Carolyn L Abitbol, Lawrence B Friedman, Gastón Zilleruelo
{"title":"Renal manifestations of sexually transmitted diseases: sexually transmitted diseases and the kidney.","authors":"Carolyn L Abitbol, Lawrence B Friedman, Gastón Zilleruelo","doi":"10.1016/j.admecli.2004.09.011","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.011","url":null,"abstract":"<p><p>The adolescent population is particularly vulnerable to STDs. Those that cause significant kidney disease are of viral origin. The primary VVD are HIV-1, HBV, and HCV. Screening of high-risk populations should include quantitation of proteinuria, including total protein and microalbumin, to assess severity of renal damage and potential for progression. Renal biopsy is indicated for diagnosis and for planning important treatment interventions if there is significant proteinuria or decreased renal function. Causes of acute renal failure are frequently reversible and should be treated aggressively. These include HUS, vaso-motor or ischemic acute tubular necrosis, and drug toxicities. The spectrum of chronic kidney disease associated with VVD is broad and may include systemic manifestations of vasculitis. HIV-associated nephropathy is the prototype, with the most prevalent lesion remaining FSGS. Progression occurs in up to 15% of the patients, who are overwhelmingly of African lineage. Significant advances in management include ongoing development of HAART, angiotensin antagonists to control proteinuria, and novel immune-modulating drugs such as MMF, CsA, and rituximab. Dialysis therapies have offered improved survival, especially in pediatric patients. Moreover, transplantation is no longer considered experimental and should be offered to select patients.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"45-65"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urinary tract infections among adolescents.","authors":"Andrea E Bonny, Ben H Brouhard","doi":"10.1016/j.admecli.2004.09.010","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.010","url":null,"abstract":"<p><p>UTIs occur quite frequently among adolescent females. In the vast majority of these patients, UTIs are uncomplicated infections and are not suggestive of underlying anatomic abnormality of the urinary tract. A UTI in an adolescent female is suggestive, however, of sexual debut. A small number of adolescent males suffer from UTI annually; in at least half of such cases, there is likewise no underlying urinary anomaly. Because of the symptomatic overlap and high prevalence of STI in adolescents, the clinician must have a high index of suspicion for STI in any adolescent presenting with urinary symptoms.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"149-61"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas H Inge, Meg Zeller, Victor F Garcia, Stephen R Daniels
{"title":"Surgical approach to adolescent obesity.","authors":"Thomas H Inge, Meg Zeller, Victor F Garcia, Stephen R Daniels","doi":"10.1016/j.admecli.2004.06.001","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.001","url":null,"abstract":"<p><p>The obesity epidemic has resulted in the premature onset of traditionally adult diseases in children and adolescents. Bariatric surgery can be used to achieve significant weight loss and resolution of major and minor comorbidities of obesity. It is not known, however, whether weight loss or comorbidity resolution after adolescent bariatric surgery is sustainable over the lifetime, given the powerful biologic mechanisms that are thought to play an important role in development of severe obesity in these patients. There are also concerns about whether bariatric procedures may have unanticipated adverse nutritional consequences when applied in adolescence. Principles of adolescent medicine and evidence from adult bariatric surgical studies can be used to rationally guide the application of bariatric procedures to a group of young patients wither serious medical and psychological comorbidities of severe obesity. Given the immediacy of some of the medical and psychosocial complications, impaired quality of life, and the added health care costs of adolescent obesity, adolescent bariatric surgery programs should be developed to meet these needs. Adolescent bariatric surgery programs should have expertise that enables them to assess and meet the unique medical, cognitive, physiological, and psychosocial needs of the adolescent. Indications for operation during adolescence should be conservative until appropriately designed clinical studies have demonstrated the safety and efficacy of these techniques applied to adolescents.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"429-53"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Breast disorders in the adolescent patient.","authors":"Marjorie J Arca, Donna A Caniano","doi":"10.1016/j.admecli.2004.06.003","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.003","url":null,"abstract":"<p><p>Although breast cancer is rare in childhood and adolescence, breast concerns among patients in this age group are common. Benign proliferative changes and benign masses such as fibroadenomas are the most common entities encountered in the adolescent patient. Evaluation of breast complaints includes a careful history and physical examination. Ultrasonography is the best adjunctive radiologic modality to assess the adolescent breast. Surgical intervention usually is contraindicated in prepubertal patients. In the postpubertal patient, discrete breast masses, which are not suspicious on clinical examination, may be observed. Additionally, FNA and surgical removal are also safe diagnostic and therapeutic alternatives in this patient population.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"473-85"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Elective plastic surgical procedures in adolescence.","authors":"Mary H McGrath, Wesley G Schooler","doi":"10.1016/j.admecli.2004.06.005","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.005","url":null,"abstract":"<p><p>Adolescent patients are seeking plastic surgery to correct deformities or perceived deformities in increasing numbers. It is essential for the physician to understand the influence of perceived body image irregularity that motivates patients of all ages to request plastic surgery. The increased demand for plastic surgical procedures among young patients is caused partially to increased media exposure to the available procedures offered by plastic surgeons. A successful aesthetic procedure can have a positive influence on a mature, well-motivated teenager, while surgery on a psychologically unstable adolescent can be damaging to the patient. The American Society for Aesthetic Plastic Surgery has developed guidelines for the appropriate selection of teenagers for aesthetic plastic surgery [26]. First, the physician must \"assess physical maturity, because operating on a feature that has not yet fully developed could interfere with growth or negate the benefits of surgery in later years.\" Second, the physician should explore emotional maturity and expectations of the teenager. The teenager should understand the goals and limitations of the proposed surgery and have realistic expectations. Third, only board certified plastic surgeons who operate in accredited facilities should perform these procedures, to ensure the safety of the teenager and the quality of the procedure. Finally, teenagers and their parents should understand the risks of surgery, postoperative restrictions on activity, and typical recovery times. The referring physician and surgeon must be aware of the positive or negative effects that plastic surgery can have on the life of a teenager and be able to select patients who have the motivation, maturity, psychosocial, and emotional attributes that will lead to patient satisfaction.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"487-502"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Benign adnexal masses in the adolescent.","authors":"Jill K Powell","doi":"10.1016/j.admecli.2004.06.008","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.008","url":null,"abstract":"<p><p>Adnexal masses are common in adolescents. Certain conditions will require immediate intervention, including possible torsion, medically refractory tuboovarian abscess, intra-abdominal hemorrhage with hemodynamic instability, or possible ectopic pregnancy. Further evaluation of other masses, including additional imaging or tumor markers may be indicated, especially if masses are complex, solid, or have features characteristic of benign or malignant neoplasms. Otherwise, expectant management and surveillance allow for spontaneous resolution of most masses, especially cystic masses, and prevents unnecessary surgical intervention with its potential risks and sequelae. Laparoscopy can be done in many patients, and conservative, adnexal-sparing surgery should be encouraged when possible. In addition, physicians should be familiar with signs and symptoms of postoperative complications to allow for early diagnosis and intervention.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"535-47"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outpatient adolescent surgical problems.","authors":"Eustace Stevers Golladay","doi":"10.1016/j.admecli.2004.06.004","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.004","url":null,"abstract":"<p><p>There are several conditions for which adolescents seek surgical opinion. Many of these necessitate the performance of an office procedure. This article gave perspective on those relatively common and superficial lesions in an office setting.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"503-20"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adolescent urology.","authors":"Venkata R Jayanthi","doi":"10.1016/j.admecli.2004.06.006","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.006","url":null,"abstract":"<p><p>There are several urologic conditions in the adolescent male and female that require medical attention. The conditions discussed in this article represent some of the most common concerns in adolescents.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"521-34"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Human papillomavirus infection in adolescents: a rational approach.","authors":"Deborah A Bartholomew","doi":"10.1016/j.admecli.2004.06.007","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.007","url":null,"abstract":"<p><p>Human papillomavirus (HPV) infection has variable clinical manifestations, from transient subclinical disease to serious cervical cancer precursors. An understanding of the natural history of this common sexually transmitted infection is necessary to allow diagnosis of clinically significant disease and judicious application of treatment modalities, especially in young adolescents. This article reviews new recommendations for initiation of screening, revisions in cytology terminology, and evidence-based guidelines for management of lower genital tract disease, including the application of HPV testing.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"569-95"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael J Goretsky, Robert E Kelly, Daniel Croitoru, Donald Nuss
{"title":"Chest wall anomalies: pectus excavatum and pectus carinatum.","authors":"Michael J Goretsky, Robert E Kelly, Daniel Croitoru, Donald Nuss","doi":"10.1016/j.admecli.2004.06.002","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.06.002","url":null,"abstract":"<p><p>Pectus excavatum, the concave depression of the breast bone, comprises most chest wall anomalies. The Nuss procedure, a minimally invasive procedure to correct pectus excavatum, has revolutionized the management of this disease over the past decade. The results and complications of this procedure are discussed. The surgical management of the less common pectus carinatum or \"pigeon breast\" also is reviewed.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"15 3","pages":"455-71"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24883347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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