Current opinion in pediatrics
-
Curr. Opin. Pediatr. · Aug 2013
ReviewAddressing social determinants of health in the adolescent medical home.
To provide a framework for addressing the social determinants of health (SDH) in the adolescent medical home. ⋯ SDH should be incorporated into the routine adolescent healthcare. Screening tools and referral programs should be developed and evaluated in the adolescent population. Programs utilizing multidisciplinary team members would be effective in reaching adolescents and facilitating connections to resources.
-
Curr. Opin. Pediatr. · Aug 2013
ReviewBariatric surgical management of adolescents with morbid obesity.
Adolescent obesity continues to be a significant public health issue. To date, there are no medical therapies that provide significant, durable weight loss. Bariatric surgery has been shown in the adult and now the adolescent population to provide a reasonable alternative for weight loss. ⋯ With the growing number of morbidly obese adolescents in the United States coupled with the relative ineffectiveness of medical therapy in this group of patients, bariatric surgery consistently provides a means for significant weight loss and the resolution of substantial comorbidities. Its approval is slowly increasing, and the growing fund of knowledge in regard to complication rates and the efficacy of bariatric surgery will ultimately result in its more widespread acceptance.
-
Curr. Opin. Pediatr. · Aug 2013
ReviewEvaluation and management of children and adolescents with gender identification and transgender disorders.
Gender identity development is poorly understood but impacted by central nervous system (CNS) factors, genes, gonadal hormones and receptors, genitalia, and social/environmental factors. Gender identity disorder (GID) is the diagnostic term to describe persons discontent with the sex they were assigned at birth and/or the gender roles associated with that sex. It is crucial that the diagnosis be verified as persistent, since gender confusion among those young persists among only a portion. ⋯ Although the concept of gender identity is a relatively new paradigm and remains an area of active and exciting investigation, findings reported here provide items of information for understanding and treatment of GIDs and illustrate the need for further research.
-
Hyperglycemia is a significant problem for children in the ICU. Use of tight glycemic control (TGC) to manage hyperglycemia remains controversial, especially given the potential risk of insulin-induced hypoglycemia. This review will address the latest evidence regarding TGC in critically ill children. ⋯ Although the clinical benefit of TGC in critically ill children is still unclear, TGC can be done safely in this population.