1,721,417 research outputs found
La disforia di genere in età pediatrica e adolescenziale: nozioni per il pediatra
No full textThe number of children and adolescents referred to the gender identity clinics is significantly increasing. The pediatrician often represents the first healthcare professional to be consulted
by families or who suspects a gender identity disorder. Consequently, the knowledge of some notions related to this condition are essential to provide the basic care to the child/adolescent and
address the topic in the most appropriate manner. Thereafter, the care will require
a multidisciplinary team composed of professionals who received a specific education
How do Italian pediatric endocrinologists approach gender incongruence?
Full text linkBackground: Gender incongruence (GI) is a term used to describe a marked and persistent incompatibility between the sex assigned at birth (SAAB) and the experienced gender. Some persons presenting with GI experience a severe psychological distress defined as gender dysphoria (GD). Although the prevalence of GI is probably underestimated, recently a great increase in numbers of transgender and gender diverse (TGD) youths presenting at the gender clinics has been registered. After a careful multidisciplinary evaluation and upon acquisition of informed consent from the youth and the legal guardian(s), puberty suppression can be started in TGD youths, followed by the addition of gender affirming hormones (GAH) by the age of 16 years. Although Italian specific guidelines are available, their application is often complex because of (among other reasons) lack of specialized centers and healthcare professional with experience in the field and the regional differences within the Italian healthcare system. Main body: To investigate the care offered to TGD youths across Italy, we proposed a survey of 20 questions to the directors of the 32 Italian Centers of pediatric endocrinology participating to the Study Group on Growth and Puberty of the Italian Society of Pediatric Endocrinology (ISPED). Eighteen pediatric endocrinologists representative of 16 different centers belonging to 11 different regions responded to the survey. In the large majority of centers TGD youths are taken in charge between the age of 12 and 18 years and at least three healthcare professional are involved. Most of Italian pediatric endocrinologists follow only a very limited number of TGD youths and reference centers for TGD youths are lacking. Conclusion: There is an urgent need for gender clinics (homogeneously distributed on the national territory) where TGD youths can access high standard care
La disforia di genere in età pediatrica e adolescenziale
Full text linkWhile the sex of an individual refers to his/her genetic and anatomical characteristics, gender concerns the perception of oneself, personal and private, as belonging to the male
or female gender, to both or neither. Generally gender perception between 3 and 7 years
of age. Gender incongruence is defined by the absence of concordance between these
two aspects, while gender dysphoria refers to the psychological distress that can follow.
The number of children and adolescents showing gender incongruence is increasing and
poses problems of diagnosis and treatment. Providing care requires the presence of a
multidisciplinary team made up of expert professionals trained in this field, which should
include neurospichiatrists, psychologists and pediatric endocrinologists. Pharmacological
therapy, that follows a phase of psychotherapy, should be started in puberty and is preliminary to subsequent therapeutic interventions; the latter ones are prerogative of adulthood. A
careful multidisciplinary follow-up is needed for these patients until adulthood
Medicina dell’adolescenza
Full text linkL’Organizzazione Mondiale della Sanità definisce come “adolescenti” le persone di età compresa tra 10 e 19 anni. Questi minori rappresentano circa il 10-25% della popolazione a seconda dei vari paesi europei (www.euro.who.int) e poco più del 9,0% in Italia al 1° gennaio 2023 (www.istat.it). Nel nostro Paese si osserva inoltre una rapida contrazione dei soggetti in età adolescenziale in conseguenza del progressivo calo delle nascite; ad esempio, si ha una riduzione di oltre l’8% (-47.165 unità) dei bambini di 10 anni rispetto ai ragazzi di 18 anni. Una prima ovvia considerazione a questo dato di fatto è la necessità di assicurare il migliore stato possibile a questa fascia di età anche in prospettiva futura. In effetti, la maggior parte degli adolescenti in Europa è sana, ma ogni giorno oltre 3.000 di loro muoiono per cause prevenibili o curabili. Inoltre, gli adolescenti presentano cause specifiche di morbilità [lesioni non intenzionali o intenzionali, disturbi della salute mentale (depressione, abuso di sostanze, disturbi alimentari), malattie infettive, comportamenti sessuali a rischio, gravidanza e parto precoci] con conseguenze sia a breve che a lungo termine (Slobođanac M., et al. www.eapaediatrics.eu/young-eap-eap-july-2019-blog-adolescent-medicine-and-health-a-training-challenge-for-europe/).
Ne deriva la necessità di percorsi formativi dedicati pre-laurea e post-laurea, compresi quelli di educazione medica continua, in Medicina dell’adolescenza. Alcuni paesi (USA, Canada, Australia) hanno riconosciuto le esigenze specifiche di salute degli adolescenti, creando percorsi formativi anche specialistici in questo nuovo settore medico
Diagnostic approach and therapy of overgrowth and tall stature in childhood
No full textAlthough referral for evaluation of tall stature is much less common than for short stature, early diagnosis in the paediatric age of clinical pictures leading to tall stature is crucial, both in order to detect conditions which can be properly treated and in order to limit excessive final heights; nowadays tall stature may be cause of psychosocial problems. This paper reviews different items related to tall stature in childhood. First of all, our review focuses on the definition of tall stature and the classification of the main clinical conditions associated with either tallness or excessive growth is discussed. Secondly, the clinical picture and the most recent breakthroughs of each of these conditions are reviewed. A diagnostic flow-chart meant to approach a patient presenting with tall stature is designed according to a few simple parameters such as chronological age, height age, bone age and growth velocity. The novel advances in the understanding of constitutional and secondary tall stature are presented and discussed, together with the hormonal treatment of constitutional tall stature and other related outstanding questions
Bone mineral content: comparison of calcaneous ultrasound (CUS), computed tomography (Pqct) and densitometry (BMD) in 726 youngsters
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