Poverty and the health of American children: implications for academic pediatrics

Article Abstract:

The role of academic pediatrics in the provision of health care to poor and disadvantaged children is discussed. Academic pediatrics is challenged to provide greater leadership in developing strategies to maintain health and prevent disease among poor children, rather than develop more high-tech treatment strategies. The special roles of academia are education and research, but it must not deny the responsibility of providing direct medical care. Would it be appropriate to take the classroom to where knowledge is applied and needed, and let medical students learn about poverty and health firsthand? What would they learn and would they be better practitioners? It seems that by such experience, young physicians would learn to apply their skills more effectively, increase their ability to identify the health problems of the poor, and understand that the need for food, clothing and shelter takes priority over health. In addition to educating new doctors, academic pediatrics focuses on research. These pursuits should explore solutions to the health problems of poor children in urban and rural areas. Research is necessary to determine the outcomes (results) of existing and new health care programs and analyze the cost-effectiveness of disease prevention strategies. Other potential roles are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Study and teaching, Medical education policy

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Use of nonsteroidal anti-inflammatory drugs in pediatrics

Article Abstract:

Nonsteroidal anti-inflammatory drugs (NSAID) are an effective and low-risk form of treatment for children. NSAIDs approved by the FDA for children under 14 include aspirin, ibuprofen, tolmetin and naproxen. They play an important role in the treatment of juvenile rheumatoid arthritis, musculoskeletal syndromes such as tendinitis and muscle strain, fever, menstrual pain, pulmonary disease and eye inflammation. NSAIDs are weak organic acids that inhibit the synthesis of prostaglandin, which mediates inflammatory responses. Although few serious side effects have been associated with NSAID usage, there have been some reports of NSAID-induced kidney disorders, gastrointestinal disorders, and neurological disorders like headache and dizziness. To minimize gastrointestinal symptoms, NSAIDs should be taken with food. Pediatricians should be aware of possible side effects and monitor NSAID use in their patients.

Health aspects, Nonsteroidal anti-inflammatory drugs, Nonsteroidal anti-inflammatory agents

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Resolved: the proliferation of subspecialties is not in the best interests of general pediatrics

Article Abstract:

An annual debate sponsored by the Ambulatory Pediatric Assn takes as its topic whether there is too much specialization in the practice of pediatric medicine. Those arguing that there is too much specialization focus on the need to see children in the context of their overall environments and the more personalized care that is possible when there is an extended patient-physician relationship. Arguments in support of specialization cover the management of increasing information and the value of increasing research to better serve the pediatric population.

Medicine, Panel Discussion, Medical specialties

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