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.     

Feeding of 10-month-old infants. What problems? What solutions?

The feeding of 279 infants aged 10 months was evaluated by the dietary history method, in Paris health centers for children. The results of this survey, as compared with the recommended dietary allowances of the Centre National de Coordination des Etudes et Recherches sur la Nutrition et l'Alimentation (CNERNA) and of the National Research Council (NRC), showed that nutriment, vitamin and mineral needs are generally covered. However, intakes lower than the recommendations were observed concerning iron in 72% of the children, polyunsaturated fatty acids in 50% and vitamin E in 70%. In other respects, protein and saccharose intakes were high. Feeding of 10 months old children could be easily improved by choosing foods properly, allowing to cover these children's needs and to avoid excesses.     

The Fontan Circulation: What Have We Learned? What to Expect?

Our knowledge of the Fontan operation tends to indicate that it remains a palliative procedure for patients with a functionally single ventricle. There is a continuing attrition and the life expectancy of these patients is likely to be different from the life expectancy of a population of individuals having a biventricular circulation. This article is an essay on the rational approach for the future management of these patients. It is suggested that a better understanding of the continuing Fontan attrition and a more subtle way to predict outcomes of patients who do receive the Fontan could help in establishing better selection criteria and designing ways to prevent, delay, or treat the side-effects of this late attrition.