Office laboratory procedures, office economics, parenting and parent education, and urinary tract infection.

We once again review four areas of interest to office-based pediatricians: office laboratory procedures, office economics, parenting and patient education, and urinary tract infections. Sean Elliott reviews the current status of the Clinical Laboratories Improvement Amendments (CLIA) and their continuing impact on physician office laboratories. Eve Shapiro reviews office economics, this year focusing on managed care, the physician workforce, practice management, and health care financing for the uninsured.

Elevated androgen, brain development and language/learning disabilities in children with congenital adrenal hyperplasia.

Individuals with congenital adrenal hyperplasia (CAH) provide a test population for the theory that elevated testosterone levels alter prenatal brain development and increase the risk of learning disabilities. Eleven subjects with CAH, five of their non-CAH siblings and 16 matched control subjects participated in two studies. The first study documented hand preference, verbal skills and non-verbal skills.

Pediatric emergency training: an alternative teaching-patient care model.

We describe a cost-effective alternative to the pediatric and general emergency department (ED), the emergent/urgent care clinic (EUC). The vast majority of pediatric Medicaid-eligible patients are rerouted from the ED to the EUC, where they receive care from pediatric residents and faculty. A retrospective analysis of patient encounter forms from two EUCs was performed.