Conceptos Categóricos

PROGRESOS EN LA ATENCION GINECOLOGICA EN LAS ADOLESCENTES

PROGRESOS EN LA ATENCION GINECOLOGICA EN LAS ADOLESCENTES

(especial para SIIC © Derechos reservados)
Los problemas ginecológicos clínicos característicos de los adolescentes requieren atención y consideración especiales, además de conocimientos adecuados y experiencia. Se aportan datos para la evaluación y el tratamiento de los problemas más comunes que enfrentan los médicos clínicos.
Autor:
Eduardo Lara-torre
Columnista Experta de SIIC

Institución:
Virginia Tech Carilion School of Medicine


Artículos publicados por Eduardo Lara-torre
Coautores
Eduardo Lara-Torre* Joseph Sanfilippo** 
Virginia Tech Carilion School of Medicine, EE.UU.*
University of Pittsburgh School of Medicine, Pittsburgh, EE.UU.**
Recepción del artículo
24 de Septiembre, 2012
Aprobación
6 de Noviembre, 2012
Primera edición
3 de Diciembre, 2012

Resumen
Los nuevos avances en el campo de la salud reproductiva adolescente produjeron un interés creciente en el sistema de salud. En esta reseña se destacan los patrones de la práctica clínica y las normas recientes para la evaluación y el tratamiento de los temas ginecológicos de la adolescencia. En primer lugar, la comprensión de las técnicas apropiadas para la evaluación y el examen inicial, que son esenciales para hacer sentir a la paciente lo más cómoda posible y para el establecimiento de una relación a largo plazo. La medicina preventiva es clave en esta población y los médicos deberían hablar de modo sencillo con sus pacientes diversos temas tales como la sexualidad, los trastornos alimentarios, el abuso de sustancias y la violencia en la pareja. Además, debe procurarse que los médicos hablen en la consulta sobre la vacuna contra el papilomavirus humano (HPV) y la indiquen, así como que implementen las modificaciones recientes más conservadoras sobre la pesquisa con citología cervical y su tratamiento en la población adolescente. La frecuencia con la que las adolescentes se inician sexualmente hacen necesario el asesoramiento sobre los métodos anticonceptivos eficaces y la pesquisa apropiada sobre las infecciones de transmisión sexual cuando sea necesario. Durante la transición por la pubertad, los trastornos menstruales son comunes y requieren la interconsulta por un ginecólogo. La etiología más frecuente de los sangrados es la anovulación. El síndrome de ovarios poliquísticos puede aparecer a comienzos de la pubertad y tiene consecuencias en la vida adulta. Por último, las consecuencias de la endometriosis sobre la fertilidad futura de los adolescentes merecen su pronto reconocimiento y tratamiento para evitar las repercusiones futuras de la enfermedad. Dados los progresos en el campo de la salud reproductiva de los adolescentes, revisamos los puntos sobresalientes de las normas y los patrones recientes de práctica clínica sobre la evaluación y el tratamiento de los temas ginecológicos en la adolescencia. Los problemas clínicos únicos de esta población requieren atención y consideración particulares y por parte de especialistas.

Palabras clave
atención de las adolescentes, anticoncepción, ginecología, adolescentes


Artículo completo

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Abstract
New developments in the field of adolescent reproductive health have created enhanced interest for healthcare providers. This review highlights recent guidelines and practice patterns in evaluation and management of adolescent gynecologic issues. First, understanding the proper techniques for the initial evaluation and examination is essential for making the patient as comfortable as possible and for establishing a long-term relationship. Preventative healthcare is key in this population, and practitioners should be at ease discussing a variety of issues including sexuality, eating disorders, substance abuse, and dating violence. Additionally, practitioners are encouraged to discuss and provide the human papillomavirus (HPV) vaccine, and implement the recent conservative changes to cervical cytology screening and management in adolescents. Given the frequency with which teens report sexual activity, counseling regarding effective contraceptive methods and appropriate screening for sexually transmitted infections is necessary. During their transition through puberty, disorders of menstruation become a common complaint requiring the attention of the gynecologist. Most commonly, anovulation is the etiology of such bleeding. Polycystic ovarian syndrome may develop in early puberty and carry consequences to adulthood. Finally, the consequences of endometriosis on the future fertility of adolescents have brought early intervention to light. Recognition and prompt treatment are advocated to prevent the future implications of this disease. Given new developments in the field of adolescent reproductive health, we review highlights in recent guidelines and practice patterns in evaluation and management of adolescent gynecologic issues. Unique clinical problems in adolescents require particular expertise, caring, and consideration.

Key words
adolescent care, contraception, gynecology, teenagers


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Obstetricia y Ginecología, Pediatría
Relacionadas: Atención Primaria, Educación Médica, Endocrinología y Metabolismo, Epidemiología, Medicina Familiar, Medicina Interna, Medicina Reproductiva, Salud Pública



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Meredith Snook, University of Pittsburgh School of Medicine, PA 15213, 300 Halket Street, Room 2314, Pittsburgh, EE.UU.
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