Adolescent Health, Medicine and Therapeutics最新文献

{"title":"Role and uptake of human papillomavirus vaccine in adolescent health in the United States.","authors":"Staci L Sudenga,&nbsp;Kathryn E Royse,&nbsp;Sadeep Shrestha","doi":"10.2147/AHMT.S15941","DOIUrl":"https://doi.org/10.2147/AHMT.S15941","url":null,"abstract":"<p><p>Both the prophylactic human papillomavirus (HPV) vaccines, Gardasil^® and Cervarix^®, are licensed for the prevention of cervical cancer in females, and Gardasil is also licensed for the prevention of genital warts and anal cancer in both males and females. This review focuses on the uptake of these vaccines in adolescent males and females in the USA and the barriers associated with vaccine initiation and completion. In the USA in 2009, approximately 44.3% of adolescent females aged 13-17 years had received at least one dose of the HPV vaccine, but only 26.7% had received all three doses. In general, the Northeast and Midwest regions of the USA have the highest rates of HPV vaccine initiation in adolescent females, while the Southeast has the lowest rates of vaccine initiation. Uptake of the first dose of the HPV vaccine in adolescent females did not vary by race/ethnicity; however, completion of all three doses is lower among African Americans (23.1%) and Latinos (23.4%) compared with Caucasians (29.3%). At present, vaccination rates among adolescent females are lower than expected, and thus vaccine models suggest that it is more cost-effective to vaccinate both adolescent males and females. Current guidelines for HPV vaccination in adolescent males is recommended only for \"permissive use,\" which leaves this population out of routine vaccination for HPV. The uptake of the vaccine is challenged by the high cost, feasibility, and logistics of three-dose deliveries. The biggest impact on acceptability of the vaccine is by adolescents, physicians, parents, and the community. Future efforts need to focus on HPV vaccine education among adolescents and decreasing the barriers associated with poor vaccine uptake and completion in adolescents before their sexual debut, but Papanicolau screening should remain routine among adults and those already infected until a therapeutic vaccine can be developed.</p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"63-74"},"PeriodicalIF":1.8,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S15941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40263409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging treatment options in bipolar disorder in adolescents: focus on ziprasidone.","authors":"Afshan A Khan,&nbsp;Jeffrey R Strawn,&nbsp;Paul E Croarkin","doi":"10.2147/AHMT.S7586","DOIUrl":"https://doi.org/10.2147/AHMT.S7586","url":null,"abstract":"<p><p>Bipolar disorder is a debilitating, and chronic condition in adolescents. The rate of diagnosis and treatment is increasing in adolescents despite considerable controversy regarding criteria for diagnosis. Atypical antipsychotics have been studied extensively for adult and adolescent bipolar disorder. Ziprasidone is an atypical neuroleptic with novel receptor-binding activity and a favorable side effect profile. It has been marketed in the US since 2000, and now has several indications approved by the US Food and Drug Administration. Emerging case reports, open-label studies, and randomized controlled trials suggest that it may have a role in the management of adolescent bipolar disorder. Somnolence, akathisia, tachycardia, and prolonged corrected QT intervals are major safety concerns. There are no definitive guidelines for dosing ziprasidone in adolescents based on current literature. However, optimal treatment may involve dosages near the adult range. Given minimal data and understanding of its effects on cardiac conduction, it might be prudent to obtain electrocardiograms prior to initiation and during treatment. While not a first-line medication choice for adolescents struggling with bipolar disorder, it may be considered in certain situations in which metabolic side effects and weight gain are of concern. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"137-43"},"PeriodicalIF":1.8,"publicationDate":"2010-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S7586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40287009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma control in adolescents: role of leukotriene inhibitors.","authors":"Stavroula Giavi,&nbsp;Nikolaos G Papadopoulos","doi":"10.2147/AHMT.S7600","DOIUrl":"https://doi.org/10.2147/AHMT.S7600","url":null,"abstract":"<p><p>Asthma is a chronic inflammatory disease of the airways and is a big burden worldwide. It affects both children and adults, but it is insufficiently studied in adolescents, although this age group has important peculiarities and is challenging to treat, due to, but not exclusively because of, lack of adherence to treatment instructions. Evidence-based guidelines for the treatment of asthma targeting specifically adolescents are lacking, due to the fact that most studies are conducted either on children or in adults. Exercise-induced asthma occurs commonly in adolescents, leading to impaired physical activity. This review describes current treatment options for asthma in adolescents, focusing on leukotriene receptor antagonists, both as a monotherapy and as an add-on therapy for optimal asthma control. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"129-36"},"PeriodicalIF":1.8,"publicationDate":"2010-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S7600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40287008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic hepatitis C virus infection in children and adolescents: Epidemiology, natural history, and assessment of the safety and efficacy of combination therapy.","authors":"Giuseppe Indolfi,&nbsp;Elisa Bartolini,&nbsp;Davide Casavola,&nbsp;Massimo Resti","doi":"10.2147/AHMT.S6750","DOIUrl":"https://doi.org/10.2147/AHMT.S6750","url":null,"abstract":"<p><p>Hepatitis C virus (HCV) is the most common cause of chronic liver disease of infectious etiology in children. Most of the children infected with HCV are asymptomatic, and only a few of them develop signs and symptoms of end-stage liver disease early in life. It is not possible to predict either in which patients HCV infection will have a bad outcome or the critical time in early adulthood when disease progression will accelerate. The experiences with therapy in children with chronic hepatitis C are based on earlier and continuing data from adult trials. The currently recommended treatment for chronic HCV infection in adults is the combination of peginterferon-á and ribavirin. The choice of this regimen is based on the results of randomized clinical trials that demonstrated the superiority of this combination treatment over standard interferon-á and ribavirin. Recently, results of pivotal, multicenter, interventional open-label studies on combined treatment with peginterferon-á and ribavirin in children have been published, and the US Food and Drug Administration and the European Medicines Agency have approved the combination therapy in those older than 3 years. The aim of this review is to evaluate critically the available data regarding the safety and efficacy of combination treatment with peginterferon-á and ribavirin in children. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"115-28"},"PeriodicalIF":1.8,"publicationDate":"2010-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S6750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40287007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of parents in adolescent self-rated health: Norwegian Nord-Trøndelag Health Study.","authors":"Hans-Johan Breidablik,&nbsp;Eivind Meland,&nbsp;Turid Lingaas Holmen,&nbsp;Stian Lydersen","doi":"10.2147/AHMT.S12877","DOIUrl":"https://doi.org/10.2147/AHMT.S12877","url":null,"abstract":"<p><strong>Background: </strong>Self-rated health (SRH) is a known important predictor of later mortality, morbidity, and health service attendance. From adolescence onwards, this multifactorial composite seems to be relatively stable. Therefore, it is important to study how SRH is also shaped and influenced by parental factors.</p><p><strong>Methods: </strong>Analyses were based on data from the Nord-Trøndelag Health studies in Norway during 1995-1997 among adolescent children aged 13-19 years and their parents. Cross-table analyses were made for parental and adolescent SRH. Proportional odds logistic regression analyses with parental SRH and a broad spectrum of other parental covariates were conducted, with adolescent SRH as the dependent variable, both unadjusted and adjusted.</p><p><strong>Results: </strong>Lower level of education, living alone, smoking, low general well being, and low life satisfaction were the most important parental factors associated with lower SRH in adolescents. However, the associations between parental SRH and adolescent SRH were rather weak, and in adjusted multivariable analyses lost significance for both genders. The net effect of genetics and early vertical family influence on adolescents' SRH thus seems to be moderate. Notably, the association between more specific health-related and lifestyle variables in parent and adolescent SRH was rather weak.</p><p><strong>Conclusion: </strong>SRH in adolescents seems to be shaped only partly by parental influence, and is less \"deterministic\" than might be expected from some genetic studies. SRH may therefore be modifiable by health-promoting efforts in early life.</p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"97-104"},"PeriodicalIF":1.8,"publicationDate":"2010-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S12877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40287005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and managing depression in adolescents.","authors":"Jami F Young,&nbsp;Michelle R Miller,&nbsp;Nida Khan","doi":"10.2147/AHMT.S7539","DOIUrl":"https://doi.org/10.2147/AHMT.S7539","url":null,"abstract":"<p><p>Approximately 10%-15% of adolescents will experience a major depressive episode. The risk factors associated with depression in adolescence include a family history of depression, being female, subthreshold depression, having a nonaffective disorder, negative cognitions, interpersonal conflict, low social support, and stressful life events. Despite the availability of measures to identify depressed adolescents and efficacious interventions to treat these adolescents, a large number of depressed adolescents go undetected and untreated. This review describes several screening measures that can be used to identify adolescents with elevated depression symptoms who would benefit from a comprehensive diagnostic evaluation. If an adolescent is diagnosed with a depressive disorder, there are several efficacious treatment options, including pharmacotherapy, cognitive behavior therapy, and interpersonal psychotherapy. The research supporting each of these approaches is outlined, and recommendations are made to help health professionals determine the appropriate course of treatment. Although existing treatments are effective for many depressed adolescents, approximately one-third of adolescents remain depressed following treatment. Continuing research is needed to enhance the efficacy of existing treatments for adolescent depression and to develop and study novel treatment approaches. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"87-95"},"PeriodicalIF":1.8,"publicationDate":"2010-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S7539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40287004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of colesevelam in managing heterozygous familial hypercholesterolemia in adolescents and children.","authors":"Travis Sonnett,&nbsp;Jennifer Robinson,&nbsp;Paul Milani,&nbsp;R Keith Campbell","doi":"10.2147/AHMT.S9272","DOIUrl":"https://doi.org/10.2147/AHMT.S9272","url":null,"abstract":"<p><strong>Background: </strong>Colesevelam hydrochloride is a synthetic, nonsystemically absorbed polymer that functions as a bile acid sequestrant for the treatment of hypercholesterolemia. Recently, colesevelam was investigated for the treatment of heterozygous familial hypercholesterolemia (HeFH) in the pediatric/adolescent population aged 10-17 years.</p><p><strong>Objective: </strong>The purpose of this article is to review the disease state of HeFH in children and adolescents, review the pharmacologic mechanism of action, kinetics, and safety profile of colesevelam, analyze the results of a recent clinical trial of colesevelam in the pediatric/adolescent HeFH population, and discuss the role of colesevelam as a viable treatment option for HeFH.</p><p><strong>Methods: </strong>A literature search using Medline (1966-03 May 2010), PubMed (1950-03 May 2010), Science Direct (1994-03 May 2010), and International Pharmaceutical Abstracts (2004-2010) was performed using the search term colesevelam. English language, original research, and review articles were examined, and citations from these articles were also assessed. The manufacturer's prescribing information and the Food and Drug Administration review of the new drug application for the powder formulation were also examined.</p><p><strong>Results: </strong>A 32-week trial was performed investigating the efficacy of colesevelam as monotherapy or combination therapy with a stable statin regimen. Upon completion of the trial, significant benefits were found in regard to the treatment of HeFH and the lowering of low-density lipoprotein cholesterol, total cholesterol, and other secondary measures. Safety and tolerability were also examined throughout the duration of the clinical trial, with adverse drug reactions considered mild in severity.</p><p><strong>Conclusion: </strong>Colesevelam has been shown to reduce low-density lipoprotein cholesterol levels significantly in pediatric/adolescent patients with HeFH, while maintaining a mild side effect profile. Although further research would be beneficial for long-term effects in this population, colesevelam should be considered when developing a treatment regimen for HeFH in the pediatric/adolescent population.</p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"53-60"},"PeriodicalIF":1.8,"publicationDate":"2010-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S9272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40286504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent insight within the working alliance: A bridge between diagnostic and psychotherapeutic processes.","authors":"Michela Gatta,&nbsp;Andrea Spoto,&nbsp;Paolo Testa,&nbsp;Lorenza Svanellini,&nbsp;Jessica Lai,&nbsp;Maurizio Salis,&nbsp;Maxim De Sauma,&nbsp;Pier Antonio Battistella","doi":"10.2147/AHMT.S9323","DOIUrl":"https://doi.org/10.2147/AHMT.S9323","url":null,"abstract":"<p><p>In the literature it has been stressed how important it is during consultation interviews to evaluate an adolescent's insight with a view to starting psychotherapeutic work. Motivated adolescents bring to the therapeutic effort a real, interiorized request for help and can start moving towards a change. The aim of this study is to assess the insight of adolescents with mental disorders during the diagnostic process and to analyze how this relates to further therapeutic compliance and clinical evolution. The study included 55 adolescents, 35 males and 20 females aged between 11 and 19 years, who were advised to receive psychotherapeutic treatment after a diagnostic procedure. Patient insight was assessed at the beginning and end of the diagnostic process. Then, six months later, a clinical interview assessed their therapeutic compliance and clinical evolution. The findings suggest that insight is important when working with adolescents because it influences both therapeutic compliance and clinical outcome. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"45-52"},"PeriodicalIF":1.8,"publicationDate":"2010-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S9323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40286503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of multiple sclerosis in adolescents - current treatment options and related adherence issues.","authors":"Jean K Mah,&nbsp;Jennifer E Thannhauser","doi":"10.2147/AHMT.S7594","DOIUrl":"https://doi.org/10.2147/AHMT.S7594","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a progressive inflammatory demyelinating disorder of the central nervous system that is increasingly recognized in children and adolescents. This realization comes with additional concerns about existing therapeutic options and the impact of the disease on health-related outcomes of adolescents with MS. This five-part review provides an update on management strategies relevant to the pediatric MS population. The first section gives an overview on the epidemiology and natural history of early onset MS. The second section outlines currently available MS treatments, including medications during acute relapses and long-term immunomodulatory therapies. The third section highlights adherence issues pertaining to MS, including the challenges uniquely faced by adolescents. The fourth section provides a summary of research into quality of life and psychosocial consequences of pediatric onset MS. Attention is drawn to the grief experience of affected adolescents and the importance of peer relationships. Finally, the family resilience framework is presented as a conceptual model to facilitate optimal adaptation of adolescents with MS. Healthcare professionals can promote resilience and treatment adherence by ensuring that these individuals and their families are sufficiently informed about available MS treatments, providing instrumental support for managing potential medication side effects, and addressing age-appropriate developmental needs. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"31-43"},"PeriodicalIF":1.8,"publicationDate":"2010-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S7594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40286502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management considerations in the treatment of migraine in adolescents.","authors":"Christine A Matarese,&nbsp;Kenneth J Mack","doi":"10.2147/AHMT.S7537","DOIUrl":"https://doi.org/10.2147/AHMT.S7537","url":null,"abstract":"<p><p>Migraine is common in adolescents. It can significantly reduce quality of life, may contribute to significant school absences, and disrupt social activities. This article will address the clinical presentation, natural history, types, evaluation, diagnosis and prognosis of migraine. Common adolescent lifestyle factors such as stress, irregular mealtimes, and sleep deprivation may exacerbate migraines. Management options are discussed including lifestyle modifications, acute and preventative therapies. Features of chronic daily headache including comorbid conditions, management, and outcome are also addressed. </p>","PeriodicalId":517889,"journal":{"name":"Adolescent Health, Medicine and Therapeutics","volume":" ","pages":"21-30"},"PeriodicalIF":1.8,"publicationDate":"2010-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/AHMT.S7537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40286501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}