Current opinion in pediatrics
-
Curr. Opin. Pediatr. · Oct 2003
ReviewAssessment and treatment of attention deficit hyperactivity disorder in children with comorbid psychiatric illness.
Attention deficit hyperactivity disorder (ADHD) frequently occurs with a wide variety of comorbid psychiatric disorders such as conduct disorder, depression, mania, anxiety, and learning disabilities. Because the vast majority of children with ADHD are treated in primary care settings, it is important that primary medical doctors be proficient in the diagnosis and initial treatment of children with ADHD and its commonly occurring comorbid disorders. ADHD research is beginning to focus on the treatment of these comorbidly ill children. This review will summarize the recent findings from the psychiatric literature in an attempt to provide the clinician with some initial diagnostic and treatment guidelines for ADHD and its comorbidities. ⋯ The presence of comorbid illness is associated with significant additional morbidity and complicates the diagnosis, treatment, and prognosis of ADHD. Therefore, it is important to identify and treat any comorbid psychiatric conditions in a child with ADHD.
-
Curr. Opin. Pediatr. · Aug 2003
ReviewPostexposure prophylaxis: an intervention to prevent human immunodeficiency virus infection in adolescents.
Postexposure prophylaxis is an effective intervention to prevent transmission of the human immunodeficiency virus (HIV). Administration of antiretroviral medications within 72 hours of a percutaneous or mucous membrane exposure to HIV can prevent infection. The use of postexposure prophylaxis for occupational and perinatal HIV exposures is well established. ⋯ Clinicians should consider initiating postexposure prophylaxis in adolescents for any oral, anal, or vaginal exposure to definitely or possibly HIV-infected blood or body fluids. Adolescents treated should be followed closely for medication toxicity, acute seroconversion, and risk-reduction counseling. Further studies are needed to characterize the use and efficacy of postexposure prophylaxis in an adolescent population.
-
Atopic dermatitis is a chronic inflammatory skin disease commonly seen in children, but it also occurs in adults. This skin disease is often triggered by bacterial, fungal, or viral skin infections. The mechanisms resulting in this increased propensity for skin infections have been an area of active investigation. ⋯ The current review will examine recent literature on the etiology and pathogenesis of infection in atopic dermatitis. These observations are likely to have importance implications for management of atopic dermatitis.
-
Children commonly present for medical care after sustaining head trauma. In children younger than 2 years of age, the practitioner must distinguish accidental head injury from abusive head injury. The following article discusses the evaluation of children with head injury and how to make the distinction between accidental and abusive head injury.