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This Month in Archives of Pediatrics and Adolescent Medicine
June 2005

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2005;159(6):511. doi:10.1001/archpedi.159.6.511

With the dramatic increase in the prevalence of obesity, increasing attention is being paid to the mental health consequences of being overweight among children and adolescents. Using data from the Youth Risk Behavior Survey on over 13 000 high school students, Eaton et al examined the relationship between suicide ideation and suicide attempts with actual and perceived measures of obesity. Students who perceived themselves as very underweight or very overweight were twice as likely to report suicide ideation and 3 times as likely to report a prior suicide attempt. How students perceive their body weight may be more important than their actual weight in terms of effect on suicide ideation and attempts.

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Although ovarian torsion is a potentially salvageable condition in pediatric patients, diagnosis is difficult and delays in diagnosis and treatment are common. In this series of children and adolescents with ovarian torsion, the affected ovary was salvaged in 27% of patients; those with salvaged ovaries were operated on within 11 hours of examination compared with 21 hours in those who underwent oophorectomy. In contrast, the time between onset of pain and presentation was not different among those with salvaged vs nonsalvaged ovaries. The diagnosis was usually made on the basis of abdominal ultrasound. Prompt ultrasound and surgical consultation may result in improved outcomes for girls with torsion of the ovary.

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Milk is promoted as a healthy beverage for children, but some investigators believe that estrone and whey protein in dairy products may promote weight gain. In this study of more than 12 000 offspring of people enrolled in the Nurses’ Health Study, children who drank more than 3 servings of milk per day increased their body mass index more than those who drank less milk. Drinking 1% or skim milk was also associated with increases in body mass index. The added calories from the larger amount of milk consumed appeared to be responsible for the increase in body mass index in these children. Drinking high amounts of milk, as with other beverages, may provide excess calories to some children, contributing to the increase in obesity in the United States.

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Stimulant medications are effective in children with attention-deficit/hyperactivity disorder and are the mainstay for most children with this disorder. Continued use of stimulants has lead to greater improvement in teacher-reported symptoms for children taking medication compared with those not taking medication. Extended-release preparations of methylphenidate hydrochloride have been formulated to allow once-daily dosing and improved compliance. Using California Medicaid data, Olfson et al examined the continuity of treatment in children on extended-release methylphenidate compared with immediate-release methylphenidate. Patients on extended-release medications took them continuously for an average of 140 days compared with 103 days for those on immediate-release medications.

Figure.
Survival distribution of methylphenidate hydrochloride treatment for attention-deficit/hyperactivity disorder. ER-MPH indicates extended-release methylphenidate; IR-MPH, immediate-release methylphenidate.

Survival distribution of methylphenidate hydrochloride treatment for attention-deficit/hyperactivity disorder. ER-MPH indicates extended-release methylphenidate; IR-MPH, immediate-release methylphenidate.

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Half of new cases of sexually transmitted infections occur among teens and young adults, and the group with the highest prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections are women aged 15 to 24 years. In this study from the Centers for Disease Control and Prevention, the effect of condom use on decreasing the prevalence of chlamydia and gonorrhea was examined among more than 500 adolescent girls. Correct and consistent use of condoms was reported by only 16% of individuals. One fifth had chlamydial infection and 7% had gonococcal infection. Correct and consistent condom use decreased the odds of having chlamydia by 60% and having gonorrhea by 90%.

Figure.
Prevalence of condom errors reported by adolescent study participants in the 3 months before the interview (N = 509).

Prevalence of condom errors reported by adolescent study participants in the 3 months before the interview (N = 509).

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This article was corrected on 6/6/2005, prior to publication of the correction in print.

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