Stories about: screening

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

From EKGs to echos: How broadly should kids be screened for heart problems?


Every three days, a young athlete somewhere in the United States collapses and dies due to an undetected heart problem. It’s a tragedy that Gian Corrado, MD, who works in Sports Medicine at Boston Children’s Hospital, has seen unfold firsthand. He was an undergraduate playing pick-up basketball when one of his teammates died suddenly on the court.

“It’s uncommon,” he says, “but it’s not so uncommon that it may not touch you. It happens, and we have no effective, efficient way to screen for it.”

There is a lot of interest in using heart screening in young athletes to reduce sudden death risk . The NCAA’s chief medical office recently suggested that it may be useful to routinely perform electrocardiograms (EKGs) and possibly other cardiac tests on some collegiate level athletes. A January 2016 opinion piece on this issue in the New York Times drew a lot of attention. Cardiac screening has also been proposed for other groups, such as children starting certain types of medications.

But there’s widespread debate in medical circles about such broad usage of EKGs. Why is this so controversial? If it’s such a valuable test, why doesn’t everyone get routine EKGs? …Read More

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Clinical Consult: Lipid Screening

heart lipid screening Sarah DeFerranti

Since 1992, the American Academy of Pediatrics (AAP) has been expanding its recommendations for childhood lipid screenings as a means to reduce the risk for early onset atherosclerosis. The most recent recommendation, from 2011, calls for universal lipid screenings on all children between 9 and 11, and then again between 17 and 21 years old.

The jury is still out as to whether this strategy is effective. Skeptics point to overworked primary care offices, excessive resource utilization, cost and burden to families. Sarah de Ferranti, MD, MPH, director of the Boston Children’s Heart Center Preventive Cardiology Clinic, is co-leading a study to model the efficacy of universal lipid screenings in adolescents and young adults according to the new AAP guidelines funded by the Patient Centered Outcomes Research Institute. …Read More

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