Management of Juvenile Idiopathic Arthritis in Adolescents.

Many terms are used to describe juvenile rheumatoid arthritis and the term most used today is JIA or juvenile idiopathic arthritis. JIA is the most common rheumatoid disorder occurring in 0.5-2.0/1,000 children and adolescents. It is typically divided into oligoarticular, polyarticular (RF-positive and RF-negative) and systemic-onset (Stills disease). The laboratory testing is nonspecific and there is no single test or combination of tests that are pathognomonic for JIA. This discussion focuses on management of JIA that centers on nondrug treatment and drug treatment. JIA pharmacology centers on NSAIDs, corticosteroids, DMARDs (especially methotrexate) and if available various cytotoxic agents and biologic response modifiers. The proper use of nonpharmacologic and pharmacologic management can control pain, reduce inflammation as well as joint damage and improve the quality-of-life for adolescents with JIA.

Pharmacologic treatment of attention-deficit hyperactivity disorder.

Attention-deficit hyperactivity disorder (ADHD) is highly prevalent in children and adolescents. Highly effective pharmacological treatments are available that allow the child and the adolescent to function at his/her full potential. Various preparations of methylphenidate and amphetamines have been used for a long time in the treatment of ADHD. This article reviews these and some of the newer drugs used in the treatment of ADHD, including atomoxetine and bupropion.

Syndromes and disorders associated with mental retardation.

This article reviews selective comments on the concept of Mental Retardation (MR) in adolescents. Issues covered include the definition, prevalence, and differential diagnosis of MR. Some of the syndromes and disorders associated with MR in the adolescents are also considered with emphasis on the behavioral concerns that may be present in this age group. Finally, concepts of management by the clinician are reviewed. It is recommended that health care professionals caring for adolescents with MR should help these youths maximize their potential as human beings, helping them achieve meaningful functioning in adulthood.