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As your specialty seeks to adapt to changing times, the issue is not whether pediatrics will rise to the occasion, but how. The author considers ways in which ingenuity and manpower can combine to meet the challenges ahead. Last of three parts.

These common overuse injuries are usually a minor problem but, if ignored, they can end a young athlete's playing days and lead to long-term problems. Here's what you need to know about evaluation, treatment, and prevention.

In the years since Contemporary Pediatrics first hit physicians' desks, pediatric practice has undergone a phenomenal change. A longtime contributor and a former editor pause to consider just how far the specialty has come.

A 14-year-old high school soccer player, referred by her pediatrician, has been brought to the sports medicine clinic reporting a one-year history of "shin splints." She describes shin pain in both legs that seems to increase with running and brisk walking, mostly over the "front" of her shins. She characterizes her pain as a "tightness" that "pinches" her legs and becomes noticeable five to seven minutes after she begins activity. The pain has become more intense the past two months--to the point where she is unable to run for more than 10 minutes at a time.

Time, cost, and adolescent patients

October 1-3 Current Issues in Child Maltreatment, Toronto, Ont. For information, e-mail ce.med@utoronto.ca

Labor Day weekend is, in ordinary times, the end of summer vacation for members of Congress. Tanned and well-rested, senators and members of the House are ready to get back to work, to tackle at least some of the domestic policy issues they have been unable to resolve until now.But this is no ordinary summer: Some members of Congress responded to the publication of the report of the 9/11 Commission by returning to work in August, and-even with time off for convention-going and politicking in an election year-a special session to deal with homeland security may even be in the cards.

What made the time with my disease infinitely easier was this ability of my parents to brainstorm and find alternative ways for me to enjoy myself.

Preventing Little League shoulder and elbow

Q As a pediatric pulmonologist, I treat quite a few children and adolescents who have exercise-induced asthma and other causes of exercise limitation. The younger children often are reluctant to talk about their experiences with sports, but their parents enthusiastically carry the conversation. In many instances, I have noticed that, when sports are involved, a parent's enthusiasm can go well beyond the usual parental pride. Such parents actually seem far more interested and invested in the sport than the child is. The child may even appear weary and disinterested when the subject comes up.

Far more people have heard of Tourette syndrome than know what it actually looks and sounds like - or how it feels to the person who has it. That's a major reason the diagnosis of this condition - the most severe tic disorder - is often missed. This is part one of a two-part series. See Tourette syndrome--Much more than tics, part 2: Management

What do physicians need to meet the challenge of providing high-quality patient care in this century? A set of well-defined competencies and a system for maintaining them throughout the course of professional practice. Part two of a three-part series.

Obtain free CME credit online

The management of Tourette syndrome is highly individualized and, when it comes to medical therapy, largely trial and error.

Far more people have heard of Tourette syndrome than know what it actually looks and sounds like - or how it feels to the person who has it. That's a major reason the diagnosis of this condition - the most severe tic disorder - is often missed. This is part one of a two-part series. See Tourette syndrome--Much more than tics, part 2: Management

EMRs are here.

EMRs are the wave of the future.

A 4-year-old girl is admitted to the ER with high fever and acute torticollis.

More approaches to toilet training/Did this infant receive proper care?

Miracles happen in children's hospitals every day, but some attempts at miracle-making don't succeed. In this hospital, now, there are children for whom even the most advanced treatments haven't been enough

Does interactive metronome treaining help ADHD?/Nail biting in a toddler: Can it be stress?

What role do environmental exposures play in the rising prevalence and severity of asthma? The authors examine the latest evidence and propose some measures pediatricians can take to protect their patients. Includes a Guide for Parents.

Specially trained nurses and lay people using certain vision screening tests to identify preschoolers with vision disorders perform effectively in their work and achieve comparable results, according to a study of more than 1,400 children that was funded by the National Institutes of Health.

You took a thorough history, performed a solid physical examination, made a reasonably good diagnosis, decided on a proper course of treatment, and wrote a prescription for your young patient. All done? Not so, unless you asked yourself:

Sucrose solution has been found to mitigate the pain of some procedures, such as circumcision, for infants.