Winter 2002 - Volume 6 Number 1

Clinical Contributions

Perinatal Screening for Congenital Malformations and Genetic Disorders: Current Status and Future Directions
Harold N Bass, MD; Jamie Beavers Taylor, BSc
This article provides a readable, concise overview of screening tests in newborn, infants and pregnant women. The field has made huge strides in recent decades, thanks in part to Kaiser Permanente efforts.

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West Meets East: A Kaiser Permanente Mid-Atlantic Experience in Providing Adolescent Health Care
Ann L Komelasky, MSN, PNP; Carol Forster, MD
Permanente Medicine has long been in the forefront with respect to special clinics for teenagers. This account by a very committed health professional details some of this history, explains the workings of such facilities, and pleads for further development in this area

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Stevens-Johnson Syndrome: A Case Study
Matthew Smelik, MD
This is a single patient report and brief review of an always-interesting, treatable and not uncommon syndrome. It should serve as a reminder of its importance to clinicians.

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Corridor Consult: Is Ceftriaxone Useful in Management of Fever Without Focus?
Gary Burkhart, MD
This informal discussion of practical aspects of treatment of children with fever of unknown cause is the first of a series of brief overviews of common clinical situations by Kaiser Permanente experts.

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Evidence-Based Clinical Vignettes from the Care Management Institute: Major Depression
David Price, MD, FAAFP
Based upon a recent revision of the Adult Depression Guideline by The Care Management Institute, this article succinctly summarizes major aspects of diagnosis, management and follow-up of this condition. Included is consideration of different cultural backgrounds, the elderly, and adolescent depression.

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The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead.
Vincent J Felitti, MD
This personal and passionate account of an important research initiative in Southern California presents convincing data showing a strong relation between emotional experiences as children and adult emotional and physical health.

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Dear Doctor
Anonymous
This single patient report is written by the patient. It personalizes the role of childhood experiences in production of illness and symptoms and drives home the point that physicians generally fail to recognize this common sequence

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Health Systems

CPC Corner: The Heart of Permanente Culture
Patricia K Fahy, MD, Ilene K Kasper, MS, Andrew M Lum, MD
The Colorado Permanente Medical Group tells the story of how they affirmed patient advocacy as a key value closely linked to a satisfying work environment for the physicians.

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Report of the Third Annual Permanente Rheumatology Association Meeting
Gerald Levy, MD, MBA; Stanford Shoor, MD
Highlights from the Third Annual Permanente Rheumatology Association meeting. You will find the discussion to be a practical and excellent, state-of-the-art overview of common rheumatologic diseases.

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Results of the First National Kaiser Permanente Continuing Medical Education Needs Assessment Survey
David W Price, MD, FAAFP; Chris C Overton, MS; Joy Pfeifer Duncan; et al
You've been asked and here is what you said! Dr Price presents the results of a survey of Permanente physicians that asked about preferences for CME topics and opinions on what determines which CME meeting they attend.

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Medical Ethics

Medical Futility
By Kate Scannell, MD, Editor
Commentary by Stephen C Henry, MD
As new, life-sustaining technologies stretch the meaning of "medical limits," age-old arguments about what constitutes "futility" and who defines it continue to spark sharp debate. We explore the issue through a case study and a commentary.

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Commentary

Research on Child and Adolescent Mental Health: NIMH's Blueprint for Change.
Mary L Durham, PhD; Mary Jane England, MD
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Editors' Comments

Reader-Focused Improvements to The Permanente Journal
Tom Janisse, MD, Editor-In-Chief
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External Affairs

Editor's Introduction: KP Mid-Atlantic--Lessons Learned at Ground Zero of the Anthrax Crisis
Jon Stewart, Associate Editor

This four-part piece on the anthrax crisis is introduced with an overview of the KP Mid-Atlantic response.
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Capitol Hill Hearing Testimony: Handling Casualties Caused by Weapons of Mass
Susan Bersoff-Matcha, MD, Physician with The Mid-Atlantic Permanente Medical Group
As one of the physicians responsible for the first anthrax patient in the Mid-Atlantic, Dr Susan Bersoff-Matcha testified before the House Committee on Veteran's Affairs. Her testimony is reprinted here.

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Smallpox Sense
Steven Black, MD
With a concise history of the smallpox vaccine, Dr Black outlines the risks, describes vaccination strategy in the case of possible bioterrorism, and cautions against routine vaccination.

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Abstracts

Abstracts of articles authored or coauthored by Permanente clinicians
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A Moment in Time

Discovering the Enduring Principles of Group Practice Medicine
Ray Kay, MD
The basic principles of prepaid group practice medicine did not develop abstractly. They evolved out of the real needs and hard choices that were confronted and overcome in the creation of the early Permanente Medical Groups, as recalled by one of the late, great pioneers of Permanente Medicine.

Letters to the Editor

Letters from our readers
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Book Reviews

Control Your Child's Asthma: A Breakthrough Program for the Treatment and Management of Childhood Asthma
Harold J Farber, MD, and Michael Boyette
Review by Richard M Roth, MD 

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The Men They Will Become: The Nature and Nurture of Male Character
Eli H Newberger, MD
Review by Eve Lynch

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Germs: Biological Weapons and America's Secret War
Judith Miller, Stephen Engelberg, William Broad 
Review by Vincent J Felitti, MD 

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For Your Own Good: Hidden Cruelty in Child-Rearing and the Roots of Violence
Alice Miller, PhD
Translated by Hildegarde and Hunter Hannum 
Review by Robin Kittrelle, RNP 
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Soul of the Healer

No Flies on Ray Kay
Tom Janisse, MD

"Snowbound"
Alan D Fremland, MD

Posters For Clinic
William F Pfeiffer, MD
Art & Full-text PDF Download

"At The Refugee Campus"
Mohammed Osman, MD
Art

"Zoe"
Tina M Smith, MD
Art

"Canyon Vistas"
Lis MacDonald, NP
Art

Valentino
Rachel Johnston
Full-text

Dreams From Childhood
Anonymous
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