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Human Immunodeficiency Virus: Adolescent Emergencies. 人类免疫缺陷病毒:青少年紧急情况。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01 DOI: 10.1542/9781581109504-emergencies
C. Salas-Humara, Sarah M. Wood, L. D'Angelo, Nadia L. Dowshen
Many adolescents are at high risk for HIV infection, and those who are infected or at-risk commonly present to the ED, often as their only or frequent source of care. It is important to consider routine screening and to have a high index of suspicion for AHI in this setting. If a diagnosis of HIV infection is made, immediate linkage to care with a specialist in adolescent and young adult HIV infection should be prioritized. For the known HIV-infected patient, management must consider unique possibilities of OIs, IRIS, and medication side effects. For any patient on ART, drug-drug interactions must be noted as part of any treatment plan. If a young person presents with a recent sexual or needlestick exposure of concern, every effort to prescribe and ensure follow-up for PEP should be made. It is essential for physicians to understand and comply with local regulations regarding HIV testing and adolescents' rights for associated confidential care. Finally, physicians who see adolescents in acute care settings have a tremendous opportunity to make a difference in ensuring improved health outcomes for youth living with HIV and to prevent new infections.
许多青少年感染艾滋病毒的风险很高，而那些被感染或有风险的青少年通常会去急诊科，经常作为他们唯一或经常的护理来源。在这种情况下，考虑常规筛查和对AHI有高怀疑指数是很重要的。如果诊断出艾滋病毒感染，应优先考虑立即与青少年和青年艾滋病毒感染专家联系。对于已知的hiv感染患者，管理必须考虑OIs、IRIS和药物副作用的独特可能性。对于任何接受抗逆转录病毒治疗的病人，药物-药物相互作用必须作为任何治疗计划的一部分加以注意。如果一个年轻人最近出现了令人担忧的性接触或针头接触，应尽一切努力开处方并确保对PEP进行随访。医生必须了解并遵守有关艾滋病毒检测和青少年获得相关保密护理权利的当地法规。最后，在急症护理机构看到青少年的医生有巨大的机会在确保改善感染艾滋病毒的青年的健康结果和预防新的感染方面发挥作用。
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引用次数: 0
Sports-Related Sudden Cardiac Injury or Death. 与运动相关的心脏猝死
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Elizabeth Anne Greene, Ann Punnoose

Symptoms such as syncope and chest pain, especially if they are accompanied by palpitations or occur with exercise in any combination, require cardiac evaluation before adolescent athletes are allowed to return to the sports field. Some life-threatening conditions will likely be associated with a family history of HCM or LQTS, but the family history may not be discovered at the first medical visit. A family history of CPVT, for example, is hard to elicit unless this diagnosis has already been established in an affected family member. The keys will be the timing of symptoms and the documentation of arrhythmia with exercise. The ECG at baseline in CPVT may be deceptively normal. Hypertrophic cardiomyopathy is progressive, so evaluation during early childhood may be negative. Long QT syndrome may not always result in an abnormal ECG, even in genetically positive individuals. A high index of suspicion is needed to make these diagnoses, especially if the family history is not available.

晕厥和胸痛等症状，特别是伴有心悸或与运动同时发生时，需要在青少年运动员被允许重返运动场之前进行心脏评估。一些危及生命的疾病可能与HCM或LQTS的家族史有关，但家族史可能不会在第一次就诊时被发现。例如，除非在受影响的家庭成员中已经确定了这种诊断，否则很难推断出CPVT的家族史。关键是症状的时间和心律失常与运动的记录。在CPVT的基线心电图可能是正常的。肥厚性心肌病是进行性的，因此在儿童早期的评估可能是阴性的。长QT综合征可能并不总是导致心电图异常，即使是基因阳性的个体。做出这些诊断需要高度的怀疑指数，特别是在没有家族史的情况下。
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引用次数: 0
Update on Meningitis in Adolescents and Young Adults. 青少年和青壮年脑膜炎最新情况。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Stephen Thacker, Caroline Cruce, John D Rowlett
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引用次数: 0
Sports-Related Head Injuries in Adolescents: A Comprehensive Update. 青少年运动相关头部损伤:全面更新。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01 DOI: 10.1542/9781581109504-update
Alexander D McGinley, C. Master, M. Zonfrillo
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引用次数: 1
Adolescent Dating Violence in the Emergency Department: Presentation, Screening, and Interventions. 青少年约会暴力在急诊科:介绍，筛选和干预。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Quyen M Epstein-Ngo, Emily Rothman
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引用次数: 0
Syncope in Children and Adolescents. 儿童和青少年晕厥。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Khalil Kanjwal, Sundus Masudi, Blair P Grubb
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引用次数: 0
Evaluation and Treatment of the Adolescent Sexual Assault Patient. 青少年性侵犯患者的评估与治疗。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01 DOI: 10.1542/9781581109504-patient
C. Mollen, M. Goyal, J. Lavelle, P. Scribano
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引用次数: 1
Adolescent Male Genitourinary Emergencies. 青少年男性泌尿生殖系统急症。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Zachary McClain, David L Bell
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引用次数: 0
Sports-Related Head Injuries in Adolescents: A Comprehensive Update. 青少年运动相关头部损伤:全面更新。
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01
Alexander D McGinley, Christina L Master, Mark R Zonfrillo
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引用次数: 0
Sports-Related Sudden Cardiac Injury or Death. 与运动相关的心脏猝死
Adolescent Medicine: State of the Art Reviews
Pub Date : 2015-12-01 DOI: 10.1542/9781581109504-death
E. A. Greene, A. Punnoose
Symptoms such as syncope and chest pain, especially if they are accompanied by palpitations or occur with exercise in any combination, require cardiac evaluation before adolescent athletes are allowed to return to the sports field. Some life-threatening conditions will likely be associated with a family history of HCM or LQTS, but the family history may not be discovered at the first medical visit. A family history of CPVT, for example, is hard to elicit unless this diagnosis has already been established in an affected family member. The keys will be the timing of symptoms and the documentation of arrhythmia with exercise. The ECG at baseline in CPVT may be deceptively normal. Hypertrophic cardiomyopathy is progressive, so evaluation during early childhood may be negative. Long QT syndrome may not always result in an abnormal ECG, even in genetically positive individuals. A high index of suspicion is needed to make these diagnoses, especially if the family history is not available.
晕厥和胸痛等症状，特别是伴有心悸或与运动同时发生时，需要在青少年运动员被允许重返运动场之前进行心脏评估。一些危及生命的疾病可能与HCM或LQTS的家族史有关，但家族史可能不会在第一次就诊时被发现。例如，除非在受影响的家庭成员中已经确定了这种诊断，否则很难推断出CPVT的家族史。关键是症状的时间和心律失常与运动的记录。在CPVT的基线心电图可能是正常的。肥厚性心肌病是进行性的，因此在儿童早期的评估可能是阴性的。长QT综合征可能并不总是导致心电图异常，即使是基因阳性的个体。做出这些诊断需要高度的怀疑指数，特别是在没有家族史的情况下。
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引用次数: 0
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