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Q I have a patient, a 9-year-old boy, whose family recently moved to a new neighborhood. Every morning since the boy started attending his new school, he has complained of nausea and had at least one episode of emesis, either before leaving for school or on the way there.

Q It seems that my patients are becoming larger, stronger, and more belligerent. Recently, a number of patients 9 to 16 years of age became uncooperative and actually combative when we performed procedures such as fingersticks for hemoglobin tests or administered vaccines.

In January, implementation of the federal government's plan to vaccinate 500,000 civilian health-care workers and emergency response teams against smallpox was begun.

Pediatric Puzzler: Emesis

With a combination vaccine that protects against five diseases now approved for use in the US--and other such vaccines on the horizon--pediatricians need answers to new questions: How should these vaccines be used for infants at various stages of immunization? Is it safe to give extra doses?

Finding an acceptable alternative to breast milk has proved to be a complicated quest that continues today.

A pediatrician argues that the prevalence and consequences of iron deficiency in the second year of life warrant a new practice: daily, prophylactic iron supplementation for 1- to 2-year-olds.

Letters from readers

Does supplementing infant formula with long-chain polyunsaturated fatty acids have an effect on visual acuity, growth, and cognitive development?

Books for children who fear medical procedures

Adoptions of foreign-born children by families in the United States, which more than tripled over the past 25 years, may raise medical, developmental, psychosocial, and legal concerns. Pediatricians who understand those concerns can better serve international adoptees and their new-found families.

Resources

Q The divorced mother of a 5-year-old boy in my practice plans to marry her boyfriend.

Q The mother of a 9-month-old girl is worried that her daughter lacks an emotional attachment to her.

You are asked to evaluate an 8-year-old boy who recently developed white rings around moles on his neck and back. Although he complains of slight itching, you don't see signs of scratching.

All cutaneous and mucosal surfaces can fall prey to fungi such as dermatophytes and yeasts. Here's how to recognize superficial fungal infections and initiate treatment.

Who, exactly, is a carrier of group A streptococci? How high is the carriage rate? And once you've identified a carrier, is treatment warranted?

The preparticipation examination of these young athletes must address some important concerns beyond those of the usual PPE.

Resources

Unremitting fever

letters from readers

Religious faith doesn't come up regularly in examining room conversation. Yet patients--and parents--beliefs can sometimes affect medical care.