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Allow me to add to Dr. Zuckerman's recommendations for the 4-year-old girl who refuses to use the toilet anywhere but home (Behavior: Ask the experts, June 2005).

Q. A 4?-year-old boy in my practice has an array of complaints—clothing sensitivities, eye itching, food aversion, and tics, to name a few. The tics began at age 3 with eye blinking, which subsided after six months, followed by snorting, which lasted three months. His tics are now at their worst.

Free software for an electronic medical record, CME on CAM, West Nile virus returns

It's difficult to imagine pediatrics today without PNPs.

For several days, a 9-year-boy has had painful swelling on the top and left side of his forehead, bilateral eye swelling, intermittent fever, and nasal congestion. He was seen in the office 4 weeks earlier, after he had hit his left eye on a school desk. At that time, he presented with a left retro-orbital headache, nasal congestion and discharge, and intermittent fever.

"Jennifer is bleeding," confides Mrs Smith outside the door to her daughter's clinic room. "She's really embarrassed to discuss it with anyone but I'm really worried. Do you think that she is having sex?" You listen to her concerns and learn that Jennifer's last menstrual period has lasted approximately 3 to 4 weeks. Jennifer and her mother came to the pediatric clinic today after Mrs Smith found multiple menstrual pads in the bathroom wastebasket every day for several days.

There's but limited advice you can dispense to parents of your patients who have a potentially life-threatening food allergy: Avoid, avoid, avoid! Yet there's cause for optimism today among stymied clinicians and the four percent of Americans who have a food allergy—often to nuts or shellfish: a new Food Allergy Research Consortium convened at the end of June by the federal government, and led by a prominent pediatrician and food allergy expert, has been charged with, first, conducting basic, clinical, and epidemiologic studies aimed at developing therapies to treat and prevent food allergy and, second, developing educational programs aimed at parents, children, and healthcare providers.

These continue to be less-than-happy times in certain corners of the pharmaceutical industry. Day by day, bad news accumulates. Even the industry's trade organization, the Pharmaceutical Research and Manufacturers Association (PhRMA), acknowledges that something has to give. Where are the unpleasantness and pressure coming from?

The American Medical Association (AMA) has released new directives to help fight childhood obesity and promote healthier lifestyles in schools across the country. In one of the planned efforts, AMA will develop a school health advocacy agenda that includes funding for school-based health programs, physical education and exercise (with stricter limits on declining participation), alternative polices for vending machines to promote healthy diets, and standards for healthier school lunches. The directives also encourage physicians to collaborate with communities to help develop health programs in schools."Children spend the majority of their productive time in the classroom, so we must improve access to healthy food and encourage more physical activity in school," said AMA Trustee Ronald M. Davis, MD. "Focusing our efforts on nutrition and exercise in schools can help prevent obesity and overweight in many children who may be at risk."

Your latest case: A 3-month-old girl with a pink, macular, anterior inguinal rash with satellite lesions that suggests diaper candidiasis, and a firm, nontender, 1 x 1-cm mass in the right inguinal area that is freely mobile.

Picky eating and the power of persuasion. Tongue-tie is an obstacle to breastfeeding.

What right does a teenager have to confidential health care? What influence does HIPAA exert on that right? How you apply the answers in your practice could determine whether an adolescent seeks health services-or forgoes necessary care.

The incidence of community-based methicillin-resistant Staphylococcus aureus (MRSA) infection in healthy children is increasing. This review discusses possible reasons for that rise, reviews antibiotic susceptibility patterns, and presents management guidelines.

Recognize this social anxiety disorder and treat it early to help prevent long-term dysfunction.

Fireworks light up the night sky, justice softens in a tobacco suit, high court nixes medical marijuana