Reversibility of TPN-Induced Cholestasis
July 27th 2009A 6-month-old boy was hospitalized because of fever and suspected central line sepsis. He had been receiving total parenteral nutrition (TPN) since shortly after birth following a small-bowel resection, which was performed to repair a midgut volvulus. Abdominal ultrasonographic findings after the procedure were normal. The infant was born at term after an uneventful pregnancy and delivery. Alkaline phosphatase and γ-glutamyl transpeptidase levels were elevated, without hyperbilirubinemia. An ultrasonogram showed hyperhomogeneous and nonhomogeneous echogenicities of the liver, consistent with fatty changes and fibrosis.
AAPD revises oral health guidelines for expectant moms
June 15th 2009Modified oral health guidelines from the AAPD include a call for all pregnant women to receive counseling and oral healthcare during pregnancy. Additionally, infants should be given an oral health risk assessment and oral care before their 1-year birthday, according to the new guidance.
Should Pica Lead to Consideration of Lead Poisoning?
June 2nd 2009In their Photoclinic case of iron deficiency in a 4-year-old boy with pica (CONSULTANT FOR PEDIATRICIANS, March 2009, page 104), Drs Ron Shaoul and David Bader do a commendable job of describing pica and of documenting the child’s iron deficiency (Figure). However, I was surprised that the possibility of lead poisoning was not considered.
When You Can’t Pry Those Hiding Eyes
June 2nd 2009When young children have an irritant in their eyes, it can be very difficult to get them to open their eyes so that they can be irrigated. To reduce the stinging and make opening the eyes easier, try putting a drop of an ocular anesthetic in each medial canthus while the child is supine; be sure to wait for it to seep in.