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The Informed Parent

Scanning The Journals: Strep; ADHD; Tree Swing Injuries

by John H. Samson, M.D., F.A.A.P.
Published on Jan. 01, 1997

Optical Immunoassay Test for Group A Beta-Hemolytic Streptococcal Pharyngitis:

JAMA Vol. 277 #11, March 19, 1997: p. 899

The rapid identification of "strep throat" infection has been a desire of physicians for years. The early tests were helpful in determining the presence of this specific organism. Unfortunately, a negative test demanded a throat culture to confirm that no "strep" bacteria was present.

An OIA test has been developed and was tested in pediatric offices in Connecticut and Chicago. In the 2113 patients evaluated by the OIA test and the standard throat culture, the authors found the OIA test appeared more sensitive than the throat culture.

This journal indicates that a negative OIA for strep may not always need to be routinely confirmed by a throat culture. What does this mean to parents?

  1. At this time, if other than an OIA test is done, a negative rapid test for "strep" demands a follow-up throat culture be pursued before feeling confident your child does not have a "strep" throat infection.
  2. A reliable rapid test for "strep" means less antibiotics will be used because the 48 hour wait for the throat culture results will be eliminated. The OIA test results are available in less than 10 minutes.
  3. As informed parents, always remember, the ability of a physician to look at a child's throat and declare "strep" bacteria present or not present is consistently impossible. Some past studies have shown experienced physicians to be wrong 50% of the time. Expect a rapid test and/or throat culture to be done before accepting the diagnosis that your child's sore throat is or is not due to a "strep" organism.

Attention Deficit Hyperactivity Disorder: A Disease or a Symptom Complex?

Journal of Pediatrics Vol. 130 #4, April 1997: p.665

This somewhat technical article points out what I wrote about in the first issue of The Informed Parent. Many conditions are currently being lumped together by clinicians. Because a child demonstrates school underachievement and easy distractibility does not mean he has ADHD or ADD. Every patient who has symptoms suggesting primary ADD will need a thorough evaluation to be certain that another diagnosis is not made which may present as ADD. The correct diagnosis is needed to institute proper therapy.

Beware of the quick diagnosis of ADD and institution of therapy before a full assessment is completed and results presented to you as the parents. Once again remember to represent your child's best interests by being informed parents.

Single Rope Tree Swing Injuries Among Children

Pediatrics Vol. 99 #4, April 1997: p. 548

This study points out objectively another traditional child recreation device that renders significant harm. We have all played on one ourselves and have watched our children do the same.

We cannot protect our children at all times from every hazard. We can only use common sense and avoid obviously dangerous pursuits. It is a fine line between assuring a safe environment for your children and creating paranoia for potential injuries. We have learned the benefit of bike helmets, wrist guards, seat belts, life jackets, etc. without overly curtailing our children's play.

Always remember, when a human falls from higher than his standing height or collides with something at a speed faster than he can run, the built-in design safety features of skulls and bones are exceeded and significant harm will occur. Humans will always operate outside that envelope. Let's hope parents provide adequate advice and safety equipment until the child is an adult and old enough to make the correct safety equipment choices.

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