History matters: why history is of importance to academic pediatricians in the 21st century.
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Biomedical subjects
Publications and source records attributed to H Markel.
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This commentary discusses several journalistic, literary, and historical accounts of the AIDS epidemic as it has unfolded in the United States over the past 2 decades. By examining the different ways that different types of storytellers chronicle the political, social, public health, medical, and economic aspects of epidemic disease, this essay will demonstrate why the AIDS epidemic has been of such intense interest not only to physicians and public health experts but also to journalists, novelists, playwrights, memoirists, and historians. AIDS is a particularly fascinating example of society's broad concern with epidemics because it both is a global pandemic and, in recent years, has become a chronic disease.
The 150th anniversary of the University of Michigan Medical School affords occasion for both celebration and reflection, not just in Ann Arbor but throughout the world, as we consider its contributions to medical education, research, and health care over the past century and a half. This article explores the medical school's origins as a frontier medical outpost and describes the vital reforms in medical education implemented in Ann Arbor long before the landmark Flexner Report on Medical Education of 1910. It also depicts how and why the medical school developed as it did and what features are distinctive or typical about the school during this period.
This article focuses on the poliomyelitis vaccine field trial directed by Thomas Francis,Jr, MD, of the University of Michigan Vaccine Evaluation Center and sponsored by the National Foundation for Infantile Paralysis (NFIP) or, as it was better known to the public, the March of Dimes. It was a landmark in the widescale testing of a vaccine and the ethical use of human subjects. Millions of American parents readily volunteered their healthy children to participate. A total of 150,000 volunteers, including schoolteachers, physicians, nurses, and health officers all endorsed the study and donated their time and effort to make it successful. Avoiding the use of marginalized groups, the field trial purposefully did not involve institutionalized children; instead, it was based in 15,000 public schools in 44 of the 48 states as clinic sites. A group of 650,000 children received some type of injection, either the vaccine or a placebo, and another 1.18 million served as controls. The field trial depended, most essentially, on both public support and the participation of millions of children who remained enrolled in a study that required a series of 3 injections and a 6-month evaluation period. Enlisting the huge number of participants presented practical examples of the difficulties in experimenting on human subjects. On April 26, 1954, Randy Kerr, a participant or "Polio Pioneer" as the children involved were called, received the first inoculation of the Salk poliomyelitis vaccine. The nationwide study "designed to test the safety and efficacy" of the Salk vaccine had officially begun.
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The majority of children living in the United States today enjoy excellent health and access to health care. This was not always so; before the late 19th century, the field of pediatric medicine scarcely existed, and the combination of harsh and unsanitary living conditions in the urban areas where most immigrants settled, infectious diseases, and improper handling of milk was particularly deadly for infants and children. This article discusses the relationship between pediatric medicine and the broader children's health and public health movements in the United States in the early decades of the 20th century. That relationship resulted in 3 developments that had a profound impact on children's health: the establishment of dispensaries and milk stations that served impoverished children, campaigns to educate parents about illness prevention and child rearing, and the medical inspection of public schools and schoolchildren. Today, American children face both new threats to health and the reemergence of infectious diseases that were once thought conquered. Pediatricians and public health professionals must work together in the same spirit of social activism and community responsibility to meet these challenges.
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Pediatrics arose as an academic and medical specialty in the United States during the late nineteenth century. This paper documents the first three stages of academic pediatrics in the United States between 1850 and 1950: (1) 1850-1880, a period focused on sanitary reform as a means of reducing infant mortality; (2) 1880-1900, the era where discoveries being made in bacteriology, physiology, and nutrition began to be applied to improving the health of children; and (3) 1900-1930, when the field was characterized by an active health reform movement directed at parents and health care professionals. Three prominent pioneer pediatricians, Drs. Abraham Jacobi, Henry Koplik, and L. Emmett Holt, are profiled as representative practitioners of these eras.
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Two adolescents with a long history of abuse of lysergic acid diethylamide (LSD) and symptoms consistent with major depressive disorder, on initiation of antidepressant therapy with selective serotonin reuptake inhibitor agents, had the new onset or worsening of LSD flashback syndrome. The similarity in neuroreceptor physiology for both LSD and serotonin suggests that the LSD flashback syndrome may be induced by these drugs in patients with a history of LSD abuse.