OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.
Acute coronary syndrome in a pediatric patient?Written by Kirsten Morrissey, MD with edits by Bracey,
Grauer, Meyers, and Smith An older teen was transferred from an outside hospital
with elevated serum troponin and and ECG demonstrating ST elevations. The patient was obese and had a medical history of only recurrent tonsillitis status post tonsillectomy and adenoidectomy but was otherwise healthy and fully vaccinated. He reported 1.5 days of chest pain that started as substernal and crushing in nature awakening him from sleep and occasionally traveling to right side of neck. The pain ...
Source: Dr. Smith's ECG Blog - December 5, 2023 Category: Cardiology Authors: Bracey Source Type: blogs
THCB 20th Birthday classics: A Brief History of Price Controls by Annoyed Republican Administrations
By UWE REINHARDT
One of the greatest pleasures of running THCB has been to get to know and host the writings of some of my health policy heroes. This week I have already published work from Jeff Goldsmith, and Ian Morrison & Michael Millenson among others will be featured next week (as the party won’t quite stop). Perhaps one of the most amazing things was that the doyen of health economists, Uwe Reinhardt, offered to write some original pieces for THCB…prodded by former editor John Irvine. This is one of my favorites, riffing on a talk I heard him give in (I think) 1993 about how HCFA was like the Kreml...
Source: The Health Care Blog - August 18, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Price controls Uwe Reinhardt Source Type: blogs
Painless Nasogastric Tube Placement
A 6-year-old boy presented with intermittent abdominal pain, nausea, and vomiting. Because his abdominal examination was unremarkable, the pain intermittent, and constipation a possibility, we provided an enema along with an abdominal pain workup but no radiographs. His pain improved, the abdominal labs were unremarkable, and the child tolerated an oral fluid challenge after treatment with ondansetron.The mother was advised at discharge to return if she became concerned about her child's condition. They did return a few hours later for increased vomiting and abdominal pain. A CT scan demonstrated multiple dilated loops ...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Nasal and throat swab test
Our younger son was chosen at random to take part in a trial, to try and see who has COVID-19 now but without symptoms. People were chosen at random from GP registers.Once enrolled, he was sent a nose and throat swab testing kit, with a link tothis subtitled video to explain to him and us what to do. Because he is under 13, we had to administer the test, which he was not pleased about, arguing he could do it himself. But protocols are protocols. We ran the risk of invalidating our part in the experiment by not doing the test properly, but would letting him do it himself do the same?S...
Source: Browsing - July 18, 2020 Category: Databases & Libraries Tags: COVID-19 NCOV Source Type: blogs
Why Isn ’ t Price Transparency Working in Healthcare?
By TAYLOR CHRISTENSEN, MD
I strongly believe that getting people the information and incentives necessary to choose higher-value providers and insurers is the solution to improving value in healthcare (see my Healthcare Incentives Framework). But, you say, we’ve tried that and it doesn’t work, and current efforts are a waste of time!
Here’s an example of some great research that you might use to support your opinion:
Examining a Health Care Price Transparency Tool: Who Uses It, and How They Shop for Care (Sinaiko and Rosenthal, Health Affairs, April 2016)
The news media would see this and...
Source: The Health Care Blog - November 7, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Patients The Business of Health Care price transparency TAYLOR CHRISTENSEN Source Type: blogs
Viral Agents of Childhood Respiratory Tract Infection in the United States
As of October, 2019 Gideon www.GideonOnline.com and the Gideon e-book series contain details of 69,204 epidemiological surveys – of which 1,107 (1.6%) are related to the prevalence of specific viral species in patients with respiratory tract infection. [1-3]
The following chronology of published studies summarizes the relative proportion of viral agents associated with non-influenza childhood respiratory infection in the United States. Additional details and primary references are available on request.
1976 – 2001 Tennessee
hMPV accounted for 20% of acute respiratory illness among children ages 0 to 5 years having ...
Source: GIDEON blog - October 25, 2019 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Ebooks Epidemiology ProMED Source Type: blogs
Safer surgery: Steps you can take
Chances are high that most of us will have a surgical procedure at some point during our lives. Estimates based on 2002 data in three states suggest Americans have a lifetime average of nine surgical procedures. In 2010 in the United States, there were an estimated 1.4 million inpatient procedures, ranging from childhood tonsillectomies, breast lumpectomies, and gallbladder removal to cataract surgeries, hernia repairs, and hip or knee replacements. And the rate of surgical procedures continues to rise. So it’s valuable to know what you can do to make safer surgery and a successful outcome more likely.
How do I choos...
Source: Harvard Health Blog - March 28, 2019 Category: Consumer Health News Authors: Susan Abookire, BSEE, MD, MPH, FACP Tags: Health Managing your health care Safety Surgery Source Type: blogs
Bad breath: What causes it and what to do about it
Almost everyone experiences bad breath once in a while. But for some people, bad breath is a daily problem, and they struggle to find a solution. Approximately 30% of the population complains of some sort of bad breath. Halitosis (Latin for “bad breath”) often occurs after a garlicky meal or in the morning after waking. Other causes of temporary halitosis include some beverages (including alcoholic drinks or coffee) and tobacco smoking.
Some people may not be aware of their own halitosis and learn about it from a relative, friend, or coworker, causing some degree of discomfort and distress. In severe cases, bad breath ...
Source: Harvard Health Blog - January 21, 2019 Category: Consumer Health News Authors: Alessandro Villa DDS, PhD, MPH Tags: Dental Health Source Type: blogs
More evidence on suppurative complications from Fusobacterium necrophorum tonsillitis
This study adds to our clinical understanding of the devastating potential of this gram negative anaerobic bacteria. We have previously found that FN pharyngitis has the same clinical presentation as strep pharyngitis. Our microbiome study showed that patients with more severe clinical pharyngitis (defined as Centor scores of 3 or 4) differed between group A strep and Fusobacterium necrophorum. The tonsils with FN infection had a less bacterial diversity – this means that FN overwhelms the microbiome in many such patients.
These findings suggest that FN more likely causes suppurative complications. We know from th...
Source: DB's Medical Rants - December 29, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 011
Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia.
You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck’). In add...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs
Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 011
Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia.
You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck’). In add...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs
Jahi McMath, Race, and Bioethics
Twice upon a time, there was a girl who died. The death certificate that New Jersey issued to 17-year-old Jahi McMath on June 22 was the second one issued for her. California issued McMath’s first death certificate in December 2013. McMath had been admitted to Children’s Hospital Oakland on December 9 for a routine tonsillectomy… Read more
The post Jahi McMath, Race, and Bioethics appeared first on The Hastings Center. (Source: blog.bioethics.net)
Source: blog.bioethics.net - July 19, 2018 Category: Medical Ethics Authors: Susan Gilbert Tags: Health Care bioethics Brain Death Chronic Conditions and End of Life Care Hastings Bioethics Forum Health and Health Care Jahi McMath race syndicated Source Type: blogs
A Physician Who Had Run Clinics Which Proselytized Patients is Now a Government Health Care Leader Positioned to Enforce Her Religious Beliefs on Patients and Citizens Who Do Not Hold Such Beliefs
DiscussionDr Foley is certainly entitled to her religious views. She is also entitled as a physician to avoid situations in which normal standards of care would push her to provide services to patients that conflict with her religious conviction. But she is not entitled as a physician to proselytize in the guise of medical practice.Furthermore, as a leader in a government health agency, she is not entitled to use that agency ' s power to enforce her personal religious beliefs on patients who do not hold such beliefs. Given her career, though, there is every reason to worry that she will do so. Furth...
Source: Health Care Renewal - July 15, 2018 Category: Health Management Tags: core values deception DHHS Donald Trump mission-hostile management Source Type: blogs
Funtabulously Frivolous Friday Five 242
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 242.
Readers can subscribe to FFFF RSS or subscribe to the FFFF weekly EMAIL
Question 1
Is stuttering more common in boys or girls?
Reveal Answer
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Boys.
With onset u...
Source: Life in the Fast Lane - June 22, 2018 Category: Emergency Medicine Authors: Mark Corden Tags: Frivolous Friday Five ASS Austin flint austin flint murmur botulism botulus breath sounds broncho-vesicular King George VI sausage stuttering TLA TOF tonsil guillotine Source Type: blogs
A tired child? What you should know
Follow me on Twitter @drClaire
Children often complain of being tired. Usually it’s for simple reasons — because it’s the end of a busy day, or because they stayed up late the night before, or because they are trying to get out of doing something they don’t want to do. When kids are sick they are usually tired, and need more rest to get better. But when a child complains all the time, and fatigue starts to get in the way of things they usually enjoy, it could be a sign of a problem.
Here are some possible reasons for chronic fatigue in children:
Sleep problems. This makes sense, obviously, since if a child doesn...
Source: Harvard Health Blog - April 17, 2018 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Children's Health Fatigue Parenting Source Type: blogs
