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If the promise of new vaccines, such as Gardasil, is to be achieved, pediatricians and family physicians must be relieved of the burdens associated with purchasing and administering them.

An almost 7-year-old girl was referred to Child Protective Services for evaluation of suspected sexual abuse after a school nurse noticed marks on her neck (Figure). The nurse was concerned that the marks were "hickeys," or suction marks, made by another person's mouth.

We, as physicians, complain about patients not following our advice and not listening to us. We should not forget that they are listening, that our words are not ignored, and that therefore, they should be well chosen.

A 3-month-old infant presented with a 4-week history of a symmetric skin eruption on her face, axillae, distal extremities, and external genitalia. The infant was otherwise healthy, although colicky since birth. She was exclusively breast-fed and had a good appetite. Voiding and stooling patterns were normal. Her growth was appropriate for age.

A 14-year-old girl came to the office with severe hip pain, which occurred after she attempted a cheerleading maneuver on a trampoline. She reported that she was bouncing as high as she could and landed on the trampoline with her left knee flexed and her right hip extended. On impact, she felt a "pop" that was immediately followed by right hip pain. She could barely move after the landing but managed to get off of the trampoline; she has been walking with pain since her injury.

Patient delivered vaginally at term to a G2P1 24-year-old mother following an uncomplicated pregnancy. Apgar scores, 7 and 9 at 1 and 5 minutes, respectively. No history of maternal exposure to teratogens. Parents non-consanguineous. No family history of congenital or chromosomal abnormality.

The use of a colorful, easy-to-read, two-page visual handout can decrease post-operative phone calls about side effects of minor concerns that occur following the removal of tonsils, a study presented in Toronto at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation has found.

A recent survey of 43,000 adults in the United States showed that those who begin drinking alcohol in their early adolescent years are at greater risk of an alcohol-related problem later. Furthermore, those who abused alcohol during their adolescent years were not only at greater risk of alcohol dependence at some point during their life but were also at greater risk of, first, dependence more quickly and at a younger age and second, chronic, relapsing dependence. Among all respondents who developed alcoholism at some point, almost half-47%-met diagnostic criteria for alcoholism by the time they were 21 years old.

Water birth: What you should know

What is causing a boy's fear of water and how can I help?

The insurance reimbursement situation, pay for performance, and expensive technology have made it harder than ever to choose the most appropriate ethical course.

Many hospitals and birthing centers offer this controversial birthing method to reduce the stress and pain of labor. But questions about safety persist. Includes a Guide for Parents.

We are not yet sure how much vitamin D a growing child needs, but we do know that most need more than they get. New recommendations are forthcoming but, until they are formulated, pediatricians should encourage maximal vitamin D intake from food, supplements, and outdoor activities whenever possible.

A "rung bell" is common and can do significant acute and long-term harm to a developing brain. Because no guideline or protocol has been adequately studied for application to children and adolescents, take a cautious approach to management of concussion in youth, the author advises.