The envelope, please

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).