Menstrual Management for Adolescents With Disabilities.

The onset of menses for adolescents with physical or intellectual disabilities can affect their independence and add additional concerns for families at home, in schools, and in other settings. The pediatrician is the primary health care provider to explore and assist with the pubertal transition and menstrual management. Menstrual management of both normal and abnormal cycles may be requested to minimize hygiene issues, premenstrual symptoms, dysmenorrhea, heavy or irregular bleeding, contraception, and conditions exacerbated by the menstrual cycle.

Is it an eating disorder, gastrointestinal disorder, or both?

Purpose Of Review: The authors examine the differential diagnosis for gastrointestinal disorders that should be considered in individuals who present with nonspecific gastrointestinal and nutritional complaints suggestive of an eating disorder.

Recent Findings: This review first identifies diseases with which eating disorders are often confused and then explores features in the history, physical examination, and laboratory studies, which can provide clues to the cause of the patient's symptoms. In addition, it discusses the recommended evaluation and treatments for the gastrointestinal diseases that most commonly mimic the presentation of eating disorders including Crohn disease (CrD), celiac disease, gastroesophageal reflux disease (GERD), and eosinophilic esophagitis (EoE).

Vaginal microbicides.

This article reviews the current status of microbicide development and challenges faced in developing safe and effective compounds. The ever growing HIV pandemic, lack of effective vaccines against HIV and other sexually transmitted infections, concern about the vulnerability of women, and difficulty in condom negotiation are factors that drive the development of topical microbicides as a prophylactic method for women. The ideal microbicide needs to be safe and highly effective and not increase viral resistance or cause disruption of host defenses.

Medical conditions with psychiatric manifestations.

A variety of medical conditions can present, or be associated, with psychiatric symptoms. At times, these may be so prominent that they can overshadow the underlying pathophysiologic process that accounts for them. Thus, it is equally important for mental health providers to be alert to the possibility that adolescents whom they are treating may have symptoms related to a treatable medical condition as it is for primary care providers to conduct a targeted history and physical examination with their adolescent patients exhibiting psychiatric symptoms.

Bacterial vaginosis: many questions--any answers?

Purpose Of Review: Bacterial vaginosis, a common disorder among young women, is associated with adverse reproductive health outcomes. This review summarizes our current understanding of bacterial vaginosis and where future research should be focused. Recommendations for prevention, diagnosis, and treatment in both nonpregnant and pregnant populations are discussed.