Volume 5 - Issue 11 - November 2006

Photoclinic: Traumatic Fibroma


A 14-year-old Hispanic boy presented with bilateral nodular lesions on the dorsal aspect of his tongue. He guessed that the lesions had been present for more than a year. They were not painful and had not changed in size or color.

Chris Taylor, APRN, FNP, of Metro Nashville Public Health Department, Tenn, noted that the patient's tongue was large and thickened but did not protrude from the mouth or interfere with oral function--as in functional macroglossia.

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This Is What a Mother Does


 

I'm a pediatrician who started out with some interest, and eventually developed some expertise, in what is euphemistically called child protection. I am 1 of 2 child abuse physicians at my hospital. There are probably only a few hundred of us nationwide. I'm glad that child protection occupies only about 20% of my clinical time--it's more than I could bear full-time. After 25 years in this field, I have heard many stories. Here is one I can't forget.

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Aplasia Cutis Congenita With the "Hair Collar Sign"

aplasia cutis congenita with hair collar signThe parents of this 4-month-old infant were concerned about an atrophic, 0.6-cm area on their son's parietal scalp that was surrounded by dark hair. The rest of the scalp was normal, and the child was otherwise healthy.

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Oral Health:


 

The American Academy of Pediatricians (AAP) holds that pediatricians are responsible for oral health supervision of children younger than 3 years. How can I do a credible job of this in a busy office practice?

----MD

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Eye Infection From Wearing Over-the-Counter Contact Lenses


A 17-year-old Haitian girl who was visiting Florida presented to the emergency department after she experienced pain and a change in vision in her left eye. Her right eye was asymptomatic. For the past 3 to 4 days, she had been wearing a pair of colored contact lenses she bought for fun at a discount store.

The patient's vital signs were stable. A slit lamp examination revealed hypopyon in the left eye. An exudate was noted during extraocular muscle testing. The right eye was normal.

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10-Day-Old Boy With Poor Feeding, Vomiting, and Weight Loss

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Ten-day-old boy born vaginally at 37 weeks breech without complications. Has history of poor feeding with vomiting and has lost weight since birth. One episode of vomiting described as projectile. Ultrasonography ruled out pyloric stenosis but revealed bilateral hydronephrosis. Patient referred to the emergency department for further evaluation.

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What Role for an Insulin Pump for the Very Young?


Q: What are the indications for use of an insulin pump in very young children (infants and preschoolers)?

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Odd Skull Shapes: Heads Up on Diagnosis and Therapy


"Does my baby's flat head mean he has to wear a helmet?" That question, recently posed by a concerned parent, is typical of the inquiries pediatricians hear regularly about head shape abnormalities. How would you respond to this parent's concern?

Here we offer a practical, objective approach to determining which patients with odd head shapes require further evaluation and treatment.

CAUSES OF HEAD SHAPE ABNORMALITIES IN INFANTS

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