Showing posts with label chronic illness. Show all posts
Showing posts with label chronic illness. Show all posts

Monday, August 31, 2015

Use of Marijuana and Alcohol among Youth with Chronic Illness, Especially Those Non-Adherent to Treatment

By: Lewis First, MD, MS; Editor-in-Chief 

          Adolescent risk-taking is something we all work hard to talk about and prevent with our teen patients during routine health maintenance visits.  But how often do we focus on risk-taking prevention in our teens with chronic illness such as cystic fibrosis, diabetes, inflammatory bowel disease and others? 
      Weitzman et al. (doi: 10.1542/peds.2015-0722) share with us the results of a cross-sectional study of more than 400 chronically ill preteens and teens ranging from 9 to 18 years who completed a self-administered survey that enabled correlation of risk-taking behaviors with disease knowledge and treatment adherence behaviors while controlling for possible confounders like mental health co-morbidities.  
      The results are concerning and show high school aged teens with chronic illness demonstrating more usage of alcohol and binge drinking as well as marijuana use than you might expect and things get even worse in those teens who forget or skip their routine medications.  There’s lots more to be learned and then shared with your patients with chronic illness with the hope of curbing their risk-taking so at no risk—read this article and learn more.   
     Are you finding your non-adherent teen patients with chronic illness are similar to those in this study when it comes to risk-taking behaviors?  Share your thoughts with us by responding to this blog, sending us an e-letter or posting on our Facebook site or Twitter.

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Friday, December 5, 2014

Is There an Association between Caesarean Section and Chronic Immune Disorder Development?

USAF photo by Tech. Sgt. Suzanne M. Day
By: Lewis First, MD, MS; Editor-in-Chief 

Sometimes we receive manuscripts that point out associations we have never before considered—and this week one such study is being published in our journal regarding the association between the increased rate of caesarean sections and the increased prevalence of chronic immune diseases like asthma, allergy, inflammatory bowel disease and type-1 diabetes.

Bisgaard et al. (doi:10.1542/peds.2014-0596) studied more than 2 million term children in a Danish registry from time of birth over 35 years and tracked them for hospitalization for chronic immune diseases such as those just mentioned above.

Controlling for confounders, the authors found that children delivered by caesarean section had an increased association with a variety of chronic immune diseases but not all of them (e.g., type-1 diabetes, psoriasis or celiac disease).

Just what role a caesarean section might play in association with an increased risk of a chronic immune disease is the basis for an interesting discussion section in this study—and you should not be immune to reading it to learn more. 

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Tuesday, October 28, 2014

College Health Services Handling Students with Chronic Illness: Are They Ready, Willing, and Able?

By: Lewis First, MD, MS; Editor-in-Chief 

Queen's College quad.  Photo by Queen's College via Flickr.
If you are practicing in a town or city where there is a college or university, have you investigated what the college health service can provide for students with a chronic medical condition like asthma or diabetes? Do you know if these health services reach out to these students or perhaps coordinate care with your office when the care gets complex? If so, how common is it for college health services to identify, support and provide care for chronically ill students?

Lemly et al. (doi:10.1542/peds.2014-1304) tackle these questions by sharing the results of a national survey of medical directors of 200 college health services in regard to their preparedness to identify and manage care for teens and young adults with diabetes, asthma, and depression. The results will likely surprise you or perhaps even make you curious enough to visit your local college health service to get a better idea of what they do offer and whether you need to link more closely with them if services are not what you expect.

The good news is the majority of these centers are well-prepared to manage acute exacerbations although the findings for identification of students and chronic management of their underlying illnesses are not as reassuring.

And if you want some additional insight into what this study shows, don’t miss the accompanying commentary by Dr. Terry Bravender (doi:10.1542/peds.2014-2645), adolescent specialist. As you transition your patients with chronic illness off to college, investigating or alerting the college health service about your patient will ease the transition—and if you aren’t in contact with those services, this article may change that going forward.

What’s been your experience with a college health service, and if you work in a college health service, what’s been your experience with referring pediatricians sending you the information you need to optimize care? Share your thoughts by responding to this blog, via an eLetter, or on Facebook or Twitter.

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