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Confronting current challenges in pediatrics aWinter 2003 This issue of The Child’s Doctor focuses on several challenging problems in pediatric clinical care. We placed special emphasis on the overweight child who faces serious psychological and medical risks. The multidisciplinary team from the Nutrition Evaluation Clinic at Children’s Memorial Hospital, together with experts from the Divisions of Endocrinology and Gastroenterology, offer insight to successful treatment and prevention. Practical strategies include changing the lifestyle of the entire family with emphasis on healthy meals and increased physical activity. Younger overweight children need early intervention and all overweight patients should be screened for type 2 diabetes. Indirect calorimetry now is available through the Nutrition Assessment Unit of the Gastroenterology Laboratory, and will be a useful tool for treatment of severe cases. Dr. Tina Tan reviews the continuing threat of antibiotic resistance by common pediatric pathogens in the Chicago area. Vancomycin-resistant Staphylococcus aureus infections have been reported recently. She refers to her recently published study of patients with complicated pneumococcal pneumonia. Almost half of them were infected with serotypes not included in the currently available conjugate vaccine. We need to place a high priority on parental and consumer education about the appropriate indications for antibiotic therapy. Dr. Denise Goodman provides a concise overview of the evidence-based guidelines for the treatment of bronchiolitis that have been developed at Children’s Memorial. She and her colleagues have integrated their clinical experience with the critical evaluation of published research. We are grateful to the community-based physicians who contributed to the formation of these recommendations. We welcome your suggestions for future topics that would be useful to your practice and expand your overview of pediatric medicine. Please email your comments to us at: vlerman@childrensmemorial.org. |
