The irides of a legally blind 19-year-old woman had been absent since birth. When she was 6 weeks old, her parents noted that she was not focusing on objects the way her siblings had. They consulted an ophthalmologist who diagnosed aniridia. The woman is able to read book print close up and can ambulate independently, although she has difficulty at times, such as when stepping off a curb in unfamiliar surroundings.
For 3 days, a 10-year-old girl had redness and vesicles on her right volar wrist. She had not had any pain, fever, or other systemic symptoms.
This lesion has developed over the past 6 months on a 6-year-old's nose. It measures 3 mm and is reddish brown with a regular border.
A 14-year-old girl presented with concerns about a "deformed" right shoulder. Despite the fact that there was no associated weakness, the defect made her self-conscious. She denied recent trauma to the site and severe physical exertion.
The mother of this 3-month-old girl was concerned about her baby's diffuse, gradual loss of scalp hair. The infant was otherwise healthy and was feeding normally.
Over the past 5 to 10 years, there has been an increasing incidence of synthetic "club" drug or "designer" drug use that has quietly permeated the adolescent and young adult culture. This review of MDMA, also known as "Ecstasy," ketamine, GHB, and methamphetamine, provides a basic introduction to help practitioners get "up to speed."
ABSTRACT: Asthma is a very serious yet very controllable illness. In acute exacerbations, bronchospasm can be reversed with nebulized albuterol (2.5 to 5 mg); give 2 additional treatments at 20-minute intervals and then every hour for the first few hours until wheezing resolves. Subcutaneous terbutaline and epinephrine are alternatives. Systemic corticosteroids may be needed to manage the acute attack (eg, 2 mg/kg of oral prednisone or pred-nisolone). In addition, an anticholinergic agent (eg, inhaled ipratropium) may be used. IV magnesium (25 to 50 mg/kg) and heliox have shown promising results in acute asthma. Maintenance therapy is indicated when daily symptoms occur more than twice per week or when nighttime symptoms occur more than twice per month; such therapy may also be warranted for an infant with exacerbations that occur less than 6 weeks apart or more than 3 times per year, or when other risk factors are present. Inhaled corticosteroids are the cornerstone of maintenance therapy and are mandatory for all patients with persistent asthma. Alternative treatments for children younger than 5 years include cromolyn and an oral leukotriene modifier (montelukast). Patient and parent education helps ensure proper drug administration, monitoring, and compliance.
A 12-year-old boy was brought by ambulance to the emergency department (ED) with fever and shaking of 3 days' duration. He was accompanied by his mother. The boy had spent the weekend at his father's home when he began to feel sick. Since returning to his mother's house, he has been lethargic and has had one episode of vomiting.
The patient is a female neonate who weighed 2210 g at birth. The mother is an 18-year-old Mexican American (gravida 1, para 0, rapid plasma reagin-nonreactive, rubella-immune, and hepatitis B surface antigen-negative) who has had no regular prenatal care. She was admitted via the emergency department to labor and delivery after spontaneous rupture of fetal membranes at home.
If the infectious agent is penicillin-sensitive and especially if the patient responds well to penicillin VK with each episode, would a longer course of penicillin be a more effective treatment?
