News

"If you are not a lobbyist, you are not doing your job as a pediatrician." That was the blunt challenge from Tom Pendergrass, MD, professor of pediatrics at the University of Washington and chair of the legislative committee of the Washington Chapter of the American Academy of Pediatrics.

Don't use a computer, personal digital assistant (PDA), or other electronic tools at the office and at home? It's time to catch up with your colleague - for good reason!

Headaches are a significant pediatric problem - and pediatricians who don't recognize and treat them aren't doing their job, according to a Stanford University researcher who spoke at the AAP 2004 National Conference and Exhibition Saturday.

Food can keep infants free of allergic disease. The right nutritional choices during the first four to six months of life can mean the difference between a healthy childhood and a progression of atopic disease that can lead to asthma.

Unintended consequences are alive and active in pediatric endocrinology. When the Food and Drug Administration approved the use of growth hormone to treat idiopathic short stature in 1993, pediatricians found themselves trying to decide how short is short enough to treat.

San Francisco City Guide

The 'golden gate' to the Golden State has much to offer explorers, sightseers, history buffs - and everyone else

With dietary vitamins having potent immunomodulating effects in vitro and in animal models, investigators were led to examine whether vitamin supplementation during infancy affects the risk of asthma and allergic disease in early childhood.

Eye on Washington

In the halls of the federal bureaucracy, October 1 is traditionally celebrated as Fiscal New Year's Day, when agencies and departments can start spending the funds Congress has appropriated to run the government.

Your Voice

Flu immunizations, prescribing errors, nail polish, and teething myths.

Waiting until a child gets older before addressing weight concerns may be too late. Routinely assessing weight and providing anticipatory guidance about eating and physical activity can help prevent weight problems from taking hold--possibly for a lifetime.

It is three years now since the calamity of September 11. Three years is long enough for researchers to count the number of children orphaned on that dreadful day and launch the earliest studies of how children react to what these experts call "traumatic bereavement."

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

You've been approached by a surgeon at your local hospital to consult on a perplexing patient: an 8-year-old African-American boy who yesterday was brought to the emergency department with a 20-hour history of abdominal pain. The child could neither localize the pain nor describe its quality. He did not have testicular pain. He had eaten dinner without difficulty the night before presentation but had two episodes of nonbloody, nonbilious emesis on his way to the ED. His mother thought that he felt warm; in the ED, the temperature was 38.4? C.

When a patient comes to me for repair of a scalp laceration, the main issue usually is "am I going to get stitches?" (Sometimes the first words out of the child's mouth are "I am not getting stitches!") I have these situations under control because I know I can repair scalp wounds without using staples, stitches, sterile strips, or surgical glue. Instead, I use the patient's hair and a nylon suture to close small scalp wounds. I learned the technique at a meeting given by the staff of Oakland (Calif.) Children's Hospital more than 10 years ago, and it has served me and my patients well ever since. Before you begin, you may wish to apply LET (lidocaine, epinephrine, and tetracaine) gel or a topical anesthetic cream to the wound at least 45 minutes before starting the procedure to ensure that the patient feels no pain.

RESOURCES

"Go-to" asthma advice in paperback

The RICE (rest, ice, compression, elevation) prescription for strains and sprains works very well if the patient applies enough cold compresses. A common problem with home compliance is that the patient often runs out of ice (or frozen vegetables and other frozen foods often used as alternatives). I advise young athletes to keep a supply of cold packs on hand by folding several clean washcloths or hand towels lengthwise, soaking them in water (and squeezing out the excess to eliminate dripping), then wrapping them in clear plastic wrap and putting them in the freezer. Because the washcloths or towels are folded lengthwise, they aren't bulky and can be molded easily around joints or other curved surfaces such as a knee or thigh. If a cold pack comes out of the freezer too stiff to be practical, the patient can soften it by running tap water over the wrapped surface. The packs remain cold for approximately one hour. Best of all, they can be readily replaced by another pack waiting in the freezer.