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Evaluating drivers
Elderly drivers have the highest rate of traffic fatalities to miles driven. Taken as a whole, however, most elderly people drive safely and responsibly. Further, they have been driving for a long time—most have safely operated motor vehicles for 40 to 50 years. And yet, as the number of older adult drivers increases, distinguishing those who are safe from those who are unsafe will become an increasing public health challenge. More than likely, physicians will be on the front lines of managing this task.
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"Shy" child? Don't overlook selective mutism
Children with selective mutism speak spontaneously in the company of parents, other family members, or a circle of trusted peers, but are consistently mute and noncommunicative, or communicate only nonverbally, with everyone else. The condition occurs in approximately 0.5 to 0.7 of every 1,000 young school-age children: There are likely to be several children with this condition diagnosed in every primary pediatric practice. Yet selective mutism is seldom cited in pediatric literature.
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Paroxetine-related tremor
Paroxetine is a phenylpiperidine derivative and is the most potent inhibitor of the reuptake of serotonin (5-HT) of all available antidepressants, including the SSRI class. Paroxetine is approved for the treatment of depression, obsessive-compulsive disorder, panic disorder, and social phobia. It is also used in the treatment of generalized anxiety disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and chronic headache. While paroxetine can significantly improve mood, side effects such as tremor can be disabling. Includes case studies.
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Ask the Experts: Too Old to Shower Together?
The father of two siblings in my practice—a 7-year-old girl and a 5-year-old boy—is upset by the fact that their mother (from whom he is divorced) showers with the two children together. At what age is it no longer appropriate for a parent to shower with a child of the opposite sex, and for two opposite-sex siblings to shower or bathe together?
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