CME: Managing diabetic ketoacidosis--a delicate balance
June 1st 2000Diabetic ketoacidosis is one of the most common, and dangerous, complications of both insulin- and noninsulin-dependent diabetes. The patient's life depends on a complex therapeutic juggling act to restore metabolic, acid-base, fluid, and electrolyte balances.
Co-sleeping: Can we ever put the issue to rest?
June 1st 2000Supporters and opponents of an increasingly popular practice have strong opinions about whether bed sharing is good or bad for babies and their parents. Examining the attitudes behind these opinions and the evidence for co-sleeping's alleged benefits and pitfalls will help you tailor your advice to the specific needs of families in your practice.
CME: Pediatrics and the Human Genome Project
May 1st 2000A massive undertaking to determine the sequence of the several billion DNA building blocks that represent the human genome is almost complete. Pediatricians can look forward to new molecular tests for diagnosing inherited disorders in the near future. Novel therapies should follow.
Bringing a formidable opponent down to size
May 1st 2000Obesity is on the rise and hard to treat. Whenever possible, you, your patient, and the family should face the problem early and deal with it before it assumes awesome proportions. For a moderately obese child, not gaining for a while may be all that's needed.
When the road gets bumpy: Managing chronic urticaria
May 1st 2000In four out of five children with chronic urticaria, it's not possible to identify a cause. Still, serious problems must be ruled out, triggers sought, and itching alleviated. Here's how to focus the history and physical, decide which tests are and aren't worth doing, and choose the appropriate medications.
Recognizing infection-related arthritis
May 1st 2000Arthritis can be caused by a range of viruses or other infectious agents, or develop in the wake of an enteric, genitourinary, or respiratory tract infection. Knowing the possible causes and typical signs and symptoms of infection-related arthritides helps make the diagnosis.
Prenatal cocaine: What's known about outcomes?
May 1st 2000As new data correct past misconceptions and add new knowledge, it's up to pediatricians to debunk myths about "crack babies," watch for varied developmental consequences in infancy and beyond, and help parents and other caregivers maximize these children's potential.
PEDIATRIC PUZZLER: Persistent fever in a 6-year-old: Licking the diagnosis
April 1st 2000The call at 3 a.m. on a warm May morning is from the emergency department. The ED physician is seeing a 6-year-old with a seven- to 10-day history of fever as high as 105? F, swollen glands, lethargy, and poor oral intake.
Practical approaches to common gastrointestinal symptoms
April 1st 2000Most children with gastroenterologic disorders feel ill because of a complex mix of psychologic, developmental, and social factors. Using several case histories, this specialist shows how focusing on these areaswhich conventional medical management addresses inadequatelyis the key to helping such patients get better.
ITP: How much treatment is enough?
April 1st 2000Idiopathic thrombocytopenic purpura is easy to recognize and generally not serious. Yet specialists differ greatly in their approach to diagnosis and treatment. Review the rationales of the opposing camps, then make up your own mind on which makes better sense.