Current research indicates that up to ten percent of children suffer from mental health problems at some point before reaching adulthood. Complex diagnostic criteria and medication regimes can make these patients a challenge to manage. The chronic shortage of child and adolescent psychiatrists has led to more and more cases being cared for by pediatricians and primary care practitioners. Patients may be on multiple medications of long duration, and reaching a decision to modify or cease treatment is often complicated.
Pediatric and Adolescent Psychopharmacology: A Practical Manual for Pediatricians is written for all non-psychiatrists who find themselves caring for children and teenagers with mental health disorders. It gives clear, expert guidance on the complexities of diagnosis of mental health disorders and provides practical, accessible advice on the complex treatment options available for many disorders. This text will be an invaluable resource for all clinicians who encounter these vulnerable patients.

In the 19th century, a greater understanding of childrens rights was acknowledged, and in the 20th century, child abuse was discovered in 1962 after many years of turning a blind eye. The number of reported cases of child abuse worldwide has since exploded into a public health epidemic with a much higher incidence than better-funded diseases such as juvenile cancer. The evaluation of child abuse and neglect is complex, with many professionals and agencies involved to try and decrease these incidences. This can be one of the reasons why the field has not been able to attract appropriate resources for prevention, treatment, education and research. Child abuse must be looked upon as a major public health problem, and professionals must make the 21st century a century for the child. In this book, the authors have given a short review of the field.

A variety of topics are presented in this book that seek to reflect on medical history before and after the golden age of the Medical Renaissance. These topics include newborn care, the story of adolescence, behavioral pediatrics, psychopharmacology, substance abuse, psychodermatology, specific organ systems (the kidney and the heart in pediatrics), and other motifs. Reflections on adolescence are provided based on society's classic disdain and envy of its youth, which is seen throughout the ages of human life. In this book, we include a variety of scholars who stood on the shoulders of giants and made giant leaps in medicine of their own. In each century since the Medial Renaissance, these giants advanced the field of medicine into what we have as today's standard medical care, and perhaps we can learn what it will be like in the future. These esteemed experts learned from the past, made mistakes, exhibited amazing courage, and faced scientific -- and sometimes -- sacerdotal criticism. Their courage was amazing, as many were confronted with minacious, inauspicious, portentous, and unpropitious attacks against their ethics and accomplishments. However, they persisted and were able to develop verifiable data that others could independently substantiate and sometimes improve upon for the benefit of all humans.

The current and future shortage of pediatric cardiologists necessitates information on the pediatric heart for primary care clinicians, as they care for the child and adolescent with cardiovascular dilemmas and disorders. In view of this shortage and the rapidly increasing knowledge in pediatric cardiology, as well as understanding indications for referral to pediatric cardiologists in the 21st century, au courant assiduous information aimed at primary care clinicians in these areas becomes increasingly important. The heart does not exist in isolation, but is involved in other aspects of the body; thus, hypertension that may involve renal pathophysiology and hyperlipidemia that involves various organ systems is also an important topic. Behavioral aspects of chronic disease, including renal disorders, should also be considered because of the importance and impact that renal (and chronic) disease has on children and adolescents. Certainly, seeking to stay current on basic principles of pediatric cardiology is important; these include fluid and electrolyte physiology, management of pediatric hypertension, and hyperlipidemia. In view of the importance of hypertension in children and adolescents concerning complications in all stages of life (i.e. renal disease, cardiovascular disease, and others), periodic ambulatory blood pressure monitoring by the primary care clinician (PCP) is an extremely important task. The current epidemic of obesity also heightens the importance of hypertension screening in the 21st century.

Tropical medicine is a branch of medicine focusing on disorders usually found in subtropical and tropical areas of the world, while tropical paediatrics is a branch of tropical medicine focusing on children in these areas. The current process of global warming and the widespread issue of international travel are bringing these conditions to many places of the globe. This second revised and enlarged edition highlights selective concepts of tropical paediatrics that are of importance to clinicians caring for children and adolescents. It is dedicated to clinicians around the world who care for these precious patients growing up in remote corners of globe. It should always be remembered that sometimes these issues become important to developed corners of the world as well.

It is estimated that 86 million adult Americans have prediabetes and with that, a risk of developing T2DM (type 2 diabetes) within one in ten patients. About 29 million people have actual diabetes, most with T2DM. It was estimated in 2012 that about 208,000 people under the age of 20 have diabetes in the United States, but there is little data available on the prevalence of diabetes in the adolescent population. A recent study looking at 12-19 year olds from 2005-2014 found the prevalence of diabetes at 0.8%, with 28.5% undiagnosed and the prevalence of prediabetes 17.7%, more common among boys (22%) than girls (13.2%). With about 9% of the total US population having diabetes, this a public health issue of considerable proportions. In this book, the reader embarks on a journey through the medical history of the discovery and treatment of diabetes mellitus. It is the story of the human mind steadfastly seeking to understand its world a story worth telling again and again that has saved millions of lives from a premature death of misery in the 20th and now 21st century.

This book is designed to provide primary care clinicians with a practical guide to the significant problems that increasingly affect the emotional health of children and adolescents. This book is written in clear, concise language by experts in developmental-behavioral pediatrics, neurodevelopmental pediatrics, adolescent medicine, psychology, and child/adolescent psychiatry. We present a comprehensive coverage of normal and pathological behaviors based on principles of child and adolescent development. The editors are nationally and internationally known experts and educators in the normal and abnormal behavior of children and youth. With the information available in this book, clinicians who care for children and adolescents will be better equipped to meet the complex needs of this fascinating and ever-changing population.

The Guest Editors have assembled expert authors to cover the full clinical span of the topic autism and autism spectrum disorders. An historical perspective of the evolution of the disorder opens the issue. Next, comprehensive coverage is given to an article on the definitions, diagnostic criteria, and clinical features of autism spectrum disorders. Other articles in the issue cover the relevant topics like epidemiology, genetic syndromes and genetic testing, early diagnosis and diagnostic evaluation, and neuroimaging and neurochemistry of autism. Authors also present information on tsocial skills for the autistic child, behavioral interventions, and transitioning the autistic child into adulthood, to name a few. This issue should be very well received by pediatricians.

Pediatric and Adolescent Psychopharmacology is reviewed in this issue of Pediatric Clinics, guest edited by Drs. Dilip Patel, Donald Greydanus, and Cynthia Feucht. Authorities in the field have come together to pen articles on Therapy in the Age of Pharmacology: Point-Counterpoint, Principles of Pharmacology and Neurotransmission, Complementary and Alternative Medicine in Pediatric Mental Health, Psychopharmacology of Anxiety Disorders, Psychopharmacologic Control of Aggression and Violence, Autistic Spectrum Disorders, Attention Deficit Hyperactivity Disorder, Psychopharmacology of Anorexia and Bulimia Nervosa, Psychopharmacology of Obesity, Psychopharmacology of Depression, Psychopharmacology of Pediatric Bipolar Disorders, Cognitive-Adaptive Disabilities, Psychopharmacology of Schizophrenia, Management of Psychotic States Induced by Medical Conditions, Substance Use and Abuse, Psychopharmacology of Tic Disorders, and Pharmacology of Sleep Disorders.

This issue of Pediatric Clinics, guest edited by Drs. Dilip Patel and Donald Greydanus, examines the topic of Adolescents and Sports. Authorities in the field have come together to pen articles on Pre-participation evaluation, Cardiovascular evaluation of young athletes, Medical conditions and sport participation, Management of the adolescent athlete with type 1 diabetes mellitus, Musculoskeletal conditions and sports participation, Stress fractures: Diagnosis and management, Computer-based neuropsychological evaluation of concussion, The female athlete, Doping: From drugs and supplements to genetics, Analgesics and anti-inflammatory medications in sports, Nutritional considerations for adolescent athletes, Resistance training guidelines for adolescents, Application of osteopathic manual medicine to treat sports injuries, and Physically and cognitively challenged athletes.

This updated and revised second edition on substance abuse in adolescents and young adults provides information on this global public health topic. We cover a wide variety of subjects within the paradigm of drug abuse and agree with the 21st century message of integrating substance abuse management with primary care services. The editors thank the many experts who so graciously and lambently provided their time and knowledge in these areas. The editors hope that the readers of this treatise find useful and beneficial information that will help them in their work seeking to understand and ameliorate the negative effects of these plants of paradise and of other chemicals that are part of the drug addiction pharmacopeia of the 21st century. The science of this field continues to evolve and this edition looks at a wide variety of concepts in this regard----including neurobiology, genetics, the role of the primary care clinicians, the US opioid epidemic, and psychosocial management. Specific drugs of abuse include tobacco, cannabis, alcohol, opioids, prescription drugs, illicit stimulant drug abuse, hallucinogens, and date rape drugs. We also look at concepts related to prenatal drug exposure, substance abuse in adolescent females, co-occurring substance use with psychiatric disorders, prescription stimulant abuse in college students, and performance enhancing drugs in sports. We conclude with a consideration of new drugs of abuse in the 21st century, the societal burden of substance abuse, and the pros as well as cons of drug legalization.

Pediatric obesity has become an epidemic of seemingly unsurmountable proportions. This book provides perspectives on pediatric obesity for health care providers with such important topics as etiology, prevalence, diagnosis and management. Various complications and co-morbidities of obesity are also explored. The editors thank our many outstanding contributors from different parts of the United States and the world for their invaluable help in this publication. We hope that our readers will find this book useful as the health care profession and society in general seek to improve this serious epidemic as the 21st century continues.

A variety of topics are presented in this book that seek to reflect on medical history before and after the golden age of the Medical Renaissance. These topics include newborn care, the story of adolescence, behavioral pediatrics, psychopharmacology, substance abuse, psychodermatology, the story of diabetes mellitus, specific organ systems that range from the lungs, gastrointestinal tract, kidney and the heart in pediatrics, and other motifs. Reflections on adolescence are provided based on societys classic disdain and envy of its youth seen throughout the ages of human life. In this book, the authors include a variety of scholars, who stood on the shoulders of giants and made exponential progress in medicine of their own. Throughout the centuries, from the Mesopotamian masters to present physicians, these giants advanced the field of medicine to represent what has been understood as the standard of current medical care, and perhaps we can learn what it will be like in the future. These esteemed experts learned from the past, made mistakes, exhibited amazing courage, and faced scientific and sometimes sacerdotal criticism. Their courage was astonishing, as many were confronted by minacious, inauspicious, portentous, and unpropitious attacks on their ethics and accomplishments. However, they persisted and were able to develop verifiable data that others could independently substantiate and sometimes improve upon for the benefit of all humans. This book celebrates their astounding, awe-inspiring achievements.

About 29 million Americans (9.3% of the population) in 2012 had diabetes. Approximately 1.25 million American children and adults have type 1 diabetes, and almost all diabetes in children less than 10 years of age is type 1. About 208,000 people younger than 20 years (0.25 % of this age group) have been diagnosed with diabetes (type 1 or type 2). Diabetes care requires a collaborative approach with multi-disciplinary professionals involved from the health, nursing, social and educational fields in order to provide optimal service to the child or adolescent and their family. Early diagnosis, treatment and monitoring can prevent or delay the long-term complications in various organs of the body, and regular care and service to this population is therefore essential. In this book, we provide a short overview of issues involved in diabetes care for children and adolescents.

The search for medicinal agents to improve emotional, behavioral, and psychiatric conditions of Homo sapiens has occurred for ages. The 20th century witnessed the development of psychopharmacologic agents, including stimulants in the 1930s (and 1950s), chlorpromazine in the 1950s, lithium, tricyclic antidepressants, benzodiazepines, SSRIs (1990s), and others. The proper use of these agents in the pediatric population continues to be an active study. Atypical antipsychotics have been approved by the FDA for children and adolescents though their safety and efficacy in the pediatric population but must be assiduously ascertained with ongoing research in the eternal iatric maxim of primum non nocere. The science of evidence-based pharmacotherapy for mental health disorders in children and adolescents is finally emerging. Exciting discoveries await the researchers of this still early 21st century lead by the crucial collaborative efforts of academicians, pharmaceutical scientists, and medical government authorities. Controversies regarding the use of various psychopharmacologic agents for the pediatric population continue in the 21st century, requiring further research and insightful judgment for its applications in this vulnerable population. Excessive and unnecessary psychopharmacologic agents should be avoided in the pediatric population with behavioral/emotional/psychiatric conditions/disorders. In this second edition, the authors present updated information about psychopharmacology in childhood and adolescence.

This book is written for the primary care clinician to help update knowledge of pediatric nephrology. The current and future shortage of pediatric nephrologists necessitates steady, rejuvenated information on the Aristolean kidney for primary care clinicians, as they care for the child and adolescent with renal and genitourinary dilemmas and disorders. In view of this shortage and the rapidly increasing knowledge in pediatric nephrology, as well as understanding indications for referral to pediatric nephrologists in the t twenty-first century, au courant assiduous information aimed at primary care clinicians in these areas becomes increasingly important. Chapters in this book cover nephrological problems in different pediatric ages, including newborns. As noted by some of the ancient scholars, the kidney does not exist in isolation, but is involved in other aspects of the body. Thus, we include chapters on the kidney in metabolic and rheumatoid disorders. Behavioral aspects of chronic disease, including renal disorders, are also considered because of the importance that renal (and chronic) disease has on the child and adolescent.

Human sexuality is a complex phenomenon involving the interaction of biologic gender, core gender identity and gender role behavior. Successful completion of normal stages of sexual development is important for children and adolescents to allow for an optimal adult life. Controversies arise for clinicians as they work with their pediatric patients regarding health care sexuality issues. It is important that clinicians help these patients in an unbiased and neutral manner. As adults, these children and adolescents will function in a number of sexuality roles, whether heterosexual, homosexual, or bisexual. In this book, the authors review many of these complex and critical issues that involve the fascinating development of human sexuality.

The search for optimal medications to support health has been part of human history since early times. One concept that was learned in early human civilisations was that medications can be harmful as well as potentially beneficial. Folklore and anecdotal information dominated human knowledge for more than 50,000 years until the work of the Chinese emperor, Shen-Nung (2737 BCE), who became a pristine, official, and erudite classifier of medicinal herbs. Pharmacologic management of human disease is clearly part of the 21st century medical armamentarium. Adolescents of the second decade of the 21st century and those adolescents soon to come will determine the outcome of our planet and life into the 22nd century. Pharmacology will remain an ever-growing part of clinicians' efforts to improve their patients' mental and medical health, but in this book, the authors' have taken a holistic approach, which they hope will please and interest the reader.

This book summarises the state of cognoscibility with regard to normal new-born care that has accumulated over the past centuries, especially the 20th and now 21st century. This compendium is not an ersatz discussion of neonatology, but of the fascinating zone that involves the new-born in the normal new-born nursery. It is not a homogenous area and thus, some overlap is inevitable in such a compilation of data. The preface details historical concepts that have followed new-borns over the millennia of homo sapiens' existence, such as infanticide, breast feeding, swaddling, neonatal resuscitation, and principles of caring for new-borns. The mortality rate of new-borns has been reduced in many parts of the world in this century and we have learned much more about how to keep increasing numbers of new-borns alive, especially when health care providers and society collaborate in this important endeavour and emphasise known preventative principles. Current modern paediatric and perinatal treatments allow new-borns in the current 21st century America to have a start on an overall life expectancy of 78.5 years (up to 76 years in males and 80.9 years in females), if they receive meticulous medical care even if born into a penurious state. Such deserved care and inevitable ongoing medical discoveries will only lengthen these life trajectories.

The integument (the natural covering of an organism or an organ, such as its skin, husk, shell, or rind) is the largest organ system of the human body and is often described as the gatekeeper to every other system. Its integrity will not only determine the admission or rejection of many foreign invaders (bacteria, viruses, fungi, etc.), but also plays a significant role in providing the milieu for the immune system to do battle with these invaders. It is typically the first view of an examiner and often yields very important clues to seemingly non-dermatologic issues. This book takes us one step further, devoting chapters to the interplay between integument and heretofore generally unnoted strongly related psychosocial issues.

Intellectual disability is characterised by deficits in cognitive and adaptive abilities that initially manifest before 18 years of age. The prevalence of intellectual disability is estimated to be between 1 and 3 out of every 100 individuals in the general population. Most individuals have mild intellectual disability and the cause is generally not identified. A small percentage of individuals have severe deficits and will need lifetime supports. The diagnosis of intellectual disability requires formal psychometric testing to assess the intelligence quotient and adaptive functioning. The management of individuals who have intellectual disability is based on providing general medical care, treatment of specific behavioral symptoms, early intervention, special education, and variable degrees of community based supports. In this book we present some current issues in intellectual and developmental disability.

The mortality rate of newborns has been reduced in many parts of the world and we have learned much about how to keep more newborns alive, especially when health care providers and society collaborate in this important endeavor and emphasize known preventative principles. We know that death of newborns causes emotional stress to the newborn's family as well as to the involved health caregivers. We are also learning about the historical rights of the fetus in modern society. Over the past 50 years, there has been an increasing focus of attention, research and resources on assuring the survival and long term outcome of infants who are born premature. As a result of advances in knowledge and technology, there has followed an increased likelihood for survival of even the smallest of premature infants. In this book, we present some of the health and social issues for children born into this world.

The abuse of drugs and chemicals has become a problematic public health dilemma for the world's population and one that must be dealt with by parents, societies, clinicians, researchers, and even countries in the world. This book discusses the complex neurobiology that underlies drug addiction and reveals how these illicit chemicals disrupt central nervous system neurotransmission involving such neurotransmitters as serotonin, dopamine, and others. This manual reviews current understanding in drug interactions with neurotransmitter systems, neuroimmune signaling, current research on reward circuitry, and current medications used to treat drug addiction. It also discusses related topics such as drug addiction in females, co-morbid conditions, drug addiction in minority populations, prenatal drug exposure and others. The book covers new drugs of the 21st century and discusses such controversial topics as legalization of drug use. It also provides internet resources, treatment facilities by state, and parent support organizations. The importance of prevention of drug abuse is a key theme of the book.

Psychodermatology is a relatively new field in evolution and thus, there is a comparative paucity of information in general. However, when it comes to children and adolescents there is a complete vacuum of information as no other book has aimed to specifically address the psychodermatological issues facing this particular population. For assessment, diagnosis, comprehensive treatment of children with psychodermatologic conditions and establishing a relationship between skin and psyche, there is a lack of clear and relevant clinical information about these complex disorders. The complexity of these disorders is related to lack of understanding in genetic, embryonic, physiologic, neuroimmunologic, neurocutaneous, stress-related neuromodulation, and psychosomatic interconnections. This book presents a clinically relevant approach to the management of psychodermatologic issues encountered in normal practice. Various classifications and major categories that are discussed include psychophysiologic disorders, psychiatric conditions with dermatologic manifestations, dermatologic disorders predisposing to psychiatric disorders, systemic diseases with psychodermatological manifestations, and special issues in management of psychocutaneous disorders in children and adolescents.