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It was established on cheap swampland that was once thought uninhabitable, but it became the capital of "the last best hope of man." Its wide avenues, streets, monuments, and buildings play witness to the steady march of time and history.

When Pierre L'Enfant first viewed the land along the banks of the Potomac in 1791, he must have been a little disappointed. He faced a daunting design task. Much of the land was uninhabitable swampland ceded from Maryland and Virginia. (Later, the land originating in Virginia was given back to that commonwealth.) There are several hills (other than Capitol Hill), but you'll never get any higher than 420 feet above sea level no matter where you go in the District of Columbia.

Eye on Washington

Majority Leader Frist jumps ship on stem-cell research, and a decision on OTC status for Plan B is imminent—maybe

Your patient is a 14-year-old boy who complains of bilateral foot pain of several weeks' duration. Sometimes, he tells you, the pain is so bad that he cannot bear weight and has to crawl from place to place. As you talk with him, you note that all 10 fingernails are abnormally thick and raised.

Your patient is a 10-year-old Latino girl brought to the clinic by her very concerned mother. The complaint is leg and joint pain-severe enough to make walking difficult. The visit comes after your colleague at the clinic saw the girl about a month ago for an unusual rash described in the record as a brownish, linear, papular eruption, possibly urticaria pigmentosa.

The inability to calculate therapeutic dosages for children accounts for the majority of pediatric drug errors, according to Ronda G. Hughes, PhD, MHS, RN, and Elizabeth A. Edgerton, MD, MPH, of the Agency for Healthcare Research and Quality. But there are practical ways for nurses-who often have primary responsibility for ensuring patient safety in the hospital and are usually the providers who administer the medications-to reduce the likelihood of a mistake.

The FDA announced in August that it has expanded the indication for Merck's approved hepatitis A vaccine (Vaqta) to include patients 12 months and older. Previously, Vaqta was approved for children 2 years and older. The change is the result of an open-label study of children with no evidence of hepatitis A infection.

In a recent survey by the American Counseling Association (ACA), eight in 10 adolescent girls said that acne makes them feel embarrassed, unhappy, or less attractive. The survey, underwritten by Dermik Laboratories, polled 738 girls between 13 and 17 years old. Its goal was to raise public awareness of the impact of acne during important moments in a teenager's life.

A Food and Drug Administration advisory committee recommended in July that Serevent (salmeterol), Advair (fluticasone propionate/salmeterol), and Foradil (formoterol) be kept on the market, despite safety concerns. The committee, which had convened in response to an FDA request to consider withdrawal of those drugs, did, however, call for the addition of a black box warning to Foradil.

Dr. Schuman will discuss the "EMR" and larger issues of technology in the pediatric office with conference attendees when he visits the Contemporary Pediatrics Exhibit Hall booth (#822) on Sunday, October 9, 2005, from noon until 4 p.m. He'll also bring his novel "Pretty Good Pediatrician" (PGP) program to the booth to recognize the hard work of pediatric clinicians.

As a world-class city, Washington, DC, is home to a wonderful selection of dining establishments featuring a wide array of international and regional American cuisines. Meals run the gamut from the sumptuous and sublime to down-to-earth and down-home. And you can generally choose an ambiance that suits either your lifestyle or current mood. Bon appetit!

Set your sights on DC

If you'd like to catch some of the sights while you're in town, all you have to do is look around. Chances are there's a monument, memorial, museum, or historical building close by. Most of the war memorials are outdoors, so take that into account if the weather is a little on the chilly side. However, a little inclement weather shouldn't stop you from taking in some of what the District has to offer. You could literally spend months in Washington, DC, and still not get through all the museums. Indeed, seeing all the museums within the Smithsonian is a daunting task in itself.