Article Abstract:
Tertiary care facilities, as found in large medical institutions, are largely inaccessible to poor and uninsured children suffering from rheumatological and musculoskeletal disorders. Diseases in these categories represent more than half of the chronic, disabling illnesses in the 19- to 24-year-old age group. Most children with these diseases are uninsured; those with some coverage are usually underinsured. Physical and occupational therapy, orthotic devices, and other remedial and therapeutic services are not readily available to the majority of poor patients. Those who receive benefits as children may lose them when they reach adulthood, when insurance coverage may be denied because of the ''pre-existing'' clinical condition. Poor children with rheumatoid arthritis and minimal education will be unable to successfully function and thrive as adults. Children with juvenile rheumatoid arthritis (an inflammatory disease of the joints) require special care, lest their medication create other clinical problems. Young patients with systemic lupus erythematosus (an inflammatory disease of connective tissue) may require routine hospital care, chemotherapy, and out-patient follow-up. Dermatomyositis (an inflammatory disease of skin and muscles) requires intensive therapy and medication. Since these diseases are usually chronic and progressive, they follow children into adulthood. Specialized transitional services are usually required. The range of these diseases demands intense supportive care from many allied health care fields. The scope of this care is expensive and currently outside the reach of poor, but needy children. Remedies to relieve the burdens children who are both poor and handicapped should not be overlooked. Publicly-supported, special interest charities serve their function well, but they can not provide all the nongovernment support that is needed. The broad medical community, working together, can encourage changes in the present health care system that will make services available when and where they are required. Physicians and researchers must also continue the scientific effort needed to eliminate or further diminish the tragic effects of these diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Advances in the medical sciences have led to an increased understanding of immune processes. Immunodeficiency disorders, or abnormalities of the immune system, can be defined in terms of basic cellular defects. New approaches to treating immunodeficiency disorders are based on the use of recombinant deoxyribonucleic acid (DNA) technology. In recombinant DNA technology, pieces of DNA, the genetic material of the cell, are taken from one organism and inserted into the DNA of another organism. This technique permits the joining of genetic material of unrelated species and can be used to isolate and examine the properties and actions of specific genes. The effects of recombinant DNA technology and the characteristics and treatments of immunodeficiency disorders are reviewed. Currently, gene replacement is accomplished by the transplantation of bone marrow. Now, patients can even receive bone marrow from persons who are not siblings; the outcome of bone marrow transplantation from nonsibling donors is similar to that from genetically matched siblings. In addition, support groups have been established to help families of patients with immunodeficiency disorders. Thus, advances have been made in both technological and social aspects of immunodeficiency diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
Genetic metabolic disorders of peroxisomes should be ruled out in the diagnosis of a child suffering from a delay in psychomotor development or progressive neurological problems. Peroxisomes play a critical role in the nervous system where they help metabolize fats. Patients with peroxisomal disorders often have distinctive body characteristics in addition to progressive degeneration of motor functions. Research into the biochemical role of peroxisomes indicates that dietary changes may help prevent the degenerative progress of some of the disorders. In other cases, bone marrow transplants have been tried. The effectiveness of the transplants is still being evaluated.
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