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Contraception remains an important part of national efforts to reduce adolescent pregnancy in the United States. A number of safe and effective contraceptive methods are available for our youth, including abstinence, barrier methods, oral contraceptives, Depo-Provera, and Norplant. Research over the past few decades has resulted in a variety of oral contraceptives with reduced amounts of hormones and reduced side-effects. A number of methods have received approval by the Food and Drug Administration since the last review in 1980, including emergency contraceptives, depomedroxyprogesterone acetate, and the cervical cap. The use of condoms and vaginal spermicides continues to be recommended for all sexually active adolescents to reduce (not eliminate) the risk for acquiring sexually transmitted diseases. A polyurethane condom is now available, in addition to the latex condom and other barrier contraceptives, including the following: diaphragm, cervical cap, vaginal sponge, female condom and vaginal spermicides. Because of continuing concerns about pelvic inflammatory disease related to intrauterine devices, currently available intrauterine devices are not recommended for most adolescents. Abortion is not considered as a contraceptive method. Pediatrics 2001;107: 562-573; abstinence, oral contraceptives, barrier contraceptives, Depo-Provera, Norplant., ABBREVIATIONS. OCP, oral contraceptive pill; IUD, intrauterine device; STD, sexually transmitted disease; FDA, Federal Drug Administration; LH, luteinizing hormone; WHO, World Health Organization; HIV, human immunodeficiency virus; VTE, venous thromboembolism; [...]

Abstract. Two cases of chorioretinitis in adolescence demonstrate the characteristic course of events. It is typically caused by Toxoplasma gondii and is usually acquired congenitally. Toxocara infection must be considered in younger children. Other etiologic agents are rarely implicated in children and youth. Diagnosis of toxoplasmic chorioretinitis is based on a characteristic history of visual disturbance and specific funduscopic appearance, along with confirmatory serological studies. Management is complex, utilizing pyrimethamine (Daraprim), sulfadiazine, and prednisone in combination for several weeks or months. The combined long-term care by the physician generalist and ophthalmologist is essential. Recognition of adolescent developmental issues is important to insure optimal compliance. The prognosis is guarded, with 5% to 30% recurrence rates noted after treatment. Severe visual impairment may be seen. [ABSTRACT FROM AUTHOR]

Presents commentaries on issues related to pediatric care and health. Contraindications of birth control pills; Information on the billings method of contraception in adolescents; Age of onset of lactose intolerance in children; Blood pressure of children in the United States.

Abstract. An overview is presented of the major methods of contraception available to the sexually active adolescent. Emphasis is given to the combined birth control pill, while the literature describing absolute and relative contraindications to oral contraception is reviewed. It is noted that adolescents with chronic illness must also be evaluated for contraceptive needs. Other methods covered include the intrauterine device, barrier methods (diaphragm, condom, and vaginal contraceptives), injectable contraceptives, postcoital contraception, and methods under current investigation. The approach to each patient must be individualized, based on her coital activity, understanding of alternatives, medical status, and what method is chosen. [ABSTRACT FROM AUTHOR]

ABSTRACT. Important management principles regarding emotional needs of the teenager with acute paraplegia during early hospitalization are discussed. One illustrative case is presented. Mourning reaction of the patient and family to this severe loss of bodily function is reviewed. Reaction of medical caretakers to this catastrophe is also discussed. It is emphasized that these concepts be applied by pediatricians in managing adolescent paraplegics. [ABSTRACT FROM AUTHOR]

The metabolic syndrome (also known as dysmetabolic syndrome, MetS, Reaven syndrome, syndrome X, and insulin-resistance syndrome) is a well-recognized and all-too-frequently encountered fact of modern life, with staggering economic consequences. Various aspects of the metabolic syndrome are considered in this review, including such features as insulin resistance with glucose intolerance, hypertension, beta-cell failure, hyperinsulinemia, frank diabetes mellitus, dyslipidemia, and release of inflammatory and procoagulant factors into the circulation. Issues of management for the adolescent are considered also. Much can be accomplished for such youth by using the knowledge we currently have in hand, but many additional issues that are noted make the prospects for success extremely challenging for clinicians who deal with adolescent patients.

Musculoskeletal complaints are a common reason for adolescents to seek medical attention. It is estimated that musculoskeletal problems account for up to 20% of visits to primary care practitioners. Many studies have shown the inadequacies of training of medical students and primary care residents in musculoskeletal medicine. Also, many practitioners do not feel comfortable in the management of common problems in this area. A general outline for approaching adolescents with musculoskeletal complaints is presented in this article and is not unlike the approach to other clinical problems. This outline follows the logical exploration of the medical history followed by physical examination and formulation of the appropriate differential diagnosis. The broad categories of conditions that should be considered in the differential diagnosis of musculoskeletal symptoms include rheumatic diseases, chronic pain syndromes, systemic vasculitides, infections, overuse syndromes, specific orthopedic conditions, metabolic bone disease, neoplasms of connective tissue and bone, psychosomatic disorders, peripheral neuropathy, and primary muscle disease.