BOOK
Advances in Pediatrics 2016, E-Book
Michael S. Kappy | Leslie L. Barton | Carol D. Berkowitz | Jane Carver | Moritz M. Ziegler
(2016)
Additional Information
Book Details
Abstract
Advances in Pediatrics reviews the most current practices in pediatrics. A distinguished editorial board, headed by Dr.Michael Kappy, identifies key areas of major progress and controversy and invites expert pediatricians to contribute original articles devoted to these topics. These insightful overviews bring concepts to a clinical level and explore their everyday impact on patient care. Topics such as fetal diagnosis and surgical intervention, updates in pharmacology, and fatty liver disease are represented, highlighting the most current and relevant information in the field.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| ADVANCES IN\rPediatrics | i | ||
| VOLUME 62 | iii | ||
| Editor-in-Chief | v | ||
| Associate Editors | v | ||
| CONTRIBUTORS | vii | ||
| CONTENTS | xiii | ||
| Introduction\r | xiii | ||
| Vincent A. Fulginiti, MD (1931–2013): A Visionary Leader in Pediatric Education, Research, and Bioethics | xiii | ||
| Advances in the Interdisciplinary Care of Children with Klinefelter Syndrome | xiii | ||
| Prader Willi Syndrome: Genetics, Metabolomics, Hormonal Function, and New Approaches to Therapy | xiv | ||
| Advances in the Care of Transgender Children and Adolescents | xiv | ||
| Asthma Management for Children: Risk Identification and Prevention | xv | ||
| The Optic Nerve Hypoplasia Spectrum: Review of the Literature and Clinical Guidelines | xvi | ||
| Update on Pediatric Human Immunodeficiency Virus Infection: Paradigms in Treatment and Prevention | xvi | ||
| Chronic Hepatitis C Infection in Children | xvii | ||
| Update on Youth-Onset Type 2 Diabetes: Lessons Learned from the Treatment Options for Type 2 Diabetes in Adolescents and Yo ... | xvii | ||
| Comorbidities of Thyroid Disease in Children | xvii | ||
| Advances in Pediatric Pharmacology, Therapeutics, and Toxicology | xviii | ||
| Attention-Deficit/Hyperactivity Disorder | xix | ||
| Updates in Pediatric Rheumatology | xix | ||
| Advances in Autism—2016 | xx | ||
| The Center for Human Development in Guatemala: An Innovative Model for Global Population Health | xx | ||
| Better Transportation to Health Care Will Improve Child Health and Lower Costs | xxi | ||
| Toxic Stress in Children and Adolescents | xxi | ||
| Update on Adolescent Contraception | xxi | ||
| Docosahexaenoic Acid and Arachidonic Acid Nutrition in Early Development | xxii | ||
| Using Shared Decision-Making Tools to Improve Care for Patients with Disorders of Sex Development | xxii | ||
| Introduction | xxv | ||
| Vincent A. Fulginiti, MD (1931–2013) | 1 | ||
| Key points | 1 | ||
| LAURA C. FULGINITI, PHD | 1 | ||
| GRANT MORROW III, MD | 9 | ||
| ELMER S. LIGHTNER, MD | 10 | ||
| Acknowledgments | 13 | ||
| References | 13 | ||
| Advances in the Interdisciplinary Care of Children with Klinefelter Syndrome | 15 | ||
| Key points | 15 | ||
| EPIDEMIOLOGY AND DIAGNOSIS | 15 | ||
| GENETICS | 22 | ||
| Mosaicism | 23 | ||
| Gene dosage and expression | 23 | ||
| Skewed X-inactivation | 25 | ||
| Parental origin | 25 | ||
| Gene polymorphisms | 25 | ||
| Genetic counseling | 26 | ||
| Disclosure | 27 | ||
| DEVELOPMENT, BEHAVIOR AND PSYCHOLOGY | 27 | ||
| Early development | 27 | ||
| Cognitive, language, and learning profiles | 28 | ||
| Behavior/social-emotional development | 30 | ||
| TESTICULAR DEVELOPMENT AND FUNCTION | 32 | ||
| Infancy | 32 | ||
| Childhood | 33 | ||
| Puberty | 33 | ||
| Adulthood | 35 | ||
| OTHER MEDICAL ISSUES | 36 | ||
| Insulin resistance and cardiovascular disorders | 36 | ||
| Bone health | 36 | ||
| Autoimmunity | 37 | ||
| Malignancy | 37 | ||
| Other medical conditions | 38 | ||
| References | 39 | ||
| Prader Willi Syndrome | 47 | ||
| Key points | 47 | ||
| INTRODUCTION | 47 | ||
| GENETICS OF PRADER WILLI SYNDROME | 48 | ||
| Chromosomal localization | 48 | ||
| Candidate genes | 48 | ||
| Necdin gene | 47 | ||
| MAGEL2 family member | 49 | ||
| SNRPN Upstream Reading Frame | 49 | ||
| SNORD 116 | 50 | ||
| CLINICAL MANIFESTATIONS OF PRADER WILLI SYNDROME | 50 | ||
| CONTROL OF FOOD INTAKE IN PRADER WILLI SYNDROME | 51 | ||
| HYPOTHALAMIC PITUITARY FUNCTION IN PRADER WILLI SYNDROME | 53 | ||
| Growth hormone deficiency and short stature | 53 | ||
| Studies in infants/toddlers | 54 | ||
| Data in older children | 55 | ||
| Data in adulthood | 56 | ||
| Central adrenal insufficiency | 57 | ||
| Hypogonadism | 58 | ||
| Hypothyroidism | 58 | ||
| Glucose homeostasis | 58 | ||
| EXTRAHORMONAL COMORBIDITIES IN PRADER WILLI SYNDROME | 60 | ||
| Sleep disorders | 60 | ||
| Behavioral problems and psychiatric disturbances | 60 | ||
| METABOLIC STUDIES | 61 | ||
| Body composition in Prader Willi syndrome | 61 | ||
| Energy balance in Prader Willi syndrome | 61 | ||
| CURRENT STANDARD THERAPIES | 62 | ||
| Nutritional phases and hyperphagia | 62 | ||
| Nutritional management | 64 | ||
| Sex hormone replacement therapy | 65 | ||
| NEW APPROACHES TO THERAPY | 66 | ||
| Oxytocin for hyperphagia and behavioral disorders | 66 | ||
| Co-enzyme Q10 and carnitine to increase energy expenditure | 66 | ||
| Modafinil for narcolepsy and daytime sleepiness | 66 | ||
| N-acetylcysteine for obsessive picking of the skin | 67 | ||
| Beloranib for hyperphagia | 67 | ||
| Bariatric surgery | 68 | ||
| LONG-TERM CARE AND LIFE SPAN | 68 | ||
| Future studies and therapies | 69 | ||
| SUMMARY | 69 | ||
| References | 70 | ||
| Advances in the Care of Transgender Children and Adolescents | 79 | ||
| INTRODUCTION | 79 | ||
| DEFINITIONS AND EPIDEMIOLOGY | 80 | ||
| HISTORICAL PERSPECTIVES | 81 | ||
| THE DEVELOPMENT OF GENDER IDENTITY | 83 | ||
| MENTAL HEALTH | 85 | ||
| SEX DIFFERENTIATION AND NORMAL PUBERTY | 87 | ||
| OVERVIEW OF MEDICAL MANAGEMENT | 88 | ||
| PREVENTION OF THE DEVELOPMENT OF UNWANTED SECONDARY SEX CHARACTERISTICS | 88 | ||
| PROMOTION OF THE DEVELOPMENT OF DESIRED SECONDARY SEX CHARACTERISTICS | 92 | ||
| LONGITUDINAL SCREENING AND ANTICIPATORY GUIDANCE | 93 | ||
| GENDER AFFIRMATIVE SURGERY | 94 | ||
| OUTCOMES | 95 | ||
| CHALLENGES AND BARRIERS TO CARE | 95 | ||
| CURRENT GENDER MANAGEMENT PROGRAMS IN THE UNITED STATES AND CANADA | 95 | ||
| CASE EXAMPLES | 96 | ||
| Patient 1 | 96 | ||
| Patient 2 | 97 | ||
| Patient 3 | 97 | ||
| Patient 4 | 97 | ||
| Patient 5 | 97 | ||
| Acknowledgments | 98 | ||
| References | 98 | ||
| Asthma Management for Children | 103 | ||
| Key points | 103 | ||
| INTRODUCTION | 103 | ||
| EARLY ASTHMA | 104 | ||
| Epidemiology of preschool and early wheeze | 104 | ||
| Risk factors for preschool and early wheeze | 105 | ||
| Phenotypes of preschool wheeze | 105 | ||
| Pathophysiology of preschool wheeze | 106 | ||
| Treatment of preschool wheeze | 106 | ||
| Progression to persistent wheeze and asthma | 107 | ||
| Long-term sequelae preschool wheeze | 108 | ||
| ASTHMA EXACERBATIONS | 108 | ||
| Predicting asthma exacerbations | 108 | ||
| Environmental factors | 103 | ||
| Biomarkers | 109 | ||
| Preventing and managing asthma exacerbations | 110 | ||
| Corticosteroids | 110 | ||
| Anticholinergics | 110 | ||
| Other emerging therapies | 111 | ||
| Preventing asthma exacerbations | 111 | ||
| SEVERE ASTHMA | 111 | ||
| Natural history of severe asthma | 112 | ||
| Severe asthma phenotypes | 113 | ||
| Mechanisms of severe asthma | 114 | ||
| Adherence | 115 | ||
| NEW MEDICATIONS | 116 | ||
| Tiotropium | 117 | ||
| Omalizumab | 117 | ||
| Mepolizumab | 118 | ||
| Reslizumab | 118 | ||
| Lebrikizumab | 119 | ||
| SUMMARY | 119 | ||
| Acknowledgments | 119 | ||
| References | 120 | ||
| The Optic Nerve Hypoplasia Spectrum | 127 | ||
| Key points | 127 | ||
| INTRODUCTION | 127 | ||
| EPIDEMIOLOGY | 128 | ||
| CAUSES AND RISK FACTORS | 129 | ||
| Prenatal factors and maternal age | 129 | ||
| Genetics | 129 | ||
| CLINICAL APPROACH TO CHILDREN WITH OPTIC NERVE HYPOPLASIA | 130 | ||
| Clinical presentations and associated features in optic nerve hypoplasia | 130 | ||
| Neonatal period to infancy | 127 | ||
| Infancy and beyond | 133 | ||
| Evaluation and management of children with optic nerve hypoplasia | 136 | ||
| Vision | 136 | ||
| Neuroanatomic malformations and neuropsychological abnormalities | 137 | ||
| Hypothalamic-pituitary axis | 138 | ||
| Other hypothalamic abnormalities | 139 | ||
| SUMMARY | 142 | ||
| References | 142 | ||
| Update on Pediatric Human Immunodeficiency Virus Infection | 147 | ||
| INTRODUCTION | 147 | ||
| EPIDEMIOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS IN THE UNITED STATES | 148 | ||
| EPIDEMIOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS WORLDWIDE | 149 | ||
| UPDATES ON HUMAN IMMUNODEFICIENCY VIRUS IMMUNOPATHOGENESIS | 149 | ||
| Immunopathogenesis of acute and chronic human immunodeficiency virus infection | 149 | ||
| Immune abnormalities resulting from human immunodeficiency virus | 151 | ||
| Elite controllers | 151 | ||
| PERSISTENCE, CONTROL, AND ERADICATION OF HUMAN IMMUNODEFICIENCY VIRUS: EFFORTS TOWARDS CURE | 152 | ||
| Human immunodeficiency virus persistence and the latent reservoir | 152 | ||
| Cure strategies | 153 | ||
| HUMAN IMMUNODEFICIENCY VIRUS DIAGNOSIS: FOCUS ON EARLY HUMAN IMMUNODEFICIENCY VIRUS INFECTION | 155 | ||
| REVISED HUMAN IMMUNODEFICIENCY VIRUS DISEASE STAGING | 157 | ||
| PARADIGMS IN HUMAN IMMUNODEFICIENCY VIRUS TREATMENT | 157 | ||
| COMPLICATIONS OF HUMAN IMMUNODEFICIENCY VIRUS AND TREATMENT | 159 | ||
| Dyslipidemia and insulin resistance | 160 | ||
| Cardiovascular and cerebrovascular risk | 160 | ||
| Bone health | 161 | ||
| Lipodystrophy | 161 | ||
| PREVENTION | 161 | ||
| Prevention of vertical human immunodeficiency virus transmission | 161 | ||
| Effects of antiretroviral and human immunodeficiency virus exposure during pregnancy and early infancy | 162 | ||
| Prevention of behavioral human immunodeficiency virus transmission | 163 | ||
| The continuum of care: treatment as prevention | 163 | ||
| SUMMARY | 165 | ||
| References | 165 | ||
| Chronic Hepatitis C Infection in Children | 173 | ||
| INTRODUCTION | 173 | ||
| EPIDEMIOLOGY | 174 | ||
| VIROLOGY AND PATHOGENESIS | 174 | ||
| TRANSMISSION | 175 | ||
| NATURAL HISTORY | 176 | ||
| DIAGNOSIS AND TESTING | 178 | ||
| TREATMENT | 179 | ||
| Who needs treatment? | 179 | ||
| Currently approved treatment in children | 179 | ||
| Interferon | 173 | ||
| Ribavirin | 181 | ||
| Side effects | 181 | ||
| Special populations | 182 | ||
| Future therapies | 184 | ||
| References | 187 | ||
| Update on Youth-Onset Type 2 Diabetes | 195 | ||
| INTRODUCTION | 195 | ||
| TREATMENT OPTIONS FOR TYPE 2 DIABETES IN ADOLESCENTS AND YOUTH TRIAL RESULTS | 196 | ||
| LESSONS FROM THE TREATMENT OPTIONS FOR TYPE 2 DIABETES IN ADOLESCENTS AND YOUTH RUN-IN | 197 | ||
| DURABLE CONTROL | 198 | ||
| METABOLIC SYNDROME | 198 | ||
| PARENTAL DIABETES | 201 | ||
| PREGNANCY | 202 | ||
| COMPLICATIONS | 204 | ||
| FUTURE RESEARCH | 206 | ||
| Acknowledgments | 206 | ||
| References | 207 | ||
| Comorbidities of Thyroid Disease in Children | 211 | ||
| INTRODUCTION: COMORBIDITIES OF THYROID DISEASE IN CHILDREN | 211 | ||
| CONGENITAL HYPOTHYROIDISM | 212 | ||
| Neurologic/psychiatric impact | 212 | ||
| Growth effects | 213 | ||
| Weight effects and related complications | 214 | ||
| Cardiovascular risk | 214 | ||
| ACQUIRED AUTOIMMUNE HYPOTHYROIDISM (HASHIMOTO THYROIDITIS) | 214 | ||
| Neurologic/psychiatric impact | 214 | ||
| Growth effects | 215 | ||
| Weight effects and related complications | 216 | ||
| Cardiovascular risk | 216 | ||
| Subclinical hypothyroidism | 217 | ||
| Neurologic/psychiatric impact | 217 | ||
| Growth effects | 217 | ||
| Weight effects and related complications | 217 | ||
| Cardiovascular risk | 218 | ||
| Who to treat with subclinical hypothyroidism | 218 | ||
| COMORBIDITIES ASSOCIATED WITH AUTOIMMUNE HYPERTHYROIDISM/GRAVES’ DISEASE | 218 | ||
| Neurologic/psychiatric impact | 218 | ||
| Growth effects | 219 | ||
| Weight effects and related complications | 220 | ||
| Cardiovascular risk | 220 | ||
| References | 220 | ||
| Advances in Pediatric Pharmacology, Therapeutics, and Toxicology | 227 | ||
| Key points | 227 | ||
| INTRODUCTION | 227 | ||
| ANESTHESIA | 228 | ||
| Sedation | 228 | ||
| Pain management | 229 | ||
| CARDIOLOGY | 234 | ||
| Pulmonary hypertension | 234 | ||
| Hypertension | 235 | ||
| DERMATOLOGY | 235 | ||
| Atopic dermatitis | 235 | ||
| GASTROENTEROLOGY | 236 | ||
| Inflammatory bowel disease: ulcerative colitis and Crohn disease | 236 | ||
| Constipation | 237 | ||
| Gastroesophageal reflux disease | 237 | ||
| GENETIC AND METABOLIC DISEASES | 238 | ||
| INFECTIOUS DISEASE | 239 | ||
| Pharmacokinetics | 239 | ||
| Pneumonia | 239 | ||
| Hepatitis B | 240 | ||
| HIV | 240 | ||
| Congenital cytomegalovirus | 241 | ||
| Pneumococcal disease | 242 | ||
| NEUROLOGY | 242 | ||
| Migraines | 242 | ||
| Seizures | 243 | ||
| ONCOLOGY | 243 | ||
| PULMONARY AND ALLERGY | 244 | ||
| Asthma | 244 | ||
| Allergic rhinitis | 244 | ||
| Cystic fibrosis | 245 | ||
| PSYCHIATRY | 246 | ||
| RHEUMATOLOGY | 246 | ||
| Juvenile idiopathic arthritis | 246 | ||
| SYMPTOMATIC CARE | 247 | ||
| SUMMARY | 248 | ||
| References | 248 | ||
| Attention-Deficit/Hyperactivity Disorder | 255 | ||
| INTRODUCTION | 255 | ||
| PREVALENCE | 256 | ||
| ETIOPATHOGENESIS | 256 | ||
| CLINICAL FEATURES AND DIAGNOSIS | 258 | ||
| DIFFERENTIAL DIAGNOSIS | 260 | ||
| COMORBIDITY | 260 | ||
| CLINICAL EVALUATION | 262 | ||
| History | 262 | ||
| Physical examination | 263 | ||
| LABORATORY EVALUATION | 263 | ||
| MANAGEMENT | 264 | ||
| Pharmacologic intervention | 264 | ||
| Stimulants | 255 | ||
| Atomoxetine | 268 | ||
| α2-Adrenergic agonists | 268 | ||
| Antidepressants | 269 | ||
| Educational intervention | 270 | ||
| Behavioral intervention | 270 | ||
| Family therapy | 271 | ||
| Psychotherapy | 271 | ||
| Dietary intervention | 271 | ||
| PROGNOSIS | 272 | ||
| References | 272 | ||
| Updates in Pediatric Rheumatology | 281 | ||
| Key points | 281 | ||
| RHEUMATIC DISEASES | 281 | ||
| Juvenile idiopathic arthritis | 282 | ||
| Biomarkers | 281 | ||
| Clinical features | 283 | ||
| Oligoarticular juvenile idiopathic arthritis | 283 | ||
| Anterior uveitis | 285 | ||
| Differential diagnosis | 285 | ||
| Laboratory tests | 285 | ||
| Treatment and prognosis | 285 | ||
| Polyarticular juvenile idiopathic arthritis | 286 | ||
| Differential diagnosis | 286 | ||
| Laboratory tests | 287 | ||
| Treatment and prognosis | 287 | ||
| Systemic juvenile idiopathic arthritis | 288 | ||
| Macrophage activation syndrome in systemic juvenile idiopathic arthritis | 289 | ||
| Differential diagnosis | 290 | ||
| Laboratory tests | 290 | ||
| Treatment and prognosis | 291 | ||
| Psoriatic arthritis | 291 | ||
| Enthesitis-related arthritis and juvenile ankylosing spondylitis | 291 | ||
| Undifferentiated | 292 | ||
| Outcomes for juvenile idiopathic arthritis | 292 | ||
| Systemic lupus erythematosus | 292 | ||
| Epidemiology | 292 | ||
| Incidence and prevalence | 292 | ||
| Ethnic background | 293 | ||
| Age and gender | 293 | ||
| Clinical presentation | 293 | ||
| Antiphospholipid syndrome | 296 | ||
| Differential diagnosis | 300 | ||
| Laboratory tests | 300 | ||
| Treatment and prognosis | 301 | ||
| Inflammatory myopathies | 302 | ||
| Epidemiology | 303 | ||
| Incidence and prevalence | 303 | ||
| Ethnic background | 303 | ||
| Age and gender | 303 | ||
| Clinical presentation | 303 | ||
| Laboratory studies | 304 | ||
| Treatment and prognosis | 304 | ||
| Scleroderma | 305 | ||
| Localized scleroderma | 305 | ||
| Epidemiology | 306 | ||
| Incidence and prevalence | 306 | ||
| Ethnic background | 306 | ||
| Age and gender | 306 | ||
| Clinical manifestations | 306 | ||
| Laboratory studies | 306 | ||
| Treatment and prognosis | 306 | ||
| Systemic sclerosis | 307 | ||
| Epidemiology | 307 | ||
| Incidence and prevalence | 307 | ||
| Ethnic background | 307 | ||
| Age and gender | 307 | ||
| Clinical manifestations | 307 | ||
| Laboratory findings | 308 | ||
| Treatment and prognosis | 308 | ||
| Vasculitis | 309 | ||
| Epidemiology | 309 | ||
| Incidence and prevalence | 309 | ||
| Ethnic background | 309 | ||
| Age and gender | 309 | ||
| Clinical manifestations | 309 | ||
| Henoch-Schönlein purpura | 309 | ||
| Differential diagnosis | 310 | ||
| Treatment and prognosis | 310 | ||
| Kawasaki disease | 310 | ||
| Differential diagnosis | 311 | ||
| Advances in Autism—2016 | 333 | ||
| INTRODUCTION | 333 | ||
| HISTORICAL OVERVIEW | 334 | ||
| REVISED DIAGNOSTIC CRITERIA FOR AUTISM | 338 | ||
| CENTRAL NERVOUS SYSTEM STRUCTURAL FINDINGS ASSOCIATED WITH CHILDREN MEETING THE CRITERIA FOR AN AUTISM SPECTRUM DISORDER | 342 | ||
| TREATMENT | 345 | ||
| Behavioral interventions | 345 | ||
| Pharmacologic interventions | 352 | ||
| DISCUSSION AND SUMMARY | 352 | ||
| Acknowledgments | 353 | ||
| References | 353 | ||
| The Center for Human Development in Guatemala | 357 | ||
| Key points | 357 | ||
| INTRODUCTION | 357 | ||
| THE POPULATION | 358 | ||
| THE AGRO-AMERICA–UNIVERSITY PARTNERSHIP | 359 | ||
| THE STRATEGIC APPROACH TO POPULATION HEALTH | 362 | ||
| COMMUNITY HEALTH ASSESSMENT | 362 | ||
| COMMUNITY ENGAGEMENT: A RAPID ANTHROPOLOGIC ASSESSMENT PROCEDURE | 366 | ||
| POPULATION HEALTH DOMAINS | 366 | ||
| Clinic services | 366 | ||
| Birthing center | 357 | ||
| Oral health program | 371 | ||
| Oral health care for workers and the community | 372 | ||
| Population evaluation | 372 | ||
| Community services | 373 | ||
| Maternal health community nursing programs | 373 | ||
| Pediatric community health nursing program | 374 | ||
| Challenges: community health nursing program | 377 | ||
| Employee health | 378 | ||
| Total Worker Health program (adult and occupational health for Agro-America) | 378 | ||
| Environment: water and sanitation | 379 | ||
| Economic opportunity | 380 | ||
| Education | 380 | ||
| CU students, residents, and fellows | 381 | ||
| Trifinio Center for Human Development staff and Coatepeque Hospital staff | 382 | ||
| Southwest Trifinio secondary and high school students | 382 | ||
| OVERARCHING FUNCTIONS | 383 | ||
| Research | 383 | ||
| Community organizing | 383 | ||
| Strategic planning and sustainability | 384 | ||
| SUMMARY | 384 | ||
| Acknowledgments | 385 | ||
| References | 385 | ||
| Better Transportation to Health Care Will Improve Child Health and Lower Costs | 389 | ||
| INTRODUCTION | 389 | ||
| TRANSPORTATION AND HEALTH CARE ACCESS | 390 | ||
| Transportation disadvantage | 390 | ||
| Geographic access and workforce shortages | 390 | ||
| Transportation and child health access | 391 | ||
| Distance, transportation, and chronic health conditions | 392 | ||
| Nonemergency medical transportation | 393 | ||
| IDENTIFYING RISK FOR TRANSPORTATION BARRIERS TO ACCESS | 393 | ||
| Methods | 394 | ||
| Results | 395 | ||
| Policy recommendations | 395 | ||
| Mobility management | 389 | ||
| Modifying paratransit services | 397 | ||
| Transportation provided by health clinics | 397 | ||
| Strengthening Medicaid nonemergency medical transportation | 398 | ||
| Coordinating transportation resources | 398 | ||
| Limitations of the study | 398 | ||
| References | 399 | ||
| Toxic Stress in Children and Adolescents | 403 | ||
| INTRODUCTION | 403 | ||
| EARLY LIFE ADVERSITY AND HEALTH OUTCOMES | 404 | ||
| Prevalence of early life adversity | 406 | ||
| Health outcomes associated with early life adversity | 406 | ||
| EARLY LIFE ADVERSITY AND TOXIC STRESS | 407 | ||
| The stress response | 408 | ||
| Anatomy and physiology of the stress response | 403 | ||
| Activation of the stress response | 409 | ||
| Sympatho-adrenomedullary axis activation | 409 | ||
| Hypothalamic-pituitary-adrenal axis activation | 412 | ||
| Central nervous system activation | 413 | ||
| Dysregulation of the stress response | 414 | ||
| Biological alterations of the stress response | 414 | ||
| Nervous system | 415 | ||
| Endocrine system | 415 | ||
| Immune system | 415 | ||
| TOXIC STRESS AND CLINICAL IMPLICATIONS | 416 | ||
| Multisystemic alterations | 416 | ||
| Neurologic, psychiatric, and behavioral alterations | 416 | ||
| Endocrine, metabolic, and reproductive alterations | 417 | ||
| Immune and inflammatory alterations | 418 | ||
| Genetic factors and epigenetic modifications | 418 | ||
| DISCUSSION | 420 | ||
| Acknowledgments | 422 | ||
| References | 422 | ||
| Update on Adolescent Contraception | 429 | ||
| ADOLESCENT CONTRACEPTION | 429 | ||
| TEEN PREGNANCY AND CONTRACEPTIVE USE | 430 | ||
| ADOLESCENT HEALTH VISITS | 431 | ||
| Adolescent-friendly environment | 431 | ||
| One-on-one relationship between provider and adolescent | 431 | ||
| Confidentiality and its limits need to be discussed | 431 | ||
| ADOLESCENT DEVELOPMENT AND THE SEXUAL HISTORY | 433 | ||
| CONTRACEPTIVE COUNSELING | 436 | ||
| Understand patient misconceptions | 436 | ||
| Discuss the potential impact of contraception on current and future goals | 437 | ||
| Empower adolescents to choose | 437 | ||
| Start a contraceptive method on the day of visit | 437 | ||
| CONTRACEPTIVE METHOD SUMMARIES | 437 | ||
| The Contraceptive implant | 438 | ||
| Key points | 429 | ||
| Mechanism of action | 439 | ||
| Advantages and method counseling | 439 | ||
| Managing common, expected side effects | 439 | ||
| Intrauterine devices | 440 | ||
| Description and mechanism of action | 440 | ||
| Method counseling | 442 | ||
| Managing common, expected side effects | 443 | ||
| Missing strings | 443 | ||
| Depot medroxyprogesterone acetate | 443 | ||
| Key points | 443 | ||
| Description and mechanism of action | 443 | ||
| Advantages and method counseling | 444 | ||
| Managing common, expected side effects | 444 | ||
| Combined hormonal contraception | 445 | ||
| Key points | 445 | ||
| Description and mechanism of action | 445 | ||
| Managing common, expected side effects | 446 | ||
| MENSTRUAL SUPPRESSION | 447 | ||
| COMPLEX MEDICAL CONDITIONS | 447 | ||
| PHYSICAL AND DEVELOPMENTAL DISABILITIES | 449 | ||
| SUMMARY | 449 | ||
| References | 449 | ||
| Docosahexaenoic Acid and Arachidonic Acid Nutrition in Early Development | 453 | ||
| Key points | 453 | ||
| INTRODUCTION | 453 | ||
| Long-chain polyunsaturated fatty acid intake as a source of docosahexaenoic acid and arachidonic acid | 455 | ||
| Fetal stores as a source of docosahexaenoic acid | 455 | ||
| Long-chain polyunsaturated fatty acid synthesis as a source of docosahexaenoic acid and arachidonic acid | 456 | ||
| Roles of docosahexaenoic acid and arachidonic acid in the brain | 456 | ||
| Brain development and assessment in infants and children | 457 | ||
| Cortical visual acuity | 459 | ||
| Cognition | 460 | ||
| Brain electrophysiology and studies in childhood | 462 | ||
| Single-nucleotide polymorphisms and cognition | 462 | ||
| Allergy and immunity | 463 | ||
| Body composition | 464 | ||
| Assessment of the literature on docosahexaenoic acid and arachidonic acid and infant development | 464 | ||
| References | 466 | ||
| Using Shared Decision-Making Tools to Improve Care for Patients with Disorders of Sex Development | 473 | ||
| INTRODUCTION | 473 | ||
| MANAGEMENT GOALS | 474 | ||
| History of the care of children with disorders of sex development | 474 | ||
| Importance of shared decision making for patients with disorders of sex development | 475 | ||
| Legal aspects of disorders of sex development care with regard to informed consent | 476 | ||
| The role of shared decision making in managing expectations | 476 | ||
| How to implement the shared decision-making tools | 477 | ||
| Special concerns for specific diagnoses | 478 | ||
| Congenital adrenal hyperplasia | 473 | ||
| Mayer Rokitansky Kuster Hauser syndrome | 478 | ||
| Complete androgen insensitivity syndrome and other XY disorders of sex development | 479 | ||
| DISCUSSION | 479 | ||
| References | 480 |