Alexander K C Leung

..In most children, bleeding ceases spontaneously, and only supportive therapy is necessary. If there is evidence of hypovolemia, the patient must be hemodynamically stabilized, active bleeding stopped, and recurrent bleeding prevented...

..Other tests should only be ordered when indicated...

..The diagnosis of TSC is based on the identification of hamartomas in more than one organ system. Treatment should be symptomatic and organ specific. A multidisciplinary management approach is necessary...

..The occurrence of concomitant anterior and posterior infantile perianal pyramidal protrusions has not been reported previously...

..Angioedema is caused by extravasation of plasma into the interstitial space of the affected tissue. We describe a six-year-old boy who developed oral and penile angioedema subsequent to the ingestion of peanuts...

..Most cases can be repaired in a single operation and on an outpatient basis. Even patients with a less than perfect surgical result are usually able to enjoy a satisfactory sexual life...

..We describe recurrent panniculitis in a 15-year-old boy with Prader-Willi syndrome. To our knowledge, this association has not been previously reported...

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..Tooth extraction is indicated if the tooth is supernumerary or excessively mobile. If the tooth does not interfere with breastfeeding and is otherwise asymptomatic, no treatment is necessary...

..The occurrence of hemorrhagic bullae in children with Henoch-Schönlein purpura is rare. A perusal of the literature revealed but seven occurrences to which we add another one...

..In the majority of cases, the disease is usually self-limited. The mortality rate is <1% and occurs predominantly in children at high risk for severe disease...

..The child should be discouraged from close, direct head contact with others or from sharing items that have come in contact with the hair...

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..These vaccines are safe, immunogenic, and well tolerated. Routine vaccination of adolescents and adults is required for optimal control of pertussis...

..The treatment of acute bacterial cervical lymphadenitis without a known primary source should provide adequate coverage for both Staphylococcus aureus and Streptococcus pyogenes...

..While all other interventions provide symptomatic relief, specific immunotherapy may have long-term effects. This review article also discuss recent patents related to the field...

..We describe a Chinese family with three affected members in two generations, suggesting a dominant mode of inheritance. The familial occurrence of melanonychia striata has not been reported previously...

..The onset of puberty usually occurs at the normal age. Premature adrenarche can be a forerunner of polycystic ovary syndrome and/or syndrome X. Continued observation and periodic re-evaluation is necessary...

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..The presence of a superimposed Mongolian spot has not been previously reported. Mongolian spots can look similar to a bruise and awareness of these lesions is important to avoid unjustified consideration of injury or child abuse...

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..Patient and caregiver education, avoidance of potential triggering factors, optimal skin care, and pharmacotherapy offer the potential for good control for most patients...

..Since the phenotypic anomaly of the male proband was no more severe than the affected female members, an autosomal dominant mode of inheritance is most likely...

..Physicians should be vigilant that ureteral calculus may, although very rarely, present with generalized abdominal cramps...

..Healthcare professionals have an important role to play in promoting and protecting breastfeeding...

..Salmonella stanleyville has not been previously reported as a cause of UTI...

..Although cabergoline is more effective and better tolerated than bromocriptine, it is more expensive, and treatment must be discontinued one month before conception is attempted. Surgical resection rarely is required for prolactinomas...

..Selected imaging studies also might be helpful. Surgical consultation is necessary if a surgical cause is suspected or the cause is not obvious after a thorough evaluation...

..Rapid diagnosis can be accomplished by detection of CMV DNA by DNA amplification or hybridization techniques...

..Histologic examination revealed a junctional nevus. To our knowledge, this represents the first report of subungual nevus in a Filipino child. The need for histologic diagnosis prior to definitive surgery cannot be overemphasized...

..An infant with benign neonatal hemangiomatosis is described. Examination for internal hemangiomas was negative. The patient had complete resolution of the lesions by 2 years of age...

..Antimicrobial therapy is the cornerstone of management and amoxicillin is the drug of choice for most cases of uncomplicated sinusitis...

..The treatment of acute bacterial cervical lymphadenitis without a known primary source should provide adequate coverage for both Staphylococcus aureus and group A beta hemolytic streptococci...

..We describe a caucasian family of which whom five members in three generations had clinodactyly of the fifth fingers. This report confirms that clinodactyly of the fifth finger can be transmitted as an autosomal dominant trait...

..We describe the case of a newborn infant with duplication of the testis and absence of the contralateral testis. The patient also had bilateral indirect inguinal hernias and an ipsilateral undescended testicle...

..A 10-year-old Filipino boy with melanonychia striata affecting six toenails is described. The occurrence of melanonychia striata affecting so many toenails has not been reported previously in a Filipino child...

..Simultaneous administration of corticosteroid and epinephrine reduces the rate of intubation in patients with severe croup and impending respiratory failure...

..Except the proband, who also had Tetralogy of Fallot, other affected members had a flat umbilicus as an isolated anomaly. Autosomal dominant transmission of isolated flat umbilicus has not been reported previously...

..Two patients had the spots on their arms while the other two had the spots on their shoulders. The persistence of Mongolian spots in Chinese adults has not been previously reported...

..Supportive counselling, reassurance, and dietary modifications if necessary, are the core measures used for the treatment of this condition. In most infants, infantile colic resolves by three to four months of age...

..Penicillin V remains the drug of choice. Alternative therapy, e.g., with cephalosporin or macrolide, is often sought because of penicillin allergy, noncompliance, and treatment failure...

..Topical immunomodulators (tacrolimus and pimecrolimus) are beneficial and safe for adults and children and represent a major new alternative to chronic corticosteroid use, especially in children...

..The prevalence of melanonychia striata in the Chinese population is not known. The purpose of this study was to investigate the prevalence and characteristics of melanonychia striata in a Chinese population of patients...

..This review article also discusses recent patents related to the field...

..Hygienic measures have little effect on the reduction of rotavirus infection rates. The disease can be effectively controlled by universal rotavirus vaccination...

..Recent technologic advances in delivery systems offer many patients the option of a once-daily dosage...

..General preventive measures include improved standards of hygiene and sanitation. Universal childhood vaccination is the most effective method for eradicating hepatitis A and preventing its transmission...

..Acyclovir is the treatment of choice for herpes zoster...

..Proper reference standards should be used in the assessment whether the nipples are closely or widely spaced...

..Typhoid vaccine is recommended for travelers who will be visiting areas with poor sanitation and hygiene...

..Conservative approaches to therapy have a successful outcome in most children. Invasive diagnostic imaging studies and pharmacologic or surgical intervention are necessary only for carefully selected children...

..Treatment options include surgical relocation or hormonal therapy. The lower the pretreatment position of the testis, the better the success rate for either method...

..In this case, a 16-year-old boy suffered a dog bite wound to the penis. The wound was cleansed with copious amounts of sterile normal saline by means of high-pressure syringe irrigation. The child had an uneventful recovery...

..To compare children with asthma to children with long-QT syndrome (LQTS) in terms of anxiety and medical fears...