BJGP March 2011

Be wary of leg pain in children with an acute illness.  It’s surprisingly specific for meningococcal disease.  Much more so, in fact, than headache, which is just as common in minor febrile infections as it is in meningococcal disease.  Less surprisingly, confusion, photophobia, and neck pain or stiffness are also highly specific for meningococcal disease, and the absence of drowsiness or a rash can be helpful in ruling it out.

Should we go back to screening boys of 8 – 9 months and 39 – 42 months for testicular descent?  There’s evidence that it’s effective in ruling out undescended testicle – or reascending testicle (my term, not theirs), which seems to be commoner than you might expect.  It seems that finding the testicles in the scrotal sac at an initial check doesn’t ensure that they’re still going to be there later on.

I’ve been curious as to whether there’s actually anything in the claim that diet can improve symptoms of depression (and it’s a theory I’m very willing to consider, if there’s good evidence for it), so I need to check out these links given by one letter-writer:

http://www.mentalhealth.org.uk/publications/feeding-minds/

Can J Public Health 2005; 96 Suppl 3: S43 – 6 and S49 – 53

Br J Psychiatry 2007; 190: 118 – 122 (omega-3 supplementation)

Aust N Z J Psychiatry 2008; 42(3): 192 – 8 (EPA supplementation, with & without Prozac)

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About Dr Sarah

I'm a GP with a husband and two young children.
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