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COVID-19 , Complicaciones Infecciosas del Embarazo , SARS-CoV-2 , Femenino , Humanos , Microscopía Electrónica , Pandemias , Placenta , EmbarazoAsunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Microscopía Electrónica de Transmisión/métodos , Placenta/virología , Neumonía Viral/virología , Complicaciones Infecciosas del Embarazo/virología , Adulto , COVID-19 , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Pandemias , Neumonía Viral/transmisión , Embarazo , SARS-CoV-2RESUMEN
The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations.
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Antineoplásicos/efectos adversos , Preservación de la Fertilidad/métodos , Radioterapia/efectos adversos , Adolescente , Factores de Edad , Niño , Femenino , Preservación de la Fertilidad/ética , Humanos , Infertilidad/etiología , Neoplasias/terapia , PubertadRESUMEN
INTRODUCTION: Sexual violence (SV) on college campuses is common, especially alcohol-related SV. This is a 2-arm cluster randomized controlled trial to test a brief intervention to reduce risk for alcohol-related sexual violence (SV) among students receiving care from college health centers (CHCs). Intervention CHC staff are trained to deliver universal SV education to all students seeking care, to facilitate patient and provider comfort in discussing SV and related abusive experiences (including the role of alcohol). Control sites provide participants with information about drinking responsibly. METHODS: Across 28 participating campuses (12 randomized to intervention and 16 to control), 2292 students seeking care at CHCs complete surveys prior to their appointment (baseline), immediately after (exit), 4months later (T2) and one year later (T3). The primary outcome is change in recognition of SV and sexual risk. Among those reporting SV exposure at baseline, changes in SV victimization, disclosure, and use of SV services are additional outcomes. Intervention effects will be assessed using generalized linear mixed models that account for clustering of repeated observations both within CHCs and within students. RESULTS: Slightly more than half of the participating colleges have undergraduate enrollment of ≥3000 students; two-thirds are public and almost half are urban. Among participants there were relatively more Asian (10 v 1%) and Black/African American (13 v 7%) and fewer White (58 v 74%) participants in the intervention compared to control. CONCLUSIONS: This study will offer the first formal assessment for SV prevention in the CHC setting. Clinical Trials #: NCT02355470.