Articles: adolescent.
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Adolescent anxiety, depressive, and eating disorders are a worsening population health issue that primary care clinicians play a critical role in addressing. Implementing universal screening into clinical practices for depression at age 12 years and anxiety at age 8 years is the first step to diagnosis. Referencing 5th edition of the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria is essential to making the correct diagnosis after ruling out underlying medical conditions. The evidence-based mainstays of treatment are unique to each specific disorder.
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Ice hockey is a popular global sport with growing participation for boys and girls yet remains a high-risk sport for injury. While the evidence for some risk factors, such as bodychecking policy is well established, other risk factors such as player sex have been understudied. The objectives of this study were to examine factors associated with rates of game-related injury, game-related injury resulting in >7 days of time-loss, and practice-related injury in youth ice hockey. ⋯ Based on data from a large 5-year Canadian youth ice hockey longitudinal cohort, several factors associated with injury were identified. Future injury prevention strategies should consider age, sex, previous concussion and injury history, and body checking leagues. Future research in female youth ice hockey including female-only leagues should be a priority to inform prevention strategies in this understudied population.
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Observational Study
Region-specific changes in brain glutamate and gamma-aminobutyric acid across the migraine attack in children and adolescents.
In patients with migraine, an excitation-inhibition imbalance that fluctuates relative to attack onset has been proposed to contribute to the underlying pathophysiology of migraine, but this has yet to be explored in children and adolescents. This prospective, observational, cohort study examined glutamate and gamma-aminobutyric acid (GABA) levels across the phases of a migraine attack and interictally in children and adolescents using magnetic resonance spectroscopy. Macromolecule-suppressed GABA (sensorimotor cortex and thalamus) and glutamate (occipital cortex, sensorimotor cortex, and thalamus) were measured in children and adolescents (10-17 years) with a migraine diagnosis with or without aura 4 times over 2 weeks. ⋯ In the 24 hours post headache onset, sensorimotor glutamate continued to decrease. Our results suggest changes in glutamate and GABA that are consistent with the thalamocortical dysrhythmia hypothesis. These findings provide insight into developmental migraine pathophysiology and may open future avenues for treatment targets specific to children and adolescents.
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Eur J Trauma Emerg Surg · Dec 2024
Is cross-sectional imaging necessary for fractures of the distal lower leg in children and adolescents: results of a nationwide survey.
In childhood and adolescence, cross-sectional imaging, most commonly computed tomography (CT), is often performed for advanced diagnosis of joint injuries of the distal lower leg and upper ankle. Due to radiation exposure, the need for CT remains controversial, as these injuries follow stereotypies and usually have a similar course. Alternatively, the performance of magnetic resonance imaging (MRI) is also discussed. Since radiation sensitivity at this young age is much higher than in adults, an effort must be to minimize radiation exposure according to as low as reasonably achievable (ALARA) principles. The aim of this survey is to evaluate the current procedure in Germany in the diagnosis of pediatric injuries of the distal lower leg and upper ankle. ⋯ The survey showed that the conventional X-ray is still the gold standard. Interestingly, more than half of the respondents regularly use the Ottawa Ankle Rules, and diagnostics using ultrasound are also used by almost a quarter. Awareness of radiation protection in children exists, although a quarter of all participants do not know the extent to which their radiology department has a specific pediatric protocol for CT imaging. Cross-sectional imaging is performed on a regular basis. Regarding the actual extent of imaging, there is a clear divergence between theory and practice.
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Preventive medicine · Dec 2024
ReviewSystematic review of the evidence on physical activity prescriptions for youth.
Despite the well-documented benefits of physical activity (PA), globally, only 20 % of youth engage in sufficient PA. Reviews support the benefits of PA prescriptions on promoting adults' PA, but no comparable reviews exist on studies among youth. This systematic review 1) assesses the state of the evidence regarding PA prescriptions from healthcare practitioners on youths' PA; and 2) identifies gaps to inform future research and practice. ⋯ There is insufficient research on healthcare practitioner delivered PA prescriptions to promote youths' PA to determine effectiveness. Future research with objectively measured PA and more diverse youth samples would advance the evidence.