February 10th 2025
Get caught up with Contemporary Pediatrics! This list helps you navigate our top stories from the week, all in one place.
Cystic Fibrosis: Classic Radiographic Findings
January 1st 20081. The chest radiographs (Figure 1) of a 9-year-old child reflect the classic findings of a particular disease. Among other findings, the size of the patient's heart is_____? A. Enlarged. B. Small to normal. C. Consistent with early failure. 2. If you were to see calcifications in the abdomen (none are present in this case), they would probably be caused by which of the following? A. Previous adrenal hemorrhage. B. Gallstones. C. Splenic granulomas. 3. Is there evidence of hyperinflation? A. Yes . B. No. 4. Do you see acute findings? A. Yes. B. No. C. Cannot be determined. 5. Which of the following organisms are common culprits in this condition? A. Pseudomonas aeruginosa. B. Burkholderia cepacia. C. Staphylococcus aureus. D. All of the above, and then some.
Peanut Allergy: Earlier Exposure-Earlier Reactions
January 1st 2008With the banning of peanut butter and jelly from someschool cafeterias, peanut allergies have become a populartopic in the media and the public. Discussions ofteninclude references to an increasing prevalence ofallergies, as well as to an earlier emergence of thoseallergies in children.
Eczema Herpeticum: A Manifestation of Hyperimmunoglobulin E Syndrome
September 1st 2007A 4-year-old girl presented with a sore throat, dysphagia, fever (temperature up to 40°C [104°F]), and a pruritic vesicular rash. On the first day of the illness, 4 days earlier, she was evaluated by her pediatrician who prescribed azithromycin for a presumed upper respiratory tract infection. About 2 days later, a papular rash developed on the abdomen and perioral skin; the fever had persisted, and the child's oral intake had decreased. The next day, the rash continued to spread, and the patient refused to take anything orally, including fluids. The mother thought that the rash was a hypersensitivity reaction to the antibiotic.
Toxic Epidermal Necrolysis Secondary to Anticonvulsant Medication
August 1st 2007A 15-year-old girl was brought to the emergency department because of bilateral shoulder and hip pain associated with myalgia and fatigue. The symptoms had been present for 2 months and had increased in intensity over the past few days. The patient had systemic lupus erythematosus, asthma, and seizure disorder.
TTN--A Benign Condition or Precursor to a Chronic Illness?
August 1st 2007Transient tachypnea of the newborn (TTN) has traditionally been seen as a benign, self-limited disorder that occurs within a few hours of birth and resolves within 72 hours. For years, we have been telling parents that this innocent condition has no long-lasting effects and is nothing to be concerned about. According to a recent study in The Journal of Pediatrics, however, we may need to rethink that advice.
ADHD and the Adolescent Driver:
February 1st 2007ABSTRACT: Adolescent drivers with attention deficit hyperactivity disorder (ADHD) are more likely to be involved in--and to die of--a driving accident than any other cause. The higher occurrence of driving mishaps is not surprising given that the core symptoms of ADHD are inattention, impulsivity, and hyperactivity. Safe driving habits can diminish the risk, however. The first step is to inform patients of the dangers of driving; the significance of adolescence, ADHD, and medication can be underscored in a written "agreement." Strategies to promote safer driving--especially optimally dosed long-acting stimulant medication taken 7 days a week--may be critical. A number of measures lead to safer driving by reducing potential distractions during driving (eg, setting the car radio before driving, no drinking or eating or cell phone use while driving, no teenage passengers in the car for the first 6 months of driving, and restricted night driving).
How Old Is Old Enough to Report on Asthma Symptoms?
February 1st 2007One of the most common illnesses we treat in general pediatrics is asthma-often in children who have not yet entered their teen years. While we ask the parents what symptoms they have noticed in their child, we don’t always ask younger children directly. How reliable are their answers?
Foreign-Body Aspiration: A Guide to Early Detection, Optimal Therapy
January 1st 2007ABSTRACT: Because foreign-body aspiration can cause symptoms that mimic those of other respiratory conditions, a high index of suspicion is crucial in all children who have pneumonia, atelectasis, or wheezing with an atypical course--especially when these conditions are unresponsive to usual medical therapy. A history of choking can usually be elicited in a patient who has aspirated a foreign body: such a history should be sought when respiratory symptoms develop suddenly. However, the absence of a choking history does not rule out foreign-body aspiration. Moreover, patients may be asymptomatic initially. Normal radiographic findings do not exclude an aspirated foreign body. Bronchoscopy should be strongly considered when an aspirated foreign body is suspected, even if radiographic images show normal findings. Rigid bronchoscopy is the procedure of choice for removing aspirated foreign bodies in children. Prevention of foreign-body aspiration can be enhanced through anticipatory guidance of parents/caregivers and through continued product safety efforts.
Foreign-Body Aspiration: A Guide to Early Detection, Optimal Therapy
January 1st 2007Foreign-body aspiration is a relatively common occurrence in children. It may present as a life-threatening event that necessitates prompt removal of the aspirated material. However, the diagnosis may be delayed when the history is atypical, when parents fail to appreciate the significance of symptoms, or when clinical and radiologic findings are misleading or overlooked by the physician.
Herpes Zoster (Shingles) in a Teenager
October 1st 2006Sixteen-year-old with a recurrent, painful, pruritic rash on right cheek and right eyelid. Current outbreak started 2 days earlier. The rash always appears in the same fashion and in the same location; it typically lasts a few days and resolves spontaneously.
Case In Point: Spontaneous Pneumothorax in a Teenage Boy
September 1st 2006A 17-year-old Asian male with no significant medical history presented to the emergency department (ED) with acute shortness of breath and associated left-sided chest pain. Symptoms began while the patient was at rest: the pain was sharp and worsened with inspiration. He denied a history of fever, trauma, cough, or any other constitutional complaints.
Pediatric Chest Pain: Keys to the Diagnosis
Chest pain in children evokes anxiety in patients and their parents--and prompts frequent visits to the pediatrician's office, urgent care facility, or emergency department (ED). In a prospective study, Selbst and colleagues reported that chest pain accounted for 6 in 1000 visits to an urban pediatric ED.
Juvenile Plantar Dermatosis and Seborrheic Dermatitis
August 1st 2006For several months, a 12-year-old boy has been bothered by intermittent pruritus of the feet. He is very active in sports all year, and his feet tend to perspire heavily. He has a family history of seasonal allergies. He says that the rash worsened after he used an over-the-counter hydrocortisone cream.
ADHD: A Guide to Assessment and Diagnosis
August 1st 2006Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed bio-behavioral disorder of childhood. It occurs in 6% to 9% of children--about the same prevalence as childhood asthma. It is also one of the most controversial diagnoses in children; parents are often perplexed about whether ADHD is underdiagnosed or overdiagnosed, or undertreated or overtreated. A good deal of this confusion stems from the fact that there are no laboratory tests, imaging studies, or psychological testing profiles that can be used to make the diagnosis.
Nasal Allergy and Sinus Infection: The Link--and Therapeutic Implications
June 1st 2006The prevalence and incidence of sinus infection, or sinusitis, is increasing and has been estimated to affect 31 million persons in the United States each year. It is one of the most common reasons why patients seek a physician's care. If left untreated, sinusitis can cause significant physical symptoms and can negatively affect quality of life by substantially impairing the daily functioning of sufferers. For children, this can mean learning difficulties at school and for adults, a loss of efficiency at work.
Chronic Cough in Children: New Guidelines Offer New Direction
April 1st 2006Until very recently, when it came to chronic cough, children were to be treated like little adults. In its 1998 guidelines on cough, the American College of Chest Physicians (ACCP) stated that "the approach to managing chronic cough in children is similar to the approach in adults."