Journal of pediatric and adolescent gynecology最新文献_第9页

Exploring the Association Between Sleep Quality and Menstrual Abnormalities in Adolescents 探讨青少年睡眠质量与月经异常的关系。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-08-11 DOI: 10.1016/j.jpag.2025.08.001

Jessica N. Zhang BS , Grace K. Sarris BS , Daniela G. Fernandez-Bergnes BS , Tatiana M. Salloum BS , Katherine M. Hofmann BS , Edith Duncan BA , Judith S. Simms-Cendan MD

Study Objective

This study aims to assess the association between sleep quality and menstrual cycle abnormalities in adolescent females in the United States (U.S.). In doing so, we address the gap in adolescent menstrual health by providing baseline data that can inform future sleep and menstrual health interventions.

Methods

An Institutional Review Board (IRB) approved, anonymous survey was distributed to new patients at an academic pediatric gynecology clinic. Exclusion criteria included age over 21, hormonal contraceptive use, prior chemotherapy, or reproductive disorders. Electronic consent was obtained. The survey included the Pittsburgh Sleep Quality Index (PSQI), menstrual cycle data, comorbidities, and demographic data. Continuous variables were analyzed using linear regression and categorical variables using chi-square (with P < .05 considered significant). Odds ratios (OR) were reported with 95% confidence intervals (CI).

Results

Among the 100 analyzed responses, 84.0% identified as Hispanic, with over one-third (37.0%) being born outside of the U.S. Sixty-three had poor sleep quality (PSQI > 5), and 64 had abnormal menses. Higher PSQI scores were significantly associated with abnormal menses (OR = 1.15, CI = 1.01, 1.32, P = .04). Poor sleep correlated with prior anxiety (χ² = 6.84, P = .01) and depression diagnoses (χ² = 3.89, P = .05).

Conclusion

Our findings suggest a significant relationship between poor sleep quality and menstrual abnormalities, emphasizing the need to evaluate sleep when managing adolescent menstrual health. Future research is needed to gain deeper insights into the mechanistic link between the two and the broader implications of this association.

研究目的：本研究旨在评估美国青春期女性睡眠质量与月经周期异常之间的关系。在此过程中，我们通过提供基线数据来解决青少年月经健康方面的差距，这些数据可以为未来的睡眠和月经健康干预提供信息。方法：一个机构审查委员会（IRB）批准，匿名调查分发给新患者在学术儿科妇科诊所。排除标准包括年龄超过21岁、使用激素避孕药、既往化疗或生殖障碍。获得电子同意。该调查包括匹兹堡睡眠质量指数（PSQI）、月经周期数据、合并症和人口统计数据。连续变量采用线性回归分析，分类变量采用卡方分析（p < 0.05认为显著）。比值比（OR）以95%置信区间（CI）报告。结果：在100个分析的回复中，84.0%被确定为西班牙裔，超过三分之一（37.0%）出生在美国以外。63人睡眠质量差（PSQI bb0.5）， 64人月经异常。PSQI评分较高与月经异常有显著相关性（OR = 1.15,CI = 1.01,1.32,p = .04）。睡眠质量差与既往焦虑（χ² = 6.84,p = .01）和抑郁诊断（χ² = 3.89,p = .05）相关。结论：我们的研究结果表明，睡眠质量差与月经异常之间存在显著关系，强调在管理青少年月经健康时评估睡眠的必要性。未来的研究需要更深入地了解两者之间的机制联系以及这种联系的更广泛的含义。

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引用次数: 0

Retraction notice to A Novel Ovarian Reserve Monitoring Algorithm for Patients at Risk of Ovarian Injury from Gonadotoxic Therapy [Journal of Pediatric and Adolescent Gynecology 38 (2025) 219] 针对促性腺毒素治疗后卵巢损伤风险患者的卵巢储备监测新算法的撤回通知[j] .儿科学与青少年妇科杂志38(2025)219。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-08-09 DOI: 10.1016/j.jpag.2025.07.001

Guluzar Turan , Victoria Kennerley , Marie-Teresa Colbert , Marcy Hoath , Kamilah Abdur-Rashid , Mikayla Ecker , Mary Sammel , Leslie Appiah

引用次数: 0

Sex Hormone Replacement Therapy and Bleeding Patterns among Adolescents and Young Adult Females with Prader–Willi Syndrome 青少年和年轻成年女性普瑞德-威利综合征的性激素替代治疗和出血模式。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-08-07 DOI: 10.1016/j.jpag.2025.07.011

Julie C. Friedman MD , Kendra Hutchens PhD , Hava Starkman MD , Laurel E. Beaty MS , Mary D. Sammel ScD , Erin Finn MD , Leslie C. Appiah MD , Veronica I. Alaniz MD , Christine L. Chan MD

Introduction

Prader–Willi syndrome (PWS) is associated with hypogonadism. Limited data exist on guidelines for sex hormone replacement therapy (HRT) in females with PWS. We aimed to characterize pubertal timing, vaginal bleeding patterns, and HRT practices in adolescent and young adult females with PWS.

Methods

We conducted a retrospective review of females ages 5-25 years, diagnosed with PWS, at a single institution (01/2013-09/2023). Demographic and clinical data were abstracted from electronic medical records and analyzed with descriptive statistics. Patients were classified as having complete hypogonadotropic hypogonadism (HH) (luteinizing hormone [LH] <0.3 mIU/mL or lack of thelarche by 13 years) or partial hypogonadism (PH) (LH >0.3 mIU/mL and estradiol <20 pg/mL or amenorrhea by 15 years).

Results

Fifty-one patients met inclusion criteria; 21 (41%) were diagnosed with hypogonadism and were included in the final analysis. Of these patients, 8 (38.1%) had HH and 13 (61.9%) PH. Delayed puberty was diagnosed at a median of 13.5 years (range: 10-15) in the HH cohort and at 14.5 years (range: 13-18) in the PH cohort. Six patients (28.6%) reported spontaneous vaginal bleeding, median age of 14.0 (range: 10-16) years. Eighteen patients (85.7%) were prescribed HRT at a median of 14.0 (range: 12-21) years, of which 8 (44.4%) discontinued HRT, with half reporting breakthrough bleeding.

Discussion

Hypogonadism is common among adolescent and young adult females with PWS. We found high rates of HRT discontinuation primarily due to breakthrough bleeding. These findings highlight the need to tailor HRT regimens and identify strategies to encourage HRT adherence to optimize long-term outcomes.

简介：Prader-Willi综合征（PWS）与性腺功能减退有关。关于女性PWS患者的性激素替代疗法（HRT）的指南资料有限。我们的目的是描述青春期时间，阴道出血模式，以及青春期和年轻成年女性PWS患者的激素替代疗法。方法：我们对同一医院（2013年1月1日- 2023年9月）诊断为PWS的5 - 25岁女性进行回顾性研究。从电子病历中提取人口学和临床数据，并进行描述性统计分析。患者被分类为完全性促性腺功能低下（HH）（促黄体生成素[LH] 0.3 mIU/mL和雌二醇）。21例（41%）被诊断为性腺功能减退，并被纳入最终分析。其中，8人（38.1%）患有HH， 13人（61.9%）患有PH。在HH队列中，诊断为青春期延迟的中位年龄为13.5岁（范围：10-15），在PH队列中为14.5岁（范围：13-18）。6例患者（28.6%）报告自发性阴道出血，中位年龄14.0岁（范围：10-16岁）。18名患者（85.7%）在中位14.0（范围：12-21）岁时接受了HRT治疗，其中8名患者（44.4%）停止了HRT治疗，其中一半报告突破性出血。讨论：性腺功能减退在患有PWS的青少年和年轻成年女性中很常见。我们发现HRT停药的高发生率主要是由于突破性出血。这些发现强调了定制HRT方案和确定策略以鼓励HRT依从性以优化长期结果的必要性。

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引用次数: 0

Perception and Attitude towards Fertility and Fertility Preservation Options in Parents of Children With Turner Syndrome: A Qualitative Survey Study 特纳综合征患儿父母对生育和保留生育选择的认知和态度：一项定性调查研究。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-08-07 DOI: 10.1016/j.jpag.2025.07.008

Victoria H. Bustamante Velez MD , Tazim Dowlut-McElroy MD , Roopa Kanakatti Shankar MBBS, MS

Study Objective

Turner Syndrome (TS) is a genetic condition often characterized by ovarian insufficiency and infertility. Fertility preservation discussions are recommended early in care, but few studies have explored parental perspectives. Our objective was to assess the knowledge, perceptions, and attitudes regarding fertility and fertility preservation among parents of young children with TS.

Methods

An anonymous bilingual survey (English/Spanish) was completed by parents of children under 12 years with TS seen at a multidisciplinary clinic (April 2022-September 2023). Quantitative data were analyzed using descriptive statistics and Fisher’s exact test. Open-ended responses were analyzed using conventional content analysis to identify recurring themes.

Results

Forty-five parents (82% mothers) completed the survey, with 60% identifying as non-Hispanic white (NHW), 20% Hispanic, 11% Black, and 9% other. All were aware of the association of infertility with TS. NHW respondents were more likely to have a higher income, educational status and private insurance (P < .05). We found differences by race/ethnicity regarding the value of biological parenthood and openness to fertility preservation options as well as factors that contribute to these decisions. Cost emerged as a major consideration across all income groups. Despite high counseling rates (>90%), only 60% of parents recalled fertility discussions. Themes from open-ended responses emphasized cost, procedural risk/benefit, child autonomy, divergent opinions on timing of counseling, and a desire for more information.

Conclusion

This study highlights the varied perspectives and priorities voiced by parents of young children with TS regarding fertility preservation and can inform fertility counseling practices by providers.

研究目的：特纳综合征（TS）是一种以卵巢功能不全和不孕为特征的遗传病。建议在护理早期讨论保留生育能力，但很少有研究探讨父母的观点。我们的目的是评估患有TS的幼儿父母对生育和保留生育能力的知识、观念和态度。方法：对在多学科诊所就诊的12岁以下TS儿童的父母进行匿名双语调查（英语/西班牙语）（2022年4月- 2023年9月）。定量数据采用描述性统计和Fisher精确检验进行分析。使用传统的内容分析来分析开放式回答，以确定重复出现的主题。结果：45位家长（82%为母亲）完成了调查，其中60%为非西班牙裔白人（NHW）， 20%为西班牙裔，11%为黑人，9%为其他。所有人都知道不孕症与TS的关系。NHW受访者更有可能具有较高的收入，教育程度和私人保险（p90%），只有60%的父母回忆起生育讨论。开放式回答的主题强调了成本、程序风险/收益、儿童自主权、对咨询时间的不同意见以及对更多信息的渴望。结论：本研究突出了TS患儿父母对生育保留的不同观点和优先事项，可以为提供者的生育咨询实践提供信息。

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引用次数: 0

Giant Mitotically Active Cellular Fibroma of the Ovary in an Adolescent 青春期卵巢巨型有丝分裂活性细胞纤维瘤。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-08-06 DOI: 10.1016/j.jpag.2025.07.009

Bade Toker Kurtmen MD , Dilnur Sevinc MD , Gürdeniz Serin MD , Emine Burcu Cigsar Kuzu MD

Background

Mitotically active cellular fibroma (MACF) of the ovary is a rare stromal tumor, representing an intermediate entity between cellular fibromas and fibrosarcomas. While fibrosarcomas show aggressive clinical behavior with nuclear atypia and high mitotic counts, MACFs demonstrate increased mitotic activity without atypia. Pediatric cases are exceptionally uncommon.

Case

A 15-year-old adolescent presented with an adnexal mass. Surgical excision revealed a large ovarian tumor, confirmed histopathologically as a mitotically active cellular fibroma. The tumor was the largest and heaviest MACF reported in a pediatric patient to date. The postoperative course was uneventful, and the patient remains under follow-up without recurrence.

Conclusion

Ovarian MACF is a rare diagnosis in children and adolescents. Its recognition is important, as it carries intermediate malignant potential and may mimic fibrosarcoma. Accurate histopathological evaluation is essential to guide management and prevent overtreatment, while ensuring appropriate follow-up for early detection of recurrence.

本病例报告描述了一个15岁的青少年诊断为卵巢有丝分裂活性细胞纤维瘤（MACF）。细胞纤维瘤约占所有卵巢纤维瘤的10%。恶性纤维肉瘤具有侵袭性行为、高有丝分裂活性和核异型性的特点，macf被认为是中间肿瘤，在有丝分裂活性和恶性潜能方面介于细胞纤维瘤和纤维肉瘤之间。在此，我们提出的情况下，最大和最重的MACF肿块报告在儿科患者的文献。

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引用次数: 0

Thickness and Contractile Performance of Lateral Abdominal Muscles and Diaphragm in Young Adult and Nulliparous Women with Primary Dysmenorrhea 青年和未生育妇女原发性痛经的腹侧肌和横膈膜的厚度和收缩性能。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-07-25 DOI: 10.1016/j.jpag.2025.07.006

Seyda Toprak Celenay PT, PhD , Mehtap Balaban MD , Nida Lalecan PT, MSc , Gamze Yilmaz MD , Bilge Ipek Torun MD

Objective

To compare the thickness and contractile performance (CP) of the transversus abdominis (TrA) and internal oblique (IO) muscles and diaphragm in young adult and nulliparous women with and without primary dysmenorrhea (PD)

Methods

Women with (PD group, n = 30) and without PD (control group, n = 30) were included. Menstrual pain intensity using a 10-cm visual analog scale was assessed. TrA and IO thickness, both in a resting state and during the abdominal drawing-in maneuver (ADIM) with an 11 MHz linear probe, and diaphragm thickness at the end of maximum inspiration and expiration with a 1-6 MHz convex probe were measured. The percentage of change (PC) in both the thickness and CP of these muscles was calculated.

Results

The mean pain intensity of the PD group was 7.18 ± 1.22 cm. No difference was detected between groups in terms of the thickness of the TrA and IO muscles at rest and during ADIM and the thickness of the diaphragm at the end of deep inspiration and expiration (P > .05). The PC in the thickness and CP of the TrAright and TrAleft muscles was smaller in the PD group than in the control group (P < .05). No difference was found between groups in terms of the PC in the thickness and CP of IOright, IOleft, and diaphragm (P > .05).

Conclusion

The PC in the thickness and CP of the TrA muscle was smaller in women with PD than in women without PD. Therefore, it may be important to consider the decreased PC in the TrA muscle thickness with the ADIM as compared with the thickness at rest and to provide exercise training in the management of PD.

目的：比较青壮年和未产妇女伴与不伴原发性痛经（PD）的腹横肌（TrA）、内斜肌（IO）和膈肌的厚度和收缩性能（CP）。方法：将女性患者（PD组，n=30）和非PD组（对照组，n=30）分为两组。用10厘米视觉模拟量表评估月经疼痛强度。用11mhz线性探头测量静息状态和ADIM时的TrA和IO厚度，用1 ~ 6mhz凸探头测量最大吸气和呼气末的膈膜厚度。计算这些肌肉的厚度和CP的变化百分率（PC）。结果：PD组平均疼痛强度为7.18±1.22 cm。两组间静息和ADIM时TrA和IO肌厚度及深吸气和呼气结束时膈肌厚度均无差异（p < 0.05）。PD组右、左肌厚度PC和CP均低于对照组（p0.05）。结论：PD患者TrA肌厚度PC和CP均低于非PD患者。因此，与休息时的厚度相比，考虑ADIM时TrA肌肉厚度PC的减少，并在PD的管理中提供运动训练可能是重要的。

{"title":"Thickness and Contractile Performance of Lateral Abdominal Muscles and Diaphragm in Young Adult and Nulliparous Women with Primary Dysmenorrhea","authors":"Seyda Toprak Celenay PT, PhD , Mehtap Balaban MD , Nida Lalecan PT, MSc , Gamze Yilmaz MD , Bilge Ipek Torun MD","doi":"10.1016/j.jpag.2025.07.006","DOIUrl":"10.1016/j.jpag.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the thickness and contractile performance (CP) of the transversus abdominis (TrA) and internal oblique (IO) muscles and diaphragm in young adult and nulliparous women with and without primary dysmenorrhea (PD)</div></div><div><h3>Methods</h3><div>Women with (PD group, <em>n</em> = 30) and without PD (control group, <em>n</em> = 30) were included. Menstrual pain intensity using a 10-cm visual analog scale was assessed. TrA and IO thickness, both in a resting state and during the abdominal drawing-in maneuver (ADIM) with an 11 MHz linear probe, and diaphragm thickness at the end of maximum inspiration and expiration with a 1-6 MHz convex probe were measured. The percentage of change (PC) in both the thickness and CP of these muscles was calculated.</div></div><div><h3>Results</h3><div>The mean pain intensity of the PD group was 7.18 ± 1.22 cm. No difference was detected between groups in terms of the thickness of the TrA and IO muscles at rest and during ADIM and the thickness of the diaphragm at the end of deep inspiration and expiration (<em>P</em> > .05). The PC in the thickness and CP of the TrAright and TrAleft muscles was smaller in the PD group than in the control group (<em>P</em> < .05). No difference was found between groups in terms of the PC in the thickness and CP of IOright, IOleft, and diaphragm (<em>P</em> > .05).</div></div><div><h3>Conclusion</h3><div>The PC in the thickness and CP of the TrA muscle was smaller in women with PD than in women without PD. Therefore, it may be important to consider the decreased PC in the TrA muscle thickness with the ADIM as compared with the thickness at rest and to provide exercise training in the management of PD.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 687-692"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731899","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

Piloting a Birth Control Navigator Program for Adolescents and Young Adults in Indiana 在印第安纳州为青少年和年轻人试行生育控制领航员计划。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-07-24 DOI: 10.1016/j.jpag.2025.07.004

Tracey A. Wilkinson MD, MPH , Faith Coleman MAE, BS, CCHW , Natasha Chaku PhD , Jeffrey F. Peipert MD, PhD , Sarah E. Wiehe MD, MPH , Aaron E. Carroll MD, MS , J. Dennis Fortenberry MD, MS

Objectives

While increasing access to contraception is important, young people often face barriers to access prior to, within and after engagement with clinical care. The objective was to examine the feasibility of a pilot adolescent and young adult (AYA) birth control navigator program.

Methods

An online and in-person outreach strategy was launched in central Indiana starting in June 2023 to reach AYA outside of clinical settings and connect them to a trained navigator. Various communication platforms were used and a link to a validated contraception decision aid and barrier assessment was sent. After program support, AYA were invited to participate in a research cohort and complete a baseline survey.

Results

The outreach strategy included social media advertising with 4,327,614 impressions and 30,210 clicks and 17 social media ambassadors with 96 posts. Of the 30 people who connected with the navigator, 18 (60%) participated in the post-programmatic research cohort. Participants had a mean age of 17.3 years (range 15-19), 33% identified as African American and 61% reported being sexually active. Addressed barriers included appointment booking (73%), access confidential care (67%) and support around transportation (30%). All participants (100%) reported that the navigator listened to them, provided helpful information, and made them feel comfortable. However, only 8 (67%) reported high-quality person-centered care was experienced during clinical encounters.

Conclusions

A human-centered designed birth control navigator pilot program can provide AYA’s personalized assistance with overcoming barriers faced. Recruitment outside of clinical environments of AYA in a restrictive state was challenging, despite online outreach strategies.

目标：虽然增加获得避孕药具的机会很重要，但年轻人在接受临床护理之前、之中和之后往往面临获得避孕药具的障碍。目的是检查一个试点青少年和年轻成人（AYA）生育控制导航程序的可行性。方法：从2023年6月开始，在印第安纳州中部启动了一项在线和面对面的外展战略，以接触临床环境之外的AYA，并将他们与训练有素的导航员联系起来。使用了各种交流平台，并发送了有效避孕决策辅助和障碍评估的链接。在项目支持后，AYA被邀请参加一个研究队列并完成一项基线调查。结果：外联策略包括社交媒体广告，曝光量为4327614次，点击量为30210次，社交媒体大使17名，帖子96篇。在与导航器连接的30人中，有18人（60%）参加了项目后研究队列。参与者的平均年龄为17.3岁（15-19岁），33%为非裔美国人，61%为性活跃。解决的障碍包括预约（73%）、获得保密护理（67%）和交通支持（30%）。所有参与者（100%）报告说，导航器倾听他们，提供有用的信息，并使他们感到舒适。然而，只有8人（67%）报告在临床接触中经历了高质量的以人为本的护理。结论：以人为本设计的节育导航员试点项目可以为AYA克服所面临的障碍提供个性化的帮助。尽管有在线推广策略，但在限制状态下的AYA临床环境之外的招聘是具有挑战性的。

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引用次数: 0

Provision of Person-Centered Contraceptive Care to Adolescents: Results From a National Survey of Family Planning Clinics 向青少年提供以人为本的避孕护理：计划生育诊所全国调查结果。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-07-23 DOI: 10.1016/j.jpag.2025.07.005

Jennifer Mueller MPH , Tamrin A. Tchou BA , Madeleine Haas BA , Priscille Osias BA , Laura D. Lindberg PhD , Alicia VandeVusse PhD

Study Objective

Access to contraceptive services is essential for adolescents to pursue sexual and reproductive well-being. Publicly supported family planning clinics are critical reproductive health safety net providers and are an essential source of contraceptive care for adolescents. Contraceptive care for adolescents should be centered on their needs to ensure reproductive autonomy.

Methods

We fielded a national survey of publicly supported family planning clinics in the United States and conducted a cross-sectional analysis to understand the extent to which these clinics provide contraceptive services that are adolescent-centered. We also examined differences by clinic type and by state policies on adolescents’ consent to contraceptive care.

Results

Many clinics have taken strides to provide adolescent-centered contraceptive care, but gaps in this care still exist, particularly among federally qualified health centers.

Conclusion

Gaps in the provision of adolescent-centered care should be addressed to ensure that adolescent populations are receiving high quality contraceptive care.

研究目的：获得避孕服务对青少年追求性健康和生殖健康至关重要。公共支持的计划生育诊所是重要的生殖健康安全网提供者，是青少年避孕护理的重要来源。青少年避孕护理应以青少年的需要为中心，确保其生殖自主权。方法：我们对美国公共支持的计划生育诊所进行了全国性调查，并进行了横断面分析，以了解这些诊所提供以青少年为中心的避孕服务的程度。我们还检查了诊所类型和国家政策在青少年同意避孕护理方面的差异。结果：许多诊所在提供以青少年为中心的避孕护理方面取得了长足的进步，但这种护理仍然存在差距，特别是在联邦合格的卫生中心之间。结论：应解决在提供以青少年为中心的护理方面的差距，以确保青少年人群获得高质量的避孕护理。

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引用次数: 0

Pubertal Development as a Marker of Gonadal Neoplasm in 46XY Complete Gonadal Dysgenesis 青春期发育作为46XY完全性性腺发育不良患者性腺肿瘤的标志。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-07-17 DOI: 10.1016/j.jpag.2025.07.003

Cristina Villena MD , Carolyn D Brookhart MDMPH , Kirsten Das MD , Swetha Naroji MD , Veronica Gomez-Lobo MD

Background

46XY Complete Gonadal Dysgenesis (CGD), also known as Swyer syndrome, is characterized by nonfunctional streak gonads and an increased risk of gonadal neoplasms. While spontaneous puberty is not expected, hormonally active gonadal tumors can mimic normal puberty delaying diagnosis.

Case Presentation

We present two adolescents with 46XY CGD and tumor-driven puberty: a 16-year-old with spontaneous thelarche and adrenarche found to have a left gonadoblastoma, and a 14-year-old with spontaneous menarche and pelvic pain who was subsequently diagnosed with a dysgerminoma and a sex cord tumor with annular tubules (SCTAT).

Discussion & Conclusion

Puberty in patients with 46XY CGD should prompt suspicion for gonadal tumors. Early recognition and gonadectomy are crucial to prevent malignant transformation and optimize outcomes.

背景：46XY完全性性腺发育不良（CGD），也称为Swyer综合征，以性腺无功能条纹和性腺肿瘤风险增加为特征。虽然自发性的青春期是不可预期的，但激素活跃的性腺肿瘤可以模仿正常的青春期延迟诊断。病例介绍：我们报告了两名患有46XY CGD和肿瘤驱动性青春期的青少年：一名16岁的自发性卵巢囊肿和肾上腺增生伴左侧性腺母细胞瘤，一名14岁的自发性月经初潮和骨盆疼痛，被诊断为生殖细胞异常瘤和性索肿瘤伴环状小管（SCTAT）。讨论与结论：46XY型CGD患者的青春期应引起对性腺肿瘤的怀疑。早期识别和性腺切除术是预防恶性转化和优化结果的关键。

引用次数: 0

Rapid, Free-Breathing Non-Contrast MRI for Evaluation of Gynecologic Pathologies in the Emergency Department: A Retrospective Cohort Study 快速、自由呼吸非对比MRI对急诊科妇科病理的评估：一项回顾性队列研究。

IF 1.8 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of pediatric and adolescent gynecology

Pub Date : 2025-07-16 DOI: 10.1016/j.jpag.2025.07.002

Taryn Wassmer MD , Rama S. Ayyala MD , Katherine N. Epstein MD , Lesley Breech MD

Study Objective

Ultrasound (US) is the gold standard for evaluation of pelvic organs; however, achieving a full bladder can be challenging for children. Recent studies have shown excellent diagnostic performance of rapid MRI for acute appendicitis. As MRI becomes more prevalent in the evaluation of right lower quadrant pain, its use for gynecologic indications should be reevaluated.

Methods

A retrospective review of patients who had rapid MRI examinations performed in the emergency department (ED) for right lower quadrant pain at a single institution was conducted from August 2022 through August 2023. A time-matched control group with US evaluation for the same indication was obtained. A rapid, non-contrast three-sequence free-breathing MRI protocol was utilized.

Results

Of the 376 rapid MRI exams performed for the indication of right lower quadrant pain, 49 were noted to have gynecologic pathology identified. Of the 250 time-matched US controls, 51 were noted to have gynecologic pathology. The median MRI scan time (first image to last image) was 10 minutes. The total length of stay in the ED was significantly shorter in the rapid MRI group than in the controls (median 338 minutes vs 442 minutes, P < .05). Time to imaging diagnosis was significantly shorter in the rapid MRI group (201 minutes vs 285 minutes, P < .01). Time to gynecology consultation was not significantly different between groups (238 minutes vs 253 minutes, P = .66).

Conclusion

First-line, rapid MRI for evaluation of gynecologic processes can provide imaging diagnoses faster than using US and results in lower overall lengths of stay in the ED.

研究目的：超声（US）是评估盆腔器官的金标准，然而，对儿童来说，实现膀胱完整可能具有挑战性。近年来的研究表明，快速MRI对急性阑尾炎有很好的诊断效果。随着MRI在右下腹疼痛的评估中越来越普遍，它在妇科适应症中的应用应该重新评估。方法：回顾性分析2022年8月至2023年8月在同一机构急诊科因右下腹疼痛进行快速MRI检查的患者。获得了一个时间匹配的对照组，对相同的适应症进行了美国评估。采用快速、非对比三序列自由呼吸MRI方案。结果：在376例进行右下腹疼痛指征的快速MRI检查中，49例被发现有妇科病理。在250名时间匹配的美国对照中，51名被注意到有妇科病理。中位MRI扫描时间（第一张图像到最后一张图像）为10分钟。快速MRI组在急诊科的总住院时间明显短于对照组（中位数为338分钟，而对照组为442分钟）。结论：评价妇科过程的一线、快速MRI能比使用超声更快地提供影像学诊断，并能缩短急诊科的总住院时间。

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引用次数: 0