Ovarian Tissue Cryopreservation in Children and Adolescents.

Cancer during childhood and adolescence remains a major public health issue, affecting a significant portion of this age group. Although newer anti-cancer treatments have improved survival rates, this comes at a cost in terms of gonadotoxic effects. As a result, the preservation of fertility is important. Ovarian tissue cryopreservation, one of the newest methods, has some advantages, especially for prepubertal patients: no need for ovarian stimulation, thus, no further risk for estrogen-sensitive cancer types, and preservation of more and better-quality primordial follicles of the ovarian cortex. The most frequent indications include treatment with alkylating agents, ovarian-focused radiotherapy, leukemias, lymphomas, brain and neurological tumors, as well as Turner syndrome and benign hemoglobinopathies. An expected survival exceeding 5 years, the absence of systematic disease and an overall risk of premature ovarian insufficiency over 50% are among the criteria that need to be fulfilled in order for a patient to undertake this method. Orthotopic transplantation is more frequently used, since it can allow both live birth and the recovery of endocrine function. Reimplantation of malignant cells is always a major risk and should always be taken into consideration. Histological analysis, as well as immunohistochemical and molecular methods, are needed in order to improve the search for malignant cells before transplantation. Ovarian tissue cryopreservation appears to be a method with specific benefits, indications and risks which can be an important tool in terms of preserving fertility in younger women.

Medical and Behavioral Aspects of Adolescent Endometriosis: A Review of the Literature.

The majority of young women will experience discomfort associated with menstrual cycles and miss out on education and social opportunities. Endometriosis, the presence of endometrial glands and stroma outside of uterus, is the most common cause of secondary dysmenorrhea and characterized by pain despite treatment with nonsteroidal anti-inflammatory drugs and hormonal agents. The true prevalence of adolescent endometriosis is not clear. Delay in diagnosis leads to persistent pain, affects quality of life, and potentially contributes to disease progression and subfertility. A laparoscopic diagnosis is the gold standard, but the surgical appearance may differ from adults, as endometriotic lesions are usually red or clear, making their identification a challenge for gynecologists who are unexperienced with endometriosis in adolescents. A personalized medical-surgical treatment is regarded as the most effective therapeutic strategy to achieve remission of symptoms, suppress disease progression, and protect future fertility. Studies have demonstrated how adolescent endometriosis negatively affects patients' quality of life and psychosocial functioning. Development of therapeutic interventions targeting psychosocial function and quality of life is imperative for adolescent patients.

Diet-Induced Hypothalamic Inflammation, Phoenixin, and Subsequent Precocious Puberty.

Recent studies have shown a rise in precocious puberty, especially in girls. At the same time, childhood obesity due to overnutrition and energy imbalance is rising too. Nutrition and fertility are currently facing major challenges in our societies, and are interconnected. Studies have shown that high-fat and/or high-glycaemic-index diet can cause hypothalamic inflammation and microglial activation. Molecular and animal studies reveal that microglial activation seems to produce and activate prostaglandins, neurotrophic factors activating GnRH (gonadotropin-releasing hormone expressing neurons), thus initiating precocious puberty. GnRH neurons' mechanisms of excitability are not well understood. In this review, we study the phenomenon of the rise of precocious puberty, we examine the physiology of GnRH neurons, and we review the recent literature regarding the pathophysiological mechanisms that connect diet-induced hypothalamic inflammation and diet-induced phoenixin regulation with precocious puberty.

Increasing self-reported suicide attempts by adolescents in Greece between 1984 and 2007.

PURPOSE: This study examines trends in self-reported suicide attempts by Greek adolescents. METHODS: Data were obtained from five nationwide school probability surveys, each of approximately 8,000-10,000 adolescents aged 14-18 years, carried out from 1984 to 2007. Students answered an anonymous questionnaire in their classrooms supervised by research assistants. Logistic regression analysis used as dependent variable any self-reported suicide attempts and as independent variables basic sociodemographic information and the year of the survey. RESULTS: Self-reported suicide attempts doubled in prevalence from 7.0% in 1984 to 13.4% in 2007. Female gender (odds ratio OR 2.49, 95% confidence interval CI 2.30-2.71), living in a single parent family (OR 1.91, CI 1.73-2.11), lower paternal education (OR 1.20, CI 1.10-1.31) and living in a major city (OR 1.17, CI 1.08-1.27 for Greater Athens and OR 1.13, CI 1.00-1.28 for Thessaloniki) were significantly associated with suicide attempts. A larger increase among males, from 2.4 to 8.4%, compared to females (11.5 to 17.9%) contributed to a decrease in gender differences. CONCLUSIONS: Changes in Greek society during the last 30 years, including loosening of family ties, increased drug use and stress because of the demands of school work, are hypothesised to have had an impact on the increasing trend in suicide attempts among adolescents.

Changes in associations between psychosocial factors and suicide attempts by adolescents in Greece from 1984 to 2007.

BACKGROUND: Suicide is the second commonest cause of death among adolescents and young adults aged 15-35 years in Europe. Suicide attempts are a strong risk indicator for suicide. This article examines psychosocial factors associated with self-reported suicide attempts in adolescents in Greece and whether the reported increase in suicide attempts from 1984 to 2007 was accompanied by changes in the pattern of related psychosocial factors. METHODS: Data were taken from nationwide probability sample surveys of Greek high school students aged 14-18 years in 1984 (n = 10,507) and 2007 (n = 9873). Logistic regression analysis was used to relate any self-reported suicide attempts to basic sociodemographic and psychosocial variables including family and psychological characteristics, and substance use. RESULTS: Female gender, smoking, illicit drug use, low socio-economic status, not living with both parents, dissatisfaction with relationship with parents, visits to a doctor for psychological problems, depression, anti-social behaviour and low self-esteem were risk factors for self-reported attempted suicide by adolescents in both surveys. Significant interaction terms showed that the effects of gender and illicit drug use were smaller in 2007 than in 1984. However, low self-esteem became significantly more important. CONCLUSIONS: Several common psychosocial factors seem to be steadily related to self-reported suicide attempts by Greek adolescents in 1984 and 2007. However, the increase in self-reported suicide attempts between 1984 and 2007 has been accompanied by changes in the relative importance of correlates.

Evaluation of a nutrition intervention in adolescents of an urban area in Greece: short- and long-term effects of the VYRONAS study.

OBJECTIVE: To assess the short-term (15-d) and long-term (12-month) effects of a school-based health and nutrition education intervention on diet, nutrition intake and BMI. DESIGN: The 12-week teacher-implemented intervention in combination with seminars organized for parents was aimed at improving children's diet and nutrition knowledge. The intervention took place between September 2007 and January 2008. The participants were randomized to two study groups, the intervention group (IG) and control group (CG), and were examined prior to the intervention on a variety of health knowledge, dietary, behavioural and anthropometric indices. The same measurements were collected 15 d and 1 year after the intervention. SETTING: All high schools in Vyronas, a densely populated district of Athens, Greece. SUBJECTS: The sample consisted of 191 students aged 12-13 years. RESULTS: Twelve months after the intervention, the programme was effective in reducing various indices in the IG compared with baseline findings (BMI: 23.3 (sd 2.8) v. 24.0 (sd 3.1) kg/m2, P < 0.001; daily energy intake: 8112.4 (sd 1412.4) v. 8503.3 (sd 1419.3) kJ/d, P < 0.001; total fat intake: 31.3 (sd 4.4) v. 35.4 (sd 4.7) % of daily energy, P < 0.001). Except for BMI, decreases in the aforementioned indices were also observed 15 d after the intervention. In addition, students of the IG reduced their weekly consumption of red meat and non-home-made meals and increased their frequency of fruit and breakfast cereal consumption. CONCLUSIONS: The beneficial effects of this nutrition education intervention among adolescents may highlight the potential of such programmes in the prevention of obesity.

Overweight/obesity and factors associated with body mass index during adolescence: the VYRONAS study.

AIM: To describe overweight and obese adolescents and to determine any correlations between an adolescent's body mass index (BMI) with personal (age, gender), lifestyle (sedentary/sport activities, smoking status) and parental (smoking status, BMI, number of cars) characteristics. METHODS: Cross-sectional data on weight, height and various characteristics from 2008 Greek adolescents (12- to 17-year olds, 50.85% boys), measured in 2005-2007, were used. RESULTS: Almost 1 in 5 (19.2%) boys and 1 in 7 (13.2%) girls 12-17 years of age were overweight while 4.4% of the boys and 1.7% of the girls were obese. The adolescents' age, mother's smoking status, father's and mother's BMI predicted boys' and girls' BMI (b = 0.551, 0.203, 0.110, 0.495 for boys, b = 0.233, 0.187, 0.180, 0.531 for girls, respectively, p < or = 0.05). Univariate analysis revealed that television watching/using personal computer/playing video games and playtime were not correlated with BMI, while an inverse association of exercising for > or = 5 h/week and BMI was found in both boys and girls (b =-1.098, -0.528, p = 0.005, 0.004 respectively). CONCLUSION: The results of our study underline the high prevalence of obesity during adolescence in Greece. Age and parental unhealthy behaviour (increased BMI and maternal smoking status) were positive predictors of increased BMI of adolescents in both genders.

Prevalence, patterns, and correlates of tranquilizer and sedative use among European adolescents.

PURPOSE: To examine the prevalence, patterns, and correlates of nonmedical use of tranquilizers or sedatives in 85,000 adolescent students from 31 European countries participating in the European School Survey on Alcohol and Other Drugs (ESPAD) in 2003. METHODS: Surveys in each country followed a standardized protocol. Logistic regression analysis was performed to identify sociodemographic and risk behavior correlates of medical and nonmedical tranquilizer or sedative use. RESULTS: Lifetime nonmedical tranquilizer or sedative use was reported by 5.6% overall. Medical tranquilizer or sedative use multiplies the odds of nonmedical use by 10.7 (95% confidence interval 9.1-12.5) for boys and 7.2 (6.3-8.3) for girls. Nonmedical tranquilizer or sedative use is also associated with the use of tobacco (odds ratio 1.3, 1.1-1.5), alcohol (1.3, 1.2-1.5), and illicit drugs (3.5, 3.1-3.9). Further correlates are truancy (1.4, 1.2-1.6), tranquilizer or sedative use by friends (6.0, 5.5-6.7) and siblings (2.7, 2.2-3.4), and dissatisfaction with relationships with parents. Medical tranquilizer or sedative use shares to a large extent the same correlates. CONCLUSIONS: Findings indicate similarities in adolescent tranquilizer or sedative use between Europe and United States. The implications of the results for prevention policies are discussed.

Correlation of foot length with height and weight in school age children.

Even though the forensic value of the correlation between foot length and human height and weight has been studied, there is a lack of studies regarding this subject in school age children. The aim of this study is to evaluate this relationship in a large sample of juveniles in a European country (Greece). The sample of the study consisted of 5093 children (average age: 11.47+/-2.71 years), who were examined during school period from 1996 to 2005. The Harris-Beath Mat for footprinting was the device used for measuring foot length. Statistical analysis included univariate and multivariate linear regression models. All statistical models were found to be significant and indicated that both right and left foot length were independent predictors of either height or weight. From all models fitted, the model having the greater predictive value was described by the formula: height (cm)=34.113+3.716 x (right foot length (cm)) +1.558 (if girl) + 2.499 x (age(years)), R(2)=0.852. It was also found that the models which contained right rather than left foot length as an explanatory variable predicted more accurately both height and weight. The results of this study suggest that foot length can estimate the stature and weight of a juvenile, especially after adjusting for age and sex.

Further investigation of psychological and environmental correlates of substance use in adolescence in six European countries.

AIM: To study the multifactorial correlates of adolescents' use of legal and illegal substances in six European countries and to assess whether a common pattern of factors exists irrespective of the countries' different sociocultural backgrounds. DESIGN: Cross-sectional European school population survey (ESPAD) following standardized methodology. PARTICIPANTS: National probability samples of 16-year-old high school students from Bulgaria, Croatia, Greece, Romania, Slovenia and the UK. Total sample 16,445. MEASUREMENTS: Anonymous questionnaire self-administered in the classroom. Self-reported use of tobacco, alcohol, marijuana and other illegal drugs. Correlates examined: environmental, such as peer culture and family-related; behavior-related such as antisocial behavior, truancy and anomie; and psychological factors such as self-esteem and depressive mood. FINDINGS: Separate logistic regressions for the two genders produced a set of psychosocial correlates common to the use of all legal and illegal substances. The strongest were peer and older sibling models of use, and peer-oriented lifestyle, followed by patterns of antisocial behavior and truancy. Family-related variables such as not living with both parents, parental monitoring and relationships with parents were less significant. Self-esteem and depressive mood were not significant. Girls' use of substances, especially illegal ones, showed stronger associations than boys' with a deviant behavior pattern. Few interactions between country and other correlates were significant. CONCLUSIONS: Common correlates can be identified across countries. Older siblings' and peers' substance have a strong impact on adolescents' use. Preventive interventions should include all substances with addictive potential.