Winter 1998
Volume 1, Issue 1

Children's Matters
 
PCPRP Home Page  About the Residency Program   Newsletter   How To Apply 
 

Inside this Issue
View From the Chair Program Director's Corner
New Primary Care Experiences New Brochure and Web Site
What Would You Do? Alumni Update
 

A Look Back...

 Did you know that the first Pediatrics resident was trained at Cook County Children’s Hospital in 1919 and the first Children’s Hospital was built in our present site in 1905?  (The present building was constructed in 1926).
 

 

View From the Chair
By: Philip Ziring, M.D., Chairman, Department of Pediatrics

On behalf of the Department of Pediatrics, I want to welcome you to the first edition of “Children’s Matters”, an effort to keep you, our hospital colleagues and other friends, informed about important events at Cook County Children’s Hospital.  From my perspective, there has not been as much creative activity and energy in our department around the hospital in years, and we will highlight some of these efforts periodically in this newsletter.  A few of these programs include… 
 
  Continuing growth of school-based clinics, and services for HIV affected youth in the adolescent division 
  Growth of pediatrics subspecialty consultation services (allergy, cardiology, neurology, endocrinology, gastroenterology) at community sites 
  Opening of a new West Side Children’s Center for general pediatrics services six days per week at Bethany Hospital by the Ambulatory Division 
  Growth in services of the South Side Children’s Center at Provident Hospital  
  Successful launch of a Pediatric Critical Care Transport Program 
  Planning (with other pediatrics centers in Chicago) by the Child Protective Division of a major national conference on Violence and Children 
  Initiation of a Reach Out and Read program in Fantus where books are distributed at each well baby visit and volunteers conduct reading sessions
  Supervision of neonatal services at Bethany and Provident Hospitals by attending physicians from the Division of Neonatology 
More changes are contemplated in the near future, especially in the Pediatrics Emergency Department and in the Pediatrics Intensive Care program.  The department continues to carry out its mission of providing patient care, education and research on behalf of infants, children and adolescents from underserved communities throughout the County, as it has for more than a century.  With the support of the county Board and the Hospital Administration, it has proven capable of adapting to changes taking place in health care in the present era with the development of a managed care organization (County Care) and a modern new hospital.  We will even have a new garage for our patients and ourselves in a few months.  These are exciting times to be at County and we hope that you will participate with us as we move forward in these efforts. 
  
 

New Primary Care Experiences

At Cook County Children’s Hospital, we believe that training pediatricians involves more than teaching them Medical skills.  We believe that all doctors must have the ability to communicate effectively with individuals from many different backgrounds and cultures. As a result, we have initiated some new primary care experiences as part of the residency programs. 

All interns attend a Communications Across Cultures class one day a week for the first six months of their residency at CCCH. Half of each session is dedicated to Medical Spanish for Pediatrics.  Two of our own Adult ER attendings, Isam Nasr, MD and Marco Cordero, MD, have written a Medical Spanish text book which they use to instruct the class.  They also have developed a Pediatric Medical Spanish manual and cassette tape especially for our course. The other half of each session is dedicated to issues of intercultural communication such as gang awareness, conflict negotiation, delivering bad news, and understanding complementary health care practices. 

To complement the skills learned in the Communications Across Cultures class, we have instituted two new rotations.  One is a Community Health block rotation and the other is a rotation split between adolescent medicine and HIV experience. 

Our first and second year residents now spend their Community Health time in a variety of sites.  Everyone goes to the Westside Health Authority, a consortium of health advocates on Chicago’s West Side, one day a week.  Residents then spend time in a number of other sites such as Bethel New Life, Marillac House, The Boys and Girls Clubs of Chicago and Park Manor Elementary School on the South side of Chicago. 

The Adolescent/HIV rotation allows the residents to get some experience in these two fields in a longitudinal fashion.  It is especially valuable in preparing the residents for their second year rotation in Adolescent Medicine. For the Adolescent half of this rotation, the residents attend the hospital based adolescent clinic, various high-school based clinics, and participate in weekly didactic sessions facilitated by a member of the Adolescent faculty. During the HIV half of this rotation, the interns participate in a number of experiences.  They all attend the Women and Children’s Wednesday HIV clinic in CCH’s Fantus clinic.  Here, the residents have the opportunity to participate in the care of infants and young children affected by HIV.  The rest of their time is spent at community agencies that focus on the needs of adolescents who are at risk for HIV or those who are HIV-positive. 

 
 

What Would You Do?
By: Albert Owusu-Ansah, M.D., Pediatrics Chief Resident

A 13 year-old African American boy was admitted because of fever, rash and joint pain.  Three weeks prior to presentation he had been seen in the ER with sore throat, abdominal pain and headache.  A diagnosis of viral syndrome was made and he was discharged.  These symptoms resolved after a few days and he remained well until this admission. 

On admission he did not look sick, his temperature was 102F; Respiration-18/min, Pulse-80/min and Blood Pressure 110/50 mmHg. The rash was erythematous, papular, well demarcated and distributed mainly on his thighs and abdomen.  The left ankle was swollen, slightly warm and tender. His chest, CVS, abdomen and CNS exam were all normal. 

The day after admission he complained of painful knee and chest pain.  P/E was essentially unchanged.  Results of Lab tests done are as follows: 

H/H-12.9/36.9  
WBC-6.1: S-68, B-4, L-24, M-4; 
ESR-50  
ANA-Negative 
RF-26 (Normal<20) 
Monospot-Negative, 
C3 & C4-Normal 
Throat Culture-Negative  
Chest X-ray-Normal 
DNAse-1/480 
ASO-491 
Hyaluronidase-1/512 
Initial EKG revealed Increased PR interval.  Echo revealed Mitral and Aortic Incompetence. 

Diagnosis? Rheumatic Fever. 

In developed countries, many young physicians have never seen a patient with rheumatic fever due to the very low prevalence of the disease, given in some studies as 0.2-0.5 per 100,000.  In view of this, a high index of suspicion is needed to identify the few cases that come to the clinics or Emergency Rooms. 
  
 

Program Director's Corner
By David F. Soglin, M.D., Residency Program Director

There have been many changes in the residency program over the past few years, some of which are highlighted in “View From the Chair” on page three, and in the description of the primary care experiences.  We received a three-year primary care training grant from HRSA to improve our training in primary care and increase the number of our graduates entering practice in urban, underserved areas.  This grant has allowed us to provide the Communication Across Cultures and Medical Spanish Course, increase our liaisons with community organizations as well as develop our new brochure, this newsletter and a web site! 

We are making a concerted effort to develop an active alumni group that can meet at national meetings, stay in touch with us and each other and help us better prepare residents for the real world of pediatrics.  Please respond to the alumni update by mail or e-mail jmatija@countypeds.org and if you know the addresses of any other alumni please let us know so we can contact them as well. 
 

 
 

New Brochure & Web Site 

Because so many exciting changes have been made in the residency program here at Cook County Children’s Hospital, we have published some new informational material about the program. 

With the help of a graphics designer, we designed a new 16-page color brochure.  In addition to the information about the program, it features quotes and photos of current and past pediatrics residents.  The brochure has been sent to hundreds of interested medical students, and it will be available at national recruiting fairs.  So far, we have received numerous compliments on the design and content of this brochure.  Write to jmatija@countypeds.org to request that a hard copy of the brochure be sent to you or visit  About the Residency Program on line. 

If you are reading this, you know that we have also created a web site.  We should be on most browsers which medical students might use to research residency programs.  This is the Pediatrics Departments first foray into the internet and we welcome your suggestions and responses.  Please send any feedback to Health Education Trainer and WebPage Editor, Sara Polonsky at  polonsky@countypeds.org  

 
 

Alumni Update 

With this newsletter, we hope to help all of our alumni keep in touch.  If you would like to tell us anything such as: a job change, an address change, a new addition to your family, the new address of one of your colleagues from your time at CCCH, or just plain good news, please let us know.  Write to jmatija@countypeds.org  and include your name (and your name when you finished your residency), and your information to be published.  This newsletter will be published quarterly, so get your information to us by April 1st for the next issue.
 
 
 
PCPRP Home Page  
  
________________
Cook County Children's Hospital Primary Care Pediatrics Residency Program
Newsletter compiled by Project Coordinator, Julie Matija
Last revised: April 24, 1998