Adolescents Research Articles

Prevalence of Exclusive Breastfeeding and Factors Associated with Exclusive Breastfeeding in Adolescent Mothers in an Upper Middle Income Country

Introduction: Exclusive breastfeeding (EBF) constitutes one of the most important preventative interventions to reduce infant mortality. In the Dominican Republic, only 4.7% of infants are exclusively breastfed through the first six months. Compared with adults, adolescent mothers have lower probability of starting breastfeeding (BF) and those that do are more likely to follow it inconsistently. To the date there is no data focused on EBF prevalence and practices in adolescent Dominican mothers. Objective: Determine the prevalence …

Blood Pressure Screening of Children in the School Setting

Background: Blood pressure (BP) tracks well throughout childhood and adolescence so children at or greater than the 90th percentile for their age and sex at an early age are likely to remain at or above the 90th percentile as adults. Therefore, it is important to identify those at high-risk so that intervention strategies can be implemented to reduce the risk of developing hypertension later in life. Most children with elevated BP remain undiagnosed during childhood and adolescence, and ethnic minority children may be at greater risk for undiagnosed hypertension. School-based …

No Pain, No Gain: Normalizing Attitudes Associated with Shoulder Pain in Adolescent Swimmers

Introduction: “Swimmer’s shoulder” is the colloquial phrase describing pain and injury in the anterolateral region of the shoulder and is reported by 40-91% of adolescent competitive swimmers (1-3). Early detection of shoulder pain is beneficial to long-term health of athletes across similar sports requiring repetitive overhead shoulder motions as shoulder pain can signal imminent overuse injury (4). However, prior studies indicate that 86% of athletes implicitly or explicitly endorse swimming through practice pain, and 84% express reluctance towards the idea of taking time off (5). Such normalization is likely derived from theories that relate …

Non-Pharmacologic Approaches to Treating Chronic Pain: A Case Study of Myofascial Pain in An Adolescent Dancer

Introduction: The American Academy of Orthopedic Surgeons Annual Meeting (March 2019) reported back pain in 33.7% of children and adolescents in the previous year, with 79% participating in sports or physical activity, and those performing at the highest level reporting the most pain. Studies estimate that up to 38% of youth suffer from chronic pain, and large proportions of adolescents are commonly prescribed opiods for pain management of headaches and sports injuries. Objective: To describe a novel integrative medicine approach to evaluate and treat patients with …

Measures of Cardiac Disease in Adolescents with Sickle Cell Disease

Background: Sickle cell disease (SCD) has long-term cardiac complications manifesting as diastolic dysfunction or pulmonary hypertension, with most end-organ damage accelerating in the 2nd decade of life. Currently, there are no cardiac screening guidelines for pediatric patients. This study aims to 1) describe cardiac manifestations in a group of adolescents with SCD by echocardiography, and 2) correlate cardiac findings with markers of SCD severity and treatment. Methods: This was a retrospective review of patients with HbSS disease (most severe genotype) ages 13-21 years. For patients with ≥1 echo, only the most recent study was included. Echo …

Undetected, not Undetectable: Adolescent HIV in the Pediatric Emergency Department

Background: CDC recommends universal HIV screening over age 13, which has been successfully implemented in adult healthcare settings. However, although adolescents are thought to account for most undiagnosed HIV infections in the US, most pediatric providers perform targeted testing for HIV in high-risk patients only. Objective: To 1) identify young adults (< 25 years) diagnosed with HIV through adult ED-based opt-out screening and 2) describe all visits made by these individuals to the pediatric ED (PED) in …

Atrial Fibrillation with E-Cigarette Use in an Otherwise Healthy Adolescent Male

Background: Atrial fibrillation is the most common cardiac arrhythmia worldwide affecting up to six million American adults. It is a rare occurrence in the pediatric population. It is mostly associated with medication or toxin ingestion, metabolic disorders, congenital heart disease, or acquired heart conditions such as cardiomyopathy and mass lesions. We present a case of atrial fibrillation in a healthy adolescent male whose only risk factor was electronic cigarette (e-cigarette) use. Case Description: A healthy 16-year-old Caucasian male presented to the ED following an unwitnessed syncopal event at home. …

The Impact of an Educational Intervention on Infant Caregivers’ Knowledge, Attitudes, and Behavior Regarding Oral Health

Background: Dental caries are the most common chronic disease affecting children and adolescents in the U.S. Rates of dental caries are rising in the 2-4 yr. age group, specifically in children from poor families and those of non-Hispanic black and Mexican American ethnicity. However, little is known about oral health practices of infants. Purpose: To evaluate the impact of an educational intervention in the Rainbow Ambulatory Practice on caregiver knowledge, attitude, and adherence to recommended oral …

Comparing the Depiction of Different Body Types in Live-Action and Cartoon Children’s Television Programming

Background: Television (TV) shows often establish unhealthy standards for body image in children and adolescents. Even though children can more easily compare themselves to characters in live-action programs than to characters in cartoons, a lack of body type diversity and stigmatizing depictions of obesity in both forms of television can be especially problematic for a young audience. This social stigma may contribute to discrimination and bias towards overweight individuals, which can lead to low-self esteem, poor mental health, and disordered eating. …

Positive Association of Depression, Anxiety, and Attention Deficit Hyperactivity Disorder in Youth with Congenital Heart Disease: A Cross-Sectional Comparative Study

Purpose: Depression and anxiety in older adolescents and adults with complex congenital heart disease (CHD) has been well described. Additionally, studies report higher rates of ADHD in children with complex CHD. These data are lacking for younger and simple CHD patients. The goal of our study was to characterize anxiety/depression and ADHD in children with all types of CHD compared to those without CHD. Methods: Data was obtained using electronic medical records between 2011-2016 from a large tertiary care pediatric hospital. Inclusion criteria were youth < 18 years …

Outcomes of Osteonecrosis of the Femoral Head in Children and Adolescents with Sickle Cell Disease (SCD)

Purpose: Osteonecrosis of the femoral head (ONFH) is a common complication of SCD. We set out to describe clinical and radiographic outcomes of SCD patients ≤21 years with ONFH, who were treated with (1) core decompression (CD) or (2) CD plus bone marrow aspirate concentrate (BMAC) injection, (3) total hip arthroplasty (THA) or (4) observation alone. Methods: 114 hips in 73 SCD patients, 42% female, mean age 16.4 years (range, 5.7-21.9 years) with an ONFH diagnosis between 2006 and 2018 were …

Brains and Sprains: The Relationship between Neurocognitive Performance and Musculoskeletal Injury Risk in High School Athletes

Background: Quick and efficient integration of complex sensory information is required to direct high-demand motor control tasks during sports. Poor neurocognitive performance may thus impair motor control and lead to an increased risk of injury. While this effect has been demonstrated on a limited basis in collegiate athletes, there are no studies which have explored this effect in an adolescent population. Purpose: To determine the relationship between neurocognitive performance and the risk of sustaining a musculoskeletal injury in high school athletes. We hypothesized that athletes who …

Impact of Right-sided Obstructive Lesions in Children & Adolescents having Cone Repair for Ebstein Anomaly

Background: Ebstein anomaly (EA) is a rare congenital heart defect characterized by apical displacement of the tricuspid valve resulting in tricuspid valve (TV) dysfunction and right ventricular myopathy. Cone reconstruction (CR) has become the standard technique for TV repair for most patients with EA. The impact of additional right-sided obstructive lesions (RSOL) on post-operative outcomes in pediatric patients undergoing CR for EA is unknown. Methods: We performed a retrospective review of all children 1 …

Hitting the Wall: Strategies of Shoulder Pain Management in Adolescent Swimmers

Introduction: “Swimmer’s shoulder” is the colloquial phrase describing pain and injury in the anterolateral region of the shoulder (1). Population studies indicate that 40-91% of adolescent competitive swimmers report shoulder pain. Management of swimmer’s shoulder traditionally relies upon “in-pool” reduction of stroke volume and reallocation of stroke effort to the lower extremity, coupled with “dry-land” muscle strengthening (often via physical therapy [PT]) (2, 3). However, the efficacy of these approaches is unclear (4). Anti-inflammatory therapy including NSAIDs have typically supplemented these approaches as a result (5). In turn, research demonstrates …

Atypical Kawasaki Disease Secondary to Streptococcal pyogenes

Introduction: Group A Streptococcus (GAS, Streptococcus pyogenes) is a major cause of invasive bacterial illness in children and adolescents. A literature search revealed very limited number of case reports showing an association between GAS pneumonia and atypical Kawasaki disease in a healthy female toddler. Case Report: We report a 2-year-old female who recently migrated from Guatemala presented with GAS pneumonia and empyema treated with thoracentesis, antibiotics and supportive care. Despite being on antibiotics which are sensitive to GAS, she continued to have recurrent high-grade fever with severe respiratory distress …

Beneficios físicos, intrapersonales e interpersonales de las intervenciones en el patio de recreo en educación primaria

Las tasas de sedentarismo y obesidad infantil preocupan a nivel internacional. En España existe un incremento alarmante de obesidad infanto-juvenil, que alcanza el 15.9% en niños de 6 a 9 años. La escolarización obligatoria tiene el potencial de paliar esta pandemia y de promover hábitos activos entre los escolares con un esfuerzo y coste relativamente bajos. Para ello es preciso implementar programas de intervención y estrategias eficaces. El presente estudio revisa la evidencia de investigación que ha analizado el impacto de las intervenciones durante los periodos de recreo aplicadas en educación primaria en la dimensión física (actividad física), intrapersonal (p. ej., motivación, comportamiento, actitudes) e interpersonal (p. ej., relación social). Los programas multicomponente (varias estrategias de intervención) y aquellos que atienden a diversos estratos de factores influyentes resultan más eficaces y completos que las intervenciones unicomponente (solo una estrategia). Se sugieren implicaciones prácticas para gestores y docentes de centros escolares. The increase in sedentary and child obesity rates worries internationally. Data from Spain reveal an alarming increase in the prevalence of childhood and adolescent obesity, which reaches 15.9% in children aged 6 to 9 years. Compulsory schooling has the potential to alleviate this pandemic and to promote active habits among all schoolchildren, with a relatively low effort and cost. This requires the implementation of intervention programs and effective strategies. This study reviews the research evidence that has analyzed the impact of interventions on recess time applied in primary schools not only at a physical level (physical activity) but also at the intrapersonal (e.g., motivation, behavior, individual attitudes, etc.) and interpersonal level (e.g., social relationship). It is concluded that multi-component programs (several intervention strategies) and those that serve different strata of influencing factors are more effective and complete than uni-component interventions (only one strategy). Finally, practical implications are suggested for principals and teachers.

A quality improvement approach to reduce opioids prescribed at a pediatric institution

Introduction: The United States is in the midst of an opioid epidemic and the pediatric population is vulnerable to prescription opioid misuse and overdose. There is a mismatch between the amount of opioids needed to treat pediatric acute pain and leftover opioids account for a substantial source available for unintentional overdose by young children and misuse among adolescents. It is imperative that providers seek to decrease the amount of excess opioids prescribed, while still providing adequate pain control. A quality improvement approach was taken at our pediatric institution to decrease excess opioid prescribing. …

Weapon Carrying and Mental Health Concerns Among Victims of Cyber-Bullying

Introduction: School violence has recently gained national attention. In several cross sectional studies, weapon carrying was associated with multiple interrelated factors which include demographic, psychosocial, behavioral, and school-related characteristics of high-school age adolescents. This study examined the association between electronic bullying and carrying weapons to school in high school students in the United States. Methods: The data for this cross-sectional study was extracted from the Center for Disease Control’s (CDC’s) …

This Guillain-Barré Won’t Go Away: Chronic Inflammatory Demyelinating Polyneuropathy in an 18-year-old male

Introduction: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare diagnosis, encompassing a group of related neuropathies that share the characteristics of chronicity, demyelination, inflammation, and immune-mediation. It exists along a temporal continuum with its acute counterpart: the demyelinating form of Guillain-Barre Syndrome (GBS), a monophasic illness which typically resolves in the span of weeks. First line treatments of CIDP include corticosteroids, intravenous immunoglobulin (IVIG), and plasma exchange, although more aggressive presentations may require additional immunotherapy. We present a case of CIDP in an adolescent patient. As a disease …

Analysis of The Mental Health among Korean Adolescents Based on The Effect of Internet Use

Analysis of The Mental Health among Korean Adolescents Based on The Effect of Internet Use