take in order to accommodate the bulk of their nappies.

Parents interested in providing their children with the most natural possible environments will now be forced to consider whether they should allow their toddlers to roam the house naked or, alternately, buy twice as many cloth diapers, one for the child’s bottom and another to protect her head. If these results lead parents to start bringing their children out in public exposed, I suppose we’ll have to legislate some new health codes to cover the situation, which could only be called, “unconcealed carry laws.”

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).

Last weekend, Seattle police hosted a gun buy-back program that netted 348 pistols, 364 rifles, three “street sweepers” (shotguns capable of holding twelve 12-gauge shells), and one Stinger surface-to-air missile launcher, slightly used. Personally, I won’t feel my kids are safe until every school in the nation is protected by personnel armed with, at minimum, anti-tank weapons, mortars, and rocket-propelled grenades. After all, the only thing that stops a bad guy with a missile launcher is a good guy with a missile launcher.

Hemera

Urine Trouble

By now, I should no longer be surprised when something I always thought was true turns out to be all wrong. Pluto is a planet! No, it’s just an conceited asteroid. Lance Armstrong is the world’s greatest cyclist! Nope, but he’s still an exceptionally talented amateur pharmacist. Infants and toddlers with unexplained fevers must be tested and treated for occult urinary tract infections or their kidneys will become so scarred that even Lance Armstrong can’t save them! Now a comprehensive literature review in Annals Of Emergency Medicine suggests that this theory should follow the dinosaurs in Walt Disney’s Fantasia, you know, the ones who perished in the desert heat?

A team of authors from Mt. Sinai and Columbia dismembered the American Academy of Pediatrics 2011 guidelines on the diagnosis and treatment of urinary tract infections in children aged 2 -24 months like a Thanksgiving turkey (Dr. Daniel Runde won the wishbone pull). How compelling was their analysis? Let’s just say that after I finished the article I composed a hand-written note of apology to every febrile toddler I’ve ever catheterized. Their argument boils down to two words:"scarring, schmarring!" Febrile urinary tract infections may only rarely represent pyelonephritis, early treatment of pyelonephritis doesn’t appear to prevent renal scarring better than later treatment, and when renal scarring does occur, it doesn’t seem to cause impaired renal function or hypertension. I’m looking forward to reading the forthcoming letters to the editor from pediatric urologists, but in the meantime, I’m wondering if the mandatory catheterized urinalysis for febrile toddlers is the next Brontosaurus.

Simple Minds

Do you have anyone in your life whose advice always starts with the words, “Why don’t you just...?” Because when you hear that clause you know that whatever comes next is going to waste your time. Overweight and obese kids must hate these words even more, since they hear them so often. “Why don’t you just eat less? Why don’t you just exercise more? Why do you look so angry?” An Australian study in Pediatrics this month drives home the point that managing childhood obesity is a lot more complicated than just adding a little exercise.

The study examined 182 overweight and obese children in Melbourne over 3 years, tracking their activity levels for a week at a time using body-mounted accelerometers. Activity levels were not completely divorced from weight outcomes, but the relationship, like hospital coffee, was disappointingly weak. Kids who increased the time they spent in moderate to vigorous activity were less likely than others to see their BMIs actually worsen. But even large increases in physical activity led to only marginal drops in children’s BMIs, results less impressive than Carly Rae Jepsen’s follow-up to “Call Me Maybe.” So next time you hear someone suggest that a kid wouldn’t be overweight if he would just add a bit of exercise, you can say, “Why don’t you just learn a little more about this subject?”

Dry, but...

I can’t wait to see how over-protective parents cope with a new study in Developmental Science. Psychologists at New York University evaluated 30 toddlers at 13 and 19 months of age to see how often they fell down while walking in cloth diapers, disposable diapers, or no diapers at all. Naked children, allowed a completely natural gait, fell rarely. Toddlers wearing thin disposable diapers fell more often, and those in cloth diapers fell the most. The authors attributed the increased number of falls to the shorter, wider steps toddlers were forced to take in order to accommodate the bulk of their nappies.

Parents interested in providing their children with the most natural possible environments will now be forced to consider whether they should allow their toddlers to roam the house naked or, alternately, buy twice as many cloth diapers, one for the child’s bottom and another to protect her head. If these results lead parents to start bringing their children out in public exposed, I suppose we’ll have to legislate some new health codes to cover the situation, which could only be called, “unconcealed carry laws.”

David L. Hill, M.D, FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).