Development Of Paediatric Medicines Research Articles

Pediatric emergency medicine: What lies ahead

In this report, Stephen Ludwig, MD, provides a perspective on the future growth and development of pediatric emergency medicine. The author acknowledges the great progress made over the past 2 decades and offers his vision for the future. The framework for that vision will address several areas of strategic growth for the specialty: continued academic achievement, improved relationships with other professional organizations and disciplines, advocacy, international health, and subspecialization within pediatric emergency medicine.

Using the History of Pediatrics

The world of medical history is often a chaotic one, concentrated around the twin attractors of the professional historian and the physician historian. This 'oppositional clustering* as Charles Rosenberg calls it, has developed over the past forty years from a new interest in the social and cultural past of medicine, health and healing, increasing interest in gender relations in medicine, and changes in the relative status of physicians and historians, together with the widespread critique of social institutions evident since the 1960s.1 This polarisation is particularly evident in the history of medicine for children, where recent social historical and sociological interest in the child welfare movement, the meaning of childhood and gender relations, have produced a new species of histories that challenge the more traditional stories of the development of pediatric medicine. This confusing multiplicity of histories is often difficult to negotiate, even for professional historians. In particular, the newer social historical approaches are frequently hard for physicians to understand or relate to. The aim of this short paper is to give a brief overview of the current historiography of the field, with particular reference to America, and to suggest ways in which doctors might find social historical approaches useful. The new histories of child health are the products of changes in historical scholarship over the last twenty years. One of their messages

Clinical Assessment of Child and Adolescent Sleep Disorders

To properly assess sleep disorders in the child and adolescent, a practitioner should be well versed in sleep disorders medicine, pediatric and adolescent medicine, child and adolescent development, behavioral medicine, and psychopathology. The history must be taken with care and in great detail to sort among the many different causes of sleeplessness, sleepiness, and sleep-associated abnormal behaviors. There are many features of these disorders peculiar to the various age groups under discussion. Therefore, in addition to general medical considerations, age, developmental level, psychological factors, and circadian functioning must be taken into account. Physical findings and specialized sleep laboratory study results may further guide the clinician.

The possibilities and dangers of longterm infusion therapy in severely ill newborn and premature infants.

The development of pediatric intensive medicine in the past 10 years has today made it possible to carry out specific longterm infusion therapy even in severely ill newborn and premature infants. The present study discusses the various technical possibilities and indications for the introduction of a caval catheter in newborn and premature infants. Although we only used a caval catheter for longterm parenteral nutrition in 9 newborn infants from 1965 to 1969, improved techniques have enabled us over the past 2 years to choose this method in 43 newborn and premature infants presenting with a wide variety of clinical conditions. We conclude that the use of caval catheters still requires a very strong indication.