Albert C Hergenroeder

• M.D.
• Professor at Baylor College of Medicine

Purpose Data from low-weight patients with restrictive eating disorders (EDs) treated in outpatient adolescent medicine-based ED treatment programs were analyzed to determine whether there was an association between hospitalization and gain to at least 90% median body mass index (mBMI) at 1-year follow-up. Methods Data were retrospectively collect...

Advancements in medicine have increased the likelihood that children with chronic illnesses will survive childhood. The success in treatment for their conditions has not been matched by methods to effectively facilitate their transition to adult care. This short report describes lessons learned in building a hospital-wide health care transition (HC...

The professional process portfolio (PPP) was adopted by the Maternal Child and Health Bureau (MCHB) as an 'innovation' in best practice for all Leadership in Education and Adolescent Health (LEAH) Training Programs; however it had not been formally evaluated. Thus the objective was to evaluate the utility of the PPP for graduates of the LEAH traini...

Purpose: The National Eating Disorders Quality Improvement Collaborative evaluated data of patients with restrictive eating disorders to analyze demographics of diagnostic categories and predictors of weight restoration at 1 year. Methods: Fourteen Adolescent Medicine eating disorder programs participated in a retrospective review of 700 adolesc...

To describe outcomes of adolescents with eating disorders treated by an interdisciplinary adolescent medicine service at a large children’s hospital and to identify factors, including hospitalization, associated with outcome. The study design was a retrospective chart review of patients. The setting was an inpatient and outpatient adolescent servic...

The purpose of the study was to investigate the impact of a 7-minute educational and motivational weight-management digital video disc (DVD) that uses real patient/parent testimonials and provider-patient interactions, on adolescent and parent knowledge of obesity-related diseases; readiness, motivation, and self-efficacy to lose weight; connectedn...

The incidence of sports related concussion appears to be increasing, raising alarm over long-term consequences of these head injuries on cognitive function in youth. The American Academy of Neurology (AAN) has recently revised its position statement on concussion in sports, reflecting the burgeoning scientific evidence on its epidemiology, neurophy...

Primary musculoskeletal etiologies, such as stress fractures, strains, facet arthropathy, and sacroiliac joint dysfunction, are more common causes of pediatric pain than systemic diseases, both in the office setting and the emergency room. Systemic features, young age, and atypical pain should clue physicians to causes other than a primary musculos...

The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with...

Psychopharmacologic medications are often prescribed to patients with restrictive eating disorders (EDs), and little is known about the frequency of use in adolescents. We examined the use of psychopharmacologic medications in adolescents referred for treatment of restrictive ED, potential factors associated with their use, and reported psychiatric...

Background: The Life Course perspective highlights transition to adulthood as a critical period of human development. MCHB identifies transition for YSHCN as a 2020 priority, but its transition objective is met for only 40% of YSHCN. MCHB-funded training programs have an unparalleled opportunity to shape public health practitioners of tomorrow. Lit...

This quality improvement project collected and analyzed short-term weight gain data for patients with restrictive eating disorders (EDs) treated in outpatient adolescent medicine-based ED programs nationally. Data on presentation and treatment of low-weight ED patients aged 9-21 years presenting in 2006 were retrospectively collected from 11 indepe...

The aims of the study were to establish waist circumference (WC) cut-off points that identify clustering of obesity-related conditions and determine if the cut-off points identified an increased risk of disease when used within BMI categories. This is a secondary analysis of the Centers for Disease Control NHANES III complex, multistage probability...

The academic successes of AM during the past 2 decades are marked by board certification, fellowship program accreditation, residency curricula creation, and the evolution of a remarkably respected scientific journal, the Journal of Adolescent Health. These same accomplishments have increased professional and public recognition of unmet population...

Calcium intake has been associated with promoting bone health in children and adolescents, thus preventing osteoporosis later in life. Behavior change such as increased calcium intake, as well as physiological factors such as bone quality, may be facilitated by psychosocial and environmental factors. The purpose of this study was to identify pathwa...

To ensure a workforce of board-certified adolescent medicine (AM) specialists, the reasons why physicians choose this specialty must be understood. This study sought to develop a profile of AM fellows and to delineate common experiences that influenced them to seek AM training. In April 2008, all AM fellows in Accreditation Council of Graduate Medi...

The purpose of this study was to identify pathways used by psychosocial factors to influence physical activity and bone health in middle-school girls. Baseline data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001 to 2003 were used. IMPACT was a 1 1/2 years nutrition and physical activity intervent...

The aim of this study was to compare the dual-energy X-ray absorptiometry (DXA) measurement of bone mass with an independent measure of body calcium obtained by neutron activation analysis (NAA). Total body bone mineral content (BMC) was measured using DXA in 46 subjects in the age range 5-47 years (17 children, 28 young women, and 1 adult male). T...

Objectives: The purpose of the study was to identify the pathways used by various psychosocial and environmental factors to influence calcium intake and bone health in middle-school girls in Texas. Methods: Data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001-2003 were utilized for the analysis. I...

Lack of regular physical activity and consequent sub-optimal bone mass acquisition in youth has been implicated as a primary cause of adult-onset osteoporosis. IMPACT was a behavioral theory-based 1 1/2 year randomized controlled field study aimed at increasing bone accretion in middle school girls. The objective of this study was to determine the...

The purpose of this study was to identify the psychosocial, environmental and behavioral factors associated with calcium intake, physical activity and bone health in a cohort of adolescent girls. Baseline data (N = 718 girls, mean age: 11.6 +/-0.4 years) from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study conducted in...

Rates of Folk and Traditional Medicine (FTM) use are high among Hispanic adults. No data have been published on FTM use among the rapidly growing Hispanic adolescent population. To determine the prevalence of and personal factors associated with FTM use among Mexican-American adolescents. Study group: 182 Mexican-American adolescents (14-19 years)...

The purpose of this study was to predict calcaneal QUS measurements in healthy adolescent females as a function of anthropometric measures, pubertal stage and menarchal status. This was a secondary data analysis from a 2-year intervention designed to increase bone accretion. Simple Pearson correlation and Spearman's rank correlation analyses, follo...

Eating disorders are chronic, life-threatening medical conditions that are the third most common chronic illness in adolescent females in the US. Although successful treatment of eating disorders on medical units has occurred for at least thirty years, some insurance companies refuse payment for such care. To describe outcomes of and reimbursement...

This research describes the development of a measure of the general attribute of "athletic" in adolescents, encompassing exercise, sport, and physical activity. Based on a theoretical model supported in adults, the 40-item Athletic Identity Questionnaire (AIQ) for adolescents assesses four dimensions: appearance, competence, importance of activity,...

Gay, lesbian, and bisexual adolescents, like all adolescents who engage in high-risk sexual behaviors, are at elevated risk for acquiring sexually transmitted infections (STIs). Personal sexual risk factors and issues related to access to care complicate the lives of youth who engage in same-gender sexual activity and who may or may not self-identi...

To review the effects of physical activity on health and behavior outcomes and develop evidence-based recommendations for physical activity in youth. A systematic literature review identified 850 articles; additional papers were identified by the expert panelists. Articles in the identified outcome areas were reviewed, evaluated and summarized by a...

Although testicular cancer is the most common cancer among 15- to 35-year-old male individuals, physicians seldom conduct testicular self-examination (TSE) education, thus potentially missing opportunities for early detection. Pediatric residents should be learning TSE skills training and be encouraged to incorporate them into routine practice. The...

Purpose: To assess the efficacy of an educational skit on improving knowledge and decision making/behavior toward obtaining a Pap smear.Methods: Ninety-two Hispanic high school female volunteers participated in an intervention, single-sample, preintervention/postintervention survey. Data were collected prior to (T0), immediately after (T1), and sev...

To assess the efficacy of an educational skit on improving knowledge and decision making/behavior toward obtaining a Pap smear. Ninety-two Hispanic high school female volunteers participated in an intervention, single-sample, preintervention/postintervention survey. Data were collected prior to (T(0)), immediately after (T(1)), and seven weeks afte...

Within the past 10 y, dual-energy X-ray absorptiometry (DXA) has become one of the most widely used methods of measuring human body composition. However, DXA has not been fully evaluated against an independent criterion method of measuring body fatness in young females. Our objective was to determine the bias and agreement between DXA and a 4-compa...

Methods are needed to improve pediatricians' skills for physical examination of the ankle and knee. To compare the effect of 2 methods of teaching the physical examination of the ankle and knee on the knowledge and skills of pediatricians. Prospective intervention trial with preintervention and postintervention tests. Pediatricians' offices. Twenty...

With advances in medical care, children with chronic medical conditions are living longer lives. They, their families, and their health care professionals are faced with new challenges: transition from pediatric care into adult medical care and meeting the vocational, educational, and other social needs to make this transition of children and youth...

Pediatric residents need the knowledge and physical examination skills to evaluate common musculoskeletal injuries. The ankle and the knee are the 2 most common sites of musculoskeletal injury in young athletes. Methods for evaluating pediatric residents' knowledge and skills in examining the ankle and knee are needed. 1) To describe the developmen...

Pediatric residents have the need for additional training in the care of common musculoskeletal injuries. To implement and evaluate the effects of a teaching intervention on pediatric residents' knowledge and skills in performing the physical examination of the ankle and knee. Prospective, intervention, single-sample study design. Pediatric residen...

Chronic renal disease often has an adverse effect on adolescent physiologic and psychosocial development. The severity of the disease may necessitate that the pediatric nephrologist be the adolescent's main medical provider and the most available physician to screen for adolescent health risk behaviors. The purpose of this study was to determine pe...

To determine whether serum insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP) concentrations are different between African American and white girls. Serum glucose and hormone concentrations were measured in blood samples collected after a 12-hour fast from 79 white and 57 African American healthy girls between 9 and 17 years of age....

Major life transitions (e.g., graduation from high school) are times when many changes occur in a person's social and physical environment. Men and women likely experience aspects of these changes differently. As a result, health-related behaviors likely change at these times with possible differences in these changes by gender. Gender differences...

To evaluate interobserver reliability of physician assessments of pubertal maturation and to evaluate the validity of self-assessment compared to physician assessments of pubertal maturation by girls in a multiethnic sample. The study design is descriptive. A total of 107 8-17-year-old healthy volunteers from settings with large minority population...

Between 1963 and 1991, the most dramatic increases in the prevalence of overweight in the United States have been reported in African-American girls. Lower basal energy expenditure and lack of physical activity are believed to be risk factors for excessive weight gain. We hypothesized that energy expenditure at rest and during physical activity are...

Differences were assessed by ethnic group in the performance of cancer risk related lifestyle behaviors through the transition out of high school. Data were obtained from a nationally representative probability sample survey, the 1992 National Health Interview Survey-Youth Risk Behavior Survey. A cross-sectional sub-sample included adolescents with...

Because African-American girls are heavier, taller, and mature earlier than Caucasian girls, we hypothesized that the serum leptin concentration differs between the two groups. Serum leptin concentrations were measured by immunoassay in 12-h fasted blood samples collected from 79 Caucasian and 57 African-American girls between 8 and 17 yr of age. B...

A survey instrument was developed to describe the nutritional habits and needs of homeless adolescents. It incorporated the Block Food Frequency (BFFQ) questionnaire with 37 questions regarding: current practices of obtaining food; nutritional education needs; and demographic information. The survey was reviewed, pilot-tested, and revised Subjects...

In summary, youth sports are part of American culture and involve millions of children and adolescents. They provide opportunities for socialization and developing coping strategies to deal with challenges and adversity. Unfortunately, three million injuries in children and adolescents occur annually in organized sports in the United States. Pediat...

Although not a comprehensive health evaluation, the PSE is viewed as such by many parents and adolescents. In this regard, these athletes are getting a lower standard of care than recommended; however, the mechanism wherein the PSE can become a cost-effective comprehensive examination has not been established. The PSE is one method of injury preven...

The effectiveness of lifestyle behavior interventions with children to reduce chronic disease risks in adulthood assumes stability in the lifestyle behaviors across time. The transition out of high school is a time when many changes occur in social roles, e.g., changing schools, leaving the parents' home, changing peers, finding employment, getting...

The objectives of this study were to assess (1) whether treatment with oral contraceptives, in comparison with medroxyprogesterone and placebo, improved bone mineral in women with hypothalamic amenorrhea and (2) whether treatment with medroxyprogesterone, in comparison with placebo, improved bone mineral in women with hypothalamic oligomenorrhea. T...

Privacy is of utmost concern to adolescents seeking advice regarding life-style and behavior choices. Lack of privacy and confidential health services are barriers to adolescents' access to health care. This study describes primary care physicians' practices with regard to inviting parent(s) to leave the room in order to interview the teen alone, a...

This article reviewed the basics of ankle diagnosis and rehabilitation. It is hoped that after reading this, pediatricians will have more confidence in caring for these injuries.

The basal metabolic rate (BMR), which accounts for 50-70% of total energy expenditure, is essential for estimation of patient and population energy needs. Numerous equations have been formulated for prediction of human BMR. Most equations in current use are based on measurements of Caucasians performed more than four decades ago. We evaluated 10 pr...

A 15-year-old African-American female presented with prolonged menstrual bleeding accompanied by a 1-week history of weakness, fatigue, dizziness, and bifrontal headaches. Her previous period was 5 weeks earlier, lasted 3 weeks, with heavy passage of clots. Family history is significant for bleeding disorders. Her platelet count was in the 60,000-8...

To assess the ability of vaginal and cervical leukocyte esterase (LE) dipstick to detect vaginitis and cervicitis. A prospective, cross-sectional study to assess the ability of the LE dipstick of vaginal secretions to detect trichomonads, candida, and bacterial vaginosis and the LE dipstick of vaginal and cervical secretions to detect gonococcal an...

The purposes of this study were: (1) to evaluate the validity of self-assessment of pubertal maturation by females in a multi-ethnic sample compared to physician assessments, and (2) to evaluate interobeserver reliability of physician assessments. The subjects were 8-17 year old European American (n=47), African American (n=43), and Hispanic (n=11)...

The purpose of this investigation was to determine whether aerobic fitness (VO2max) differed between black (N = 40) and white (N = 53) adolescent girls who were similar in age (13.5 yr) and percent body fat (24.6%). Expired gases were collected continuously while each girl performed a standard Bruce protocol to volitional exhaustion on a motorized...

1. The vast majority of bone mineralization in girls occurs by the middle of the second decade. 2. Premature bone demineralization occurs in women with hypothalamic dysfunction manifest as amenorrhea and oligomenorrhea, associated with athletics, dancing, and eating disorders. 3. In young women with amenorrhea associated with weight loss, BMD loss...

Exercise and physical conditioning or physical fitness play an important role in disease prevention. The three primary components of physical conditioning are endurance, flexibility, and strength training. Like adults, adolescents can improve their aerobic fitness by doing aerobic activity with achievement of 60% to 90% of the maximum heart rate fo...

The purpose of this study was to determine historical and physical factors associated with anterior knee pain in a cross section of athletic and nonathletic adolescents. We studied 142 high-school students, each of whom answered a questionnaire addressing athletic involvement and a history of knee pain. All subjects underwent a complete knee examin...

Recent surveys have shown adolescents have become more obese than their counterparts in the 1960s. Obesity during adolesce Skinfold Measurements, Oxygen Uptake, and Exercise in Adoles... : Clinical Journal of Sport Medicine var scpl_time = new Date(); scpl_time = scpl_time.getTime(); ProcessImn(); ProcessImnMarkers(); .ctl00_Dummy_PlaceHolderMain_L...

The purpose of this study was to develop and cross-validate an equation for estimating fat-free mass (FFM) in female ballet dancers. One hundred twelve, 11- to 25-yr old, female dancers had FFM measured by total body electrical conductivity (TOBEC) and anthropometrics, including skinfold and circumference measurements. The regression equation that...

The purposes of this study were to compare the lumbar spine bone mineral density of eumenorrheic and amenorrheic white subjects aged 15 to 21 years, and to describe the femoral neck bone mineral density in the eumenorrheic subjects. Twenty-eight eumenorrheic females had lumbar bone mineral density (mean +/- SD) of 1.213 +/- 0.117 g/cm2, and femoral...

The purpose of this study was to describe the body composition of adolescent and young adult ballet dancers using total body electrical conductivity (TOBEC). We studied 112 female and 33 male dancers. The mean ages were 15.0 +/- 2.0 and 18.7 +/- 3.1 yr for females and males, respectively. The mean percent body fat (PBF) values were 20.1 +/- 3.6% fo...

Nine male and seven female high level ballet students had total body water (TBW) measured by two methods: 1) H2(18)O isotope dilution and 2) total body electrical conductivity (TOBEC). TBW from TOBEC measurements was calculated using an equation previously derived from adults, and these new measurements correlated highly with TBW by isotope dilutio...

To describe the knowledge, attitudes, and behaviors of runaway and homeless youths regarding infection with the human immunodeficiency virus (HIV). Cross-sectional, descriptive. A crisis shelter for runaway and homeless youths. One hundred one residents, aged 13 to 20 years, of a shelter for homeless and runaway youths in Houston, Tex. None. A self...

This article has set out to provide basic knowledge about body composition in athletic and nonathletic adolescents and young adults and to provide the practicing physician with methods of making body composition assessment. We suggest the physician approach the adolescent athlete who requests information about body composition in the following way:...

Athletic amenorrhea is a problem because it is associated with an increased risk of injuries and potentially an increased risk of osteoporosis in later life. This article gives suggestions for the evaluation of the athlete with amenorrhea and for treatment protocols. Primary care physicians should routinely screen female adolescent athletes for ame...

The responsibility of the physician performing a preseason sports physical examination includes identifying cardiac disease and giving appropriate guidance about participation in competitive sports. This article reviews the leading causes of sudden cardiac death in young athletes, discusses other common cardiac conditions, assesses recommendations...

• Many pediatricians desire to work with young athletes. However, most pediatricians have not been trained to treat common musculoskeletal injuries in athletes. The tendency is to refer the athlete to a specialist with expertise in the management of musculoskeletal trauma. However, pediatricians should be more involved in the diagnosis, treatment,...