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Biomedical subjects

R E Kreipe

Publications and source records attributed to R E Kreipe.

32 records · Page 2Linked to original sources
PubMed1987

Communicating with adolescents who have behavior problems.

Any clinician providing health care to adolescents needs to be able to communicate with them about behavior problems. For reasons relating both to adolescents and to health care providers, such communication is often challenging and sometimes frustrating. Nevertheless, one can develop a method of communicating with adolescents about their problems that will provide information that can be used therapeutically and will make the practice of adolescent medicine more rewarding for the professional. Numerous skills and techniques have been presented that enable the practitioner to initiate, facilitate, and encourage effective communication. These include both verbal and nonverbal methods. Methods for maintaining communication also have been discussed, since there are numerous ways in which communication with adolescents can go awry once it is established. Many health care providers already have developed other individualized skills and techniques; they are encouraged to consider adding those presented in this article. However, communication skills and techniques are useless unless they are based on an interest in the patient. As Peabody wrote almost 6 decades ago: "The secret of the care of the patient is in caring for the patient."

Adolescent↗
PubMed1986

A comparison of chronologic age and gynecologic age as indices of biologic maturity.

The clinical usefulness of gynecologic age (GA) (the difference between chronologic age [CA] and menarcheal age [MA]) is controversial. We compared CA and GA with bone age (BA) (the standard reference criterion for biologic maturity), in 107 Caucasian girls who ranged in age from 8.3 to 18.5 years. Chronologic age and GA each correlated significantly with BA. Regression analysis revealed no significant difference between the BAs of early-maturing girls and late-maturing girls of the same CA. However, the BAs of late-maturing girls were significantly greater than those of early-maturing girls of the same GA. Chronologic age may be preferable to GA in studies of adolescents that require an assessment of biologic maturity because CA is a more accurate measure of BA than is GA.

Adolescent↗
PubMed1986

Ventricular dilation on CAT scans of patients with anorexia nervosa.

Computerized tomographic brain scans of five patients with anorexia nervosa showed significantly more dilation of the third and lateral ventricles than in control subjects. Measurements of lean body mass suggest that these findings are secondary to the anorexic patients' protein malnutrition.

Adolescent↗
PubMed1986

Inpatient management of anorexia nervosa and bulimia.

The principles guiding the inpatient treatment of adolescents with anorexia nervosa or bulimia are no different than those guiding the treatment of adolescents with cystic fibrosis, leukemia, or depression. The patient is treated first and foremost as an adolescent, avoiding reinforcement of the sick role. Biologic, psychologic, and social needs must all be considered. Further, the family must be included in the treatment, since the vast majority of patients will be returning to their families after discharge from the hospital. Hospitalization may be required for a number of reasons. Regardless of the indications for admission to the hospital, a consistent, individualized, positively reinforcing plan for evaluation and treatment needs to be developed and executed. By so doing, the hospital team is in a unique position to help the patient and the family develop more healthy patterns of acting and interacting.

Adolescent↗
PubMed1985

Physical maturity screening for participation in sports.

In an effort to develop screening criteria to allow nonphysicians to detect physically immature boys prior to interscholastic sports competition, 364 male adolescents were studied as part of their group preparticipation health evaluation. Handgrip and self-assessed Tanner stage were measured, in addition to the routine preparticipation health evaluation procedures. Of the 118 boys who were Tanner 3 or less (immature), 103 (87%) had weak grips (less than 55 lb [24.9 kg]), and 88 (75%) rated themselves as Tanner 3 or less. Of the 246 boys who were greater than Tanner 3 (mature), 223 (91%) had strong grips (greater than or equal to 55 [24.9 kg]), and 229 (93%) rated themselves as greater than Tanner 3. Six of the 118 immature boys (5%) had both a strong grip and mature self-assessed Tanner stage; three of the 246 mature boys (1%) had both a weak grip and an immature self-assessed Tanner stage. Only 67 of 364 (18%) boys had grips and self-assessed Tanner staging that were discordant. Use of grip strength and self-assessed Tanner staging may obviate the need for physician assessment of Tanner stage for the majority of adolescent boys prior to participation in collision sports.

Adolescent↗
PubMed1984

Body composition changes during recovery from anorexia nervosa: comparison of two dietary regimes.

Twelve patients with anorexia nervosa were studied on the Clinical Research Center for periods of 15 to 58 days. Five patients were fed a diet providing 20% of energy from protein and seven patients were fed a diet with only 10% of energy from protein. These patients had a reduced lean body mass in addition to a loss of body fat, and during recovery about two-thirds of the weight gain was lean tissue. The average energy cost of the weight gain was 5.3 kcal/g. There was no significant difference between the two diets for elemental metabolic balance, changes in anthropometric measures, in weight gain, or in potassium-40 counts; nor was there any difference in the energy cost of weight gain, in the rise in basal metabolic rate, or the change in hematocrit, serum albumin, or cholesterol. However, blood urea nitrogen was higher in those patients who received the high protein diet. Satisfactory nutritional rehabilitation of patients with anorexia nervosa does not require a high protein diet.

Adolescent↗
PubMed1981

Early adolescent childbearing: a changing morbidity?

Statistics on births and abortions in Monroe County, New York were analyzed for the years 1967 through 1978, with special attention to the proportion of infants born weighing less than 2501 g to mothers less than 14 years of age. For that age group, there was an overall increase in low-birth-weight infants from 12.5% to 16.2% of live births. The nonwhite younger adolescents experienced widely fluctuating changes in the proportion of low-birth-weight infants from year to year, with a slight overall increase in the 12 year interval; the white younger adolescents exhibited a steady dramatic increase from 9.1% to 19.2% of live births. Although these changes whether for single year pairs or for grouped years, have not reached statistical significance, we hypothesize that this trend is the result of use of abortion among young adolescents.

Abortion, Legal↗
PubMedDate not supplied

Menstrual cycle abnormalities and subclinical eating disorders: a preliminary report.

Menstrual dysfunction is a common concomitant of anorexia nervosa and bulimia. Initial investigations emphasized the role of weight loss and lean/fat ratio in amenorrhea. Subsequent studies suggest a more complex interaction between eating disorders and menstrual status. However, in past investigations, menstrual abnormalities have been confounded with low weight. We conducted two studies to ascertain the prevalence of menstrual abnormalities in a group of women with subclinical eating pathology versus an age-, education-, and weight-matched group of normal controls. In Study I, 93.4% of the subclinical subjects reported a history of menstrual abnormality as compared to 11.7% of the normal controls. In Study II, 100% of the subclinical subjects, versus 15.0% of the controls, reported an abnormal menstrual history. These data suggest that menstrual dysfunction often occurs in women with abnormal eating attitudes but without weight loss or diagnosable eating pathology. Several hypotheses for this finding are proposed.

Adolescent↗