Stories about: Pediatric Dose February 2016

From EKGs to echos: How broadly should kids be screened for heart problems?

Heart-screenings-athletes

Every three days, a young athlete somewhere in the United States collapses and dies due to an undetected heart problem. It’s a tragedy that Gian Corrado, MD, who works in Sports Medicine at Boston Children’s Hospital, has seen unfold firsthand. He was an undergraduate playing pick-up basketball when one of his teammates died suddenly on the court.

“It’s uncommon,” he says, “but it’s not so uncommon that it may not touch you. It happens, and we have no effective, efficient way to screen for it.”

There is a lot of interest in using heart screening in young athletes to reduce sudden death risk . The NCAA’s chief medical office recently suggested that it may be useful to routinely perform electrocardiograms (EKGs) and possibly other cardiac tests on some collegiate level athletes. A January 2016 opinion piece on this issue in the New York Times drew a lot of attention. Cardiac screening has also been proposed for other groups, such as children starting certain types of medications.

But there’s widespread debate in medical circles about such broad usage of EKGs. Why is this so controversial? If it’s such a valuable test, why doesn’t everyone get routine EKGs? …Read More

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Clinical Consult: Childhood obesity

medical scale apple childhood obesity
(esolla/Shutterstock)

Pediatric obesity has become a national public health crisis over the last decade, with the U.S. Centers for Disease Control and Prevention (CDC) recording rates of childhood obesity as high as 17 percent nationwide. This does not make the individual conversation with families about obesity and its consequences any simpler. In fact, the widespread nature of this problem has served to normalize it in society and often complicates the discussions and motivation for treatment. However, the dire potential consequences of childhood obesity mandate that we as pediatricians work to prevent as well as diagnosis and treat this disorder. …Read More

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Preventing childhood obesity is all about communication

childhood obesity warning sign conversation
(Gustavo Frazao/Shutterstock)

Much of pediatric care focuses on prevention. Pediatricians generally understand how to prevent communicable diseases (by vaccinating) and injuries (periodic guidance around safety). But current pediatric practice also demands prevention of more chronic diseases. Some, like asthma, have good prevention guidelines. But one chronic disease that seems hard to prevent is obesity.

Childhood obesity is a multi-factorial disease that is poorly understood and has different etiologies in different children. Seen through another lens, however, obesity prevention is a matter of understanding how a person takes in energy (eats) and uses up energy (exercise and activity) and running a household that promotes healthy “energy” habits. Obviously, if that were easy to do, we would all do it. So, as pediatricians we must strive to help families create homes that promote healthy eating and exercise.

But, how can a pediatrician help a parent prevent childhood obesity? I have struggled with this question for many years and my solutions are a work in progress. However you go about it, it’s important to set all families up for success by promoting weight-healthy behaviors from the very beginning. Here are some of the approaches I have come upon as this health crisis has become more and more widespread. …Read More

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