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The disappearance of the "family doctor."

A male neonate was born at 39 weeks' gestation by vertex vaginal delivery with focal swelling of the head. Vacuum extraction and forceps were not necessary for delivery. The mother had no complications during labor. Apgar scores were 7 and 9 at 1 and 5 minutes, respectively. A cephalhematoma was suspected when the fluctuant parietal swelling did not transilluminate.

The mumps outbreak in Iowa and other midwestern states appears to be slowing. However, it is not yet contained. Are you prepared?

A 9-day-old boy was brought in for routine care. His mother had noticed these teeth at the child's birth. There were no other remarkable physical findings. Natal teeth occur in 1:700 to 1:6000 births, write Howard Fischer, MD, and Ahdi Amer, MD, of Children's Hospital of Michigan in Detroit. Such teeth are most often seen in the mandibular incisor area, often in pairs.

Pediatric ECGs are regularly performed for a variety of conditions, including chest pain, syncope, and suspected arrhythmia. Correct interpretation of ECGs can be challenging when technique is faulty or when the variability of normal values in children is not taken into account.

A 6-year-old girl with a nonproductive cough for 4 days and chest pain for 2 days was brought to the emergency department. According to the mother, the child had no fever or wheezing. She had no history of surgery, was not taking any medications, and had no contact with ill persons.

A 71-year-old man presents with stiffness, clumsiness, and a sense of weakness in his left arm. He is concerned that he has had a stroke. What is the most appropriate management strategy?

Ten-year-old girl assessed because of limitation of neck motion. Born at term to non-consanguineous parents. No history of necktrauma. Family history andpast health unremarkable.

Adding cognitive behavior therapy (CBT) to a single selective serotonin reuptake inhibitor (SSRI) mildly improves symptoms of depression compared to the effect of the SSRI alone, a new study shows. But the full potential and effect of CBT may have been weakened by a reduction in subjects' use of SSRIs, according to Gregory Clarke, PhD, of the Kaiser Permanente Center for Health Research, where the study was performed.

The "Media-Smart Youth: Eat, Think, and Be Active"! program is now available to help young people 11 to 13 years old, first, become aware of how the media can influence their dietary choices and, second, make smart decisions about what they eat and how they spend their time. Developed by the National Institute of Child Health and Human Development (NICHD), one of the National Institutes of Health (NIH), the after-school program offers fun, hands-on activities that teach critical thinking skills.

An evidence-based clinical practice guideline aimed at identifying, reducing, and preventing childhood overweight was recently released by the National Association of Pediatric Nurse Practitioners. The goal of the NAPNAP initiative, "Identifying and Preventing Overweight in Children" is to slow, and even reverse, the rapid increase in overweight among children.

New research reported at the annual meeting of the American Psychiatric Association in Toronto in May shows that Shire Pharmaceutical Group's methylphenidate transdermal system (Daytrana) appears a safe and well-tolerated alternative to OROS methylphenidate, and is equally efficacious.

Because states now test for 30 or more metabolic disorders at or soon after birth, false-positive results are on the rise in newborns. This can cause considerable parental stress-even when a baby's results prove negative on retesting. Now, researchers from Children's Hospital Boston report that the stress could be alleviated by better educating parents and pediatricians. The findings appear in the June 2006 issue of Pediatrics.

How much should you know about the background of those who handle your office payments, payroll, and finances-before you hire them?

Munchausen syndrome by proxy is a complex of diagnostic contradictions, tangled parental interactions, charged emotions, and significant clinical discomfort. It's a problem that takes you beyond pathophysiology into shades of gray of the mind. The central goal of intervention is, always, the child's well-being.

A careful history, thorough physical examination, and limited diagnostic studies often point the way to the cause and successful treatment of this distressing disorder.

Vulnerable child syndrome distorts parents' perceptions of their child's health, disrupts the parent-child relationship, and can harm development and behavior in an otherwise healthy child. Here are steps you can take to recognize problems early and improve family interactions.

What's causing chronic, intermittent abdominal pain radiating to both flanks in a 15-year-old girl?