Stories about: Expert’s Corner

Health consequences of low energy availability in female athletes

Ackerman RED-S female athletes energy deficiency sports

For all young athletes, having the necessary energy to participate in sports — while also supporting a growing body — is imperative to their overall health. The Female Athlete Triad is a well-known consequence of low energy availability in female athletes and can result in menstrual dysfunction and decreased bone mineral density.

Recently, the focus has turned from the Triad to a more inclusive term; Relative Energy Deficiency in Sport, or “RED-S.” This syndrome also appears to be a result of low energy availability, but has health consequences other than menstrual dysfunction and bone health in females and acknowledges that relative energy deficiency can happen in males.

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Functional abdominal pain: ‘The pain is real’

A guide for PCPs to functional abdominal pain

As physicians, we are trained on the classic medical model. A patient has a symptom, we do a test, we find a disease, we give a therapy, and the issue goes away. Unfortunately, chronic diseases like functional abdominal pain do not fit neatly into this model.

The majority of the hundreds of thousands of children a year who experience abdominal pain will improve with time. But for some children, their pain becomes chronic and debilitating. According to the Rome IV guidelines, once a child has experienced eight weeks of abdominal pain, we have to consider functional abdominal pain. …Read More

Learning disabilities: Kids and families struggle beyond the academics

Boy with learning disabilities struggles with homework

Most research on learning disabilities focuses on remediating specific academic skills like reading and math. But struggles at school and with homework can create an enormous amount of stress and anxiety for children and families, says neuropsychologist Deborah Waber, PhD, who directs the Learning Disabilities Program at Boston Children’s Hospital. …Read More

Lyme disease: What to know, how to treat and when to refer

Image of the deer tick, which transmits Lyme disease
Lyme disease is transmitted by the deer tick.

We asked pediatric infectious disease specialist Catherine Lachenauer, MD, of the Boston Children’s Hospital Division of Infectious Diseases, to answer some frequently-asked questions about Lyme disease in children. Here’s what she had to say:

How common is Lyme disease and what are some early symptoms?

Lyme disease is the most common tick-borne infection in the US. The number of reported cases has been rising over the years.

One of the best recognized and earliest symptoms of Lyme disease is the erythema migrans, or EM rash, that may appear within the first month (usually within the first two weeks) following the tick bite.  The EM rash occurs at the site of the bite, typically as a circular red rash that enlarges over the course of several days.  Often, there is clearing as the rash enlarges such that it appears as a “bullseye,” although it may also be a solid, or confluent, rash.  Patients may also have non-specific, flu-like symptoms including fever, headache, joint aches and fatigue, as early symptoms of Lyme disease.

A tick needs to be attached for at least 48 hours to transmit the Lyme-causing bacteria

What are some later-stage symptoms of Lyme disease in children?

Most symptoms of Lyme disease occur in three stages: early localized, early disseminated and late-stage disease.

In the early localized stage, usually within one to two weeks following the tick bite, a single EM rash may appear. Patients who are not diagnosed and treated with antibiotics in the early localized stage, they may go on to have symptoms of early disseminated disease. …Read More