The inbetweeners: a review of the transition from child into adult care for young people with chronic health conditions.

The National Confidential Enquiry into Patient Outcome and Death reviewed the barriers and facilitators in the process of the transition of children and young people with chronic health conditions into adult health services. The report focuses on five issues - developmentally appropriate healthcare, the involvement of children and young people and their parents or carers in transition planning, communication and coordination of care, the organisation of transition services and leadership - and makes recommendations for practice.

Fifteen-minute consultation: The overweight teenage girl with acne.

Polycystic ovary syndrome (PCOS) is a common endocrine condition which often presents in adolescence. The symptoms and signs, which include obesity, acne, hirsutism and irregular menstrual periods, can have profound psychosocial, metabolic and reproductive consequences. Diagnosis in the adolescent population can be particularly difficult as there is significant overlap between the clinical features of PCOS and those of normal pubertal development. International guidelines published in 2018 have produced diagnostic criteria for adolescents to aid the physician, but there will still be many cases in which diagnostic uncertainty remains. In this article, we present a structured approach to adolescents with symptoms of PCOS, covering clinical assessment, investigation, diagnosis and management. We emphasise that intervention, with lifestyle advice and combined oral contraception should be considered even in the absence of a definitive diagnosis.

Fifteen-minute consultation: History and examination in adolescent gynaecology.

Disorders of reproductive and sexual health are commonly encountered in paediatric clinics and can present many challenges to the general paediatrician. In this article we aim to discuss general consultation skills relevant to adolescents, appropriate screening questions for reproductive health concerns and the comprehensive assessment of any gynaecological symptoms identified. Crucially a vast array of conditions can be diagnosed with history and examination alone, sometimes with the addition of simple and readily available investigations, without the need for specialist gynaecology referral. Often reassurance that a concern is simply part of normal reproductive development is all that is required.