OB/GYN

Here is startling news: Much of what you know about childhood and adolescent vaccines is passing out of date. New vaccines in development and new mortality data mean that recommendations for vaccination against influenza, hepatitis A, meningococcal disease, varicella, human papillomavirus, and rotavirus are on the move.

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

Putting their baby in day care is an emotional occasion for parents, as well as a subject that often comes up during office visits. You're in an opportune position to provide advice and support on returning to work and finding the best child-care arrangement for the family.

Teething has long been the subject of superstition, speculation, and opinion, but little research. So, what do we know, and how can we best advise parents?

The daunting number and diversity of neonatal and infant eruptions, nodules, and other lesions that the author describes will readily submit to his novel algorithm for classification and identification.

Respiratory signs and symptoms in newborns may reflect a problem that requires treatment or referral. A systems-based approach will help you recognize true respiratory distress and keep evaluation and management on track.

Deformational plagiocephaly may be preventable if early signs of torticollis--believed to be a precipitating factor--are identified and simple instructions for parents are followed. Includes a Guide for Parents.

The role of the generalist pediatrician in the specialized field of genetics is key: Screen for genetic disorders; recognize when findings point to a genetic disorder and warrant referral to a geneticist; and counsel families.

Toilet training done badly can lead to medical complications. This second of two articles describes in detail how to treat toilet training problems before they cause harm. Includes three Guides for Parents.

Specialists in adolescent medicine show you how to evaluate your sexually active female patients for PID and manage this common complication of sexually transmitted disease.

Inflicted head trauma is disturbingly common in infants and carries a poor prognosis. Know what to look for and when to suspect abuse.

One pediatrician's quest to find the answer to colic leads to a hypothesis about the condition and a five-step technique pediatricians can teach parents to calm their crying baby. Includes two Guides for Parents.

Some varicoceles that appear during adolescence impair fertility later on; most do not. How do you decide which ones to refer for treatment? And what treatments are most effective?

From an easy-to-use umbilical cord clamp to an affordable electronic medical record system and a growing number of electronic databases and Internet resources, it was a good year for medical innovation.

Yellow bumps on the lips: What do they say to you? (Fordyce granules or spots)

Prophylactic antibiotics have long provided asplenic children with a measure of protection against bacteremia and sepsis. Recent progress in vaccines promises to strengthen the defense.

Increased use of intrapartum antimicrobial prophylaxis has greatly reduced the rate of invasive GBS disease. Universal implementation of updated guidelines for disease prevention will accelerate this important trend.

The physical examination for a patient seeking clearance to participate in a sport should focus on areas likely to yield significant findings--notably, the cardiovascular and musculoskeletal systems.

Office pediatricians need to be prepared to evaluate a patient?s suitability to participate in the sport of his or her choosing. Most significant findings can be uncovered by taking a thorough medical history.

Pediatric Puzzler: Swollen eyes (Orbital pseudotumor)

The stimulants your patient is taking won't necessarily be in her chart under "medication history." Consumption of caffeine, ephedra, or another herbal stimulant may be an overlooked factor affecting your patient's health.

The author reviews the presentation, diagnosis, and treatment of a handful (and they are a handful!) of dermatologic complaints: eczema, diaper rash, scabies, lice, and alopecia areata.

Preventing the potentially irreversible effects of congenital hypothyroidism requires early recognition, prompt treatment, and constant reassessment. A screening test for hypothyroidism on all newborns is just the beginning of your role.