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Vitamin D Insufficiency

Vitamin D Insufficiency

Dr Pytlak offers tips on what parents can do to protect the whole family from colds and flu this season with some seasoned home remedies.

A 4-week-old boy with tactile fever for the past 24 hours and fussiness of 2 weeks' duration is referred to the emergency department (ED).

I saw a 12-year-old African American US girl as a new patient and checked her vitamin D level, as we usually do on our panels these days. The level was 8.8 ng/mL, with a "normal" reported as over 32 ng/mL. What are current recommendations for vitamin D replacement in children—let alone dark-skinned children?

A 3-month-old boy was brought by his mother to his busy primary care physician’s office for follow-up of bronchiolitis when numerous bruises were noted. The mother said that the infant had a 1-week history of unexplained bruising, petechiae, and irritability. The child was referred to the local emergency department (ED) because of concern for nonaccidental trauma.

Although at present there is no cure for type 1 diabetes mellitus, good treatments are available that can enable affected children to lead healthy, active lives. Insulin regimens should be designed to optimize metabolic control while minimizing the risk of adverse events, such as hypoglycemic episodes, which can be more serious in children. Regimens of 3 in- jections per day work well for children who cannot receive an injection at lunchtime, while multiple daily injection (MDI) regimens provide more flexibility. Continuous subcutaneous insulin infusion (CSII) can provide better quality of life than MDI regimens, but CSII requires a high level of motivation and carries its own risks. In all children, insulin regimens must be adjusted to accommodate the physiological changes of growth and development. Long-term follow-up is important to monitor for complications of diabetes.

A 3-month-old African American boy was referred for evaluation of poor weight gain and vomiting. The infant had been evaluated by his primary care physician 15 times within the past 6 weeks; he had no change in symptoms despite various treatments.

The areas of hyperpigmentation shown here on the trunk of a 15-year-old girl appeared 2 years earlier as 1- to 2-mm hyperpigmented papules with either flat or verrucous surfaces.

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