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At a time when 18 states are seeking to eliminate Medicaid coverage for circumcision of newborn males and at least 1 city sought to ban the practice, an editorial published in a leading medical journal says that such efforts are wrongheaded and that more should be done to promote the procedure. The authors maintain that hundreds of studies in the last 5 years document the benefits of circumcision. What did those studies find, and should neutral pediatric guidelines be changed?

Addressing health issues affecting your obese patients now instead of waiting until they develop medical conditions later can help save $3 billion in US health costs a year. But you have to be careful how you discuss children’s obesity issues with their parents. What are the terms most likely to be accepted, understood, and acted on?

Now more than ever you are on the front lines in the battle to get children immunized against dangerous diseases. More than 1 in 8 parents have adopted an alternative vaccination schedule for their children, with almost twice that number saying they do not believe the government’s recommended schedule is the best one to follow. You might be shocked to find out how dramatically risk increases when even 1 scheduled vaccine is skipped.

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Deepak Kamat MD, PhDProfessor of Pediatrics Wayne State University Vice Chair of Education The Carman and Ann Adams Department of Pediatrics Children's Hospital of Michigan Detroit, Michigan

Screening adolescents for Bariatric Surgery : When diet, exercise just aren't enough Bats! 3 steps for rabies exposure prophylaxis Dermcase : Atrophic scars and poor wound healing in young boy Puzzler : Abrupt, intermittent pain and fever, but no apparent cause Updates : Infant formula, CDC on Flu vaccination, Medication poisoning, Antibiotics, AAP on Poliovirus, Varicella, Hepatitis A and Tdap

Peds HPV

A Presidential candidate recently made the unsubstantiated comment on national television that the HPV vaccine has "very serious consequences" and that it can cause mental retardation. (Details can be read by clicking here.) We invite you to share your views with other pediatricians about whether such claims by public figures have an impact on the general public's decision to vaccinate. How would you respond to such claims? What will you tell your patients if they ask? Please share your views by clicking here.

Proponents often maintain that basketball is a safer sport for young athletes than rougher activities such as football or hockey. But that is not a slam dunk case, according to a new study, which found that playing basketball can lead to abnormal development of the head of the femur in young players, resulting in a deformed hip with impaired rotation and pain during movement. Read more to discover the longer-term implications of that injury.

The current protocol for HPV 16/18 vaccine, 3 doses over 6 months, can be expensive and inconvenient. Now, a new study suggests that fewer than 3 doses may be just as effective as the standard 3-dose regimen when it comes to preventing cervical cancer with one of the approved vaccines. Find out how this discovery came about and how it potentially could be used to increase vaccination rates.

An unidentified food allergy can be life threatening for some children, but it is not always clear when screening is appropriate. A new study has found that self-reported black race and African ancestry, determined by genetic analysis, were associated with a high number of sensitizations to food, most notably peanuts. See what researchers have to say about the possible relationships between ethnic background and food sensitization.

Treatment guidelines on community-acquired pneumonia (CAP) are very clear on the critical first step: Make sure that your patients are immunized against influenza, a leading cause of pneumonia in children. The guidelines from 2 major infectious disease societies offer other valuable advice to help you diagnose accurately and respond effectively without over treating.

Can providers turn to the courts to block states from making drastic cuts to Medicaid payments? That is the issue to ultimately be decided by the US Supreme Court. The case involves California?s 10% rate cut for Medi-Cal in 2008, which providers claim violates the federal Medicaid Act?s guarantee of equal access to health care. Find out why this case is important and what could happen to Medicaid payments in your state if the court rules in favor of California.

Some 5% of US children will lose a parent during their childhood or adolescence. It often can be difficult for pediatricians to detect when typical grief turns into something more pathologic. A new study offers some information on what is normal and what factors can lead to longer-term depression and dysfunction.

The American Academy of Pediatrics has corrected false campaign statements made this week by Republican presidential candidates that the vaccine for human papillomavirus, administered to girls and young women to protect against cervical cancer, is dangerous and can cause mental retardation.

Pediatricians should just say no to drugs when considering prescribing antibiotics for conditions that don?t usually require them. That?s the position of public health officials who say that pediatricians are doing a better job of limiting antibiotic prescriptions but still have a way to go before reaching appropriate levels of use. Inappropriate use of antibiotics continues unabated in 3 of 5 acute respiratory infections. Find out which ones.

The influenza vaccine?s formulation may be unchanged from last year, but immunity in children can decline precipitously without another dose this year, according to new recommendations. The good news is that kids aged 6 months to 8 years need only 1 dose if they were vaccinated last year; others in that age group will still require 2 doses. Find out what else the new recommendations have to say, especially about immunization for youngsters with egg allergies.

Many pediatricians, especially those in primary care, do not currently employ midlevel providers but do plan to add them, according to recent survey. However, hiring and retaining nurse practitioners and physicians assistants will only get more difficult over the next few years, according to several reports that note that salaries are likely to skyrocket with the shortage of clinicians at that level. Can your practice stay competitive with current salaries and future increases?

The CDC is warning pediatricians to be on the lookout for influenza in patients with recent exposure to pigs after 2 separate cases of swine-origin influenza were identified in children late this summer. Clinicians are being asked to speedily obtain an analysis and to consider starting the patient on antiviral treatment to quickly limit potential human transmission if a case is identified. Find out why these cases are different from other cases of animal-transmitted influenza.

A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse. A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse.

Trichomoniasis in adolescents : Safe and easy screening options Teens and confidentiality : Know the legal challenges in your state EHRs and your pediatric practice : What requirements and costs mean for you Oral contraceptive therapy for teens : 7 strategies for talking to parents who object Dermcase : Maffucci syndrome in a 10-year-old boy Puzzler : Upper extremity hemiparesis in toddler with seizures

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The mission of Contemporary Pediatrics is to provide readers with up-to-date, evidence-based information that will inform and enhance medical care for children.