Pleomorphic liposarcoma of the pterygomandibular space involving the maxilla.

Liposarcoma of the head and neck is rare. Because of its rarity, we report this case of pleomorphic liposarcoma of the left pterygomandibular space, involving the maxilla, maxillary sinus, left lateral maxillary wall, left maxillary gingiva with extension into the buccal space, retro-orbital region, left mandibular ramus, and left zygomatic process. To our knowledge, there are only two other reported cases of liposarcoma involving the maxilla, one of which was a pleomorphic liposarcoma. The pertinent literature is reviewed with an emphasis on the importance of histopathologic classification.

Hispanic adolescent pregnancy testers: a comparative analysis of negative testers, childbearers and aborters.

Fifty-six Hispanic adolescents who requested a pregnancy determination at a municipal outpatient adolescent clinic participated in a comparative study of negative testers, childbearers, and aborters. The study's purposes were to assess differences between negative and positive pregnancy testers and to evaluate the pregnancy resolution decision-making process of positive testers. Data were collected using a two-part structured interview administered prior to and following knowledge of pregnancy test results. Results indicated that negative and positive pregnancy testers were similar in all areas evaluated. However, positive testers were slightly older and had higher self-esteem than negative testers. Of the 36 positive testers, 29 chose to deliver and keep the baby. None of the adolescents chose adoption. Adolescents were consistent in their pregnancy resolution decision before and after knowledge of pregnancy test results. The pregnant adolescents considered themselves to be the most influential person in the decision-making process. There were no significant differences between the childbearers and the aborters, although the former demonstrated higher self-esteem and greater religiosity. Most of the teenagers were at risk for unintended pregnancy; therefore, subsequent family planning counseling efforts should be directed at this population.

PIP: The study population of 56 Hispanic (Puerto Rican, Dominican, and Central and South American) females 14-19 requesting pregnancy status was recruited from a municipal adolescent clinic in a Hispanic section of New York City in 1988. The investigation involved descriptively differentiating negative and positive pregnancy testers and evaluating the factors involved in the resolution of the pregnancy. The sample population was described as predominately born in the US (79%) with a mean age of 17.2 years, 86% Catholic, 93% unmarried, 59% living with parent/s and 21% with boyfriend/husband. 64% had a positive pregnancy test. There were no statistically significant differences, disregarding the small sample sizes, between positive and negative testers on nationality of birthplace, how support was received, or presence of a maternal teenage pregnancy. There were no significant differences by self-esteem, religiosity, education, duration of relationship, onset of sexual activity, contraceptive use (50% of positive testers and 33% of negative), and pregnancy resolution. School attendance showed similar patterns, i.e., of school attenders, 65% tested positive, and of dropouts, 64% tested positive. School performance was the same with average or above average grades, and plans to graduate were similar. Planned pregnancy resolution was similar for positive vs. negative testers with 67% vs. 65% planning to deliver and keep the baby, 19% vs. 5% planning to terminate the pregnancy, and 14% vs. 30% undecided. There were no plans to place the baby for adoption. The final resolution revealed that 81% decided to deliver and keep the baby. Of the group prior to test results desiring to keep the baby, 69% stated the pregnancy was unwanted. Among those childbearers and terminators, self- esteem was higher among those choosing to deliver; more childbearers indicated some religiosity. Of those attending school, 80% chose to deliver, and of those dropping out 81% chose to deliver. All school attenders planned to complete their education. Childbearers and terminators had similar durations of relationship with the father (1 year). 93% of those childbearers and 100% of those choosing termination said that their own opinion was the most important, then came the influence of the child's father, and then their mother. The strongest support for the decision was seen as coming from the child's father, then their mother. Locus of control was the similar for terminators and childbearers. The implications are that family planning counseling efforts should be directed at the entire population being tested.

Hepatitis B virus markers and persistent antigenemia in adolescents.

Adolescents attending a municipal outpatient adolescent clinic in New York City were evaluated for the prevalence of hepatitis B virus (HBV) markers and persistent antigenemia. Among 313 teenagers tested in 1 year, 11.8% were HBV marker positive, and 4.8% had persistent antigenemia. Hispanic teens had a marker rate of 6.4% and an antigenemia rate of 1.4%. Dominican Republic teens had a significantly higher marker rate than Puerto Rican teens. Among Hispanics, sexual activity status and foreign- vs. U.S.-born status were not significantly related to the presence of HBV markers. Asian teenagers had a 50% marker rate and a 27.2% rate for persistent antigenemia. Marker and antigenemia rates were highest in the most recent immigrants. Unexplained persistent hematuria occurred more frequently in patients with HBV markers than in patients without markers. We recommend routine hepatitis B surface antigen screening in Hispanic and Asian adolescents. The greatest at-risk groups are Asians, especially recent immigrants, immigrants from the Dominican Republic, and probably patients with unexplained persistent hematuria.

Influence of family planning counseling in an adolescent clinic on sexual activity and contraceptive use.

We evaluated whether family planning counseling (FPC) in an adolescent clinic promoted the onset of sexual activity among the non-sexually active teens and/or increased contraceptive use among the sexually active teens. The FPC focused on the teens' establishing sexual values, the right to say "no," abstinence and alternate forms of intimacy, consequences of intercourse, and the various contraceptive methods. Data for one year were collected on the adolescents' first and subsequent visits to a medically oriented, municipal outpatient adolescent clinic. There were 383 teenagers who qualified for the study. Of these, 35% (134) reported premarital sexual activity. During the study period, 3% (8) of the 249 nonsexually active teens reported becoming sexually active. Among the 134 sexually active teens at clinic entry, 27% reported using a contraceptive method at their most recent sexual encounter. Among the 142 sexually active adolescents at the conclusion of the study, 76% reported contraceptive use at their most recent sexual encounter (p less than 0.001). We conclude that the provision of FPC to nonsexually active and sexually active teens does not appear to promote the onset of sexual activity significantly among the non-sexually active group, although it significantly increases contraceptive use among the sexually active group.

PIP: Whether family planning counselling (FPC) in an adolescent clinic promoted the onset of sexual activity among non-sexually active adolescents and/or increased contraceptive use among sexually active adolescents was evaluated. The FPC focused on the adolescents' establishing sexual values, the right to say "no," abstinence and alternate forms of intimacy, consequences of intercourse, and various contraceptive methods. Data for 1 year were collected on adolescents' 1st and subsequent visits to a medically-oriented, municipal outpatient adolescent clinic located in a predominately Hispanic, working-poor area of New York City. 383 adolescents qualified for the study. Of these, 35% (134) reported premarital sexual activity. during the study period, 3% (8) of the 249 non-sexually active adolescents reported becoming sexually active. Among the 134 adolescents sexually active at clinic entry, 27% reported using a contraceptive method at their most recent sexual encounter. Among the 142 sexually active adolescents at the conclusion of the study, 76% reported contraceptive use at their most recent sexual encounter (p 0.001). It was concluded that FPC provision to non-sexually active and sexually active teens does not appear to promote the onset of sexual activity significantly among the non-sexually active group, although it significantly increases contraceptive use among the sexually active group.