Showing papers in "Adolescent medicine (Philadelphia) in 1991"

Minor Head Injuries in Sports.

Abstract: This chapter describes the incidence, diagnosis, and management of cerebral concussions A scheme for grading the severity of a concussion is presented and guidelines are given for when to allow the athlete to return to competition Other types of head injuries described include epidural and subdural hematoma, subarachnoid hemorrhage, and malignant brain edema syndrome

Chronic Fatigue Syndrome and Fibromyalgia in Adolescence.

Abstract: A complaint of persistent, debilitating fatigue in an adolescent, accompanied by symptoms that meet the recently adopted criteria for chronic fatigue syndrome (CFS), presents a difficult challenge for the clinician. This article describes the diagnostic criteria for CFS and fibromyalgia, and discusses the epidemiology, etiology, and management of these conditions.

Epidemiology of Sports Injuries in Adolescents.

Abstract: This chapter discusses the epidemiology of injuries in organized sports in adolescents from junior high school through college age. Epidemiology includes the study of the distribution, causes, and prevention of disease. Epidemiologic data on sports injuries can help pediatricians to counsel families about the risks of specific sports, to know what injuries to expect in a given activity, to help athletic programs plan for medical care, and to advise athletes and coaches on injury prevention. Language: en

The Adolescent with Chronic Pains: Basic Principles of Psychosomatic Medicine.

Abstract: This chapter examines the diagnosis and management of psychosomatic illness in adolescents. Included are case studies and discussions of chronic pain, including chronic abdominal pain, chronic chest pain, and chronic headaches.

Stress and the Adolescent Athlete.

Abstract: Some degree of stress is inherent in all competitive situations. But some athletes experience excessive chronic stress that can contribute to a variety of psychological as well as physical maladies. This chapter emphasizes that an understanding of the antecedents, dynamics, and consequences of athletic stress can pave the way for preventive, diagnostic, and remedial measures. The role of physicians in helping coaches, parents, and adolescent athletes to keep competition with a healthy perspective is addressed, and a relaxation training program is described.

Obstacles to Adolescent Care in General Practice.

Abstract: The physician who provides care for the adolescent must integrate a number of issues outside the usual framework of medical practice. The adolescent alternates between the child and young adult, and so creates a series of challenges for his or her physician relative to the young person's autonomy and the continued legal role of the family. This article outlines several problems inherent in work with adolescents. ADOLESC MED 2:389-396, 1991

Catastrophic Head and Neck Injuries.

Abstract: Although all athletic injuries require careful attention, the evaluation and management of injuries to the head and neck should proceed with particular consideration. The actual or potential involvement of the nervous system creates a high-risk situation in which the margin for error is low. This chapter presents guidelines for classification, evaluation, and emergency management of catastrophic injuries that occur to the head and neck as a result of participation in competitive and recreational activities.

The Sports Physical.

Abstract: This chapter discusses the preparticipation examination and outlines its components. Sports participation history and physical forms recently published by the Sports Medicine Committee of the American Academy of Pediatrics are provided. The author stresses the importance of performing a musculoskeletal assessment as part of the sports physical, and describes the "two-minute orthopedic examination."

The Athlete and Menstruation.

Abstract: In the past 20 years, a large number of female children and adolescents have begun participating in sports and physical activities previously not open to them. Female athletes may present with disorders of menstruation, such as delayed menarche, amenorrhea, oligomenorrhea, dysmenorrhea, and anovulation with irregular cycles. This chapter addresses these clinical situations and methods of treatment.

Incorporating Adolescent Gynecology into a General Practice.

Abstract: Including adolescent gynecologic services in a physician's practice provides patients with complete medical care, and the advantage to adolescent patients is tremendous: A sensitive area in their life can be addressed in a safe, familiar setting that will minimize the trauma of confronting this new and scary experience. This article describes the sequence of activities involved in an adolescent gynecologic examination and discusses the issue of confidentiality. Common gynecologic complaints of adolescents are also described.

Death on the Playing Field.

Abstract: Sudden death during activity in children and adolescents is a rare event, considering the larger number of hours spent by this population in recreational and organized physical activities. The shock following such an occurrence frequently results in the family and physician's questioning whether the death could have been avoided. Common misconceptions are (1) that the physical fitness of a child correlates with the condition of the heart, and (2) that cardiac disorders responsible for sudden death give ample symptoms or clues to forecast these tragedies. This article discusses the more common disorders that cause sudden death during exercise, and addresses what, if any, practical measures can be taken to prevent it.

Obstacles to Adolescent Care: Economic Issues.

Abstract: This article discusses economic issues that are relevant to a medical practice that deals with teenagers. The economic obstacles are divided into four major categories: (1) attitude toward physician; (2) sources of referrals and recruitment of patients; (3) overhead; and (4) billing procedures and accounts receivable.

Asthma in Adolescence.

Abstract: Asthma is the most common chronic illness in adolescents and is one of the most important causes of school absenteeism, emergency room visits, and hospitalizations. The authors provide the clinician with an updated review of recent developments in the diagnosis and treatment of asthma.

Overcoming Obstacles to Care: Ethical Issues.

Abstract: The focus of this article is the conflict between the principle of autonomy and the principle of beneficence as they relate to the medical care of teenagers, and more specifically the thoughts involved in deciding which one applies more appropriately in a given circumstance.

Principles of Office Counseling: The Healthy Adolescent.

Abstract: The focus of this chapter is the parents of healthy adolescents and the problems that practitioners encounter when trying to meet the sometimes competing needs of parents and adolescents. Potential pitfalls in counseling parents of healthy adolescents are explored and practical approaches to common problems are described. Issues such as discipline, dating and social activities, and advice-giving are addressed.

Principles of Care for the Ill Adolescent.

Abstract: This chapter outlines principles to assist the primary health care provider in the care of the ill adolescent. The focus is on how illness affects the ability of the adolescent to function rather than on specific illnesses and their manifestations.

The Office Setting for Adolescent Care: Concerns of Physicians, Patients and Parents.

Abstract: Rickey L. Williams The author describes several issues of concern to physicians caring for adolescents. Methods of recruiting adolescent patients and the problem of confidentiality are described. The care of adolescents with special needs is also discussed.

Arthritis in Adolescence.

Abstract: Arthritis may be one of many symptoms of a systemic illness or a sole manifestation of an inflammatory or infectious condition localized to the joint(s). The differential diagnosis of arthritis and the more common conditions encountered in adolescents that may begin with arthritis are discussed.

Thyroid Disorders in Adolescents and Young Adults.

Abstract: Common thyroid disorders affecting adolescents and young adults are reviewed. Normal physiology of the thyroid gland and diagnostic tests are discussed and specific disorders and their treatment are described.

Hematuria and Proteinuria.

Abstract: Evaluation of an adolescent with proteinuria or hematuria must address several general issues. Are the urinary abnormalities clinically significant? What is the etiology of the proteinuria or hematuria? What treatment, if any, is needed? These issues are addressed, and the evaluation and workup of these patients are described.

Medical Exclusion from Sport.

Abstract: This chapter presents the American Academy of Pediatrics guidelines for participation in competitive sports, and discusses several conditions that may require exclusion. These conditions include absence of paired organs, hernia, Down syndrome, hypertension, cardiac and respiratory diseases, diabetes mellitus, dermatologic infections, and neurologic disorders.

Physicians, Parents, and Adolescents.

Abstract: In treating adolescents, physicians have tended to be illness-oriented and less concerned with the psychosocial considerations of adolescence or the associated effects of health disorders. This article describes changing trends in family structure and society and examines ways in which the physician can better understand adolescents and bring about more comprehensive and effective health care.

Principles of Office Counseling: The High-risk or Troubled Adolescent.

Abstract: Skillfully interviewing, assessing, and counseling a troubled adolescent must be based on a method of understanding the origins of problem behaviors. The authors describe the HEADS model of assessment and intervention used in the High-risk Youth Programs at Childrens Hospital of Los Angeles and present recommendations for effective counseling for these patients.

The Status of Adolescent Fitness.

Abstract: Over the past decade numerous reports have cited the health benefits associated with physical activity and regular exercise. This chapter reviews the current status of adolescent physical fitness, describes the benefits of physical fitness, and suggests methods the physician can use to improve the physical activity and fitness of adolescents.

Management of Soft Tissue Injuries.

Abstract: This chapter is intended to help primary care physicians and other providers of health care to adolescents to become more knowledgeable about the management of soft tissue injuries. Discussion includes the pathophysiology of injury, the assessment of the degree of injury, and the rationale for the RICE (rest, ice, compression, and elevation) method of acute treatment. Principles of rehabilitation are also discussed along with objective criteria that can be used to make return-to-play decisions following a soft tissue injury.