Reasons for a missed diagnosis of child abuse include:

1.   "No history obtained from verbal children"

2.   "Acceptance of inadequate explanation for injuries"

3.   "Insufficient explanation of signs and symptoms"

4.   "Inattention to skin and subconjunctival findings"

5.   "Incorrect diagnosis form radiologic examination"

6.   "Non-adherence to the maltreatment pathway"

7.   "Non-(or limited) access to previous medical records"

8.   "Admission to less-than-optimal setting"

Clinical Pediatrics 

Benralizumab is an investigational humanized monoclonal whole antibody directed against the interleukin-5 receptor. Interleukin-5 is a selective cytokine produced by a number of cell types and is responsible for the maturation and release of eosinophils in the bone marrow; these are frequently prominent in the inflammatory process associated with asthma.

Patients with frequent asthma episodes are at risk for future exacerbations. A randomized, double-blind, placebo controlled study of a single IV infusion of placebo vs. Benralizumab indicates that the drug appears to reduce asthma exacerbation rates and hospitalization by 49% and 60% respectively.

Benralizumab is an investigational drug that appears to hold promise for a select group of asthmatic patients - particularly those who are steroid resistant with high blood eosinophil counts.

Topiramate (Topamax, Trokendi XR �) is an anti-epilepsy drug which was approved in 2012 (in combination with

Adolescent Obesity Raises Risk of Severe Obesity in Adulthood

phentermine) by the FDA for weight loss. In obese adults it has been found with lifestyle modifications (LSM) to result in weight reduction. Few drugs (with LSM) are available to manage severely obese adolescents.

A retrospective chart review investigation of 28 obese (mean BMI : 46.2) adolescents (mean age: 15.2 years) treated with LSM plus Topiramate in a pediatric program for at least three months, indicates that for severely obese adolescents a meaningful reduction in weight can be achieved (randomized control clinical trials for efficacy and safety still needed).

Clinical Pediatrics