Today




		brilliantbaby.com the website that can help you have a happy, smarter child.

			Welcome to second Edition of brilliantbaby.com Watch for Today for new posting to this website. I will try to Update this section every week. Practical, interesting information, new medical findings, clinical histories, and new recommendations will be posted here. 31 August, Answer to Coughing & Fever 30 August, Coughing & Fever in a 3 year old girl 29 August, Answer to the baby with grunting & belly pain 28 August, Grunting, belly pain in a Baby 27 August, Dogs & Diseases 26 August, Answer to the Back Pain Case 25 August, A Child with Back Pain 24 August, Flame retardants and carcinogens 23 August, How to give a good Headache history 22 August, 10 Commandments to Reduce Medical Errors 21 August, Screening questions on Autism & Emotional problem 20 August, Have you heard of Ehrlichiosis? 19 August, Alice in Wonderland Syndrome 18 August, Features of Serious Headache 17 August, Five Steps to Safer Health Care 16 August, Cyanotic spells in a 6 year old 15 August, Weakness in the right are & leg in a young woman 14 August, Whooping Cough in an infant 13 August, Reducing Medical Errors 12 August, Fever and Leg Pain 11 August, POEM (Parent Oriented Evidence Medicine) 10 August, Swimming and Hives 9 August, Acid Reflux in a 2 month old 8 August, Case Study Using Differential Diagnosis (Paralysis in a child) 7 August, Use of Probability in Decision Making 6 August, Why have a Differential Diagnosis 5 August, Introduction to Clinical Decision Making 4 August, Example of A Clinical History 3 August, Other Parts of the Clinical History 2 August, History of Present Illness 1 August, Medical Thinking, Start of a New Series 20 July, Reach for the Mobile 18 July, Ribbon & Mobile Experiment 16 July, Four to Six Months 14 July, Two Months Old 12 July, Newborn 10 July, Counting and Emotion 7 July, Success Score 1 July, Apple and Orange Experiment 27 June, Detecting Autism 21 June, An Infant & a Two year old, my advice 6 June, PDA Fever 28 May, PDA Cough longer than 3 weeks. 24 April, Hugging and Holdring Your Baby 20 April, Melatonin for Insomnia in children 18 April, GER and Milk Allergy 16 April, Helping your baby in the visual world 8 April, Imaging studies in UTI may not be needed in children 6 April, Importance of Make Believe Stage 2 April, Warning on Lindane (treatment for Lice & Scabies) 30 March, How do you know your baby is responding to you? 28 March, Your Baby Needs Daily Positive Emotional Interactions. 24 March, No to Pacifiers 22 March, The Internet & Asthma Education 20 March, On Sleeping Position & Low Birth Weight 18 March, Eczema and Asthma are closely related 17 March, Poison Prevention Week, March 16 to 22 16 March, No To Smallpox Shot 14 March, 6 to 10 Guidelines Added 12 March, Dr. Leonidas 20 Guidelines 10 March, Death from a candy 8 March, Prolonged Fever 26 February, Flying Infusion Pump Hits MRI, Missing Child 24 February, Importance of Make Believe Stage 23 February, Finger & Hand Concepts 22 February, Making Magic Moments 20 February, Facts and Findings that might help your Clinician 19 February, What questions to Ask when your child has runny nose 18 February, Runny Nose: Colds, Allergy, Sinusitis 17 February, “Suffocation Roulette” an Upcoming Teen Thing? 14 February, Easy Multiplication of similar numbers 13 February, How to Choose a Pediatrician 12 February, Improving the Memory of young children 10 February, Ear Tubes not helpful in language, speech, and cognition 9 February, When to Remove the Tonsils 7 February, Higher IQ with Baby Sign Language 6 February, 10 Commandments for Better Outcome 5 February, Babies can Add 4 February, Success Score Card 3 February, Visiting a mother with a Newborn January 31, Abdominal and Soft Spot Examination. January 30, Fever, Belly Pain, Confusion in a 9 year old girl. January 29, Ten Commandments to Have Smart Child. January 28, Baby Body Language, New way of how a baby can communicate with her parents. January 27, Diagnostic Likelihood and Laboratory Tests or How Clinicians Decide when to Request for Laboratory Tests or Procedures. January 26, Nasal Irrigation of the nose to reduce recurrent sinusitis. Some allergist and Ear, Nose, Throat specialists are recommending this method. January 25, Endocarditis after Navel Piercing A 13 year old girl was seen at a physician’s office because of a 3 days history of low grade fever, nausea, vomiting, and abdominal pain. There was no history of headache, joint swelling, cough, runny nose, or rashes. Shortly after birth she had surgery for transposition of great arteries, ballon septostomy and Blalock-Taussig procedure. At 3 years old she had Rastelli procedure. Four months before this present illness she had a heart evaluation and everything was normal. One month before she had navel piercing. She did it herself using sewing needle before insertion of a navel ring. She cleaned her skin with rubbing alcohol before her self piercing. Two days after the navel piercing, the entry site became painful, red, and looked “infected” to the girl. The redness got better after removing the ring. She did not have any injury nor had any dental procedure. No recent oral antibiotics was taken. Because she look sick, she was sent to an Emergency room and was put in the hospital. Her physical examination showed crackles at the right lung base and systolic murmur of II/VI with diastolic component. Her blood culture grew methicillin susceptible S. Aureus. Spinal and urine culture were negative. She was given intravenous vancomycin, which was changed subsequently to nafcillin and gentamicin with oral rifampin. Blood culture became negative on the seventh day. [*The Pediatric Infectious Disease Journal,* vol. 22, No. 1, January 2003, page 94] Comment: S. aureus is the most common bug associated with body piercing. This is the first report of endocarditis following navel piercing. Children with congenital heart disease, cardiac surgery, or immune problems should be advised to avoid body piercing or should have oral antibiotics before and after the procedure. On second thought, I think all children should avoid body piercing except at the ear lobe. January 24, Today I received a laboratory report with high Sweat Chloride. This is abnormal and it indicates possible Cystic Fibrosis. I called the mother about the result and I recommended another Sweat Chloride test to confirm the first report. Cystic Fibrosis is a genetic disorder with symptoms that can be mild to severe. A common symptom is frequent cough, bronchitis, or pneumonia. Chronic diarrhea can occur also as well rectal prolapse. My patient with high sweat test had rectal prolapse and otherwise he is doing fine. He never had any bronchitis or pneumonia before. There has no family history of cystic fibrosis. I saw an 18 month old boy today for Routine Check up. He can say about 50 English and 50 Spanish words. His mother talked to him mostly in Spanish and his father in English. He was very cooperative during the physical examination. Children who are advanced in language and cognitive development are usually cooperative and not a cry baby. According to Jack L. Paradise, MD of the Children’s Hospital of Philadelphia, the surgical insertion of ear (tympanostomy) tubes within the first 3 years of life in children who have Otitis Media with effusion (OME) of several’s month duration appears to have no statistically significant favoralbe impact on cognition, language, or speech sound production at age 4. Dr. Paradise and his team studied 6350 children from 2 months old to 4 years old. With this study I think primary care physicians should reconsider their advise on when to recommend ear tubes. (Reference: Infectious Diseases in Children, November 2002, p. 47) January 23, I updated the section on Physical Examination and Best Practice. I wrote the Introduction to Physical examination and the top three important physical examination in an Infant. On Best Practice, I wrote about How to Give a good Present Illness History to save time and How to Dispense liquid medications. Please use the Navigation Bar on the left hand column and Click on Physical Examination or Best Practice. Leo Leonidas, MD, FAAP, Assistant Clinical Professor in Pediatrics, Tufts University School of Medicine, Boston; Attending Pediatrician, Eastern Maine Medical Center, Bangor, Maine Please send my your suggestions and comments to improve this site: lleonidas@pcpediatrics.org I wrote and desinged this website for parents of our practice. Before you use ideas from this website, please discuss it first with your clinician if you are not with our practice. copyright Leo Leonidas 2002

[Home] [Smart Baby] [Baby Math] [Our Graduates] [Toddlers] [Pre-School] [Today] [February] [June] [September 03] [Falling In Love] [January 2004] [March 2004] [Diagnosis] [Medical Errors] [Physical Examination] [Treatment] [Best Practice] [Parents Grand Rounds] [Medical Decisions] [About Us]