Health article

How concussions affect kids and teens

Christina Master, M.D.

Concussions among professional athletes have been covered widely in the media. But Christina Master, M.D., co-director of the concussion program at Children’s Hospital of Philadelphia, thinks more attention should be paid to brain injuries in children and teens.

The latest figures show that each year in the U.S. about 283,000 children under the age of 18 visit the emergency room for recreation-related traumatic brain injuries, including concussion. Injuries from playground activities and contact sports—especially football, soccer, and basketball—make up nearly half these visits.

Greater awareness of concussions at the pro athlete level “has certainly trickled down to the youth athlete level” and has sparked more research in recent years, Dr. Master says.

New research paths

Many of these new studies are changing our ideas about treatment and diagnosis, for example, how long a full recovery takes and the differences in concussion between girls and boys.

“The idea of sitting in a dark room after a concussion is probably going by the wayside.”

– Christina Master, M.D.

Dr. Master has worked on recent National Institutes of Health-funded studies that have looked at new, quicker, and more objective ways to diagnose concussion. These include simple balance tests in a doctor’s office and eye tracking tests that can tell if a brain injury happened.

Research also shows that one in six children between the ages of 5 and 15 who get a concussion will have another one within two years. A recent study of Children’s Hospital of Philadelphia patients found that the risk of repeat injury was highest among the oldest kids.

Rethinking recovery

Research suggests that kids who have suffered a concussion may need more help at school and with sports as they recover. But light exercise, such as walking on a treadmill or riding a stationary bike, could

Health article

Acute Flaccid Myelitis (AFM) | VitalSigns

Acute flaccid myelitis (AFM) is an uncommon, but life-threatening neurologic condition that affects mostly children and can lead to permanent paralysis. Enteroviruses, particularly EV-D68, are likely responsible for the increase in cases every two years since 2014. AFM is a medical emergency and patients must be hospitalized and monitored in case they progress to respiratory failure. Prompt recognition and immediate action by pediatricians, and emergency department and urgent care providers are critical to achieving the best possible outcomes.

  • AFM typically presents with sudden limb weakness. Most patients had respiratory illness or fever before AFM onset.
  • Patient health can decline quickly, resulting in paralysis or the need for a ventilator. AFM can lead to permanent disability.
  • Patients who tested positive for EV-D68 typically had more severe AFM illness, requiring hospitalized intensive care and ventilation.
  • Most cases occur between August and November.

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Maturity-onset diabetes of the young – Genetics Home Reference

Maturity-onset diabetes of the young (MODY) is a group of several conditions characterized by abnormally high blood sugar levels. These forms of diabetes typically begin before age 30, although they can occur later in life. In MODY, elevated blood sugar arises from reduced production of , which is a hormone produced in the that helps regulate blood sugar levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source.

The different types of MODY are distinguished by their genetic causes. The most common types are HNF1A-MODY (also known as MODY3), accounting for 50 to 70 percent of cases, and GCK-MODY (MODY2), accounting for 30 to 50 percent of cases. Less frequent types include HNF4A-MODY (MODY1) and renal cysts and diabetes (RCAD) syndrome (also known as HNF1B-MODY or MODY5), which each account for 5 to 10 percent of cases. At least ten other types have been identified, and these are very rare.

HNF1A-MODY and HNF4A-MODY have similar signs and symptoms that develop slowly over time. Early signs and symptoms in these types are caused by high blood sugar and may include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, weight loss, and recurrent skin infections. Over time uncontrolled high blood sugar can damage small blood vessels in the eyes and kidneys. Damage to the light-sensitive tissue at the back of the eye (the ) causes a condition known as diabetic retinopathy that can lead to vision loss and eventual blindness. damage (diabetic nephropathy) can lead to kidney failure and end-stage renal disease (ESRD). While these two types of MODY are very similar, certain features are particular to each type. For example, babies with HNF4A-MODY tend to weigh more

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Teen vaping research is a priority as marijuana and nicotine use surge

Vaping has led to a dramatic rise in nicotine and marijuana use among young people in recent years. Marijuana vaping among 12th graders, for instance, nearly doubled from 2018 to 2019, according to the National Institute on Drug Abuse (NIDA).

Vaping involves inhaling an aerosol, or vapor, that may contain addictive drugs, including nicotine or THC (a chemical in marijuana that can affect behavior, mood, and thoughts). Because of the capacity of vaping to damage the lungs, it’s also a major concern as COVID-19 spreads. NIDA Director Nora Volkow, M.D., spoke about these concerning trends and how the institute is addressing them head on.

What kind of story is the latest data showing?

There has been a very abrupt increase in vaping THC. This was the second highest increase we’ve ever seen since the inception of the NIDA Monitoring the Future Survey in 1975. The first was the increase in vaping nicotine in 2018. These both have worried us enormously. More teenagers are embracing vaping as a culture for taking drugs that they may not have taken otherwise.

Why is vaping so concerning, especially with marijuana?

Particularly among teenagers, one of the main concerns that we have about the use of marijuana is that it can interfere with the developing brain. The data that has emerged indeed has shown that teenagers who smoke marijuana are at much greater risk of becoming addicted to it. And becoming addicted as teens increases the risk of becoming addicted to other drugs as you age.

How is NIDA research responding to these trends?

“Smoking chemicals can produce severe lung damage.”

– Nora Volkow, M.D.

We’re interested in treatments. And we’re interested in how vaping is influenced by social networks. Right now, there are no published studies regarding the treatment of teenagers who have become