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Pediatric inflammatory bowel disease (IBD) is a chronic, life-threatening gastrointestinal tract disease that usually involves the terminal ileum, cecum, colon, and perianal area. There has been a growing incidence of IBD reported worldwide, and it is becoming an increasing concern for pediatric health care. This discussion covers the global significance, the subtypes, diagnostic criteria, and advances in pediatric IBD management. [ABSTRACT FROM AUTHOR]

The quest for understanding the pathophysiology and management of hepatobiliary disorders has taken Homo sapiens thousands of years. The liver was viewed in religious terms at first and as designated priests utilized divination practice to predict the future, lasting lessons of anatomy were learned. The liver was viewed in various ways, including as the center of one's life and/or the place of negative emotions (anger, greed, jealousy). Gallstones were described by Galen and Alexander of Trailles. Knowledge of anatomy led to etiologic understanding of hepatobiliary disorders and eventually methods of treatment emerged over the passing millennia. This discussion considers some of the polyglottic pantheons in this regard, including Galen of Pergamon (AD 129-c.200/c.216), Avicenna (980-1037), Andreas Vesalius (1514-1564), Francis Glisson (1597-1677), Giovanni Battister Morgagni (1682-1771), René Théophile Hyacinthe Laënnec (1781-1826), Claude Bernard (1813-1878), Henry W. Gray (1827-1861), Karl Wilhelm von Kupffer (1829-1902), Tadeusz Browicz (1847-1928), Johann Ludwig Wilhelm Thudichum (1829-1901), Samuel Alexander Kinnier Wilson (1878-1937), Frank H. Netter (1906-1991), and other sages of surgery and medicine. Much has been learned from the Greek myth of Promethius to the prodigious pantheons of progress in the past and present. [ABSTRACT FROM AUTHOR]

Homo sapiens may have emerged from complex and miraculous origins 300,000 years ago, and sophisticated speech may have emerged many millennia later. Changes in speech development, such as the FOXP2 gene around 100,000 years ago, led to remarkable speech patterns in these humans that allowed verbal passage of learned information from generation to generation. Wandering humans finally began to settle down with the development of agriculture over 10,000 years ago in various places in the world that include the near East, Africa, China, and Southeast Asia. Knowledge gained over the past 10 millennia regarding gastrointestinal disorders in humans is now reviewed from a historical perspective and beginning in Mesopotamia. [ABSTRACT FROM AUTHOR]

In the quest for winning the game, some athletes take various chemicals (ie, drugs, herbs, or supplements) in attempts to develop greater strength, endurance, or other elements that bring a competitive advantage. There are more than 30,000 chemicals sold throughout the world with unrestrained and unproven claims; however, some athletes consume them with hopes of increasing their athletic abilities, often without knowledge of the potential adverse effects and with limited evidence of efficacy. Complicating this picture is that research on ergogenic chemicals is typically conducted with elite adult male athletes and not with athletes who are in high school. A few of these ergogenic aids include creatine, anabolic androgenic steroids, selective androgen receptor modulators, clenbuterol, androstenedione, dehydroepiandrosterone, human growth hormone, ephedrine, gamma hydroxybutyrate, caffeine, stimulants (amphetamines or methylphenidate), and blood doping. In this article, we describe the purpose of ergogenic aids as well as the potential side effects. [Pediatr Ann. 2023;52(6):e207–e212.] [ABSTRACT FROM AUTHOR]

Human sexuality is a complex phenomenon involving the interaction of one's biologic sex, core gender identity, and gender role behavior. Successful completion of normal stages of sexuality development is important for children and adolescents to enhance optimal life as an adult. Controversies arise for clinicians as they work with their pediatric patients regarding health care sexuality issues. It is important that clinicians help these patients in an unbiased and neutral manner. As adults, these children and adolescents will function in a number of sexuality roles, whether heterosexual, homosexual, pansexual, or other. This discussion considers many of these complex and critical issues that involve the fascinating development of human sexuality in pediatric patients. [ABSTRACT FROM AUTHOR]

Incontinence disorders are an important group of problems clinicians manage in children and adolescents. This paper reviews the physiology of micturition, the epidemiology of enuresis, general clinical approach to enuresis, laboratory evaluation, and general principles of management. [ABSTRACT FROM AUTHOR]

Tics are one of the most common neuropsychiatric disturbances in children and adolescents. This paper reviews tic disorder definition, epidemiology, differential diagnosis, and co-morbidity. The major emphasis is on current principles of psychopharmacologic management of tic disorders in children and adolescents. Chronic motor tic disorder and Tourette's syndrome typically require the use of psychopharmacologic agents that traditionally have included haloperidol, pimozide, and clonidine. Risperidone and aripiprazole are now preferred by many to haloperidol. A variety of other medications have been used to ameliorate tics, but with less anecdotal and research support. The safe and effective treatment of Tourette's disorder, and other tic disorders, is based on a logical hierarchy of interventions, from cognitive and behavioral therapies to pharmacologic agents. Thus, it is important for clinicians caring for pediatric patients to have knowledge of the various medications used to ameliorate tics. [ABSTRACT FROM AUTHOR]

This discussion presents current research findings on postpartum depression (PPD) in the adolescent female. PPD is defined and then the etiopathogenesis of PPD are reviewed. Emphasis is placed on screening by the primary care clinician to identify this condition and issues in this regard are discussed. PPD management is considered including both non-pharmacologic and pharmacologic approaches. Recent research on PPD in the adolescent is presented. It is the recommendation of the authors that primary care clinicians become more knowledgeable about PPD to make an early identification and suggest effective means of management to reduce the devastation PPD can cause in the young mother, her newborn baby, and her family in general. [ABSTRACT FROM AUTHOR]

Obesity is a major risk factor for child, adolescent and adult health. Though diet and exercise are the cornerstone of obesity prevention and treatment, many pediatric persons do not adhere to a nutrition-exercise approach. This review reflects on concepts of pharmacology for the management of obesity in children and adolescents in the early 21st century. Medications considered in the management of obesity include sympathomimetics (with or without topiramate), serotonin agonists, fat blockers (gastrointestinal lipase inhibitors), glucagon-like peptide 1 (GLP-1) agonists, antidepressant/opioid antagonist combination and others. Medications that were used for obesity management and later pulled from the market are also discussed. There are two drugs, orlistat and liraglutide, approved by the United States Food and Drug Administration (US-FDA) for adolescents ≥ 12 years of age with obesity. In the pediatric population there remains limited evidence on the safety and efficacy of anti-obesity medications used in adults and close monitoring for adverse effects is needed. The use of medications to assist in the management of overweight and obesity in pediatric and adult persons will increase as the 21st century continues. Clinicians should be vigilant about the current state of the art with regard to pharmacology of obesity and to its future. [ABSTRACT FROM AUTHOR]

Gynecologic features of eating disorders include relationships to puberty, fertility effects, and the low estrogen underpinnings of eventual osteopenia as well as osteoporosis. It is concluded that clinicians should provide judicious observation for potential eating disorders in pubertal females along with prompt management of anorexia nervosa, bulimia nervosa, or other eating disorders that may be arise in children, adolescents and adults. [ABSTRACT FROM AUTHOR]

Eating disorders are complex biopsychosocial disorders that include anorexia nervosa and bulimia nervosa. This review considers both of these disorders with the emphasis on anorexia nervosa and its effects on adolescent females. Concepts of epidemiology, etiology, differential diagnosis, and management are considered. Particular emphasis is given to gynecologic and psychologic effects of anorexia and their management. Clinicians including those involved in adolescent gynecology can be very beneficial to these patients if the condition is recognized early and comprehensive, team-based care is provided. [ABSTRACT FROM AUTHOR]

Aggression, aggressive behaviors, and violence are common phenomena in human beings including children, adolescents, and young adults. Aggression is a symptom of various disorders that can be medical, psychiatric, and combinations of these categories, such as substance use disorders. This discussion provides definitions of aggression and violence as well as consideration of etiologic concepts. Management of aggression depends on the underlying contribution disorders and includes behavioral approaches as well as potentially, pharmacologic interventions. Aggression in humans leads to severe consequences in the victims including turbulent trauma and even death. [ABSTRACT FROM AUTHOR]

The first steam-powered vehicle is attributed to Ferdinand Verbiest in China made in 1672 for the Kangxi Emperor. The first recorded automobile death was Mary Ward in Ireland who was thrown from a steam-powered car and fell under its wheels in 1869. The first person killed in the United States is recorded as Henry Bliss in New York City on Wednesday, September 13, 1899. As the automobile became popular among all groups of humans, motor vehicle crashes became the major cause of death and disability among children and adolescents. Research initially focused on the physical trauma that motor vehicle accidents or crashes induced, but eventually the psychological toll of motor vehicle crashes (MVCs) in the pediatric population became appreciated. This discussion reflects on how this occurred taking the entire 20th century to be acknowledged by researchers, clinicians, parents, and the general society. [ABSTRACT FROM AUTHOR]

The motor vehicle crash is the main cause of death and destruction in children and adolescents. One of the major psychological consequences to those who survive a motor vehicle crash (MCV) is post-traumatic stress disorder (PTSD). This discussion considers the future of research in this field that may also involve the use of artificial intelligence in control of motor vehicles that will take human error out of motor vehicle operation. It is important to consider all means in lowering the death and destruction faced by our children and adolescents on the killing fields of the roads in the United States and the world. [ABSTRACT FROM AUTHOR]