Treatment of Clitoral Keratin Pearls with Topical Estrogen Cream: Case Report.

Background: Keratin pearls are intraepithelial accumulations of squamous cells and debris that can be an etiology of vulvovaginal irritation in pediatric patients and are often associated with clitoral adhesions. Historically, most cases have been managed with manual or operative lysis of adhesions.

Case: Two prepubertal girls presented to our clinic with chronic clitoral irritation and were found to have clitoral adhesions with keratin pearls.

A randomized controlled trial to prevent excessive gestational weight gain and promote postpartum weight loss in overweight and obese women: Health In Pregnancy and Postpartum (HIPP).

Background: Interventions to prevent excessive gestational weight gain and promote postpartum weight loss have yielded modest results, particularly in overweight and obese women.

Objectives: To examine the impact of a theory-based lifestyle intervention on gestational weight gain, postpartum weight loss, and related maternal and child outcomes and to examine race differences in these outcomes.

Design: A randomized controlled trial (target N=400; 200 intervention, 200 standard care; 200 African American, 200 white).

Delaying Pap test screening in the adolescent population: an evidence-based approach.

Cervical cancer screening guidelines have evolved significantly over the past ten years in the adolescent population. The objective of this article is to review the cervical screening guidelines in the adolescent population as well as examine the evidence and studies that support delaying screening until 21 years old. Delaying HPV and Papanicolaou testing until 21 years old is safe and will not increase cervical cancer rates in the adolescent population.

Hyperprolactinemia-related adverse events associated with antipsychotic treatment in children and adolescents.

Purpose: To characterize factors related to the development of hyperprolactinemia and the ensuing reproductive/sexual adverse events in children and adolescents treated with antipsychotic and other psychotropic agents, and the additional risk posed for those with comorbid obesity, metabolic, or endocrine disorders.

Methods: A retrospective cohort design evaluating medical and pharmacy claims from South Carolina's Medicaid program was used to compare incidence rates for sexual/reproductive adverse events in 4140 children and adolescents who were newly prescribed one of six atypical or two conventional antipsychotic medications, and a random sample of 4500 children not treated with psychotropic medications, January 1998 to December 2005. Logistic and Cox Proportional Hazards regression and Kaplan-Meier survival analysis were performed.

Cervical cytology screening and management of abnormal cytology in adolescents.

The consensus guidelines recognize adolescents as a special group and allow for more conservative follow- up of abnormal cytology and histology. The guidelines recognize the role of high rates of HPV infection and reinfection in teens, along with high rates of clearance of HPV and low rates of invasive cervical cancer. Risks of treatment are balanced with risk for disease progression.

Prepubertal Skene's abscess.

Background: Skene's glands are believed to be homologues of the prostate gland derived from the urogenital sinus.(1) Complications of Skene's glands occur most often in the third and fourth decades and are rarely seen in premenarchal females.

Case: A 3-year-old presented to her pediatrician with a 9-day complaint of vulvar pain.

A pure Sertoli cell tumor of the ovary in a 10-year-old female.

Study Objective: To document an unusual presentation of a pure Sertoli Cell tumor.

Design: Case report.

Results: We present a 10-year-old female who presented with abdominal pain and diarrhea with no symptoms of puberty.

Pregnancy after Essure placement: report of two cases.

Objective: To report two cases of pregnancy after placement of Essure micro-inserts.

Design: Case report.

Setting: University-based Department of Obstetrics and Gynecology.

Disseminated gonococcal infection in pregnancy presenting as meningitis and dermatitis.

Background: In 2003, the reported gonorrhea rate among women was 118.8 per 100,000 women. Most gonococcal infections in pregnant women are asymptomatic or produce a mildly symptomatic genital infection.

Hair thread tourniquet syndrome in adolescents: a presentation and review of the literature.

Hair thread tourniquet syndrome has been recognized since the 1600s when a strangulating hair was reported around the glans penis. Since that time sporadic reports have appeared in the literature describing strangulation of appendages by human hair. Most often the constriction involves fingers, toes, or the penis.

Communicating with the adolescent gynecology patient.

Providing health care to adolescents begins with good communication. Teens appreciate providers who are genuine and not parental. Guidelines to facilitate adolescent communication are presented.