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The insurance reimbursement situation, pay for performance, and expensive technology have made it harder than ever to choose the most appropriate ethical course.

Many hospitals and birthing centers offer this controversial birthing method to reduce the stress and pain of labor. But questions about safety persist. Includes a Guide for Parents.

We are not yet sure how much vitamin D a growing child needs, but we do know that most need more than they get. New recommendations are forthcoming but, until they are formulated, pediatricians should encourage maximal vitamin D intake from food, supplements, and outdoor activities whenever possible.

A "rung bell" is common and can do significant acute and long-term harm to a developing brain. Because no guideline or protocol has been adequately studied for application to children and adolescents, take a cautious approach to management of concussion in youth, the author advises.

Effective health care for the homeschooled child requires understanding of the issues, an open line of communication to parents, and the vigilance to ensure that children not covered by the safety net of school screening get the care they need.

The event may or may not be witnessed; the child may or may not have classic symptoms. A high index of suspicion and knowledge of the many possible presentations are your best insurance against the hazards of a missed or delayed diagnosis.

An adolescent girl complains of headaches and presents with lateral-gaze paralysis of the right eye. Can you solve this mystery?

This season, pediatric offices and clinics will work to meet the challenges posed by the new influenza vaccination.

If you’ve been a reader of Consultant For Pediatricians for more than afew months, you’ve probably noticed that the journal is growing. Over thepast year, the number of editorial pages has increased considerably-thanks to your readership support.

The American Academy of Pediatricians (AAP) holds that pediatricians are responsible for oral health supervision of children younger than 3 years. How can I do a credible job of this in a busy office practice?

Ten-day-old boy born vaginally at 37 weeks breech without complications. Has history of poor feeding with vomiting and has lost weight since birth. One episode of vomiting described as projectile. Ultrasonography ruled out pyloric stenosis but revealed bilateral hydronephrosis. Patient referred to the emergency department for further evaluation.

What are the indications for use of an insulin pump in veryyoung children (infants and preschoolers)?

A 14-year-old girl was referred for evaluation of a several-year history of growth failure, chronic abdominal pain, and intermittent emesis. The parents described the child as a "picky eater," and various foods (eg, meat products and beans) frequently caused abdominal distention.

Your last appointment of the day is with a 16-year-old boy who needs medical clearance to participate on the school basketball team. You have read about young athletes who die suddenly on the field. Is there anything you should do in addition to a history and physical examination to assure yourself that it is safe for your patient to play sports?

I'm a pediatrician who started out with some interest, and eventually developed some expertise, in what is euphemistically called child protection. I'm glad that child protection occupies only about 20% of my clinical time--it's more than I could bear full-time. After 25 years in this field, I have heard many stories. Here is one I can't forget.

Head shape abnormalities in infants may be the result of pressure on the malleable bones in the newborn skull during a vaginal delivery (molding), of constant gravitational forces on the occiput when an infant is kept in the same supine position for prolonged periods (positional deformational plagiocephaly), or of premature fusing of one or more of the cranial sutures (craniosynostosis).

Do you often fight feelings of tiredness, ineffectiveness, and isolation from the people and activities that are important to you? If so, you may be burned out, and you have a lot of company among your peers.

Issues arising from racial, ethnic, and gender disparities among adolescents will be the healthcare challenges making the headlines tomorrow, according to Howell Wechsler, EdD, MPH, Director of the Division of Adolescent and School Health at the Centers for Disease Control and Prevention (CDC).

Parents of your patients probably aren’t aware that vitamins, herbal preparations, and nutritional supplements are not regulated by the US Food and Drug Administration the way pharmaceuticals are, and that this lack of standards and enforcement can have dangerous consequences under certain circumstances. They need to be cautioned about what they give to their child-and you are in the best position to raise a red flag and provide education.

Pediatricians are incredibly important to adolescents-they are the only professionals who see teenagers repeatedly, and in confidence, through the adolescent years.

Julie Gerberding, MD, Director of the Centers for Disease Control and Prevention (CDC), reported on progress in the availability of influenza vaccine during a plenary session presentation this morning at the American Academy of Pediatrics 2006 National Convention and Exhibition.

Which virus causes the greatest number of hospitalizations among children in the United States younger than 5 years? Did you say "influenza"?