A seizure in response to a fever, called a febrile seizure, is an extremely common event in childhood. They affect 2 to 5 percent of children between 6 months and five years of age and have a peak incidence between 12 and 18 months of age. They generally occur after a rapid rise in temperature; it appears the rate of rise is more important than the actual ...

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"In a case that could have wide-reaching implications for medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on April 17 in the case of Warren v. Dinter holding that the existence of a physician-patient relationship is not a prerequisite for a medical malpractice action. Rather, a person may sue a physician for malpractice – even if that person was not a patient of the physician – if the harm ...

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All good doctors learn to filter what parents say to them during history taking, to examine each parental statement for reliability, likelihood, and sheer outlandishness. Parents of sick children are a cross-section of humanity and, like all of us, vary in their observational skills, their ability to express themselves, and their tendency to exaggerate or minimize what they see. Parents, not being physicians, may not notice and comment on things ...

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This article concerns what I call the poor conversationalist. There are several common versions of this, and all of them have corresponding parallels in nonmedical settings. Often the most basic difficulty is one of manner. A good conversationalist is a person who, no matter what he is thinking, outwardly projects an air of interest in what the other person is saying. The doctor who acts distracted, hurried, or even uninterested ...

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A physician, like anyone, can be a poor explainer of things for several reasons, but foremost among these is the tendency to use medical jargon. This is not a problem unique to doctors. When I take my car in for repairs, I often must ask the mechanic to explain what is wrong in a way I can understand. I have a rudimentary understanding of what the various parts of the ...

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Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have ...

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Children are relatively healthy overall. Although 25% of the American population is under the age of 19, only 2% of annual deaths occur in this age group. There was a time when the contributions of diseases to pediatric death rates were much higher. Declines in deaths from infectious disease or cancer, the result of early diagnosis, vaccinations, antibiotics, and medical and surgical treatment, have given way to increases in deaths from ...

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Attention deficit hyperactivity disorder (ADHD) is a common diagnosis in children today, and is increasingly a diagnosis assigned to adults, too. ADHD is a real thing, despite some having some skeptics and a few outright denialists; differences in brain scans between persons who have it and who don’t show there is a definite physiological basis for the disorder. But in practice, we don’t do brain scans. We base the diagnosis on ...

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The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data demonstrating their usefulness behind some well-defined disorders is pretty scant. Their potential usefulness in many ...

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I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue ...

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