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The way a child’s doctor brings up the subject of shots may make a big difference in whether parents agree to them, a new study shows. If the doctor starts out with a question, the parents are much more likely to say no. Researchers videotaped 111 vaccine discussions between parents and doctors. About 3 out of 4 doctors used “presumptive” language, such as, “We have to do shots.” The others used “participatory” language. For example, they might ask: “What do you want to do about shots?” Parents were 17 times as likely to object to shots if the doctor used the participatory language. About half of the time, the doctor persisted, saying that the shots were necessary. In this case, about half of the resistant parents agreed to the shots. In recent years, more doctors have encouraged patients to share in making decisions about their health.

New guidelines aim to rein in excess use of antibiotics in children. The American Academy of Pediatrics (AAP) developed the guidelines with the Centers for Disease Control and Prevention (CDC). The goal is to educate parents and doctors about the risks of using antibiotics for upper respiratory infections when they are not needed. Experts say more careful use will help stem the tide of antibiotic resistance. A CDC report in September noted that 2 million people in the United States each year get infections that are resistant to antibiotics. That means the drugs are no longer effective. The report also said that at least 23,000 people die each year as a result. The AAP published the guidelines in its journal Pediatrics. Their release was part of the Get Smart About Antibiotics Week campaign. HealthDay news wrote about the guidelines Nov. 18.

New recommendations for migraine treatment focus on avoiding harmful and unnecessary care. The recommendations were made by the American Headache Society. They say that opioid painkillers used to treat migraines pose a danger of addiction. Long-term use of over-the-counter pain relievers is not wise, the recommendations say. People should take them no more than twice a week. Regular, frequent use poses risks to the kidneys, liver and stomach. The group recommends MRIs over CT scans to help diagnose migraine. About 12% of Americans get migraines. They are three times as common in women as in men. The recommendations were published in the November-December issue of the journal Headache. HealthDay News wrote about them November 21.

A new study finds that most men and women have similar chest pain or discomfort when they are having a heart attack. But there are other conditions that can cause chest pain. The study did not find any details about the type of pain that could help doctors tell whether a heart attack is the cause. The study included about 800 women and 1,700 men who went to emergency rooms with severe chest pain. Researchers asked detailed questions about their pain. The questions included where exactly the pain was located, whether it spread beyond the chest and what it felt like. About 18% of the women and 22% of the men were actually having a heart attack. Men’s and women’s answers to the detailed questions about symptoms also were mostly similar. No specific details about the chest pain were definitely linked with a greater chance of having a heart attack.