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During circumcision, a newborn is noted to have continuous dribbling of urine from his meatus and stool from his anus. After several minutes of observation, the urinary stream appears weak and remains a constant trickle. The baby boy was born at term via an uncomplicated spontaneous vaginal delivery. He was treated in the neonatal ICU for hypoglycemia. A radiograph of his pelvis is shown.

Quick Quizzes

Questions from parents touch on almost every aspect of child-rearing and can pose some of the greatest challenges in daily practice. Here, help with some of the thornier questions parents ask.

Specialty formulary management strategies, ePrescribing, and unique formulary benefit designs top the list of critical initiatives at MCOs, according to Cynthia J. Pigg, RPh, MHA, executive director of the Foundation for Managed Care Pharmacy. She discusses results from the Foundation’s 2009 Emerging Trends Survey.

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A 50-year-old African American man with HIV infection had a CD4+ T-cell count of 18/μL (1%), CD8+ cell count of 1035/μL (69%), and CD4:CD8 ratio of 0.01 at the time of diagnosis. He had multiple erythematosquamous skin lesions over his forehead, face, chest, back, and extremities

In 2006, the CDC recommended “opt-out” routine HIV testing in all health care encounters for persons 13 to 64 years of age. While this recommendation has garnered some support, concerns about the feasibility of such routine testing in a busy office without disrupting patient care has persisted. We report the results of a pilot study to determine the feasibility of routine testing in a busy urban clinic.

Hear an interview with Ted Rosen, MD, professor of dermatology at Baylor College of Medicine, and chief of Dermatology Service at Veterans Affairs Medical Center, Houston. Dr Rosen has a keen interest in current healthcare reform; he recently attended a summit in Washington with a group of think-tank leaders who are at the forefront of reform efforts.

On January 15, 2010, top congressional Democrats reported that they were “close” to an agreement with the White House on cost and coverage issues and that a draft would soon be sent to the Congressional Budget Office, the official authority on the cost and extent of coverage that any new legislation would provide. However, the outcome of the Massachusetts Senate race has created a significant obstacle to passing a health care reform bill for the Democrats in the Senate.

A 38-year-old man had fever and fatigue for the past 6 days and tenderness in the left upper abdominal quadrant for the past 3 days. He also had a facial butterfly rash that had been present for 10 years and a 1-year history of lupus nephritis, treated with prednisone and mycophenolate. He denied respiratory complaints or recent weight loss.

Lymphocytic Hypophysitis

A 26-year-old woman at 30 weeks’ gestation presented to the emergency department with a throbbing frontal headache of 1 month’s duration. She had also had peripheral blurred vision for the past 2 weeks. Acetaminophen initially decreased her pain but was no longer effective. She had had a previous miscarriage.