Hearing loss is defined by the pure tone threshold:
Normal hearing has a threshold of 0-20 dB
Mild hearing loss from 20-40 dB
Moderate hearing loss from 40-60 dB
Severe hearing loss from 60-80 dB
Profound hearing loss greater than 80 dB
What is the natural history of the uncircumcised foreskin?
4% are fully retractable at birth
50% are fully retractable at 1 year
80% by 2 years
96% by school age
100% by 17 years
Manual retraction does not expedite retraction
No special care is needed
What age has the highest risk for SIDS?
2-4 months. In the NICHD study (1988), the median age for SIDS deaths was 11 weeks (~3 months), the peak incidence was between 2 and 4 months, and 90 percent occurred before 6 months of age.
What are the three treatment options for labial adhesions?
80% of labial adhesions resolve spontaneously within 1 year of diagnosis, and nearly all resolve by puberty.
Therefore, treatment can be reserved for patients who are symptomatic or have extensive adhesions or for patients whose parents are very concerned about physical appearance.
The most frequently recommended treatment is topical estrogen (estradiol or conjugated estrogen applied once or twice daily for 4-6 weeks).
The success rate is reported to be 46% to 100%
Rare adverse reactions include breast enlargement or tenderness, labial engorgement, and vulvar hyperpigmentation.
Myers et al studied topical betamethasone as an alternative to estrogen with the hopes of eliminating these adverse effects. They found that 1 to 3 courses (4-6 weeks each) of twice daily topical 0.05% betamethasone successfully treated labial adhesions 68% of the time. There were no adverse events related to this treatment
Myers JB, Sorensen CM, Wisner BO, Furness PD, Passamaneck M, Koyle MA. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol. 2006;19(6):407-411
When is retinoblastoma usually detected?
The average age at the time of diagnosis is 2 years in unilateral cases and 1 year in bilateral cases.
Leukocoria and strabismus are the most common presenting findings.