News

Summertime stings-which actually peak in incidence late in the season-can result in either a mild local reaction and a lesson learned, or a systemic allergic reaction with a devastating outcome. Here are strategies to help you and your patients prevent stings and their potentially devastating outcomes.

A 3-year-old girl develops a red, dry, flaky rash over her body, and a dried, yellow crust around her eyes. What's the diagnosis?

What has--and hasn't--changed in pediatrics since 1976.

Guide for Parents: Bees, wasps, and other ?stingers?: Keep your child safe! Bees, wasps, and other ?stingers?: Keep your child safe!

The parents of a 3-year-old girl sought evaluation of their daughter's hair loss. During the past several months, a large patch of alopecia with scaling had developed. The differential diagnosis included seborrhea, trichotillomania, and tinea capitis. Joe R. Monroe, PA-C, MPAS, of Tulsa, Okla, writes that in seborrhea, scaling typically occurs throughout the scalp without the patches of alopecia seen in this patient. Broken-off hairs--a key to trichotillomania--were absent here. A potassium hydroxide preparation of scrapings that contained hairs from the affected area were positive for the "endothrix" phenomenon--the finding of fungal elements inside the hair shaft. Palpable, tender suboccipital lymph nodes were also detected. Both of these findings are common in tinea capitis and essentially confirm the diagnosis.

Musculoskeletal infections in children encompass a broad spectrum of entities that vary greatly in severity and complexity. Their presentation ranges from obvious and acute to insidious and chronic.

For several months, a 12-year-old boy has been bothered by intermittent pruritus of the feet. He is very active in sports all year, and his feet tend to perspire heavily. He has a family history of seasonal allergies. He says that the rash worsened after he used an over-the-counter hydrocortisone cream.

The adoptive parents of an 11-month-old infant noticed that their son did not use his right arm as often as the left. Concern for brachial plexus injury was raised. Antenatal, natal, family, and early developmental history were unknown.

There are many exciting new studies of the biologic basis of ADHD that use neuroimaging and genetic testing. However, none of these methods can reliably diagnose this complex disorder. Someday, these technologies will be used to help subtype ADHD and improve treatment matching.

A 27-month-old boy is brought by his mother to the emergency department (ED) with a 1-day history of sluggish behavior and unsteady gait. The child had been sleepy but was arousable.

This past February, I wrote an editorial for this journal called "Skeptical Sentiments."1 In that essay, I mentioned the satisfaction I had derived from helping children and families during my 30-year career as a pediatrician. I also listed a series of things and situations I have learned to distrust. Chief among them were:

Two excellent review atricles on attention deficit hypertention disorder (ADHD) follow. The first, by Michael Reiff MD, of the university of Minesota, presents an overview of the assessment and diagnosis of ADHD with clear, straightforward recommendations for the primary care practictioner illustrated with clinical vignettes. The format lends itself to a quick read, but the details are included if you want to drill down.

The patient was a 6-year-old boy who had Menkes syndrome and bladder diverticula. He was receiving care at home with sterile intermittent catheterization.

A 16-month-old toddler was brought to the emergency department after he and the sibling who was carrying him fell down a flight of stairs. The child had not been able to bear weight on his left ankle since the fall and resisted his mother's efforts to put on his shoe. Prior medical records showed no history of broken bones or evidence of past abuse or questionable injuries.

The American Medical Association (AMA) has introduced two new books to help answer questions that your patients may have about the changes happening to their bodies during puberty. American Medical Association Girl's Guide to Becoming a Teen (Jossey-Bass/A Wiley Imprint, June 2006; $12.95; Paper; ISBN: 0787983446) and American Medical Association Boy's Guide to Becoming a Teen (Jossey-Bass/A Wiley Imprint, June 2006; $12.95; Paper; ISBN: 0787983438) provide information on important and timely topics, including the physical and emotional changes that occur during puberty, the benefits of a healthy diet and regular exercise, and changing relationships.

A new study provides some of the first clues to the underlying workings of episodes of bipolar disorder that disrupt friendships, school, and family life in as many as 1% of children. Children and adolescents with bipolar disorder misread facial expressions as hostile and show heightened neural reactions when they focus on emotional aspects of neutral faces, researchers at the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH) have discovered.

New findings from a study supported by the National Institute on Drug Abuse (NIDA) at the National Institutes of Health show that girls and boys who exhibit a high level of risky behavior have a similar chance of developing symptoms of depression. Gender differences become apparent at low and moderate levels of risky behavior, however, with girls being significantly more likely than boys to experience symptoms of depression. The study, which incorporated data from almost 19,000 teenagers, was published in the May 15, 2006, issue of the Archives of Women's Mental Health.

People of all ages struggle with body weight, but recent statistics out of a treatment facility for eating disorders show an alarming trend on several fronts: 63% of elementary school teachers are concerned with eating disorders in their classrooms; 80% of pre-teenage girls are dieting, and those who diet are eight times more likely to develop an eating disorder; 81% of 10-year-olds are afraid of becoming fat; and more than 50% of 9- and 10-year-olds report feeling better when dieting.

A study of 17,000 adolescents in the United States found that African-American and Hispanic girls are less physically active than white, non-Hispanic girls—but that those differences are attributable to the schools they attend, not to their ethnic or racial background: African-American, white, and Hispanic girls attending the same school exhibit no difference in physical activity. The findings of the study, led by Tracy Richmond, MD, of the division of adolescent medicine at Children's Hospital Boston, can be found in the June 2006 issue of Pediatrics.

The last of four articles in the Nutritional Intervention series examines the evidence of zinc supplementation for treating diarrhea, colds, and ADHD.