DETORSION AND OOPHOROPEXY IN A CASE OF ASYNCHRONOUS BILATERAL ADNEXAL TORSION: A CASE REPORT

Prikazuje se slučaj 17-godišnje djevojke, koja je došla sa simptomima akutnog abdomena. Na ultrazvučnom pregledu nađen je povećan lijevi jajnik s funkcionalnom cistom 55x50mm. Na pregledu kolor doplerom pronađen je protok na periferiji lijevog jajnika. Četiri godine ranije, kao 13-godišnjoj djevojčici zbog torzije desnog jajnika učinjena je na kirurškom odjelu desnostrana ovarijektomija.Tada nije bila učinjena preventivna fiksacija jajnika (ovariopeksija) zdravog jajnika. Zbog anamnestičkih podataka, kliničkog nalaza, kao i nalaza ultrazvuka postavljena je sumnja na torziju lijevog jajnika. Hitnim operativnim zahvatom učinjena je detorzija lijevog jajnika i ovariopeksija, te je na taj način spriječen njegov gubitak. Navodi se osvrt na literaturu te stavovi prema preventivnoj ovariopeksije drugog zdravog jajnika kod jednostane torzije jajnika.A case of 17 years old girl with acute onset of lower abdominal pain is presented. The ultrasound examination demonstrated enlarged left ovary with a simple ovarian cyst 55 x50 mm. On Color Doppler examination the flow was detected only on the periphery of the left ovary. Four years ago in the same patient an operation with right oophorectomy because of ovarian torsion was performed; preventive oophoropexy of healthy ovary was not performed. Because of patient\u27s history data, clinical findings and ultrasound examination strongly suggestion of left ovarian torsion was made. The left ovary was saved by immediate surgical intervention and detorsion. Oophoropexy of the same ovary was performed. The value of elective prophylactic oophoropexy of healthy ovary in unilateral ovarian torsion with review of the literature is discussed

Sexually Transmitted Infections in Adolescents

Adolescenti su dio populacije koja ima specifične fiziološke karakteristike, ali i posebne karakteristike ponašanja, koje su razlog za osobito visoku izloženost i rizik od brojnih spolno prenosivih infekcija. Dijagnoza i pravodobno liječenje spolno prenosivih infekcija najvažniji su za buduće reproduktivno zdravlje adolescenata, kao i za prevenciju prijenosa budućim partnerima. Probir, ciljani edukacijski napori i cijepljenje (HPV) mogu spriječiti velik broj za dob specifičnih obolijevanja, a time potencijalno smanjiti ukupno opterećenje bolestima u njihovu kasnijem životu.Adolescents have specific physiological and specific behavioral characteristics that place them at an increased risk for numerous sexually transmitted infections (STI). Diagnosis and prompt treatment of STI are of paramount importance for an adolescent’s future reproductive health and prevention of transmission to future partners. Screening, targeted educational efforts and vaccination (HPV) of adolescents can prevent a large portion of age-specific morbidities as well as potentially minimize their overall burden of disease later in life

Sexually Transmitted Infections in Adolescents

Adolescenti su dio populacije koja ima specifične fiziološke karakteristike, ali i posebne karakteristike ponašanja, koje su razlog za osobito visoku izloženost i rizik od brojnih spolno prenosivih infekcija. Dijagnoza i pravodobno liječenje spolno prenosivih infekcija najvažniji su za buduće reproduktivno zdravlje adolescenata, kao i za prevenciju prijenosa budućim partnerima. Probir, ciljani edukacijski napori i cijepljenje (HPV) mogu spriječiti velik broj za dob specifičnih obolijevanja, a time potencijalno smanjiti ukupno opterećenje bolestima u njihovu kasnijem životu.Adolescents have specific physiological and specific behavioral characteristics that place them at an increased risk for numerous sexually transmitted infections (STI). Diagnosis and prompt treatment of STI are of paramount importance for an adolescent’s future reproductive health and prevention of transmission to future partners. Screening, targeted educational efforts and vaccination (HPV) of adolescents can prevent a large portion of age-specific morbidities as well as potentially minimize their overall burden of disease later in life

Treatment of Anogenital Warts in an 18-month-old Girl with 5% Imiquimod Cream

Possible modes of transmission of human papilloma virus (HPV) in children include perinatal transmission, sexual transmission or extragenital contact. Conventional treatment options with chemical and physical destruction methods can be difficult and painful and often require general anesthesia. Imiquimod is topically active immunomodulatory agent and it\u27s use for pediatric anogenital warts has been reported with good results. We report a case of extensive anogenital warts in a 18-months-old girl who was successfully treated with topical 5% imiquimod cream.</p

Acute Skin Sun Damage in Children and Its Consequences in Adults

Children spend more time outdoors than adults and there is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of the sun. The negative effects of solar radiation are accumulated during the entire lifetime; however 80% of total lifetime sun exposure is taking place before the age of 18 years. Child skin is more sensitive than adult skin because natural defense mechanisms are not fully developed. A short exposure to midday sun will result in sunburns. Epidemiologic studies show a higher incidence of malignant melanoma in persons with a history of sunburns during childhood and adolescence. Sun exposure among infants and pre-school children is largely dependent on the discretion of adult care providers. Sun protective habits of mothers may predict the level of sun exposure in children. It is very important to transfer the knowledge and positive habits of proper sun protection to children. The purpose of sun-safety behavior is not to avoid outdoor activities, but rather to protect the skin from detrimental sun effects. Proper sun protection of children includes protection from excessive sun exposure, sunburns and other forms of skin damage caused by sun, which may lead to the future development of skin cancers. This paper reviews acute skin reactivity to sun in childhood and adolescence that causes damage in skin structure and function and produces undesirable chronic changes in adults

»Halo Nevi« and UV Radiation

Halo nevi, also termed Sutton nevi, are defined as benign melanocytic nevi that are surrounded by an area of depigmentation resembling a halo. Halo nevi are common in children and young adults, with a mean age at onset of 15 years. The incidence in the population is estimated to be approximately 1%. Affected individuals frequently have multiple lesions which are usually localized on the back. A familial tendency for halo nevi has been reported. The etiology of halo nevi is unknown. It is an autoimmune response and T lymphocytes are considered to play a key role in the progressive destruction of nevus cells. Halo nevi may be associated with autoimmune disorders such as vitiligo, Hashimoto thyroiditis, alopecia areata, celiac disease, atopic dermatitis and others. It has been proved that halo nevi are detected after an intense sun exposure especially after sunburns. The etiology of halo nevi, association with malignant melanoma and the role of sun exposure in the development of halo nevi are discussed

Acute Skin Sun Damage in Children and Its Consequences in Adults

Children spend more time outdoors than adults and there is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of the sun. The negative effects of solar radiation are accumulated during the entire lifetime; however 80% of total lifetime sun exposure is taking place before the age of 18 years. Child skin is more sensitive than adult skin because natural defense mechanisms are not fully developed. A short exposure to midday sun will result in sunburns. Epidemiologic studies show a higher incidence of malignant melanoma in persons with a history of sunburns during childhood and adolescence. Sun exposure among infants and pre-school children is largely dependent on the discretion of adult care providers. Sun protective habits of mothers may predict the level of sun exposure in children. It is very important to transfer the knowledge and positive habits of proper sun protection to children. The purpose of sun-safety behavior is not to avoid outdoor activities, but rather to protect the skin from detrimental sun effects. Proper sun protection of children includes protection from excessive sun exposure, sunburns and other forms of skin damage caused by sun, which may lead to the future development of skin cancers. This paper reviews acute skin reactivity to sun in childhood and adolescence that causes damage in skin structure and function and produces undesirable chronic changes in adults

Prevalence of Chlamydial Genital Infection and Associated Risk Factors in Adolescent Females at an Urban Reproductive Health Care Center in Croatia

The study was undertaken to determine the prevalence of chlamydial genital infection in sexually active, urban adolescent females 15–19 years; to identify behavioral, demographic, and clinical factors associated with chlamydial infections; and to develop criteria for potential screening strategies. 500 adolescent women, median age 17.7 years, who visited gynecological outpatient clinic in Children’s Hospital Zagreb for different reasons were enrolled in this study. Gynecological exam, colposcopy, detection of chlamydial infection by the rapid direct immunoassay of endocervical swab (Clearview Chlamydia – Unipath), endocervical cytological examination – Papanicolaou smear, and questionnaire to obtain demographic, social, behavioral and presence of symptoms data were performed. Positive Chlamydia trachomatis test were found in 16.4% of participants, cytologic cervical abnormalities – cervical intraepithelial neoplasia (CIN I – CIN III) were found in 25.2% and cytological signs of Human papilloma virus were found in 11.4%. Stepwise multivariate logistic regression analysis identified five factors associated with infection: the age of menarche 13 years, 4 lifetime sexual partners, non-use of contraception (rare or never), cervical friability, and abnormal Papanicolaou test. Urban adolescent sexually active women are at high risk for chlamydial infection and other sexually transmitted diseases including HIV infection. Association between chlamydial genital infection and risk-taking sexual and contraceptive behavior was found. Routine Chlamydia trachomatis testing for this population is recommended as well as implementation of school based sexual health education because of their risk-taking sexual behavior