chessandmedicine

Trends in Otitis Media and Mastoiditis Mastoiditis is uncommon, and fewer than one third of children who develop it have recent diagnoses of AOM. Has the watch-and-wait approach to managing children with acute otitis media (AOM) increased the incidence of mastoiditis? Investigators used a general practice U.K. database of more than 2.5 million children (age range, 3 months to 15 years) to examine trends in diagnosis of AOM and mastoiditis from 1990 through 2006. Of 854 children with diagnoses of mastoiditis, only 36% had received diagnoses of AOM during the previous 3 months. During the 16-year study, the incidence of mastoiditis remained stable (average incidence, 1.2 per 10,000 child-years), whereas the incidence of AOM diagnoses declined 34%, and the proportion of children with AOM who were treated with antibiotics declined significantly from 77% to 58%. Risk for developing mastoiditis was 53% lower in children with AOM who received antibiotics than in children with AOM who did not ...

Vicks VapoRub May Cause Respiratory Distress in Infants , Animal Study Suggests Parents may ask about a Chest study suggesting that Vicks VapoRub may act as an airway irritant in very young children. When an 18-month-old child was brought to an emergency room in severe respiratory distress after a grandparent applied Vicks VapoRub directly under her nose, clinicians investigated whether the ointment — a mixture of camphor, menthol, and eucalyptus oil — was at fault. (The product is not recommended for application to the nostril or for children under age 2 years.) Their studies in healthy ferrets, which have an airway anatomy similar to humans, showed that mucus secretion increased and ciliary activity decreased in the presence of the ointment. The authors conclude that the effect "may be of little physiologic consequence in older children and adults, but in infants and small children this potentially can lead to respiratory distress Chest Website of Vicks VapoRub Treadmill Exerci...