Weekly updates #9

Avettand-Fenoel V, Marlin S, Vauloup-Fellous C, Loundon N, Francois M, Couloigner V, Rouillon I, Drouin-Garraud V, Laccourreye L, Denoyelle F et al: Congenital Cytomegalovirus Is the Second Most Frequent Cause of Bilateral Hearing Loss in Young French Children. J Pediatr 2012(0). When a baby fails a hearing screen, they should routinely be tested for CMV.

The following aren’t really neonatal, but each has a message for us I think.

Van den Bruel A, Thompson M, Buntinx F, Mant D: Clinicians’ gut feeling about serious infections in children: Observational study. Bmj 2012, 345(sep25 2):e6144-e6144. This is interesting, when clinicians were evaluating children for whether they had a serious infection or not, the clinical evaluation sometimes suggested a low risk, but the clinician had a “gut feeling” that something was not right (it seems that this was often when the parents were very anxious, or the child was lethargic and not laughing or was breathing funny). The gut feeling added significantly to the more objective clinical evaluation and picked up a few kids with serious infections. I don’t know quite what this means, or if it applies in the NICU, but its not unusual to have an experienced nurse tell me that the baby isn’t the way they usually are, without much that is really objective, and they are often right. It is very difficult or impossible to teach this, maybe someone will devise gut training sessions soon, probably we need a gut feeling simulator.

Mehta NM, Bechard LJ, Cahill N, Wang M, Day A, Duggan CP, Heyland DK: Nutritional practices and their relationship to clinical outcomes in critically ill children–an international multicenter cohort study*. Crit Care Med 2012, 40(7):2204-2211. This study looked at how well pediatric intensivists met the nutritional needs of their patients. They are lousy.  Worse than we (neonatologists) are. And the children who were most nutritionally compromised had higher mortality. Having a feeding protocol was the best way to improve the situation.

Yavchitz A, Boutron I, Bafeta A, Marroun I, Charles P, Mantz J, Ravaud P: Misrepresentation of randomized controlled trials in press releases and news coverage: A cohort study. PLoS Med 2012, 9(9):e1001308. People often complain about how skewed and over the top press coverage of medical research can be. In England the Daily Mail is often mocked as being a source of long lists of things which either cause or prevent cancer, with red wine and coffee being in both lists. Very often those stories are based on studies in  experimental rodents, or on cellular or molecular studies. Yaychitz and his co-workers looked into this and showed that “spin”  as they call it, in press reports, was indeed common, but the most common reason for the overblown press reports was overblown conclusions in the published abstract. You know the sort of thing, Resfertabarol was shown to block enzyme pgpgp3 in a mouse cancer cell line. last line of the abstract, “Resfertabarol holds promise to reduce mortality from cancer.” !

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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