Journal of pediatric and adolescent gynecology最新文献

{"title":"7. Fertility Attitudes and Turner Syndrome","authors":"Lauren Roth ,&nbsp;Madeline Ross ,&nbsp;Anne-Marie Priebe ,&nbsp;Jacqueline Maher ,&nbsp;Veronica Gomez-Lobo ,&nbsp;Tazim Dowlut-McElroy","doi":"10.1016/j.jpag.2025.01.019","DOIUrl":"10.1016/j.jpag.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Primary Ovarian Insufficiency is the main reproductive effect in individuals with Turner syndrome (TS). Guidelines recommend disclosure of reduced fertility in individuals with TS and counseling inclusive of options for fertility preservation and family planning. Although ovarian tissue cryopreservation (OTC) and oocyte cryopreservation (OC) are offered to individuals with TS, live births rates remain unknown. Also unknown are the attitudes of adolescents and young adults with TS (AYA-TS) and their parents regarding future fertility. The objective of this study was to compare differences in attitudes between AYA-TS and their parents regarding future fertility and fertility preservation.</div></div><div><h3>Methods</h3><div>After IRB approval, we conducted two studies in sequence of 12- to 25-year-olds with TS and their parents. First, to maximize acceptability/applicability of the Fertility ConcepTS questionnaire, a two-staged Delphi Procedure was implemented during 3 focus groups with AYA-TS and parents to develop/ refine survey questions. Second, a finalized cross-sectional survey was distributed via a social media platform of the Turner Syndrome Global Alliance and during a multidisciplinary TS clinic. Statistical analysis was performed using SPSS. Statistical significance was defined as P &lt;.05.</div></div><div><h3>Results</h3><div>A total of 28 participants were included in the analysis. Sixteen (57%) were AYA-TS and 12 (43%) were parents (Table 1). The median age of AYA-TS was 17.5 (IQR 10.5) years and of parents was 48.0 (IQR 9.3) years. AYA-TS and parents did not differ in their interest in understanding the effects of TS on fertility and pregnancy, their interest building a family, their desire for awareness of the possibility of biological children, and their awareness that feelings about building a family might change (Table 2). AYA-TS and their parents differed in their consideration for adoption (p=.005), use of donor egg (p&lt;.001), use of a gestational carrier (p&lt;.001) and raising a child as a single parent (p=.002). While 6.3%, 18.8%, 37.5% and 31.3% of AYA-TS disagreed/strongly disagreed with adoption, donor egg, gestational carrier, and single parenthood, respectively, all parents agreed/strongly agreed. AYA-TS and their parents differed in their consideration for OC (p=.042), OTC (p=.021), and awareness of change in opportunity for OC/OTC (p=.002). Although all parents agreed/strongly agreed, 18.8%, 43.8%, and 18.5% of AYA-TS, respectively, disagreed/strongly disagreed with OC, OTC, and awareness of change in opportunity for OC/OTC.</div></div><div><h3>Conclusions</h3><div>AYA-TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA-TS alongside parent priorities.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 223"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520006","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}

{"title":"29. Early growth in first trimester scan in adolescent pregnancies: Results from a comparative cohort study.","authors":"Anastasia Vatopoulou ,&nbsp;Athina Samara ,&nbsp;Hara Skentou ,&nbsp;Katerina Dadouli ,&nbsp;Fani Gkrozou ,&nbsp;Antonios Garas ,&nbsp;Sotirios Sotiriou","doi":"10.1016/j.jpag.2025.01.062","DOIUrl":"10.1016/j.jpag.2025.01.062","url":null,"abstract":"<div><h3>Background</h3><div>In the present study we aim to assess the Crown-rump length (CRL) values measured in first trimester scan in adolescent pregnancies compared with the respective CRL values in adult pregnancies.</div></div><div><h3>Methods</h3><div>All consecutive pregnancies that underwent a first trimester ultrasound scan in two fetomaternal units in Greece during a twelve-year period were included in the present study. Ultrasound findings, demographic characteristics and medical records were retrospectively reviewed and recorded in an anonymous database. Cases with a maternal age&lt; 20 years were characterized as adolescent pregnancies, and all other cases were grouped as adult pregnancies (control group). All statistical analyses were performed using R (version 4.2.2) software packages. The Kolmogorov-Smirnov test was used to test the normality of the variables. Multivariate linear regression model and linear regression model were used to assess the association between the weighted for gestational age CRL and the independent variables. The results are represented as the effect size of the CRL. Statistical significance was set at P&lt; 0.05 (two tailed).</div></div><div><h3>Results</h3><div>In total, 3234 pregnancies were included in the present study; 325 were identified as adolescent pregnancies and 2909 were adult pregnancies. In multivariate analysis, CRL values were statistically significant lower (52.6 mm and 58.8 mm respectively) in adolescent pregnancies (p&lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Based on our results, pregnancy in adolescents has been associated, with statistically significant lower CRL measures compared with adult pregnancies. More prospective studies with larger cohort series are needed.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519869","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}

{"title":"3. A novel approach for controlled drainage of giant ovarian cysts through mini-laparotomy","authors":"Victoria Huynh ,&nbsp;Megan Sumida ,&nbsp;Kathleen McDowell Takahashi ,&nbsp;Ana Cisneros-Camacho ,&nbsp;Amitha Ganti ,&nbsp;Jennifer Bercaw-Pratt ,&nbsp;Sanjeev Vasudevan ,&nbsp;Olivia Winfrey","doi":"10.1016/j.jpag.2025.01.036","DOIUrl":"10.1016/j.jpag.2025.01.036","url":null,"abstract":"<div><h3>Background</h3><div>Large ovarian cysts in adolescents often present with low malignancy risk, prompting discussions about optimal surgical strategies. Minimally invasive methods aim to reduce complications, pain, hospitalization length, and scar appearance. As such, there is a desire to utilize less invasive approaches for the removal of large to giant masses. However, the advantages of minimally invasive surgery must be balanced with the risks of spillage, including malignant seeding and upstaging, chemical peritonitis, and recurrence. A few minimally invasive techniques have been proposed, including adherence of surgical gloves or bandages, controlled drainage with catheters, or use of the Alexis laparoscopic system. These techniques are poorly standardized and can fail to remain adherent during the case. We aim to describe a unique approach for the safe drainage of giant ovarian cysts.</div></div><div><h3>Case</h3><div>We present four adolescents with giant ovarian cysts (10-30 cm) and low pre-operative concern for malignancy, who proceeded to surgery for definitive treatment of the mass and associated symptoms. In all cases, a 4-6 cm midline infraumbilical incision was used. After obtaining adequate exposure of the mass, we adhered the rigid ring of a sterile 3 cm silo bag designed for ventral wall defects (Image 1) to a dried surface of the mass using sterile surgical glue. After ensuring the glue was dry, we trimmed off the closed distal end of the bag to allow access to the cyst surface. Through the constructed opening of the bag, the cyst was then entered sharply and contents were drained. In three cases, no spillage of contents was noted (Image 2) after multiple (1.9-5) liters were drained. In one case, there was minimal spillage noted due to malfunction of the suction device. In all but one case, the ovarian cortex was spared after cystectomy. In all cases, the bags remained firmly adherent to the ovarian cortex until the ovary and cyst could be exteriorized. There were no postoperative complications, and patients were discharged on postoperative days 0-2.</div></div><div><h3>Comments</h3><div>We introduce a safe, ovarian-sparing approach for extracorporeal drainage of giant adnexal cysts using a silo bag for spillage prevention through a mini-laparotomy incision. We believe this technique would be readily reproducible at many hospitals.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 230-231"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519878","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}

{"title":"37. Examining contraceptive knowledge, use and preferences of adolescents hospitalized with psychiatric disorders","authors":"Abigail Underwood ,&nbsp;Alicia Bunger ,&nbsp;Brittny Manos ,&nbsp;Elise Berlan","doi":"10.1016/j.jpag.2025.01.070","DOIUrl":"10.1016/j.jpag.2025.01.070","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with psychiatric symptoms have unique sexual health needs. These adolescents can have younger age at first sex, less frequent and/or inconsistent contraception use, and higher risk sexual behaviors than their peers without psychiatric symptoms. We examined contraception knowledge, use, and preferences among adolescents assigned female at birth (AFAB) hospitalized for psychiatric care, in addition to patient factors associated with contraceptive use.</div></div><div><h3>Methods</h3><div>Between November 2021 and March 2023, we recruited 451 adolescents AFAB ages 14-17 from 4 inpatient psychiatric units at a large children's hospital. As part of a larger study examining integration of contraception care in inpatient psychiatric settings, participants answered a survey about reproductive health, mental health, contraception knowledge, use, and preferences. The survey was administered via an electronic tablet using REDCap. Participants received a gift card incentive. Descriptive statistics included mean and standard deviation (SD) for continuous variables and frequencies and percentages for categorical variables. We used logistic regression to examine characteristics associated with contraception use. This study was approved by the institutional review board.</div></div><div><h3>Results</h3><div>Mean age was 16.1 (95% CI: 14.1-18.1); 65.4% identified as white and 9.3% identified as Hispanic. Most respondents reported knowledge about the contraceptive pill (98.9%), implant (76.1%), intrauterine device (IUD; 75.2%), and injectable (51.4%). Among the 44.6% of respondents that reported ever having intercourse, condoms (49.3%), withdrawal (29.4%) and contraceptive pills (23.4%) were the most common methods of contraception. Some (37.3%) reported using multiple methods and few (13.4%) reported using no method to prevent pregnancy. When asked to select their preferred method, participants chose contraceptive pills (38.6%) most, followed by the implant (16.0%) and IUD (11.3%). Age was significantly associated with contraceptive use (OR: 1.6; 95% confidence interval 1.3, 1.9; p&lt; 0.001) with older adolescents reporting higher odds of contraceptive use. Patient race, experience with sexual education, and insurance status were not significantly associated with contraceptive use.</div></div><div><h3>Conclusions</h3><div>Many adolescents hospitalized with psychiatric disorders are sexually active. Despite knowledge of contraceptives and preferences for more effective methods, their use of condoms and withdrawal may indicate their contraceptive needs are not being met. As adolescents face increasing rates of psychiatric symptoms, effort is recommended to ensure they have accessible sexual health services.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 247"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520015","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}

{"title":"Urethral Prolapse in the Course of Cystic Fibrosis: A Case Report","authors":"Anna Mordarska MD ,&nbsp;Karolina Kowalczyk MD, PhD ,&nbsp;Grzegorz Kudela MD, PhD ,&nbsp;Agnieszka Drosdzol-Cop MD, PhD","doi":"10.1016/j.jpag.2025.02.009","DOIUrl":"10.1016/j.jpag.2025.02.009","url":null,"abstract":"<div><div>This case report highlights a rare occurrence of urethral prolapse (UP) in a 7-year-old girl diagnosed with cystic fibrosis (CF). The patient displayed a protruding, swollen, and bleeding mass at the urinary orifice, accompanied by chronic constipation and a recent respiratory syncytial virus (RSV) infection. Cystovaginoscopy and circumferential excision were performed, leading to a successful outcome. Since the operation, the patient has been pain-free. The association between CF and UP underscores the need for heightened awareness among clinicians. The report focuses on recognizing and managing UP in pediatric CF patients to provide the best possible care.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 4","pages":"Pages 525-527"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537329","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}

{"title":"58. Is Reproductive Health Knowledge Protective Against Adolescent Pregnancy?","authors":"Wendy Jackson,&nbsp;Stephanie Stockburger,&nbsp;Mary Nunn,&nbsp;Madison Tackett,&nbsp;Rachel Cooper","doi":"10.1016/j.jpag.2025.01.091","DOIUrl":"10.1016/j.jpag.2025.01.091","url":null,"abstract":"<div><h3>Background</h3><div>Though teen pregnancy rates are declining, it remains a pressing issue. Data is limited on prevention of teen pregnancy but contraception and engagement with family and community have been identified as protective. A more universal intervention may have more equitable results. This study aims to identify if knowledge of female genitourinary (GU) structures is associated with nulliparity in adolescents, assessed by identification of anatomical structures on a digital image. Nulliparous adolescents will identify more female GU structures correctly than parous adolescents.</div></div><div><h3>Methods</h3><div>Subjects were adolescents (12-21 years old) and patients of University of Kentucky's Adolescent Medicine Clinic (AMC) or Young Parent Program Clinic (YPP). Participant's received a $20 check through the mail after completing a survey on an iPad with questions about demographics, educational background, and identification of GU structures. The survey was offered in English and Spanish. This was a cross-sectional study with purposive sampling. Sample size was 103, 55 from the AMC and 48 from YPP. Fisher's exact, χ2, and Shapiro-Wilk normality tests were used to compare answers between the two groups. Statistical significance was set at p≤0.05, all tests were two-sided. Respective clinic attendance was the predictive variable. The primary outcome was the number and percent of GU structures identified correctly. University of Kentucky Institutional Review Board approved this study (#81195).</div></div><div><h3>Results</h3><div>The participants in AMC scored significantly higher than YPP participants having a higher median overall correct responses (17 vs 13). The median percent correct was 89.5% in the AMC group and 68.4% in the YPP group (Table 2). Therefore, the hypothesis was accepted as true. Grade of reproductive education differed significantly between groups. In the AMC group 41.1% reported education in grades 6-9, 39% beyond high school, and 20.5% received no education compared to 58.5%, 29% and 12% in the YPP group, respectively (Table 1).</div></div><div><h3>Conclusions</h3><div>These results suggest reproductive health knowledge may serve as a protective variable against teen pregnancy. Though a majority of nulliparous teens reported receiving education after high school or no education at all. Interestingly, students are taught reproductive anatomy, but these concepts are not revisited at later grade levels (10-12) when adolescents may be more likely to engage in sexual activity. Despite health education being implemented in schools, the delivery and delivery timing may be ineffective. These conclusions are limited by the cross-sectional design of the study but strengthened by a racially and ethnically diverse sample population.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 256"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519705","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}

{"title":"15. Asking About Gender Identity in Pediatric and Adolescent Gynecology Clinic: Patient, Family and Provider Perspectives (The REFLECTIVE Study).","authors":"Madeline Ross ,&nbsp;H. Sema Baghaki ,&nbsp;Hannah Suffian ,&nbsp;Lauren Roth ,&nbsp;Jeanette Higgins ,&nbsp;Tazim Dowlut-McElroy","doi":"10.1016/j.jpag.2025.01.048","DOIUrl":"10.1016/j.jpag.2025.01.048","url":null,"abstract":"<div><h3>Background</h3><div>The provision of medical and psychosocial supports requires the identification of gender diverse individuals in health care settings. However, in primary care settings, some adolescents and parents expressed that gender identity screening (GIS) was offensive and clinicians expressed that GIS negatively affected their workflow. We sought to assess the acceptability and feasibility of GIS in Pediatric and Adolescent Gynecology (PAG) clinics of a large tertiary care children's hospital in the United States (US) Midwest.</div></div><div><h3>Methods</h3><div>A GIS survey developed in the US West Coast was modified with permission. After IRB approval, the anonymous single-site cross-sectional survey was administered to patients ages 12-25 years (AYA), parents of the 12-to-17-year-olds, and healthcare providers (HCPs) in our PAG clinics from July through September 2024. Statistical analysis was performed using SPSS version 29 (IBM Corp, Armonk, NY). Categorical variables were compared using the Chi-Square test /Fishers’ exact test or the Kruskal-Wallis test as appropriate. Continuous variables were compared using the ANOVA test. Statistical significance was defined as P &lt;.05.</div></div><div><h3>Results</h3><div>Fifty-six participants completed the survey (Table1). The majority were 12-to17-year-olds (27, 48.2%) and their parents (16, 28.6%). The mean (SD) age of 12-to-17-year-olds, 18-to-25-years-olds, parents of 12-to-17-year-olds, and healthcare providers (HCPs) was 14.9 (1.6), 18.4 (.79), 46.8 (15.4), and 46.8 (15.4) years, respectively. Most AYA did not find GIS confusing, uncomfortable, or offensive (Table 2). An equal number of parents did/did not want parental permission prior to GIS screening for their children. Although more parents than HCPs preferred informing parents about the content of GIS before AYA were asked questions, the difference was not significant (10, 62.5% vs. 2, 33.3%, p=.348). Most 18-to-25-years-olds (4, 57.1%), parents of 12-to-17-year-olds (12, 75%), and HCPs (6, 100%) did not think that GIS should be performed in front of parents as compared to only 9 (33.3%) of 12-to-17-year-olds (p=.005). There was a statistically significant difference between the preferred method of GIS with 16 (80%) of 12-to-17-year-olds and 6 (100%) of HCPs preferring direct communication between patient and provider as compared to most 18-to-25-years-olds (5, 71.4%) who preferred to enter GIS on a computer or tablet (p=.008). HCPs did not think that GIS affected their workflow.</div></div><div><h3>Conclusions</h3><div>AYA have differing preferences for the method of GIS in PAG clinics which HCPs should take into consideration.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 236"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520018","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}

{"title":"57. Intralesional Cidofovir: A Promising Treatment for Refractory Genital Warts in Pediatric Patients","authors":"Mónica Muñoz ,&nbsp;Carolina Pastene ,&nbsp;Jorge Morales ,&nbsp;Patricio Garcia ,&nbsp;eugenio Ramirez ,&nbsp;Nicole Bruneau ,&nbsp;monserrat Balanda ,&nbsp;Paula Muñoz ,&nbsp;Magdalena Castro ,&nbsp;Patricia Romero","doi":"10.1016/j.jpag.2025.01.090","DOIUrl":"10.1016/j.jpag.2025.01.090","url":null,"abstract":"<div><h3>Background</h3><div>Human Papillomavirus (HPV) infections can lead to genital warts (GW) in pediatric patients, posing significant treatment challenges. Currently, no FDA-approved therapies for GW exist for children under 12, and conventional treatments often result in high recurrence rates. Emerging evidence suggests that intralesional Cidofovir, a broad-spectrum antiviral, may be effective for refractory GW, as demonstrated in related conditions like recurrent laryngeal papillomatosis.</div></div><div><h3>Case</h3><div>We present a case of a 2-year-and-8-month-old girl with persistent GW, unresponsive to multiple treatment regimens, including podophyllotoxin, liquid nitrogen, imiquimod, and trichloroacetic acid. After 2 years of failed therapies and a persistent HPV genotype 11 infection, she underwent surgical excision with intralesional Cidofovir instillation. Two years post-treatment, the patient remained asymptomatic, with no recurrence of vulvar lesions, and a negative HPV PCR molecular test. Ethics Approval: This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna, in accordance with institutional guidelines.</div></div><div><h3>Comments</h3><div>This case underscores the potential of intralesional Cidofovir as a promising treatment for refractory GW in pediatric patients. Given the lack of approved therapies for children and the high recurrence rates associated with conventional treatments, Cidofovir may offer a new therapeutic option. Further studies are necessary to explore its efficacy as a first-line treatment for this vulnerable population. Financial Disclosure: The authors have no financial relationships relevant to this case to disclose.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 255-256"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519704","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}

{"title":"11. Knowledge and Awareness of Gender-Affirming Language Among Cisgender Adolescents and Their Guardians","authors":"Blair Lacy ,&nbsp;Jennifer Silk ,&nbsp;Christina Blanchard ,&nbsp;Janeen Arbuckle","doi":"10.1016/j.jpag.2025.01.023","DOIUrl":"10.1016/j.jpag.2025.01.023","url":null,"abstract":"<div><h3>Background</h3><div>Relative to their age-matched cisgender peers, transgender adolescents are more likely to suffer from mental health disorders and are at higher risk of self-harm and suicide. Social support, including use of gender-affirming language, from peers and family has been shown to be protective against these untoward mental health outcomes. We hypothesize that adolescents are more likely to positively relate to gender-affirming language than their guardian. We aim to assess the baseline knowledge and awareness of gender-affirming language among cisgender adolescents and their guardian and to examine the respective concordance or dissonance within the adolescent-guardian dyad.</div></div><div><h3>Methods</h3><div>Adolescents aged 14-21 seen in the Pediatric and Adolescent Gynecology clinic and their guardians were invited to participate in a voluntary survey regarding gender-affirming language. Adolescents ages 18-21 completed the survey without parental consent. No protected health information was gathered. Respondents completed the survey via a tablet with access to a RedCap-based questionnaire. Patients were asked to self-report their demographics including age, race, ethnicity, extent of education, and religion. Assuming a rate of acceptance of gender-affirming language among adolescents of 25% and 12.5% among guardians, 152 dyad respondents were needed to reach a power of 80%. Aggregate data from each generation and paired dyad data were analyzed using a Chi-square test for categorical data and student's t-test for continuous variables. Institutional IRB approval was obtained.</div></div><div><h3>Results</h3><div>Adolescent respondents were more likely to have pronouns they prefer (p&lt; 0.0001) and to recognize the importance of using a person's preferred pronouns (p=0.002) compared to adult respondents (Table 1). Adolescents were also more receptive to being asked their preferred pronouns, relative to the adult respondents (p=0.001). These questions were statistically significant when comparing adolescents to guardians in the paired dyad (Table 2). Self-reported level of education positively correlated with having preferred pronouns, being receptive to being asked their preferred pronouns, and utilizing a person's preferred pronouns (all p&lt; 0.05). Black race was also associated with having preferred pronouns (p=0.03).</div></div><div><h3>Conclusions</h3><div>Adolescents in this cohort demonstrated a greater awareness of the importance of gender-affirming language compared to adults. Limitations of this study are that it is single site and may not be representative of all patient populations. Surveys were also obtained with both adolescent and guardian present which may have influenced responses from either or both groups.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 226"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520010","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}

{"title":"13. Pain outcomes in adolescents with surgically confirmed endometriosis: A single-site retrospective cohort analysis","authors":"Madeline Ross ,&nbsp;Priyanka Suvarna ,&nbsp;Adam Booser ,&nbsp;Ashli Lawson","doi":"10.1016/j.jpag.2025.01.025","DOIUrl":"10.1016/j.jpag.2025.01.025","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a leading cause of dysmenorrhea globally, with two thirds of women reporting symptoms beginning in adolescence. Despite increased awareness of adolescent endometriosis, there is a paucity of data regarding best practice for surgical and medical management to improve pain outcomes. This study aims to analyze pain outcomes at one year post index surgery in adolescent patients with surgically diagnosed endometriosis.</div></div><div><h3>Methods</h3><div>This was a single-site, IRB-approved (STUDY2514), retrospective cohort study reviewing the care of natal females (12-22 years old) with surgically diagnosed endometriosis from 2009 to 2021. Baseline characteristics (demographics and preoperative clinical characteristics) were gathered from chart review. Surgery was classified as diagnostic laparoscopy only, versus ablation and/or excisional biopsy based on the surgeon's operative report. Subset analysis of post-op hormonal management with an intrauterine device (IUD) or leuprolide was performed. Changes in pain status (defined as resolved, improved, same, or worse) were gathered from the subjective documentation within gynecology appointment notes one year post-op. Statistical analysis was performed using independent t-tests and Chi-Squared/Fisher's Exact tests. Statistical significance was defined as p&lt; 0.05.</div></div><div><h3>Results</h3><div>53 patients were identified in this study period. Mean age at time of index surgery was 15 (SD 1.7) years old, and the majority had stage 1 endometriosis. 66% of patients reported their pain was improved one year after their index surgery. There was no significant difference in pain outcome at one year based on whether a patient had a diagnostic surgery only compared to ablation and/or excisional biopsy of endometriosis lesions (p=0.43). There was no significant difference in pain based on the type of hormonal regimen implemented after the index surgery, including those who had an IUD (p=0.76) or received a post-operative course of leuprolide (p=0.7). There was no statistically significant difference in pain outcomes regarding patient demographics, including age (p=0.34) and BMI (p=0.36). Regarding pre-operative clinical characteristics, patients who reported worse pain had seen one additional specialist prior to diagnosis (p=0.005).</div></div><div><h3>Conclusions</h3><div>Over two thirds of patients who underwent surgical management of endometriosis reported their pain had improved one year following surgery. Patients who had worsening pain, had seen more specialists prior to their index surgery. There was no difference in pain outcomes based on the type of surgical or hormonal intervention, or other baseline patient characteristics.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 227-228"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520020","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}