Journal of pediatric and adolescent gynecology最新文献_第6页

Effect of Lifestyle Modifications on Polycystic Ovary Syndrome in Predominantly Young Adults: A Systematic Review. 改变生活方式对以年轻人为主的多囊卵巢综合征的影响：系统回顾

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-11-21 DOI: 10.1016/j.jpag.2024.11.003

Jessica R Long, Megan Parker, Sanjay Jumani, Aisha Ahmed, Victoria Huynh, Veronica Gomez-Lobo

{"title":"Effect of Lifestyle Modifications on Polycystic Ovary Syndrome in Predominantly Young Adults: A Systematic Review.","authors":"Jessica R Long, Megan Parker, Sanjay Jumani, Aisha Ahmed, Victoria Huynh, Veronica Gomez-Lobo","doi":"10.1016/j.jpag.2024.11.003","DOIUrl":"10.1016/j.jpag.2024.11.003","url":null,"abstract":"Objective: To improve counseling and outcomes for the adolescent population (ages 10-24-years-old), with polycystic ovary syndrome we conducted a systematic review of randomized controlled trials with the primary objective to generate evidence-based recommendations for which lifestyle interventions with or without medications lead to the best outcomes.Methods: A literature search was conducted. Randomized controlled trials on lifestyle interventions with or without medications in the adolescent population were included. Nonrandomized trials, case-control studies, observational studies, and animal studies were excluded. Of 3,699 articles, 13 studies including 789 participants were included. Each included study was assessed for bias using the Cochrane Risk of Bias 2 tool. Due to significant interstudy heterogeneity, meta-analysis was infeasible; we synthesized results across lifestyle intervention/control types and outcome.Results: Thirteen studies met inclusion criteria. These studies offer mixed support for lifestyle interventions improving hyperandrogenism. There is some evidence that lifestyle interventions improve menstrual regularity, cardiometabolic health, and metabolic function. Almost all studies found reduced body mass index, adiposity among participants who completed combined exercise and diet, exercise only, and diet only interventions.Conclusions: The studies in this systematic review demonstrated that lifestyle interventions incorporating increased physical activity and/or healthy dietary choices show beneficial effects in the adolescent population aged ≥ 18-years-old with polycystic ovary syndrome. Medications may also play a key role in treating the disorder. More quality research is needed to identify specific lifestyle interventions that optimize the management of polycystic ovary syndrome amongst those aged 10-17-years-old as well.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Menstrual Suppression in Gender-Diverse Youth: What's Most Important to Patients? 不同性别青少年的月经抑制：什么对患者最重要？

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-11-20 DOI: 10.1016/j.jpag.2024.11.004

Heather L Stewart, Brittny E Manos, Gayathri Chelvakumar, Andrea E Bonny

{"title":"Menstrual Suppression in Gender-Diverse Youth: What's Most Important to Patients?","authors":"Heather L Stewart, Brittny E Manos, Gayathri Chelvakumar, Andrea E Bonny","doi":"10.1016/j.jpag.2024.11.004","DOIUrl":"10.1016/j.jpag.2024.11.004","url":null,"abstract":"Study objective: To explore reasons for menstrual suppression method choice among transgender and gender-diverse (TGD) youth at the time of method initiation DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of baseline data from a prospective cohort study of menstruating TGD youth (N = 55), aged 12-17 years, initiating a hormonal method for menstrual suppression in a gender health specialty clinic at a single site, quaternary hospital in the Midwest INTERVENTIONS AND MAIN OUTCOME MEASURES: Participants completed a baseline survey that included identifying the most important reason, as well as other important reasons, for menstrual suppression method selection.Results: The mean age was 14.9 (SD 1.5) years, and most participants identified as White (81.8%) and male or transgender male (90.9%). For menstrual suppression, participants chose progestin-only pills (43.6%), followed by depot medroxyprogesterone acetate injections (29.1%), levonorgestrel intrauterine devices (21.8%), and continuous combined oral contraceptive pills (5.5%). The 3 most reported reasons important to method choice were \"seemed like the best choice for me,\" \"ease of use,\" and \"I don't want anything with estrogen in it.\" \"Uncomfortable with a device in my body\" and \"not wanting a pelvic exam\" were also frequently indicated as important factors influencing method choice.Conclusion: Consistent with a patient-centered approach, comfort level with estrogen, implantable devices, and pelvic exam should be assessed early when discussing menstrual suppression options with TGD youth.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gonadal Tumors in Individuals with Turner Syndrome and Y-Chromosome Mosaicism: A Retrospective Multisite Study. 特纳综合征和 Y 染色体嵌合患者的性腺肿瘤：一项多站点回顾性研究

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-11-20 DOI: 10.1016/j.jpag.2024.11.005

Tazim Dowlut-McElroy, Jessica R Long, Allison C Mayhew, Ashli Lawson, Yeuyang Frances Fei, Anne K Smith, Roopa Kanakatti Shankar, Veronica Gomez-Lobo

{"title":"Gonadal Tumors in Individuals with Turner Syndrome and Y-Chromosome Mosaicism: A Retrospective Multisite Study.","authors":"Tazim Dowlut-McElroy, Jessica R Long, Allison C Mayhew, Ashli Lawson, Yeuyang Frances Fei, Anne K Smith, Roopa Kanakatti Shankar, Veronica Gomez-Lobo","doi":"10.1016/j.jpag.2024.11.005","DOIUrl":"10.1016/j.jpag.2024.11.005","url":null,"abstract":"Study objective: To evaluate the prevalence of germ cell tumors and the clinical monitoring practices for those who deferred prophylactic gonadectomy in a large North American cohort of individuals with Turner syndrome with Y-chromosome mosaicism (TS+Y).Method: A query of the medical records at multiple North American children's hospitals was done using ICD codes related to Turner Syndrome. A retrospective chart review was conducted on those patients between ages 0 to 30 years with Y-mosaicism.Results: The data of 57 participants were analyzed. Eight (25.8%, n = 31) ≥ 13 years underwent spontaneous thelarche. One (3.2%) had spontaneous menarche. Forty-seven (82.5%) had gonadectomy at a median age of 8 years (IQR 11.0, range <1 to 19 years). Sixteen (34%) had growth hormone therapy exposure prior to gonadectomy. Fourteen (29.8%) had gonadoblastoma. Two (4.3%) had dysgerminoma. Differences in age at gonadectomy, presence of the entire Y-chromosome, and exposure to growth hormone when comparing those with vs without gonadal tumor were not statistically significant. Gonadectomy had not been performed in 10 individuals, median age 6.5 (IQR 9.0, range <1 to 14 years). There was no consistency in the plan for ultrasound and/or tumor markers for follow-up.Conclusions: Our data shows a prevalence of 24.6% of gonadal tumors in individuals with TS +Y and a relatively low risk of malignant transformation (3.5%). Prior exposure to growth hormone was not predictive of the presence of gonadal tumor. Future cytogenetic studies are needed to better understand the factors involved in the development of gonadal tumors.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ovarian Tissue Cryopreservation in Pediatric Centers across the United States: Practice Patterns and Barriers. 全美儿科中心的卵巢组织冷冻：实践模式和障碍。

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-11-16 DOI: 10.1016/j.jpag.2024.11.002

Chelsea A Kebodeaux, Megan Pruett, Veronica Gomez-Lobo, Leena Nahata, Amanda J Saraf, Holly R Hoefgen

{"title":"Ovarian Tissue Cryopreservation in Pediatric Centers across the United States: Practice Patterns and Barriers.","authors":"Chelsea A Kebodeaux, Megan Pruett, Veronica Gomez-Lobo, Leena Nahata, Amanda J Saraf, Holly R Hoefgen","doi":"10.1016/j.jpag.2024.11.002","DOIUrl":"10.1016/j.jpag.2024.11.002","url":null,"abstract":"Study objective: To evaluate practice patterns in ovarian tissue cryopreservation (OTC) provision METHODS: US providers practicing or developing OTC in pediatric programs were invited to participate in a survey disseminated via the Oncofertility Consortium.Results: Twenty-seven programs representing a wide geographic area responded, largely representing academic institutions (85.2%). Of these, 21 (77.4%) performed OTC at their facility, most for oncology patients receiving gonadotoxic therapy, relapsed patients, and non-oncologic patients receiving gonadotoxic therapy (95.7%, 87.0%, and 82.6%, respectively). OTC procedures were most commonly performed by pediatric gynecology surgeons (71.4%) via laparoscopic oophorectomy (90.5%) using a heat-based method (55.0%) for dissection. Most centers used an outside compensated service (50%) or a reproductive endocrinology group (45%) for processing tissue. Many (13, 61.9%) performed OTC as standard of care, and 7 utilized an institutional review board for data collection. Of the 8 centers whose OTC programs were in the planning or early stages, frequently identified barriers were lack of priority within their medical team or institution (5/8), lack of protected time (3/8), and lack of funding (3/8).Conclusion: OTC is commonly offered to oncology patients receiving highly gonadotoxic therapy, with pediatric gynecologists frequently involved in counseling and performing OTC. Variability exists in offering OTC to other patient populations, as well as in research practices, surgical technique, and processing. Institutions continue to face barriers in offering OTC when necessary resources are not prioritized by leadership.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Co-occurrence of Unicornuate Uterus with Noncommunicating Functioning Rudimentary Horn and VACTERL Association-A Case Report. 单角子宫与无交流功能原始角和 VACTERL 相关性并存--病例报告。

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-11-12 DOI: 10.1016/j.jpag.2024.11.001

Jibladze Ana, Kristesashvili Jenaro, Asanidze Elene, Kutateladze Mariam, Chapidze Ia

{"title":"Co-occurrence of Unicornuate Uterus with Noncommunicating Functioning Rudimentary Horn and VACTERL Association-A Case Report.","authors":"Jibladze Ana, Kristesashvili Jenaro, Asanidze Elene, Kutateladze Mariam, Chapidze Ia","doi":"10.1016/j.jpag.2024.11.001","DOIUrl":"10.1016/j.jpag.2024.11.001","url":null,"abstract":"Introduction: The co-occurrence of a unicornuate uterus with a noncommunicating, functioning rudimentary horn and VACTERL association represents an extremely rare condition, with only 3 similar cases reported in the literature.Case: The patient, aged 12 years and 9 months, presented with pelvic pain and severe dysmenorrhea, which started shortly after her menarche at 12 years and 4 months. At birth, she exhibited 3 characteristic components of VACTERL association: bronchoesophageal fistula/esophageal atresia, anal atresia, and polydactyly. Magnetic resonance imaging revealed a unicornuate uterus with a noncommunicating, functioning rudimentary horn, and subsequently, VACTERL association was diagnosed. The rudimentary horn was laparoscopically excised 8 months post-menarche, resulting in symptom resolution.Conclusion: Health care providers should consider the possibility of genital anomalies when diagnosing VACTERL association, especially in cases presenting with severe early dysmenorrhea.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Adnexa with Preserved Flow to the Ovary: Could Isolated Tubal Torsion Be the Cause? 急性附件炎，卵巢血流通畅：孤立的输卵管扭转会是原因吗？

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-10-28 DOI: 10.1016/j.jpag.2024.10.004

Kathryn L McElhinney, Michela Carter, Suhail Zeineddin, Joseph Pitt Benjamin, Samantha L Ahle, Mehul V Raval, Seth D Goldstein, Timothy B Lautz, Julia E Grabowski, Erin E Rowell

{"title":"Acute Adnexa with Preserved Flow to the Ovary: Could Isolated Tubal Torsion Be the Cause?","authors":"Kathryn L McElhinney, Michela Carter, Suhail Zeineddin, Joseph Pitt Benjamin, Samantha L Ahle, Mehul V Raval, Seth D Goldstein, Timothy B Lautz, Julia E Grabowski, Erin E Rowell","doi":"10.1016/j.jpag.2024.10.004","DOIUrl":"10.1016/j.jpag.2024.10.004","url":null,"abstract":"Study objective: Isolated tubal torsion (ITT) is a surgical emergency that is less well characterized than ovarian torsion and presents with its own diagnostic challenges. We retrospectively examined patients with ITT and compared them to patients with ovarian torsion to better understand the unique features of this pathophysiologic process.Methods: The medical records of patients who were identified as having ITT or ovarian torsion intraoperatively between January 2019 and November 2022 were reviewed. Patient demographics, clinical documentation, diagnostic imaging reports, operative reports, and pathology results were collected.Results: A total of 82 patients met inclusion criteria of which 62 (75.6%) had ovarian torsion and 20 (24.4%) had ITT. Most patients (63.4%) underwent 2 or more imaging studies prior to the operating room. A diagnosis of torsion occurred more often on preoperative imaging for the ovarian torsion group (67.7% ovarian torsion vs 35.0% ITT, P = .01). Doppler flow to the ovary was expectedly absent in 65.9% of ovarian torsion patients but interestingly also absent in 25% of ITT patients (P = .01). Patients with ovarian torsion were more likely to have ovarian cysts (56.5% vs 10.0%, P < .001), while patients with ITT were significantly more likely to have a paratubal cyst (90.0% vs 38.7%, P < .001).Conclusion: ITT is a surgical emergency that poses a risk to future fertility. Ultrasound studies, including doppler, may not be as definitive in patients with ITT and early cross-sectional imaging should be considered. When there is a high clinical suspicion for ovarian torsion or ITT, there should be a low threshold for diagnostic laparoscopy.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adolescent Obstetrics: Who Cares for Pregnant Adolescents, and does PAG Include Obstetrics? 青少年产科：谁来照顾怀孕少女，PAG 是否包括产科？

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-10-28 DOI: 10.1016/j.jpag.2024.10.003

Paula J Adams Hillard MD (JPAG-Editor-In-Chief, She, Her, Hers)

引用次数: 0

Acknowledgement of Reviewers 2024 鸣谢审查员 2024

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-10-28 DOI: 10.1016/S1083-3188(24)00309-7

引用次数: 0

Oophorectomy Rates in Pediatric and Adolescent Patients with Adnexal Torsion in US Emergency Departments. 美国急诊科附件扭转小儿和青少年患者的输卵管切除率。

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-10-19 DOI: 10.1016/j.jpag.2024.10.002

Kirsten Jay Hartwick Das, Victoria Huynh, Stephanie Wang, Eduardo A Trujillo Rivera, Veronica Gomez Lobo

{"title":"Oophorectomy Rates in Pediatric and Adolescent Patients with Adnexal Torsion in US Emergency Departments.","authors":"Kirsten Jay Hartwick Das, Victoria Huynh, Stephanie Wang, Eduardo A Trujillo Rivera, Veronica Gomez Lobo","doi":"10.1016/j.jpag.2024.10.002","DOIUrl":"10.1016/j.jpag.2024.10.002","url":null,"abstract":"Objective: To evaluate oophorectomy rates in pediatric and adolescent patients who presented to a US emergency department with adnexal torsion METHODS: This study was a retrospective, cross-sectional analysis utilizing the National Emergency Department Sample data from 2016 to 2018. It included patients younger than 20 years old and of the female sex. International Classification of Diseases Version 10 and ICD 10 Procedure Coding System codes were utilized to define patients with adnexal torsion who underwent adnexal surgery. Descriptive statistics and multivariate logistic regression were utilized to compare oophorectomy rates according to patient demographic characteristics.Results: There were 263 sampled patients younger than 20 years old who presented to a US emergency department with a diagnosis of adnexal torsion and underwent adnexal surgery. Of them, 177 had an oophorectomy (67.3%); 85 had a minimally invasive surgery (48%). Compared with 10- to 14-year-olds, 15- to 19-year-olds were 2.54 times more likely to have an oophorectomy (95% CI, 1.42-4.71; Table 2).Conclusion: Despite standards for ovarian-sparing surgery since 2016 and data suggestive of safety since the 1990s, oophorectomy rates remain high in pediatric and adolescent patients with torsion who present to US emergency departments for care. Continued efforts should identify barriers to ovarian-sparing surgeries and better quantify specific clinical nuances when oophorectomies are performed.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Application of Hysteroscopy in the Treatment of Mullerian Adenosarcoma of the Cervix in an Adolescent Girl with 7 Years of Follow-up. 应用宫腔镜治疗一名少女的宫颈 Mullerian 腺肉瘤，随访 7 年。

IF 1.7 4区医学

Journal of pediatric and adolescent gynecology Pub Date : 2024-10-05 DOI: 10.1016/j.jpag.2024.09.009

Chengchao Du, Yue Xiang, Honggui Zhou, Yuhua Zeng, Rongyu Liu, Zhengyu Li

{"title":"Application of Hysteroscopy in the Treatment of Mullerian Adenosarcoma of the Cervix in an Adolescent Girl with 7 Years of Follow-up.","authors":"Chengchao Du, Yue Xiang, Honggui Zhou, Yuhua Zeng, Rongyu Liu, Zhengyu Li","doi":"10.1016/j.jpag.2024.09.009","DOIUrl":"10.1016/j.jpag.2024.09.009","url":null,"abstract":"Background: Mullerian adenosarcoma of the cervix is a rare biphasic tumor composed of a benign epithelial component and a malignant stromal component. Here, we report a rare case of Mullerian adenosarcoma of the cervix in an adolescent girl treated with hysteroscopic resection.Case presentation: A 16-year-old girl presented to the Affiliated Hospital of North Sichuan Medical College in April 2017 with a 1-year history of a painless vaginal mass. Ten hours before presentation, she had experienced rapid enlargement of the vaginal mass and mild vaginal bleeding. Sixteen hours after hospitalization, a mass measuring 14 × 10 × 4 cm was spontaneously expelled from the vagina. Histopathological examination of the mass confirmed a diagnosis of Mullerian adenosarcoma. On May 10, 2017, the patient underwent hysteroscopic resection of a cervical lesion and partial cervical resection. After nearly 7 years of follow-up, the tumor has not recurred.Conclusion: Mullerian adenosarcoma of the cervix is difficult to diagnose in adolescents. For young women affected by low-risk early-stage Mullerian adenosarcoma of the cervix, fertility-preserving treatment using hysteroscopic resection with robust follow-up is a reasonable management option.","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0