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A gentle, patient approach is important when examining a prepubertal girl. Pay special attention to anatomic and pathophysiologic differences in the child. Emphasize setting the stage to make the examination a positive experience for your young patient.

Medicine-pediatrics, the child of pediatrics and internal medicine, has become a young adult, and its parents can be proud of its achievements to date. This expert's crystal ball shows a rosy future as well

It was once the only way to treat acute otitis media. Now it's more useful than ever, the author argues, especially in light of increasing antibiotic resistance. Learn what tympanocentesis can do for your patients and how to perform it in the office.

Every day pediatricians must diagnose middle ear disease and decide whether to prescribe antibiotics. To help meet this challenge, consider using the technologies described here--tympanometry, spectral gradient acoustic reflectometry, and distortion product otoacoustic emissions audiometry.

Physicians have known for three decades that taking high doses of oral contraceptive pills afterunprotected intercourse can prevent ovulation and implantation. Isn't it time you considered offering adolescent patients this effective means of avoiding unintended pregnancy?

A 14-year-old is referred to your emergency department for evaluation of recurrent episodes of abdominal pain. Over the past year he has had five such episodes, separated by symptom-free intervals of about two months. The pain has been consistently periumbilical, without radiation or localization, and each of the five instances of pain has been associated with a bifrontal headache. The last episode before the present one, two months ago, was the first associated with fever.

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We speak a common language when we discuss and try to provide optimal health care for children. However ambiguous and misleading those other words may be, "pediatrician" is a word we understand.

Most eye defects in children are correctable, but delay can lead to permanent vision loss. Pediatricians must check young infants and preschoolers and not wait for school exams to identify problems.

Croup sometimes resembles more serious disease, and management options range from home treatment with mist to PICU admission. The authors explain how to recognize viral croup, review the latest studies on when to use nebulized or systemic steroids, and suggest common-sense criteria for hospitalization.

Why are more parents than ever complaining that their children are out of control? One reason, this authority suggests, is a lack of parental effectiveness or "presence."It follows that strengthening this quality in the parent may be the best way to help the child.

Rotavirus vaccine has just been added to the recommended immunization schedule. Learn the characteristics of this new vaccine and how to administer it in your practice.

Whether to circumcise a newborn son is one of the first decisions parents must make for their child. Pediatricians can help them sort through the confusion and controversy surrounding the issue by providing accurate information and answers to their questions.

Despite promising developments such as the new rotavirus vaccine, acute diarrhea won't disappear from pediatric practice any time soon. This straightforward strategy for office management rests on the cornerstones of oral rehydration and continued feeding.

With more babies being put to sleep in the supine position, pediatricians increasingly are seeing infants whose skulls are flattened in back. You need to distinguish these children-- whose "flat heads" merit mainly parental reassurance--from the occasional child whose misshapen skull calls for referral and surgical intervention.

The youngster's primary pediatrician found only some abdominal bloating thought to be related to the constipation. This morning new symptoms appeared: yellowish-green rhinorrhea and a cough, which resulted in one episode of vomiting. The abdominal pain has continued, and the youngster has been walking leaning forward.

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Is that "bruise" or "burn" really a sign of child abuse? To avoid a misdiagnosis that can have profound consequences for the child, family, and suspected perpetrator, be sure you consider the full range of possibilities.

Is MIS the best bet for a patient with Hodgkin's disease who needs a splenectomy? What about an ordinary hernia repair, or a child who may have appendicitis, or the teenager who might have an ectopic pregnancy?

Mucking the stalls without the help of creatine

In this symposium, two obstetricians and a pediatrician reflect on more than two years of experience with the CDC guidelines for prevention of perinatal Group B streptococcal disease. They address the effectiveness of prophylaxis, unforeseen problems with the guidelines, and more.

During a routine well-infant visit the mother of a smiling, chubby 9-month-old expresses concern about his noisy breathing. She states that her son has had noisy breathing since birth; in fact, the nurses in the well-baby nursery thought that he was very "mucousy." The mother calls the noisy breathing a "rattling in his chest" but denies that her son has had a chronic cough or wheezing.