How to help an adolescent who is using cannabis

A greenhouse where cannabis plants are grown legally.
A greenhouse where cannabis plants are grown legally.

Over recent years, big shifts in the marijuana landscape have made it easier than ever for American teens to be exposed to cannabis and to have the opportunity to use it.

Currently, only six states consider all forms of cannabis use to be illegal. Meanwhile, most states legally allow at least some medical cannabis use and several (including Massachusetts) have already legalized both medical and recreational use for adults.

“Whatever your views are on medical or recreational cannabis use for adults, however, there’s near-universal agreement that adolescents should not use cannabis,” says Lydia Shrier, MD, MPH, who directs clinic-based research in the Boston Children’s Hospital Division of Adolescent/Young Adult Medicine.

But the legal system’s increasing support of cannabis and a rise in public approval of the drug has lowered the perception of risks associated with its use. As a result, in states where medical or recreational use for adults is legal, adolescents between the ages of 12 and 17 are more likely to use cannabis than in states where all uses of the drug are illegal. …Read More

Quick Note: Odds of hospital readmission increase for children as they become adults

Busy garage as hospital readmission rates increase

As accountable care organizations continue to evolve, primary care pediatricians may increasingly share financial risks with hospitals on quality of care measures, including hospital readmissions.

In an article published in The BMJ, Boston Children’s Hospital readmission experts Jay Berry, MD, MPH, and Emily Bucholz, MD, MPH, PhD, show that the odds of hospital readmission increase substantially for children as they become adolescents and enter adulthood. In fact, their odds of readmission are just as high or higher than elderly, Medicare beneficiaries.

Berry and Bucholz discuss the reasons for those findings and how better systems of care are needed for children — especially those with chronic conditions — as they transition to adulthood.

Read the paper published in The BMJ.

Expert’s corner: Caring for labral tears in young athletes

Hip labral tears lead image Young-Jo Kim

Labral tears are one of the most common hip injuries in young athletes and can be a result of acute injury to the hip, an underlying anatomical issue that damages the labrum or in some cases, both. Treatment of labral tears ranges from rest and physical therapy to arthroscopy to open surgery. So how do you know what course of treatment is right for each patient?

Young-Jo Kim, MD, PhD, a pediatric and young adult orthopedic hip specialist at Boston Children’s Orthopedic and Sports Medicine Center, discusses the causes of labral tears and his philosophy for treatment of this injury in young athletes.

…Read More

Paper Trail: Challenges for developmental-behavioral workforce, pediatric dentistry trends, implications of herpes zoster and more

Clinical research from Boston Children's

Boston Children’s Hospital is at the forefront of clinical research. Stay connected with Paper Trail — a monthly feature highlighting recently published outcomes data and new approaches to the diagnosis, treatment and prevention of pediatric illnesses.

Implications of herpes zoster in vaccinated children

Researchers including dermatologist Jennifer Huang, MD, describe seven children without a history of primary varicella who presented with herpes zoster that correlated with the original VZV vaccination site and resolved without complications. These cases, published on Feb. 6 in Pediatric Dermatology, highlight the close correlation between the vaccination site and cutaneous eruption.

Trends in pediatric dental care use

Co-authored by Dentist-in-Chief Man Wai Ng and published in the April 2018 issue of Dental Clinics of North America, this article explores trends in three areas of pediatric dental services: access among Medicaid-enrolled children, treatment of oral health conditions, and use of emergency departments for dental needs among U.S. children.

Parents’ perceptions of their child’s health status 

The aim of this study by Nurse Scientists Kristine Maria Ruggiero and Judith A. Vessey, Associate Chief Nurse Patricia Hickey and colleagues, was to examine parents’ perceptions of the health-related quality of life (HRQOL) in their school-age child with congenital heart disease (CHD). The results of this study, published in the Journal for Specialists in Pediatric Nursing, are useful in providing practical recommendations in caring for children with CHDs while informing relevant policies.

Challenges for developmental-behavioral peds

In this Pediatrics paper published Feb. 16, Carolyn Bridgemohan, MD and colleagues surveyed a sample of the developmental-behavioral pediatric workforce and found it struggles to meet current service demands. Clinician burnout was reported with increased patient complexity and female subspecialists spent more time in billable and nonbillable components of clinical care.

For more clinically-actionable insights, bookmark Boston Children’s Notes blog for primary care providers.