Update in adolescent dermatology.

This dermatology article serves as a quick reference for the physician treating adolescents. We first review the diagnostic approach to a dermatologic problem: configuration, color, pattern, and distribution. The next section discusses diagnosis and management of the most common clinical situations encountered in everyday practice, including skin infections, infestations, dermatitis, hypersensitivity reactions, and papulosquamous disorders.

Bleeding at circumcision: patient or operator issue?

Objective: The goal of this study is to define precisely bleeding after circumcision and to determine whether patient-related variables or experience of the operator is associated with subsequent bleeding.

Methods: This is a prospective cohort study of 537 consecutive Gomco circumcisions. The authors defined bleeding and operator experience, both current and long term, and sought to correlate them.

Gastrointestinal care of children and adolescents with developmental disabilities.

This article discusses nutrition in and specific conditions affecting children and adolescents who have disabilities. It is geared toward the practitioner of pediatrics to provide education regarding nutritional needs and how to meet them in these patients. The article reviews common problems in diagnosis and management, with particular emphasis on day-to-day issues that are in the purview of the primary care physician, and presents some recent developments in these topics.

Blood lead screening.

To evaluate local procedures for and barriers to testing Medicaid patients for lead toxicity, a retrospective review of 675 charts of Medicaid patients' age 12 to 36 months form the 7 practices who serve the vast majority of Medicaid children in Kalamazoo, Michigan was undertaken. We identified and tested a model for barriers to patients and physicians obtaining blood lead levels. Only 27.

A 1999 quality improvement initiative-reassessment in 2004.

We obtained a longitudinal overview of physician compliance with the American Academy of Pediatrics Policy RE9539 regarding early newborn discharge between 1999 and 2004. In previous studies we reported the results of a Quality Improvement/Feedback (QI/F) initiative at one community hospital (intervention) in 1999, during which time physician education occurred at a grand rounds and the hospital QI department reviewed all newborn charts for a 1-year period, notifying physicians of any deviations from the policy. We also assessed the very same physicians at another community hospital (control), which did not have this initiative and found significant changes in physician behavior only at the intervention hospital.

Does making newborn follow-up appointments from the hospital improve compliance?

Objective: To test a system of arranging the first newborn follow-up appointments made from the hospital prior to discharge.

Methods: Prospective randomized study of 328 term healthy newborns divided into control and intervention groups. As there were multiple practices, we checked for clustering in the two groups and then compared them for patient compliance with the first newborn appointment.

Patient compliance with the first newborn visit appointment.

Objective: To analyze patient compliance regarding the first newborn visit after hospital discharge.

Study Design: We selected at random 640 charts over a 1-year period from two community hospitals of healthy term newborns who were cared for by four practices in Kalamazoo, MI. We collected demographic data from the hospital chart and recorded the discharge order for time of posthospital follow-up.

Syncope in the adolescent.

Syncope in the adolescent is a common dilemma and can be frightening to patients, families, and physicians. An evidence-based approach to the evaluation of syncope in the adolescent is presented, with the emphasis on neurally mediated syncope (NMS). NMS does not actually lead to the youth's death; however, leaving such adolescents in unprotected situations (e.

Early newborn discharge: a tale of two hospitals.

This study reviews physician documentation of compliance with The American Academy of Pediatrics (AAP) policy RE9539 regarding early newborn hospital discharge and follow-up. All pediatricians in Kalamazoo, MI, were educated at a grand rounds regarding the AAP early newborn discharge policy. Newborns are seen at 2 community hospitals.