News

From the point of view of a pediatric practitioner, little changed in the work of the federal government since being reviewed in these pages last month.

How should pediatricians be prepared for the prospect of community-acquired methicillin-resistant Staphylococcus aureus?

Prophylactic antibiotics have long provided asplenic children with a measure of protection against bacteremia and sepsis. Recent progress in vaccines promises to strengthen the defense.

Can 6-year-old head banger be stopped?

Appropriate evaluation and treatment of fractures of the distal radius, elbow, clavicle, and tibia hinge on the clinician?s recognition of mechanisms and patterns of injury and physical and radiographic findings.

Increased use of fluoroquinolones has been associated with some decreased susceptibility to these agents among Streptococcus pneumoniae. Consider the potential for a further increase in the prevalence of antimicrobial resistance, as well as safety concerns in children, when prescribing fluoroquinolones.

Pediatric Puzzler: Respiratory distress (respiratory depression secondary to opiate ingestion)

The pioneering use of a health educator has helped this small, rural pediatric practice realize its medical mission and its business goals. The clinic's experience, the authors assert, can be applied anywhere.

Pediatricians increasingly are recognizing a mandate to treat pain aggressively. Psychotropic drugs have new pediatric uses, broadening clinicians' options.

We now understand the importance of controlling pain in children, and we understand better how to control it safely.

Wheeler D et al: Arch Dis Child 2003;88:688

Q I have treated an 8-year-old boy and his 5-year-old sister in my practice for the past two years. They have always been healthy and seem to have good interactions with each other, their mother, and me when they are in the office. However, at a routine well-child examination, the boy's mother informed me of two concerns about her son and even broke down in tears when describing them.

Q I have a 9-month-old boy in my practice who doesn't sleep through the night. I advised the parents to let the baby cry and then go to his room at intervals of five, 10, and 15 minutes to check on him and talk to him, but not to hold him.

September days are crisper, and President and Congress have returned from summer vacation. It's time to confront the legislative agenda, pass the 13 appropriation bills that keep the federal government functioning, and bring pending legislation to a conclusion.

Pediatric vaccines have been much in the news recently, with new FDA approvals and the release of data on immunization coverage as of 2002 by the National Immunization Program (NIP) of the CDC.

A 22-month-old boy is brought to you with an asymptomatic, linear scaly rash that developed on his right elbow four months ago. Two weeks after onset, the eruption had extended down his right arm to the top of the hand and onto the fourth finger.

Pediatric Puzzler: Weakness (thyrotoxic periodic paralysis)