CRC CLINIC PEDIC ADOLESCNT GYNCOL PDF

Preface

As medicine advances, as both art and science, we see specific focus on pediatric and adolescent gynecology. We live in an age in which the foundation for prevention of cervical cancer is being established. The advent of HPV vaccination appears to have a profound impact on prevention of cervical dysplasia and the sequela of a time-honored problem that oftentimes begins in adolescence. Strategies for fostering HPV vaccination beginning at nine years of age must be considered as we provide care to this unique age group. What about "attitudes" of health care providers rendering care to patients from birth through early twenties? This has taken on a whole new perspective as we advance both in the art as well as the science of pediatric adolescent gynecology. We now reflect on evidencebased data support for the presence of endometriosis in prepubertal girls. We remain aware of the fact that adolescent pregnancy rates are once again on the rise after a significant period of decline. We have learned much about communication with the teen and teen with parent or guardian. What are the barriers to communication and how should you the health care provider address such? Risk-taking behavior as well as emphasis on abstinence and "safe sex" have moved to the forefront of options when it comes to intimacy among adolescents.

We observe the evolution of new organizations across the world that provide cutting-edge information for those who provide care for the pediatric and adolescent age group. The North American Society for Pediatric and Adolescent Gynecology (NASPAG) and "FIGIJ" (the International Society for Pediatric and Adolescent Gynecology) were among the first to organize a forum for exchange of information and updating knowledge of the subspecialty area. EUROPAG (European Pediatric and Adolescent Gynecology Society), ALOGIA (South American Society for Pediatric and Adolescent Gynecology) and BRITSPAG (British Society for Pediatric and Adolescent Gynecology), as well as the Israeli Society for Pediatric and Adolescent Gynecology, continue to participate in fostering an environment of enhanced knowledge exchange for clinicians worldwide. The American College of Obstetricians and Gynecologists provides a committee, namely the Adolescent Health Care Committee, which is a multispecialty forum for the development of new educational tools to facilitate state-of-the-art care by obstetricians and gynecologists worldwide. The American Academy of Pediatrics and the American Academy of Family Practice have developed segments of their societies specifically designed to address adolescent gynecology. The Society for Adolescent Medicine is one other specialty society that includes a focus of gynecologic care. How to make an office or clinic environment "adolescent friendly" remains a goal of these specialty societies. The responsibility of making the first "gynecologic encounter" a pleasant and atraumatic event remains of paramount importance in the provision of care in this age group.

In this book's corresponding CD we have included an appendix to facilitate ready access of information at the clinician "office side" as opposed to the "bedside." The CD's video selections are designed to convey specific surgical technique for provision of care for problems in large part unique to this age group. The editors have made the decision to provide a portion of royalties from this textbook to NASPAG in an effort to expand the tools that can be utilized for education of providers of pediatric and adolescent reproductive health care worldwide. The editors remain indebted to the contributing authors for taking the time to share their time, talents and expertise with our reader audience. We have provided a comprehensive approach, designed to address virtually every problem the clinician is likely to encounter in evaluation and management of the pediatric and adolescent gynecologic patient.