Pediatric clinics of North America
-
Pediatr. Clin. North Am. · Aug 2002
ReviewCentral nervous system trauma management of concussions in athletes.
The care of athletes with concussions is challenging because each patient has different symptoms. An athlete should never be returned to play until completely asymptomatic. ⋯ Abbreviated neuropsychological testing and balance tests show promise for use in the field to increase the sensitivity of our neurological evaluation on injured athletes. Any neuropsychological or balance evaluation is more helpful if baseline data is collected on athletes before they are injured.
-
It is imperative to know what risk factors are more likely to appear during specific developmental stages so that identification and interventions can be used to decrease the risk for future SUD. Continued surveying of risk factors that can occur at any stage in childhood are important to ensure that other risk factors are anticipated and intervened upon as well. Multiple risk factors increase the magnitude of the risk for SUD, and therefore all risk factors should be detected to convert these to protective factors. ⋯ It is important to form a team approach so that all risk factors can be approached. Members of the team often include a primary care physician, a child psychologist, the parents, the patient, a teacher, a school counselor, a child psychiatrist, and sometimes a pediatric neurologist. No one member of the treatment team can provide all of the necessary services to prevent the future risk for substance abuse.
-
Although all states have laws that allow minors to consent to substance abuse treatment, there is variability from state to state. Health care providers need to be aware of laws within their states. When providing health care to adolescents, many situations arise in which the provider must make a determination of the patient's competence to consent and whether parental notification would be in the patient's best interest. ⋯ Physicians and other medical care providers also need to manage confidentiality issues in drug testing, billing of services, and medical records and need to work with clinical administrative staff to clarify and implement policies to maintain confidentiality. Proposed changes to medical privacy regulations may compromise confidentiality for medical care of adolescents. Medical providers should continue to work with their professional societies and legislators to ensure that appropriate consent and confidentiality statues exist to provide optimal health care to adolescents.
-
Pediatr. Clin. North Am. · Feb 2002
ReviewProbiotics in health and disease in the pediatric patient.
Probiotics are truly a timeless concept. Initially standard components of the human diet, potentially beneficial bacteria and yeast have been eliminated systematically through modern methods of preparing and preserving foods. ⋯ Furthermore, the potential uses for these organisms may extend far beyond what originally was thought. In no way should probiotics be thought of as a panacea for the diseases described earlier; however, when used appropriately, they represent a potentially beneficial adjunct to other proved therapies and have the added benefit of providing a stabilizing influence on the delicate balance between the ecosystem that consists of the human and its flora.
-
Despite governmental efforts to improve the quality of outdoor air, a significant number of children growing up in the US are exposed to airborne pollutants. It is now recognized that infants generally at risk for atrophy when exposed to specific environmental airborne pollutants are more likely to develop asthma. ⋯ Airborne ozone and suspended articles are the two most important criteria pollutants with respect to exposure prevalence and suspected adverse health effects in US children. Pediatricians should be involved both in community advocacy programs to improve air quality and as knowledgeable practitioners in discussing practical air pollution avoidance strategies with patients and their families.