Obstetrics-Gynecology & Women's Health

There will be many new vaccines and new vaccine recommendations over the next three years or so, two of the top experts in the vaccine arena reported today at the AAP National Conference.

Prompt diagnosis and treatment of what was once considered a rare disorder of early childhood can eliminate symptoms and prevent long-term problems, such as osteoporosis and intestinal cancer.

Breast is best but success isn't a given. These guidelines help you encourage mothers to breastfeed and give them the support they need to do well--without short-changing reimbursement.

Contrary to earlier findings, inhaled nitric oxide (NO) therapy for lung immaturity in premature infants does not reduce an infant's risk of death or further lung problems, according to a study by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health that appeared in the July 7 issue of the New England Journal of Medicine. "Premature infants weighing less than 1,500 g should not receive inhaled NO therapy unless they are part of a research study," said NICHD Director Duane Alexander, MD.

Your latest case: A 3-month-old girl with a pink, macular, anterior inguinal rash with satellite lesions that suggests diaper candidiasis, and a firm, nontender, 1 x 1-cm mass in the right inguinal area that is freely mobile.

What right does a teenager have to confidential health care? What influence does HIPAA exert on that right? How you apply the answers in your practice could determine whether an adolescent seeks health services-or forgoes necessary care.

Anyone who is instrumental in helping a resident achieve the goals of learning enough to be an excellent pediatrician while doing everything possible to provide knowledgeable care for sometimes extremely ill patients, is an important link in the chain from one class of new pediatricians to the next.

Pediatricians need a keen understanding of the variables that influence how phototherapy lowers the bilirubin level and of how to deliver an optimal dose of light.

Women "tend to deny" drinking during pregnancy when asked directly by their physician, but screening using a new software system can make a significant difference in identifying women who consume alcohol while pregnant, said Margaret Rodan, MD, Georgetown University, Washington, D.C., at the PAS 2005 Annual Meeting. Health-care providers can then target those women for intervention.

A vaccine for the human papillomavirus virus (HPV) will likely be available within two to four years and will probably be targeted to preadolescent children. Given the need for the consent of parents to administer the vaccine in that population, parents will play a key role in how widely accepted the vaccine is.

Fewer than one in every 1,000 deliveries is stillborn but, of those that are, little is known about survival and neurologic outcome. Currently, the International Liaison Committee is considering a proposal to stop resuscitative efforts after 10 minutes on stillborn babies, even though most respond to resuscitative treatment beyond that time.

Extreme hyperbilirubinemia must be treated swiftly to prevent neurologic damage. Here are methods for determining a newborn's likelihood of developing severe jaundice and guidelines for treating those judged at greatest risk.

Yes, jaundice in newborns is prevalent and usually benign, but these babies still need ongoing clinical assessment. Part 1 reviews ways to identify and categorize hyperbilirubinemia and sets out the testing that a jaundiced infant requires.

Despite a reputation as a "safe"sport, soccer is associated with a variety of acute and overuse injuries. This overview helps you diagnose, manage, and refer these problems, and clarifies how to prevent them.

Your patient in the emergency department today is a 5-day-old girl brought in by her parents because of an episode of what they describe as "shaking." First, they tell you, she had an episode of choking and gagging during a feed, accompanied by noises resembling the hiccups. Shortly afterward, she developed rhythmic twitching of the arms and legs.

Early signs of bilirubin-induced neurologic damage in healthy term and near-term newborns are often vague. A comprehensive approach to management helps prevent rapid progression and irreversible consequence.

With the recent licensing of conjugated, quadrivalent meningococcal vaccine (MCV4) and likely approval of other "childhood" vaccines to prevent disease during adolescence and adulthood, the national immunization program ventures onto new ground.

High blood pressure in an infant can be the presenting sign of serious illness. Here’s a road map for how to proceed-from making the diagnosis to finding and treating the cause.

Music, carefully selected, may reduce stress, enhance relaxation, offer distraction from pain, and even improve cognitive performance. So, should you be prescribing tunes for tots?

An 11-year-old girl reports that she has experienced genital itching and pain for several months. The pain is especially intense when she wipes herself after urinating.

Here is startling news: Much of what you know about childhood and adolescent vaccines is passing out of date. New vaccines in development and new mortality data mean that recommendations for vaccination against influenza, hepatitis A, meningococcal disease, varicella, human papillomavirus, and rotavirus are on the move.

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

Putting their baby in day care is an emotional occasion for parents, as well as a subject that often comes up during office visits. You're in an opportune position to provide advice and support on returning to work and finding the best child-care arrangement for the family.

Teething has long been the subject of superstition, speculation, and opinion, but little research. So, what do we know, and how can we best advise parents?

The daunting number and diversity of neonatal and infant eruptions, nodules, and other lesions that the author describes will readily submit to his novel algorithm for classification and identification.

Respiratory signs and symptoms in newborns may reflect a problem that requires treatment or referral. A systems-based approach will help you recognize true respiratory distress and keep evaluation and management on track.