Adolescent Gynecology

A Guide for Clinicians
Springer (Verlag)
  • erschienen am 11. November 2013
  • |
  • XX, 258 Seiten
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978-1-4615-8324-0 (ISBN)
ABOUT THE SUBJECT MATTER Adolescence is a time of significant change. The adolescent era spans the interval between childhood and adulthood. It is a time of physical, social, and even emotional upheaval. During this relatively brief period of time not only does physical growth accelerate but, of more significance in the biology of any species, the individual attains reproductive maturity. Within this time frame, the human being acquires the capacity to procreate and perpetuate our species. From a reproductive standpoint, throughout adeolescence the individual is being prepared for perhaps what might be considered the most important function an organism has during his/her brief sojourn on earth, namely to endow successor(s) with a minute quan tity of DNA to enable continuation of its form of life. The interlude be tween childhood and adulthood is not always socially or emotionally sim ple. The anatomic and physiologic modifications that come to pass during adolescence are not necessarily paralleled by a capacity to assume the societal responsibilities associated with reproductive maturity. Although the physiologic changes normally proceed in a predetermined fashion, adaptation to a changing role is a far more trying process. Accustomed to living in a child's world, the subject of adolescent change requires considerable time and understanding to facilitate exis tence in the adult world. The early stages of sexual awareness, for ex ample, are generally extremely confusing and, as evidenced by the in ordinately high frequency of teenage pregnancy and sexually transmitted diseases, can be extraordinarily dangerous.
  • Englisch
  • NY
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  • USA
Springer US
22 s/w Abbildungen
978-1-4615-8324-0 (9781461583240)
weitere Ausgaben werden ermittelt
1 The Initial Encounter.- 1. Introduction.- 2. The Physician.- 3. The Patient.- 4. The Physical Examination.- 5. The Consultation.- 6. The Team Approach.- 7. Summary.- 2 Pubertal Development.- 1. Introduction.- 2. Ovarian Embryology.- 2.1. Folliculogenesis.- 2.2. Follicle Atresia.- 3. Endocrinology of the Female Fetus.- 3.1. Endocrinology of the Newborn Female.- 3.2. Ovarian Morphology in the Female Infant.- 4. Adolescent Growth and Maturation.- 5. Hormonal Changes at Puberty.- 5.1. CNS.- 5.2. Changes in Pituitary Function at Puberty.- 5.3. Menarche.- References.- 3 Ovarian Dysfunction in the Adolescent.- 1. Introduction.- 2. Normal Sexual Development.- 3. Classification of Menstrual Dysfunction.- 3.1. Uterine and Vaginal Anomalies.- 3.2. Disorders of the Ovary.- 3.3. Pituitary Disorders.- 3.4. Hypothalamic Disorders.- 4. Diagnosis.- 5. Therapy.- References.- 4 Sexual Behavior in Adolescence.- 1. Introduction.- 2. The Sexual System.- 2.1. Biological Sex.- 2.2. Core Gender Identity.- 2.3. Gender Identity.- 2.4. Gender Role Behavior.- 3. Aspects of Physician-Patient Interaction.- 3.1. Physician Comfort.- 3.2. Roles of Physician.- 3.3. Confidentiality.- 4. Changing Social and Sexual Mores.- 5. Psychosexual Development in Adolescence.- 5.1. Biologic Development in the Adolescent Female.- 5.2. Biologic Development in the Adolescent Male.- 5.3. Psychologic Development in Adolescent Males and Females.- 6. Interviewing and History Taking.- 6.1. Communication.- 6.2. Other Defenses.- 6.3. Content of Sexual Concerns.- 6.4. History Taking.- 7. Physical Examination.- 8. Common Sexual Problems.- 8.1. Sexual Concerns of Adolescents.- 8.2. Concerns of Parents.- 8.3. Sexual Dysfunctions.- 8.4. Homosexuality.- 8.5. STDs.- 8.6. Rape.- 8.7. Incest.- 9. Uncommon Sexual Disorders.- 9.1. Intersexuality.- 9.2. Gender Dysphorias.- 9.3. Paraphilias.- References.- Recommended Reading for Teenagers and Adults.- 5 Teenage Pregnancy.- 1. Introduction.- 1.1. Incidence of Pregnancy.- 1.2. Reasons for Adolescent Pregnancy.- 2. Cost to Society of Adolescent Pregnancy.- 3. Health Problems and Teen Pregnancy.- 3.1. Compliance.- 3.2. Pelvic Examination and the Pregnant Teenager.- 3.3. Iron and Folacin Intake.- 3.4. Hypertension.- 3.5. Preeclampsia.- 3.6. Endocrine Disorders.- 3.7. Drugs.- 3.8. Abortion.- 3.9. Rubella and Cytomegaloviruses.- 3.10. Diabetes.- 3.11. Intrauterine Fetal Growth Retardation.- 4. Prevention.- 5. A Hospital-Based Program Description.- 5.1. Antepartum.- 5.2. Intrapartum and Early Postpartum.- 5.3. Family Planning Clinic.- 5.4. Teen Tot Clinic.- 5.5. Outreach Services.- 6. Other Programs for Pregnant Adolescents.- 6.1. School-Based Programs.- 6.2. Community-Based Programs.- 6.3. Programs to Enhance Early Childhood Education.- 6.4. Preparation of School Professional in Human Sexuality.- 6.5. Cure.- References.- 6 Contraceptive Use among Adolescents.- 1. Introduction.- 1.1. Use of Contraceptives.- 1.2. Consequences of Early Adolescent Pregnancy.- 1.3. Reasons for Nonuse of Contraception.- 1.4. Effectiveness of Various Contraceptive Methods.- 1.5. Adolescent Contraception and the Law.- 1.6. Choice of Contraceptive Method.- 2. Contraception and Neoplasia.- 2.1. Problems of Investigation.- 2.2. Oral Contraceptives and Disease.- 2.3. Other Medical Concerns.- 3. Methods to Improve Contraceptive Utilization.- 3.1. Increased Sex Education.- 3.2. Family Planning Programs.- 3.3. Role of the Private Physician.- 4. Recommendations for Contraceptive Use.- 4.1. Oral Contraceptives.- 4.2. IUDs.- 4.3. Barrier Methods.- References.- 7 Venereal Disease in Adolescents.- 1. Introduction.- 2. Overview of Sexually Transmitted Diseases.- 3. Gonorrhea.- 3.1. Epidemiology.- 3.2. Clinical Spectrum.- 3.3. Sites of Gonorrheal Infection.- 3.4. Diagnosis of N. gonorrheae.- 3.5. Therapy.- 4. Syphilis.- 4.1. Pregnancy and Syphilis.- 4.2. Treatment.- 5. Herpes Genital Infection.- 5.1. Diagnosis.- 5.2. Neonatal Infection.- 5.3. Therapy.- 6. Condyloma Acuminatum.- 7. Pediculosis Pubis (Crab Lice).- 8. Scabies.- 9. Chancroid.- 10. Granuloma Inguinale.- 11. Chlamydia trachomatus.- 11.1. Inclusion Conjunctivitis.- 11.2. Neonatal Pneumonia.- 11.3. Diagnosis.- 11.4. Treatment.- 12. Vulvovaginitis.- 12.1. Candida albicans.- 12.2. Trichomonas vaginalis.- 12.3. Nonspecific Vaginitis.- 12.4. Diagnosis.- 12.5. Treatment.- 13. Conclusion.- 8 Rape of the Adolescent.- 1. Introduction.- 2. Notification of Authorities.- 3. Permission to Examine and Treat.- 4. The Police Interview.- 5. Medical Examination and Treatment.- 6. Laboratory Evaluation.- 7. Specific Laboratory Tests.- 8. Medical Therapy.- 9. Evidence Handling.- 10. Records.- 11. Follow-Up.- 12. Psychological Aspects of Rape.- References.- 9 Gynecologic Tumors of Adolescence.- 1. Introduction.- 2. Incidence.- 3. Etiology.- 4. Diagnosis.- 5. Vulva.- 6. Vagina.- 7. Uterus.- 7.1. Cervix.- 7.2. Corpus.- 8. Fallopian Tube.- 9. Ovary.- 9.1. Germinal Epithelial Tumors.- 9.2. Gonadal Stromal Tumors.- 9.3. Germ Cell Tumors.- 9.4. Gonadoblastoma.- References.- 10 Laboratory Evaluation in Adolescence.- 1. Clinical Evaluation.- 2. Pituitary Hormones.- 2.1. Gonadotropins.- 2.2. Prolactin.- 3. Ovarian Hormones.- 4. Androgens.- 4.1. In Serum.- 4.2. Urinary Hormones.- 4.3. Suppression Tests.- 5. Adrenal Function.- 6. Sex Chromosome Analysis.- 7. Thyroid Tests.- References.- 11 Legal Considerations in the Treatment of Minors.- 1. Introduction.- 2. Legal Background.- 3. Special Legal Considerations in the Treatment of Adolescents.- 4. Statutes Set the Law of Each State.- 5. A Physician's Liability for Lack of Consent.- 6. Emergency Treatment.- 7. A Parent's Refusal to Consent to Treatment of a Minor Child.- 8. Compensation for Services.- 9. Conclusion.- References.- Recommended Reading.

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