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1.
Deirdre A. Quinn Stephanie J. Mitchell Amy Lewin 《Journal of pediatric and adolescent gynecology》2017,30(1):35-40
Study Objective
To explore interpersonal factors associated with maintaining contraceptive use over time among urban, African American teen mothers.Design
Longitudinal study, 2011-2015.Setting
Six pediatric primary care sites in the same city, all of which primarily serve urban, low-income, African American families.Participants
Teen mothers accessing health services for their child at one of the six study sites.Interventions
The current study was a secondary data analysis of data that were collected as part of a patient-centered medical home model intervention, that compared a group of teen mothers and their children who were participants in the intervention with mother-child dyads who were enrolled in standard community-based pediatric primary care. Structured interviews were conducted with teen mothers at baseline/enrollment, when their children were, on average, 3 months old, and again 12 months later.Main Outcome Measures
Maintenance of contraceptive use over time.Results
Teen mothers who perceived any tangible support from their own mothers were significantly less likely to maintain contraceptive use over time (adjusted odds ratio [AOR] = .27). However, teens who perceived any emotional support from their own mothers were nearly four times more likely to maintain contraceptive use (AOR = 3.74). Teens who lived with their own mothers were more than 5 times more likely to maintain contraceptive use over time (AOR = 5.49).Conclusion
To better understand contraceptive discontinuation and thus to prevent repeat pregnancies among teen mothers, it might be necessary to further examine the role of support relationships in teen mothers' contraceptive decision-making. Secondary pregnancy prevention programs should include key support persons. 相似文献2.
Kristl Tomlin Tammalynn Bambulas Maureen Sutton Vanessa Pazdernik Dean V. Coonrod 《Journal of pediatric and adolescent gynecology》2017,30(3):383-388
Study Objective
To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group.Design and Setting
Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care.Participants
Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014.Interventions
Motivational interviewing within the context of adolescent-focused prenatal care.Main Outcome Measures
Rates of uptake of LARC within 13 postpartum weeks.Results
The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95% CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable contraceptive device.Conclusion
Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared with standard prenatal care. 相似文献3.
Jong-Wook Seo Dong-Yun Lee Byung-Koo Yoon DooSeok Choi 《Journal of pediatric and adolescent gynecology》2017,30(2):223-227
Study Objective
Young age is a possible risk factor of endometriosis recurrence after surgery. However, the efficacy of postoperative medical treatment has not been well addressed in adolescents. The purpose of this study was to evaluate whether postoperative medical treatment is as effective in adolescents as it is in adults in the prevention of endometrioma recurrence.Design
A retrospective cohort study.Setting
Samsung Medical Center, Seoul, Korea.Participants
This study included 176 reproductive-aged women who underwent conservative laparoscopic surgery for pathology-confirmed endometrioma. Women were classified into 2 groups according to age: adolescents (20 years of age and younger, n = 34; group I) and reproductive-aged women (aged 25-35 years, n = 142; group II).Interventions
The same surgeon performed all of the surgeries for uniformity. Postoperatively, patients were treated monthly with a gonadotropin-releasing hormone agonist depot for 3-6 months, followed by cyclic oral contraceptives.Main Outcome Measures
Endometrioma recurrence was determined using ultrasonography. The recurrence rate of endometrioma was compared between the 2 groups.Results
During the treatment period (median, 41.0 months; range, 6-159 months), recurrence was noted in 8 cases (4.5%). After adjusting for confounders (which were statistically different between the groups), the cumulative proportion of recurrent endometriomas after 60 months was comparable between the 2 groups (5.3% in group I and 8.5% in group II).Conclusion
Long-term postoperative medical treatment with cyclic oral contraceptives after a gonadotropin-releasing hormone agonist can be as effective in adolescents as it is in adults in the prevention of endometrioma recurrence. 相似文献4.
Katharine K. Sznajder Kathy S. Tomaszewski Anne E. Burke Maria Trent 《Journal of pediatric and adolescent gynecology》2017,30(1):53-57
Study Objective
To estimate long-acting reversible contraception (LARC) discontinuation rates. Secondary aims were to determine risk factors for discontinuation, describe reasons for discontinuation, evaluate complications related to placement, and estimate pregnancy rates after discontinuation.Design
We conducted a retrospective cohort study of LARC method use through review of electronic medical record data.Setting
Our program is housed in an academic primary care pediatric and adolescent clinic in Baltimore, Maryland.Participants
One hundred sixty women ages 12-24 years who received an intrauterine device or subdermal implant through our program between December 10, 2012 and December 10, 2015.Interventions
None.Main Outcome Measures
Complications from LARC insertion, device discontinuation, reason(s) for discontinuation, pregnancies resulting from device failure, and occurrence of pregnancy within 1 year of discontinuation.Results
Thirty-five women discontinued their LARC method. The 6-month discontinuation rate was 11.3% and the 12-month rate was 21.9%. Discontinuation was associated with history of sexually transmitted infection (adjusted hazard ratio, 3.21; 95% confidence interval, 1.49-6.90). The most common reason for discontinuation was bleeding for the implant and expulsion for the intrauterine device.Conclusion
Our results support the safety and low discontinuation rates of LARC provision to adolescents and young adult women in a primary care setting. Discontinuation rates and reasons are consistent with those described in other studies. 相似文献5.
Soo Yoon Lee Mi-La Kim Seok Ju Seong Jong Woon Bae Yeon Jean Cho 《Journal of pediatric and adolescent gynecology》2017,30(2):228-233
Study Objective
To evaluate the cumulative recurrence rate of endometriomas after a laparoscopic endometriotic cyst enucleation in adolescents and to find the factors associated with recurrence.Design
A multicenter retrospective cohort study.Setting
Three university hospitals.Participants
One hundred five patients surgically treated with laparoscopic enucleation of endometriotic cysts younger than 20 years of age were selected.Interventions
None.Main Outcome Measures
Endometrioma recurrence was considered when transvaginal or transrectal sonography indicated a cystic mass with a diameter of 20 mm or greater. Recurrence rate of endometrioma and median time to recurrence were evaluated.Results
In total, 105 patients were followed for 47.3 (±44.3) months (range, 3-161 months). Seventeen patients (16.2%) experienced recurrence after the first-line surgery and 8 patients (7%) underwent a second surgery. The median time to recurrence was 53.0 (±8.5) months (range, 8-111 months). Using Kaplan-Meier method, the cumulative recurrence rates of endometrioma per patient at 24, 36, 60, and 96 months after the first-line surgery were 6.4%, 10%, 19.9% and 30.9%, respectively. Surgical characteristics, such as the diameter of the cyst, revised American Society for Reproductive Medicine stage, unilateral or bilateral involvement, and coexistence of deep endometriosis were not associated with recurrence in this age group.Conclusion
Although the short-term recurrence rate in adolescents after first-line surgery is relatively low, the recurrence rate appears to be higher according to the follow-up duration. Long-term and continuous follow-up is needed for patients who have undergone surgical treatment for endometriosis in the adolescent period. 相似文献6.
Lindsay M. Kissane Rose Calixte Bogdan Grigorescu Peter Finamore Anthony Vintzileos 《Journal of minimally invasive gynecology》2017,24(1):36-40
Study Objective
To compare operative time in women stratified by body mass index (BMI) undergoing robotic-assisted sacrocolpopexy (RASC). Secondary objectives included characterizing perioperative characteristics and reoperation rates.Design
Retrospective cohort study (Canadian Task Force classification II-2).Setting
University-affiliated teaching hospital.Patients
One hundred seventy-nine consecutive patients who underwent RASC by a single surgeon from 2009 through 2013.Interventions
RASC.Measurements and Main Results
Of 179 patients, 61 (34%) were normal weight (BMI < 25 kg/m2), 72 (40%) were overweight (BMI 25–30 kg/m2), and 46 (26%) were obese (BMI ≥ 30 kg/m2). Overweight patients were significantly older, more parous, more frequently postmenopausal, and more frequently underwent concomitant salpingo-oophorectomy. Median operative times were 202, 206, and 216 minutes in the normal-weight, overweight, and obese groups, respectively (p = .53).Conclusion
Obese women undergoing RASC have similar operative time and procedural characteristics as normal-weight and overweight patients. Longer term outcomes are needed to ensure comparable surgical and anatomic success. 相似文献7.
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9.
Hyun-Woong Cho Yu-Jin Koo Kyung-Jin Min Jin-Hwa Hong Jae-Kwan Lee 《Journal of pediatric and adolescent gynecology》2017,30(2):203-208
Study Objective
To evaluate the incidence of pelvic inflammatory disease (PID) in virgin women and investigate the clinical characteristics of the patients.Design
Retrospective chart review and literature review.Setting
Tertiary academic center.Participants
Virgin women who were confirmed to have PID via surgery from 2002 to 2014.Interventions
None.Main Outcome Measures
The evaluation of medicosurgical history, clinical progress, surgical record, and pathologic reports.Results
Of 122 patients diagnosed with PID via surgery, 5 women were virgins (4.1%). The median age was 21 years (range, 14-24 years), and all patients presented with abdominal pain. The median diameter of the pelvic abscess pocket on preoperative imaging was 4.5 cm (range, 2.6-15 cm). Only 1 case was preoperatively diagnosed as a tubo-ovarian abscess; the others were expected to be benign ovarian tumors, such as endometrioma and dermoid cysts. No possible source of infection was identified for any patient, except 1 who had a history of an appendectomy because of a ruptured appendix. The results of the histopathological analysis of the excisional biopsy performed during surgery in 4 cases were consistent with acute suppurative inflammation. After postoperative antibiotic use, the conditions of all patients stabilized, and they were discharged from the hospital on median postoperative day 9.Conclusion
PID in virgin women is rare, but it should be considered in all women with abdominal pain, regardless of sexual history. 相似文献10.
11.
Elizabeth J. Geller Emma Babb Andrea G. Nackley Denniz Zolnoun 《Journal of minimally invasive gynecology》2017,24(1):67-73
Study Objective
Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation.Design
Retrospective study (Canadian Task Force classification II-2).Setting
Single university hospital.Patients
Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence.Interventions
Telephone interviews to assess pain, sexual function, and general health.Measurements and Main Results
Pain was measured by the McGill Short-Form Pain Questionnaire for somatic pain, Neuropathic Pain Symptom Inventory for neuropathic pain, Pennebaker Inventory of Limbic Languidness for somatization, and Female Sexual Function Index (FSFI) for sexual health and dyspareunia. General health was assessed with the 12-item Short-Form Health Survey. Among 160 enrolled women, mean time since surgery was 20.8 ± 10.5 months, mean age was 62.1 ± 11.2 years, 93.8% were white, 86.3% were postmenopausal, and 3.1% were tobacco users. Types of mesh included midurethral sling for stress incontinence (78.8%), abdominal/robotic sacrocolpopexy (35.7%), transvaginal for prolapse (6.3%), and perirectal for fecal incontinence (1.9%), with 23.8% concomitant mesh implants for both prolapse and incontinence. Our main outcome, self-reported pelvic pain at least 1 year after surgery, was 15.6%. Women reporting pain were younger, with fibromyalgia, worse physical health, higher somatization, and lower surgery satisfaction (all p < .05). Current pelvic pain correlated with early postoperative pelvic pain (p < .001), fibromyalgia (p = .002), worse physical health (p = .003), and somatization (p = .003). Sexual function was suboptimal (mean FSFI, 16.2 ± 12.1). Only 54.0% were sexually active, with 19.0% of those reporting dyspareunia.Conclusion
One in 6 women reported de novo pelvic pain after pelvic mesh implant surgery, with decreased sexual function. Risk factors included younger age, fibromyalgia, early postoperative pain, poorer physical health, and somatization. Understanding risk factors for pelvic pain after mesh implantation may improve patient selection. 相似文献12.
Jennie Lee Yoost Rachael Whitley Starcher Rebecca Ann King-Mallory Nafeeza Hussain Christina Ann Hensley Todd William Gress 《Journal of pediatric and adolescent gynecology》2017,30(2):193-198
Study Objective
To evaluate the use of telehealth to teach reproductive health to rural areas with high rates of teen pregnancy.Design
Prospective cohort study.Setting
Two high schools in rural West Virginia.Participants
High school female students who attended telehealth sessions.Interventions
Teleconferencing equipment connected rural high schools to a distal academic institution. Telehealth sessions included reproductive health and life skills topics. Demographic information, session pre- and post-tests, and 6- month assessment was obtained.Main Outcome Measures
Reproductive health knowledge, behavior, and self-efficacy were assessed at intervention and at 6 months, along with Likert scale evaluation of telehealth as an educational tool.Results
Fifty-five students participated in the program with an average age of 16.14 (SD 1.24) years. Only 20% (10/50) of subjects' mothers and 12% (6/50) of subjects' fathers had achieved education beyond high school, and 20% (10/50) of subject's mothers had experienced teen pregnancies (age 18 or younger). Sexual activity was reported among 52% (26/50) of subjects, 4/50 (8%) reported desire to become pregnant within the next year, and 4/50 (8%) reported already pregnant. Thirty-seven students completed the 6-month follow-up survey. Reported condom use increased from 20% (10/50) at baseline to 40% (15/37) at 6 months (P = .04) and hormonal contraception use increased from 22% (11/50) to 38% (14/37) (P = .12). Report of human papillomavirus vaccination increased from 38% (10/26) to 70% (26/37) (P = .001) among all subjects. At 6 months, 91.8% (34/37) reported the use of telehealth was “very effective” as a means to teach the material.Conclusions
Telehealth is an effective tool to teach reproductive health to rural areas. 相似文献13.
Jenny Sadler Gallagher Henry A. Feldman Natalie A. Stokes Marc R. Laufer Mark D. Hornstein Catherine M. Gordon Amy D. DiVasta 《Journal of pediatric and adolescent gynecology》2017,30(2):215-222
Study Objective
Use of gonadotropin-releasing hormone agonists (GnRHa) to treat endometriosis can cause mood and vasomotor side effects. “Add-back therapy,” the combination of low-dose hormones, limits side effects but research is limited to adults. We sought to characterize quality of life (QOL) before treatment and to compare an add-back regimen of norethindrone acetate (NA) with conjugated estrogens (CEE) to NA alone for preventing side effects of GnRHa therapy in female adolescents with endometriosis.Design
Twelve-month double-blind, placebo-controlled trial.Setting
Pediatric Gynecology clinic in Boston, Massachusetts.Participants
Fifty female adolescents (aged 15-22 years) with surgically confirmed endometriosis initiating treatment with GnRHa.Interventions
Subjects were randomized to: NA (5 mg/d) with CEE (0.625 mg/d) or NA (5 mg/d) with placebo. All subjects received leuprolide acetate depot every 3 months.Main Outcome Measures
The Short Form-36 v2 Health Survey, Beck Depression Inventory II, and Menopause Rating Scale were completed at repeated intervals.Results
At baseline, subjects reported impaired physical health-related QOL compared with national norms (all P < .0001). Over 12 months, these Short Form-36 v2 scores improved (all P < .05). Subjects receiving NA with CEE showed greater improvements in the pain, vitality, and physical health subscales (Pbetween groups < .05) than those receiving NA alone, as well as better physical functioning (P < .05). There were no changes in depression or menopause-like symptoms in either group.Conclusion
Female adolescents with endometriosis initiating GnRHa therapy have impaired QOL. Treatment with GnRHa combined with add-back therapy led to improved QOL, with no worsening of mood or menopausal side effects. NA with CEE was superior to NA alone for improving physical health-related QOL. 相似文献14.
Philippe Laberge Jose Garza-Leal Claude Fortin David Grainger Delbert Johns Royce T. Adkins James Presthus Cindy Basinski Monte Swarup Richard Gimpelson Nicholas Leyland John Thiel Micah Harris Pamela E. Burnett Gene F. Ray 《Journal of minimally invasive gynecology》2017,24(1):124-132
Study Objective
To assess the safety and effectiveness of the Minerva Endometrial Ablation System for the treatment of heavy menstrual bleeding in premenopausal women.Design
Multicenter, randomized, controlled, international study (Canadian Task Force classification I).Setting
Thirteen academic and private medical centers.Patients
Premenopausal women (n = 153) suffering from heavy menstrual bleeding (PALM-COEIN: E, O).Intervention
Patients were treated using the Minerva Endometrial Ablation System or rollerball ablation.Measurements and Main Results
At 1-year post-treatment, study success (alkaline hematin ≤80 mL) was observed in 93.1% of Minerva subjects and 80.4% of rollerball subjects with amenorrhea reported by 71.6% and 49% of subjects, respectively. The mean procedure times were 3.1 minutes for Minerva and 17.2 minutes for rollerball. There were no intraoperative adverse events and/or complications reported.Conclusion
The results of this multicenter randomized controlled trial demonstrate that at the 12-month follow-up, the Minerva procedure produces statistically significantly higher rates of success, amenorrhea, and patient satisfaction as well as a shorter procedure time when compared with the historic criterion standard of rollerball ablation. Safety results were excellent and similar for both procedures. 相似文献15.
María I. Tomás-Rodríguez Antonio Palazón-Bru Damian R.J. Martínez-St John Felipe Navarro-Cremades José V. Toledo-Marhuenda Vicente F. Gil-Guillén 《Journal of pediatric and adolescent gynecology》2017,30(2):199-202
Study Objective
In the literature about primary dysmenorrhea (PD), either a pain gradient has been studied just in women with PD or pain was assessed as a binary variable (presence or absence). Accordingly, we decided to carry out a study in young women to determine possible factors associated with intense pain.Design
A cross-sectional observational study.Setting
A Spanish University in 2016.Participants
A total of 306 women, aged 18-30 years.Interventions
A questionnaire was filled in by the participants to assess associated factors with dysmenorrhoea.Main Outcome Measures
Our outcome measure was the Andersch and Milsom scale (grade from 0 to 3). Definition: grade 0 (menstruation is not painful and daily activity is unaffected), grade 1 (menstruation is painful but seldom inhibits normal activity, analgesics are seldom required, and mild pain), grade 2 (daily activity affected, analgesics required and give relief so that absence from work or school is unusual, and moderate pain), and grade 3 (activity clearly inhibited, poor effect of analgesics, vegetative symptoms and severe pain).Results
Factors significantly associated with more extreme pain: a higher menstrual flow (odds ratio [OR], 2.11; P < .001), a worse quality of life (OR, 0.97; P < .001) and use of medication for PD (OR, 8.22; P < .001).Conclusion
We determined factors associated with extreme pain in PD in a novel way. Further studies are required to corroborate our results. 相似文献16.
Huihua Cai Lin Qiao KaiJing Song Yuanli He 《Journal of minimally invasive gynecology》2017,24(1):80-88
Study Objective
To compare the efficacy of an oxidized, regenerated cellulose adhesion barrier (Interceed; Ethicon, Somerville, NJ) combined with an intrauterine device (IUD) versus an IUD alone for preventing adhesion recurrence following hysteroscopic adhesiolysis for moderate to severe intrauterine adhesions (IUAs).Design
Retrospective case series (Canadian Task Force classification III).Setting
Tertiary care teaching hospital.Patients
Patients undergoing treatment for moderate to severe IUAs. The severity of IUA was determined based on the American Fertility Society scoring system (mild, moderate, or severe).Interventions
All cases of hysteroscopic adhesiolysis were reviewed.Measurements and Results
Seventy-six women with moderate to severe IUAs treated between March 2009 and August 2015 were included. After hysteroscopic adhesiolysis, 35 patients were treated with an IUD alone (group 1), and 41 patients were treated with Interceed plus an IUD (group 2). A second hysteroscopy was performed in all cases three months after the initial hysteroscopy and both groups achieved significant reduction in adhesion scores and grade, especially in group 2 (scores, p < .001; grade, p = .039). Compared with group 1, menstruation dysfunction, pregnancy rate, and live birth rate in group 2 improved with no statistical difference (menstruation improvement, p = .764; pregnancy rate, p = .310; live birth rate, p = .068). However, an adhesion-free uterine cavity was regained significantly owing to the fewer operations in group 2 compared with group 1 (median, 3 vs 4; p = .001). The interval from initial hysteroscopy to conception was significantly shorter in group 2 (median, 12 months vs 51 months; p < .001).Conclusions
For moderate to severe IUAs, Interceed combined with an IUD may be an alternative approach for reducing adhesion recurrence after hysteroscopic adhesiolysis. 相似文献17.
Antonino Ditto Giorgio Bogani Fabio Martinelli Mauro Signorelli Valentina Chiappa Cono Scaffa Alice Indini Umberto Leone Roberti Maggiore Domenica Lorusso Francesco Raspagliesi 《Journal of minimally invasive gynecology》2017,24(1):98-102
Study Objective
Growing evidence supports the safety of a laparoscopic approach for patients affected by apparent early-stage ovarian cancer. However, no well-designed studies comparing laparoscopic and open surgical staging are available. In the present investigation we aimed to provide a balanced long-term comparison between these 2 approaches.Design
Retrospective study (Canadian Task Force classification II-2).Setting
Tertiary center.Patients
Data of consecutive patients affected by early-stage ovarian cancer who had laparoscopic staging were matched 1:1 with a cohort of patients undergoing open surgical staging. The matching was conducted by a propensity-score comparison.Intervention
Laparoscopic and open surgical staging.Measurements and Main Results
Fifty patient pairs (100 patients: 50 undergoing laparoscopic staging vs 50 undergoing open surgical staging) were included. Demographic and baseline oncologic characteristics were balanced between groups (p > .2). We observed that patients undergoing laparoscopic staging experienced longer operative time (207.2 [71.6] minutes vs 180.7 [47.0] minutes; p = .04), lower blood loss (150 [52.7] mL vs 339.8 [225.9] mL; p < .001), and shorter length of hospital stay (4.0 [2.6] days vs 6.1 [1.6] days; p < .001) compared with patients undergoing open surgical staging. No conversion to open surgery occurred. Complication rate was similar between groups. No difference in survival outcomes were observed, after a mean (SD) follow-up of 49.5 (64) and 52.6 (31.7) months after laparoscopic and open surgical staging, respectively.Conclusions
Our findings suggest that the implementation of minimally invasive staging does not influence survival outcomes of patients affected by early-stage ovarian cancer. Laparoscopic staging improved patient outcomes, reducing length of hospital stay. Further large prospective studies are warranted. 相似文献18.
Valerio Gallotta Vito Chiantera Carmine Conte Giuseppe Vizzielli Anna Fagotti Camilla Nero Barbara Costantini Alessandro Lucidi Carla Cicero Giovanni Scambia Gabriella Ferrandina 《Journal of minimally invasive gynecology》2017,24(1):133-139
Study Objective
To assess the feasibility of total robotic radical surgery (TRRS) in patients with locally advanced cervical cancer (LACC) who receive chemoradiation therapy (CT/RT).Design
A prospective (preplanned) study of a nonrandomized controlled trial (Canadian Task Force classification level 2).Setting
Catholic University of the Sacred Hearth, Rome, Italy.Patients
Between September 2013 and January 2016, a total of 40 patients with LACC (Fédération Internationale de Gynécologie et d'Obstétrique stage IB2–III) were enrolled in the study.Interventions
Robotic radical hysterectomy (RRH) plus pelvic and/or aortic lymphadenectomy was attempted within 6 weeks after CT/RT. The feasibility of TRRS as well as the rate, pattern, and severity of early and late postoperative complications were analyzed.Measurements and Main Results
After CT/RT, 29 patients (72.5%) underwent type B2 RRH, and 11 (27.5%) underwent type C1 RRH. Pelvic lymphadenectomy was performed in all cases. TRRS was successful in 39 of 40 cases (feasibility rate = 97.5%). In patients successfully completing TRRS, the median operating time was 185 minutes (range, 100–330 minutes), and the median blood loss was 100 mL (range, 50–300 mL). The median time of hospitalization counted from the first postoperative day was 2 days (range, 1–4 days). No intraoperative complications were recorded. During the observation period (median = 18 months; range, 4–28 months), 9 of 40 (22.5%) experienced postoperative complications, for a total number of 12 complications. As of April 2016, recurrence of disease was documented in 5 cases (12.5%).Conclusion
TRRS is feasible in LACC patients administered preoperative CT/RT, providing perioperative outcomes comparable with those registered in early-stage disease, and LACC patients receiving neoadjuvant chemotherapy. 相似文献19.
Paula C. Brady Stacey A. Missmer Marc R. Laufer 《Journal of pediatric and adolescent gynecology》2017,30(3):422-424
Background
Endometriosis—ectopic implantation of endometrial-like tissue—affects 10% of female adolescents and adults. First-line treatment includes progesterone only (such as norethindrone acetate [NET-A]) or combined estrogen/progestin oral contraceptive pills. Estrogen-containing contraceptives confer increased risk of hepatic adenomas, whereas the association with NET-A is very rarely reported.Case
Three adolescents with stage I to II endometriosis managed with NET-A (up to 15 mg/d for 28-78 months) were diagnosed with hepatic adenomas at ages 17-22 years. They previously received estrogen-containing medications, which were stopped 24 months or longer before diagnosis of hepatic adenoma.Summary and Conclusion
NET-A in a dose greater than 10 mg/d might be associated with increased risk for hepatic adenomas, likely due to peripheral conversion to ethinyl estradiol. Use of NET-A might not be advisable in patients with known hepatic adenomas. 相似文献20.
Lauren M. Bergeron Katherine C. Bishop Holly R. Hoefgen Margaret S. Abraham Nhial T. Tutlam Diane F. Merritt Jeffrey F. Peipert 《Journal of pediatric and adolescent gynecology》2017,30(1):123-127