Ellen Rome - Academia.edu (original) (raw)

Papers by Ellen Rome

Journal of nutritional health & food science, Dec 29, 2016

Cleveland Clinic Journal of Medicine, Nov 1, 1996

Primary care clinicians play an important role in detecting and managing eating disorders, especi... more Primary care clinicians play an important role in detecting and managing eating disorders, especially since the earlier the problem is identified and treatment initiated, the better the prognosis. Eating disorders can be readily detected by recognizing certain "red flags" and by asking appropriate questions.

Current Opinion in Pediatrics, Aug 1, 1994

CRC Press eBooks, May 23, 2022

International Journal of Eating Disorders, 2007

: The purpose of this article is to summarize major conceptual and clinical variables related to ... more : The purpose of this article is to summarize major conceptual and clinical variables related to age-appropriate and developmentally appropriate classification of eating problems and disorders in children and adolescents. A review of current classifications and related literature in child development is provided. Problems with current classification schemes are identified and discussed. Current classifications are inadequate to address the clinical and research needs of children and adolescents with eating disturbances and disorders. A range of possible changes in classification strategies for eating disorders in children and adolescents are described.

Clinical Pediatrics

The study goal was to investigate electrocardiographic findings, including corrected QT interval ... more The study goal was to investigate electrocardiographic findings, including corrected QT interval (QTc), in patients aged 8 to 23 with eating disorders (EDs) at presentation, compared with an age-and sex-matched control population. We retrospectively reviewed 200 ED patients, and 200 controls. Blinded electrocardiograms (ECGs) were interpreted by an expert reader, and QT intervals corrected using the Bazett formula. Eating disorder patients were 89.5% female, with mean age 16.4 years and median percent median body mass index (BMI)-for-age (%mBMI)a of 91.1%. In ED patients, QTc was significantly shorter than controls (399.6 vs 415.0msec, P < .001). After adjusting for height, %mBMI, sex, magnesium level, and bradycardia, mean QTc duration in patients with anorexia nervosa-restricting subtype (AN-R) was significantly shorter than other ED patients ( P = .010). Higher %mBMI was associated with shorter QTc duration ( P = .041) after adjusting for height, magnesium, bradycardia, and Di...

JAMA Pediatrics

ImportanceThe COVID-19 pandemic has affected youth mental health. Increases in site-specific eati... more ImportanceThe COVID-19 pandemic has affected youth mental health. Increases in site-specific eating disorder (ED) care have been documented; however, multisite studies demonstrating national trends are lacking.ObjectiveTo compare the number of adolescent/young adult patients seeking inpatient and outpatient ED care before and after onset of the COVID-19 pandemic.Design, Setting, and ParticipantsUsing an observational case series design, changes in volume in inpatient and outpatient ED-related care across 15 member sites (14 geographically diverse hospital-based adolescent medicine programs and 1 nonhospital-based ED program) of the US National Eating Disorder Quality Improvement Collaborative was examined. Sites reported monthly volumes of patients seeking inpatient and outpatient ED care between January 2018 and December 2021. Patient volumes pre- and postpandemic onset were compared separately for inpatient and outpatient settings. Demographic data such as race and ethnicity were ...

Journal of Adolescent Health, 2022

Disabilities are common in children and adolescents with >5% of children and adolescents affec... more Disabilities are common in children and adolescents with >5% of children and adolescents affected by a physical or intellectual disability. The onset and progression through puberty may be challenging for girls with mental and physical disabilities and their families and caregivers. Gynecologic care may be underutilized in adolescents with disabilities, but pediatricians and pediatric and adolescent gynecologists should use a nonjudgmental approach, incorporating anticipatory guidance regarding pubertal changes and options for menstrual regulation, confidential care with the adolescent, and attention to parental concerns. Menstrual regulation can be useful to reduce symptoms of dysmenorrhea, reduce irregular menstrual bleeding, and decrease the frequency or amount of menstrual breeding. Options for menstrual regulation include combined hormonal contraceptives (available in pill, patch, and vaginal rings), progesterone-only contraceptives (including pills, injectables, implants, a...

The Journal of Pediatrics, 2021

Cleveland Clinic Journal of Medicine, 2019

Vaping devices, introduced to the US market in 2007 as aids for smoking cessation, have become po... more Vaping devices, introduced to the US market in 2007 as aids for smoking cessation, have become popular among youth and young adults because of their enticing fl avors and perceived lack of negative health effects. However, evidence is emerging that vaping may introduce high levels of dangerous chemicals into the body and cause severe lung injury and death. This article reviews the history and prevalence of vaping and available research on its health effects and effi cacy in smoking cessation, and proposes recommendations for clinicians and legislators to reduce harms associated with vaping. KEY POINTS Vaping is a common gateway to tobacco and marijuana use for adolescents and adults. The Juul vaping device delivers high nicotine concentrations that may pose a higher risk of nicotine addiction. Vaping has had unintended consequences that include poisoning of children who swallowed liquid nicotine, fi res and explosions from defective batteries in the devices, and effects on the developing brain. Vaping is associated with respiratory illness and, in rare cases, death, likely due to vaporized agents introduced into the lungs. Small amounts of heavy metals, acetone, and other carcinogenic compounds in the vaping aerosol may cause lung damage.

Pediatrics, 2019

Aluminum has no known biological function; however, it is a contaminant present in most foods and... more Aluminum has no known biological function; however, it is a contaminant present in most foods and medications. Aluminum is excreted by the renal system, and patients with renal diseases should avoid aluminum-containing medications. Studies demonstrating long-term toxicity from the aluminum content in parenteral nutrition components led the US Food and Drug Administration to implement rules for these solutions. Large-volume ingredients were required to reduce the aluminum concentration, and small-volume components were required to be labeled with the aluminum concentration. Despite these rules, the total aluminum concentration from some components continues to be above the recommended final concentration. The concerns about toxicity from the aluminum present in infant formulas and antiperspirants have not been substantiated but require more research. Aluminum is one of the most effective adjuvants used in vaccines, and a large number of studies have documented minimal adverse effects...

Journal of Adolescent Health, 2019

the 15,197 young adults aged 18-26 years old, 26.5% of young men reported attempts to gain weight... more the 15,197 young adults aged 18-26 years old, 26.5% of young men reported attempts to gain weight, including 39.5% of men who were normal weight, 21.5% who were overweight, and 7.9% who were obese by BMI. By contrast, only 4.6% of women reported attempts to gain weight. Young men reported behaviors such as lifting weights (15.7%); legal performance enhancing substances such as creatine, monohydrate, and androstenedione (15.7%); and androgenic anabolic steroids (2.7%). Multivariate logistic regression analyses demonstrated that Black/African American males (Odds ratio [OR] 2.40; 95% confidence interval [CI] 1.84-3.13) had greater odds of weight gain attempts than White males. Adolescent males identifying as homosexual or bisexual had lower odds (OR 0.46; 95% CI 0.25 e 0.84) of weight gain attempts than adolescent males identifying as heterosexual. Young men who reported weightlifting to bulk up had less BMI (B¼-0.33 kg/m2, p¼0.023) and weight (B¼-0.87 kg, p¼0.

Journal of Adolescent Health, 2017

control), distress about binge eating, and absence of weekly compensatory behaviors. Algorithms a... more control), distress about binge eating, and absence of weekly compensatory behaviors. Algorithms also identified parents without eating disorders: denial of weekly binge-eating episodes and compensatory behaviors, denial of moderate/severe body image disturbance and eating-related distress. Additionally, parents in the OB group (n¼85) had a body mass index >30 kg/m2, and parents in the HW group (n¼183) had a body mass index 18.5-24.9 kg/m2. This study was reviewed and approved by the Yale Institutional Review Board. Results: More parents with BED (20.6%) reported child binge eating compared with parents with OB (4.7%) and HW (4.9%),

Journal of Pediatric and Adolescent Gynecology, 2017

School principals of seven different school boards in CHEO's catchment area were asked to complet... more School principals of seven different school boards in CHEO's catchment area were asked to complete an anonymous, self-administered, Internetbased survey. REB approval was granted. The primary outcome assessed was the evaluation of the material being taught for sexual health education in primary and secondary schools in CHEO's catchment area. Our survey collected data on the structure of sexual health education programs, program content, and instructor qualifications. The secondary outcome assessed the need for additional resources based on the challenges faced by instructors. Results: Seven school boards were contacted to participate in the study.

Pediatric Annals, 2015

Menstrual suppression—the use of hormones to delay or eliminate menses—is often used in adolescen... more Menstrual suppression—the use of hormones to delay or eliminate menses—is often used in adolescents to manage conditions associated with the menstrual cycle and to accommodate lifestyle preferences. Reducing the frequency of menstrual bleeding does not cause any known physiologic harm and has potential short-term and long-term advantages. Different methods used for menstrual suppression, however, have associated risks and side effects that need to be weighed against the benefits of controlling menses. This article reviews the advantages and disadvantages of menstrual suppression and the different methods available for adolescents. [ Pediatr Ann . 2015;44(9):e231–e236.]

Gastroenterology, 2013

within 3 months of surgery. There were seven major complications in NI patients (shock (n=1), abs... more within 3 months of surgery. There were seven major complications in NI patients (shock (n=1), abscess or other infection (n=5), obstruction (n=1)). There were five major INF group complications; four patients experienced early major complications and one experienced a delayed complication. Early complications included anastomotic leak, tubular necrosis requiring dialysis, bacteremia, and intra-abdominal phlegmon treated with antibiotics. The delayed complication was a laparoscopic lysis of adhesions three years following an open ileocecectomy. There was no significant difference in postoperative length of stay between groups. Conclusions: Infliximab use prior to surgery is not associated with an increased number of complications in our pediatric CD population following a major operation. As this therapy continues to be used for management CD, further large-volume and multicenter studies will be beneficial to understanding the interaction of infliximab with major surgical intervention.

Journal of Adolescent Health, 2015

Nutrition in pediatrics: …, 2003

This chapter addresses the nutritional concerns of the healthy adolescent, as well as the specifi... more This chapter addresses the nutritional concerns of the healthy adolescent, as well as the specific dietary concerns of eating disorder patients. Topics covered include the diagnostic criteria for anorexia nervosa, bulimia nervosa and eating disorder not ...