Disease In Teenagers Research Articles

Peculiar Aspects of Endometriosis in Adolescents

Although documented rates of endometriosis in adolescent patients undergoing laparoscopy for chronic pelvic pain range from about 25% to 45%, adolescent endometriosis has received limited attention in terms of research activity and follow-up studies. In this manuscript, distinctive characteristics of adolescent and young endometriosis have been considered in order to define pathogenetic and scientific concepts that might be useful in clarifying some aspects of the adult disease as well. Some highlights relative to the cellular origin of the disease can be derived from reported cases before menarche, from the appearance of endometriotic lesions in teenagers (mostly stage I-II endometriosis), and from the relative infrequency of ovarian endometriotic cysts in this population. Adolescents and young patients might be also particularly useful for studying the natural course of the disease. To this end, clinical manifestations and recurrence patterns of the disease in adolescent patients need to be elucidated. Differences in clinical aspects of the disease between the adult and young populations are presented. Risk of recurrence and potential risk factors involved in the reappearance of the disease in teenagers are completely unknown. (Journal of Endometriosis 2010; 2: 19–25)

Quoi de neuf en allergologie pédiatrique en 2007–2008 ? Partie 1 : épidémiologie, diagnostic précoce et prévention (une revue de la littérature internationale d’octobre 2007 à septembre–octobre 2008)

As far as the years go on, more and more studies include larger and larger numbers of children prospectively followed during longer periods. Many of the studies analysed in this review are very large prospective studies and meta-analyses. Most of them confirm and/or clarify previous results published in the recent years. The influence of allergenic and non-allergenic environmental factors on the prevalence of atopy and allergy is highly variable upon genetic factors, ethnicity and lifestyle of the children, and upon the type of environmental factors and the timing, the level and length of exposure. Breastfeeding and feeding with extensively hydrolyzed cow's milk proteins are associated with a lower prevalence of allergic diseases in young children. However, their long-term efficacy is highly doubtful. There are no significant relationships between infections and vaccinations in young children, and prevalence of atopy and allergic diseases in teenagers and adults. At present, with genetic predisposing factors, passive smoking in utero and during the first months of age and paracetamol (acetaminophen) consumption by mothers during the last months of pregnancy and the child during the first years of life are considered as major risk factors for atopy and allergy in children.

Vaccination as teenagers against meningococcal disease and the risk of the chronic fatigue syndrome

The etiology of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is unknown. In Norway, a vaccine against Neisseria meningitides group B was administered to teenagers in 1988–1989 in a protection trial. In order to estimate the relative risk of CFS/ME according to vaccine history, we conducted a case–control study in 2007, with 201 cases diagnosed at one of two hospitals and 389 controls. The adjusted odds ratio for CFS/ME was 1.06 (95% CI: 0.67–1.66) for subjects who received the active vaccine contrasted to subjects who did not. Using this design, no statistically significant association between vaccination against meningococcal disease in teenagers and occurrence of CFS/ME could be observed.

Is it exposure to cigarette smoke or to smokers which increases the risk of meningococcal disease in teenagers?

Passive smoking appears to increase the risk of meningococcal disease (MD) in adolescents. Whether this effect is attributable to exposure to cigarette smoke or contact with smokers is unknown. We conducted a prospective population-based case-control study with age, sex matched-controls in 1:1 matching. Participants were 15-19 year old with MD recruited at hospital admission in six regions (65% of the population of England) from January 1999 through June 2000, and their matched controls. Data on potential risk factors were gathered by confidential interview, including seven passive smoking variables. Factor analysis was performed to assess the dimensionality of the passive smoking exposure variables. The data were analysed with univariate and multivariate conditional logistic regression. 144 case-control pairs were recruited (51% male; median age 17.6). Factor analysis identified two independent factors representing passive smoking (P < 0.01), one associated with 'exposure to smoke', the other with 'smoker contact'. Only smoker contact was a significant risk factor for MD (OR = 1.8; 95% CI 1.0-3.3; P = 0.05). In multivariate analysis this factor was still associated with MD independently of potential confounders such as active smoker status and household crowding. Contact with smokers is associated with increased risk of MD in adolescents. This is more likely to be due to higher carriage rates in smokers than to exposure to smoke and emphasizes the importance of public health measures to stop smoking. In epidemiological studies that assess risk from passive smoking, exposure to smoke should be differentiated where possible from contact with smokers.

The natural history of meningococcal carriage and disease

The prevalence of Neisseria meningitidis carriage is highest in teenagers and lowest in young children. In contrast, invasive meningococcal disease is most common in young children with a smaller secondary peak in teenagers. Data on carriage and disease were analysed to quantify the risks of infection and disease by age and serogroup. The forces of infection for serogroups B, C, other meningococci and Neisseria lactamica were modelled together with the risk of disease given infection for serogroups B and C, using maximum likelihood to fit the models to the available data. The risk of meningococcal disease given infection declines steeply through childhood and is higher for serogroup C than for serogroup B. The secondary peak in disease in teenagers appears to be explained mostly by increased transmission although there is a suggestion that other factors may also contribute. These analyses provide important insights and may be used to guide further data collection and modelling studies.

Cardiothoracic transplantation for congenital heart disease in teenagers and adults

Since 1980, 194 patients aged between 10–52 years have undergone cardiothoracic transplantation for congenital heart disease (CHD) at our institution. Sixty underwent heart transplantation, 129 heart-lung transplantation, and 5 bilateral lung transplantation with repair of the underlying defect. This represented 4%, 27% and 3 % of all patients undergoing heart, heart-lung and bilateral lung transplantation respectively. Patients undergoing heart transplantation either had complex abnormalities with low pulmonary artery pressure (n = 37) or myocardial failure after previous reparative operations (n = 23). Fourteen patients undergoing heart-lung transplantation had complex pulmonary atresia and 115 had CHD with pulmonary hypertension. The type of operation has been modified during the period under review to take account of the increasing scarcity of donor organs. Operative techniques are adapted according to the complexity of the underlying anatomy. In-hospital mortality was 20/60 (33%) for hearts, 41/115 (36%) in heart-lung transplantation for CHD and pulmonary hypertension and 12/14 (85%) for complex pulmonary atresia. There were no deaths in the five patients undergoing bilateral lung transplantation and repair. Major risk factors for early death in the heart-lung transplant group were complex pulmonary atresia, previous lateral thoracotomy and age greater than 35 years at transplant. Actuarial survival in the heart transplants was 60%, 54% and 46% at 1 year, 5 years, and 10 years respectively and 61%, 45% and 36% at 1 year, 5 years and 10 years respectively for heart-lung transplant patients with CHD and pulmonary hypertension. It is concluded that risk of early death is greater in patients with complex CHD undergoing heart transplantation than in patients with acquired heart disease. Thereafter survival in patients with CHD is similar to other patients undergoing heart or heart-lung transplantation.

Stress, risk-behaviours and meningococcal disease in teenagers

Purpose: Meningococcal disease (MD) is a life-threatening condition with a bimodal age distribution. The teenage peak in incidence is poorly understood. Developmental and behavioural factors associated with adolescence may be important risk factors. We tested the hypotheses that life stress, intimate relationships, smoking, alcohol and substance use are risk factors for MD in adolescents.

Perceptions of sexually transmitted diseases among teenagers.

An exploratory descriptive study was undertaken, focussing on sexually transmitted diseases (STD) among teenagers. The aim of the study was to explore and describe the possible reasons for the high rate of sexually transmitted diseases in teenagers. The perceptions of teenagers and community nurses regarding sexually transmitted disease among teenagers involved in the teenage clinic in a specific predominantly black area were assessed. Twenty teenagers and five community nurses were participants in the study. Two focus group interviews were conducted with teenagers and community nurses. It can be concluded that the attitudes of community nurses may have an influence on the high rate of sexually transmitted diseases among teenagers. The knowledge of the teenagers about sexually transmitted diseases is often based on myths and misconceptions which could be intensified by the community nurse. The recommendations made are that the education standards of all community nurses should be reviewed and adapted to meet the needs of teenagers attending the teenage health services. The policy on in-service training must be reviewed and monitored. Community nurses' intensive training on teenage health service delivery and sexually transmitted diseases services should be in accordance with the principles of Primary Health Care. Community nurses need to attend intensive courses on interpersonal skills specifically related to teenagers. Selection procedures for recruiting community nurses to attend to teenagers specifically should be researched. Teenagers should be involved in planning programs and the teenage clinic should be evaluated frequently to improve the standards. The availability of adequate teenage health services can result in a decrease in sexually transmitted diseases among teenagers.

Educación sexual de niños y adolescentes

There is a remarkable ignorance about sexuality among Chilean teenagers, as underscored by the paper by Fernández et al, published in this issue. The authors analyze the biological, psychological and social consequences of the lack of parental and school sexual education. Among them, there is an increasing incidence of unwanted pregnancies, abortions and sexually transmitted diseases in teenagers. Child abuse, neglect, battering, mortality and maternal deprivation are more frequent among the offspring of teenage parents. School desertion caused by unwanted pregnancies will seriously jeopardize the education and training of these teenagers, perpetuating the cycle of poverty.

Vol. 54, no. 7 (July 1999), pp. 716–721, “Allergic disease in teenagers in relation to urban or rural residence at various stages of childhood”

Vol. 54, no. 7 (July 1999), pp. 716–721, “Allergic disease in teenagers in relation to urban or rural residence at various stages of childhood”

Allergic disease in teenagers in relation to urban or rural residence at various stages of childhood.

Higher prevalences of allergic diseases and IgE antibodies to inhalant allergens have been reported for persons living in urban areas than for persons living in rural areas. Associations between cumulative incidences of allergic diseases in 1878 children aged 13-14 years and their place of residence (urban, semiurban, or rural) from birth were assessed by questionnaire (ISAAC), in order to find out whether there is a period of increased sensitivity to external influences during the first few years of life. Family history and exposure to pets, tobacco smoke, and damp were considered in multiple regression. There was a significantly higher prevalence of allergic diseases with urban residence than with rural residence during the first 2 years of life (e.g., for bronchial asthma, relative risk (RR) for the first year 2.1, 95% CI 1.2-3.7). An increased risk was still found after multiple regression (RR=1.7). Semiurban residence was associated with an intermediate cumulative incidence of allergic diseases. Maternal smoking during pregnancy was associated with asthma (RR=1.4, 95% CI 1.0-2.0). The findings support a period of increased susceptibility during the first years of life. Whether rural lifestyle protects against allergy or whether urban pollutants contribute to allergy has to be elucidated [corrected].

Lumbar disc herniation in teenagers

We report 48 patients operated on for lumbar disc herniation in the second decade of life (aged 13-20 years) in our Neurosurgical Division. To analyze the clinical and diagnostic features and surgical outcome of the disease in teenagers and to point out any differences from adults, we made a detailed study of over 900 juvenile cases and compared them with 11000 adult cases reported in the literature. Low-back pain proved to be less frequent among youngsters both as a first symptom and at diagnosis, while sensorimotor deficits have the same frequency in the two age groups. Herniation occurs more often at L4-L5 and is more frequently median among teenagers. The long-term surgical results in children and adolescents are better than in adults.

Importance of Family History in Adolescent Gallbladder Disease

Sir .—As medical students, we all learned the Rule of Fs in relation to gallbladder disease, ie, its predilection for fat, fecund, females aged 40 to 50 years with a fatty food intolerance. As an adolescent medicine specialist, I have always taught that the rules for gallbladder disease in teenagers are the same: a fat, fecund female aged 15 years with fatty food problems is most at risk, but I suggest adding an extra F for family history of early gallbladder disease. For this reason I was disturbed that there was no mention of family history in the review of cases of childhood gallbladder disease in the January 1991 issue of AJDC. 1 I would be very interested in those data, particularly for the idiopathic cases that accounted for one fifth of the sample, and also for the pregnant teenagers. In teenagers, it is always better, in my opinion, to

Periodontal status of 14-16 year-old Danish schoolchildren.

The purpose of this study was to determine the prevalence of periodontal disease in teenagers. The survey was conducted on 325 children aged 14, 15 and 16 years, living in Aarhus, Denmark. Pocket depth and loss of attachment was measured in mm at the maxillary and mandibular first molars and incisors. Plaque, calculus and gingival bleeding on probing were recorded. A total of 221 children (68%) had 4-5 mm deep pockets and 19 children (5.8%) had pockets deeper than 5 mm on at least one tooth. Approximately 11% of the subjects showed loss of attachment on at least one tooth. The frequency of surfaces with plaque and gingivitis was high in all three age groups. Plaque, gingivitis, deepened pockets and loss of attachment were most frequently observed on interproximal surfaces. No significant differences were observed between the sexes with regard to periodontal disease.

SEXUAL PROBLEMS IN CHILDREN AND ADOLESCENTS

ACCURATE DATA on teenage sexual behavior is difficult to obtain. Only a small proportion of the problem behavior comes to the attention of the juvenile courts, and schools usually prefer to direct little attention to sexual behavior among students. To equip professionals in the health fields to cope with contemporary problems of American youth, more attention should be directed toward studying deviant sexual behavior, especially homosexuality, drugs, use of contraceptives, sex education, and venereal disease in teenagers. Since most teenage problems related to identification and sexual behavior have their genesis in early childhood, the family physician plays an important role in promoting optimum childrearing practices and identifying potentially problematic behavior. THE NEED FOR RESEARCH There is a limited amount of valid scientific knowledge regarding the sexual behavior of adolescents. Although this subject receives considerable attention from the lay press, few good studies have been published. Information which is available is often based on folklore, prejudiced moral judgments, and retrospective anecdotal reporting. The pediatrician usually has limited knowledge on which to base the counseling and advice he is frequently called on to give regarding these problems. The Committee on Youth recommends that this subject be investigated thoroughly and encourages the development of studies to increase our meager knowledge and provide a basis on which to judge contemporary standards of normal and deviant behavior. SEX EDUCATION Any program of sex education is made more complicated by three recent developments: (1) Conception can now be readily controlled by oral medication. (2) There is an increasing interest in, and detailed understanding of, the physiology of the sexual response in both sexes.