Sara Freeman

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – Extremely low birth weight infants need extended follow-up for renal problems, according to a 7-year follow-up of Polish children born between 2002 and 2003.

The regional cohort study results show that, at a mean age of 6.7 years, kidney function was not only significantly reduced in extremely-low-birth-weight (ELBW) infants vs. normal-weight control subjects, but that several ELBW children had hypertension.

Furthermore, renal volume was significantly lower in the ELBW children, with 13 (18%) of 72 children having smaller-than-expected kidneys for their age (P = .04).

"Survival rates [among ELBW infants] are now pretty good, so we have an increasing number of school-aged children," the study’s lead author Dr. Przemko Kwinta said in an interview at the Excellence in Paediatrics annual meeting.

"Traditionally we think about the mental development, the motor development, but there’s a lot of risk factors during early life that can also influence the kidney," Dr. Kwinta, head of the department of pediatrics at Jagiellonian University in Krakow, Poland, said. "We think that there are a lot of babies with borderline [renal] function, so maybe it is necessary to introduce some type of prophylaxis."

ELBW during the study was defined as a weight of less than 1,000 g at birth. Of 95 children born in the Malopolska district of Poland between 2002 and 2003, 72 infants had a mean birth weight of 841 g, and 23 had a mean birth weight of 3,559 g.

The mean gestational age of the ELBW and normal-weight infants was 27.3 weeks and 39.9 weeks, respectively, and the mean age at follow-up was 6.7 and 6.9 years.

Mean estimated glomerular filtration (eGFR) rates were significantly lower (94.8 vs. 103.9 mL/min per 1.73 m2; P less than .01) in the ELBW vs. the normal-weight groups, but the mean serum cystatin C level was higher (0.64 vs. 0.57 mg/L; P less than .01) in the ELBW group. However, in all children, both eGFR and cystatin C were within normal ranges.

Hypertension was observed in three (4.1%) of ELBW infants but in none of the normal-weight children (P = .1). Three ELBW children also had microalbuminuria, which was not seen in any child in the control group.

The mean volume of both the left and right kidneys was reduced in the ELBW children vs. the control group, and small kidneys (defined as less than 70% of the predicted size) was detected in 13 ELBW children, but none of the control children (P = .04).

Based on their clinical experience Dr. Kwinta and associates believe that ELBW infants require very close renal follow-up.

"We have to check the renal function, not only after birth or at 1 year, but also after 3, 6, and 7 years because the prevalence of renal problems is quite high," Dr. Kwinta observed. This may help us to recognize the early stages of renal disease so that problems in later life can be prevented.

Further follow-up of the cohort is planned at ages 10 and 11 years.

The Polish Ministry of Science supported the study. Dr. Kwinta said he had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.

After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.

"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.

Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."

The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.

All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.

Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.

"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.

Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).

Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).

The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.

"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.

The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.

"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.

Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."

Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.

He and Dr. Vorre said they had no relevant financial disclosures.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Close links exist between physical and mental health, yet the two are often treated separately, according to an expert in child and adolescent mental health.

"We know that physical and mental health are inextricably linked," said Dr. Elena Garralda, professor of child and adolescent psychiatry at Imperial College London. However, speaking Dec. 3 at the Excellence in Paediatrics annual meeting, she noted that pediatric services had become very disjointed over the years, with children seen by different specialists depending on their physical and mental health problems.

Psychiatric disorders can have an adverse effect on physical health, and they can also be a manifestation of physical disorders, Dr. Garralda explained, so it is important that the two be considered together rather than in isolation.

"Until very recently, the links between physical and mental health tended to focus on disorders such as epilepsy and the brain, because as we all know the brain is the basis of emotions and behavior," Dr. Garralda said. Over the past 10 years, however, there has been increasing realization that psychiatric morbidity may be a manifestation of physical illness, and in turn, that psychiatric disorders can have an adverse impact on physical health.

Children with attention-deficit/hyperactivity disorder (ADHD), for example, tend to be more prone than those without the disorder to have accidents, including road traffic incidents. Depression is linked to deliberate self-harm, and anorexia with increased mortality. All of these conditions and their consequences can affect adherence with prescribed treatment.

It can be difficult to tease out the relative contribution of physical and psychiatric factors and to decide which needs to be treated first, but it is clear that physical and psychological problems need to be addressed jointly. Indeed, clinical psychiatrists and pediatricians need to work together – ideally within the same clinical unit.

"There is very high psychiatric comorbidity among children attending pediatric clinics," Dr. Garralda observed. Psychiatric disorders are particularly increased in children with unexplained medical symptoms, chronic physical illnesses, and acute, life-threatening illnesses.

Unexplained medical symptoms may include recurrent abdominal pains, which have been linked to anxiety and depression in primary care (Pediatrics 2004;113:817-24). Treatment of these underlying psychological problems may therefore resolve the physical symptoms to a greater extent that addressing the physical signs directly.

Risk factors for unexplained medical symptoms and emotional disorders might be shared, and include intrinsic or environmental influences. Intrinsic influences are personality features and sensitivity to stress, whereas environmental influences include parental responses to illness, and life’s stresses in general.

More dialogue is needed between psychiatric and pediatric care, Dr. Garralda said.

Dr. Garralda had no conflicts of interest.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to one expert.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

“To be a teenager means that you get involved in risk-taking behavior,” Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale 2009;35[suppl. 6]:S182-9).

“Think of [STDs] not as a genital problem but as a brain disease,” Dr. Greydanus said.

He explained that adolescence is a period when the brain is still developing. While risky sexual behavior is perhaps par for the course among adolescents, all health care professionals need to get involved and help youths understand the risks that they are taking with their health.

“It's amazing how young these kids start being sexually active,” Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse.

“All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them.”

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32).

Asking two simple questions – “Are you sexually active?” and “Are you using a condom?” – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of sexually transmitted infections provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results.

Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

“Whether you are a cardiologist, a neurologist, a generalist – it doesn't matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing,” he said.

Adolescents represent a unique group within pediatric care, with distinct physiologic and neurologic development in comparison to infants, children, and adults, said Dr. Russell Viner of the Institute for Child Health, University College London. “The good modern pediatrician must be an expert on adolescent physiology and psychology,” he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

Ask adolescents two simple questions: 'Are you sexually active?' and 'Are you using a condom?'

Source DR. GREYDANUS

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to one expert.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

“To be a teenager means that you get involved in risk-taking behavior,” Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale 2009;35[suppl. 6]:S182-9).

“Think of [STDs] not as a genital problem but as a brain disease,” Dr. Greydanus said.

He explained that adolescence is a period when the brain is still developing. While risky sexual behavior is perhaps par for the course among adolescents, all health care professionals need to get involved and help youths understand the risks that they are taking with their health.

“It's amazing how young these kids start being sexually active,” Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse.

“All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them.”

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32).

Asking two simple questions – “Are you sexually active?” and “Are you using a condom?” – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of sexually transmitted infections provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results.

Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

“Whether you are a cardiologist, a neurologist, a generalist – it doesn't matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing,” he said.

Adolescents represent a unique group within pediatric care, with distinct physiologic and neurologic development in comparison to infants, children, and adults, said Dr. Russell Viner of the Institute for Child Health, University College London. “The good modern pediatrician must be an expert on adolescent physiology and psychology,” he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

Ask adolescents two simple questions: 'Are you sexually active?' and 'Are you using a condom?'

Source DR. GREYDANUS

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to one expert.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

“To be a teenager means that you get involved in risk-taking behavior,” Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale 2009;35[suppl. 6]:S182-9).

“Think of [STDs] not as a genital problem but as a brain disease,” Dr. Greydanus said.

He explained that adolescence is a period when the brain is still developing. While risky sexual behavior is perhaps par for the course among adolescents, all health care professionals need to get involved and help youths understand the risks that they are taking with their health.

“It's amazing how young these kids start being sexually active,” Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse.

“All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them.”

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32).

Asking two simple questions – “Are you sexually active?” and “Are you using a condom?” – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of sexually transmitted infections provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results.

Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

“Whether you are a cardiologist, a neurologist, a generalist – it doesn't matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing,” he said.

Adolescents represent a unique group within pediatric care, with distinct physiologic and neurologic development in comparison to infants, children, and adults, said Dr. Russell Viner of the Institute for Child Health, University College London. “The good modern pediatrician must be an expert on adolescent physiology and psychology,” he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

Ask adolescents two simple questions: 'Are you sexually active?' and 'Are you using a condom?'

Source DR. GREYDANUS

LONDON — The daily, long-term use of low-dose aspirin cuts the risk of death from several types cancer, in addition to colorectal cancer, according to a large meta-analysis.

In a meta-analysis of eight randomized clinical trials involving 25,570 patients, low-dose aspirin taken for 5 years or longer reduced mortality from esophageal, pancreatic, brain, stomach, colorectal, prostate, and even lung cancer, with doses as low as 75 mg/day having an effect.

This is the first time that low-dose aspirin has been linked to a reduction in cancer mortality other than colorectal cancer, said Dr. Peter M. Rothwell, who conceived and coordinated the research.

Dr. Rothwell of the John Radcliffe Hospital and the University of Oxford, England, and his associates in October 2010 showed that low-dose aspirin reduced the 20-year risk of new colon cancer cases by approximately one-quarter and deaths by a third (Lancet 2010; 376:1741-50).

The current study looked at all deaths from cancer that occurred during or after completion of eight randomized clinical trials that had been performed to look at the effects of daily aspirin vs. control for the primary or secondary prevention of vascular events (Lancet 2010 [doi:10.1016/S0140-6736 (10)62110-1]).

Across all eight trials, 674 cancer deaths occurred in 25,570 patients, with aspirin treatment significantly reducing the risk of death, compared with no aspirin treatment (pooled odds ratio [OR] 0.79, 95% confidence interval [CI] 0.68-0.92, P = .003).

From individual patient data available for seven of the trials and in which 657 cancer deaths occurred in 23,535 patients, the benefit of aspirin therapy was apparent only after 5 years or more of follow-up. The hazard ratio (HR) for death from all types of cancer was 0.66 (95% CI 0.50-0.87, P =.003), with a greater effect seen in patients with gastrointestinal tumors (HR 0.46, 95% CI 0.27-0.77, P =.003).

“We found that within the trials, while people were still on aspirin vs. no aspirin, the aspirin group had about a 30%-40% reduction in cancer deaths between year 5 and the end of the trial,” Dr. Rothwell said at a press briefing.

To determine the longer-term effects of aspirin on cancer mortality, the team looked more closely at data from three of the trials.

These had all been conducted in the United Kingdom and continued to collect information on cancer deaths via national death certification and cancer registration systems long after the trials had concluded.

In all, individual patient data were obtained on 1,634 cancer deaths that had occurred in 12,659 patients. Aspirin was found to reduce the 20-year risk of death from all solid cancers by 20% (HR 0.80, 95% CI 0.72-0.88, P less than .0001).

Again, the effect on gastrointestinal cancer was greater (HR 0.65, 95% CI 0.54-0.78, P less than .0001), but there was no effect on hematologic malignancies.

At least 5 years of therapy were needed to reduce the risk of death from esophageal, pancreatic, brain, or lung cancer, with 10 years or more treatment required to see any effect on stomach and colorectal cancer death rates, and 15 years or more for prostate cancer.

With regard to both lung and esophageal cancer, the effect of aspirin was limited to adenocarcinomas.

While the findings do not mean that everyone over the age of 40 years should now suddenly start taking a daily dose of aspirin to prevent cancer, given the increased risk of bleeding in some individuals, “We should probably stop taking people off aspirin unless they've got side effects,” Dr. Rothwell said in an interview.

“We probably shouldn't discourage those who want to take aspirin as actively as we have been doing,” he added, and perhaps physicians should “think about prescribing aspirin more in people at increased vascular risk, because they certainly benefit already.”

“There is a fundamental difference between the treatment and the prevention of a disease,” said Dr. Peter Elwood, professor of epidemiology at Cardiff University, Wales.

Dr. Elwood suggested that deciding to take a daily dose of aspirin to prevent cancer could be another choice patients make once they have all the relevant facts, much as lifestyle changes are advised but not prescribed for cardiovascular disease prevention.

The study was conducted independently of the Pharmaceutical industry and other commercial interests. Dr. Rothwell has received honoraria from pharmaceutical companies with an interest in anti-platelet therapy, including AstraZeneca, Bayer, Boehringer Ingelheim, Sanofi-Aventis/BMS, and Servier. Dr. Elwood reported no relevant financial disclosures.

LONDON — The daily, long-term use of low-dose aspirin cuts the risk of death from several types cancer, in addition to colorectal cancer, according to a large meta-analysis.

In a meta-analysis of eight randomized clinical trials involving 25,570 patients, low-dose aspirin taken for 5 years or longer reduced mortality from esophageal, pancreatic, brain, stomach, colorectal, prostate, and even lung cancer, with doses as low as 75 mg/day having an effect.

This is the first time that low-dose aspirin has been linked to a reduction in cancer mortality other than colorectal cancer, said Dr. Peter M. Rothwell, who conceived and coordinated the research.

Dr. Rothwell of the John Radcliffe Hospital and the University of Oxford, England, and his associates in October 2010 showed that low-dose aspirin reduced the 20-year risk of new colon cancer cases by approximately one-quarter and deaths by a third (Lancet 2010; 376:1741-50).

The current study looked at all deaths from cancer that occurred during or after completion of eight randomized clinical trials that had been performed to look at the effects of daily aspirin vs. control for the primary or secondary prevention of vascular events (Lancet 2010 [doi:10.1016/S0140-6736 (10)62110-1]).

Across all eight trials, 674 cancer deaths occurred in 25,570 patients, with aspirin treatment significantly reducing the risk of death, compared with no aspirin treatment (pooled odds ratio [OR] 0.79, 95% confidence interval [CI] 0.68-0.92, P = .003).

From individual patient data available for seven of the trials and in which 657 cancer deaths occurred in 23,535 patients, the benefit of aspirin therapy was apparent only after 5 years or more of follow-up. The hazard ratio (HR) for death from all types of cancer was 0.66 (95% CI 0.50-0.87, P =.003), with a greater effect seen in patients with gastrointestinal tumors (HR 0.46, 95% CI 0.27-0.77, P =.003).

“We found that within the trials, while people were still on aspirin vs. no aspirin, the aspirin group had about a 30%-40% reduction in cancer deaths between year 5 and the end of the trial,” Dr. Rothwell said at a press briefing.

To determine the longer-term effects of aspirin on cancer mortality, the team looked more closely at data from three of the trials.

These had all been conducted in the United Kingdom and continued to collect information on cancer deaths via national death certification and cancer registration systems long after the trials had concluded.

In all, individual patient data were obtained on 1,634 cancer deaths that had occurred in 12,659 patients. Aspirin was found to reduce the 20-year risk of death from all solid cancers by 20% (HR 0.80, 95% CI 0.72-0.88, P less than .0001).

Again, the effect on gastrointestinal cancer was greater (HR 0.65, 95% CI 0.54-0.78, P less than .0001), but there was no effect on hematologic malignancies.

At least 5 years of therapy were needed to reduce the risk of death from esophageal, pancreatic, brain, or lung cancer, with 10 years or more treatment required to see any effect on stomach and colorectal cancer death rates, and 15 years or more for prostate cancer.

With regard to both lung and esophageal cancer, the effect of aspirin was limited to adenocarcinomas.

While the findings do not mean that everyone over the age of 40 years should now suddenly start taking a daily dose of aspirin to prevent cancer, given the increased risk of bleeding in some individuals, “We should probably stop taking people off aspirin unless they've got side effects,” Dr. Rothwell said in an interview.

“We probably shouldn't discourage those who want to take aspirin as actively as we have been doing,” he added, and perhaps physicians should “think about prescribing aspirin more in people at increased vascular risk, because they certainly benefit already.”

“There is a fundamental difference between the treatment and the prevention of a disease,” said Dr. Peter Elwood, professor of epidemiology at Cardiff University, Wales.

Dr. Elwood suggested that deciding to take a daily dose of aspirin to prevent cancer could be another choice patients make once they have all the relevant facts, much as lifestyle changes are advised but not prescribed for cardiovascular disease prevention.

The study was conducted independently of the Pharmaceutical industry and other commercial interests. Dr. Rothwell has received honoraria from pharmaceutical companies with an interest in anti-platelet therapy, including AstraZeneca, Bayer, Boehringer Ingelheim, Sanofi-Aventis/BMS, and Servier. Dr. Elwood reported no relevant financial disclosures.

LONDON — The daily, long-term use of low-dose aspirin cuts the risk of death from several types cancer, in addition to colorectal cancer, according to a large meta-analysis.

In a meta-analysis of eight randomized clinical trials involving 25,570 patients, low-dose aspirin taken for 5 years or longer reduced mortality from esophageal, pancreatic, brain, stomach, colorectal, prostate, and even lung cancer, with doses as low as 75 mg/day having an effect.

This is the first time that low-dose aspirin has been linked to a reduction in cancer mortality other than colorectal cancer, said Dr. Peter M. Rothwell, who conceived and coordinated the research.

Dr. Rothwell of the John Radcliffe Hospital and the University of Oxford, England, and his associates in October 2010 showed that low-dose aspirin reduced the 20-year risk of new colon cancer cases by approximately one-quarter and deaths by a third (Lancet 2010; 376:1741-50).

The current study looked at all deaths from cancer that occurred during or after completion of eight randomized clinical trials that had been performed to look at the effects of daily aspirin vs. control for the primary or secondary prevention of vascular events (Lancet 2010 [doi:10.1016/S0140-6736 (10)62110-1]).

Across all eight trials, 674 cancer deaths occurred in 25,570 patients, with aspirin treatment significantly reducing the risk of death, compared with no aspirin treatment (pooled odds ratio [OR] 0.79, 95% confidence interval [CI] 0.68-0.92, P = .003).

From individual patient data available for seven of the trials and in which 657 cancer deaths occurred in 23,535 patients, the benefit of aspirin therapy was apparent only after 5 years or more of follow-up. The hazard ratio (HR) for death from all types of cancer was 0.66 (95% CI 0.50-0.87, P =.003), with a greater effect seen in patients with gastrointestinal tumors (HR 0.46, 95% CI 0.27-0.77, P =.003).

“We found that within the trials, while people were still on aspirin vs. no aspirin, the aspirin group had about a 30%-40% reduction in cancer deaths between year 5 and the end of the trial,” Dr. Rothwell said at a press briefing.

To determine the longer-term effects of aspirin on cancer mortality, the team looked more closely at data from three of the trials.

These had all been conducted in the United Kingdom and continued to collect information on cancer deaths via national death certification and cancer registration systems long after the trials had concluded.

In all, individual patient data were obtained on 1,634 cancer deaths that had occurred in 12,659 patients. Aspirin was found to reduce the 20-year risk of death from all solid cancers by 20% (HR 0.80, 95% CI 0.72-0.88, P less than .0001).

Again, the effect on gastrointestinal cancer was greater (HR 0.65, 95% CI 0.54-0.78, P less than .0001), but there was no effect on hematologic malignancies.

At least 5 years of therapy were needed to reduce the risk of death from esophageal, pancreatic, brain, or lung cancer, with 10 years or more treatment required to see any effect on stomach and colorectal cancer death rates, and 15 years or more for prostate cancer.

With regard to both lung and esophageal cancer, the effect of aspirin was limited to adenocarcinomas.

While the findings do not mean that everyone over the age of 40 years should now suddenly start taking a daily dose of aspirin to prevent cancer, given the increased risk of bleeding in some individuals, “We should probably stop taking people off aspirin unless they've got side effects,” Dr. Rothwell said in an interview.

“We probably shouldn't discourage those who want to take aspirin as actively as we have been doing,” he added, and perhaps physicians should “think about prescribing aspirin more in people at increased vascular risk, because they certainly benefit already.”

“There is a fundamental difference between the treatment and the prevention of a disease,” said Dr. Peter Elwood, professor of epidemiology at Cardiff University, Wales.

Dr. Elwood suggested that deciding to take a daily dose of aspirin to prevent cancer could be another choice patients make once they have all the relevant facts, much as lifestyle changes are advised but not prescribed for cardiovascular disease prevention.

The study was conducted independently of the Pharmaceutical industry and other commercial interests. Dr. Rothwell has received honoraria from pharmaceutical companies with an interest in anti-platelet therapy, including AstraZeneca, Bayer, Boehringer Ingelheim, Sanofi-Aventis/BMS, and Servier. Dr. Elwood reported no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

[Almost All Depressed Adolescents Recover, but Nearly Half Have Recurrence]

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

[Almost All Depressed Adolescents Recover, but Nearly Half Have Recurrence]

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.

LONDON – Sexually transmitted diseases in children and adolescents should be considered a problem of the brain rather than of the genitals, according to a leading pediatrician.

Although largely preventable through the routine use of condoms and through curbing the number of sexual partners, around 15 million new sexually transmitted disease (STD) cases occur in the United States each year. Most of these cases occur in teenagers and young adults.

[Almost All Depressed Adolescents Recover, but Nearly Half Have Recurrence]

"To be a teenager means that you get involved in risk-taking behavior," Dr. Donald E. Greydanus, professor of pediatrics and human development at Michigan State University in Kalamazoo, said at the Excellence in Paediatrics annual meeting.

Dr. Greydanus noted that teenagers are more likely than adults to be risk takers, seek out novelty situations, experience emotional intensity and lability, and succumb to peer-group influences, all as a result of underlying neurobiologic mechanisms (Encephale. 2009;35[suppl. 6]:S182–9).

"Think of [STDs] not as a genital problem but as a brain disease," Dr. Greydanus said, who explained that adolescence is a time when the brain is still developing. While risky sexual behavior is perhaps par for the course, all health care professionals need to get involved and help adolescents understand the risks that they are taking with their health.

"It’s amazing how young these kids start being sexually active," Dr. Greydanus observed in an interview, noting that children as young as 6 years old may reach puberty and begin to engage in sexual intercourse. "All of us, no matter what field we are in, need to recognize that the majority of teenagers that we see will be sexually active, or soon will be, after we have seen them."

[FDA and CDC to Consider Gardasil for Anal Cancer Prevention]

Adolescents should be screened for STDs at every appropriate opportunity, he advised, and treated accordingly if an STD is diagnosed. Data show that if one STD is present, then there is a good chance there may be another (Sex. Trans. Dis. 1999;26:26-32). Asking two simple questions – "Are you sexually active?" and "Are you using a condom?" – could help health care professionals have a huge impact on the number of STDs occurring in adolescents, suggested Dr. Greydanus, who also serves as director of the pediatrics program at the university.

The World Health Organization guidelines on the management of STIs provide a good model for the early diagnosis and treatment of STDs without the need to wait for laboratory results. Dr. Greydanus advised that all clinicians, regardless of their specialty, try to address any likely STDs rather than simply refer, as adolescents might not attend a follow-up appointment or visit a sexual health clinic.

He urged: "Whether you are a cardiologist, a neurologist, a generalist – it doesn’t matter. We are all in this fight together, and because we are not doing a good job globally, [sexually transmitted] diseases are increasing, not decreasing."

In several European countries, pediatrics is split between primary and secondary care, said Dr. Russell Viner of the Institute for Child Health, University College London. Although primary care pediatricians might be more attuned to the problem of STDs in their young patients, those working in secondary care might not be so aware or willing to investigate.

"Certainly in Britain, I think there is a real reluctance to think about STIs and a general lack of knowledge as it’s not seen as a pediatrician’s business," Dr. Viner said. Yet with up to 50% of 15-year-olds and 15% of under 13-year-olds being sexually active, there is clearly a need for more screening and treatment by both primary and secondary care pediatricians.

Adolescents represent a unique group within pediatric care, Dr. Viner said, with distinct physiologic and neurologic development in comparison to infants, children, and adults. "The good modern pediatrician must be an expert on adolescent physiology and psychology," he said.

Dr. Greydanus and Dr. Viner reported that they had no relevant financial disclosures.