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Berger K, Schiefner F, Rudolf M, Awiszus F, Junne F, Vogel M, Lohmann CH. Long-term effects of doping with anabolic steroids during adolescence on physical and mental health. ORTHOPADIE (HEIDELBERG, GERMANY) 2024:10.1007/s00132-024-04498-3. [PMID: 38653791 DOI: 10.1007/s00132-024-04498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Systematic doping programs like in the GDR were applied in adolescent competitive athletes to induce supramaximal athletic performance. The substances had adverse somatic and psychological effects. The psychological development of the young athletes was impaired and they suffered in adulthood from long-term effects and secondary diseases even years after the doping period. METHOD The study compared three groups: competitive athletes with doping (I), competitive athletes without doping (II) and persons with no sports activities (III). Somatic and psychological diseases were analyzed to identify the adverse effects of doping in the most vulnerable phase of development in adolescence. Participants were asked to supply a patient history and completed a questionnaire with standardized psychological tests. RESULTS The doping cohort had a higher rate of somatic diseases, psychological disorders and social and professional difficulties. The differences were gender-specific with males more often having impaired liver function, depression, tumors and difficulties associated with the workplace . The doping group reported more emotional and physical neglect during childhood. They proved to be less optimistic but more pessimistic, to perceive less social support and to be more depressive. The study identified less extraversion and more neuroticism. Posttraumatic stress disorder (PTSD) occurred in a small number of participants in the doping group. Doping is associated with psychiatric variables. Predictors were the subscale identifying feelings of the Toronto alexithymia scale 20 (TAS-20), the sense of coherence and the Beck depression inventory 2 (BDI-II) and the Beck depression inventory (BDI). CONCLUSION Physical and psychosocial effects imply correlation with the application of doping substances but might not only be due to the side effects of these substances but also caused by the system, which exerts great psychological pressure and stress during adolescence, a highly vulnerable phase.
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Affiliation(s)
- K Berger
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - F Schiefner
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - M Rudolf
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Awiszus
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Junne
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - M Vogel
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - C H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
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Taim BC, Lye J, Suppiah HT, Chan TW, Chia M, Clarke A. Menstrual cycle characteristics, perceived impact on performance, and barriers to communication: Perspectives of high-performance adolescent athletes in Singapore. Scand J Med Sci Sports 2024; 34:e14488. [PMID: 37682006 DOI: 10.1111/sms.14488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/09/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
The purpose of this study was to examine the menstrual cycle (MC) characteristics, explore the impact on performance, and identify barriers to and facilitators of MC-related communication among high-performance female adolescent athletes in Singapore. Ninety athletes (15.4 ± 1.8 years) from multiple sports completed an online questionnaire. Eighty-four athletes were postmenarcheal (menarcheal age 11.9 ± 1.3 years), including two who were using an oral contraceptive pill (OCP). Secondary amenorrhea, current or history of, was self-reported in 16% of athletes. Sixty-two percent and 67% of non-OCP athletes perceived that the MC affected their ability to train and compete, respectively. Athletes preferred speaking to a parent (85%) and a female figure (67%) about MC-related concerns. Through thematic analysis, three barriers to communication were constructed: (1) pervasive menstrual stigma, (2) constraints of the training environment, and (3) the low value placed on MC-related conversations. Two facilitators of communication were constructed: (1) respect athletes' individual experiences as menstruating girls and (2) foster a safe space for MC-related conversations. Findings demonstrated that menstrual irregularities are common in adolescent athletes and screening for MC disorders, particularly primary amenorrhea should be undertaken in this population, with clear support pathways for management including symptom mitigation. To support athletes in raising MC-related concerns when needed, structured communication pathways that consider individual preferences and involve a (female) point of contact should be established within the training environment. Improving menstrual health literacy among adolescent athletes before any misinformation or negative perceptions are firmly established may contribute to longevity in their athletic careers.
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Affiliation(s)
- Bernadette Cherianne Taim
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, Athlone, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, Athlone, Ireland
- National Youth Sports Institute, Singapore
| | - Jamie Lye
- National Youth Sports Institute, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Haresh T Suppiah
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | | | - Michael Chia
- Physical Education and Sports Science Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Anthea Clarke
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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3
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Taim BC, Ó Catháin C, Renard M, Elliott-Sale KJ, Madigan S, Ní Chéilleachair N. The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review. Sports Med 2023; 53:1963-1984. [PMID: 37389782 DOI: 10.1007/s40279-023-01871-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Menstrual cycle (MC) disorders and MC-related symptoms can have debilitating effects on the health and performance of female athletes. As the participation of women in sports continues to increase, understanding the prevalence of a range of MC disorders and MC-related symptoms may guide preventive strategies to protect the health and optimise the performance of female athletes. OBJECTIVE To examine the prevalence of MC disorders and MC-related symptoms among female athletes who are not using hormonal contraceptives and evaluate the assessment methods used to identify MC disorders and MC-related symptoms. METHODS This systematic review was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Six databases were searched until September 2022 for all original research that reported the prevalence of MC disorders and/or MC-related symptoms in athletes not using hormonal contraceptives, which included the definitions of the MC disorders examined, and the assessment methods used. MC disorders included amenorrhoea, anovulation, dysmenorrhoea, heavy menstrual bleeding (HMB), luteal phase deficiency (LPD), oligomenorrhoea, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). MC-related symptoms included any affective and physical symptoms related to the MC that do not cause significant personal, interpersonal or functional impairment. The prevalence data across eligible studies were combined, and all studies were qualitatively synthesised to evaluate the assessment methods and tools used to identify MC disorders and MC-related symptoms. The methodological quality of studies was assessed using a modified Downs and Black checklist. RESULTS Sixty studies involving 6380 athletes were included. A wide range of prevalence was observed for all types of MC disorders, with a dearth of data on anovulation and LPD. Based on pooled data, dysmenorrhoea (32.3%; range 7.8-85.6%) was the most prevalent MC disorder. Studies reporting MC-related symptoms mostly examined the premenstrual and menstruation phases, where affective symptoms appeared more prevalent than physical symptoms. A larger proportion of athletes reported symptoms during the initial days of menstruation compared with the premenstrual phase. MC disorders and MC-related symptoms were retrospectively assessed using self-report methods in 90.0% of studies. Most studies (76.7%) in this review were graded as moderate quality. DISCUSSION MC disorders and MC-related symptoms are commonplace among female athletes, warranting further research examining their impact on performance and preventive/management strategies to optimise athlete health. To increase the quality of future studies, researchers should adopt standardised definitions of MC disorders and assessment methods such as a combination of calendar counting, urinary ovulation tests and a mid-luteal phase serum progesterone measurement when assessing menstrual function. Similarly, standardised diagnostic criteria should be used when examining MC disorders such as HMB, PMS and PMDD. Practically, implementing prospective cycle monitoring that includes ovulation testing, mid-luteal blood sampling (where feasible) and symptom logging throughout the MC could support athletes and practitioners to promptly identify and manage MC disorders and/or MC-related symptoms. TRIAL REGISTRATION This review has been registered in the PROSPERO database (CRD42021268757).
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Affiliation(s)
- Bernadette Cherianne Taim
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland.
| | - Ciarán Ó Catháin
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Michèle Renard
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
| | - Kirsty Jayne Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, 99 Oxford Road, M1 7EL, Manchester, UK
| | - Sharon Madigan
- Sport Ireland Institute, Dublin, Ireland
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Niamh Ní Chéilleachair
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
- SHE Research Group, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, N37 HD68, Westmeath, Ireland
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Roux F, Chih HJ, Hendriks J, Burns S. Validation of an adolescent ovulatory menstrual health literacy questionnaire. Aust N Z J Obstet Gynaecol 2023; 63:588-593. [PMID: 37062904 DOI: 10.1111/ajo.13680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/25/2023] [Indexed: 04/18/2023]
Abstract
This study aimed to face validate an adolescent ovulatory menstrual (OM) health literacy questionnaire and to measure reliability by test-retest. Draft questions from an earlier content validation were adjusted following face validity assessment with 28 adolescents. Test-retest reliability was assessed by 89 adolescents aged 14-18 years over a two-week period across four school sites. The mean levels of agreement recorded from the critical, interactive and functional health literacy domains were 83%, 74% and 68%, respectively. There were 44 out of 74 items with Kappa statistics >0.40. The questionnaire has confirmed face validity and adequate test-retest reliability for assessing adolescent OM health literacy.
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Affiliation(s)
- Felicity Roux
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Hui Jun Chih
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jacqueline Hendriks
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Sharyn Burns
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
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Lebduska E, Beshear D, Spataro BM. Abnormal Uterine Bleeding. Med Clin North Am 2023; 107:235-246. [PMID: 36759094 DOI: 10.1016/j.mcna.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abnormal uterine bleeding is a common problem in premenopausal women and refers to uterine bleeding that is abnormal in frequency, duration, volume, and/or regularity. Etiologies can be classified using the PALM-COIEN system. Patients should receive a comprehensive history and physical with special attention to menstrual, sexual, and family history. Physical examination needs to include a pelvic examination with speculum and bimanual components. All patients need to have a pregnancy test and CBC with platelets. Treatments vary by etiology. Medical treatments include levonorgestrel intrauterine devices, oral contraceptive pills, and tranexamic acid. Surgical treatment options include endometrial ablation and hysterectomy.
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Affiliation(s)
- Elena Lebduska
- University of Colorado, UC Heath Internal Medicine - Lowry, 8111 E. Lowry boulevard, Denver, CO 80230, USA
| | - Deidra Beshear
- University of Kentucky, 1000 S. Limestone, Lexington, KY 40536, USA
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Anthuber S, Reinbach C. 12/w mit vaginaler Blutung seit ca. 6 Wochen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Brown N, Williams R, Bruinvels G, Piasecki J, Forrest LJ. Teachers' Perceptions and Experiences of Menstrual Cycle Education and Support in UK Schools. Front Glob Womens Health 2022; 3:827365. [PMID: 35237766 PMCID: PMC8882726 DOI: 10.3389/fgwh.2022.827365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was 2-fold, to (1) explore current education provision in UK schools including barriers to menstrual cycle education and (2) assess the perceived support teachers received to deliver menstrual cycle education. Seven hundred eighty-nine teachers (91% female) from all stages of school education in England (48%), Scotland (24%), Wales (22%) and Northern Ireland (6%) completed an online survey. The survey captured information on menstrual education in schools, teacher's knowledge and confidence of the menstrual cycle, support provided to teachers, provision of menstrual products in school and perceived impact of the menstrual cycle on young people in school. Four hundred ninety-eight teachers reported lessons were provided on the menstrual cycle (63%), predominantly delivered within personal, social, health and economic or science subjects, with over half of the lessons focusing on the biology (56%) or provision of menstrual products (40%) rather than lived experiences (14%). Teachers perceived the menstrual cycle affected participation in PE (88%), pupil confidence (88%), school attendance (82%) and attitude and behavior (82%). Overall, 80% of teachers felt receiving training would be beneficial to improve menstrual education. The results highlight education is scientifically focused, with less education on management of symptoms or lived experiences. Teachers also perceive the menstrual cycle to influence multiple aspects of school attendance and personal performance. There is a need to address menstrual education provided in schools across the UK to help empower girls to manage their menstrual cycle, preventing a negative impact on health and school performance.
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Affiliation(s)
- Natalie Brown
- School of Sport and Exercise Science, Swansea University, Swansea, United Kingdom
- Welsh Institute of Performance Science, School of Sport and Exercise Science, Swansea University, Swansea, United Kingdom
- *Correspondence: Natalie Brown
| | - Rebekah Williams
- Stride Active CIC (Community Interest Company), Hereford, United Kingdom
- Whitecross Hereford, Hereford, United Kingdom
| | - Georgie Bruinvels
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
- Orreco Ltd., Galway, Ireland
| | - Jessica Piasecki
- Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Laura J. Forrest
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
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8
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Mejías-Gil E, Garrido-Ardila EM, Montanero-Fernández J, Jiménez-Palomares M, Rodríguez-Mansilla J, González López-Arza MV. Kinesio Taping vs. Auricular Acupressure for the Personalised Treatment of Primary Dysmenorrhoea: A Pilot Randomized Controlled Trial. J Pers Med 2021; 11:jpm11080809. [PMID: 34442453 PMCID: PMC8398516 DOI: 10.3390/jpm11080809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Dysmenorrhoea is the medical term for menstrual pain. The World Health Organization estimates that up to 81% of women of childbearing age are affected by this condition, and it is one of the leading causes of absenteeism from work and school among women. Although there are pharmacological treatments available for menstrual-pain relief, they do not respond to all women's needs. Therefore, there is a need to study and develop non-pharmacological alternatives to broaden the individualised treatment options for dysmenorrhea. There are scarce studies published on non-pharmacological treatments, such as kinesio tape and auricular acupressure for the relief of menstrual pain, but the scientific evidence available suggest that these techniques may be beneficial in addressing this problem. The objective of this pilot study was to assess and compare the effectiveness of kinesio tape and auricular acupressure to decrease pain and drug intake in women with primary dysmenorrhoea. METHODS This was a double-blind randomized clinical controlled trial. The period of study was from September 2017 to August 2018. Women enrolled in the University of Extremadura and who had primary dysmenorrhoea were randomized to five groups: control (n = 23), kinesio tape (n = 23), placebo kinesio tape (n = 23), auricular acupressure (n = 23) and placebo auricular acupressure (n = 22). Measures were taken during the pretreatment phase (at four menstrual cycles), during the post-intervention phase (at four menstrual cycles) and during the follow-up phase (at the first and third menstrual cycles after the treatment was completed). The primary outcome measures were mean pain intensity, maximum pain intensity, number of painful days and dose of drug intake during menstruation, measured with the Visual Analogue Scale. The secondary outcome measures were the length of the cycle, the length of menstruation, the drug intake and the type of drug. RESULTS In all, 108 participants completed the study. The statistical analysis (MANOVA, ANOVA, t-paired and McNemar tests) showed that kinesio tape and auricular acupressure have a beneficial effect on pain relief (mean pain intensity, p < 0.001; maximum pain intensity, p < 0.001; number of painful days, p = 0.021; dose of drug intake, p < 0.001). In addition, once the treatments were withdrawn, the auricular-acupressure group maintained lower scores during the first follow-up cycle (p < 0.001). CONCLUSIONS Kinesio tape and auricular acupressure decrease pain and drug intake in women with primary dysmenorrhoea. The changes in the auricular-acupressure group seemed to last longer. The results suggest that these techniques could be used as complementary personalised therapies to the pharmacological treatment and not as a substitution.
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Affiliation(s)
- Elena Mejías-Gil
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
| | - Elisa María Garrido-Ardila
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
- Correspondence: (E.M.G.-A.); (J.R.-M.)
| | - Jesús Montanero-Fernández
- Mathematics Department, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain;
| | - María Jiménez-Palomares
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
| | - Juan Rodríguez-Mansilla
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
- Correspondence: (E.M.G.-A.); (J.R.-M.)
| | - María Victoria González López-Arza
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
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Kakiuchi T, Azusa K. Imperforate hymen due to vaginal hypoplasia presenting as an acute abdomen in adolescence. Clin Case Rep 2021; 9:e04450. [PMID: 34295482 PMCID: PMC8287312 DOI: 10.1002/ccr3.4450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/30/2021] [Accepted: 05/22/2021] [Indexed: 12/01/2022] Open
Abstract
Imperforate hymen due to vaginal hypoplasia is a rare condition but should be considered as a differential diagnosis in patients complaining of abdominal pain.
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Affiliation(s)
| | - Koji Azusa
- Department of Pediatrics, Faculty of MedicineSaga UniversitySagaJapan
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10
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Sun L, Wang C, Shen Q, Zhu L, Gao H, Chen D, Jin L. Psychiatric referral is required in children with vaginal foreign body injury: A case-control study from China. J Pediatr Nurs 2020; 53:e195-e198. [PMID: 32349881 DOI: 10.1016/j.pedn.2020.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The rate of vaginal foreign body (VFB) injury has been increasing in recent years. VFB will cause vaginal inflammation, injury and negative psychological impacts in girls. Our study aimed to elucidate the need of psychological referral in children with VFB. DESIGN AND METHODS A case-control study was performed. A total of 67 girls who visited the clinic due to vaginal foreign bodies were recruited. A questionnaire and Family environment scale-Chinese version (FES-CV) and social anxiety scale for children-Chinese version (SASC-CV) were completed by parents and children. Demographic information, parenting pattern, girls' social anxiety status, and their daily life trajectory and outdoor activities were collected. RESULTS The mean age of the 67 girls with VFB was 6.6 ± 2.1 years with a range of 2 years10 months-13 years. The 72 girls of the control group were age-matched with the patients. Scorings in two subscales of FES-CV including family cohesion, emotion expression were significantly lower in the VFB group than those in the control group (7.2 ± 2.4 vs. 7.9 ± 1.7, p < 0.05; 5.2 ± 1.6 vs. 6.5 ± 1.3, p < 0.001). Social anxiety level was higher in the VFB group comparing with the control group. Shorter time of outdoor activities (t = 3.205, p = 0.002) and significantly longer screen time were in the VFB group (t = 5.74, p < 0.001). CONCLUSIONS AND IMPLICATIONS The occurrence of VFB was associated with parenting patterns and social anxiety level. Psychiatric referral is required in children with VFB.
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Affiliation(s)
- Liying Sun
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
| | - Chaoqun Wang
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qiuxiang Shen
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Li Zhu
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Huihui Gao
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Dandan Chen
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lingling Jin
- Department of Pediatrics and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Yaşa C, Güngör Uğurlucan F. Approach to Abnormal Uterine Bleeding in Adolescents. J Clin Res Pediatr Endocrinol 2020; 12:1-6. [PMID: 32041387 PMCID: PMC7053441 DOI: 10.4274/jcrpe.galenos.2019.2019.s0200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 01/15/2023] Open
Abstract
This article reviews the current understanding and management of abnormal uterine bleeding (AUB) in adolescents. It is hoped that this review will provide readers with an approach to the evaluation and treatment of mild to severe uterine bleeding. AUB is a common problem which has significantly adverse effects on an affected adolescent’s quality of life. The most common underlying condition in AUB in adolescence is anovulation. During the evaluation, pregnancy, trauma and sexually transmitted diseases must be ruled out, regardless of history. It should be kept in mind that AUB during this period may be the first sign of underlying bleeding disorders. Although observation is sufficient in the mild form of AUB, at the other end of the spectrum life-threatening bleeding may necessitate the use of high doses of combined oral contraceptives, intravenous estrogen and/or interventional procedures.
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Affiliation(s)
- Cenk Yaşa
- İstanbul University, İstanbul Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Funda Güngör Uğurlucan
- İstanbul University, İstanbul Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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12
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Roux F, Burns S, Chih HJ, Hendriks J. Developing and trialling a school-based ovulatory-menstrual health literacy programme for adolescent girls: a quasi-experimental mixed-method protocol. BMJ Open 2019; 9:e023582. [PMID: 30898802 PMCID: PMC6528013 DOI: 10.1136/bmjopen-2018-023582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION A review of international and Australian school-based resources suggests that teaching of the ovulatory-menstrual (OM) cycle is predominantly couched in biology. A whole-person framework that integrates spiritual, intellectual, social and emotional dimensions with the physical changes of the OM cycle is needed to facilitate adolescent OM health literacy. This paper describes the protocol for a study that aims to develop and trial an intervention for adolescent girls aged 13-16 years that enhances positive attitudes towards OM health coupled with developing skills to monitor and self-report OM health. These skills aim to foster acceptance of the OM cycle as a 'vital sign' and facilitate confident communication of common OM disturbances (namely, dysmenorrhoea, abnormal uterine bleeding and premenstrual syndrome), which are known to impact school and social activities. METHODS AND ANALYSIS Phase I will comprise a Delphi panel of women's health specialists, public health professionals and curriculum consultants and focus groups with adolescent girls, teachers and school healthcare professionals. This will inform the development of an intervention to facilitate OM health literacy. The Delphi panel will also inform the development of a valid and reliable questionnaire to evaluate OM health literacy. Phase II will trial the intervention with a convenience sample of at least 175 adolescent girls from one single-sex school. The mixed-method evaluation of the intervention will include a pre-intervention and post-intervention questionnaire. One-on-one interviews with teachers and school healthcare professionals will expand the understanding of the barriers, enablers and suitability of implementation of the intervention in a school-based setting. Finally, focus groups with purposively selected trial participants will further refine the intervention. ETHICS AND DISSEMINATION The study findings will be disseminated through local community seminars, conferences, peer-review articles and media channels where appropriate. The Curtin University of Human Research Ethics Committee has approved this study (approval HRE2018-0101). This project is registered with the 'Australian and New Zealand Clinical Trials Registry'. TRIAL REGISTRATION NUMBER ACTRN12619000031167; Pre-results.
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Affiliation(s)
- Felicity Roux
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Sharyn Burns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - HuiJun Jun Chih
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jacqueline Hendriks
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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McShane M, Perucho J, Olsakowski M, Gaughan JP, Brown RT, Feldman-Winter L. Menstrual History-Taking at Annual Well Visits for Adolescent Girls. J Pediatr Adolesc Gynecol 2018; 31:566-570. [PMID: 30081084 DOI: 10.1016/j.jpag.2018.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/23/2018] [Accepted: 07/29/2018] [Indexed: 10/28/2022]
Abstract
STUDY OBJECTIVE To determine the rates at which primary care providers elicit menstrual histories from adolescent girls at well visits. DESIGN Retrospective chart review. SETTING The departments of Pediatrics, Adolescent Medicine, and Family Medicine of Cooper University Healthcare from January 1, 2010 to June 1, 2016. PARTICIPANTS Women aged 12-21 years who were seen for a well visit in the described setting. INTERVENTIONS None. MAIN OUTCOME MEASURES We searched physician well visit notes for documentation of the following aspects of menstrual history: menarche, last menstrual period, usual length of cycle, and the presence or absence of associated symptoms (such as pain and cramps). The presence or absence of each aspect was recorded in a binary fashion in a deidentified data set. RESULTS A total of 954 unique charts were analyzed: 415 from Adolescent Medicine, 289 from Family Medicine, and 250 from General Pediatrics at Cooper University Healthcare. Adolescent Medicine was 6.44 times more likely to take a complete menstrual history than Family Medicine (P < .0001) and 5.80 times more likely than Pediatrics (P < .0001). There was no statistical difference between Pediatrics and Family Medicine (odds ratio, 0.55; P = .3150). CONCLUSION Menstrual history-taking is often incomplete and can vary between departments, even within the same institution. These results indicate opportunities to raise awareness about the importance of a complete menstrual history and to develop quality improvement initiatives to increase documentation of the complete menstrual history.
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Affiliation(s)
- Mark McShane
- Cooper Medical School of Rowan University, Camden, New Jersey.
| | - James Perucho
- Cooper Medical School of Rowan University, Camden, New Jersey
| | | | - John P Gaughan
- Cooper Research Institute, Cooper University Healthcare, Camden, New Jersey
| | - Robert T Brown
- Department of Pediatrics, Division of Adolescent Medicine, Cooper University Healthcare, Camden, New Jersey
| | - Lori Feldman-Winter
- Department of Pediatrics, Division of Adolescent Medicine, Cooper University Healthcare, Camden, New Jersey
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Gynecologic and Obstetric Consequences of Obesity in Adolescent Girls. J Pediatr Adolesc Gynecol 2017; 30:156-168. [PMID: 26915924 DOI: 10.1016/j.jpag.2016.02.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/06/2016] [Accepted: 02/15/2016] [Indexed: 12/24/2022]
Abstract
In the past few decades, there has been an overwhelming increase in childhood and adolescent obesity worldwide. Besides the well recognized cardiometabolic complications and other physical conditions associated with obesity, during adolescence, it causes psychological and social distress in a period of life that is already sensitive for a girl. This in turn increases their risk of low self-esteem and depression. Furthermore, obesity diminishes health-related quality of life and years of life. Overweight and obese teenagers are more likely to have gynecologic and obstetric complications, during adolescence and also later in life. Consequences of obese and overweight childhood and adolescence include sexual maturation and reproductive dysfunction, alterations in menstruation, dysmenorrhea, risky sexual behavior, and inefficient use of contraception, polycystic ovary syndrome, bone density abnormalities, macromastia, and an increased risk of breast and endometrial cancer. Obese adolescents are at greater risk of pregnancy and perinatal complications, such as preeclampsia, gestational hypertension and preeclampsia, gestational diabetes mellitus, primary cesarean delivery, and induction of labor, to mention a few. Evidence shows that infants born to obese teenagers are also more likely to have complications including preterm or post-term delivery, small-for-gestational age newborns, macrosomia, meconium aspiration, respiratory distress, and even stillbirth, among others. This comprehensive review focuses on the gynecological and obstetric consequences of obesity in adolescent girls.
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Abstract
Menstrual disorders and abnormal uterine bleeding are common concerns of young women. Complaints include menses that are: too painful (dysmenorrhea), absent or occur irregularly (amenorrhea or oligoamenorrhea), or prolonged and heavy (menorrhagia, or excessive uterine bleeding). In providing optimal reproductive care, the medical provider must be able to distinguish between normal developmental patterns or symptoms requiring education and reassurance from pathologic conditions requiring prompt assessment and treatment. This article discusses the normal menstrual patterns seen in adolescent females and provides an evaluation and management approach to primary and secondary dysmenorrhea.
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Rodionova EY, Chutko LS, Krotin PN. [Psychoautonomic disorders in girls with impaired development of menstrual cycle]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 116:30-33. [PMID: 28139622 DOI: 10.17116/jnevro201611612130-33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To study clinical and psychological features of autonomic dysfunction in girls with impaired development of menstrual functions (algodismenorrhea type) and to assess the efficacy of noofen in the treatment of these disorders. MATERIAL AND METHODS Seventy-five women, aged 14-17 years, with algomenorrhea and manifestations of autonomic dysfunction were examined. Conventional neurological and psychological examinations, a 10-cm Visual Analogue Scale (VAS), the Multidimensional Fatigue Inventory (MFI-20), A.M. Vein questionnaire, Kerdo index, Spielberger-Khanin questionnaire were used. Patients were divided into two groups. Patients of the first group (n=45) received noofen in dosage 500 mg daily. Patients of the second group (n=30) received cyclic vitamin therapy (1 tablet from the 1st to the 14th day of the menstrual cycle and 2 tablets from the 14th to the 28th day). The duration of the study was 30 days. RESULTS AND CONCLUSION Girls with algodismenorrhea had various neurological complaints and autonomic disorders. They were characterized by higher anxiety and asthenia as well. The efficacy of noofen in treatment of this disease was shown.
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Affiliation(s)
- E Yu Rodionova
- N. Bekhtereva Institute of Human Brain, Russian Academy of Sciences, St. Petersburg, Russia ,Consultative and diagnostic Centre for the children 'Yuventa', St. Petersburg, Russia
| | - L S Chutko
- N. Bekhtereva Institute of Human Brain, Russian Academy of Sciences, St. Petersburg, Russia ,Consultative and diagnostic Centre for the children 'Yuventa', St. Petersburg, Russia
| | - P N Krotin
- N. Bekhtereva Institute of Human Brain, Russian Academy of Sciences, St. Petersburg, Russia ,Consultative and diagnostic Centre for the children 'Yuventa', St. Petersburg, Russia
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