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The Informed Parent

Scanning The Journals

by John H. Samson, M.D., F.A.A.P.
Published on Jan. 01, 1997
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Heavy Prenatal Alcohol Exposure With or Without Physical Features of Fetal Alcohol Syndrome Lead to IQ Deficits, by Sarah Mattson, Ph.D., Edward Riley, Ph.D., Laura Gramling, M.A., Dean Delis,Ph.D., Kenneth Jones, M.D.; Journal of Pediatrics, Nov. 1997, Vol 131, #5, p. 718

This article points out that decrease in intellectual function may occur in children, even if there are no physical features of prenatal alcohol exposure. The maternal alcohol exposure causing nervous system impairment had to be more than an occasional glass of wine. Daily alcohol exposure was seen in these cases of decreased IQ.

This tells us the hallmarks of fetal alcohol syndrome (FAS), unusual facies and growth deficiencies need not be present for nervous system deficit to occur. It seems clear that the fetal nervous system is most sensitive to alcohol exposure. No rational parent would give their newborn a shot of whiskey. Why give it to your fetus?

The Role of Cockroach Allergy and Exposure to Cockroach Allergen in Causing Morbidity Among Inner-City Children with Asthma; Rosenstreich D.L., Eggleston P., Kattan M.; New England Journal of Medicine, 1997, 336: p 1356-1363

This paper looked at the role of many asthma triggers in these children. It looked primarily at cockroach allergen exposure. This gives us an insight into the allergens in house dust. We know dust mites, animal dander and now cockroaches are significant allergens. The true allergy triggers in house dust, in addition to animal dander, will ultimately be found to be the protein debris of insect carcasses. House dust protein may contain house fly and spider protein. Assuming no animals abound, I think we will find that the true allergen of house dust are decaying insects.

This is important because testing with standardized specific insect allergen will prove more accurate than using an extract of dust collected from a home. When we look at dust allergy from this aspect, we will have a better understanding for "dust allergy" management measures.

Renal Function After Short-Term Ibuprofen Use in Infants and Children, Samuel Lesko, M.D., MPH, Allen Mitchell, M.D. Pediatrics, Vol. 100, #6, Dec. 1997, p 954

We know that chronic high dose Ibuprofen use in adults can lead to kidney failure. The question then was raised, what does short-term use of this medication do to childhood kidney function?

This paper showed that the risk of even minimal kidney impairment was very small and not significantly greater than that seen with acetaminophen (tylenol) use. In other words, either substance can be used for acute relief of fever and pain without significant worry or kidney impairment.

Vapocoolant Spray is Equally Effective as EMLA Cream in Reducing Immunization Pain in School-Age Children, Evelyn Reis, M.D. and Richard Holubkov, Ph.D., Pediatrics, 1997; 100 (6) URL: http://www.pediatrics.org

From the fans of the skin anesthetic agent, EMLA Cream, here is something else to excite them. The spray one uses for cryotherapy of warts can be used as a topical anesthetic before a shot. The relative cost of these measures are: $15.00 for the cream and 50 cents for the freeze approach.

To me the whole subject seems over protective. The super sharp disposable needles in the hands of an experienced shot giver causes such minute pain that local anesthetic given first is overkill. I fear that a society which must protect itself from the minimal discomfort of a modern injection system has lost sight of reality. I'm not in favor of inflicting pain at all. But the minimal discomfort of a modern needle piercing the skin is barely trauma. Nevertheless, if someone needs this protection from discomfort this article offers a quicker and more fiscally responsible agent.




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