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My daughter has been overweight her whole lifeand is always the largest kid in class. She’s juststarted high school and wants so badly to feelattractive, yet she cannot bear trying anotherweight loss program. At 5 ft 6 in, she weighs262 lb. Can you refer her to a surgeon so she canhave the operation that helps her lose weight?

The areas of hyperpigmentation shown here on the trunk of a 15-year-old girl appeared 2 years earlier as 1- to 2-mm hyperpigmented papules with either flat or verrucous surfaces.

A 16-month-old girl was initially brought to her primary care physician because of persistent nonproductive cough of 1 to 2 weeks’ duration, with lethargy, poor feeding, and worsening cough for the past 36 hours. She had been afebrile. The patient was noted to be pale and had a decreased level of interaction. She was promptly sent to the local emergency department. Laboratory studies showed a hemoglobin level of 3.8 g/dL and hypochromic microcytic anemia. The patient was subsequently transferred to the pediatric ICU for evaluation.

An overweight 13-year-old girl, with a body mass index of 29, presented with a lump in her axilla for the fourth time in the past several months. This time, the lump recurred in the left axilla; it had developed in the right axilla on 2 other occasions.

Read reviews of "Caring for Your Baby and Young Child: Birth to Age 5;" "Mental Health, Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body;" "Raising Twins: From Pregnancy to Preschool;" and books by Mary Mahony.

A physician in his mid-40s, Dr. Rifkin presumably may be roughly midway through his career as primary care pediatrician. And this has led to some personal reflections about being a pediatrician.

FDA has approved InnoMed's Nasal-Aire II Petite for continuous positive airway pressure (CPAP) therapy for the treatment of obstructive sleep apnea in children aged older than 7 years or weighing more than 40 lbs.

You are the senior resident covering the pediatric intensive care unit (PICU) when you receive a call from the emergency department (ED) regarding a nearly 14-year-old Caucasian female patient with a diagnosis of "acute abdomen and suspected septic shock." Ten days before admission, she had had a lipoma removed from her back under general anesthesia.

A 6-year-old girl has peeling soles on her feet. Although the peeling is not usually symptomatic, her feet become cracked, fissured, tender, and occasionally infected during the middle of the winter and summer.

Paraphimosis

A 2-year-old boy presented with paraphimosis.This condition occurs when retraction of the foreskin behind the corona of the penis forms a tight ring that impairs blood and lymph flow from the glans and prepuce. Untreated, paraphimosis can lead to pain, urethral obstruction with urine retention and hydronephrosis, or tissue ischemia (with ulceration, penile gangrene, and auto-amputation of the penis).