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Jean Someshwar, MD



Adolescent Confidentiality: Where Are the Boundaries?

May 01, 2009

The angry mother of a 15-year-old girl has called the office multiple times asking for the laboratoryresults from her daughter’s office visit last week and demanding to know whether the teen was “put on the pill.” Along with other lab work, tests for sexually transmitted infections (STIs) and pregnancy were performed, and the patient was given a prescription for a hormonal contraceptive.

Cerebral Palsy: A Multisystem Review

June 01, 2007

ABSTRACT: Most cases of cerebral palsy (CP) are the result of congenital, genetic, inflammatory, anoxic, traumatic, toxic, and metabolic disorders. A minority of cases result from asphyxia at birth. Nearly three-quarters of children with CP aged 7 years had a normal neurological evaluation at birth. Abnormal motor development usually provides the first diagnostic clue. Neuroimaging is recommended if the cause of CP has not been established with perinatal imaging. MRI is preferred to CT. Management of the multisystemic manifestations begins with a comprehensive medical evaluation by a multidisciplinary team that includes family members. Therapy is aimed at maximizing the patient's level of function. Key areas include ambulation, cognitive skills, activities of daily living, hygiene, and rehabilitation into society.

Case in Point: Ups and Downs of Trampoline Use

December 01, 2006

A 14-year-old girl came to the office with severe hip pain, which occurred after she attempted a cheerleading maneuver on a trampoline. She reported that she was bouncing as high as she could and landed on the trampoline with her left knee flexed and her right hip extended. On impact, she felt a "pop" that was immediately followed by right hip pain. She could barely move after the landing but managed to get off of the trampoline; she has been walking with pain since her injury.