On November 7, 1994, a panel of infectious disease experts and adolescent medicine specialists gathered at the New York Academy of Sciences in New York City to discuss hepatitis B virus infection in ...adolescents. The purpose was to evaluate current approaches to prevention, share clinical experience, and build a consensus for strategies that would protect adolescents against the disease.
Common menstrual disorders Coupey, S M; Ahlstrom, P
The Pediatric clinics of North America,
06/1989, Letnik:
36, Številka:
3
Journal Article
Recenzirano
Clinically significant PMS is experienced infrequently by young girls and adolescents. It becomes more prevalent as women get older and is reported in up to 40 per cent of older women. To date, the ...etiology and underlying pathophysiologic mechanisms leading to symptoms of PMS have not been identified. Although multiple treatments are utilized, randomized double-blind crossover studies have failed to confirm the benefit of any one regimen. Most adolescents should be managed with reassurance and dietary and exercise modifications rather than with medication.
While issues of independence, sexuality, and identity are important for all adolescents, they become of particular concern for chronically ill teenagers because of the interaction of rapid ...developmental change in these areas with the stresses of chronic illness. Unlike adults with chronic diseases who often need to be rehabilitated so that they can function independently again and resume their sexual lives, adolescents need to be habilitated; they have no prior experience to draw on. Chronically ill children can be sheltered and protected from many stresses by their families, but as they move into the adolescent years, they must be allowed to gradually take over responsibility for their actions. This takes practice, and some mistakes are inevitable. In addition, teenagers with chronic illnesses deserve assistance to help them maximize their strengths and develop a positive self-identity. Health professionals have a significant role to play in encouraging independence, preventing adverse consequences of sexual behavior, and enhancing the self-image of their chronically ill adolescent patients.
Contraception Belkind, Uri; Coupey, Susan M; Godfrey, Emily M ...
Practical Pediatric and Adolescent Gynecology,
04/2013
Book Chapter
Barrier contraceptive methods act by preventing spermatozoa from reaching the upper female genital tract or, in combination with spermicides, killing them. These methods include the male and female ...condom, diaphragm, contraceptive sponge, Lea's shield, and cervical cap. They have no systemic side effects and are safe to use in most instances, but are not as effective for pregnancy prevention as hormonal methods. Because of their mechanism of action, adequate efficacy is only achieved by consistent use with each act of sexual intercourse, so counseling is of the utmost importance. Barrier methods may not be the right choice for young women with altered vaginal anatomy.
Combined hormonal oral contraception (pills that contain both estrogen and progestin), or COC, is one of the most popular birth control methods used by teenagers in the US. Because COCs are often considered synonymous with “birth control,” this method may be appealing to adolescents in its familiarity. In addition to protecting a teen from unwanted pregnancy, COCs can be used to treat medical conditions commonly seen in adolescence, such as dysmenorrhea, menstrual abnormalities, and acne. Providers can assist patients' success with COC use by using “quick start” to initiate pills, rather than waiting until the next menstruation; prescribing sufficient COCs for a full year; and avoiding unnecessary exams and tests. COCs can also be prescribed using an extended or continuous regimen. Clinical “tips” regarding talking to parents, and helping teens with daily pill taking and managing common side effects are highlighted throughout the chapter.
The transdermal patch, OrthoEvra
R
, and the transvaginal ring, NuvaRing
R
, are two forms of birth control aimed at simplifying the contraceptive regimen. Though both are similar to traditional oral contraceptive pills with regard to mechanism of action, side effects, and contraindications, there are unique differences that should be reviewed with adolescents prior to prescribing. In addition, counseling should be conducted with the adolescent and parent, if applicable, on options for method initiation, management, and follow‐up. This chapter reviews these two contractive methods and provides additional tips, precautions, and a review of scientific evidence to facilitate optimal implementation by the prescriber.
Intrauterine devices (IUDs) can be considered first‐line contraception for adolescents. IUDs require minimal patient adherence. The levonorgestrel IUD results in less bleeding and is often preferred by adolescents. IUDs do not result in greater pelvic inflammatory disease or sexually‐transmitted infections in adolescents. IUDs do not affect long‐term fertility. Premedication will reduce patient complaints with insertion.
Progestin‐only contraceptive methods (pills, the injectable, and the implant) represent safe and effective methods for adolescent contraception. As progestin‐only methods do not contain estrogen, there are few contraindications to their use. Consistent and correct use of contraceptive methods is often challenging for adolescents. When recommending and prescribing contraception for this age group, it is important to consider the most highly effective methods that require the lowest maintenance. Accordingly, nondaily methods (injectables and the implant) often represent preferred choices for adolescents. Injectable and implantable contraception is particularly important in the prevention of rapid repeat pregnancies in postpartum/postabortion adolescents.
Emergency contraception is a safe and effective option for young women seeking to prevent pregnancy in the event of unprotected intercourse from lack of contraceptive use, contraceptive failure, or forced intercourse. There are several dedicated products currently available in the US. Providers have a unique role in educating adolescents about the method's availability and facilitating its use.
Eight retarded teenage girls are presented whose cases highlight some of the considerations in pregnancy prevention for this population. Their mean age was 15.8 years, and 7 were considered to be ...educable (IQ 50-70) and 1 of borderline intelligence. Presenting complaints included pregnancy, sexual molestation, salpingitis, and a request for contraception in 2 patients each. Pelvic examination with no anesthesia was accomplished after multiple educational sessions in 7 patients. Contraceptive choices included an intrauterine device (2 patients), postcoital estrogen (1 patient), abstinence (1 patient), no contraception (2 patients). Of the 2 pregnant teenagers, 1 elected to continue and 1 to terminate. Unique considerations were the need for current information about consent, alternatives to sterilization, specific risks of contraception for the retarded with medical problems, and communication skills for eliciting sexual information and attitudes. The 8 patients presented reflect the special features posed by the interaction of adolescence, sexuality, and retardation.
Pulmonary embolism in adolescents Bernstein, D; Coupey, S; Schonberg, S K
American journal of diseases of children (1960),
07/1986, Letnik:
140, Številka:
7
Journal Article
To clarify the epidemiology of pulmonary embolism in adolescents, a retrospective analysis of adolescent admissions to a general hospital over a 15-year period was performed. Eighteen patients had 19 ...episodes of pulmonary embolism, an incidence of 78 per 100,000 hospitalized adolescents. There were twice as many female as male patients. Common complaints were chest pain, dyspnea, cough, and hemoptysis. Common findings were hypoxemia and deepvein thrombosis. Major risk factors were oral contraceptive use and elective abortion in 75% of female patients and trauma in 67% of male patients. Unlike its effect in adults, pulmonary embolism is rarely fatal in adolescents. Although clinical features in adolescents are similar to those in adults, there is a high incidence of both overdiagnosis and underdiagnosis. The early use of pulmonary arteriography in difficult diagnostic situations is suggested.
Panel discussion/morning Baldwin, W; Brooks-Gunn, J; Fullilove, M T ...
Bulletin of the New York Academy of Medicine (1925)
67, Številka:
6
Journal Article
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