Substance Use and Depressive Symptoms among Adolescents Treated in a Pediatric Emergency Department.

The current study examined associations between substance use and depressed mood by gender and type of substance used (no use, alcohol, marijuana or both alcohol and marijuana) in a sample of 713 adolescents (M = 15.3) recruited from a Pediatric Emergency Department (PED). Adolescents who reported any marijuana use had higher overall depressed mood scores compared to all other adolescents.

Trajectories of adolescent alcohol use after brief treatment in an Emergency Department.

Objective: The primary aim of this study was to identify distinct classes of trajectories of adolescent substance use following a brief motivational interviewing (MI) intervention in an Emergency Department (ED). The secondary aim was to identify predictors of class membership.

Methods: Latent growth mixture modeling was used with 177 adolescents who participated in two randomized clinical trials evaluating MI for an alcohol-related event.

Enhanced motivational interviewing versus brief advice for adolescent smoking cessation: results from a randomized clinical trial.

Background: Motivational interviewing (MI) is widely used for adolescent smoking cessation but empirical support for this approach is mixed.

Methods: Adolescent cigarette smokers 14-18 years old (N=162) were recruited from medical, school, and community settings and randomly assigned to enhanced MI or brief advice (BA) for smoking cessation. MI comprised an in-person individual session, a telephone booster session one week later, and a brief telephone-based parent intervention.

Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial.

Objective: To determine whether a brief individual motivational interview (IMI) plus a family motivational interview (Family Check-Up [FCU]) would reduce alcohol use in adolescents treated in an emergency department after an alcohol-related event more effectively than would an IMI only.

Design: Two-group randomized design with 3 follow-up time points.

Setting: An urban regional level I trauma center.

Alcohol use history differentiates adolescents treated in the emergency department after an alcohol-related incident.

Objectives: The current study compared 3 groups of adolescents identified in an emergency department (ED) following an alcohol-related event: (1) alcohol-positive adolescents scoring at or above the clinical cutoff on a measure of problematic drinking, the Adolescent Drinking Inventory (ADI) (n = 45); (2) alcohol-positive adolescents scoring below the clinical cutoff on the ADI (n = 68), and (3) alcohol-negative adolescents (n = 64). We examined whether these 3 groups of adolescents differed on measures of substance use as well as psychosocial factors.

Methods: Participants were recruited as part of a larger clinical trial.

The significance of marijuana use among alcohol-using adolescent emergency department patients.

Objectives: The objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol-related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use.

Methods: This was a cross-sectional comparison of adolescents 13-17 years old, with evidence of recent alcohol use, presenting to a PED with a self-reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale.

Comparison of methohexital and pentobarbital as sedative agents for pediatric emergency department patients for computed tomography.

Objectives: To determine if there are differences in the duration of sedation between pediatric emergency department (PED) patients receiving methohexital and PED patients receiving pentobarbital for the purpose of obtaining a head computed tomographic (CT) scan.

Methods: Retrospective cohort study of PED patients receiving either methohexital or pentobarbital for a sedated head CT. Data were collected on patient demographics and medical condition, indications for head CT, duration of sedation, medication dosage, and medication adverse events.

Parental factors influence teen alcohol use after an emergency department visit.

Objectives: To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit.

Methods: Adolescents, 13 to 17 years, who either had evidence or reported usage of alcohol in the 6 hours before an ED visit, were eligible for this study. Alcohol use was assessed at baseline and at 3-month follow-up.

Emergency department detection of adolescents with a history of alcohol abuse and alcohol problems.

Objective: To compare the characteristics of adolescents with and without a history of problematic alcohol use, who are treated in the emergency department (ED) for an alcohol-related problem.

Methods: Three hundred seventeen adolescents presenting to the ED after an alcohol-related incident were divided into 2 groups based on whether their score on the Adolescent Drinking Inventory reached the clinical cutoff on problematic drinking, and compared regarding current drinking, depression, and risk-taking behaviors.

Results: Adolescents who reached the clinical cutoff on the Adolescent Drinking Inventory were older and reported more frequent drinking, greater depressed mood, and more risk-taking behaviors.

Brief motivational intervention for adolescent smokers in medical settings.

This study evaluated the efficacy of using a brief motivational intervention to reduce smoking among adolescent patients treated in a hospital outpatient clinic or Emergency Department. Patients aged 14-19 years (N=85) were randomly assigned to receive either one session of motivational interviewing (MI) or standardized brief advice (BA) to quit smoking. The assessment and intervention were conducted in the medical setting proximal to the patient's medical treatment.

A randomized clinical trial of a brief motivational intervention for alcohol-positive adolescents treated in an emergency department.

We tested whether a brief motivational interview (MI) would reduce alcohol-related consequences and use among adolescents treated in an emergency department (ED) after an alcohol-related event. Patients aged 13 to 17 years (N = 152) with a positive blood alcohol concentration (BAC) by lab test or self-report were recruited in the ED and randomly assigned to receive either MI or standard care (SC). Both conditions resulted in reduced quantity of drinking during the 12-month follow-up, whereas alcohol-related negative consequences were relatively low and stayed low at follow-up.

Potential biases in case detection of alcohol involvement among adolescents in an emergency department.

Objective: To determine the factors associated with physician decisions to test for alcohol involvement in adolescents treated in an emergency department (ED) and to examine patient and event characteristics associated with being identified as alcohol positive, either by testing or by clinical examination.

Methods: Medical chart reviews were conducted for all adolescent patients (n = 9,660; age range, 13-19 y) treated over a 1-year period in a Level I regional trauma center/ED.

Results: Among all 9,660 patients in the ED, 298 (3.

Risks associated with alcohol-positive status among adolescents in the emergency department: a matched case-control study.

Objective: The purpose of this study was to examine alcohol use, alcohol-related problems, other risk-taking behaviors, and parental monitoring in adolescents who tested positive for alcohol in an emergency department.

Study Design: A matched case-control design was implemented for adolescents presenting to a pediatric emergency department who were screened for alcohol use. An alcohol-positive sample (N = 150) was compared with a matched alcohol-negative sample (N = 150) for alcohol use, alcohol problems, depression, smoking, risk-taking behavior, and parental monitoring.

Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department.

This study evaluated the use of a brief motivational interview (MI) to reduce alcohol-related consequences and use among adolescents treated in an emergency room (ER) following an alcohol-related event. Patients aged 18 to 19 years (N = 94) were randomly assigned to receive either MI or standard care (SC). Assessment and intervention were conducted in the ER during or after the patient's treatment.

Methemoglobinemia: etiology, pharmacology, and clinical management.

Methemoglobin (MHb) may arise from a variety of etiologies including genetic, dietary, idiopathic, and toxicologic sources. Symptoms vary from mild headache to coma/death and may not correlate with measured MHb concentrations. Toxin-induced MHb may be complicated by the drug's effect on other organ systems such as the liver or lungs.

Intravenous catheter blood cultures: utility and contamination.

Objective: In pediatrics, blood cultures (BCs) are often drawn as intravenous (IV) catheters are placed. This routine minimizes the number of painful and often difficult punctures a child must undergo but results in the discarding of multiple BC bottles when these cultures are later determined to be unnecessary. If the contamination rate of BCs drawn through an indwelling IV did not exceed the contamination rate of BCs drawn at the time of IV placement, BCs could be drawn from the IV without subjecting the patient to another venipuncture.

Effect of metoclopramide dose on preventing emesis after oral administration of N-acetylcysteine for acetaminophen overdose.

Objective: To determine the effect of the metoclopramide dose on the prevention of vomiting of N-acetylcysteine in acetaminophen overdose.

Methods: Patients with acetaminophen ingestions receiving metoclopramide prior to emergency department administration of N-acetylcysteine were included. Emergency Department and poison center records were reviewed for administration of metoclopramide pre-N-acetylcysteine and incidence of subsequent vomiting.

Detection of alcohol use in adolescent patients in the emergency department.

Objectives: To examine 3 methods of detecting alcohol use among adolescent patients visiting a Level-1 regional trauma center.

Methods: Part 1 was a retrospective review of laboratory records and (13- to 19-year-old) patient medical records over the 1-year period from August 1993 to July 1994. Part 2 was a review of ICD-9 discharge diagnoses for the same age range during the same 1-year period.

Brief motivational interviewing in a hospital setting for adolescent smoking: a preliminary study.

This study tested the feasibility and efficacy of a brief smoking intervention for adolescents in a hospital setting. Forty adolescent patients were randomized to receive either brief advice or a motivational interview, a nonconfrontational therapeutic intervention. Feasibility of brief smoking interventions with teen patients was supported by high rates of recruitment, retention, and quit attempts, and long periods of continuous abstinence.

Frozen oral hydration as an alternative to conventional enteral fluids.

Background: Oral hydration therapy is effective in dehydration, but is often bypassed or may fail.

Objective: To compare the tolerance (amount accepted minus amount vomited) of a frozen solution (FS) (Revital-ICE, PTS Labs, Deerfield, Ill) with the conventional glucose electrolyte solution (CS).

Design: Prospective, controlled crossover trial.

Enhancement of lithium elimination by multiple-dose sodium polystyrene sulfonate.

Objective: To determine whether multiple doses of sodium polystyrene sulfonate (SPS) enhance the elimination of IV-administered lithium (Li).

Methods: The study was a placebo-controlled, investigator-unblinded, murine trial of multiple doses of SPS on serum Li concentrations. Seventy-five male CD-1 mice were given IV pretreatment with LiCl (125 mg/ kg) followed by gavage treatments with SPS (5 g/kg/dose) 20, 40, 90, 150, and 210 minutes after LiCl (experimental group) or deionized water at equivalent times (control group).