Journal of Pediatric and Adolescent Gynecology via MedWorm.com

Journal of Pediatric and Adolescent Gynecology — Fri, 06 Jan 2012 03:24:22 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Fri, 06 Jan 2012 03:24:22 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Body Dissatisfaction on Top of Depressive Mood among Adolescents with Severe Dysmenorrhea

Journal of Pediatric and Adolescent Gynecology — Fri, 06 Jan 2012 03:24:22 +0100

Conclusion: Patients with SD not only show a different profile from their peers in terms of their mental health academic track and gynecological age, but they are also more dissatisfied with their body appearance. Clinicians should pay particular attention to patients with SD and offer them a global evaluation, bearing in mind what factors can be associated with SD. (Source: Journal of Pediatric and Adolescent Gynecology)

Editor’s Workshop

Journal of Pediatric and Adolescent Gynecology — Fri, 06 Jan 2012 03:24:22 +0100

In this issue of the Journal of Pediatric and Adolescent Gynecology we focus on the Juvenile Justice System as addressed in our Mini-Review, authored by Drs. Risk and Alderman. Specifically, girls charged with a juvenile offense are a special group of individuals that require clinicians to understand the unique problems associated with this population. Depression, severe neglect, sexual and physical abuse, and this occurs oftentimes while in the care of a government agency, is the background to the problem. New laws have been enacted that appear to “allow children to be housed in county jails outside the oversight, supervision or even inspection(s) by anyone experienced with the care of children”; the Florida Department of Justice has been front and center on this issue. (Source: Journ...

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:52 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:52 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Teenage Pregnancy and the Influence of Paternal Involvement on Fetal Outcomes

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:52 +0100

Conclusions: Lack of paternal involvement is a risk factor for adverse birth outcomes among teenage mothers; risks are most pronounced among African-American teenagers. Our findings suggest that increased paternal involvement can have a positive impact on birth outcomes for teenage mothers, which may be important for decreasing the racial disparities in infant morbidities. More studies assessing the impact of greater paternal involvement on birth outcomes are needed. (Source: Journal of Pediatric and Adolescent Gynecology)

A Comparison of the Prevalence of Premenstrual Dysphoric Disorder and Comorbidities among Adolescents in the United States of America and Nigeria

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:52 +0100

Conclusions: Premenstrual dysphoric disorder is prevalent across different cultures. It is a chronic condition that causes significant morbidity among adolescents. There is a need for simple diagnostic methods for early detection and evidence-based management guidelines. (Source: Journal of Pediatric and Adolescent Gynecology)

Advance Provision of Emergency Contraception in an Urban Pediatric Emergency Department

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:52 +0100

Conclusions: Despite a policy and an educational intervention for providers, little change occurred in advance EC prescribing in an urban, pediatric ED. Additionally, many providers were not documenting last unprotected sexual intercourse, potentially missing an opportunity to treat patients with EC at the time of their visit. (Source: Journal of Pediatric and Adolescent Gynecology)

Obstetric and Perinatal Outcomes of Teenage Pregnancies in Thailand

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:50 +0100

Conclusion: Independent of known confounding factors, teenage pregnancy was associated with increased risks of adverse maternal and neonatal outcomes requiring clinical and outreach interventions from health care providers. (Source: Journal of Pediatric and Adolescent Gynecology)

Premature Thelarche in Infants and Toddlers: Prevalence, Natural History and Environmental Determinants

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:50 +0100

Conclusions: Our study demonstrated a higher prevalence of premature thelarche than has been previously reported. This study lacked power because of the small number of premature thelarche cases, the ubiquitous presence of environmental exposure as well as the potentially small effect of each environmental factor. Future studies need to employ a very large sample in order to accurately analyze the relationship between environmental toxicants and premature thelarche. (Source: Journal of Pediatric and Adolescent Gynecology)

Mood Disorders

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:50 +0100

Relating the biochemical changes accompanying physical development at puberty with a child’s emotions, communication difficulties, and behavior is obviously a challenge. The contribution by Vigil and colleagues (“Endocrine Modulation of the Adolescent Brain”) in this issue of the journal reviews some of the countless studies and clinical observations used to bridge this gap. The authors have lined up a selection of suspect proteins and steroids that may modify the adolescent brain, affect moods, and alter behavior. It is obvious that the pharmacology of mood chemistry is alive and well. However, it is unlikely that there will ever be a scientific tool to estimate the degrees of neural plasticity necessary to process information appropriately and negotiate this challenging period of l...

Editorial

Journal of Pediatric and Adolescent Gynecology — Sat, 19 Nov 2011 16:11:49 +0100

In this issue we have initiated a new forum for the Journal of Pediatric and Adolescent Gynecology (JPAG). Specifically, we have called upon the former Editor-in-Chief of JPAG, viz. Dr. Paul McDonough to provide Editorial Comment on our Mini-review. Dr. McDonough is a founding father of NASPAG. He in collaboration with Dr. Alvin Goldfarb organized the first NASPAG annual meeting; it was held in Washington, D.C. and served as the FIGIJ (Federation Internationale de Gynecologie Infantile et Juvenile)-part of FIGO (International Federation of Gynecology and Obstetrics) international meeting in 1986. (Source: Journal of Pediatric and Adolescent Gynecology)

Congenital Paraurethral Cysts in two Newborn Girls: Differential Diagnosis, Management Strategies, and Spontaneous Resolution

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion: Paraurethral cysts of the newborn and hymenal cysts rarely cause urinary obstruction or spotting, and are self-resolving. When positively identified, no evaluation of upper urinary tract is required and neither aspiration of cyst contents or marsupialization procedure is necessary. (Source: Journal of Pediatric and Adolescent Gynecology)

Differences in Stimulated Androgen Levels in Black and White Obese Adolescent Females

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion: There appear to be race-related differences in stimulated androgen levels in obese adolescent females. These differences deserve further study, as measurements of androgen levels are commonly used in clinical practice and research. (Source: Journal of Pediatric and Adolescent Gynecology)

Adolescent Caesarean Delivery in the US Military Health Care System

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions: Teenagers in the military health care system have increasing rates of CD. Independent demographic risk factors for teenage CD include age > 17 years, sponsor's race African American, and delivery at a civilian facility. (Source: Journal of Pediatric and Adolescent Gynecology)

Cervical Pap Screening Cytological Abnormalities among HIV-Infected Adolescents in the LEGACY Cohort

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Abstract: Objectives: To determine the prevalence of cervical Pap screening (CPAP-S), identify factors associated with CPAP-S, and explore risk factors for abnormal cervical cytology in female adolescents with perinatally and behaviorally acquired HIV infection.Design: Cross-sectional.Setting: LEGACY is a national observational cohort chart review study of 1478 HIV-infected persons ( (Source: Journal of Pediatric and Adolescent Gynecology)

The Incidence, Attitudes and Practices of the Removal of Pubic Hair as a Body Modification

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion: Based on this study, removal of pubic hair as a body modification is common. The results of this study demonstrated that removal of pubic hair was more common in sexually active participants compared to non-sexually active participants. Therefore, providers should additionally be aware that removal of pubic hair may be a warning sign of sexual behaviors or impending sexual activity. (Source: Journal of Pediatric and Adolescent Gynecology)

Adolescent Depressive Symptoms and Subsequent Pregnancy, Pregnancy Completion and Pregnancy Termination in Young Adulthood: Findings from the Victorian Adolescent Health Cohort Study

Journal of Pediatric and Adolescent Gynecology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions: Adolescent antisocial and drug use behavior, not depressive symptoms, independently predict pregnancy outcomes in young adulthood. (Source: Journal of Pediatric and Adolescent Gynecology)

Bone Mineral Density, Fracture, and Vitamin D in Adolescents and Young Women Using Depot Medroxyprogesterone Acetate

Journal of Pediatric and Adolescent Gynecology — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions: Most subjects on DMPA had normal BMD at first DXA. Low spinal BMD was associated with longer DMPA use, and some BMD measurements declined with prolonged use. Fracture history is not an absolute contraindication to DMPA use in this population. Studies are needed to determine possible benefits of vitamin D supplementation in DMPA users. (Source: Journal of Pediatric and Adolescent Gynecology)

Diagnostic Imaging: Pediatrics

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Pediatrics is a unique and challenging field in which the practitioner must understand the problems that affect children and be able to recognize them from normal variants. Diagnostic Imaging: Pediatrics offers a comprehensive and complete look at pediatric pathology and the imaging associated with it. This book is suited for both radiologists and non-radiologists who deal with a pediatric population. Although the book focuses on imaging findings, clinical issues are addressed with each topic. The authors keep the reader (including Pediatric Adolescents Gynecologists) in mind, which results in an efficient, yet thorough review. The book can serve many purposes, including as a day-to-day reference, study guide, or a teaching aide. (Source: Journal of Pediatric and Adolescent Gynecology)

Diagnosis and Management of Precocious Puberty in Atypical Presentations of McCune-Albright Syndrome: A Case Series Review

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Although different in presentation, all three atypical cases of suspected McCune-Albright syndrome with gonadotropin-independent precocious puberty were successfully treated with aromatase inhibitors. This small case series shows the utility and efficacy of aromatase inhibitors in the setting of atypical cases of suspected MAS with gonadotropin-independent precocious puberty. (Source: Journal of Pediatric and Adolescent Gynecology)

Ovarian Endometrioma in an 11-Year-Old Girl before Menarche: A Case Study with Literature Review

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: We discuss the above mentioned case and consider data published in the literature. Endometrioma should be considered even in premenarcheal girls with ovarian cysts, regardless of their size. (Source: Journal of Pediatric and Adolescent Gynecology)

When Parents Do Not Want Their Daughters on Birth Control Pills: Tips for Navigating a Difficult Clinical Situation

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

“The Pill” just celebrated its 50th birthday. When looking back at this monumental discovery, how many clinicians have wished its creators had named it something other than “the birth control pill”? Imagine if it had been called “the menstrual cycle regulation pill,” “the menstrual cramp avoidance pill,” or “the anti-acne pill.” If the name had been separated from its contraceptive effects, our job of helping adolescents with menstrual maladies would be much easier. We could tell patients and their parents that this medication will safely cure dysmenorrhea, improve acne, and regulate cycles, and incidentally, prevent ovulation. (Source: Journal of Pediatric and Adolescent Gynecology)

Urogenital Symptoms in Premenarchal Girls: Parents' and Girls' Perceptions and Associations with Irritants

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Almost half the girls had histories of urogenital symptoms. Poor hygiene and soap exposure were perceived causes of most symptoms. When no cause for urogenital symptoms is identified, treatment should be focused on hygiene, soap exposure, and tight-fitting clothes, not on bike or horseback riding or wearing nylon underwear or tights. Vaginal discharge warrants further evaluation. (Source: Journal of Pediatric and Adolescent Gynecology)

The Role of Examination under Anesthesia (EUA) and Vaginoscopy in Pediatric and Adolescent Gynecology: A Retrospective Review

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: EUA/vaginoscopy is a safe and highly useful method in the assessment of the lower genital tract in pediatric and adolescent patients. (Source: Journal of Pediatric and Adolescent Gynecology)

Long Acting Reversible Contraception in Postpartum Adolescents: Early Initiation of Etonogestrel Implant is Superior to IUDs in the Outpatient Setting

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: In postpartum teens attending a clinic that prioritizes contraceptive use, the implant is far more likely to be received prior to resumption of sexual activity than the IUD. This may be due to more and earlier opportunities for placement, or waning commitment with time since delivery. Post-placental IUDs may be needed to equal the success of the implant in this patient population. Short-acting, reliable contraceptive methods should be implemented for postpartum adolescents preferring to wait for IUD insertion. (Source: Journal of Pediatric and Adolescent Gynecology)

Vaginal Agenesis, the Hymen, and Associated Anomalies

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: An absent hymen makes renal agenesis more likely and increases the likelihood that dilator techniques will fail. This condition appears to be associated with reports of long-term problems with poor lubrication that are potentially related to the absence of the peri-hymenal Bartholin’s glands. (Source: Journal of Pediatric and Adolescent Gynecology)

Prevalence and Correlates of Recent Vaginal Douching among African American Adolescent Females

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Increased age, lower socioeconomic status, and older partners may be salient risk factors for douching behavior among African American young women. (Source: Journal of Pediatric and Adolescent Gynecology)

Cultural Practices Relating to Menarche and Menstruation among Adolescent Girls in Taiwan—Qualitative Investigation

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Educators and health professionals should seek to understand this generation of girls, who perceive the world as more flexible and available and have more creativity and new eating behaviors and hobbies. (Source: Journal of Pediatric and Adolescent Gynecology)

Awareness and Knowledge of the Intrauterine Device in Adolescents

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: Over 70% of the adolescents had not heard of the IUD and less than half of adolescents who had heard of the IUD were able to identify key features about this contraceptive method. The lack of knowledge of this effective and safe contraceptive option is concerning given that most participants were at high risk for unintended pregnancy. (Source: Journal of Pediatric and Adolescent Gynecology)

The Use of Effective Contraception among Young Hispanic Women: The Role of Acculturation

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Educational efforts should focus on young Hispanic women who are bicultural and low in acculturation in order to increase their use of more effective contraceptive methods and reduce the number of unplanned pregnancies among this population. (Source: Journal of Pediatric and Adolescent Gynecology)

Substance Use and Mental Health Disparities among Sexual Minority Girls: Results from the Pittsburgh Girls Study

Journal of Pediatric and Adolescent Gynecology — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Sexual minority girls are an underrepresented group in the health disparities literature, and compared with heterosexual girls, they are at higher risk for mental health problems, most likely because of minority stress experiences such as discrimination and victimization. The disparities found in this report highlight the importance of discussing sexual orientation as part of a comprehensive preventive care visit. (Source: Journal of Pediatric and Adolescent Gynecology)

Minocycline-Induced Hyperpigmentation

Journal of Pediatric and Adolescent Gynecology — Mon, 26 Sep 2011 04:00:00 +0100

A 16-year-old Caucasian female presented for evaluation of irregular menstrual periods. She also complained of a persistent bruise on her right thigh present for 2 years. Her mother is concerned that the 2 problems are related. The patient’s medical history is significant for acne vulagris for which she has been on long-term oral antibiotic therapy prescribed by her primary care physician. On physical exam, an irregular bluish, non-blanchable patch was seen on the right lateral thigh (). A referral to a dermatologist was ordered. (Source: Journal of Pediatric and Adolescent Gynecology)

How Should We Treat Prepubertal Labial Adhesions? Retrospective Comparison of Topical Treatments: Estrogen Only, Betamethasone Only, and Combination Estrogen and Betamethasone

Journal of Pediatric and Adolescent Gynecology — Mon, 26 Sep 2011 04:00:00 +0100

Abstract: Labial adhesion is a common finding in prepubertal girls. Traditionally, topical estrogen cream application has been the choice of conservative treatment, however, topical betamethasone treatment has also recently been employed with some success. In this retrospective study, we analysed 131 children with labial adhesions. Eleven of 71 (15.4%) patients were treated successfully with topical estrogen cream only, and 5 of 32 (15.6%) patients were treated successfully with betamethasone cream only. We successfully treated 5 of 28 (28.5%) patients with a combination of estrogen and betamethasone creams. The mean time of treatment for each regimen of therapy was 4 weeks. There was no significance between the single-therapy estrogen and single-therapy betamethasone groups (P = 1.00), be...

Epithelial Ovarian Tumors in Adolescents: A Retrospective Pathologic Study and a Critical Review of the Literature

Journal of Pediatric and Adolescent Gynecology — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions: A relatively high frequency of epithelial ovarian neoplasms among all ovarian tumors in a purely adolescent population was found in our study. Age-related selection bias may account at least in part for the discrepancy between our data and most previous reports. The most common subtype of epithelial ovarian tumor in our series was the benign serous cystadenoma. (Source: Journal of Pediatric and Adolescent Gynecology)

Gestational Weight Gain in Adolescents: A Comparison to the New Institute of Medicine Recommendations

Journal of Pediatric and Adolescent Gynecology — Mon, 26 Sep 2011 04:00:00 +0100

Conclusion: Practitioners can safely use the new IOM gestational weight gain ranges to monitor weight gain in pregnant adolescent patients using adult BMI classifications. Future research should examine the range of gestational weight gain in adolescents considering a broader scope of birth and maternal outcomes. (Source: Journal of Pediatric and Adolescent Gynecology)

Adolescents’ Fertility Concerns: “I’m not trying to get pregnant, but if I did…”

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Aliah is a 20-year-old African American female who became sexually active at age 17. She has been in a 2-year monogamous relationship with her 22-year-old boyfriend, who is her second lifetime partner. Previous contraceptive methods included Implanon for 8 months, followed by inconsistent use of oral contraceptive pills and condoms. Menarche was at age 13, and her periods were initially monthly but then became irregular. Her body mass index has vacillated between the overweight and healthy range. She has never been pregnant and has never had a sexually transmitted infection. Aliah is one of 7 children. (Source: Journal of Pediatric and Adolescent Gynecology)

Human Papillomavirus Vaccination Recommendation May be Linked to Reimbursement: A Survey of Virginia Family Practitioners and Gynecologists

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: Gynecologists are providing HPV vaccination at rates similar to family practitioners. Reimbursement concerns may negatively have an impact on doctors’ recommendation of the HPV vaccine. (Source: Journal of Pediatric and Adolescent Gynecology)

High Rate of Endometriosis Recurrence in Young Women

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: The recurrence rate of endometriosis in young women appears higher than in older women. Since no determinants for recurrence have been detected among the factors examined, a profile of women at increased risk cannot be drawn. (Source: Journal of Pediatric and Adolescent Gynecology)

Immunocytochemical Characterization of Pacinian-like Corpuscles in the Labia Minora of Prepubertal Girls

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusion: PGP 9.5, NSE, ERα, nNOS, and 5HTT immunoreaction detected in the outer core and external capsule could indicate these areas may play an important role in the functional aspects of the Pacinian-like corpuscle. (Source: Journal of Pediatric and Adolescent Gynecology)

Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Abstract: The purpose of the study was to identify diagnostic criteria that can distinguish between subjects with functional hypothalamic amenorrhea largely related to minimal energy deficiency and those in whom failure of adaptive response to stress prevails. We studied 59 young women with secondary amenorrhea related to modest eating disorders and 58 who complained of stressful events in their history. We assessed anthropometric measurements, body composition using dual energy X-ray absorptiometry (DEXA) and bioelectrical impedance analysis (BIA), and basal endocrine profile. Subjects with disordered eating had lower body mass index (BMI), fat mass (FM) measured with both techniques, lumbar mineral density and direct and indirect measures of lean mass. Leptin and free tri-iodothyronine(F...

Tables of Contents

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:19 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:19 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Adolescent Users of an Online Contraception Selection Tool: How User Preferences and Characteristics Differ From Those of Adults

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:17 +0100

Conclusions: Choosing Wisely is attracting large numbers of teens and adults, whose responses provide insight into the characteristics of those seeking contraception. Our data corroborate the need for contraceptive options such as combined contraceptives that do not require daily pill-taking and contraceptives that offer menstrual management. However, the magnitude of these statistically significant differences was not always as impressive clinically. (Source: Journal of Pediatric and Adolescent Gynecology)

MRSA: Rare in the Vagina

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:17 +0100

Conclusion: The prevalence of MRSA in a sample of sexually active adolescents was as rare as reported in other populations. It is unlikely that vaginal MRSA is a reservoir for community acquired infections. (Source: Journal of Pediatric and Adolescent Gynecology)

Female Adolescent Athletes’ Awareness of the Connection between Menstrual Status and Bone Health

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:17 +0100

Conclusions: The prevalence of irregular menses is high among adolescent track athletes and a larger-scale inquiry to clarify adolescent athletes’ knowledge of and attitudes about the link between menstrual patterns and BMD is indicated. Education may provide one key to improved health behavior among this at-risk population. (Source: Journal of Pediatric and Adolescent Gynecology)

Premenstrual Syndrome: The Experience from a Sample of Sri Lankan Adolescents

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:16 +0100

Conclusion: Premenstrual syndrome is a common condition among adolescent schoolgirls with a high negative influence on their daily life. The health care seeking behavior is poor, indicating the necessity to address the subject at adolescent reproductive health programs. (Source: Journal of Pediatric and Adolescent Gynecology)

Ambiguous Genitalia in the Newborn: An Overview and Teaching Tool

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:13 +0100

Abstract: Ambiguous genitalia is a significant example of a disorder of sexual development, in which the external genitalia do not have the typical appearance of either sex. Although the birth of a child with ambiguous genitalia is rare, the emergent nature of the issue demands that healthcare providers have at least a familiarity with the underlying etiologies, the issues, and the initial approach to diagnosis and management. With numerous etiologies, potential difficulties with reaching a diagnosis, and many challenges with immediate and long-term care, the topic of ambiguous genitalia can be daunting. We provide a review of basic embryology, as well as a classification system for understanding the various etiological causes of ambiguous genitalia. The important clinical aspects of diagn...

Congenital Adrenal Hyperplasia and Ambiguous Genitalia

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:12 +0100

We are providing a 2-part mini-review series for the Journal of Pediatric & Adolescent Gynecology. In the first segment, provided by Drs. Witchel and Azziz, the focus is on congenital adrenal hyperplasia. We learn about genetic aspects and the role of P450c21 as associated with 21-hydroxylase deficiency in this autosomal recessive disorder. The molecular basis of the disease process is emphasized, as is the “missense mutation” and how that affects the phenotypic findings and the pathophysiology, and we then segue into the clinical aspects of the disease. We learn about newborn screening, laboratory assessment, and unique aspects associated with precocious puberty, adrenomedullary dysfunction, gonadal rest neoplasms, and what is current with respect to contiguous gene deletion syndrome....

Ambiguous Genitalia - Disorders of Sexual Differentiation

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:12 +0100

In dealing with disorders of sexual differentiation, key points include immediacy, sensitivity, and team approach. When faced with the problem of ambiguous genitalia, we as Pediatric Adolescent Gynecologists must be there for the patient, the parents, and our colleagues who call upon us. A team approach that would include a pediatric urologist, a pediatric endocrinologist, a geneticist, and an appropriately trained gynecologic or pediatric surgeon is of paramount importance: What is the correct diagnosis? What are the immediate tests to order? (Source: Journal of Pediatric and Adolescent Gynecology)

Endometriosis in Adolescents: A Whole Different Focus

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:11 +0100

A rare week goes by that a NASPAG member does not see an adolescent with pelvic pain and ultimately “presumed endometriosis.” It’s not an easy disease to “spot” in our patient population, with an incidence of 5–10% in the general population , i.e. among reproductive age patients. Fast forward to the adolescent and young adult and we may be dealing with an incidence in the 73% range, depending upon the study you cite. Now the pathophysiology remains “the great debate.” Is it Sampson’s theory reported in 1940 of retrograde menstruation or is it coelomic metaplasia or is it hematogenous or lymphatic mechanisms of “dissemination”?4 (Source: Journal of Pediatric and Adolescent Gynecology)

Insight: Prolonged Vaginal Bleeding during Central Precocious Puberty Therapy with a Long-acting Gonadotropin-Releasing Hormone Agonist: A Proposed Mechanism and Management Plan

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 04:00:00 +0100

Abstract: We have previously described our data collected after administration of gonadotropin releasing hormone-agonist (GnRH-a) to delay sexual maturation, in premenarchal girls suffering from idiopathic central precocious puberty. We have explained the recurrent episodes of bleeding due to discontinuation of the estrogen support of the proliferative and stable endometrium. The recognition in recent years of the extra-pituitary functions of GnRH-a, the ability of GnRH to stimulate prostaglandin production and the known role of prostaglandins in irregular vaginal bleeding prompted us to seek alternative explanations to our data.We suggest considering a potential clinical use of combination therapies of GnRH agonists and prostanoid receptor antagonists to treat central precocious puberty. ...

Cervicitis in Adolescents: Do Clinicians Understand Diagnosis and Treatment?

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 04:00:00 +0100

Conclusions: Our findings suggest that knowledge deficits exist in diagnosis and treatment of cervicitis in adolescent patients and in differentiating between cervicitis and PID. Educational tools, simulated patient exercises, and order sets may be warranted for quality improvement to allow for improved care of this at risk sexually active population. (Source: Journal of Pediatric and Adolescent Gynecology)

Sources of Sex Information and its Effects on Sexual Practices among In-school Female Adolescents in Osisioma Ngwa LGA, South East Nigeria

Journal of Pediatric and Adolescent Gynecology — Sun, 17 Jul 2011 23:00:00 +0100

Conclusion: The study highlights the need for increased roles of parents and teachers in early sexuality education of adolescent girls. This can be done by increasing capacity of parents to discuss sexuality issues with their children. (Source: Journal of Pediatric and Adolescent Gynecology)

Paratubal Borderline Tumor Diagnosed In The Adolescent Period: A Case Report And Review of The Literature

Journal of Pediatric and Adolescent Gynecology — Thu, 07 Jul 2011 23:00:00 +0100

Conclusion: The evaluation of the structure of cyst by ultrasound and the performance of intraoperative frozen section analysis are two important issues to diagnose the nature of a cyst. Fertility-sparing surgery is the main point of management. (Source: Journal of Pediatric and Adolescent Gynecology)

Journal of Pediatric and Adolescent Gynecology — Thu, 07 Jul 2011 15:55:10 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Thu, 07 Jul 2011 15:55:10 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Issues and Answers in Pediatric and Adolescent Gynecology

Journal of Pediatric and Adolescent Gynecology — Thu, 07 Jul 2011 15:55:05 +0100

Allow me to highlight the most well attended North American Society for Pediatric & Adolescent Gynecology (NASPAG) annual meeting to date. The location was Chicago, the “education venue” pervaded throughout the entire meeting. Now for the pearls: (Source: Journal of Pediatric and Adolescent Gynecology)

A New Technique For the Treatment of Transverse Vaginal Septum by Foley Catheter

Journal of Pediatric and Adolescent Gynecology — Sun, 03 Jul 2011 23:00:00 +0100

We report a new surgical technique for the management of transverse vaginal septum in a 13-year-old girl who presented with abdominal pain. Imaging techniques yielded hematocolpos. The patient and her family refused vaginal surgery in order to preserve hymenal integrity for sociocultural beliefs. At laparotomy, a vertical incision was made on posterior vaginal wall. An artery forceps was introduced from the hymenal opening while preserving the hymenal integrity. The septum located on the upper third of vagina was perforated by the help of a forceps introduced from posterior vaginal wall via an abdominal route. A Foley catheter was introduced from the introitus toward the septal perforation and was held by the forceps. The balloon of the catheter was placed on the perforated septum and it w...

Localized Epidermolysis Bullosa Simplex (Weber-Cockayne type)

Journal of Pediatric and Adolescent Gynecology — Thu, 30 Jun 2011 04:00:00 +0100

A 15-year-old nulliparous white female presents to her gynecologist because she would like to begin taking oral contraceptive pills and is sexually active. During her visit, the patient complains of persistent blistering on her feet that is exacerbated by persistent sweating of her feet. She reports that she develops blisters on her feet and occasionally on her hands and other sites of trauma that are exacerbated by the warm weather. The blisters arise and heal spontaneously after several weeks. She is otherwise in good health and denies any significant past medical or surgical history. However, her mother and siblings have similar changes. She denies using any current or past medications except for multivitamins. On physical exam, the patient has a large blister on the plantar aspect of h...

Hysteroscopic Resection of a Symptomatic Uterine Leiomyoma in an Adolescent

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusion: Surgical intervention for abnormal bleeding due to a submucosal myoma was more successful than medical treatment. In adolescents, hysteroscopic resection of a symptomatic submucosal myoma is a reasonable minimally invasive management option. (Source: Journal of Pediatric and Adolescent Gynecology)

Idiopathic Pulmonary Hypertension Causing Acquired von Willebrand Disease and Menorrhagia

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

We report a case of menorrhagia due to acquired VWD in a patient with idiopathic pulmonary hypertension.Case: An adolescent female with known idiopathic pulmonary hypertension developed acquired VWD. Her primary disease necessitates the use of platelet inhibitors and intermittent anticoagulation. At menarche she also developed menorrhagia due to acquired VWD. She is currently controlled with stimate and progesterone-only therapy. VWD in a patient with idiopathic pulmonary hypertension causing menorrhagia. Although VWD and menorrhagia are commonly linked, the treatment and disease process in a patient with idiopathic pulmonary arterial hypertension is incredibly complex. (Source: Journal of Pediatric and Adolescent Gynecology)

A Rare Vulvar Manifestation of Neurofibromatosis 1 in a Teen

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Abstract: Neurofibromatosis 1 is an autosomal dominant disorder with cutaneous findings that include multiple café-au-lait spots, axillary/inguinal freckling, dermal, and plexiform neurofibromas. Skin manifestations, including involvement of the vulva, are often the most troubling physical finding to patients. Hormonal and growth factor changes during puberty have been implicated in neurofibroma growth. In the case presented here, an exceedingly rare isolated vulvar neurofibroma without clitoral involvement became enlarged and symptomatic, requiring excisional surgery after puberty. The diffuse involvement of these tumors makes complete resection very difficult and recurrence is common. (Source: Journal of Pediatric and Adolescent Gynecology)

Laparoscopic Treatment of Ovarian Cysts in Adolescents and Young Adults

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusion: With a careful preoperative screening, the laparoscopic surgery of ovarian cyst is an efficient and safe treatment for adolescents and young adults. (Source: Journal of Pediatric and Adolescent Gynecology)

Seasonal Trends in Adolescent Pregnancy Conception Rates

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusions: There are several plausible explanations for the modest but real differences identified in this study including trends in fecundity/fertility or social/school events that lead to increased sexual activity. Peaks in conception indicate times when a greater need for health care services exists, and when preventive education can be most effective. (Source: Journal of Pediatric and Adolescent Gynecology)

“Sex Isn’t Something You Do with Someone You Don’t Care About”: Young Women’s Definitions of Sex

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusions: Variations in young women’s definitions of sex may influence their responses to clinical questions about sexual activity and their understanding of their STI risk. As such, our findings have important implications for clinical counseling regarding sexual behavior and correct condom use and for researchers investigating young women’s sexual behavior. (Source: Journal of Pediatric and Adolescent Gynecology)

Mother-Daughter Communication and College Women’s Confidence to Communicate with Family Members and Doctors about the Human Papillomavirus and Sexual Health

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusion: Positive communication experiences with mothers in the early years may reduce the shame, embarrassment, and anxiety associated with talking to physicians about sensitive sexuality issues. (Source: Journal of Pediatric and Adolescent Gynecology)

Fertility Outcomes Subsequent to Treatment of Tubal Ectopic Pregnancy in Younger Turkish Women

Journal of Pediatric and Adolescent Gynecology — Wed, 29 Jun 2011 23:00:00 +0100

Conclusion: Since we found no difference in terms of pregnancy rates among three groups, medical treatment appears to be more favored with early and accurate diagnosis. After salpingectomy, patients may conceive later in life when compared with other groups so selected patients should be assessed according to their age for the decision of assisted reproductive techniques. (Source: Journal of Pediatric and Adolescent Gynecology)

Anovulatory Bleeding in a 12-Year-Old as Presenting Sign for Rare Undifferentiated Sarcoma

Journal of Pediatric and Adolescent Gynecology — Sun, 29 May 2011 23:00:00 +0100

Abstract: Background: Abnormal uterine bleeding is a common phenomenon in perimenarchal females. Though most cases of abnormal bleeding are due to anovulatory bleeding or bleeding disorders, rare cases are attributable to underlying malignancy.Case: Here we report a 12-year-old female patient who presented with abnormal uterine bleeding three months after menarche. She was ultimately diagnosed with a pelvic sarcoma of unknown primary origin. She was subsequently treated with chemotherapy, whole pelvic radiation, and hysterectomy with bilateral salpingo-oophorectomy.Summary: Abnormal uterine bleeding unresponsive to conventional temporizing measures should be thoroughly evaluated. Management of pelvic malignancies in the pediatric population requires cooperation amongst specialists from an ...

Is Young Maternal Age Really a Risk Factor for Adverse Pregnancy Outcome in a Canadian Tertiary Referral Hospital?

Journal of Pediatric and Adolescent Gynecology — Sun, 29 May 2011 23:00:00 +0100

Abstract: Objective: To assess the risk of adverse pregnancy outcome among teenage mothers within a large tertiary referral center in Canada.Methods: All nulliparous singleton births in the McGill University Health Centre during 2001–2007 were retrieved using the "MOND" database. Patients were divided according to maternal age: (Source: Journal of Pediatric and Adolescent Gynecology)

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:32 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:32 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Side Effects of Doxycycline in Adolescents Treated for Pelvic Inflammatory Disease

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:32 +0100

A commonly-used outpatient therapy for pelvic inflammatory disease (PID) in the USA is that recommended by the Centers for Disease Control and Prevention (CDC), an injection of a cephalosporin followed by oral doxycycline. We were unable to find literature on doxycycline’s side effects during its use for the treatment of PID in adolescents. Because of the serious long-term complications of PID, effective treatment is important, and side effects may lead to poor compliance with therapy. The purpose of this study was to assess adverse reactions to doxycycline in adolescents under treatment for PID. (Source: Journal of Pediatric and Adolescent Gynecology)

The Approach to Ovarian Dermoids in Adolescents and Young Women

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:32 +0100

Conclusion: The risks of expectant management in women like the one presented are small. This suggests that although the traditional treatment for MCTs is laparoscopic ovarian cystectomy, in children and adolescents with MCTs we should consider close follow-up without intervention to preserve ovarian function and future fertility. (Source: Journal of Pediatric and Adolescent Gynecology)

Congenital Adrenal Hyperplasia

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:28 +0100

This article will review key aspects regarding pathophysiology, diagnosis, and treatment of CAH. (Source: Journal of Pediatric and Adolescent Gynecology)

Vulvodynia in Adolescence: Childhood Vulvar Pain Syndromes

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:28 +0100

Conclusions: Women with vulvodynia vary in ages from 16 to 80 years with the majority between the ages of 20 to 50 years. Young women in their teens and early twenties are at the greatest risk of developing vulvodynia. Vulvar pain disorders are important in these groups because early pain syndromes may affect future development of body image, self-esteem, and attitudes toward sexual behavior and functioning. (Source: Journal of Pediatric and Adolescent Gynecology)

Fox-Fordyce Disease (Apocrine Miliaria)

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:27 +0100

A 17-year-old female presents for her initial pelvic exam due to recently becoming sexual active. She denies any vaginal complaints but does mention a two-year history of intense, bilateral axillary pruritus. Her symptoms are worse over the summer months and after exercise. She is otherwise healthy, takes no medications, and has no family history of this disorder. On exam, both axilla have tiny, uniform, equidistant flesh-colored papules, some of which have central hairs (). A referral to a dermatologist is ordered. (Source: Journal of Pediatric and Adolescent Gynecology)

Dermatology for Pediatric/Adolescent Gynecology

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:27 +0100

I am honored to have been selected to become a new member of the Journal of Pediatric and Adolescent Gynecology team. Dr. Sanfilippo has entrusted me to revamp and lead the Dermatology Section of JPAG into the next decade. It is not often that physicians from different specialties make an impact on ones career as profoundly as Dr. Sanfilippo has for mine. He has been a colleague, consultant, mentor and friend since my arrival at the University of Pittsburgh approximately 8 years ago. His passion for excellence in patient care is contagious and ample fuel to help me bring a fresh new approach to helping Pediatric and Adolescent Gynecologists stay on the forefront of dermatologic diseases. The previous title for this section “Pedi-Gyn Derm” seemed restrictive and suggests limiting topics...

Introduction of Section Editor: Dermatology for Pediatric/Adolescent Gynecology

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:27 +0100

If there is ever a specialty in medicine that I wish I had spent more time in, had more enhanced knowledge, the ability to “take a look” and say, “Aha”, this is the best topical (or systemic) treatment, indeed it’s Dermatology. That having been said, we strive to provide you, the Journal of Pediatric and Adolescent Gynecology (JPAG) audience, with the knowledge base, the aptitude, and in essence facilitate “the learning curve”, when it comes to Dermatology in our patient age group. (Source: Journal of Pediatric and Adolescent Gynecology)

Albert Altchek, MD

Journal of Pediatric and Adolescent Gynecology — Wed, 25 May 2011 16:45:27 +0100

A Friend of NASPAG, Founding Father, and Faithful Contributor to our society, that is the history behind Dr. Albert Altchek. He was Clinical Professor with Tenure in Obstetrics, Gynecology, and Reproductive Science at Mount Sinai in New York City. Dr. Altchek died on May 2, 2011, following a brief hospitalization. He was a graduate of New York University where he received his undergraduate degree in Biology and went on to complete his formal education at NYU Medical School in 1949. He was a member of Alpha Omega Alpha Honor Medical Society. Indeed Dr. Altchek was a pioneer in Pediatric and Adolescent Gynecology. He educated many clinicians across the nation with his post-graduate courses and his seven textbooks, the most recent of which is Pediatric, Adolescent and Young Adult Gynecology. ...

Demodex Folliculitis

Journal of Pediatric and Adolescent Gynecology — Tue, 24 May 2011 23:00:00 +0100

A 20-year-old woman presents to the office for a refill of her birth control prescription. She had no gynecological complaints and was generally in good health. Her only issue was the presence of multiple pustules over her mid-forehead that appeared acutely, and she was otherwise asymptomatic except for their presence and persistence. The patient had been treated with topical acne medications including a benzoyl peroxide wash, clindamycin gel topical 1%, and tretinoin cream 0.05% by her primary care physician with no success. On examination, the patient had multiple diffuse erythematous pustules primarily over her mid-forehead (). A dermatology consult was ordered. (Source: Journal of Pediatric and Adolescent Gynecology)

Comment on “Menstrual Disorders in Adolescent School Girls in Enugu, Nigeria” by Nw.wo et al: Does Adolescent Dysmenorrhea Ameliorate After Age 20?

Journal of Pediatric and Adolescent Gynecology — Tue, 24 May 2011 23:00:00 +0100

Nw.wo et al showed that a quarter of Nigerian schoolgirls were suffering from dysmenorrhea. They ended their article, “…parents and adolescents should be encouraged to consult experts when significant menstrual disorder occurs.” We wonder whether early consultation may affect future amelioration of adolescent dysmenorrhea. We have two clarifications. (Source: Journal of Pediatric and Adolescent Gynecology)

Community-Acquired Methicillin-Resistant Staphylococcus aureus Skin Infection

Journal of Pediatric and Adolescent Gynecology — Tue, 24 May 2011 23:00:00 +0100

A 16-year-old white female soccer player presents to the clinic with several painful, rapidly enlarging, red, fluctuant dermal nodules with surrounding erythema and induration on the posterior thigh and lower leg. Accompanying symptoms include fever, chills, malaise, nausea, and vomiting of a few days’ duration (). She reports frequent skin abrasions and cuts during soccer practice. A dermatology consult is ordered. (Source: Journal of Pediatric and Adolescent Gynecology)

Van Wyk and Grumbach Syndrome: An Unusual Case and Review of the Literature

Journal of Pediatric and Adolescent Gynecology — Tue, 24 May 2011 23:00:00 +0100

Abstract: Background: The syndrome consisting of primary hypothyroidism, precocious puberty, and massive ovarian cysts was termed Van Wyk and Grumbach syndrome in 1960. Little is known about the effect of the cysts on ovarian tumor markers.Case: A 12-year-old Caucasian female presented with headaches and fatigue. Imaging to evaluate her headaches revealed a pituitary macroadenoma. Soon after her macroadenoma was discovered, she presented to the emergency room with abdominal pain. Imaging at that time revealed massive bilateral ovarian masses with the left measuring 17 × 13 × 8.5 cm and the right measuring 18 × 11 × 10 cm. Ovarian tumor markers were drawn at this time, most of which were highly elevated. Subsequent evaluation revealed extreme hypothyroidism.Given these findings of a pit...

Management of Children and Adolescents with Gender Dysphoria

Journal of Pediatric and Adolescent Gynecology — Tue, 24 May 2011 23:00:00 +0100

Gender Identity Disorder (GID) is a psychiatric diagnosis that applies to persons whose gender identity is different from their assigned gender both in individuals with Disorders of Sex Development (DSM IV, GID Not Otherwise Specified) and in sexually normal individuals (DSM IV, GID). The core characteristics of patients diagnosed with GID include a strong and persistent cross-gender identification, persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex, a preoccupation with getting rid of primary and secondary sex characteristics, and significant distress or impairment in social, occupational or other areas of functioning. The defining characteristic of GID is gender dysphoria which includes discomfort with the individual’s gender role and...

Use of Emergency Contraception by US Teens: Effect of Access on Promptness of Use and Satisfaction

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: Fewer than half of participants had used EC, despite being aware of EC at the time of unprotected intercourse. Policies allowing minors to access EC without a prescription may increase timely use of EC. (Source: Journal of Pediatric and Adolescent Gynecology)

A Retrospective Review of the Effect of Surgeon Specialty on the Management of 190 Benign and Malignant Pediatric and Adolescent Adnexal Masses

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: Ovarian conservation should be prioritized in cases with benign lesions, whereas complete and accurate surgical staging is imperative when malignancy is identified. (Source: Journal of Pediatric and Adolescent Gynecology)

Knowledge of HPV in West Virginia High School Health Students and the Effects of an Educational Tool

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: The educational HPV DVD we created was shown to be an effective learning tool. This is the first reported study to look at the effects of an educational program created by health care providers on the topic of HPV that would be used in the school setting. We believe this tool can be used to supplement the current health education curriculum in the school system. (Source: Journal of Pediatric and Adolescent Gynecology)

Premenstrual Syndrome and Dysmenorrhea: Urban-Rural and Multiethnic Differences in Perception, Impacts, and Treatment Seeking

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: Menstruation-related education would have a positive impact in improving adolescent girls’ knowledge and in nurturing a positive attitude toward menstruation-related matters at home, at school, and in the community. (Source: Journal of Pediatric and Adolescent Gynecology)

Prevalence of Polycystic Ovarian Syndrome in Indian Adolescents

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: Prevalence of PCOS in Indian adolescents is 9.13%.This draws attention to the issue of early diagnosis in adolescent girls. (Source: Journal of Pediatric and Adolescent Gynecology)

Voiding Dysfunction: Another Etiology of Vulvovaginitis in Young Girls

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: VD is an important cause when considering the etiology of PVV. (Source: Journal of Pediatric and Adolescent Gynecology)

Endocrine Modulation of the Adolescent Brain: A Review

Journal of Pediatric and Adolescent Gynecology — Fri, 22 Apr 2011 04:00:00 +0100

Abstract: Neurophysiological and behavioral development is particularly complex in adolescence. Youngsters experience strong emotions and impulsivity, reduced self-control, and preference for actions which offer immediate rewards, among other behavioral patterns. Given the growing interest in endocrine effects on adolescent central nervous system development and their implications on later stages of life, this article reviews the effects of gonadal steroid hormones on the adolescent brain. These effects are classified as organizational, the capacity of steroids to determine nervous system structure during development, and activational, the ability of steroids to modify nervous activity to promote certain behaviors. During transition from puberty to adolescence, steroid hormones trigger var...

Current Trends in the Management of Pediatric Patients with Perineal Groove

Journal of Pediatric and Adolescent Gynecology — Thu, 21 Apr 2011 23:00:00 +0100

Conclusions: A perineal groove is a rare anomaly in young girls. Treatment consists in the surgical excision of the groove, generally after two years of age. On the basis of our experience it is preferable to cover the suture with a chemical glue to impermeabilize the suture line and protect the skin from infections. (Source: Journal of Pediatric and Adolescent Gynecology)

The Adolescent with Menorrhagia: Why, Who, and How to Evaluate for a Bleeding Disorder

Journal of Pediatric and Adolescent Gynecology — Thu, 21 Apr 2011 23:00:00 +0100

Profuse and prolonged menstruation is one of the most common adolescent gynecologic complaints. In the majority of patients, anovulation is the underlying cause and it is easily managed with hormonal therapy. Between 10% and 47% of women with menorrhagia may have an underlying bleeding disorder that could benefit from the addition of nonhormonal therapies or may be relevant to future pregnancies or surgeries. Of women with the two most common bleeding disorders, von Willebrand disease (VWD) and platelet dysfunction, 32–100% complain of menorrhagia. Other hematologic disorders associated with menorrhagia include Factor XI deficiency, hemophilia carrier states, and rare factor deficiencies. (Source: Journal of Pediatric and Adolescent Gynecology)

Müllerian Duct Anomalies: Successful Endoscopic Management of a Hybrid Bicornuate/Septate Variety

Journal of Pediatric and Adolescent Gynecology — Thu, 21 Apr 2011 23:00:00 +0100

Conclusions: External fundal depression which characterizes bicornuate uterus was associated with a septate uterus with hemi uterine obstruction. This report demonstrates the coexistence of the two anomalies. Endoscopic management of this patient was safe and successful. (Source: Journal of Pediatric and Adolescent Gynecology)

Effect of Three Yoga Poses (Cobra, Cat and Fish Poses) in Women with Primary Dysmenorrhea: A Randomized Clinical Trial

Journal of Pediatric and Adolescent Gynecology — Thu, 21 Apr 2011 23:00:00 +0100

Conclusion: Yoga reduced the severity and duration of primary dysmenorrhea. The findings suggest that yoga poses are safe and simple treatment for primary dysmenorrhea. (Source: Journal of Pediatric and Adolescent Gynecology)

Homocysteine and Ghrelin Link with Polcystic Ovary Syndrome in Relation to Obesity

Journal of Pediatric and Adolescent Gynecology — Sun, 03 Apr 2011 23:00:00 +0100

Conclusion: Elevated plasma homocysteine levels in polycystic ovary syndrome was independent from obesity. Adversely ghrelin levels were depressed with polycystic ovary syndrome in relation to obesity. (Source: Journal of Pediatric and Adolescent Gynecology)

Acceptability of the Vaginal Contraceptive Ring Among Adolescent Women

Journal of Pediatric and Adolescent Gynecology — Wed, 30 Mar 2011 23:00:00 +0100

Conclusions: Willingness to try the ring was associated with positive feelings about genitals (e.g., comfort with appearance, hygiene, function). Thus, to increase willingness to try the vaginal ring among adolescents, providers should make it common practice to discuss basic female reproductive anatomy, raise awareness about female genital health and address concerns about their genitals. Providers can offer alternative insertion techniques (e.g., gloves) to make use more accessible. These strategies may increase vaginal ring use among adolescents. (Source: Journal of Pediatric and Adolescent Gynecology)

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

Journal of Pediatric and Adolescent Gynecology — Wed, 30 Mar 2011 23:00:00 +0100

Conclusions: Despite apparent advantages of the patch over the pill, adolescents using both methods continue to face challenges achieving perfect and sustained contraceptive use. (Source: Journal of Pediatric and Adolescent Gynecology)

Pelvic Pain in Adolescents

Journal of Pediatric and Adolescent Gynecology — Wed, 30 Mar 2011 23:00:00 +0100

Pain is a common reason for a visit to the doctor’s office and adolescents are no exception. The cause of acute pain is determined by physical exam, laboratory tests, and imaging. When the patient’s pain resolves with appropriate treatment, it is very satisfying to the physician. However, with chronic pain, in many cases there is no clear identifiable cause and thus no easy resolution to the problem. This can be incredibly frustrating for both patients and physicians. Teaching young physicians to understand and treat patients with chronic pain can be equally challenging. The following article outlines the main principles of caring for adolescents with chronic pelvic pain. (Source: Journal of Pediatric and Adolescent Gynecology)

Issues in Gynecologic Care for Adolescent Girls in the Juvenile Justice System

Journal of Pediatric and Adolescent Gynecology — Mon, 21 Mar 2011 04:00:00 +0100

It is estimated that 2.3 million adolescents pass through the juvenile justice system each year. In the year 2000, adolescent girls comprised 28% of these offenders, reflecting a dramatic 35% increase in the number of female delinquents from 1980. Recent data shows that on average 14,590 female juvenile offenders are housed in correctional facilities on any given day. These adolescent girls have significant health needs. They represent a medically underserved and hard-to-access population who are at high risk of medical, gynecologic, and emotional disorders. A large percentage of these troubled youth have been the victims of child abuse including sexual abuse and neglect. They have high rates of learning disabilities and substance abuse and engage in high-risk behaviors. With the majority ...

Effect of Weight Loss on Menstrual Function in Adolescents with Polycystic Ovary Syndrome

Journal of Pediatric and Adolescent Gynecology — Mon, 21 Mar 2011 00:00:00 +0100

Conclusions: Weight loss is feasible in adolescents with PCOS and results in significant improvements in BMI, WC, and menstrual function. Weight management may be preferable as first-line treatment in adolescents, because it targets both the menstrual dysfunction and risk factors for long-term morbidity associated with PCOS. (Source: Journal of Pediatric and Adolescent Gynecology)

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Editorial Board

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

(Source: Journal of Pediatric and Adolescent Gynecology)

Survival of the Abstinent Teen: What Really Matters?

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

The 2009 Youth Risk Behavior Surveillance Survey found that 45.7% of high school females had ever been sexually active with the prevalence of sexual activity increasing with age (9th grade 29.3% vs. 12th grade 65.0%). To determine the characteristics of those adolescents who elect to remain sexually abstinent, we surveyed female patients ages 12-21 and an accompanying parent. We hypothesized that greater involvement in activities, higher academic achievement, and open family communication about sexual activity would be positively associated with abstinence. (Source: Journal of Pediatric and Adolescent Gynecology)

Prevalence of Sexual Abuse in Young Women With Endometriosis and in Well-Women Attending Gynaecological Hospitals for Health Maintenance Visits

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

This study aimed to examine the prevalence of sexual abuse (both childhood sexual abuse ‘CSA’, and unwanted adolescent sexual experiences ‘UASE') in young women with biopsy-confirmed endometriosis, as well as those attending well-women's clinics at gynaecological hospitals; and also to see if results are comparable between the two groups. (Source: Journal of Pediatric and Adolescent Gynecology)

Physiological and Behavioral Predictors of Amenorrhea in Normal-Weight Adolescents With Eating Disorders

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

This study compares clinical and behavioral characteristics of low and normal-weight amenorrheic adolescents with EDs in treatmentat presentation and at return of menses (ROM) or at the last clinic date (LCD) if menses did not return. (Source: Journal of Pediatric and Adolescent Gynecology)

Use of Contraceptive Implant (Implanon®) Among Chilean Adolescents

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

The objective of this abstract is to present the experience in the use of Implanon® in two Adolescent health centers in Santiago de Chile. (Source: Journal of Pediatric and Adolescent Gynecology)

Use of Oral Estrogen in Prepubertal Girl to Distinguish Between Retroareolar Nodule and Telarche

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

Breast nodules in children may occur due to presence of breast bud or other causes. The purpose of this study was to report the use of oral estrogen to distinguish retroareolar nodule (abnormal tissue) from normal breast tissue in a prepubertal girl. (Source: Journal of Pediatric and Adolescent Gynecology)

Treatment for partial vaginal agenesis, bicornuate uterus and rudimentary cervical

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

The lack of exteriorization of the menstrual flow after menarche causes cryptomenorrhea and blood accumulation in the vagina causes hematocolpus. The imaging diagnosis for hematosalpinx or hematometra, associated or not to hematocolpus has great importance. The test must be extended for other organs, especially of the urinary tract, for the research of associated malformations. The transperineal ultrassound must be taken in consideration for the differencial diagnosis for primary amenorrhea, when the access through the vagina is not possible. It might be used for the detection of cervical or vaginal atresia, and transverse vaginal septum. CT and RMI have great value evaluating specific images of the genital tract, showing the kind of annomaly present in the müllerian ducts. (Source: Journ...

Toxic Shock Syndrome, a Gynecological Source in an Adolescent: A Case Report