m. susan Jay

• Medical College of Wisconsin

This study is a comparison of eating disorder patient outcomes on similar nutrition regimens regardless of degree of malnutrition. Acuity of symptoms in chronically and acutely malnourished patients were analyzed to determine the influence the duration of malnutrition has on refeeding syndrome. Patient outcomes did not differ based on chronicity of...

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...

Purpose: To determine the distribution of eating disorders (ED) in children and adolescents comparing the fourth edition of the Diagnostic and Statistical Manual (DSM) to the proposed fifth edition DSM criteria. Methods: A total of 215 consecutive patients (15.4 ± 3.3 years) presenting for initial ED evaluation to adolescent medicine physicians...

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...

Tubo-ovarian abscesses (TOA) are acute complications of pelvic inflammatory disease (PID). PID is an infection of the upper genital tract that is usually caused by an ascending sexually transmitted infection. We present two cases of TOA in patients who deny any history of sexual activity or sexual abuse. In our first case a TOA was the primary mani...

The purpose of this article is to review the common complaints related to the vaginal area in pubertal girls and offer an approach to those presenting with nonurologic perineal problems or issues related to emerging sexuality. Included is a discussion of the symptoms, diagnosis, and treatment of physiologic discharge, vulvovaginal candidiasis, bact...

1.Only the pediatrician, and to a lesser degree the family physician and the optometrist, can change the public conception that expectant treatment is proper for the squinting child.2.The period of opportunity for development of visual function (birth to age 5 to 6 years) will be used, squint or no squint. With strabismus it will be devoted to the...

Tuboovarian abscess is a serious consequence of pelvic inflammatory disease, especially in the adolescent population. Early diagnosis and treatment are essential to prevent further sequelae including infertility, ectopic pregnancy, and chronic pelvic pain. Not all patients, however, present with pelvic pain, pelvic mass, fever, and leukocytosis. We...

A 14-year-old girl was diagnosed at age 6 with type 1 diabetes mellitus. Both of her parents have been actively involved in her diabetic management. She recently gained 5.8 kg. At the time of presentation she was 174.2 cm tall and weighed 73.9 kg. While she was only moderately concerned about her recent weight gain, both her parents showed much mor...

Pediatricians frequently encounter patients in their daily clinical practice who present having chronic or recurrent symptoms that do not suggest a physical disorder. In fact, social, emotional, or behavioral problems can constitute up to 25% of visits in a pediatric practice, and it has been estimated that as many as 68% of children who present fo...

The purpose of this study was to compare adolescents' knowledge of alcohol after receiving either a computer-assisted instruction program or physician-delivered anticipatory guidance or no intervention. In addition, adolescents' satisfaction was compared between intervention groups. A total of 89 adolescents attending a general medical clinic were...

Because of their often multiple, complex, and time-consuming problems, adolescents often receive less than optimal care in the emergency room and represent for the physician a frustrating experience. This problem is compounded by the fact that for many adolescents visits to the emergency room are their only contact with the health-care system. An u...

It has been estimated that as many as 250,000 adolescents are using anabolic steroids (AS). Recently, anecdotal reports suggest that athletes may also be using human growth hormone (HGH). The purpose of the present study was to determine the following: 1) if adolescents in two suburban midwestern high schools (83% white, 14% Asian, and 3% black) we...

Thromboembolic events in systemic lupus erythematosus (SLE) are an occasional but significant occurrence. Cerebrovascular disease in adults with SLE has been well described.1-4 Antiphospholipid antibodies, such as lupus anticoagulant, an immunoglobulin directed against the platelet phospholipid component of the prothrombin activator complex, and th...

The acquisition and subsequent use of condoms are two important behaviors that sexually active adolescents must adopt to reduce the transmission of human immunodeficiency virus (HIV). The aims of this study were: first, to evaluate whether combining prescriptions for free condoms with anticipatory guidance would increase the number of adolescents a...

Education programs for adolescents regarding acquired immunodeficiency syndrome (AIDS) have been advocated by many professionals to help minimize the risk of infection in this population. This study compares a peer-led vs. an adult-led AIDS education program on the knowledge, attitudes, and satisfaction of the adolescents with their education. Eigh...

Abnormalities of the genital tract are common in adolescent females. Evaluation of pelvic pathology generally involves the use of ultrasonography. Recently, MRI has been shown to be effective in the diagnosis of pelvic pathology in adult females. Here, we present the case of an 11-year-old female with a pelvic mass in whom MRI proved to be an impor...

The social morbidities of adolescents represent a unique challenge to health professionals. These conditions include biologic and psychosocial factors that adversely affect the adolescent's health, and often only the consequences are treated. Facilitating compliance to improve the health status of adolescents includes strategies not only to increas...

Health providers are becoming increasingly aware that adolescents are a population at risk for acquired immune deficiency syndrome (AIDS) and have identified education as essential for prevention. This study evaluates three clinic-based programs designed to determine the effects of education on knowledge and attitudes regarding AIDS and condom acqu...

To test a previous theoretical model, we studied the relationships between social, attitude, and psychological factors and adolescent contraceptive behavior over a 6-month period. A pretested questionnaire was administered to a random sample of 115 black females aged 12 to 18 years from a low socioeconomic population. Six months after the initial i...

Assuming that contraceptives are readily available and affordable to most adolescents, but that insufficient contraceptive use and high pregnancy rates stem from adolescent female risk-taking, a multivariate model of adolescent female contraceptive risk-taking behavior is described. Derived from behavioral science theory and empirical research, the...

We tested the hypothesis that the nature of the heterosexual relationship would be associated with the contraceptive and sexual behavior among three groups of females: those with a boyfriend who agreed to be interviewed (n = 31); those whose boyfriends refused to be interviewed (n = 38); and those without a single identifiable boyfriend (n = 44). A...

The effects of oral contraceptive use and habitual physical activity on serum cholesterol and lipoproteins were studied in 37 black females ages 16 to 28 years over a 3-month period. By the third month of oral contraceptive use, high-density lipoprotein (HDL) levels were lower and the low-density lipoprotein (LDL) to HDL ratio and total serum chole...

Condom use has been advocated as a method to prevent human immunodeficiency virus (HIV) transmission. Although condoms are not uniformly popular with adolescent males, adolescent females' beliefs about condom use are unclear. To assess the specific health attitudes and behaviors as they relate to condom purchase by adolescents, we surveyed 99 adole...

Anabolic steroids have recently been used by professional and college athletes to improve athletic ability by increasing muscle size and strength. A study was done to determine the extent of steroid use and knowledge about these drugs in a population of high school male adolescents in a southern state. A self-report questionnaire, which allowed mul...

Although today's adolescents have access to a variety of contraceptive options, they remain inconsistent and suboptimal users of these methods. A particularly frustrating problem for those caring for adolescents is the issue of noncompliance with contraceptives, which is an important antecedent of adolescent pregnancy. In the future, new fertility-...

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were...

More than 50% of all adolescents in the U.S. have engaged in sexual intercourse by the age of 18. Due to the increase in involvement of adolescents in sexual activity, it is imperative that the health care provider be aware of the contraceptive methods that are best for compliance and effectiveness in these young patients. An open and nonjudgmental...

Drawing on a theoretical model of adolescent contraceptive behavior, we examined the relationships between various social and behavioral variables and contraceptive use by sexually active female adolescents. Hypotheses were tested with the use of a national random sample of sexually active female adolescents (n = 1426), aged 15 to 20 years, from Cy...

Adolescence is often a time when experimentation with alcohol, cigarette smoking, and substance abuse occur. We report a rare complication of smoking, toxic pneumonitis, in an adolescent female who combined an over-the-counter novelty item, Snow Storm tablets, with cigarettes.

This study assessed the influence of internal health locus of control (IHLC) and anxiety on the adolescent's response to the treatment of mild and moderate pain. Fifty-four adolescents (ages 16-22 years) from two adolescent clinics presenting with mild to moderate pain caused by dysmenorrhea, muscle sprain or strain, headache, or backache were stud...

With the increasing number of adolescent females participating in organized athletics, there has been concern over their susceptibility to injury during participation. This study assesses whether females differ from males in the severity and frequency of abnormalities on the preparticipation athletic examination (PAE). Standardized PAEs were perfor...

We compared male and female pediatric residents' perceptions of adolescent females' attitude and experience during a pelvic examination. Females (n = 112) ages 12-19 years were randomly assigned to a male of female examiner and to a supine or semisitting pelvic-examination position. Pre- and postexamination questionnaires were completed by the pati...

Oral contraceptives are the most popular birth control method for teenagers, yet many teens discontinue use of these contraceptives prematurely. The need to minimize any potential long-term medical complications from the use of contraceptive hormones must be balanced with the desirability of increasing acceptance of contraceptives by adolescents. T...

A theoretical model is proposed to help the clinician organize the multiple interrelationships between factors that may influence a female adolescent's compliance with her birth control method. 1 variable that has been found to be predictive for compliance in adults that was not included in the model is the quality of the patient-physician relation...

Reiter's syndrome (RS) generally affects adult white males. It occurs infrequently in adolescents. This condition is characterized by a triad of symptoms: arthritis, urethritis, and ocular abnormalities, and it usually has a benign course. We report an atypical case of RS in a black adolescent female who developed articular and ocular sequelae. Des...

Despite the availability of effective contraceptives, adolescent pregnancy remains a formidable health issue. Previous studies of adolescent contraceptive risk-taking have been atheoretical in nature and have been analyzed in univariate and bivariate modes. The purpose of this study was to test a multivariate theoretical model which predicts (1) th...

The purpose of this study was to assess the influence of internal health locus of control (IHLC) and anxiety on adolescents' response to a nonsteroidal anti-inflammatory agent (NSAIA) for the treatment of mild to moderate pain. Fifty-four adolescents (ages 16 to 22 years) from two adolescent clinics presenting with mild to moderate pain due to dysm...

The purpose of this study was to determine whether adolescents with "spasmodic" dysmenorrhea (SD) versus "congestive" dysmenorrhea (CD) respond differently to naproxen sodium therapy. Forty-five females ages 12-18 years were pretested and randomly assigned in a double-blind fashion to one of five treatment regimens of various dosages of naproxen so...

Symptomatic infection with Neisseria gonorrhea (NG) has become a major health problem in the adolescent population. While sexually active adults, who carry Neisseria gonorrhea may serve as a reservoir of infection even when asymptomatic, there are few data documenting the frequency of the asymptomatic carrier state in adolescent males. The purpose...

Symptomatic infection with Neisseria gonorrhea (NG) has become a major health problem in the adolescent population. While sexually active adults, who carry Neisseria gonorrhea may serve as a reservoir of infection even when asymptomatic, there are few data documenting the frequency of the asymptomatic carrier state in adolescent males. The purpose...

It has been reported that adult women prefer the semi-sitting position over the supine position for the pelvic examination. We determined the effect of the pelvic examination position and the examiner's gender on adolescent anxiety with the pelvic examination. Adolescent girls (n = 112) aged 12 to 19 years were randomly assigned to a semi-sitting o...

Sjogren's syndrome is a chronic autoimmune disorder characterized by keratoconjunctivitis sicca, xerostomia, and recurrent enlargement of the salivary glands. Most commonly noted in adults, it rarely affects adolescents. We describe a 15-year-old adolescent with recurrent parotid enlargement as an initial manifestation of this disease.

Self-concept and autonomy are typically negotiated during adolescence, a time when many females also become sexually active. Nonuse and discontinuation of contraceptives by teenagers place them at high risk for pregnancy. The present study explores the relationship between these psychological factors and contraceptive noncompliance during adolescen...

Myositis ossificans, an abnormal formation of new bone in an injured muscle, can occur in young athletes involved in contact sports. Recognition and appropriate therapy can reduce associated disability. This report illustrates the condition and reviews the clinical manifestations and available therapeutic modalities.

This section provides current information related to the medical needs of young athletes, as pertinent to counseling young athletes and their parents regarding sports participation and practices contributing to the health maintenance of the athlete, as well as current concepts in the prevention, diagnosis, and treatment of sports-related illnesses...

The efficacy of different regimens of naproxen sodium for relief of dysmenorrhea in female adolescents was compared and the effect of other social/psychologic factors on the response to treatment tested. Following pretesting, 45 female adolescents were randomly assigned in a double-blind fashion to one of five treatment regimens and were followed u...

PIP Focusing on the issue of adolescent compliance with medical regimens, the discussion defines compliance; reports on the incidence of noncompliance; discussed direct and indirect methods of measuring compliance; considers noncompliance as a diagnostic issue; reviews theoretical approaches to compliance research -- individualistic models, the hea...

Pneumothoraces and pneumohemathoraces have been described in adults with systemic lupus erythematosus (SLE). Although a spectrum of pulmonary involvement has been associated with SLE in childhood and adolescence, recurrent pneumothoraces have not been reported. We describe a case of a 13-year-old adolescent with fulminant SLE and a recurrent left p...

Poor compliance with contraceptive regimens has been shown to be an important antecedent of adolescent pregnancy. The purpose of this study was to test prospectively the effect of a peer v nurse counseling program on adolescent compliance with the use of oral contraceptives. Fifty-seven females aged 14 to 19 years from a lower socioeconomic backgro...

This paper prospectively tests the influence of a variety of sociomedical and psychosocial factors on compliance with oral contraceptives among adolescent females from a population at high risk for pregnancy. Fifty-six females aged 14-19 yr from a lower socioeconomic background received a battery of pretest measurements and were then given Ortho-No...

• The purpose of this study was to test the reliability of using the tablet marker, riboflavin, as an indicator of adolescent compliance with oral contraceptives, as compared with self-reports and more costly quantitative determinations of serum norethindrone levels. In a pilot study, a total of 31 urine samples were obtained from 11 subjects, aged...

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Preview Dysmenorrhea is a common gynecologic complaint with widespread physical, economic, and sociologic implications. Painful menses results in a staggering number of lost work hours annually. This article reviews the recent advances relating to our understanding of the physiologic and biochemical causes of dysmenorrhea and the available treatmen...

Upbeat nystagmus is a vertical jerk nystagmus present in the primary position with a fast upward phase. It is to be distinguished from gaze-evoked upbeating nystagmus which is not present in the primary position, but is elicited only on upgaze. Drug toxicity commonly causes gaze-evoked upbeating nystagmus but rarely primary position upbeat nystagmu...

This study evaluated the influence of a family history of coronary heart disease (CHD) and CHD risk factors on the total serum cholesterol/high density lipoprotein (TChol/HDL) and the low density lipoprotein/HDL (LDL/HDL) ratios of 84 black children (ages 7-11 years) and adolescents (ages 12-15 years). Fasting lipid determinations were measured on...

Primary dysmenorrhea is menstrual pain that is not associated with pelvis pathology. It usually begins with the onset of ovulatory cycles, characteristically appearing in the year after menarche and increasing with time. The pain is associated with increased myometrial activity. Oral contraceptives and prostaglandin synthetase inhibitors are effect...

Skeletal changes following burn injury have been reported to occur in all major joints. Although the incidence of this complication appears to be relatively small, it is reasonable to assume that it is often overlooked, because the musculoskeletal involvement does not always produce symptoms that warrant radiographic investigation. The following ca...

The development of motion sickness appears intimately related to the visual system. The Sensory Rearrangement Theory states that situations which promote motion sickness are characterized by a condition in which the motion signals transmitted by the eyes, vestibular system, and the nonvestibular proprioceptors are at variance as to what was expecte...