What Do You Consider to Be the Top Medical Advances of the Past 20 Years?

Ryan Syrek, Editor

Disclosures

May 27, 2015

BMI used for weight concerns: BMI must be compared with a reference standard that accounts for both the child's age and sex. The incorporation of BMI into measurement parameters calculated during well-child care is now used to detect early signs of weight problems concerns and to trigger the need for guidance and education on healthy eating habits and lifestyle behavior. It has potential for addressing comorbidities associated with obesity early in life, with ultimate lifelong benefit.

Treatment approaches to MRSA infections: Awareness and subsequent identification of skin and soft-tissue infections due to MRSA by medical personnel allows appropriate treatment. The rise in MRSA infections required awareness by patients and caregivers, athletic coaches, and school personnel about new treatment approaches. Understanding the emergence of new pathogens and antibiotic resistance in treating bacterial infections due to antibiotic overuse has been important.

Concussion guidelines for athletes in contact sports: Key changes in the medical understanding of head and brain trauma in sports have been crucial, including awareness that concussive events occur even without apparent loss of consciousness. This has stressed the importance of focused neurologic screening to minimize risk for recurrent head trauma and potential for long-term neurologic sequelae.

Vaccines as cancer prevention: Human papillomavirus (HPV) can cause genital warts, cancer of the cervix, and cancers of the vulva or vagina. The HPV vaccine prevents genital warts and cervical, vaginal, and anal cancer caused by this virus in girls and young women aged 9-26 years. The Centers for Disease Control and Prevention (CDC) recommends HPV vaccine for all girls aged 11-12 years, and for girls and women aged 13-26 years who have not received the vaccine or have not completed the vaccine series. This has been a landmark advance in preventive medicine.

Noninvasive sexually transmitted infection screening for adolescents: Cell culture and nonculture assays have been replaced by molecular tests called nucleic acid amplification tests (NAATs). The CDC recommends NAATs as the diagnostic assays of choice for chlamydia and gonorrhea. Traditionally, chlamydia tests were done on cervical swabs for females and urethral swabs for males. Owing to the greater sensitivity and specificity of NAATs, less invasive samples, such as urine, can be used to test females and males for these infections. Urine specimens are an easier option for primary care offices that do not offer gynecologic services and are easier to use in outreach screening programs. Noninvasive specimens eliminate the necessity for a clinician-performed pelvic examination in asymptomatic females. For males, a urine specimen is the sample of choice for chlamydia detection. This advance has fostered greater discussion of and increased willingness to perform testing for these conditions in adolescents.

Top pediatrics advances selected by Germaine L. Defendi, MD, MS, Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center, Los Angeles, California.

For more on the use of vaccines in cancer prevention, read here.

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