Faculty Bibliography

Suggestions on how to make the right choice for a medical newsletter are presented

The dread disease? Chicken pox. There are other more serious infections (bacterial meningitis, AIDS, trichinosis, cholera, leprosy), but chicken pox spreads wildly, far more easily than any of those. One kid with chicken pox sitting in a waiting room can infect every other vulnerable child there. One hospital worker who is exposed to chicken pox and then comes to work can close down an intensive-care unit. Chicken pox is the scourge of the pediatric ward; no other infection so regularly provokes such panic

For babies born with hypoplastic left heart syndrome (HLHS), the malformation of the heart can possibly be corrected with two operations but they are risky. The case is discussed of one such baby where the parents were faced with weighing the suffering against the survival rate and deciding whether to allow the surgery

A discussion of claiming authority in a situation which is rightfully yours is presented. Sometimes its hard to take an authoritative stance, more so for women than for men

Dr Perri Klass warns that temperatures that in older children are no cause for alarm may signal serious difficulty in infants

The next wave of the deadly AIDS epidemic is starting to hit the children of the inner city

Dr Perri Klass warns that temperatures that in older children are no cause for alarm may signal serious difficulty in infants

Many physicians and hospitals are screening and questioning patients more thoroughly lately, in an effort to cut down on patient drug abuse and medical liability

Well, to begin with, there are developmental screening tests that are helpful and should be applied to babies periodically as a matter of course. As indicators of normal social development, for example, a 6-to-8-month-old may play peek-a-boo, smile spontaneously and resist having a toy pulled away. Language skills should include turning toward a voice, laughing, squealing and making ''dada'' and ''mama'' sounds - though she may not specifically associate them with her parents. She should be able to bear some weight on her legs and sit without support (gross motor skills) and she should reach for an object, and successfully pass it from one hand to the other (fine motor). The absence of any one of these behaviors by itself does not mean a serious problem exists. Some babies don't like peek-a-boo. But taken together, or with other bits of abnormal behavior, they may well be matters of concern. As the baby grows into a toddler, the range of normal behavior broadens to include all manner of tantrums, obstreperous behaviors and power struggles. ''Does she say 'no' a lot?'' I ask parents. ''Does she even know the word for 'yes'?'' For some parents, this period is exhausting but delightful; there is, after all, something very endearing about the way a 2-year-old stands up to the world. For other parents, the toddler years are one battle after another, and, inevitably, they start to wonder whether something is wrong. Hyperactivity, for example, can be a real problem and can develop into a real handicap, but it is hard to diagnose because among most toddlers perpetual motion and short attention spans are the norm. Other nonmedical, developmental problems are more common and far less serious but are often nevertheless difficult for the families to put up with, and hard for the pediatrician to treat. Bed-wetting, for example. As a basic rule of thumb, nighttime loss of bladder control in a child of 5 or more who is able to stay dry during the day is unlikely to have any medical cause. The pediatrician will check for urinary-tract infections. Usually, however, the bed-wetting problem has emotional roots. School phobias and separation anxiety are also seen in this age group, and may well require counseling and therapy from someone beyond the general pediatrician. All these problems need to be treated - it's important to help a child learn to stay dry all night, or overcome a fear of school. It's important, too, to help the parents deal with their own shame, failure, anger or guilt, often engendered by their child's wet sheets or scenes at the schoolroom door

Child abuse is an epidemic in this country. A nurse describes her reaction to questions following an incident when her son was accidentally burned. The need for constant vigilance to protect innocent children is stressed