News

Whether to circumcise a newborn son is one of the first decisions parents must make for their child. Pediatricians can help them sort through the confusion and controversy surrounding the issue by providing accurate information and answers to their questions.

Despite promising developments such as the new rotavirus vaccine, acute diarrhea won't disappear from pediatric practice any time soon. This straightforward strategy for office management rests on the cornerstones of oral rehydration and continued feeding.

With more babies being put to sleep in the supine position, pediatricians increasingly are seeing infants whose skulls are flattened in back. You need to distinguish these children-- whose "flat heads" merit mainly parental reassurance--from the occasional child whose misshapen skull calls for referral and surgical intervention.

PEDIATRIC PUZZLER

The youngster's primary pediatrician found only some abdominal bloating thought to be related to the constipation. This morning new symptoms appeared: yellowish-green rhinorrhea and a cough, which resulted in one episode of vomiting. The abdominal pain has continued, and the youngster has been walking leaning forward.

UPDATES

Violence: The AAP takes a stand, Organized sports: Good or bad for children? Flying solo, What's happening to managed care? Just the facts, Resources for parents; Eye on Washington

Is that "bruise" or "burn" really a sign of child abuse? To avoid a misdiagnosis that can have profound consequences for the child, family, and suspected perpetrator, be sure you consider the full range of possibilities.

Is MIS the best bet for a patient with Hodgkin's disease who needs a splenectomy? What about an ordinary hernia repair, or a child who may have appendicitis, or the teenager who might have an ectopic pregnancy?

POISON PEN

Mucking the stalls without the help of creatine

In this symposium, two obstetricians and a pediatrician reflect on more than two years of experience with the CDC guidelines for prevention of perinatal Group B streptococcal disease. They address the effectiveness of prophylaxis, unforeseen problems with the guidelines, and more.

During a routine well-infant visit the mother of a smiling, chubby 9-month-old expresses concern about his noisy breathing. She states that her son has had noisy breathing since birth; in fact, the nurses in the well-baby nursery thought that he was very "mucousy." The mother calls the noisy breathing a "rattling in his chest" but denies that her son has had a chronic cough or wheezing.

PEDIATRIC DERMATOLOGY

At a routine visit you note multiple skin tags in the perianal area of an otherwise healthy 12-month-old girl. Her mother first noticed a small bump near the anus when the child was 2 months old but didn't mention it to you because it did not seem to bother the child.

Special report

What's new in the 1999 immunization schedule

UPDATES

Immunization in the real world, ADHD: Looking for consensus, Teens and STDs, Get your application kit now, How good is your health plan? R is for Risk groups; Eye on Washington

Advocates for children

From the migrant camps of New York and California to the community health centers that serve New England's rural poor, this pediatrician's life of service has been a grand adventure. And it's not over yet.

Pregnancy-prevention programs that succeed--and many don't--have certain characteristics in common. This review will help you evaluate the adolescent health services available to your patients and may suggest some new ways of looking at the counseling you offer during office visits.

The best asthma treatment plans fail when families don't cooperate. Learn how to tailor regimens most families will accept and what to do when lack of adherence threatens children's well-being.

For most young people, adolescence is a time of growth and development, not of illness. When illness occurs, it is often related to the increased risk-taking behavior that is part of the normal adolescent process of exploration.