The challenge of caring for indigent children with rheumatologic diseases
Article Abstract:
Tertiary care facilities, as found in large medical institutions, are largely inaccessible to poor and uninsured children suffering from rheumatological and musculoskeletal disorders. Diseases in these categories represent more than half of the chronic, disabling illnesses in the 19- to 24-year-old age group. Most children with these diseases are uninsured; those with some coverage are usually underinsured. Physical and occupational therapy, orthotic devices, and other remedial and therapeutic services are not readily available to the majority of poor patients. Those who receive benefits as children may lose them when they reach adulthood, when insurance coverage may be denied because of the ''pre-existing'' clinical condition. Poor children with rheumatoid arthritis and minimal education will be unable to successfully function and thrive as adults. Children with juvenile rheumatoid arthritis (an inflammatory disease of the joints) require special care, lest their medication create other clinical problems. Young patients with systemic lupus erythematosus (an inflammatory disease of connective tissue) may require routine hospital care, chemotherapy, and out-patient follow-up. Dermatomyositis (an inflammatory disease of skin and muscles) requires intensive therapy and medication. Since these diseases are usually chronic and progressive, they follow children into adulthood. Specialized transitional services are usually required. The range of these diseases demands intense supportive care from many allied health care fields. The scope of this care is expensive and currently outside the reach of poor, but needy children. Remedies to relieve the burdens children who are both poor and handicapped should not be overlooked. Publicly-supported, special interest charities serve their function well, but they can not provide all the nongovernment support that is needed. The broad medical community, working together, can encourage changes in the present health care system that will make services available when and where they are required. Physicians and researchers must also continue the scientific effort needed to eliminate or further diminish the tragic effects of these diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1991
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Peroxisomal disorders: neurodevelopmental and biochemical aspects
Article Abstract:
Genetic metabolic disorders of peroxisomes should be ruled out in the diagnosis of a child suffering from a delay in psychomotor development or progressive neurological problems. Peroxisomes play a critical role in the nervous system where they help metabolize fats. Patients with peroxisomal disorders often have distinctive body characteristics in addition to progressive degeneration of motor functions. Research into the biochemical role of peroxisomes indicates that dietary changes may help prevent the degenerative progress of some of the disorders. In other cases, bone marrow transplants have been tried. The effectiveness of the transplants is still being evaluated.
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1993
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