Pediatric clinics of North America
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Participation in sports is important to many college students. Student athletes come from different levels of previous sport experience as they enter collegiate athletics. The primary source of student medical care is the campus student health center. ⋯ Preparticipation evaluation provides an opportunity to assess the general health of the student athlete and to identify conditions that might increase the risk of further injury. Sudden cardiac death and sports-associated concussions have generated much interest and are reviewed in this article. Other areas reviewed here include use of drugs and supplements, ankle sprains, acute knee ligament injuries, back pain, and shoulder impingement syndrome.
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Fear and anxiety are common experiences throughout childhood and adolescence. Anxiety disorders, along with depression and dysthymia, are characterized as internalizing disorders; they stand in distinction from the externalizing disorders representing such conditions as oppositional-defiant disorder and conduct disorder. Clinicians evaluating anxiety disorders in college youth face the task of differentiating normal, transient, developmentally appropriate expression of anxiety from pathologic states of anxiety. ⋯ The treatment of anxiety and depression in youth is ideally multi-modal, involving medication, psychotherapy, and psychosocial interventions. This article focuses on assessment and treatment of anxiety and depression. These are presented separately, although areas of overlap often are encountered in practice.
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This article focuses on sudden unexpected cardiac death (SCD) in children and adolescents. The authors discuss the epidemiology of SCD in children and adolescents, its incidence and etiologies, and strategies for prevention. Because most of the episodes of SCD or sudden cardiac arrest in children and adolescents occur in asymptomatic individuals unknown to have an underlying abnormality before their "event," the issues in this article primarily focus on this group of individuals.
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Commotio cordis is ventricular fibrillation that results from blunt chest trauma and is a life threatening condition; early resuscitation and defibrillation are critical. This may occur during sporting events or from child abuse and most patients are boys who are younger than 16 years. ⋯ Automatic defibrillators at convenient locations near sporting events, combined with improved cardiopulmonary resuscitation education, may improve chances of survival after this rare phenomenon. Transient cardiac conduction abnormalities and arrhythmias have been observed in survivors; therefore, cardiac clearance before resumption of sports is indicated.
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Pediatr. Clin. North Am. · Oct 2004
ReviewSudden cardiac death in children and adolescents: introduction and overview.
Sudden unexpected cardiac death (SCD) in a child or adolescent is a devastating event with serious impact on the family, the school, and the community. This article reviews the epidemiology of SCD in children and adolescents and includes a discussion of its incidence and etiologies. It also discusses strategies for prevention.