A Clinical Handbook in Adolescent Medicine

The following sections are included:

• Contents

• FOREWORD

• ACKNOWLEDGEMENTS

• Contributors

The following sections are included:

• Introduction

• The Physiology of Puberty
  • Activation of the Hypothalamic–Pituitary–Gonadal Axis
  • Adrenarche
  • The Growth Hormone Axis

• Timing of Puberty and Secular Trends

• Physical Changes of Puberty
  • Physical Changes in Boys (see Fig. 1 and Table 1)
  • Physical Changes in Girls (see Fig. 2 and Table 2)
  • Growth and Body Composition at Puberty
  • Practical Clinical Assessment of Puberty
    • History
    • Physical examination

• References

The following sections are included:

• Introduction

• Brain Development
  • Synaptic Pruning
  • Myelination

• The Influence of Brain Changes on Cognitive Development in Adolescence
  • Rapid Engagement of Frontal Regions

• Development of the Emotional Brain in Adolescence
  • The Emotional Brain
    • The nonconscious emotional brain in adolescence
    • The conscious emotional brain in adolescence
    • Self regulation and the emotional brain in adolescence

• Summary

• References

The following sections are included:

• Introduction

• Modern Concepts of Adolescence

• Normal Adolescent Development
  • Developmental Stages
    • Early adolescence (10–13 years)
    • Mid-adolescence (14–16 years)
    • Later adolescence and young adulthood (17–26 years)
  • Psychosocial Development and Behaviour
  • Neurocognitive Development
  • Moral Development

• Adolescence in Broader Contexts
  • Family, School, and Peers
    • Family and parenting
    • School
    • Peer group
  • Impact of Cultural Background
  • Growing Up in a Rapidly Changing World

• Conclusion

• References

The following sections are included:

• Introduction

• Definition of Body Image

• Presentation of Body Image Problems in Clinical Practice
  • Concerns in Girls
  • Concerns in Boys

• Dieting and Fad Diets
  • Fad Weight Loss Methods
  • Dieting For Weight Gain

• Assessment of Body Image Problems in Clinical Practice

• The Preventive Role of the Clinician

• References

The following sections are included:

• Introduction

• Setting the Stage

• Making Contact

• Communication and the Medical Visit

• Communication for Behaviour Change

• Discovering Risk Behaviours

• The Dance of the Professionals

• Making the Visit More Rewarding

• The HEADSS Risk Profile Assessment

• Conclusion

• References

The following sections are included:

• Background
  • Ethical and Legal Principles

• Young People's Capacity to Consent
  • Competence
    • Assessment of competence
    • Assessment of cognitive abilities and maturity
    • Assessment of the family context
    • Complexity of treatment
  • When is a Young Person Not Deemed to be Mature Minor?
  • Refusal of Treatment
    • Non-essential treatment
    • Treatment for a potentially serious condition, or life saving treatment

• Confidentiality
  • Confidentiality — The Clinical Context
  • Exceptions to the Duty of Confidentiality
  • Communicating with Parents

• Conclusions

• References

The following sections are included:

• Introduction

• Influence of Parents
  • General Parent–Adolescent Interactions
  • Health/Illness Related Interactions
    • Supportive interactions
    • ‘Miscarried helping’
    • Transition to independence
  • Knowledge, Attitudes, and Beliefs
  • Parental Stress and Coping

• How Clinicians Can Help Parents Support Adolescents with Health Conditions
  • Involvement in Treatment
  • Guidance
  • Positive Relationships

• Conclusion

• References

The following sections are included:

• Introduction

• Direct Communication
  • Text Messaging
  • Email
  • Chat
  • Online Peer Support Networks

• Clinical Tools
  • Online Clinical Resources
  • Online Journals
  • Serious Games
  • Virtual Worlds
  • Online Health Records

• Engaging Young People
  • Social Inclusion
  • Promoting Access to Information and Services
  • Youth Participation

• Conclusion

• References

The following sections are included:

• Introduction

• The Hospital School

• Adult Hospitals

• Chronic Illness and Cognitive Ability
  • Metabolic Disturbances
  • Frontal Lobe Damage
  • Early Hypoxia

• The Developmental Role for Schools

• References

The following sections are included:

• Introduction

• Adolescents in Hospital: Opportunistic Health Assessments

• Adolescent Wards

• Adolescents and Young Adults in Adult Hospitals

• Hospitalisation as a Transition from Paediatric to Adult Care in Chronic Illness

• Creating a Youth-Friendly Hospitalisation

• Summary

• References

The following sections are included:

• Introduction

• The Requirements of Self-Management
  • Knowledge
  • Plans
  • What to do in an Emergency
  • Local Health Care Knowledge
  • Looking After Themselves

• The Primary Goals for Self-Management

• Transitions to Self-Management

• Adolescent Development and Self Management
  • Early Adolescence
  • Middle Adolescence
  • Late Adolescence

• Therapy Adherence
  • Reasons
  • Strategies
  • What the Clinician Can Do
  • What Parents/Carers Can Do

• References

The following sections are included:

• Introduction

• Definitions
  • Medically Unexplained Symptoms
  • Functional Symptoms
  • Somatisation
  • Somatoform Disorders
  • Functional Clinical Syndromes
  • Abnormal Illness Behaviour

• Epidemiology

• Diagnostic Considerations

• Aetiology
  • Examples of Risk Factors
  • Examples of Triggers
  • Examples of Maintaining Factors

• Presentation

• Assessment
  • A Detailed and Comprehensive History
  • Psychosocial Assessment
  • A Thorough Physical Examination
  • Differential Diagnosis
  • Investigations
  • Feed Back to the Family

• Management
  • Inpatient Management
  • Ambulatory Management
  • Pharmacological Management
  • Management Challenges

• Prognosis

• Common Challenges in Complex Chronic Illness

• References

The following sections are included:

• Introduction

• Prevalence of Chronic Illness

• The Definition of Transition

• Principles of Transition
  • Transition Planning
    • The process
    • Culminates in transfer and follow up
    • Effective transition from a young person's perspective should
  • Developmental Issues Related to Health Care Transition
  • Preparation, Planning, and Communication
  • Communication Between Health Care Teams
  • Practical Advice, Resources, and Support
  • Transferring Medical Information

• Challenges to the Transition Process
  • Multiple Stakeholders: Health Care Services, Providers, Parents, and Young People
  • Paediatric and Adult Care Systems: Bridging the Divide
  • Transition Challenges for the Adolescent Patient
  • Transition Challenges for Parents: Role of the Family
  • Role of Paediatric Sub-Speciality Providers
  • Adult Health Care Providers
  • Primary Care Doctor

• Emerging Adulthood

• Models of Care

• Conclusion

• References

The following sections are included:

• What Is Resilience?
  • Components of Resilience
    • Individual components of resilience
    • External components of resilience
    • Adversity required for demonstration of resilience

• Why Is Resilience Important when Working with Adolescents?

• How Do You Assess Resilience?

• Interventions Relating to Resilience
  • A Model of Resilience for Use in Practice: The Resilience Doughnut
  • Program for Building Adolescent Resilience: RAP — Resourceful Adolescent Project

• Summary

• References

The following sections are included:

• Introduction to Substance Abuse in Young People
  • Spectrum of Drug Use
    • Substance use
    • Substance abuse
    • Substance dependence

• Risk and Protective Factors

• Assessment
  • Screening
  • History Taking
  • Clinical Assessment
  • Risk Assessment

• Drug and Alcohol Treatment Principles
  • Primary Intervention
  • Secondary Intervention
    • Brief intervention
    • Stages of change
    • Motivational Counselling
  • Tertiary Intervention
    • Harm minimisation
      • Individual cognitive behaviour therapy
      • Pharmacotherapy
      • Family therapy
      • Residential drug and alcohol rehabilitation

• Common Substances of Abuse
  • Alcohol
    • Effects of alcohol
    • Pattern of alcohol use in young people
    • Risks associated with adolescent alcohol use
    • Management of acute alcohol intoxication
    • Alcohol dependence
    • Alcohol withdrawal syndrome
    • Longer term treatment of alcohol dependence
  • Cannabis
    • Effects of cannabis
    • Pattern of cannabis use in young people
    • Cannabis dependence
    • Cannabis withdrawal syndrome
  • Psychostimulants
    • Effects of amphetamines
    • Amphetamine use in young people
    • Specific treatment of amphetamine use
  • Opioids
    • Effects of opioids
    • Pattern of opioid use in young people
    • Opioid withdrawal syndrome
    • Treatments for opioid dependence
    • Opioid replacement therapy
  • Lysergic Acid Diethylamide, Hallucinogens and Others
    • Effects of hallucinogens
    • Hallucinogen use in young people
  • Inhalants
    • Effects of inhalants
    • Pattern of inhalant use in young people
  • Benzodiazepines

• Common Comorbidities of Substance Abuse
  • Attention Deficit Hyperactivity Disorder
  • Mental Health
    • Anxiety and depression
    • Risk of psychosis
  • Young People In Out of Home Care
  • Young Offenders

• Transition

• References

The following sections are included:

• Introduction
  • Risk and Protective Factors
  • Causes of Unintentional Injuries
    • Transportation
      • Motor-vehicle
    • Poisoning
    • Drowning
    • Burns, fire, and flames
    • Sports
  • Prevention
    • Educational interventions
    • Environmental interventions
    • Legislation
  • Conclusions

• References

The following sections are included:

• Introduction

• Individual Experiences — Growing Up in the Country

• The Importance of Climate Change

• Inequalities in the Determinants of Rural Adolescent Health
  • Education
  • Social Support
  • Transport
  • Health Services
  • Nutrition
  • Smoking, Alcohol and Other Drugs

• Other Inequalities in Rural Adolescents
  • Life Expectancy
  • Mortality Rates
  • Self Reported Health
  • Injury and Accidents
    • Injury
    • Traffic accidents
    • Violence and assault
    • Poisoning
    • Farm accidents
  • Chronic Illness and Disability
  • Mental Illness
  • Teenage Pregnancy

• Conclusion

• References

The following sections are included:

• Introduction

• Incarcerated Youth
  • Background
  • International and National Guidelines
  • Demographics
    • Epidemiology and psychosocial adversity
    • High turnover
    • Recidivism
    • Indigenous youth
  • Health Needs
    • Health
    • Mental health
    • Abuse
    • Consequences of conduct disorder
    • Substance use
    • Sexual health
  • Recommendations for Achieving ‘Best Practice’ for Health Care Needs

• Homeless Youth
  • Definition and Demographics
  • Health Needs
  • Seeing Young People in Context: Barriers to Health Care for Young People with Homelessness
  • Type of Health Care Interaction
  • Core Principles for Health Care Providers Caring for Homeless Young People
  • The Initial Assessment
    • History
    • Examination
    • Investigations
  • Specific Health Care Problems
    • Skin infections and infestations
    • Trauma
    • Nutrition
    • Dental
    • Mental health
    • Alcohol and other drugs
    • Respiratory health
    • Sexual health and pregnancy
    • Safeguarding and child protection

• References

‘Please see me, hear me, talk, laugh and cry with me… and maybe remember me.’ (16 year old speaking on what she wanted from her doctors in the weeks before her death).

The following sections are included:

• Introduction

• Delayed and Absent Puberty
  • Intact Hypothalamic–Pituitary–Gonadal Axis (Functional Abnormality) (see Table 1)
    • Constitutional Delay of Growth and Puberty diagnosis
    • Treatment
  • Abnormalities of the Hypothalamus (see Table 1)
    • Diagnosis
    • Treatment
  • Abnormalities of the Pituitary (see Table 1)
  • Abnormalities of the Gonads (see Table 2)
    • Diagnosis
    • Klinefelter syndrome
    • Turner syndrome
  • Other Causes of Primary Amenorrhoea
  • Hormone Developmental Therapy
    • The principles of Hormone Developmental Therapy
    • Females
    • Males

• Early Puberty
  • True Central (Gonadotropin Dependent) Precocious Puberty
    • Diagnosis
    • Treatment
  • Gonadotropin Independent Precocious Puberty (also known as Pseudo or Non-Central Precocious Puberty)
    • Isosexual
    • Contrasexual
    • Endocrine disruptors

• Other Abnormal Pubertal Events
  • Gynaecomastia
  • Female Hirsutism
  • Premature Pubarche
  • Premature Thelarche

• Transition to Adult Care
  • Ongoing Medical Management
  • Potential Long Term Health Implications

• References

The following sections are included:

• Introduction

• Definitions

• Aetiology
  • Connexin 26
  • Waardenburg Syndrome
  • Usher Syndrome
  • Jervell and Lange-Nielsen Syndrome
  • Alport Syndrome
  • Congenital Rubella Syndrome

• Deaf Identity Development
  • Hearing
  • Immersion
  • Bicultural
  • Marginal

• Psychosocial risks

• Transitioning to Adulthood
  • Health Access
  • Higher Education and Employment

• References

The following sections are included:

• Introduction
  • Demedicalisation
  • Legal Rights and Advocacy
  • A Change in Attitudes to Disability

• Spina Bifida
  • Infancy and Childhood
  • Growth and Development
  • Spina Bifida Occulta
  • Tethered Cord
  • Myelomeningocele
    • Neurological impairments
    • Hydrocephalus
    • Latex allergy
    • Other management issues in myelomeningocele
    • Psychosocial and quality of life aspects

• Cerebral Palsy
  • Associated Health Conditions
  • Management Issues
  • Psychosocial and Quality of Life Issues
  • Ongoing Health Care Needs
  • Progressive Health Issues
    • Orthopaedic and musculoskeletal
    • Seizures
    • Nutrition
  • Summary

• Down Syndrome
  • Puberty and Adolescence
  • Specific Health Issues and Associations
  • Mental Health and Emotional Well-being

• Conclusion

• References

The following sections are included:

• Introduction

• Definitions
  • Body Mass Index
  • Waist Circumference and Waist-to-Height Ratio

• Prevalence

• Aetiology and Risk Factors
  • Genetic Factors
  • Risk Factors
    • Ethnicity
    • Screen time
    • Sweetened beverages, nutritional intake, and eating patterns
    • Sleep duration
    • Viral factors
    • Environmental pollutants
    • Endocrine disorders
    • Medications

• Obesity Complications
  • Obstructive Sleep Apnoea
  • Insulin Resistance
  • Hypertension
  • Dyslipidaemia
  • Cardiovascular Disease
  • Fatty Liver Disease
  • Polycystic Ovary Syndrome
  • Other Physical Comorbidities
  • Depression and Social Exclusion

• Clinical Assessment
  • History
  • Physical Examination

• Management
  • Conventional Approach: Lifestyle Interventions
    • Dietary management
    • Physical activity and sedentary behaviour management
  • Non-Conventional Approaches
    • Very low energy diets
    • Pharmacotherapy
    • Bariatric surgery
  • Specific Treatment of Comorbidities

• Transition Planning

• Prevention Strategies

• References

The following sections are included:

• Epidemiology

• Classification of Adolescent Eating Disorders and Disturbances

• Developmental Perspectives

• Spectrum of Eating Disorders in Adolescents
  • Anorexia Nervosa
  • Bulimia Nervosa
  • Eating Disorder Not Otherwise Specified

• Aetiology

• Prevention of Eating Disorders
  • Targeted Prevention
  • Programs

• Assessment and Treatment of Eating Disorders
  • Comorbid Medical Problems
  • Other Potential Medical Comorbidity
  • Comorbid Psychiatric Problems
    • Changes secondary to starvation
    • Other psychiatric disorders
  • Baseline Medical Investigations
  • General Therapeutic Approaches
  • Criteria for Hospital Admission
  • Inpatient Management
    • Acute medical management of the medically compromised patient
    • Refeeding
    • Ward management
  • Family Based Treatment

• Day Care Programs

• Transition

• Morbidity and Mortality

• References

The following sections are included:

• Introduction

• Adolescent Sexual Identity and Sexual Behaviour
  • Puberty
  • Diversity in Sexuality Experiences
  • Partnered Sexual Behaviour

• Sexual History Taking in Young People
  • Introduction
  • General Guidelines for Taking a Sexual History
  • Medico–Legal Obligations

• Sexually Transmitted Infections
  • Introduction
  • Epidemiology and Clinical Presentation of STIs in Adolescence
    • Chlamydia
    • Genital herpes and human papillomavirus
    • Hepatitis B Virus
    • Human Immunodeficiency Virus
  • Screening Asymptomatic Young People for STIs
  • Management of STIs

• Contraception in Adolescence
  • Introduction
  • Contraceptive Counselling
  • Contraceptive Options
  • Hormonal Contraceptives
    • Combined oral contraceptive pill
    • Vaginal ring
    • Transdermal combined contraceptive patch
    • Contraceptive implant
    • Contraceptive long acting injection
    • Levonorgestrel-releasing intrauterine system
    • Copper Intrauterine Devices
    • Post coital emergency contraception
  • Barrier Methods

• Pregnancy in Adolescence
  • Introduction
  • Epidemiology of Adolescent Pregnancy and Fertility
    • Incidence of teenage pregnancy and fertility
    • Correlates of teenage pregnancy and fertility
  • Medico–Legal Implications of Pregnancy in Adolescence
    • Pregnancy in a minor
    • Adolescent abortion
  • Adolescent Parenting
    • Clinical care of the pregnant teenager and young mother
    • Improving outcomes

• Summary

• References

The following sections are included:

• Introduction

• Benefits of Sports Participation and Physical Activity in Adolescence
  • Improved Performance
    • Changes with maturation
    • Relative age effect
    • Changes with training
  • Bone Health
  • Psychosocial Well-being
  • Disease Prevention and Treatment

• Musculoskeletal Injury
  • The Adolescent Musculoskeletal System
  • Effect of Maturation on Injury Risk
  • Issues Relating to Size and Pubertal Status Mismatch in Adolescent Sport
  • Common Acute Injuries in Adolescents
    • Acute fractures, including avulsion fractures
  • Common Chronic and Overuse Injuries in Adolescents
    • Osteochondroses
    • Spondylolysis

• Joint Hyper-mobility Syndrome in Adolescents
  • Clinical Presentation and Assessment
  • Management Including Sport Recommendations

• Prevention of Injuries in Adolescents
  • Prevention of Overtraining
  • Protective Equipment
  • Future Strategies

• Potential Long Term Health Implications

• References

The following sections are included:

• Introduction
  • Major Depressive Disorders
  • Anxiety and Anxiety Disorders
    • Generalised anxiety disorder
    • Social phobia
    • Post traumatic stress disorder
    • Obsessive-compulsive disorder — a different type of anxiety

• Aetiology

• Assessment
  • Anxiety Disorders
  • Major Depression

• Treatment
  • Cognitive Behavioural Therapy
    • CBT in anxiety
    • CBT in depression
  • Interpersonal Therapy
  • Selective Serotonin Reuptake Inhibitors
    • SSRIs in anxiety disorders
    • SSRIs in major depression
    • Which SSRI?
    • SSRIs dosage and side effects
    • SSRIs and concurrent medical illness
  • Tricyclic Antidepressants
  • Benzodiazepines

• Conclusions

• References

The following sections are included:

• Introduction

• Assessment
  • Symptoms
  • Obtaining a History
  • Other Assessments

• Making a Diagnosis
  • Are Reported Symptoms Truly Psychotic?
  • Prodrome
  • The Difficulties of Establishing a Diagnosis

• Physical Investigations for Early Onset Psychosis

• Management
  • Risk Assessment
  • Urgent Sedation
  • Next Step Medication
  • Psychoeducation
  • Cognitive Behavioural Therapy
  • Working with Families

• Maintenance Medication and Side Effects

• Early Psychosis in Specific Populations

• Services for Early Psychosis

• Recovery, Return to Education and Outcome

• Transition to Adult Services

• Case Study

• References

The following sections are included:

• Introduction

• Deliberate Self-Harm
  • Clinical Description
  • Epidemiology
  • Associated Factors
  • Assessment
  • Management
  • Outcome

• Suicide
  • Clinical Description
  • Epidemiology
  • Prevention
  • Managing the Aftermath of a Suicide

• References

The following sections are included:

• Introduction

• Stigmatisation

• Prevalence of Intellectual Disability and Autism

• Aetiology

• ID and Mental Health
  • Associated Physical Health Needs
  • Communication and Problem Solving Skills and Mental Health
  • Challenging Behaviour Versus Mental Health Disorder
  • Diagnosis
  • Prevalence of Mental Disorders in Adolescents and Young Adults with ID and Transition Issues
  • Specific Mental Health Diagnoses in ID
    • Depression
    • Anxiety disorders
    • Psychoses
    • Impulse control disorders
    • Organic mental disorders

• Barriers To Mental Health Care in ID and How to Overcome These

• Models of Care

• Conclusions

• References

The following sections are included:

• Introduction

• Normal Changes in Sleep with Puberty and Adolescence
  • Circadian Rhythm
  • Psychosocial Factors
  • Week Day and Weekend Sleep
  • Sleep Hygiene

• Sleep Disordered Breathing
  • Diagnosis
  • Treatment

• Hypersomnolence

• Delayed Sleep Phase Syndrome
  • Diagnosis
  • Treatment

• Narcolepsy
  • Diagnostic Criteria
  • Treatment

• Periodic Hypersomnolence: Including Kleine–Levin Syndrome and Menstrual-Related Hypersomnolence
  • Diagnosis
  • Presentation and Treatment

• Insomnia
  • Definition
  • Contributing factors
  • Management of Sleep Disorders
    • Optimisation of sleep hygiene
    • The primary behavioural management principle
    • Medication

• Sleep in Other Disorders
  • Intellectual Disability
  • Change at Adolescence
  • Specific Syndromes
  • Treatment

• Conclusion

• References

The following sections are included:

• Introduction

• What is ADHD?
  • Aetiology
  • Epidemiology

• Diagnosis and Assessment
  • DSM-IV-TR
  • ICD-10
  • Other Diagnostic Tools
  • Differential Diagnoses

• Comorbidities
  • Psychiatric Disorders
  • Learning and Development
  • Other Assessments

• Management
  • Introduction
  • Medication
    • Stimulants
    • Atomoxetine
    • Other medications
  • Psychosocial Management
  • Complementary and Alternative Treatments
  • Review and Ongoing Management
  • Transition
    • College and tertiary education
    • Workplace
    • Independence from family

• Conclusions

• Case History

• References

The following sections are included:

• Introduction

• General Immunisation Guidelines

• Vaccinations Recommended for All Adolescents
  • Primary Immunisations
  • Booster Immunisations
  • Catch-Up Programs
    • Measles, mumps, and rubella
    • Polio
    • Hepatitis B
    • Varicella
    • Meningococcal C

• Immunisations for Adolescents at Risk
  • Underlying Medical Conditions
    • Influenza
    • Pneumococcal vaccination
    • Other medical conditions which may require additional vaccinations
  • Immunisation in Pregnancy
    • During pregnancy
    • Planning or post pregnancy

• Travel Vaccinations
  • Poliomyelitis
  • Yellow Fever
  • Typhoid
  • Hepatitis A
  • Rabies
  • Japanese Encephalitis

• Future Vaccines for Adolescents

• Hurdles for Adolescent Vaccine Delivery

• References

The following sections are included:

• Introduction

• Asthma
  • The Diagnosis of Asthma
  • Treatment
  • Collaboration with High Schools and Transition from Paediatric to Adult Health Care

• Cystic Fibrosis
  • Pulmonary Complications
  • Extrapulmonary Complications of CF
    • Pancreatic insufficiency and diabetes
    • Liver disease
    • Bone disease
    • Fertility
  • Lung Transplantation

• Non-CF Bronchiectasis
  • Recurrent Aspiration
  • Primary Ciliary Dyskinesia
  • Primary Immunodeficiency

• Acute Lung Disease

• Technology-Dependent Respiratory Disorders

• Adult Consequences of Neonatal Lung Disease

• Smoking Cessation

• References

The following sections are included:

• Introduction

• Thyroid disorders
  • Hypothyroidism
    • Clinical presentation
    • Aetiology
    • Investigations
    • Treatment
  • Hyperthyroidism
    • Symptoms and signs
    • Investigations
    • Therapy
  • Thyroid Cancer

• Growth Hormone Deficiency and Hypopituitarism
  • Causes of Growth Hormone Deficiency
  • Presentation in Adolescence
  • Therapy

• Craniopharyngiomas
  • Presenting Symptoms
  • Neurological Morbidity
  • Investigation
  • Treatment
    • Surgery and radiotherapy
    • Pituitary hormone replacement
    • Hypothalamic obesity and metabolic complications

• Prolactinomas
  • Symptoms
  • Investigations
  • Treatment
    • Dopamine agonists
    • Other therapies

• Adrenal Disorders
  • Adrenal Insufficiency
    • Clinical features
    • Investigations
    • Treatment
  • Congenital Adrenal Hyperplasia
    • Investigations
    • Treatment

• Cushing Syndrome

• References

The following sections are included:

• Introduction

• Monitoring Diabetes

• Growth and Puberty

• Insulin Pump Therapy

• Diabetic Ketoacidosis

• School

• Diabetes Camps

• Diabetes and Surgery

• Long Term Complications

• Other Autoimmune Disease

• Risky Behaviours

• Other Forms of Diabetes

• Transition from Paediatric to Adult Care

• References

The following sections are included:

• Introduction

• Osteoporosis
  • Definition
  • Diagnosis
    • Bone mass/density
    • Biochemical markers

• Primary Osteoporosis
  • Osteogenesis Imperfecta

• Secondary Osteoporosis
  • Reduced Mobility
  • Pubertal Delay

• Nutrition and Low Body Weight
  • Anorexia Nervosa
  • Calcium and Vitamin D

• Glucocorticoids

• Inflammatory Cytokines and Growth Factors

• Treatment of Osteopaenia/Osteoporosis

• References

The following sections are included:

• Introduction

• Headache
  • Evaluation of Headache
    • Migraines
    • Tension type headaches
    • Headache with raised intracranial pressure
    • Examination
    • Imaging
  • Treatment of Primary Headache Disorders
    • Migraine
    • Preventive treatment
    • Chronic daily headaches

• Paroxysmal Disorders
  • Evaluation of Paroxysmal Disorders
  • Syncope
    • Neurocardiogenic syncope
    • Evaluation
    • Treatment
  • Epilepsy
    • Evaluation of epilepsy
    • Juvenile myoclonic epilepsy
    • Choice of anti-epileptic medications in adolescence
    • Lifestyle in adolescents with epilepsy
    • Contraception
    • Driving
    • Employment

• Neuromuscular Disorders
  • Acute Neuromuscular Disorders
    • Assessment
    • Guillain–Barré syndrome
    • Autoimmune myasthenia gravis
  • Chronic Neuromuscular Disease

• Neurodegenerative Disorders
  • Evaluating the Adolescent with a Possible Neurodegenerative Disorder
    • Investigation

• Stroke
  • Investigation
  • Treatment

• Infectious and Inflammatory Disorders
  • Meningitis
  • Encephalitis
  • Immunologically Mediated Inflammatory Disorders of the CNS

• Evaluation of Suspected Conversion Disorders

• References

The following sections are included:

• Introduction

• Functional Gastrointestinal Disorders
  • Diagnosis of FGIDs
    • Adolescent rumination syndrome
    • Functional dyspepsia
    • Irritable bowel syndrome
    • Abdominal migraine and cyclical vomiting syndrome
    • Adolescent functional abdominal pain
    • Functional constipation and incontinence
  • Investigations for FGIDs
  • Treatment of FGIDs

• Oesophagitis
  • Gastro–Oesophageal Reflux Disease
    • Diagnosis
    • Treatment
  • Eosinophilic oesophagitis
    • Diagnosis
    • Treatment

• Peptic Ulcer Disease and Gastritis
  • H. pylori Infection
    • Diagnosis
    • Treatment
  • Gastritis and Gastric or Duodenal Ulcer Without H. pylori Disease

• Coeliac Disease
  • Presentation
  • Diagnosis
  • Treatment
  • Complications

• Inflammatory Bowel Disease
  • Types
  • Diagnosis
  • Treatment

• Hereditary Polyposis Syndromes

• Pancreatitis

• Acute Liver Disease

• Chronic Liver Disease
  • Causes of Chronic Liver Disease in the Adolescent
  • Liver Transplantation

• Transitional Issues

• References

The following sections are included:

• Introduction

• Dermatological Conditions Which Mainly Occur in Adolescence
  • Acne
    • Pathogenesis
    • Clinical features of acne
    • Problems associated with acne
    • Management
      • Topical therapy in acne
      • Oral therapy in acne
      • Physical modalities for acne treatment
  • Dandruff and Seborrhoeic Dermatitis
    • Pathogenesis
    • Clinical features
    • Treatment
  • Disorders of Hair Growth
    • Hirsutism
      • Causes of hirsutism
      • Management of hirsutism
    • Hypertrichosis
    • Alopecia
  • Disorders of Sweat Glands
    • Bromhidrosis (osmidrosis)
    • Chromhidrosis
    • Fox–Fordyce disease or apocrine miliaria
    • Hidradenitis suppurativa
    • Hyperhidrosis
  • Disturbances of Melanin Pigmentation
    • Naevi
    • Other pigmentation disorders

• Other Dermatological Conditions which Occur in Adolescence
  • Infections
    • Fungal infections
    • Viral infections
  • Infestations
    • Scabies
    • Pediculosis capitis
    • Pediculosis pubis
    • Larva migrans
  • Eczema
    • Atopic dermatitis
    • Contact dermatitis
    • Photodermatitis
    • Sun damage, including solariums
  • Papulosquamous Disorders
    • Pityrasis rosea
    • Psoriasis
    • Lichen planus
  • Urticaria
  • Tattooing and Piercing

• Conclusion

• References

The following sections are included:

• Haematological Changes in Adolescence

• Anaemia in Adolescents
  • Iron Deficiency
    • Aetiology
    • Prevalence
    • Symptoms of iron deficiency
    • Diagnosis of iron deficiency
    • Treatment of iron deficiency
  • Haemoglobinopathies
    • Thalassaemia major
    • Sickle cell disease
  • Other Anaemias

• Disorders of Haemostasis
  • Bleeding Disorders in Adolescence
  • Congenital Bleeding Disorders
    • Haemophilia
    • Von Willebrand disease
    • Inherited bone marrow failure syndromes
  • Acquired Bleeding Disorders in Adolescence
    • Immune thrombocytopaenic purpura
    • Other acquired bleeding disorders presenting in adolescence
  • Investigation of Bleeding Disorders in Adolescents
  • Management of Bleeding Disorders

• Thromboembolic Disorders
  • Inherited Prothrombotic Disorders
  • Management of an Acute Thrombotic Event

• Transition to Adult Care in Established Haematological Disease

• References

The following sections are included:

• Introduction

• Food Allergy in Adolescence
  • Prevalence of IgE Mediated Food Allergy
  • Symptoms
  • Factors Increasing Risk in Adolescent Food Allergy
  • Management

• Oral Allergy Syndrome
  • Presentation
  • Diagnosis
  • Treatment

• Eosinophilic Oesophagitis
  • Prevalence
  • Presentation
  • Diagnosis
  • Management

• Allergic Rhinitis in Adolescence
  • Prevalence
  • Classification
  • Treatment
    • Topical medication
    • Oral medication
    • Immunotherapy

• Common Variable Immune Deficiency in Adolescence
  • Prevalence
  • Presentation
  • Diagnosis
  • Management

• References

The following sections are included:

• Introduction

• Patterns and Incidence of Cancer in AYA

• Specific AYA Issues in Cancer Management
  • Different Biology
  • Delay in Diagnosis
  • Choice of Treatment Setting and Specialist
  • Decreased Participation in Clinical Trials
  • Psychosocial Issues and Supportive Care
  • Treatment Adherence
  • Fertility Preservation

• Summary

• References

The following sections are included:

• Introduction

• Cancer Diagnoses

• Cancer Therapies

• Consequences and Management

• Consequences from the Perspective of the Adolescent
  • Quality of Life and Neuropsychological Functioning
  • Appearance
    • Growth
    • Puberty
    • Obesity
    • Other
  • Fertility
  • Living Life to the Full
    • Education and vocation
    • Healthy living
    • Travel

• Consequences from the Perspective of the Healthcare Professional
  • Subsequent Malignant Neoplasms
    • Cancer therapy
    • Other potential influences on the development of SMN
  • Cardiovascular Consequences
  • Endocrine Consequences
    • Hypothalamic–pituitary axis
    • Thyroid gland
  • Fertility and Pregnancy

• Delivery of Care

• References

The following sections are included:

• Introduction

• Congenital Heart Lesions
  • Atrial Septal Defect
    • Classification
    • Presentation
    • Diagnosis
    • Management
  • Ventricular Septal Defect
    • Classification
    • Presentation
    • Diagnosis
    • Management
  • Patent Ductus Arteriosus
    • Presentation
    • Diagnosis
    • Management
  • Bicuspid Aortic Valve
  • Coarctation of the Aorta
    • Clinical features
    • Diagnosis
    • Management
  • Tetralogy of Fallot
  • Transposition of the Great Arteries
  • Other Complex Congenital Heart Defects

• Tachyarrhythmias
  • Paroxysmal Supraventricular Tachycardia
  • Atrial Flutter
  • Atrial Fibrillation
  • Ventricular Tachycardia

• Sudden Cardiac Death in Adolescents and Young Adults

• Bacterial Endocarditis

• Psychosocial Aspects of Congenital Heart Disease

• Transition to Adult Care
  • Psychological Counselling
  • General Health
  • Pregnancy

• References

The following sections are included:

• Introduction

• Renal Conditions in Adolescents
  • Haematuria
  • Nephritic Syndrome
  • IgA Nephropathy
  • Alport Syndrome
  • Autosomal Dominant Polycystic Kidney Disease
  • Henoch–Schönlein Pupura
  • Proteinuria
  • Nephrotic Syndrome
  • Focal Segmental Glomerulosclerosis
  • Lupus Nephropathy and Membranous Nephropathy
  • Membranoproliferative Glomerulonephritis

• Other Causes of Renal Impairment in Adolescents

• Management of the Adolescent with Chronic and End Stage Kidney Disease
  • Growth and Nutrition
  • Anaemia
  • Hypertension and Proteinuria
  • Cardiovascular Risk

• Management of the Adolescent with Renal Transplant
  • Medications — See Table 5
  • Infection
  • Rejection
  • Malignancy
  • Cardiovascular Risk
  • Pregnancy and the Kidney Transplant Recipient

• Other Issues in Adolescents with Chronic Kidney Disease
  • Quality of Life
  • Education and Employment

• Emerging Risk Factors for Adult Onset CKD During Adolescence
  • Hypertension
  • Other Risk Factors
  • High Risk Groups: Indigenous Australians

• Transition to Adult Care: Specific Issues for the Renal Patient

• References

The following sections are included:

• Introduction

• Arthritis
  • Juvenile Idiopathic Arthritis and Its Subtypes
  • Oligoarticular arthritis
  • Polyarticular arthritis
  • Systemic arthritis
  • Enthesitis related arthritis
  • Psoriatic arthritis
• Complications of Juvenile Idiopathic Arthritis
• Treatment of Juvenile Idiopathic Arthritis
  • Pharmacological therapies for juvenile idiopathic arthritis
  • Non-pharmacological therapies for juvenile idiopathic arthritis
• Prognosis and Outcome

• Systemic Lupus Erythematosus
  • Aetiology and Epidemiology
  • Clinical Presentation
  • Treatment
  • Outcomes

• Musculoskeletal Pain Syndromes (Pain Amplification Syndromes)
  • Classification
    • Diffuse idiopathic pain
    • Localised pain syndromes
  • Diagnosis
  • Treatment
  • Outcomes

• Back Pain
  • Aetiology
    • Mechanical causes of back pain
    • Inflammatory causes of back pain

• Rarer Rheumatic Conditions in Adolescents and Young Adults
  • Juvenile Dermatomyositis
  • Systemic Vasculitides
  • Periodic Fever Syndromes (Auto-Inflammatory Syndromes)
  • Raynaud's Disease and Phenomenon
  • Scleroderma
  • Overlap Syndromes

• References

The following sections are included:

• Introduction

• Talking with Adolescents About Heritability
  • Genetic Testing and Screening in Adolescents
  • Presymptomatic and Predictive Testing of Young Adults for Late Onset Genetic Disorders

• Where Teenagers Can Go for Information
  • Genetics on the Web
  • Help for Parents in Explaining Genetic Concepts and Disorders
  • Direct to Consumer Genetic Testing
  • Transitional Specialty Services for Chronic Genetic Disorders in Young Adults
    • Neuromuscular disorders
    • Neurofibromatosis

• Principles of Genetics

• A Future for Adolescent Genetic Health

• References

The following sections are included:

• Introduction

• Problems of the Penis and Foreskin
  • Phimosis
  • Circumcision
    • Meatal stenosis
    • Suture sinuses
    • Surgical adhesions
  • Fraenulum
  • Hypospadias
    • Aetiology and presentation
    • Classification
    • Surgical repair
    • Post hypospadias surgery problems
  • Chordee

• Testicular Conditions
  • Testis Not in the Scrotum
    • Undescended
    • Retractile testes
    • Ectopic testes
    • Impalpable testes
  • Torsion of the Testis
    • Presentation
    • Treatment
  • Varicocoele

• Pelviureteric Junction Obstruction

• Vesicoureteric Reflux

• Neurogenic Bladder — Spina Bifida as an Example
  • Failure to Empty and to Store
  • Assessment
  • Baseline Intervention
  • Follow-up
  • Treatment for Reduced Bladder Capacity

• Dysfunctional Elimination Syndrome

• Exstrophy and Epispadias

• Renal and Ureteric Calculi
  • Aetiology and Investigation
  • Symptoms and Signs
  • When to Treat
    • Asymptomatic renal calculi
    • Ureteric colic
    • Renal calculi in association with infection
    • Adjunctive therapies

• References

The following sections are included:

• Introduction

• History and Examination
  • History
  • Examination
  • Use of Pelvic Ultrasound

• The Normal Menstrual Cycle

• Common Medical Issues in Adolescent Gynaecology
  • Dysfunctional Uterine Bleeding
  • Dysmenorrhoea
  • Polycystic Ovarian Syndrome
    • Symptoms
    • Criteria for diagnosis
    • Diagnosis of polycystic ovaries in adolescence
    • Management of PCOS
  • Oligomenorrhea and Secondary Amenorrhoea
  • Vulval and Vaginal Issues
    • Vulvovaginitis
    • Vulvodynia
    • Swelling of the vulva and labia
    • Labial inequality

• Common Surgical Issues in Adolescent Gynaecology
  • Endometriosis and Pelvic Pain, Including Chronic Pelvic Pain
    • Endometriosis
  • Ovarian Cysts Including Ovarian Torsion
  • Congenital Anomalies of the Reproductive Tract
    • Imperforate hymen (or low vaginal atresia)
    • Müllerian agenesis
  • Solid Tumours of the Reproductive Tract in Adolescence
  • Laparoscopy in the Adolescent

• Menstrual Management in the Developmentally Delayed Patient
  • Oral Therapy
  • The Levonorgestrel IUS
  • Endometrial Ablation or Hysterectomy

• Fertility Preservation in Patients with Significant Childhood Illness

• Transition to Adult Care

• References

The following sections are included:

• Introduction

• Puberty

• Disorders of Male Puberty
  • Normal Puberty
  • Precocious Puberty
  • Delayed Puberty

• Male Reproductive Health Disorders in Adolescence
  • Klinefelter Syndrome
  • Fertility
    • Vulnerability of seminiferous tubules
    • Causes of male subfertility
    • Prevention of subfertility
    • Preservation of fertility in the adolescent cancer patient
  • Virilisation
    • Early onset of defective virilisation
    • Later onset of defective virilisation

• Sexuality

• References

The following sections are included:

• Introduction

• The Process of Atherosclerosis

• Hyperlipidaemia
  • Familial Hypercholesterolaemia
  • Familial Combined Hyperlipidaemia
  • Mixed Environmental–Genetic Hyperlipidaemia
  • Metabolic Syndrome

• Evaluation

• Identifying Adolescents at Risk: Case Scenarios
  • Incidental Finding
  • Positive Family History
  • Secondary Dyslipidaemia

• Lifestyle Management
  • Basic Elements of a Therapeutic Lifestyle Change Diet
  • Follow-Up Procedures

• Pharmacotherapeutic Challenges
  • Failure of Therapeutic Lifestyle Change
  • Multiple Lipid Abnormalities in an Overweight Adolescent
  • Dyslipidaemia in a Thin Adolescent

• Non Pharmacological Agents
  • Cholesterol Lowering Products
  • Triglyceride Lowering Products

• Conclusion

• References

The following sections are included:

• Abbreviations

• Index