Menstrual Issues in Adolescents with Physical and Developmental Disabilities

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72241/1/annals.1429.020.pd

Cervical Cancer Screening with Liquid Cytology in Women with Developmental Disabilities

Abstract Objective: To evaluate the use of liquid cytology in Pap smears in women with developmental disabilities (DD) for endocervical cell yield and abnormalities, via speculum examination or blind technique. Methods: We used retrospective chart review of gynecological visits by women with DD from October 2002 to November 2005. Cervical cytology screening included speculum examination or blind technique. Endocervical cell yield was analyzed via Pearson's chi-square test. Results: Of 240 attempted liquid cytology Pap smears, 199 (82.9%) were completed. Of these, 193 met inclusion criteria for the study, and 120 (62.2%) contained endocervical cells. The endocervical cell yield with liquid cytology/speculum was 80.0% and was 43.6% with liquid cytology/blind (p < 0.001). Two blind smears (1.0%) were abnormal; both revealed atypical squamous cells of undetermined significance (ASCUS) with subsequent negative human papillomavirus (HPV) typing. Conclusions: Cervical screening with liquid cytology in women with DD provides an overall rate of endocervical cells of approximately 44%-80% depending on the technique used. Although this is much lower than in the general population, this compares favorably with slide Pap smear in women with DD. The 44% yield of endocervical cells and the finding of abnormal Pap smears with the blind technique suggest this is a reasonable alternative for obtaining Pap smears in women with difficult pelvic examinations who otherwise would not receive cervical screening.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78111/1/jwh.2008.0795.pd

Transvaginal Ultrasound Shear Wave Elastography for the Evaluation of Benign Uterine Pathologies: A Prospective Pilot Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147163/1/jum14676.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147163/2/jum14676_am.pd

Depression in adolescents and young adults with heavy menstrual bleeding in a referral clinic setting

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167085/1/ajh26093_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167085/2/ajh26093.pd

The Effect of Menstrual Issues on Young Women with Angelman Syndrome

Study Objective—To characterize menstrual health issues and their effect in young women with Angelman syndrome (AS). Our secondary objective was to compare them with young women with autism spectrum disorders (ASDs). Design—Cross-sectional convenience sample survey. Setting—An institutional review board–approved Web-based survey of young female members of the Angelman Syndrome Foundation. Participants—Caregivers of young women with AS, aged 12–25 years. Interventions—None. Main Outcome Measures—Symptom characterization and effect of menses on young women with AS. Results—Menstrual and premenstrual symptoms were common among young women with AS, but infrequently caused problems at home or school. Less than half of the subjects used hormones to control their flow. Of those who used hormones, 75% used them continuously. Caregivers were satisfied with their method to control periods. Girls with seizures were more likely to use hormonal methods to control menses than those without seizures. Menstrualassociated morbidity in young women with ASD and AS was fairly similar, but with greater morbidity in the ASD group than in the AS group. However, girls with AS had more problems with menstrual hygiene with almost all of them requiring full assistance for managing hygiene. Conclusion—In this group of young women with AS, who have moderate to severe neurodevelopmental disabilities and cannot manage their own hygiene, menstruation is not associated with significant problems. Menstrual management by hormones is used by less than half. When hormonal therapy is used, it is most commonly used continuously to suppress menses

Occurrence of Gonadoblastoma in Patients with 45,X/46,XY Mosaicism.

STUDY OBJECTIVE: To estimate the overall frequency of gonadal tumors in patients with 45,X/46,XY mosaicism who underwent gonadectomy and to determine whether the degree of external masculinization or the location of gonads were associated with the presence of gonadal tumor. DESIGN: Retrospective study of patients with karyotype of 45,X/46,XY or variant who received care at the study institution between 1995 and 2012. SETTING: University of Michigan Health System (Ann Arbor, Michigan), a tertiary care academic center. PARTICIPANTS: Sixteen patients with karyotype of 45,X/46,XY who underwent gonadectomy. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Presence of pathology-confirmed gonadal tumor. RESULTS: In patients who underwent bilateral gonadectomy, gonadoblastomas were detected in 36.4% (4 of 11), and all were identified in patients with normal female external genitalia (4 of 8 [50.0%]). Abdominal gonads were associated with a nonsignificant increase in rate of gonadal tumor compared with inguinal or scrotal gonads. No malignant tumors were identified. CONCLUSION: The overall rate of gonadoblastoma was higher than previously reported. The high rate of gonadoblastoma in patients with female external genitalia and the lack of gonadal function support continuing the standard of care of practice of prophylactic gonadectomy in this patient population