A key tenet of adolescent medicine is that the occurrence and content of a physician-patient encounter is confidential unless the life of the patient or someone else is threatened. Changes in Texas law during the last few years require that parents give consent for minors to receive contraceptives and require that sexually active patients younger than 17 years be reported to the police. Franzini and colleagues examined the potential cost implications of these legislative changes that may result in teenagers foregoing reproductive health care. A projected additional 11 pregnancies per 100 teens currently receiving health care would occur, resulting in an increase of $44 million annually in health care costs in Texas alone. These are substantial costs and must be considered by legislators.
Adolescents and young adults are the groups at highest risk of sexual assault, and the vast majority of the offenders are known to the women who are assaulted. In this survey of 691 adolescent and young adult women, 30% reported having an unwanted sexual experience in the previous year. Prior physical aggression by a dating partner increased the risk by as much as 15-fold. Going to the perpetrator’s house to be alone also raised the threat of sexual assault. These findings suggest the need to educate young women of how to effectively manage verbal and psychological abuse by male partners on a date in order to minimize the risk of unwanted sexual experiences.
Prior studies have indicated that iron deficiency has substantial effects on the central nervous system, leading to behavior problems. Iron is necessary for dopamine synthesis, a key pathway target of drugs used to treat attention-deficit/hyperactivity disorder (ADHD). This study found that mean ferritin levels among children with ADHD were approximately half those of children without ADHD and that the level of ferritin was correlated with ADHD symptoms. Serum ferritin levels were abnormal in 84% of children with ADHD but in only 18% of control children, suggesting that children with ADHD may benefit from iron supplementation.
Kawasaki disease was first described more than 35 years ago, and many of the patients who had the disease as children are now parents. This study reports on periodic nationwide surveys of Kawasaki disease in Japan. Children of parents who had Kawasaki disease were more likely to develop the disease than were children born to parents without such a history. The likelihood of sibling cases in this second generation was increased 7-fold, providing strong support for a genetic susceptibility to Kawasaki disease. These second-generation cases were more likely to be recurrent and to have coronary abnormalities. Family history of Kawasaki disease may be a marker for potential disease severity.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2004;158(12):1103. doi:10.1001/archpedi.158.12.1103