It’s estimated that one in three children with recurrent urinary tract infections have vesicoureteral reflux (VUR), a urological condition where urine flows backwards from the bladder to the kidney.
Though the condition’s management has evolved, the question of which treatment is the preferred one — and specifically, whether urologists should continue to turn to endoscopic injections of dextranomer/hyaluronic acid copolymer (Dx/HA, aka Deflux) — remains a source of debate.
As I reflect on my last few months at Phebe Hospital in Bong County, Liberia, my thoughts are drawn to particular patients who are hard to forget, like:
The 6-year-old boy who burned his leg severely falling into a fire during a seizure. His family spent two months seeking care elsewhere; he spent another two months in the hospital recovering from surgery.
The developmentally delayed, severely malnourished 1-year-old, who weighed 4 kg (8.8 lbs; the average weight of a 2-week old) when I first met him one Wednesday afternoon.
The 4-year-old girl with malaria, treated in the hospital after experiencing fevers and seizures. She was covered in chalk after being treated with herbs in the village.
The 6-month-old girl who arrived in the emergency room with a florid full body rash. Her parents had been treating her with a cream of herbs mixed into zinc oxide.
It is amazing how quickly I adjusted to hearing stories like these, which would seem so far-fetched if heard in the Boston Children’s emergency room. However, an overriding theme that seemed to link a lot of my patients’ stories was shopping around for local remedies before coming to Phebe. …Read More
How much screen time is too much? That’s the essence of a question one parent sent in to Boston Children’s Hospital’s Mediatrician, Michael Rich, MD, MPH, director of the hospital’s Center on Media and Child Health, about the hours upon hours her preteen daughter spends on the computer playing Minecraft.
Rich notes that as screens have become ever present in society, the pediatric establishment’s view on screen time has evolved:
As technologies continue to develop and screen media become more and more prevalent in all of our lives, experts including the American Academy of Pediatrics (AAP) are moving away from the concept of screen time limits for children.
Before offering advice on how to talk to her daughter about her Minecraft time, Rich adds that families need to view a child’s on- and offline activities in the context of her age and developmental needs:
Remember, your daughter is at a stage in life where one of her key developmental tasks is how to prioritize activities and manage her time. Her academic and social demands are increasing and she is moving out of the nuclear family unit to a much larger universe of peers and the public. Minecraft is just one of many activities she will need to prioritize, put into perspective and ultimately regulate in terms of her time and attention. Ironically, time management and getting enough rest is essential to success within the game of Minecraft.
Collectively, the trials involved more than 12,000 children or adolescents with an ADHD diagnosis. Most compared methylphenidate to placebo, with treatment durations ranging from 1 to 425 days (average, 75). Of the 185 trials, 72 (40 percent) were industry-funded.
While the collective data indicate that the drug reduced hyperactivity and impulsivity and increased children’s ability to concentrate, most trials were small and judged to be low quality. For example, methylphenidate’s side effects may have compromised blinding in many studies. While short-term data indicated no life-threatening harms, the drug was associated with an increased risk of side effects such as sleeping problems and decreased appetite.