News

Is that sore throat "strep"? Which patients should you test-and how? Does every rapid test require a backup throat culture? Here's what you need to know.

A structured psychosocial interview allows you to assess if, and how, a male teenager's lifestyle or home and school environment pose a risk to his mental and physical health. The authors show you the right questions to ask and how to ask them-the keys to getting your patient to open up.

The discovery of an attached tick on a child can provoke great anxiety in parents. Here are concise instructions for completely removing those tiny, stubborn subjects of worrisome scrutiny in your office. Includes a Guide for Parents.

What's causing a 7-month-old boy to be hospitalized for failure to thrive, recurrent wheezing, and bilateral infiltrates refractory to antibiotics?

What's the cause for an asymptomatic plaque that has been growing slowly on a boy's nose?

Laws that are advocated by groups like putchildrenfirst.org areunnecessary and threaten to interrupt the supply of influenzavaccine for the immediate future.

Time is one of the most important barriers to more effective health counseling by pediatricians. But a recent study using personal digital assistants (PDAs) shows that technology can help make those few counseling minutes more useful and more effective.

Early attention to maternal diet and infant nutrition may help prevent allergy and food intolerance in high-risk infants who are unable to be completely breastfed, according to recent data and speakers at a dinner symposium Sunday evening. Speakers Peyton Eggleston, MD, professor of pediatrics at Johns Hopkins University School of Medicine; Mark Boguniewicz, MD, National Jewish Medical and Research Center and University of Colorado School of Medicine; and John A. Kerner, MD, Stanford University School of Medicine, discussed the rising prevalence of allergic disease worldwide and the key factors shaping the trend, the progression of atopic disease in genetically predisposed children, the factors associated with risk of developing allergic disease, and the evidence for a role of diet in preventing allergic disease in young children.

There are no easy answers when it comes to mandatory testing ofnewborns for HIV. In a year when about 250 US infants are expectedto be born HIV positive with no advance warning or maternaltesting, ethics, politics, and costs are colliding in an explosionof argument, opinion, and data.

Small lifestyle changes can make a major difference in childhoodweight gain. Adding as few as 2,000 steps to daily activity andreducing daily food intake by 100 calories through a familyintervention program can significantly reduce body mass index inchildren and limit weight gain.

A new study on potential interactions between genetic and environmental factors in ADHD suggests that current limits on lead exposure are too high. Lead exposure below the current limits allowed by Environmental Protection Agency regulations produced measurable impairment of executive functions, especially in boys, who have a specific variation in the DRD4 dopamine receptor gene.

Fifteen-year-old girl with several- day history of worsening right-sided facial pain and swelling. Pain severity 10 on a scale of 1 to 10. Limited oral intake.

For several weeks, a 6-year-old girl has had a worsening mildly pruritic rash on the trunk. She has a history of seasonal allergies. The family has had a cat and a dog in the house for a number of years.

Primary care and emergency physicians frequently see young children who have fractured a bone after a fall from a low height. The child's caregiver may describe a fall from furniture, play equipment, stairs, and various other structures--or the child may have even been dropped while being carried. The clinician then has to decide whether the explanation for the fall is plausible--or whether a child abuse investigation should be pursued.

This 14-year-old boy has Lesch-Nyhan syndrome. The picture shows chronic scarring of the lip--a result of self-mutilating behavior that characterizes this syndrome. Lesch-Nyhan syndrome is also characterized by dystonia, choreoathetosis, and mental retardation--all of which are associated with hyperuricemia, write Arvind Vasudevan, MD, and Atiya Khan, MD, of Morgantown, WVa. This X-linked recessive abnormality of the long arm of the X chromosome (Xq26) causes a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) in the brain, liver, and red blood cells.1 In the United States, this condition may be as rare as 1 in 1.2 million.2 Because of the mode of transmission, this disorder affects males primarily; however, cases involving females have been reported.1 Partial variants of the syndrome involving decreased, but not entirely absent, levels of HGPRT also have been identified.2

A 12-year-old otherwise healthy boy was referred to a sports medicine clinic for back pain of 7 months' duration. The pain, which originated to the right of his thoracic spine, was associated with shooting hockey pucks. Results of his physical examination were normal.

Photoclinic: Catscratch Disease This 12-year-old girl had a persistent, nontender enlarged lymph node in the right groin. After the lymphadenopathy had failed to respond to antibiotic therapy, pathologic examination of the lymph node established the diagnosis of catscratch disease. The child remembered that she had been scratched on the right calf by a cat the month before; the scratch had already healed when the lymph node appeared. This child had no symptoms other than lymph node enlargement; however, systemic symptoms of fever, malaise, and headache may occur 2 to 3 weeks after a cat scratch. Spontaneous node regression usually occurs within 4 weeks writes Barbara Barlow, MD, of New York, NY.

A 14-year-old boy was brought by Child Welfare Services and the police for a pre-placement examination before entering foster care. The patient had been in foster care for the last 6 months after an allegation of maternal drug use; he had run away from his last foster home. He was found with a 13-year-old friend and his 17-year-old brother--both of whom were also on the run and in foster care.

This 13-year-old boy plays basketball for his school team. His mother brings him to your office and asks you about her son's toenail that has changed appearance and now looks like his father's great toenail. The father has psoriasis.

Giving patients vaccination records for their children can helpboost up-to-date vaccination rates across all racial and ethnicgroups. But giving parents a shot card also increases rates ofover-vaccination in most groups.