AAO-HNS Releases New Guidelines on Tonsillectomy in Children

By Eric Gantwerker MD, MMSc (MedEd), FACS
May 23, 2019

Recently the American Academy of Otolaryngology-Head and Neck Surgery updated their clinical practice guidelines (CPG) on Tonsillectomy in Children (Mitchell et al., 2019). As more studies are published, a periodic review of the literature is necessary.  The last CPG was released in 2011 (Baugh et al., 2011). Since that time 2,190 studies have been indexed in PubMed under the search term “pediatric sleep apnea” with over half of those occurring just since 2016 (1140) (“US National Library of Medicine – NCBI PubMed,” n.d.). Continue reading “AAO-HNS Releases New Guidelines on Tonsillectomy in Children”

Cardiac Risk Assessment in Young Adults: Predictive Value via the CARDIA Study

By Martina M. McGrath, MD
August 22, 2017

Metabolic changes leading to the development of atherosclerosis can start early in life, and are frequently unrecognized in their early stages. For example, obesity in childhood and young adulthood has repeatedly been shown to increase the risk of cardiovascular disease (CVD) later in life.1,2 Given the current epidemic of obesity, inactivity, and poor diet, this is an issue of great public health importance. Tools aimed at young people that encourage early recognition of modifiable risk factors could have major clinical impact in the long term. However, estimating a young person’s risk of CVD, in the absence of typical CV risk factors such as diabetes or hypertension has proven challenging. The Framingham risk score and similar cardiac risk estimating equations are useful tools in middle-aged and older adults but are poorly validated in younger people due to their low absolute risk and the frequent lack of traditional CV risk factors. Continue reading “Cardiac Risk Assessment in Young Adults: Predictive Value via the CARDIA Study”

Underutilization of Epinephrine for Anaphylaxis in Children

By Martina M. McGrath, MD
August 15, 2017

Food allergies are increasingly common and are reported to affect up to 7% of children.1 The most severe form of allergy is anaphylaxis, which is a rapid onset, potentially life-threatening, allergic reaction. Treatment is by urgent administration of intramuscular epinephrine, and early administration is associated with decreased severity of reaction and reductions in mortality.2 Despite the widespread availability of epinephrine, and extensive efforts in education of families and caregivers about recognition of anaphylaxis, delays in recognizing severe reactions and administering the appropriate treatment are still common.2,3 Continue reading “Underutilization of Epinephrine for Anaphylaxis in Children”

Stemming the Rising Tide of Peanut Allergy in Children

By Martina M. McGrath, MD
July 6, 2016

Food allergies are an increasing public health issue. Recent years have seen a dramatic rise in prevalence of peanut allergy, from 0.4% in 1997 to 1.4% in 2008. Today, peanut allergy is the most common cause of anaphylaxis and food allergy related deaths in the United States. Several recent landmark studies have furthered our understanding of the development of peanut allergy and indicated an alternative approach to the prior dogma of delayed introduction and strict avoidance of potential food allergens. Continue reading “Stemming the Rising Tide of Peanut Allergy in Children”

E-cigarettes: Gateway to conventional smoking?

By Martina M. McGrath, MD
July 6, 2016

E-cigarettes are an increasingly popular method of tobacco use and a public health debate is raging as to their potential risks, benefits and appropriate regulation. Touted as a useful tool to help smokers quit, there is also a concern that unregulated marketing and availability of e-cigarettes, particularly to teenagers and young adults, could lead to increased recruitment to traditional cigarette use. Continue reading “E-cigarettes: Gateway to conventional smoking?”