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G B Slap

Publications and source records attributed to G B Slap.

46 records · Page 3Linked to original sources
PubMed1989

Adolescent smoking. A review of prevalence and prevention.

This review critically evaluates the extensive literature on the epidemiology and prevention of adolescent smoking. Trends in adolescent smoking attitudes and behavior as well as the immediate and long-term health consequences of adolescent smoking are discussed. The factors associated with adolescent smoking and several smoking interventions are analyzed. Suggestions are made for improving the evaluation of future programs designed to prevent adolescent smoking.

Adolescent↗
PubMed1989

Risk factors for attempted suicide during adolescence.

It is unknown whether adolescents can provide the information necessary to identify their risk for attempted suicide. The present study was designed to determine whether data collected directly from adolescents can be used to develop a simple model for differentiating suicidal from nonsuicidal adolescents. Patients aged 13 to 19 years hospitalized for medical complications of serious suicide attempts (n = 56) or for acute illnesses unrelated to injuries or ingestions (n = 248) completed self-administered questionnaires pertaining to psychosocial function, recent stress, alcohol and drug use, and health care use. Compared with ill adolescents, suicidal adolescents had poorer mental health, impulse control, family relationships, and school performance; higher 3-month stress scores and alcohol-use scores; and more use of 7 of 12 drugs (P less than .05). Compared with ill adolescents, suicidal adolescents were more likely to report previous suicide attempts (39% vs 10%, P less than .001) and previous mental health care (27% vs 8%, P less than .001) but were less likely to identify a primary care site (61% vs 87%, P less than .001). In a logistic regression model based on previous suicide attempts, previous mental health care, poor school performance, marijuana use, and dependence on the emergency room for primary care, 84% of the suicidal and 55% of the ill adolescents were correctly identified. If validated prospectively, these five self-administered questions may constitute a helpful screen for the rapid identification of suicidal adolescents.

Adolescent↗
PubMed1984

When to perform biopsies of enlarged peripheral lymph nodes in young patients.

Identification of young patients with peripheral lymphadenopathy who will benefit from lymph node biopsy often is difficult. A model was developed to differentiate patients whose biopsy results do not lead to treatment (normal, hyperplastic, or benign inflammatory lymph nodes) from those whose biopsy results do lead to treatment (granulomatous or malignant nodes). The medical records and histopathology slides of 123 nine- to 25-year-old patients who underwent biopsies of enlarged peripheral lymph nodes were reviewed for pathological diagnosis and 22 clinical findings. Seventy-two (58%) patients had biopsy results that did not lead to treatment, and 51 (42%) had results that did lead to treatment. Using stepwise discriminant analysis, a predictive model was developed that assigned 95% of the cases to the correct biopsy group based on lymph node size; history of recent ear, nose, and throat symptoms; and chest roentgenogram. When tested prospectively on new patients, the model correctly classified 32 (97%) of 33. We conclude that this simple model can help select adolescents and young adults with peripheral lymphadenopathy for biopsy.

Adolescent↗
PubMed1984

Screening for chest disease in college students: policies of student health services regarding the use of routine screening chest radiographs and tuberculin skin tests.

We conducted a survey of college health services to determine their policies regarding the use of screening chest radiographs and tuberculin skin tests. Pre-enrollment chest radiographs are prescribed for all incoming students by 24 per cent of the 531 respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 20 per cent, 19 per cent, and 6 per cent, respectively. Periodic chest radiography is conducted for all students by 7 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 22 per cent, 16 per cent, and 8 per cent, respectively. Pre-enrollment tuberculin skin tests are prescribed for all incoming students by 52 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 29 per cent, and 9 per cent, respectively. Periodic tuberculin skin testing is conducted for all students by 27 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 23 per cent, and 16 per cent, respectively. We estimate from these data that 723,000 incoming students in the United States received screening chest radiographs in 1979 with estimated charges totaling between $7 million and $27 million. There may be 0.05 to 0.33 induced cases of lung cancer, leukemia, thyroid cancer, and female breast cancer over a 20-year period among this group of students exposed to ionizing radiation.

Diagnostic Tests, Routine↗
PubMed1984

Adolescent medicine: attitudes and skills of pediatric and medical residents.

Adolescents receive care from different specialists whose training may affect the quality of care. To measure possible effects, all 80 level 1 and 3 pediatric and medical residents at one institution completed a questionnaire that asked if they planned to care for adolescents and determined their attitudes and skills for 30 relevant tasks. The mean age chosen for transfer of care from a pediatrician to an internist was 18.7 years by the pediatric residents and 16.6 years by the medical residents (P = .00001). Skill in obtaining histories; staging puberty; screening for scoliosis; performing pelvic examinations; diagnosing delayed puberty, psychiatric disorders, or learning disabilities; immunizing; and treating knee and hip pain more often were thought to be important by pediatric residents (88% to 100%) than by medical residents (40% to 75%) (P less than .02). More than 70% of PL-3 but fewer than 50% of ML-3 residents rated themselves skilled for these tasks (P less than .05). Fewer than 60% of each resident group rated themselves skilled in contraception. Both groups rated themselves underskilled in adolescent history-taking; counseling; evaluation of psychopathology; and treatment of dysmenorrhea and hypertension. In both groups, the decision to care for an adolescent was negatively influenced by the presence of a psychosocial disorder. In conclusion, both pediatric and medical residents plan to care for adolescents, and both recognize deficiencies in their training. Pediatric residents, however, are more confident of their skills in adolescent care than are medical residents.

Adolescent↗
PubMed1981

Oral contraceptives and depression: impact, prevalence and cause.

One million American adolescents are currently using oral contraceptives. Sixty percent of those beginning the pill discontinue its use within a year. Concern that mood change might be contributing to the decision to stop the pill prompted a review of the literature on the association between oral contraceptive use and depression. Trends in adolescent pregnancy, contraceptive use, and compliance are discussed in the first section. In the second, 12 clinical studies are analyzed. Because there are no studies of mood change and oral contraceptive use in adolescents, some data from adults are presented. Biochemical theories to explain an association between oral contraceptive use and depression are discussed in section three. Nine of the 12 clinical studies reported depression in 16-56% of women using oral contraceptives. Three studies found no association between oral contraceptive use and depression. The major problems found in the clinical trials were selection bias, poor assessment of pre-therapeutic mood state and unclear definition or measurement of depression. Current biochemical research suggests that oral contraceptives induce tryptophan oxygenase, which leads to pyridoxine deficiency in some women. However, the use of pyridoxine to prevent or treat depression in women taking oral contraceptives requires further study.

Adolescent↗
PubMed1978

Anaerobic spinal epidural abscess. Case report.

An acute spinal epidural abscess is reported from which a pure growth of the anaerobe Fusobacterium necrophorum was isolated. The mode of infection and pathogen makes it unique. The literature concerning the bacteriology of epidural abscess and the implications of anaerobic epidural infection are discussed.

Abscess↗
PubMedDate not supplied

Validation of a model to identify young patients for lymph node biopsy.

A model to identify 9- to 25-year-old patients with malignant or granulomatous lymphadenopathy demonstrated a sensitivity/specificity of 0.95/0.96 in the original sample. This study tests the performance of the model in three new samples (n = 34, 87, 46) of young patients with peripheral lymphadenopathy. Patient charts were reviewed for the biopsy diagnosis and for the three variables in the model (lymph node size, recent ear-nose-throat symptoms, and chest roentgenogram). Prevalence rates of malignancy or granuloma in the three samples were 0.71, 0.37, and 0.37. The model's sensitivity/specificity in the three samples were 0.96/1.00, 0.88/0.80, and 0.82/0.83. Receiver operating characteristic curve areas for the model ranged from 0.87 to 0.98, indicating excellent discrimination. Likelihood ratios were calculated for all scores to allow adjustment of the model's predictions for population differences in the prevalence of malignancy or granuloma. We conclude that the model performs well and can help physicians to select those young patients with peripheral lymphadenopathy who should undergo biopsy.

Adolescent↗