Value of ultrasonographic detection of normal ovarian tissue in the differential diagnosis of adnexal masses in pediatric patients.

OBJECTIVE: The aim of the study was to evaluate whether the presence of normal ovarian tissue, the 'ovarian crescent sign' (OCS), could assist in the differential diagnosis between benign and malignant adnexal masses in young patients. METHODS: This was a prospective observational study, from March 2004 to January 2006, which included 98 patients younger than 20 years of age (including two with bilateral tumors) with an ultrasonographic diagnosis of an adnexal mass. Morphological assessment using the Ueland index was performed in each case. Patients were also systematically examined for the presence of the OCS and a comparison was made with the Ueland index. All findings in surgically treated patients were compared with the final histological diagnosis. RESULTS: There were 100 adnexal masses: 90 were benign and 10 were malignant. Forty-eight were managed expectantly and 52, including 17 cases of adnexal torsion, underwent surgical treatment. The OCS was found in 65 (72%) benign adnexal masses and in one (10%) non-invasive malignant tumor. A Ueland index score of < 7 was found in 85 (94%) benign masses and in one (10%) non-invasive malignancy. The OCS was seen in 15 (45%) of 33 masses in premenarchal patients and in 51 (76%) of 67 masses in postmenarchal patients. The OCS was absent in 15 (88%) of the torsioned adnexal masses. CONCLUSIONS: The presence of normal ovarian tissue adjacent to an ovarian mass is a useful morphological feature that can assist exclusion of a malignant tumor in pediatric and adolescent patients. When compared with the Ueland index, diagnostic sensitivity of the OCS is similar, but specificity is lower. The presence of the OCS is significantly less frequent in premenarchal patients than in postmenarchal patients.

Antipsychotics affect multiple calcium calmodulin dependent proteins.

Calcineurin is a calmodulin (CaM) dependent protein phosphatase recently found to be altered in the brains of patients suffering from schizophrenia and by repeated antipsychotic treatment in rats. Some data suggest, however, that antipsychotics and schizophrenia may have a more widespread effect on the CaM signaling axis than calcineurin alone. In the current study, the effects of selected psychoactive drugs were investigated using Western blotting, in situ hybridization and immunocytochemistry to determine if they target CaM, calmodulin-dependent protein kinases (CaMK) or calcineurin. Results indicated that repeated treatment with haloperidol, clozapine or risperidone increased CaM protein and CaMII mRNA levels but decreased calmodulin-dependent protein kinase IIalpha (CaMKIIalpha) IV (CaMKIV), kinase alpha (CaMKKalpha), kinase beta (CaMKKbeta) and calcineurin protein levels in the striatum of Sprague-Dawley rats (Rattus Norvegicus). Closer examination of CaMKIV, CaMKKalpha and CaMKKbeta revealed that the observed decreases in protein levels were short-lived following antipsychotic treatment and reversed (i.e. upregulated) 24 h post-treatment similar to what was previously reported for calcineurin. The D(2)/D(3)dopamine receptor antagonist raclopride mimicked the decreases in CaMKIV, CaMKKalpha, CaMKKbeta and calcineurin observed following antipsychotic treatment whereas increases in these proteins were observed in an amphetamine model of the positive symptoms of schizophrenia. Mood stabilizers such as lithium and valproic acid or the antidepressant fluoxetine had no effect on CaMKIV, CaMKKalpha, CaMKKbeta and calcineurin with the exception of an increase in CaMKKbeta following lithium treatment. The results collectively suggest that antipsychotic specifically target several proteins associated with CaM signaling.

[Children's knowledge of sex behavior and contraception]. / Znanja dece iz oblasti seksualnog zivota i kontracepcije.

INTRODUCTION: Adolescent sexuality is not a new phenomenon, but it has been accepted differently at various times and societies. In modern times, adolescents start sexual life early, not well educated and not prepared for possible consequences. The period between the first sexual relationship, marriage and having children is prolonged with a greater possibility of having artificial abortions or sexually transmitted diseases (STD). It is of great importance to work on proper education of children and adolescents on sexual life and contraception. MATERIAL AND METHODS: An inquiry into the knowledge of sex and contraception was performed in an elementary school in Novi Sad, comprising 134 children from VII and VIII grade (aged 13-14, 77 girls and 57 boys) in order to prepare a lecture on these topics. RESULTS: Most of the knowledge on these topics children aged 13 and 14 got watching TV and reading magazines (44.15% girls and 70.17% boys) and from their friends (42.1%). Communication about sex and contraception exists mostly among friends (51.95% girls and 82.46% boys). One third of girls talk with parents and one quarter got knowledge from them. Only four boys (2.98%) had sexual intercourse without complications: artificial abortion or STD. Almost every child (96.95%) knows about AIDS and 89.25% children know about at least one method of contraception (mostly condom). Three quarters claim artificial abortion is harmful. 50% of children want more education about sex and contraception. DISCUSSION AND CONCLUSIONS: Most of the knowledge on sexual life and contraception children get from various forms of mass-media and from one another which is unreliable and incomplete. Unfortunately, parents and teachers play a minor role in sex education of children. In order to prevent spreading of sexually transmitted diseases and to decrease the percentage of adolescent pregnancy and artificial abortions, it is of great importance to investigate knowledge, attitudes and practice of children and adolescents in regard to sexual life and contraception and to prepare acceptable and efficient programs for education on these topics. However, not only education is important, but also acceptance and behavior of children and adolescents resulting from these programs.

[Sex knowledge and behavior in male high school students]. / Prilog o seksualnom znanju i ponasanju mladica u srednjoj skoli.

INTRODUCTION: Adolescent sexual activity has increased in the last 30 years. Nowadays approximately 73% of male adolescent had sexual intercourse by the age of 18. Practice is not always followed by adequate knowledge and behavior. Therefore, it is of utmost importance to have appropriate education on sexual life and contraception in order to prevent unwanted pregnancies, abortions and spreading of sexually transmitted diseases. MATERIAL AND METHODS: Sexual behavior and knowledge was surveyed in a high school in Novi Sad among 520 male students, aged 15-19, in order to prepare lectures on sexual topics. RESULTS: Most information male teenagers got from different forms of mass-media (63.65%) and through communication with friends (50.58%). The communication with parents (5%) and experts (1%) is poor. According to their opinion, 69% have enough knowledge about sexuality and 62% about contraception, but 75.77% want further education from experts. 90% participated in some kind of sexual activity by the age of 18, and 84.3% had sexual intercourse for the first time at the age of 15.55 years, on average. artificial abortion occurred only in one case of pregnancy. Almost all young men knew about AIDS. The most common known means of contraception was condom (90%) and 70% consider it as the best method. 90% of male students consider abortion harmful, because it can cause infertility (51.38%). DISCUSSION: Most knowledge on sex life and contraception male adolescents gain from magazines, TV and friends, which can not be accepted as appropriate and undoubtedly can be incorrect and inadequate. Communication with parents and teachers is poor. Male adolescents are aware of their need for more education on these subjects and they want it from experts. CONCLUSION: Young men are not educated about sexual life and contraception well enough. Proper sexual education among adolescents is of great importance for psychic and reproductive health of young people.