- Email: [email protected]
Self-esteem during adolescence
238
NASPAG 18th Annual Clinical Meeting
Department of Obstetrics and Gynecology,1 Department of Pediatrics,2 Department of Pharmacology and Toxicology3 at the Wright State University School of Medicine, Dayton, Ohio 45409
Purpose: To assess the efficacy and safety of two standard treatment approaches, oral contraceptive pills and desmopressin acetate nasal spray, in managing menorrhagia in adolescents with von Willebrand disease. Patients and Methods: Medical records of 41 adolescent females between ages 9–18 yrs with documented von Willebrand Disease (vWD) and menorrhagia were retrospectively reviewed. Subjects with vWD type 1 (n ⫽ 36) administered a regimen of either oral contraceptive pills (OCPs) or DDAVP (1-deamino-8-d-arginine vasopressin) nasal spray, and followed from 6 months to 4 years, were selected for inclusion. Treatment outcomes were examined with respect to efficacy and safety and were compared between age-matched controls. Results: No significant differences were identified in efficacy and safety between OCP and DDAVP, 86% vs 77% (p ⬎ 0.05) and 0% vs 14% (p ⬎ 0.05), respectively, in 36 adolescents with vWD type 1 as assessed by alleviation of menorrhagia symptoms and by reported or observed clinical side effects, respectively. OCP therapy showed equal efficacy among subjects with vWD and menorrhagia (n ⫽ 36) when compared between two control groups (no vWD) receiving OCPs for menorrhagia (n ⫽ 13) or for contraception without menorrhagia (n ⫽ 13), 86% vs 78% (p ⬎ 0.05), respectively. For the control groups, safety outcomes were not significantly greater when nonvWD subjects treated with OCPs for menorrhagia were compared between those that received OCP therapy for contraception, (n ⫽ 26). Conclusions: Both standard approaches, OCPs and intranasal DDAVP, used for managing menorrhagia in adolescents with documented vWD demonstrated equal efficacy in alleviating menorrhagia symptoms and shared similar safety outcomes. Oral contraceptives demonstrated similar therapeutic success in alleviating menorrhagia in both vWD and non-vWD adolescents. These findings suggest that OCPs should be considered as first-line therapy in adolescent, vWD type 1 patients with menorrhagia due to their effectiveness, comparable side effect profile and lesser expense.
Self-Esteem During Adolescence Frank M. Biro, MD, Ruth Striegel-Moore, PhD, Justina Padgett, PhD, Debra Franco, PhD, Judy Bean, PhD, George Schreiber,
DSc, Patricia Crawford, DrPH and Steve Daniels, MD, PhD Cincinnati Children’s Hospital Medical Center, Cincinnati OH
Introduction: Self esteem is a major “predictor” of satisfaction with life, and low self-esteem is associated with adverse outcomes in health and lifestyles, such as depression, substance abuse, and pregnancy during adolescence. Methods: Girls ages 9 and 10 were recruited initially through the NHLBI Growth and Health Study, and followed to 22 years of age. The Harter Self-Perception Profile was administered semi-annually. Scores from the Global Self-Worth Scale were analyzed, utilizing 3 phases for age: ages 9–12 (Phase I), 13–16 (Phase II), and ages 17–22 (Phase III). Regression modeling included age, race, and clinical site as main effects, and BMI, parental education, and self-attained education as co-variates. Results: In the final model, significant variables within both phase I and phase II were age, race, and BMI. Within Phase III, significant variables were race, BMI, and self-attained education. Global self-worth was generally greater in black than white women, and greater with lower BMI; there was an interaction between race and BMI. Global self worth was generally lower in Phase II, contrasted to Phases I and III. Conclusions: In this longitudinal analysis of girls, age is an important variable, but the majority of variance is explained by “phase” (stage of adolescence). Race and BMI are important explanatory variables in each stage. Self esteem in white girls begins to decline at age 11, the age corresponding to the transition out of elementary school, as well as into/during early puberty.
Paratubal Cyst Causing Uteroovarian Ligament Torsion with Preservation of the Adnexa Michael J. Heard, MD, Jennifer E. Dietrich, MD, and Creighton Edwards, MD Background: In the rare event of paratubal cyst torsion, the infundibulopelvic ligament and ovary are usually involved. In this case of torsion, the ovary and fallopian tube were preserved. Case: An 11yo Hispanic female presented with complaints of bilateral lower quadrant abdominal pain for 1 1/2 days. She denied nausea, emesis, constipation, diarrhea, dysuria, fever or chills. Her last menstrual period was 2 weeks ago, and otherwise no
NASPAG 18th Annual Clinical Meeting
Department of Obstetrics and Gynecology,1 Department of Pediatrics,2 Department of Pharmacology and Toxicology3 at the Wright State University School of Medicine, Dayton, Ohio 45409
Purpose: To assess the efficacy and safety of two standard treatment approaches, oral contraceptive pills and desmopressin acetate nasal spray, in managing menorrhagia in adolescents with von Willebrand disease. Patients and Methods: Medical records of 41 adolescent females between ages 9–18 yrs with documented von Willebrand Disease (vWD) and menorrhagia were retrospectively reviewed. Subjects with vWD type 1 (n ⫽ 36) administered a regimen of either oral contraceptive pills (OCPs) or DDAVP (1-deamino-8-d-arginine vasopressin) nasal spray, and followed from 6 months to 4 years, were selected for inclusion. Treatment outcomes were examined with respect to efficacy and safety and were compared between age-matched controls. Results: No significant differences were identified in efficacy and safety between OCP and DDAVP, 86% vs 77% (p ⬎ 0.05) and 0% vs 14% (p ⬎ 0.05), respectively, in 36 adolescents with vWD type 1 as assessed by alleviation of menorrhagia symptoms and by reported or observed clinical side effects, respectively. OCP therapy showed equal efficacy among subjects with vWD and menorrhagia (n ⫽ 36) when compared between two control groups (no vWD) receiving OCPs for menorrhagia (n ⫽ 13) or for contraception without menorrhagia (n ⫽ 13), 86% vs 78% (p ⬎ 0.05), respectively. For the control groups, safety outcomes were not significantly greater when nonvWD subjects treated with OCPs for menorrhagia were compared between those that received OCP therapy for contraception, (n ⫽ 26). Conclusions: Both standard approaches, OCPs and intranasal DDAVP, used for managing menorrhagia in adolescents with documented vWD demonstrated equal efficacy in alleviating menorrhagia symptoms and shared similar safety outcomes. Oral contraceptives demonstrated similar therapeutic success in alleviating menorrhagia in both vWD and non-vWD adolescents. These findings suggest that OCPs should be considered as first-line therapy in adolescent, vWD type 1 patients with menorrhagia due to their effectiveness, comparable side effect profile and lesser expense.
Self-Esteem During Adolescence Frank M. Biro, MD, Ruth Striegel-Moore, PhD, Justina Padgett, PhD, Debra Franco, PhD, Judy Bean, PhD, George Schreiber,
DSc, Patricia Crawford, DrPH and Steve Daniels, MD, PhD Cincinnati Children’s Hospital Medical Center, Cincinnati OH
Introduction: Self esteem is a major “predictor” of satisfaction with life, and low self-esteem is associated with adverse outcomes in health and lifestyles, such as depression, substance abuse, and pregnancy during adolescence. Methods: Girls ages 9 and 10 were recruited initially through the NHLBI Growth and Health Study, and followed to 22 years of age. The Harter Self-Perception Profile was administered semi-annually. Scores from the Global Self-Worth Scale were analyzed, utilizing 3 phases for age: ages 9–12 (Phase I), 13–16 (Phase II), and ages 17–22 (Phase III). Regression modeling included age, race, and clinical site as main effects, and BMI, parental education, and self-attained education as co-variates. Results: In the final model, significant variables within both phase I and phase II were age, race, and BMI. Within Phase III, significant variables were race, BMI, and self-attained education. Global self-worth was generally greater in black than white women, and greater with lower BMI; there was an interaction between race and BMI. Global self worth was generally lower in Phase II, contrasted to Phases I and III. Conclusions: In this longitudinal analysis of girls, age is an important variable, but the majority of variance is explained by “phase” (stage of adolescence). Race and BMI are important explanatory variables in each stage. Self esteem in white girls begins to decline at age 11, the age corresponding to the transition out of elementary school, as well as into/during early puberty.
Paratubal Cyst Causing Uteroovarian Ligament Torsion with Preservation of the Adnexa Michael J. Heard, MD, Jennifer E. Dietrich, MD, and Creighton Edwards, MD Background: In the rare event of paratubal cyst torsion, the infundibulopelvic ligament and ovary are usually involved. In this case of torsion, the ovary and fallopian tube were preserved. Case: An 11yo Hispanic female presented with complaints of bilateral lower quadrant abdominal pain for 1 1/2 days. She denied nausea, emesis, constipation, diarrhea, dysuria, fever or chills. Her last menstrual period was 2 weeks ago, and otherwise no