News

Munchausen syndrome by proxy is a complex of diagnostic contradictions, tangled parental interactions, charged emotions, and significant clinical discomfort. It's a problem that takes you beyond pathophysiology into shades of gray of the mind. The central goal of intervention is, always, the child's well-being.

A careful history, thorough physical examination, and limited diagnostic studies often point the way to the cause and successful treatment of this distressing disorder.

Vulnerable child syndrome distorts parents' perceptions of their child's health, disrupts the parent-child relationship, and can harm development and behavior in an otherwise healthy child. Here are steps you can take to recognize problems early and improve family interactions.

What's causing chronic, intermittent abdominal pain radiating to both flanks in a 15-year-old girl?

A solicitation of medical advice over dinner with a new acquaintance is cause for discomfort.

The April issue of Consultant For Pediatricians included a case of a 12-year-old girl with poliosis. The author, Bhagwan Das Bang, MD, noted that poliosis is associated with ocular chronic staphylococcal blepharitis, Waardenburg syndrome, Marfan syndrome, vitiligo, and Vogt-Koyanagi syndrome.

Several asymptomatic, erythematous papules and plaques had appeared on the hands of an otherwise healthy 11-year-old girl. The personal and family medical histories were noncontributory. A punch biopsy from the largest lesion on the palm confirmed the clinical diagnosis of localized granuloma annulare, a self-limited inflammation of the dermis

The "A" in the title stands for acrodermatitis enteropathica, an uncommon underlying cause of diaper dermatitis (DD). The "Pee," the colloquial term for urine, is probably the most common irritant (along with feces) that contributes to the breakdown of skin in the diaper area.

A 5-year-old African girl, whose family lived in France, was brought to the emergency department of our hospital during a family visit to the United States. The child had a 1-week history of difficulty in swallowing, a temperature of up to 38.3°C (101°F), and rhinorrhea. She had lost 4 lb during the week. According to her mother, the patient had no history of cough, nausea, vomiting, diarrhea, abdominal pain, or sick contacts.

Pediatricians are getting fed up with how much they still seecharacters smoking in motion pictures, reports Stanton A. Glantz,PhD, professor of medicine at the University of San Francisco.Speaking at a podium session at the Pediatric Academic Societies2006 Annual Meeting in San Francisco, on April 29, Dr. Glanz wenton to call smoking in films "a continuing danger to today'syouth."

AstraZeneca announced earlier this month that the FDA hasapproved the use of esomeprazole magnesium (sold as Nexium)delayed-release capsules for short-term treatment ofgastroesophageal reflux disease (GERD) in children 12 to 17 yearsof age.

The era of the personal health record has arrived, and its usewill only grow, so you should learn now what a PHR is, what it isnot, and what impact it will have on your practice. That was theprescription offered by Kathy Giannagelo, RHIA, CCS, of theAmerican Health Information Management Association in Chicago in atalk given at the American College of Physicians Annual Session inPhiladelphia, April 6-8.

Two studies—one in Europe, one in the UnitedStates—have independently reached the conclusion that childrenwhose cavities are filled with dental amalgam aren't at risk ofrelated adverse health effects. The news comes from scientists whoreported their findings, in the April 19 issue of the Journal ofthe American Medical Association, on the first randomized clinicaltrials to evaluate the safety of placing amalgam fillings thatcontain mercury in the teeth of children. The research wassupported by the National Institute of Dental and CraniofacialResearch (NIDCR), part of the National Institutes of Health.

Guide for Patients: On the Web: Health resources for male adolescents (PDF)

Guide for Parents: Easy ways to avoid a tick bite (PDF)

A structured psychosocial interview allows you to assess if, and how, a male teenager’s lifestyle or home and school environment pose a risk to his mental and physical health. The authors show you the right questions to ask and how to ask them – the keys to getting your patient to open up.

What's causing a 7-month-old boy to be hospitalized for failure to thrive, recurrent wheezing, and bilateral infiltrates refractory to antibiotics?

There are no easy answers when it comes to mandatory testing ofnewborns for HIV. In a year when about 250 US infants are expectedto be born HIV positive with no advance warning or maternaltesting, ethics, politics, and costs are colliding in an explosionof argument, opinion, and data.