Unintentional Perineal Injury in Prepubescent Girls: A Multicenter, Prospective Report of 56 Girls

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 628-631
Author(s):  
G. Randall Bond ◽  
M. Denise Dowd ◽  
Ira Landsman ◽  
Mary Rimsza
Keyword(s):  
Unintentional Injury ◽  
Tanner Stage ◽  
Older Children ◽  
Care Clinic ◽  
Pattern Of Injury ◽  
Labia Minora ◽  
Perineal Injury ◽  
Perineal Injuries ◽  
Stage 1 ◽  
Age Range

Objective. To determine the pattern of perineal injuries and frequency of hymenal involvement resulting from unintentional trauma in prepubescent girls. Design. Prospective, multicenter. Observation by skilled observers. Determination of the circumstance and physical pattern of injury, with specific attention to the hymen. Setting. Children's emergency department or acute care clinic. Patients. Tanner stage 1 girls presenting with acute perineal injury. Criteria for unintentional injury: observation of the event or knowledge of the girl's engagement in a risky activity (eg, biking or climbing monkey bars) immediately before the injury. Results. Fifty-six girls were evaluated. Age range: 1 to 12 years (median, 6 years; mean, 6.2 years). Associations: bicycle, 39%; other outdoor injuries, 25% (climbing apparatus, straddling an object, and falls); indoor injuries, 36% (straddling furniture and falls). Most injuries were minor. In each group the labia minora was the most frequent structure involved. The majority of injuries were anterior or lateral to the hymen. However, in 34% some or all of the injuries were posterior to the hymen. Thigh injuries were observed only in older children engaged in bicycle riding or outdoor play. In only one patient was the hymen involved. That patient was a 2 year old who fell outdoors, at a park, abducting her legs in a splits-type mechanism. She had a pinpoint abraded area on the hymenal surface at three o'clock. Otherwise, no unique pattern of injury was associated with age or circumstance of injury. Conclusions. Hymenal injuries are rarely the result of unintentional injury. The presence of a hymenal injury should suggest sexual abuse. Involvement of other perineal structures was commonly associated with unintended injury. Given the limited resources for prevention, the relative infrequency of perineal injuries and the minor nature of most of these injuries, significant preventive efforts are not justified.

Urinary gonadotropin measurements by enhanced luminometric assays (LIA) for the evaluation of pubertal development

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
And Demir ◽  
Adem Aydın ◽  
Atilla Büyükgebiz ◽  
Ulf-Håkan Stenman ◽  
Matti Hero
Keyword(s):  
Healthy Subjects ◽  
Reliable Method ◽  
Pubertal Development ◽  
High Sensitivity ◽  
Tanner Stage ◽  
Time Resolved ◽  
Stage 1 ◽  
Sensitive Detection Technique ◽  
Serum And Urine

Abstract Objectives Determination of LH in urine has proved to be a reliable method for evaluation of pubertal development. The human LH assay based on time-resolved immunofluorometric (IFMA) technology (AutoDELFIA, PerkinElmer, Wallac) has been found to be suitable for this purpose thanks to its high sensitivity but other assays have not been evaluated. We have analyzed our data obtained by another potentially sensitive detection technique, enhanced luminometric assay (LIA) with the objective of finding a viable alternative to IFMA since these may not be available in the future. Methods LIA was used to measure LH and FSH in serum and urine samples from 100 healthy subjects of each Tanner stage and both genders, whose pubertal development has been determined. Results Urinary gonodotropin concentrations measured by LIA correlated well with Tanner stage [(r=0.93 for girls, r=0.81 for boys; p<0.01 for LH) and (r=0.81 for girls, r=0.73 for boys; p<0.01 for FSH)]. LIA determinations revealed the increase in U-LH concentrations during the transition from Tanner stage 1–2 in both girls and boys (p<0.001), whereas U-FSH and S-LH were able to detect the increase from Tanner stage 1–2 only in boys or girls, respectively (both p<0.001). Conclusions Measurement of urinary gonadotropin concentrations by LIA may be useful for the evaluation of overall pubertal development and also in the detection of transition from prepuberty to puberty.

scholarly journals Cognitive and Physical Activity-Related Aspects of Children Associated to the Performance of the Crunning Movement

2021 ◽  
Vol 6 (1) ◽  
pp. 9
Author(s):  
Ewan Thomas ◽  
Marianna Alesi ◽  
Garden Tabacchi ◽  
Carlos Marques da Silva ◽  
David J. Sturm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Team Sports ◽  
Group Differences ◽  
Test Results ◽  
Older Children ◽  
Related Factors ◽  
Movement Performance ◽  
Individual Sports ◽  
Age Range

The aim of this investigation was to identify possible related factors associated to the performance of the crunning test in European children and adolescents. A total number of 559 children and adolescents (age range 6–14 years) of which 308 boys (55.1%) and 251 girls (44.9%), from seven European countries, were screened. A questionnaire concerning demographic and personal life-related factors and a cognitive assessment were performed. A regression analysis was conducted with the performance measures of the crunning movement. T-tests and ANCOVA were used to analyze sub-group differences. Boys have greater crunning performance values compared to girls (5.55 s vs. 7.06 s, p < 0.001) and older children perform better than younger ones (R2 −0.23; p < 0.001). Children with healthy and active habits (exercising or spending time with family members vs. reading or surfing the internet) performed better in the test. Children engaged in team sports had better crunning performances compared to those engaged in individual sports (6.01 s vs. 6.66 s, p = 0.0166). No significant association was found regarding cognitive-related aspects in either children engaged in team or individual sports and the crunning performance. Older and male children performed better in the crunning test than younger and female children. Physical activity-related aspects of children’s life are associated with crunning movement performance. No association was found between higher cognitive performance and the crunning test results.

scholarly journals Perineal trauma after vaginal delivery in healthy pregnant women

2014 ◽  
Vol 132 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Larissa Santos Oliveira ◽  
Luiz Gustavo Oliveira Brito ◽  
Silvana Maria Quintana ◽  
Geraldo Duarte ◽  
Alessandra Cristina Marcolin
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Standing Position ◽  
Professional Activity ◽  
Factors Associated ◽  
Perineal Injury ◽  
Secondary Hospital ◽  
Perineal Injuries

CONTEXT AND OBJECTIVE:Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS) in healthy pregnant women after vaginal delivery.DESIGN AND SETTING:Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.METHODS:A standardized questionnaire was prepared and applied to medical files that had been completely filled out (classification of the Royal College of Obstetricians and Gynecologists, RCOG) in order to identify OASIS and analyze risk factors associated with mild and severe perineal lacerations.RESULTS:The women's mean age was 25 years; more than half (54.4%) were primiparae. Almost 38% of the participants had perineal lacerations; these were severe in 0.9% of the cases. Previous vaginal delivery (odds ratio, OR: 1.64 [1.33-2.04]) and forceps delivery (OR: 2.04 [1.39-2.97]) were risk factors associated with mild perineal injuries (1st and 2nd OASIS classifications). Only remaining standing for prolonged periods during professional activity (OR: 2.85 [1.34-6.09]) was associated with severe perineal injuries.CONCLUSION:The prevalence of severe perineal injuries was concordant with data in the literature. The variable of standing position was considered to be a risk factor for severe perineal injury and should be further investigated.

scholarly journals PREVALENSI DAN ANALISIS FAKTOR RISIKO HIPERTENSI DI WILAYAH KERJA PUSKESMAS NANGGALO PADANG

2021 ◽  
Vol 9 (1) ◽  
pp. 1-9
Author(s):  
Verra Widhi Astuti ◽  
Tasman Tasman ◽  
Lola Felnanda Amri
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Significant Relationship ◽  
Community Health Center ◽  
Saturated Fat ◽  
Survey Method ◽  
Cross Sectional ◽  
Work Area ◽  
Stage 1 ◽  
Age Range

ABSTRAK Pendahuluan: Hipertensi disebut sebagai "silent killer" artinya dapat menyebabkan kematian secara diam-diam. Hanya melalui pengukuranlah deteksi dapat dilakukan. Penelitian ini bertujuan untuk mengetahui prevalensi hipertensi dan faktor-faktor yang mempengaruhi hipertensi di Wilayah Kerja Puskesmas Nanggalo, Padang. Metode: Penelitian ini menggunakan metode survei analitik dengan pendekatan cross sectional. Penelitian dilakukan pada masyarakat usia > 18 tahun di wilayah Kerja Puskemas Nanggalo dengan sampel sebanyak 438 responden. Hasil: Hasil penelitian menunjukkan bahwa proporsi hipertensi di masyarakat Wilayah Kerja Nanggalo tahun 2019 sebesar 13,7 yang terdiri dari 10,7% hipertensi stage 1 dan 3% hipertensi stage 2. Sedangkan 19,2% responden sudah memasuki tahap pra hipertensi. Responden paling banyak pada usia produktif yaitu pada rentang usia 18-50 tahun; responden antara laki-laki dan perempuan jumlahnya hampir sama; sebagian besar memiliki status gizi (IMT) normal (64,2%), sebagian besar responden beraktivitas fisik secara rutin (77,9%); sebagian besar responden tidak merokok (61%); dan konsumsi makanan tinggi lemak jenuh dan rendah lemak jenuh hampir sama. Kesimpulan: Ada hubungan yang signifikan antara usia, berat badan (IMT) dan aktivitas fisik dengan kejadian hipertensi. Serta tidak ada hubungan yang signifikan antara jenis kelamin, kebiasaan merokok, dan makan makanan berlemak jenuh dengan kejadian hipertensi. Hasil penelitian ini diharapkan mampu meningkatkan kesadaran responden terhadap faktor-faktor risiko hipertensi.   Kata kunci: Faktor risiko, hipertensi,  prevalensi.   ABSTRACT Introduction: Hypertension is called the "silent killer" which means it can cause death silently. Therefore, detection can only be done through measurement. This study aims to determine the prevalence of hypertension and the risk factors that influence hypertension in the working area of ​​the Nanggalo Community Health Center, Padang. Methods: This study used an analytic survey method with a cross sectional approach. The research was conducted on people aged> 18 years in the working area of ​​Puskemas Nanggalo with 438 respondents as a sample. Result: The results showed that the proportion of hypertension in Nanggalo Work Area was 13.7 consisting of 10.7% stage 1 hypertension and 3% stage 2 hypertension. While 19.2% of respondents had entered the pre hypertension stage. Most respondents are in productive age, namely in the age range 18-50 years; the number of respondents between men and women is almost the same; most of them had normal nutritional status (BMI) (64.2%), most of the respondents had regular physical activity (77.9%); most of the respondents do not smoke (61%); and consumption of foods high in saturated fat and low in saturated fat is about the same. Conclusion: There is a significant relationship between age, body weight (BMI) and physical activity with the incidence of hypertension. And there is no significant relationship between gender, smoking habits, and eating saturated fatty foods with the incidence of hypertension. The results of this study are expected to be able to increase respondents' awareness of risk factors for hypertension.   Keywords: Hypertension, prevalence, risk factor

scholarly journals Can children's spelling of schwa vowels in stems be improved?

2010 ◽  
pp. 113-127 ◽  
Author(s):  
João Rosa ◽  
Terezinha Nunes
Keyword(s):  
Primary School ◽  
Significant Interaction ◽  
Older Children ◽  
Priming Effects ◽  
Early Signs ◽  
Priming Condition ◽  
Priming Paradigm ◽  
Written Form ◽  
Age Range ◽  
Morphological Representation

Children in the early grades of primary school do not seem to have much awareness of morphemes. In this study, a priming paradigm was used to try to detect early signs of morphological representation of stems through a spelling task presented to Portuguese children (N= 396; age range 6 to 9 years). Primes shared the stem with the targets and contained well-articulated, stressed vowels; the stems of the target words contained non-stressed schwa vowels, which typically result in spelling difficulties. If priming proved effective, the well-articulated vowels in the prime should lead to improvement in the spelling of the schwa vowels in the targets. Primes were presented in two conditions: in only-oral or in oral-plus-written form. Effectiveness of priming was assessed by comparison with a no-priming condition. There was a significant interaction between priming effects and grade. No priming effects were detected in 6- and 7-year-old children; oral-plus-written priming produced higher rates of correct vowel spelling for 8- and 9-year-olds; only-oral priming was effective in improving the vowel spelling of 9-year-olds. Thus the older children used morphological information under priming conditions but there is no evidence to suggest that younger children did so.

Abstract P134: Selected Social Determinants Of Health And Hypertension For Patients Of An Urban Community Primary Care Clinic

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Melvin R Echols ◽  
Paula Pollard-Thomas ◽  
Henry Nuss ◽  
Heartley Egwuogu ◽  
Kristen Hobbs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
African American ◽  
Food Insecurity ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Clinic ◽  
Financial Strain ◽  
Care Clinic ◽  
Stage 1

Background: Hypertension (HTN) is the most potent cardiovascular disease worldwide and a major public health concern in the U.S. Although Social Determinants of Health (SDoH) are associated with HTN, it is unclear whether these indicators are routinely captured in the primary care setting. We sought to examine the prevalence of any HTN and its association with captured SDoH for new patients (pts) presenting to an urban community primary care clinic for 2019 and 2020. Methods and Results: We identified a cohort-based, cross-sectional sample of 2,577 new pts ≥ 18 years of age in a community clinic in Atlanta, GA, between Jan 2019 and Dec 2020. Electronic health records were reviewed to determine the rate of selected SDoH indicators (financial strain, transportation, medical transportation, and food insecurity) captured at any time and the presenting blood pressure for all new patients. Blood pressure was classified as follows: normal, systolic BP/diastolic BP (SBP/DBP) ≤120/80 mmHg, elevated SBP 120-129mmHg and DBP<80mm, stage 1 SBP 130-139mmHg or DBP 80-90mmHg, and stage 2 SBP ≥ 140mmHg+ or DBP 90mmHg+. Likelihood-ratio Chi-square tests were analyzed to detect an association between SDOH and stages of HTN. Of the 2,577 pts seen, 93% were African American, 72% were female, 59% were single, 77% had BMI ≥ 25, and 85% were insured. Only 41% (n=1062) pts had information of at least one SDoH measure in the entire cohort. Of the SDoH domains evaluated, financial strain and food insecurity were more likely in new pts with stage 1 HTN or higher (χ2= 16.0, df=8, p=0.04; χ2= 27.7, df=12, p=0.006). Conclusion: Routine assessments of SDoH for African American pts presenting for new pt visits are suboptimal in the primary care setting. However, financial strain and food insecurity are significantly associated with stage 1 and 2 HTN in this population. Standardization of intake processes is essential to increase the collection of SDoH indicators and may ultimately guide secondary prevention strategies for HTN interventions.

Quality of Life in Paediatric Migraine: Characterization of Age-Related Effects Using PedsQL 4.0

Cephalalgia ◽  
2004 ◽  
Vol 24 (2) ◽  
pp. 120-127 ◽  
Author(s):  
SW Powers ◽  
SR Patton ◽  
KA Hommel ◽  
AD Hershey
Keyword(s):  
Quality Of Life ◽  
Young Children ◽  
Parent Report ◽  
Clinic Visit ◽  
Older Children ◽  
Quality Of Life Inventory ◽  
Age Related ◽  
Pedsql 4.0 ◽  
Age Range

The aim of this study was to measure quality of life (QOL) across a broad age range of paediatric migraine patients. Children and adolescents ( n = 686) with migraine completed the Pediatric Quality of Life Inventory, version 4.0 (PedsQL 4.0) and a standardized headache assessment at an initial clinic visit. The sample size for each PedsQL age group was: age 2-4 = 21, age 5-7 = 86, age 8-12 = 298, and age 13-18 = 281. Mean total score was 72.7 ± 14.8, significantly less than healthy norms ( P < 0.01). Teens reported lower School Functioning than older and young children ( P < 0.05) and young children reported lower Social Functioning than older children and teens ( P < 0.001). A moderate relation was found between self and parent report. Age-related effects on QOL have implications for the evaluation and management of migraine in paediatric practice. The self and parent report forms of the PedsQL can be used in a practice setting.

scholarly journals The Norwegian industry-led scheme restricting marketing of unhealthy food and beverages to children

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Øvrebø ◽  
A Helleve
Keyword(s):  
Food Industry ◽  
Unhealthy Food ◽  
Older Children ◽  
Regulatory Scheme ◽  
Know How ◽  
Food And Beverages ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Health Authorities ◽  
Age Range

Abstract Issue The Norwegian food industry has implemented a self-regulatory scheme to restrict the marketing of unhealthy foods and beverages to children under the age of 13 years. In the period 2014-2019, the scheme has treated 77 complaints and made 126 assessments of planned marketing campaigns. Description The aim of the evaluation was to explore perceptions of the scheme through interviews with stakeholders from the industry, non-governmental organizations (NGOs), and health authorities. Further, a survey among parents (n = 1117) with children under the age of 16 years was completed to map opinions on marketing of unhealthy foods and beverages to children. Results The stakeholders had different views of the scheme, where the industry was positive, while the NGOs had mostly critical views. The dispute relates mainly to the content of the scheme's code and guidance, and less to the practice of the scheme's committee. NGOs and health authorities argue that older children should be covered by the scheme, whereas the industry opposes this. However, the scheme specifies to take precautions when marketing to adolescents below 16 years. More than 40 percent of parents are worried that their child is excessively exposed to marketing of unhealthy foods and beverages and report that it affects their child. About one-third of the parents had heard about the scheme. Lessons The possibility of having an assessment of planned marketing campaigns is a strength; however, there are still disagreements concerning the scheme's code and guidance. To make complaints, consumers need to know how, complicating supervision. However, parents experience that children are exposed to marketing of unhealthy foods and beverages and support regulations protecting them from such marketing. Key messages The industry, NGOs, and authorities have different views about the scheme. Disagreement applies mainly to the age range that should be protected from marketing of unhealthy foods and beverages.

scholarly journals Signaling between the pituitary gland and the testes: inverse relationship between serum FSH and inhibin B concentrations in boys in early puberty

2000 ◽  
pp. 150-156 ◽  
Author(s):  
T Raivio ◽  
S Saukkonen ◽  
J Jaaskelainen ◽  
J Komulainen ◽  
L Dunkel
Keyword(s):  
Tanner Stage ◽  
Inhibin B ◽  
Human Testis ◽  
Early Puberty ◽  
Assay Sensitivity ◽  
Reciprocal Regulation ◽  
Prepubertal Boys ◽  
The Difference ◽  
Age Range ◽  
Estradiol Levels

OBJECTIVES: To study the relationship between serum inhibin B and sex steroid concentrations and pituitary FSH responsiveness to GnRH in boys in early puberty, and to examine serum inhibin B levels in prepubertal boys with different timing of the onset of gonadotropin deficiency (GD). DESIGN: Twenty-five boys with constitutional delay of puberty (CDP; 20 in Tanner stage G2 and 5 in G3; age range, 13. 5-16.8 years) and eight prepubertal boys (G1P1) with GD (age range, 10.0-13.2 years) were clinically examined, and serum inhibin B, testosterone and estradiol concentrations were measured from sera obtained immediately before the administration of GnRH (Relefact; 3.5 microgram/kg, maximum 100 microgram i.v.). Thereafter, FSH levels were measured at 30min intervals up to 90min. RESULTS: In the boys with CDP, basal inhibin B and FSH levels did not correlate. However, inhibin B and GnRH-stimulated FSH concentrations (r(S)= -0.43 to -0.45, n=25, P<0.05) and the difference between basal and peak serum FSH levels were inversely related (r(S)= -0.63, n=25, P<0.005). This relationship remained significant in boys at stage G2 (r(S)= -0.66, n=20, P<0.005). Basal testosterone concentrations and GnRH-induced FSH levels did not correlate. Estradiol levels were too low (64% of the boys had estradiol levels below the assay sensitivity) to allow correlation analysis. The boys with GD had low inhibin B concentrations (range, <15.6-53pg/ml); the lowest levels were observed in boys with presumably congenital onset of the disease. Serum inhibin B levels and testis volumes correlated positively (r(S)=0.70, n=8, P=0.07). CONCLUSIONS: These results suggest that, in boys, the reciprocal regulation between inhibin B and FSH is in operation before mid-puberty. Moreover, autonomous inhibin B secretion by the prepubertal human testis is likely to reflect the number of Sertoli cells.

scholarly journals Serological study of the epidemiology of mumps virus infection in north-west England

1990 ◽  
Vol 105 (1) ◽  
pp. 175-195 ◽  
Author(s):  
D. J. Nokes ◽  
J. Wright ◽  
P. Morgan-Capner ◽  
R. M. Anderson
Keyword(s):  
Virus Infection ◽  
Virus Transmission ◽  
Mumps Virus ◽  
Older Children ◽  
Serum Samples ◽  
North West ◽  
Force Of Infection ◽  
Age Related ◽  
Age Range ◽  
Notification Data

SUMMARYSerum samples from individuals of a wide age range, collected in northwest England in 1984 and 1986, provide the basis for an analysis of the epidemiology of mumps virus infection. A radial haemolysis test yielding quantitative antibody measurements was used to screen samples for mumps-specific IgG. Analyses of resultant age-seroprevalence profiles, using statistical models, revealed an age-related pattern in the rate of infection per susceptible similar to that observed for other childhood infections. This rate, or force of infection, was low in young children, high in older children, and low in adults. In addition, the serological surveys provide evidence for time-dependent changes (both epidemic and longer-term) in the rate of mumps virus transmission. The longer-term changes, reflected in the pattern of the age-acquisition of specific antibodies, are supported by evidence from case notification data. The implications of temporal changes in incidence to the interpretation and design of serological surveys are considered.

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