Physiology constants of adolescents are important to understand growing living systems and are a useful reference in clinical and epidemiological research. Until recently, physiology constants were not available in China and therefore most physiologists, physicians, and nutritionists had to use data from abroad for reference. However, the very difference between the Eastern and Western races casts doubt on the usefulness of overseas data. We have therefore created a database system to provide a repository for the storage of physiology constants of teen-agers in Beijing. The several thousands of pieces of data are now divided into hematological biochemistry, lung function, and cardiac function with all data manually checked before being transferred into the database. The database was accomplished through the development of a web interface, scripts, and a relational database. The physiology data were integrated into the relational database system to provide flexible facilities by using combinations of various terms and parameters. A web browser interface was designed for the users to facilitate their searching. The database is available on the web. The statistical table, scatter diagram, and histogram of the data are available for both anonym and user according to queries, while only the user can achieve detail, including download data and advanced search.

Wei Wei-Qi

Zhu Guang-Jin

Xu Cheng-Li

Han Shao-Mei

Qi Bao-Shen

Chen Li

Zu Shu-Yu

Zhou Xiao-Mei

Hu Wen-Feng

Zhang Zheng-Guo

The Physiology Constant Database of Teen-Agers in Beijing

The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) is a subphenotype of the polycystic ovary syndrome. It is one of the most common causes of menstrual problems, hyperandrogenic symptoms, and insulin resistance among young women. Review of clinical data in an outpatient adolescent clinic showed that of the 1,002 young women (ages 10&#x2014;21 years) attending the clinic over a 2-year period, 50 (5%) were diagnosed with HAIR-AN syndrome. Mean age of the patients was 15.5, initial mean weight at diagnosis was 94.5 kg, and the mean BMI was 33.33 kg/m2. Patients were treated with a weight-stabilization and -reduction program, oral contraceptive pills, and in most cases metformin. Of the patients, 80% were compliant with the follow-up and treatment regimen, 60% maintained or reduced their weight, 95% had regular menstrual cycles, and in most patients, the acne and/or hirsutism were the same or better than at the start of treatment. We conclude that HAIR-AN syndrome is a common disease in young women and multifaceted, aggressive treatment appears to be effective in reducing the severity of symptoms and preventing further consequences.

Hatim A. Omar

Stephanie Logsdon

Jessica Richards

Clinical Profiles, Occurrence, and Management of Adolescent Patients with HAIR-AN Syndrome

Asymptomatic hematuria is very common in pediatric and adolescent patients. In contrast to painless hematuria in adults, the differential diagnosis and investigative modalities in the pediatric population is vastly different. This article presents the major diseases that may cause hematuria in children and suggests an evaluation algorithm for the pediatric urologist.

Sarel Halachmi

David Kakiashvili

Shimon Meretyk

A Review on Hematuria in Children

Frequent school absence is often cited as a risk factor for peer relationship problems in youngsters with chronic illnesses, but this assumption has not been subjected to quantitative empirical examination. This issue was examined in the present study by exploring the relationship between school absenteeism, peer aggression, and loneliness in adolescents with chronic illnesses. Forty-one adolescents with chronic illnesses completed a modified version of the Direct and Indirect Aggression Scale and the Asher Loneliness Scale. Details of school absences and hospitalizations were obtained from parents and school and hospital records. No evidence was found to support the notion that peer aggression and loneliness are related to absenteeism, but social aggression (for both boys and girls) and verbal aggression (more markedly for girls) were associated with loneliness. Of the group, 19% reported experiencing verbal aggression and 12% social aggression at least weekly; informal qualitative data suggesting that such aggression is often related to limited sporting ability and appearance. Interventions at both the individual and school community level are warranted.

Rosalyn H. Shute

Christine Walsh

Adolescents with Chronic Illnesses: School Absenteeism, Perceived Peer Aggression, and Loneliness

Weight perceptions and weight control behaviors have been documented with underweight and overweight adolescents, yet limited information is available on normal weight adolescents. This study investigates the prevalence of overweight misperceptions and weight control behaviors among normal weight adolescents in the U.S. by sociodemographic and geographic characteristics. We examined data from the 2003 Youth Risk Behavior Survey (YRBS). A total of 9,714 normal weight U.S. high school students were included in this study. Outcome measures included self-reported height and weight measurements, overweight misperceptions, and weight control behaviors. Weighted prevalence estimates and odds ratios were computed. There were 16.2&#x25; of normal weight students who perceived themselves as overweight. Females (25.3&#x25;) were more likely to perceive themselves as overweight than males (6.7&#x25;) (p &#x3C; 0.05). Misperceptions of overweight were highest among white (18.3&#x25;) and Hispanic students (15.2&#x25;) and lowest among black students (5.8&#x25;). Females (16.8&#x25;) outnumbered males (6.8&#x25;) in practicing at least one unhealthy weight control behavior (use of diet pills, laxatives, and fasting) in the past 30 days. The percentage of students who practiced at least one weight control behavior was similar by ethnicity. There were no significant differences in overweight misperception and weight control behaviors by grade level, geographic region, or metropolitan status. A significant portion of normal weight adolescents misperceive themselves as overweight and are engaging in unhealthy weight control behaviors. These data suggest that obesity prevention programs should address weight misperceptions and the harmful effects of unhealthy weight control methods even among normal weight adolescents.

Kathleen S. Talamayan

Andrew E. Springer

Steven H. Kelder

Emmanuel C. Gorospe

Karen A. Joye

Prevalence of overweight misperception and weight control behaviors among normal weight adolescents in the United States

The transdermal contraceptive patch, Ortho Evra&#x2122;, was approved in December 2001 and released on the market in June 2002. In this study, we reviewed clinical data of young women who started the patch between June 2002 and December 2003 in the adolescent medicine clinic at a university-based outpatient center. A total of 62 patients started the patch in that period and two of them were lost to follow-up. Mean age of patients was 17.9 years and mean length of use was 10 cycles. Only 10 patients (16.7%) discontinued use. Reasons for discontinuation were moderate to severe skin irritation (3 patients, 5%), complete detachment (3 patients, 5%), and economic reasons (4 patients, 6.7%). Compliance was excellent overall and the side-effects profile was good. No pregnancies occurred during this period. These results confirmed that the transdermal contraceptive patch is easy to use and an effective method of birth control that may be better tolerated by young women. It also seemed to improve contraceptive compliance in this population.

Long-Term Evaluation of the Use of the Transdermal Contraceptive Patch in Adolescents

Cannabis use and suicidal behaviour are causes of adolescent morbidity and mortality worldwide. Changing trends in these behaviours in younger age groups, higher incidence, gender differences and sociocultural variations present an enormous challenge. There is no consensus whether these complex relationships are either a direct or an indirect effect due to other mental disorders, or a social response of disclosure of drug taking habits to family members and school authorities. This paper reviews the epidemiology of suicidal behaviour and cannabis use among adolescents and looks at the relationship of these behaviours regionally and internationally. The Caribbean islands have an established use of cannabis with higher suicidal rates, which provides an ideal setting to investigate the interrelationship of these disorders. Preliminary research findings in Trinidad indicate high rates of cannabis use among school students with higher rates in vocational schools compared to grammar schools. Utilising the CAPE questionnaire, depressive and psychotic experiences were common findings in adolescent cannabis users with a significant preponderance of depressive experiences (p&lt;0.01). Our findings suggest that there is a convincing relationship between suicidal behaviour and cannabis use, the latter awakening depressive experiences. Suicidal behaviour and cannabis use are major public health problems and require a multidimensional approach with culturally competent preventive interactions. School based prevention programmes are necessary at the levels of parent-teacher partnership and classroom intervention. The treatment of adolescent disorders remains a major challenge of the future. Double disorders such as cannabis use and suicidal behaviour are uncharted areas and need novel approaches.

Hari D. Maharajh

Monique Konings

Cannabis and Suicidal Behaviour Among Adolescents: A Pilot Study from Trinidad

High discontinuation rates for depot medroxyprogesterone acetate (DMPA) in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP) raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

Kristin M. Rager

Amy Fowler

Successful treatment of  Depot Medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in Adolescents

This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic rickets in infancy was the magnitude of the final stature. The use of growth hormone can be helpful in these patients. However, research reporting treatments with the use of the growth hormone for rickets are controversial. The majority of the authors agree that treatment using vitamin D and phosphate enables some statural growth in cases of early diagnosis, reflecting a better prognosis.

Mauro M.S. Borghi

Veronica Coates

Evaluation of Stature Development During Childhood and Adolescence in Individuals with Familial Hypophosphatemic Rickets

Galactorrhea is rarely mentioned as a possible side effect of the use of Depot-Medroxyprogesterone Acetate (DMPA). Over the last few years, we have noticed an increased number of patients complaining of galactorrhea. A review of clinical data showed that between 1999 and 2005, 360 adolescents in our clinic used DMPA for at least 6 months. After medical follow-up, 13 (3.6%) of these patients were found to have developed galactorrhea. The mean age of the patients was 19.4 years with a range from 13—24. Prolactin levels in these patients were normal, and in all subjects, the galactorrhea resolved spontaneously within the next year in both patients who continued use and those who discontinued use of DMPA. It appears that galactorrhea is a benign side effect and as previous reports have suggested, it did not seem to be related to changes in Prolactin levels in our patients. It is thought that this is a progesterone-mediated effect. We believe that reassurance and education of patients is sufficient and there is no evidence of need for further intervention. Since the sample size is small in this study, additional research is recommended as to validate the presence of progesterone-mediated effects secondary to the use of DMPA.

Rana M. Zakharia

Shibani Kanungo

Marlene Huff

Kimberly McClanahan

Incidence of Galactorrhea in Young Women Using Depot-Medroxyprogesterone Acetate

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