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Biomedical subjects

S K Schonberg

Publications and source records attributed to S K Schonberg.

At least 19 recordsLinked to original sources
PubMed2001

Adolescent children of drug-abusing parents.

The effects of a substance-abusing parent on a child are wide-spread, and unfortunately they follow that child well into adolescence and adulthood. Cognitive difficulty, poor judgment, and conduct problems are but a few of the sequelae, and similar results are seen whether the drug is alcohol or cocaine or another illicit substance. In addition to affecting the biology of the adolescent from the perinatal period, parental substance abuse often causes a disrupted, chaotic home, financial insecurity, and exposure of the teen to illegal substances and violence. The emotional toll on the adolescent is steep, and the overall cost to the health care system is enormous. Ultimately, many of these adolescents progress to substance abuse themselves. Health care providers need to be sensitive to the possibility of substance abuse in the home, and should aggressively pursue early treatment/therapy options for those teens at risk.

Adolescent↗
PubMed1997

Marijuana.

Explore the source record for details and available documents.

Adolescent↗
PubMed1994

HIV in adolescents.

Although the number of adolescents with diagnosed AIDS in the United States remains less than 1000, many more have HIV infection that has not yet manifested as clinical illness. In addition, most adolescents are involved in risk behaviors that potentially expose them to the virus. Medical providers should be prepared to identify those at highest risk and be familiar with the legal and ethical issues surrounding the evaluation and testing for HIV infection in this population of teenagers. HIV prevention and the presence of infection during pregnancy are particularly challenging to the provider in light of the special developmental and social issues that are inherent to the process of adolescence.

AIDS Serodiagnosis↗
PubMed1992

The pediatrician's role in the diagnosis and treatment of substance abuse.

Abuse of drugs and alcohol is pervasive in our society. The role of the pediatrician as a health-care provider from birth through young adulthood includes recognizing the stigmata in newborns of prenatally ingested drugs as well as being able to treat neonatal drug withdrawal syndromes. Questioning about drug use and other closely related topics should be incorporated into all health-care maintenance visits, starting at the age of 10 y, with parental participation and anticipatory guidance being offered. Physical examination and laboratory testing are not as helpful in confirming an impression of substance abuse as a comprehensive interview and a full appreciation of the warning signs of substance abuse. Treatment of the problematic user with a multidisciplinary team that understands adolescent development and behavior as well as the problem of substance abuse is crucial. The decision to treat the teen in an ambulatory or inpatient setting is determined by the extent of abuse, underlying medical problems and psychopathology, and the degree of family dysfunction. The pediatrician must not avoid addressing these issues with patients. If, however, upon identifying an adolescent or a newborn with a drug problem, the pediatrician feels uncomfortable or ill-prepared to manage the patient, appropriate professional referrals are warranted. Despite exercising the referral option for treatment, as advocate for child and family, the pediatrician remains professionally bound to track all drug abuse-related referrals while continuing to participate in the general ongoing care of the patient and family. Finally, the pediatrician should retain a public advocacy role in the community by offering educational, preventive, and supportive efforts in the continuing struggle against drug abuse.

Adolescent↗
PubMed1986

Pulmonary embolism in adolescents.

To clarify the epidemiology of pulmonary embolism in adolescents, a retrospective analysis of adolescent admissions to a general hospital over a 15-year period was performed. Eighteen patients had 19 episodes of pulmonary embolism, an incidence of 78 per 100,000 hospitalized adolescents. There were twice as many female as male patients. Common complaints were chest pain, dyspnea, cough, and hemoptysis. Common findings were hypoxemia and deepvein thrombosis. Major risk factors were oral contraceptive use and elective abortion in 75% of female patients and trauma in 67% of male patients. Unlike its effect in adults, pulmonary embolism is rarely fatal in adolescents. Although clinical features in adolescents are similar to those in adults, there is a high incidence of both overdiagnosis and underdiagnosis. The early use of pulmonary arteriography in difficult diagnostic situations is suggested.

Adolescent↗
PubMed1986

Driving safety and adolescent behavior.

Accidents, and mainly automotive accidents, are currently the leading cause of mortality and morbidity among young people. Understanding and addressing the issue of automotive accident prevention requires an awareness of the multiple psychodynamic, familial, and societal influences that affect the development and behavior of adolescents. Risk-taking behavior is the product of complex personal and environmental factors. As pediatricians, we have the obligation and the opportunity to improve the safety of our youth who drive and ride. This opportunity is available to us not only in our roles as counselors to youth and families, but also as we serve as role models, educators, and agents for change within our communities.

Accidents, Traffic↗
PubMed1982

Evaluation and management of drug problems in adolescents.

With the emergence of recreational alcohol and marijuana use as normative behaviors in the older adolescent population, and the recognition of both addictive and problematic drug use as issues which impact upon teenagers, the health care professional has been left no option but to participate in the prevention of morbidity and mortality related to the use of psychoactive drugs. This participation requires knowledge of the role of these intoxicants in contributing to developmental dysfunction, family stress and accidents in the teenage population. By applying the interviewing skills, preventive health strategies and counseling techniques which have been used successfully in other aspects of childhood health care, health professionals should be well equipped to identify teenagers at risk from drug use and devise achievable goals and appropriate intervention for the reduction of illness secondary to such drug use.

Adolescent↗
PubMed1980

Juvenile detention: another boundary issue for physicians.

It is estimated that there are 500,000 youngsters in detention in the United States per year. Detention facilities offer a unique environment in which adolescents at high risk for medical problems can be identified and treated. A health care program within the secure juvenile detention facility for New York is described in order to demonstrate how an academic medical center can effect improvement in the health status of underserved, incarcerated youth while meeting professional educational objectives for health trainees. Results of medical services are given for the past 11 years. Medical problems were diagnosed in 46% of the 47,288 adolescents examined. The conditions were grouped into those related to the legal status of the youngsters, socioeconomic background, and/or the institutional setting. The interrelationship of medical conditions with legal, ethical, and youth advocacy issues were demonstrated. The setting affords on opportunity to train primary care physicians with special emphasis on issues such as the nature of the doctor-patient relationship, confidentiality, and patient advocacy, while providing a necessary service to medically disadvantaged adolescents.

Academic Medical Centers↗
PubMed1979

Health needs of the adolescent.

In recent years, considerable effort has been devoted to the study of those core elements necessary to define a reference standard of health for adolescents. In our program, indices of adolescent disability were developed based on an analysis of 12 years of data from approximately 75,000 teenage patients. In-hospital (14,000), ambulatory (15,000), and community based (50,000) adolescent contacts offered differing indices of disease. Targeted screening efforts produced significant epidemiologic data and generated recommendations for adolescent ambulatory screening standards which were then applied to such community experiences as school health programs and urban group home settings. Both demonstrated significant levels of disability in excess of 50% of the populations studied. Alternatively, review of more complex problems observed within a hospital setting specific for adolescents revealed significant chronic disability. Clearly the health requirements of the adolescent are extensive but effective interventions must be based on carefully considered indicators of unmet needs.

Adolescent↗
PubMed1976

Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.

Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.

Adolescent↗