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This Month in Archives of Pediatrics and Adolescent Medicine
November 2007

This Month in Archives of Pediatrics & Adolescent Medicine

Author Affiliations

Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Pediatr Adolesc Med. 2007;161(11):1025. doi:10.1001/archpedi.161.11.1025
A Randomized Controlled Trial of Fluoxetine and Cognitive Behavioral Therapy

Adolescents with substance use disorders have higher rates of depression than the general population, but the use of selective serotonin reuptake inhibitors has not been studied in adolescents with this dual diagnosis. In this randomized controlled trial, depression improved in adolescents receiving both fluoxetine and cognitive behavioral therapy (CBT) as well as in those treated for 16 weeks with CBT alone. Combined therapy had a greater effect on one but not both measures of depression compared with medication therapy. In the context of CBT for substance use, co-occurring depression may improve or remit without antidepressant medication.

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Adjusted change in the depression response indicated by number of conduct disorder symptoms in the past 30 days. Estimates of percentages and means have been adjusted for fixed and random effects and are derived from the polynomial (linear, quadratic, and cubic) generalized estimating equation and random coefficient models selected for each variable based on deviance and likelihood-based criteria, respectively.

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Exercise Training Program in Cerebral Palsy: A Randomized Controlled Trial

Low aerobic and anaerobic capacity may contribute to the difficulties in motor activities that most children with cerebral palsy encounter in daily life. This randomized controlled trial sought to evaluate whether a standard exercise program could improve aerobic and anaerobic capacity as well as disability and health-related quality of life in children with cerebral palsy. The intervention improved fitness, muscle strength, agility, and sense of athletic competence. Children's level of participation in everyday activities also increased. There were difficulties, however, in maintaining these gains, suggesting that training must continue to sustain fitness levels.

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Profile plots for aerobic capacity (P < .001). P value is for the repeated-measures analysis of variance (group [2] × time [3]). T0 indicates baseline; T1, after 4 months; T2, after 8 months.

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Characteristics of Cannabis Users Who Have Never Smoked Tobacco

The gateway theory hypothesizes that the use of legal drugs such as tobacco may lead to cannabis consumption. This study sought to determine the prevalence of Swiss youth who use cannabis but have never been tobacco smokers and to assess how they differ from youth using both substances. Six percent of youth were current cannabis users, 21% of whom had never used tobacco. Compared with those using both substances, youth using only cannabis were younger, more likely to be male, played sports, and did well in school. They were less likely to report having been drunk, started cannabis use at a later age, and had less overall use. However, the path between being an occasional vs regular user of cannabis is not well established, and this group of adolescents needs to be monitored over time.

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Glutamine-Enriched Enteral Nutrition in Very Low-Birth-Weight Infants: Effect on Allergic and Infectious Diseases

Glutamine plays an important role in maintaining the functional integrity of the gut as well as the immune system. Glutamine supplementation during the first month of life decreases the incidence of serious infections in the neonatal period. This randomized trial investigated whether this early enteral supplementation with glutamine would also affect the incidence of allergic and infectious problems during the remainder of the first year. Glutamine supplementation was associated with an 87% lower risk of atopic dermatitis, but there was no difference in reactive airway disease, respiratory infections, or gastroenteritis. Further study of the effect of glutamine on the immune system of very low-birth-weight infants is indicated.

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