User login
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as 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.
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as 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.
Does everyone have that grandmother who uses the holidays to indulge in whimsical gift giving? My Nana Fran is now 95, and she remains savvy enough to scour dozens of catalogs for the most offbeat musical, animated plastic geegaw China can produce and make sure it’s on my doorstep with plenty of time to install the batteries and...stare. This year I’ll need to make room next to the singing snow-couple and the big band gramophone for Maestro Mouse in Love. I can tell you’re just as confused as I was when I read the shipping label.
The box contains one tuxedoed rodent seated at a grand piano, with candelabra. So you’ll know this is a Christmas geegaw, he’s wearing a Santa hat. I would have been plenty impressed at the simple fact that a mouse can put on cuff links, but this one can also play 24 different Christmas carols, reading from little plastic cards (take that, Algernon!).
But what, you ask, would motivate a mouse to master a skill (two skills with the cuff links) that is so frankly impractical in the murine world? Then you notice the she-mouse, perched atop the piano in a clingy red dress and white feather boa, looking all Fabulous Baker Boys. Seriously, you just have to see this thing. Drop by and I’ll pour you some eggnog. But don’t tell Nana Fran.
Beta dog
Despite the existence of clear guidelines recommending treating community-acquired pneumonia with narrow-spectrum antibiotics (usually amoxicillin, but macrolides count), many pediatricians just can’t help reaching for the big guns. Their thinking is that pneumonia is a really serious infection, so if you don’t also wipe out the gut flora, you’re not really trying. A new study in Pediatrics aimed to settle the question of which works better for community-acquired pneumonia, narrow-spectrum or broad-spectrum antibiotics.
Just to make sure they were focusing on seriously ill kids, the investigators included children aged 2 months to 18 years who were admitted to four children’s hospitals in 2010 with a discharge diagnosis of pneumonia. This was, in other words, the ID version that laundry detergent commercial where they first rub the clothes in really nasty dirt. In this case, “which white shirt is cleanest” involved total length of stay, oxygen requirement, duration of fever, and hospital readmission.
So you know who won, right? Ampicillin or ampicillin/sulbactam not only equaled “Brand X” (where “X” stands for 2nd- or 3rd-generation cephalosporins), but the narrow spectrum meds were actually superior when it came to average length of stay. Which is why beta-lactams were used in...wait for it...1/3 of admissions in the study, itself a massive improvement over the 7% rate noted in other surveys of pediatric pneumonia treatment.
Of course one study, even one this well-constructed, won’t change prescribing practices overnight. But next time you treat community-acquired pneumonia, ask yourself, is there any reason at all to use an antibiotic that rhymes with “ref my hack zone” when it might be cheaper, safer, and better to use one that sounds like “damp is chillin’ ”? When in doubt, ask the intestinal flora.
Whirled peas
There are two kinds of people in the world: those who find pictures of toddlers covered in food amusing and those who see those images and experience an overwhelming urge to find a large, damp washcloth (I’m in that second group, which I suspect is secretly a lot bigger than the first one -- people feel pressured to laugh politely when you show them photos of your kids.) But what if those children wearing spaghetti-bowl helmets aren’t just posing for cute greeting cards? What if they’re learning language?
I’d still want to clean them up. But that’s not the point. The point is that Larissa Samuelson and her colleagues from the University of Iowa (clearly members of the first group) actually published a paper in Developmental Science demonstrating that kids who smear strained prunes all over their high chairs are better able to distinguish prunes from pureed peaches and to remember the names of each. They added that the high chairs themselves seemed more conducive to food-related learning than dining room tables, presumably because people like me are constantly wiping up actual furniture, whereas we just put the high chair in the driveway and hose it down. Finally, I understand why my kids still can’t tell avocados from artichokes...and I have no regrets.
Off note
It’s rare that I read a study that completely undermines one of my core beliefs. That might be because I rarely read. Or maybe it’s because I have no core beliefs. Regardless, I am left agape after discovering that researchers at the Brigham and Women’s Hospital found no correlation whatsoever between the content of medical chart notes and the quality of care patients received. That’ll teach me to read.
I am a stickler for complete, accurate, and grammatically correct progress notes. I don’t want to brag, but one of my H&P’s was short-listed for the Man Booker Prize. And to think it didn’t contribute anything to patient care, even though it, “...offered a rare glimpse into the human soul that was simultaneously hilarious and profoundly moving!” (Kirkus Reviews). According to the study, patients with diabetes mellitus and heart disease got equally good care whether or not their doctors mentioned little things like the reason for their visits or their medication lists. Seriously, I give up. If you’re looking for me, I’ll be at home, staring at a piano-playing mouse, at least until December 26th.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as 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.