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Linda S. Nield, MD


PO 207


Newborn With Urinary Dysfunction

March 07, 2011

During circumcision, a newborn is noted to have continuous dribbling of urine from his meatus and stool from his anus. After several minutes of observation, the urinary stream appears weak and remains a constant trickle. The baby boy was born at term via an uncomplicated spontaneous vaginal delivery.

Abdominal Mass in Teenage Girl: Hair's the Diagnosis

February 08, 2011

A 14-year-old girl had fatigue, a slight sore throat, and low-grade fever for a week. The mother was concerned that she had “mono” like her older sister who had the same symptoms and in whom the illness was diagnosed 2 months earlier.

Vaccinating theImmunocompromised Child

October 02, 2009

Given the array of childhood disorders that can adversely affect the immune system, most pediatricians at some point will care for children who are immunodeficient.

Polycystic Ovary Syndrome

November 01, 2008

A 13-year-old girl presented to her primary care pediatrician for continuing evaluation of intermittent right lower quadrant and right hip pain of 7 months' duration. As part of the workup, a pediatric orthopedist had ordered an MRI scan of her pelvis. The findings were normal except for the presence of multiple ovarian follicles bilaterally (Figures 1 and 2).

Strabismus: What to Tell Parents and When to Consider Surgery

June 01, 2008

Alignment. Accommodative esotropia is treated initially with glasses. The glasses may not improve visual acuity. They are used so the child does not have to make the accommodative effort; the eyes may not "turn in" and the child can use the eyes together, binocularly. If the eyes are aligned with spectacle correction, surgery may never be required. However, if the eyes are not aligned with glasses and/or bifocals, or if the child cannot be weaned from bifocals as he or she grows, then surgery may be indicated. We all lose our ability to accommodate for near tasks as time goes by-the loss of accommodative effort over time is of benefit to children with accommodative esotropia, because they may outgrow the need for glasses and avoid muscle surgery.

Boy With Extraordinarily High Blood Lead Levels

April 01, 2008

A 9-year-old asymptomatic boy was referred to our tertiary care facility with a blood lead level (BLL) of 59 ?g/dL. A diagnosis of attention deficit hyperactivity disorder, which was managed with amphetamine/dextroamphetamine, had been made when the patient was 6 years old.