Contraception in adolescence: an overview for the pediatrician.
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Adolescent↗
Biomedical subjects
D E Greydanus
Publications and source records attributed to D E Greydanus.
Psychological factors in diabetes mellitus. A review of the literature with emphasis on adolescence.
In this thorough review of the literature of the past 100 years concerning psychological factors in diabetes mellitus, interpretation is channeled toward adolescence. In addition, emphasis is given to the major role that emotional components play in the development and maintenance of the brittle teenage diabetic. The integration of adolescent developmental issues of into physician treatment plans is stressed.
Adolescent↗
Psychological management of acute paraplegia in adolescence.
Important management principles regarding emotional needs of the teenager with acute paraplegia during early hospitalization are discussed. One illustrative case is presented. Mourning reaction of the patient and family to this severe loss of bodily function is reviewed. Reaction of medical caretakers to this catastrophe is also discussed. It is emphasized that these concepts be applied by pediatricians in managing adolescent paraplegics.
Adolescent↗
A perspective on the brittle teenage diabetic.
The brittle teenage diabetic presents a difficult problem well known to clinicians. It is the authors' contention that its major component is psychological and not biological, and that much of this poor control can be avoided by proper developmental planning from the onset of disease. Failure to modify transactional health care models appropriate for the child to that appropriate for the adolescent accounts for much of this difficulty. Anticipatory long-range planning is outlined to aid the physician in allowing the youth to isolate and insulate his diabetes from becoming either a focus for control contests and power struggles or a maladaptive, manipulative regressive behavior. The reasonable goal is to prevent any further hospitalizations for ketoacidosis or hypoglycemia beyond the first admission for diagnosis and initial stabilization. Five illustrative cases augment this discussion.
Adolescent↗
Haloperidol-induced comatose state with hyperthermia and rigidity in adolescence: two case reports with a literature review.
Two adolescents who developed severe extrapyramidal and hypothalamic reactions due to haloperidol therapy are describe. This is a rarely reported result of utilizing this medication in children and youth, and caution is urged in its use. Prolonged reactions have occurred.
Adolescent↗
Hypothalamic syndrome in children with acute lymphocytic leukemia.
Five children had six episodes of central nervous system leukemia which were characterized by features suggestive of hypothalamic infiltration. All five patients had been in prolonged bone marrow remission and had no other evidence of active leukemia when the hypothalamic syndrome was diagnosed. Five of the six episodes responded promptly to intrathecally administered methotrexate and cranial irradiation, but bone marrow relapse, which was resistant to further therapy, developed within 4 months in three patients and after 18 months in the fourth. Only one patient remains in bone marrow remission without recurrence of hypothalamic symptoms 10 months later.
Body Weight↗
Acute encephalopathy with liver dysfunction, chylous ascites and cytomegalovirus infection.
A child with acute encephalopathy and liver dysfunction subsequently developed acute chylous ascites. Titers for cytomegalovirus increased from less than 1:2 to 1:32 during the illness, and cytomegalovirus was isolated from the urine. The case is the first one possibly linking cytomegalovirus and acute encephalopathy and liver dysfunction in a child. In our patient, enlargement of the abdominal lymph nodes, as seen on a lymphangiogram, resulted in a severe obstruction of abdominal lymphatic flow, producing a transudation of lymph into the peritoneal cavity. The acute chylous ascites associated with mesenteric lymphadenitis was likely caused by the cytomegalovirus infection.
Brain Diseases↗
Chorioretinitis in the adolescent: two case presentations with discussion.
Two cases of chorioretinitis in adolescence demonstrate the characteristic course of events. It is typically caused by Toxoplasma gondii and is usually acquired congenitally. Toxocara infection must be considered in younger children. Other etiologic agents are rarely implicated in children and youth. Diagnosis of toxoplasmic chorioretinitis is based on a characteristic history of visual disturbance and specific funduscopic appearance, along with confirmatory serological studies. Management is complex, utilizing pyrimethamine (Daraprim), sulfadiazine, and prednisone in combination for several weeks or months. The combined long-term care by the physician generalist and ophthalmologist is essential. Recognition of adolescent developmental issues is important to insure optimal compliance. The prognosis is guarded, with 5% to 30% recurrence rates noted after treatment. Severe visual impairment may be seen.
Adolescent↗
Middle ear effusions. Current concepts.
Current concepts of middle ear effusions in childhood including a discussion of etiology, diagnosis, and treatment are presented. We emphasize recent studies on the histochemical makeup of the middle ear, as well as the enzymatic and immunologic defense systems of that space. The mucociliary transport system is explained and recent literature is reviewed.
Adenoids↗
Substance abuse: a pediatric concern.
Use of alcohol, tobacco, and other drugs is a worldwide problem and affects many children and adolescents. The use of opiates, cannabis, tobacco, and alcohol have been well recognized for centuries in India. Abuse of alcohol is widespread in college campuses. In the United States, in 1997, 54.3% of high-school students had used an illicit drug by the time they entered 12th grade. In India the use of drugs and alcohol within the context of religious beliefs and local traditions has been historically documented. Children & adolescents are exposed to alcohol, cannabis products, and tobacco product. Several risk factors and protective factors have been identified. A screening psychosocial history is the most useful tool to identify non-specific indicators of substance abuse. In India the use of pan masala, and home brewed products containing marijuana and alcohol have special significance. Pan masala is shown to have carcinogenic, genotoxic, and clastogenic properties. The pediatrician can play a vital role in the appropriate recognition and early referral.
Child↗
Reproductive health: an international perspective.
The twentieth century began with approximately 1.6 billion human beings in the world and, with an increase of 96 million people per year, will end with over 6 billion people. Unless this trend is directly confronted by the world governments and their citizens, there will be nearly 8 billion by 2025 and over 11 billion by 2050. Thus, reproductive health is and will remain an issue of critical importance for all countries to realize and study. Part of this trend is because of the many pregnancies which occur in adolescents around the world. A number of issues have developed this century contributing to the many pregnant teenagers. For example, India has one of the world's largest populations of teenagers--over 23 million, representing over 26% of the total in the world. Effective methods for contraception and sexually transmitted diseases prevention are available, but not to all sexually active humans. However, many barriers to effective contraception exist around the globe. This article discusses some of them and also reviews use of contraceptive methods in various countries. These include oral contraceptives, emergency contraceptives, injectable and implantable contraceptives, intrauterine devices, barrier contraceptives and others. Reproductive health remains a critical, universal issue for all humans in the world. We all must examine the many pitfalls to controlling the world's populations, including lack of sex education, limited access to effective contraceptives, and others. We cannot afford to let the population continue unchecked. Effective strategies are needed at this time; otherwise, the population will continue to run out of control, negatively damaging the world for the coming generations. There is need to leave a positive, and not negative legacy for the next generation.
Adolescent↗
Enuresis: current concepts.
Incontinence disorders are an important group of problems that clinicians manage in children and adolescents. This paper reviews the physiology of micturition, the epidemiology of enuresis, etiologic concepts of incontinence disorders, a general clinical approach to enuretic patients, laboratory evaluation and general principles of management. Neurological and nephrological concepts of enuresis are emphasized in this discussion.
Adolescent↗