Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Adolescence is the transitional period between childhood and adulthood. Depending on female gonads’ function and on hypothalamic-pituitary-ovarian axis activation, results in teenager’s body growth, in secondary sex characteristics’ development and finally in their reproductive potential. In adolescence, the negative feedback of gonadal steroids on gonadotropins is disturbed. Teenagers presenting with dysfunctional bleedings are usually suspected of hemorrhagic ovarian cysts or endometriosis and require gynecologic examination, evaluation, and hormone therapy. It is of great importance both for teenagers and their parents to understand that hormone therapy is the first line treatment for bleeding disorders in these ages. A detailed medical history is necessary to determine the appropriate treatment plan. Primary care includes the detection of adolescents with acute or chronic pelvic pain that may be associated with endometriosis or other pathologies like mullerian duct abnormalities, imperforate hymen, ovarian teratomas, ovarian torsion, and vaginal absence or atresia. Mullerian duct abnormalities are associated with increased rates of unexplained infertility, spontaneous abortions, and pathological conditions of pregnancy. Specialists, should help teenagers in getting familiar to their bodies, to their sexuality, inform them about the sexually transmitted diseases, and safety options including vaccination and guide them in contraception issues

Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors

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Abortions in First Trimester Pregnancy, Management, Treatment

The miscarriages’ investigation should include a familiar history, gynecological examination and a full laboratory testing including hormonal control, as well as karyotype, maternal immune control and thrombophilia testing. If the physician suspects the cause of abortions is chromosomal due to heredity, a special blood test (karyotype) for the pair is recommended. Chromosomal abnormalities are the most common reason for first trimester abortions, and are impossible to be prevented. Based on the above data, abortion and the subsequent possible infertility should not be considered as a personal failure for the woman and the treating physician. Nowadays, medical advancement provides many options combined with psychological support can actually reduce the miscarriages’ risk

Abortions in First Trimester Pregnancy, Management, Treatment

Tujuan dari penelitian: 1. Mendeskripsikan penerepan pendekatan Client Centered dalam mengatasi kepribadian introvert pada siswa kelas XI IPS MA Al Hidayah Kudus Tahun Pelajaran 2016/2017. 2. Mendeskripsikan kepribadian introvert pada konseli siswa kelas XI IPS MA Al Hidayah Kudus setelah diberikan konseling dengan pendekatan Client Centered. Pendekatan client centered adalah pendekatan yang berpusat pada diri klien, yang mana seorang konselor hanya memberikan konseling serta mengawasi klien pada saat mendapatkan pemberian konseling tersebut agar klien dapat berkembang atau keluar dari masalah yang dihadapinya. Introvert merupakan tipe kepribadian individu yang mempunyai kecenderungan menutup diri dari dunia luar. Jenis penelitian yang digunakan adalah peneltian kualitatif studi kasus. Penelitian dilakukan di MA NU Al Hidayah Kudus Tahun Pelajaran 2016/2017, dengan dua subjek penelitian (ABS, DAS). Metode pengumpulan data yang digunakan: 1. Wawancara, 2. Observasi, 3. Dokumentasi dan 4. Home Visit. Analisis data yang digunakan adalah: analisis sistem Bacon. Hasil penelitian: 1. Konseli I (ABS) faktor yang menyebabkan memiliki kepribadian intovert: 1. Tidak percaya diri. ABS yang berusia 16 tahun dan saat ini tengah duduk di kelas XI IPS MA NU Al Hidayah Kudus merasa kurang percaya diri dengan bentuk kaki yang dimiliki membuat ABS menjadi pibadi yang tidak percaya diri dalam pergaulan, sehingga membuat konseli sering mendapatkan perlakuan yang tidak menyenangkan dari siswa-siswi lain. Konseli memang terlahir dengan keadaan yang tidak sempurna karena cacat fisik pada salah satu kakinya atau yang biasa disebut sebagai (Clubfoot) atau kaki pengkor. 2. Perlakuan diskriminasi. Karena bentuk fisik yang dimiliki oleh konseli yang berbeda, konseli mendapatkan perlakuan diskrinasi dari siswa-siswi lain. 2. Konseli II (DAS) faktor yang menyebabkan konseli memiliki kepribadian introvert: 1. Rendahnya kemampuan interaksi konseli. Konseli sering berpindah tempat tinggal sejak usia sekolah dasar membuat kemampuan interaksi DAS kurang. Di sekolah, konseli banyak diperhatikan oleh siswa-siswi di sekolah karena secara fisik DAS merupakan siswa yang berpenampilan menarik. Tetapi kurang interaksi sosial, konseli lebih banyak memilih menyendiri dan tidak terlihat aktif dalam hubungan pertemanan yang sering terjalin pada anak usia sekolah atau remaja awal. 2. Perceraian kedua orang tua konseli. Perceraian yang ditimbulkan karena keuangan keluarga yang memburuk membuat konseli harus bekerja keras untuk membiayai sekolahnya semakin membuat konseli tidak memiliki waktu untuk bersosialisasi dengan teman sebayanya. Setelah pelaksanaan tiga kali konseling client centered terhadap kedua konseli diperoleh keterangan bahwa, konseli I (ABS) telah mampu menerima kekurangan dirinya yang memiliki keterbatasan pada kakinya. ABS telah percaya diri dan mampu bersosialisasi dengan baik. Konseli II (DAS) telah menyadari bahwa kehidupan yang ia alami harus tetap berjalan, dan DAS juga telah memahami bahwa makna kehidupan adalah terus bekerja dan bahagia atas apa yang dimilikinya sekarang. Berdasarkan kesimpulan di atas peneliti dapat memberikan saran: 1. Kepala sekolah: Dalam penelitian ini menunjukkan bahwa konseling individual sangat membantu siswa dalam memberikan mengatasi perilaku introvert siswa. Sehingga diharapkan kepala sekolah dapat mendukung adanya layanan konseling indivual ini dengan memfasilitasi guru pembimbing dalam memberikan layanan konseling individual. 2. Guru bimbingan dan konseling: Diharapkan guru bimbingan dan konseling dapat menjadikan hasil penelitian sebagai acuan dalam memberikan pelayanan konseling individual dengan konseling client centered. 3. Siswa: Diharapkan siswa dapat bergaul dengan baik dan semakin meningkatkan hubungan interpersonal. 4. Penelitian selanjutnya: Diharapkan peneliti selanjutnya dapat mengembangkan penelitian yang sejenis dengan menggunakan layanan konseling yang lebih varatif, sehingga didapatkan komparasi yang berbeda dengan penelitian ini

Vein Thrombosis Risk in Women and Travel

Deep vein thrombosis (DVT) of the lower limbs is a serious condition that can lead to pulmonary embolism (PE) in about 15–24% of cases. If it is not diagnosed/treated timely, nearly 15% of these PE are lethal. The relationship between travel and staying in the same position for a long time is well-known since World War II. Generally, it is more frequent in air flights. It is also associated with the economic downturn in airplanes because passengers have limited space and have greater difficulty of moving. It is estimated that approximately 1–6% of long-haul passengers arrive at their destination with a clot in their veins, but most DVT are asymptomatic

The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

Uterine fibroids have remarkably heterogeneous clinical characteristics with unknown exact etiology. The treatment of fibroids should be individualized based on their size, location, growth rate, the symptoms that they cause, the desire to have children and the age of the woman. Embolization is currently the most advanced non-surgical technique. The majority of women report satisfactory post-treatment results like shorter hospitalization period and recovery time in comparison to hysterectomy and improvement or complete remission of clinical symptoms. Complications include amenorrhea (in the majority of cases: recurrence after three months) and infections that are generally treated with antibiotics. The results from most clinical studies and our published experience indicate that embolization improves pelvic symptoms related to uterine fibroids. Collaborative efforts between gynecologists and interventional radiologists are necessary in order to optimize the safety and efficacy of this procedure. In the future, embolization could be generally recommended as treatment option for women who desire future fertility/pregnancy

Twin Pregnancies Labour Modus and Timing

Twin pregnancies are categorized according to three factors, zygosity, chorionicity and amnionicity. Dizygotic twins are always dichorionic and diamniotic, where each twin has its own chorionic and amniotic sac. Monozygotic twins account for 1/3 of twin pregnancies and show higher morbidity and mortality. In monozygotic twins, chorionicity and amnionicity are determined by the time of zygote division. Chorionicity and amnionicity determine the risks of twin pregnancy. Morbitidies are shown notable decreasing tendency depending on improving of high risk obstetric and neonatal care, however is still discussed the optimum labour management in twin pregnancies Vaginal delivery in twin pregnancies is possible when both have cephalic presentation and in the late weeks of pregnancy during which the risks of prematurity are minimized. The aim of this review was the assessment and evaluation the impact of the labour modus and timing of termination of twin pregnancies due to rise of their occurrence based on scientific aspects of the new published literature on perinatal outcome

ΕΝΔΕΙΞΕΙΣ ΚΑΙ ΘΕΡΑΠΕΥΤΙΚΑΙ ΔΥΝΑΤΟΤΗΤΕΣ ΤΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ ΕΙΣ ΤΗΝ ΟΞΕΙΑΝ ΠΑΓΚΡΕΑΤΙΤΙΔΑ

IN THIS STUDY WE DESCRIBE THE INDICATIONS AND POSSIBILITIES OF TREATMENT OF THEACUTE PANCREATITIS BY MEANS OF SURGERY. WE REPORT THE INDICATIONS WHICH ARE GENERALLY ACCEPTED IN ORDER TO OPERATE THE ACUTE PANCREATITIS AND ALSO THE INDICATIONS AS THE RESULT OF OUR EXPERIENCE. FINALLY, WE REPORT THE AIM OF SURGERY IN THE TREATMENT OF THE ACUTE PANCREATITIS, WHICH ARISES FROM THE INTERNATIONAL BIBLIOGRAPHY AND FROM OUR EXPERIENCE DURING THE PAST 11 YEARS. IT SHOULD BE NOTED THAT ON A TOTAL OF 27 CASES OF PATIENTS OPERATED, FINALLY FOUR OF THEM DIED. HOWEVER, TWO OF THEM HAD OTHER INJURIES TOO, IN SOME OTHER ORGANS. THAT IS TO SAY, WE HAD ACTUALLY TWO DEATHS, FROM ACUTE NECROTIZING PANCREATITIS, WHICH WE COULDN'T AVOID, OF COURSE, BY USING A CONSERVATIVE MEDICAL TREATMENT.THUS, THE RESULTS OF SURGICAL TREATMENT OF ACUTE PANCREATITIS, ON 27 CASES OFPATIENTS OPERATED, IN OUR OWN CLINIC, ARE CONSIDERED TO BE GOOD OR RATHER EXCELLENT, WHENEVER THE INDICATIONS, FOR SUCH AN OPERATION WERE KEPT.ΕΙΣ ΤΗΝ ΠΑΡΟΥΣΑ ΜΕΛΕΤΗΝ ΠΕΡΙΓΡΑΦΟΝΤΑΙ ΑΙ ΕΝΔΕΙΞΕΙΣ ΚΑΙ ΑΙ ΘΕΡΑΠΕΥΤΙΚΑΙ ΔΥΝΑΤΟΤΗΤΕΣ ΤΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ ΕΙΣ ΤΗΝ ΟΠ. ΑΝΑΦΕΡΟΜΕΝ ΤΑΣ ΕΝΔΕΙΞΕΙΣ, ΑΙ ΟΠΟΙΑΙ ΕΙΝΑΙ ΓΕΝΙΚΩΣ ΠΑΡΑΔΕΚΤΑΙ ΠΡΟΚΕΙΜΕΝΟΥ ΝΑ ΧΕΙΡΟΥΡΓΗΣΩΜΕΝ ΤΗΝ ΟΠ ΩΣ ΚΑΙ ΤΑΣ ΕΝΔΕΙΞΕΙΣ ΑΠΟ ΤΗΝ ΠΕΙΡΑΝ ΤΗΣ ΗΜΕΤΕΡΑΣ ΚΛΙΝΙΚΗΣ. ΕΠΙΣΗΣ ΑΝΑΦΕΡΟΜΕΝ ΤΟΝ ΣΚΟΠΟΝ ΤΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ ΕΙΣ ΤΗΝ ΘΕΡΑΠΕΙΑΝ ΤΗΣ ΟΠ, Ο ΟΠΟΙΟΣ ΠΡΟΚΥΠΤΕΙ ΑΠΟ ΤΗΝ ΠΕΙΡΑΝ ΤΗΣ ΗΜΕΤΕΡΑΣ ΚΛΙΝΙΚΗΣ ΚΑΤΑ ΤΗΝ ΤΕΛΕΥΤΑΙΑΝ 11ΕΤΙΑΝ ΚΑΙ ΑΠΟ ΤΗΝ ΔΙΕΘΝΗ ΒΙΒΛΙΟΓΡΑΦΙΑΝ. ΑΣ ΣΗΜΕΙΩΘΗ ΟΤΙ ΕΠΙ ΤΟΥ ΣΥΝΟΛΟΥ ΤΩΝ 27 ΧΕΙΡΟΥΡΓΗΘΕΝΤΩΝ ΑΣΘΕΝΩΝ ΑΠΕΘΑΝΟΝ ΤΕΛΙΚΩΣ 4, ΕΚΤΩΝ ΟΠΟΙΩΝ ΟΜΩΣ ΟΙ ΔΥΟ ΕΦΕΡΟΝ ΚΑΙ ΚΑΚΩΣΕΙΣ ΑΛΛΩΝ ΟΡΓΑΝΩΝ ΣΥΝΕΠΕΙΑ ΤΡΑΥΜΑΤΙΣΜΟΥ. ΟΥΣΙΑΣΤΙΚΩΣ ΔΗΛ. ΕΙΧΟΜΕΝ 2 ΘΑΝΑΤΟΥΣ ΕΞ ΟΞΕΙΑΣ ΝΕΚΡΩΤΙΚΗΣ ΠΑΓΚΡΕΑΤΙΤΙΔΟΣ, ΘΑΝΑΤΟΥΣ ΤΟΥΣ ΟΠΟΙΟΥΣ ΒΕΒΑΙΩΣ ΔΕΝ ΘΑ ΗΔΥΝΑΜΕΘΑ ΝΑ ΑΠΟΦΥΓΩΜΕΝ ΔΙΑ ΤΗΣ ΣΥΝΤΗΡΗΤΙΚΗΣ ΘΕΡΑΠΕΙΑΣ. ΤΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΕΠΟΜΕΝΩΣ ΕΚ ΤΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ ΘΕΡΑΠΕΙΑΣ ΤΗΣ ΟΠ ΕΙΣ 27 ΑΣΘΕΝΕΙΣ ΧΕΙΡΟΥΡΓΗΘΕΝΤΑΣ ΕΙΣ ΤΗΝ ΗΜΕΤΕΡΑ ΚΛΙΝΙΚΗΝ ΚΡΙΝΟΝΤΑΙ ΚΑΛΑ ΕΩΣ ΑΡΙΣΤΑ ΟΤΑΝ ΕΤΗΡΟΥΝΤΟ ΑΙ ΕΝΔΕΙΞΕΙΣ ΔΙΑ ΤΗΝ ΤΟΙΟΥΤΟΥ ΕΙΔΟΥΣ ΕΠΕΜΒΑΣΙΝ

Elderly Patients with Gynecological Cancer: Is the Management Individualized?

The change in life expectancy affects the clinical presentation and the prognosis of elderly patients with gynecological cancer. The in-crease of life expectancy and increased numbers of elderly patients, the healthcare systems have to deal more frequently with patients who are not simply older adults but have also severe comorbidities and physiological, psychological, functional, and social needs that require individualised management. Discussing every individual after detailed assessment in a multidisciplinary meeting is extremely important. Several studies have shown that elderly patients with gynecological malignancies are not treated to the same extent as young-er patients and have lower odds of receiving standard care according to the oncological protocols. Individualization of management in these patients could be identified in several studies in the literature showing that increasing age at diagnosis predicts deviation from guidelines for surgical therapy, adjuvant radiotherapy or chemotherapy. The authors performed a literature review to clarify whether there are any changes in the treatment of such patients, and whether their management should be considered to be individualized, depending on their age and comorbidities

Breast milk suction pumping and a possible relation to breast cancer: A bicentric study

<p><i>In a bicentric clinical study of 343 patients who consulted for breast problems, we collected a questionnaire regarding the use or not of breast milk suction pump during their previous breast feeding. Our results calculate with the <strong>Fisher's Exact Test</strong> found that in breast cancer patients the previous use of the pump was much more frequent than in patients without breast cancer (p<0.003). A possible role of chronic inflammation created by the breast milk pump could be evoked to explain this result. This impressive finding should be more investigated in large series to confirm or not if breast milk pump using could be considered as a risk of breast cancer.</i></p&gt