It’s one of the tenets of the evidence-based practice process that questions are framed as ‘PICO’: patient, intervention, comparison and outcome. But what happens when the question is bigger than PICO? […]
Latest articles
Q: Pneumothorices and white rabbits?
Not just Alice in Wonderland, it seems, but a bunch of our colleagues are chasing fluffy-tailed bunnies in their treatment of pneumothorax. Oxygen – in high concentrations – is used by some people to treat spontaneous, non-tension, pneumothorax. But why? […]
Should we give tamixofen for pubertal gynaecomastia?
Well, the media has occasional frenzies over the rising tide of male ‘boob jobs’, but to the average paediatrician it’s the rare adolescent that can’t take his T-shirt off because of pubertal breast enlargement that causes real concern. How should such a potentially disabling and yet ultimately short-lived problem be addressed? […]
Monteleukast helps parents feel better
Well, it does, doesn’t it? There’s nothing much you can actually do for recurrent/intermittent viral wheezers, but if you stick them on a few granules of monteleukast in their yoghurt, at least it seems like we’re doing something. Or am I behind the times and there’s great evidence of it’s effectiveness? […]
Where did I leave that data?
Data can be lost or go missing for lots of different reasons, and it’s quite important to know why as it might make you fundamentally muck-up the results of your study of you deal with it badly. The most obvious reason for data to get lost is by bad luck, for example a freak accident […]
Treating penicillin-resistant pneumococci with penicillin
Now if you ask me, the idea of treating a penicillin-resistant organism with penicillin seems faintly ridiculous… like an iron with drawing pins on the sole plate. Either the bug is resistant (which to me means it resists dying when I use the drug) or it isn’t (so it will die) but it seems that […]
HPV – do infected mothers need caesarean section?
It’s an interesting question, and one which may not concern us in the next twenty years (if vaccination programmes are effective and maintained). But until we can eradicate HPV, what should we recommend to mothers who are infected? […]
When do strawberry naevi go away?
Summer’s here in Yorkshire, and the fruit of the season is strawberries. But strawberry naevi can be troublesome, and cause lots and lots of worries for parents. So how well do we know their natural history? Resolution of 50% at 5 years, 70% at 7 years and 90% at 9 years? […]
Move over reading, ‘riting and ‘rithmatic …
“The 3Rs are dead; long live the 3Rs.” So might a herald cry from the battlements of an evidence-based hill. Sharon Straus and Brian Haynes have captured beautifully the need to move beyond just publishing your paper to making evidence available that is ‘reliable, relevant, and readable’. Why these three Rs? […]
Q: Midazolam or Ketamine
You have a 7 year old in the ED that needs sutures to a wound inflected when he and his twin were playing Pirates of the Caribbean with kitchen knives … he’s not the sort of chap that will lie still while you stitch him up … so what would you use to keep him […]