pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Showing posts from: September 2017

George Papanicolaou: Cytopathology, Cancer

If Dr. George Papanicolaou isn’t considered with our list of the top 50 influential physicians of all time; then, who is?

I must confess that I must have said the words “Pap test” thousands of times in my training without once thinking about the man whose name those words were associated with.
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Marijuana: Test What You Know

Yea, I know there have been some reports about possible “benefits” of smoking Marijuana but you have to realize that I’m from THE generation where Leary convinced millions of gullibles to indiscriminately use drugs of all kinds with the sweeping generality: “look man, it don’t hurt nobody if I do it!”

That was looooong before the goofball that told me that had absolutely ANY proof of what he was saying… one way or the other. NOW we do!
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Prenatal Marijuana (Cannabis) and Brains

To my way of thinking the very thought that medical researchers are forced to stop what they are doing on important issues beyond our control and do research to prove that marijuana is bad for you and shouldn’t be used as a “toy” is unconscionable to the extreme.

We just can’t let the scammers and dealers destroy unborn babies like they did pushing tobacco however; so, that’s just what researchers had to do.
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Children’s Fitness: The Bleep Test

Assessing Children’s Health and Fitness
The “bleep” test, the “beep” test, the “Multistage Fitness Test” (MSFT)

The test had its beginnings in Britain to quantify the fitness level of children and sports team participants. Its popularity has grown world-wide and it is now used by major league teams as a requirement of participation, not to mention military units, the FBI, schools and other venues where fitness is a job requirement. Many other “clones” of the test have been developed (such as the yo-yo test) but all of them are pretty much the same measurement of the body’s ability to utilize oxygen and get it to its cells.

For those of you who wish to have a copy of the test to use in your family, an MP3 file is downloadable below.

Setup of the bleep test

The “game” or “exercise” is easy to set up and just as easy to perform (except for the running part) but it does need some explanation to those you want to administer it to. The tape uses “beeps” to time the exercise. You start the tape and don’t stop it until the last person taking the test has dropped out. Ostensibly to the highest level it takes just over 20 minutes; but no one has been verified as completing it even though several have claimed to do so. Most fit individuals reach their maximum around 10 minutes, only professional level athletes make it above level 12 or so (there are 21).

Give the instructions, start the tape, wait for the first set of three beeps and runners begin at a pace “just fast enough” to arrive at the cone where they wait until the next beep sounds and they start back. They run back and forth at the same pace waiting at the end for the next beep until another series of three beeps indicate the “next level” and the pace picks up. So, it’s back and forth to the time of single beeps until three beeps announces the next level of faster pace.

The “players” continue until maximal effort is reached with encouragement from the onlookers. The idea is to keep going until they have been “late for the beep” two times in a row and their score becomes the last level that they reached on time. Everyone in the family will be different and playing the game will improve both the score and fitness. Here is a video of a college professor teaching students how to administer the test.


So, what to expect at the various ages for “fitness?” Barring preclusive physical impairments here are the charts for boys and girls 9 through 17. Children younger than nine can run to the beeps but really shouldn’t do so under pressure. Developing a love for how their bodies feel when they’re fit and active should be the FIRST agenda. Nine is early enough to begin the challenge of competing with one’s self for improvement as the SECOND agenda. Physical competition against others should be left for sometime AFTER 12 as the THIRD agenda.



Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/4 3/5-4/4 4/5-5/4 5/5-6/4 6/5-7/7 > 7/7
10 < 2/2 2/2-3/5 3/6-4/5 4/6-5/5 5/6-6/6 6/7-8/1 > 8/1
11 < 2/2 2/2-3/6 3/7-4/7 4/8-5/8 5/9-6/10 7/1-8/6 > 8/6
12 < 2/2 2/2-3/8 4/1-5/1 5/2-6/4 6/5-7/6 7/7-9/3 > 9/3
13 < 2/4 2/4-4/2 4/3-5/6 5/7-6/9 6/10-8/3 8/4-10/1 > 10/1
14 < 2/6 2/6-4/5 4/6-6/1 6/2-7/4 7/5-8/9 8/10-10/9 > 10/9
15 < 2/7 2/7-4/7 4/8-6/3 6/4-7/7 7/8-9/2 9/3-11/3 > 11/3
16 < 2/8 2/8-4/9 5/1-6/6 6/7-7/10 8/1-9/6 9/7-11/8 > 11/8
17 < 3/1 3/1-5/2 5/3-6/8 6/9-8/3 8/4-9/9 9/10-12/1 > 12/1


Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/1 3/2-3/8 4/1-4/6 4/7-5/4 5/5- 6/6 > 6/6
10 < 1/7 1/7-3/1 3/2- 3/8 4/1-4/7 4/8-5/6 5/7- 6/8 > 6/8
11 < 1/6 1/6-2/8 3/1- 3/8 4/1-4/8 4/9-5/8 5/9-7/1 > 7/1
12 < 1/5 1/5-2/8 3/1-4/1 4/2-4/9 5/1-5/9 6/1-7/3 > 7/3
13 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/1 6/2- 7/5 > 7/5
14 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/2 6/3- 7/6 > 7/6
15 < 1/5 1/5-3/12 3/2-4/2 4/3-5/2 5/3-6/3 6/4-7/7 > 7/7
16 < 1/5 1/5-3/1 3/2- 4/2 4/3-5/2 5/3-6/3 6/4-7/8 > 7/8
17 < 1/5 1/5-3/1 3/2-4/2 4/3-5/3 5/4-6/4 6/5- 7/9 > 7/9

Finally, if you’re still with me, here is a summary chart of the entire test levels and shuttles on each level. It shows the relative speed the child is running (km/h) at each level as well as times and distances.


Bleep test summary information


Children’s Health: Less Healthy Than 50 Years Ago

Your grandparents and great-grandparents are always the shortest ones in all your family photos, right? It’s the same with all of us.

Your kids are taller, better fed and wealthier than your grandparents; so, why are today’s children LESS healthy than 50 years ago? Children’s health has actually gotten worse!
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I’ve written before about appendicitis and the research going on to find the best type of treatment. A big part of that research is to make double-dog sure that it keeps people safe because this thing used to kill people right and left!

Contrary to what the charlatans on the internet try to get you to believe, NOT EVERYONE is safe waiting to see if antibiotics are the only treatment needed; and, not every doctor is bad just because they recommend surgery.
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As Much As You Want To Know About Autism – Autistic Spectrum Disorder (ASD)

Autism Explanations
From Diagnosis to Treatment to Living With It

Carefully selected from the hundreds of videos about the subject of Autism, here are four others chosen for their clarity, succinctness yet completeness and amazing insight.

Faith Jegede Cole · Writer

Writer Faith Jegede Cole draws on her experiences growing up with two autistic brothers in order to spread awareness and understanding about this increasingly common diagnosis.
She says: “Don’t tell me I’m ‘normal'”, and thinks of her brothers not so much as ‘ordinary’ but extraordinary.

Steve Silberman · Writer and editor

Steve Silberman is a writer and contributing editor for “Wired” who covers science and society. His newest book explores neurodiversity and the link between autism and genius. He relates the history of the autism diagnosis; the Connors vs Asperger issue; and, implications for diagnosis and treatment.

Ami Klin · Autism researcher

Ami Klin is an award winning autism spectrum disorder researcher who explains why we need to find new avenues for early diagnosis and what he and others are doing about it.

Temple Grandin · Livestock handling designer, autism activist

Through groundbreaking research and the lens of her own Asperger’s, Temple Grandin brings startling insight into two worlds.

She makes the case that the world needs people on the autism spectrum: visual thinkers, pattern thinkers, verbal thinkers, and all kinds of smart geeky kids.

Her insight: “…Einstein, Mozart, tesla would all be diagnosed as having ASD today… attends to detail… I think in pictures… one of the things that worries me is where are the younger versions of these people going today – they’re not ending up in silicon valley where they belong… if you got rid of all the Asperger’s there would be no silicon valley.”

“Is it unrealistic to think that their child loves them? Let me tell you that that child would be loyal, if your house was burning down they’re gonna get you out of it.”


James Parkinson: Social Activist and Advocate, Parkinson’s Disease and Palentology

Dr. James Parkinson was born on World Parkinson’s Disease Day, April 11th 1755, in London, England. Of course he didn’t know it at the time. Come to think of it, neither did his parents; nor the fact that he would become one of the 50 most influential doctors of all time.

Affecting an estimated 1% of people over 60 years of age, what has come to be known as “Parkinson’s Disease” is one of the most common neurologic disorders known today.
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