• 文章类型: Journal Article
    足底筋膜炎(PF)是一般人群中足跟痛的常见原因。新加坡缺乏标准的实践指南给这种痛苦的疾病的教育和临床实践带来了挑战。这些共识声明和指南旨在简化和改进PF的管理,涵盖关键方面,如诊断,调查,危险因素,治疗方式,监控和返回工作/游戏。
    由6名运动医师组成的多学科专家小组,2名整形外科医生,根据他们在PF的临床和学术经验,召集了来自SingHealthDuke-NUS运动医学中心(SDSC)的2名足病医生和1名物理治疗师。推荐的分级,评估,使用开发和评估(GRADE)方法来评估证据的质量,并随后准备一套与PF管理有关的临床建议。使用改进的Delphi过程达成共识。
    制定了18项共识声明,以涵盖PF管理的关键组成部分,从最初的诊断到治疗方式,最后,临床进展。随后根据拟议的PF治疗途径指南进行合并。
    SDSC共识声明和指南为新加坡PF的管理提供了简明建议。
    UNASSIGNED: Plantar fasciitis (PF) is a common cause of heel pain among the general population. The lack of standard practice guideline in Singapore presents challenges in education and clinical practice for this painful condition. These consensus statements and guideline were developed to streamline and improve the management of PF, covering key aspects such as diagnosis, investigations, risk factors, treatment modalities, monitoring and return to work/play.
    UNASSIGNED: A multidisciplinary expert panel consisting of 6 sports physicians, 2 orthopaedic surgeons, 2 podiatrists and 1 physiotherapist from SingHealth Duke-NUS Sport & Exercise Medicine Centre (SDSC) was convened based on their clinical and academic experience with PF. The Grading of Recommen-dations, Assessment, Development and Evaluations (GRADE) approach was used to evaluate the quality of the evidence and subsequently prepare a set of clinical recommen-dations pertaining to the manage-ment of PF. A modified Delphi process was used to reach consensus.
    UNASSIGNED: Eighteen consensus statements were developed to cover key components of PF management, from initial diagnosis to treatment modalities and finally, clinical progression. They were subsequently consolidated under a proposed treatment pathway guideline for PF.
    UNASSIGNED: The SDSC consensus statements and guideline provide concise recommendations for the management of PF in Singapore.
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  • 文章类型: Journal Article
    国际妇产科超声学会(ISUOG)和国际深子宫内膜异位症分析(IDEA)组,欧洲子宫内膜异位症联盟(EEL),欧洲妇科内窥镜学会(ESGE),欧洲人类生殖和胚胎学学会(ESHRE),国际妇科内窥镜学会(ISGE),美国妇科腹腔镜医师协会(AAGL)和欧洲泌尿生殖系统放射学学会(ESUR)选出了国际,妇科外科医生的多学科小组,超声波检查者和放射科医生,包括一个指导委员会,该研究在文献中检索相关文章,以回顾文献,并提供关于使用影像学技术进行盆腔深部子宫内膜异位症的非侵入性诊断和分类的循证和临床相关陈述。初步声明是在审查相关文献的基础上起草的。经过两轮修订和参与社团主席精心安排的投票,协商一致的声明已经定稿。该文件的最终版本随后重新提交给协会主席批准。起草了20份声明,其中14人在第一轮投票后达成了强有力的协议,3人达成了温和的协议。其余三项发言由指导委员会全体成员及社团主席讨论,并重新措辞,随后又进行了一轮投票。过程结束时,14份声明有强烈的观点,5份声明有温和的观点,只剩下一个陈述。这项共识工作旨在指导临床医生在患者评估期间参与治疗疑似子宫内膜异位症的女性。外科治疗策略的咨询和计划。本共识声明应引用为:\'G.Condous,B.Gerges,I.Thomassin-Naggara,C.贝克尔,C.托马塞蒂,H.Krentel,B.J.vanHerendael,M.Malzoni,M.S.Abrao,E.Saridogan,J.Keckstein,G.Hudelist和合作者。盆腔深层子宫内膜异位症的非侵入性成像技术和子宫内膜异位症分类系统:国际共识声明。欧尔.J.Radiol。2024.https://doi.org/10.1016/j.ejrad.2024.111450。\'
    The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and International Deep Endometriosis Analysis (IDEA) group, the European Endometriosis League (EEL), the European Society for Gynaecological Endoscopy (ESGE), the European Society of Human Reproduction and Embryology (ESHRE), the International Society for Gynecologic Endoscopy (ISGE), the American Association of Gynecologic Laparoscopists (AAGL) and the European Society of Urogenital Radiology (ESUR) elected an international, multidisciplinary panel of gynecological surgeons, sonographers and radiologists, including a steering committee, which searched the literature for relevant articles in order to review the literature and provide evidence-based and clinically relevant statements on the use of imaging techniques for non-invasive diagnosis and classification of pelvic deep endometriosis. Preliminary statements were drafted based on review of the relevant literature. Following two rounds of revisions and voting orchestrated by chairs of the participating societies, consensus statements were finalized. A final version of the document was then resubmitted to the society chairs for approval. Twenty statements were drafted, of which 14 reached strong and three moderate agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and society chairs and rephrased, followed by an additional round of voting. At the conclusion of the process, 14 statements had strong and five statements moderate agreement, with one statement left in equipoise. This consensus work aims to guide clinicians involved in treating women with suspected endometriosis during patient assessment, counseling and planning of surgical treatment strategies. This Consensus Statement should be cited as: \'G. Condous, B. Gerges, I. Thomassin-Naggara, C. Becker, C. Tomassetti, H. Krentel, B.J. van Herendael, M. Malzoni, M. S. Abrao, E. Saridogan, J. Keckstein, G. Hudelist and Collaborators. Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: An International Consensus Statement. Eur. J. Radiol. 2024. https://doi.org/10.1016/j.ejrad.2024.111450.\'
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  • 文章类型: English Abstract
    The evolution of critical care medicine is inextricably linked to the development of critical care procedures. These procedures not only facilitate diagnosis and treatment of critically ill patients, but also provide valuable insights into disease pathophysiology. While critical care interventions offer undeniable benefits, the potential for iatrogenic complications necessitates careful consideration. The recent surge in critical care ultrasound (US) utilization is a testament to its unique advantages: non-invasiveness, real-time bedside availability, direct visualization of internal structures, elimination of ionizing radiation exposure, repeatability, and relative ease of learning. Recognizing the need to optimize procedures and minimize complications, critical care utrasound study group of Beijing critical care ultrasound research assocition convened a panel of critical care experts to generate this consensus statement. This document serves as a guide for healthcare providers, aiming to ensure patient safety and best practices in critical care.
    重症医学的发展伴随着重症相关操作,重症相关操作亦使重症医学得到更深入的发展。通过相关操作可使临床医生了解重症患者的病理生理学,重症相关操作在重症相关诊断、治疗中均起到积极的作用。但重症相关操作带来医源性损伤不容忽视,有些操作会产生严重的后果。随着近年来重症超声在重症医学科的快速发展,重症超声有其独特的优势,具有无创、床旁、可视化、无辐射、可重复、易学等优点,已在临床广泛应用。为更好地规范重症相关操作,北京重症超声研究会重症超声研究组组织了重症相关专家撰写本共识,旨在提高临床医护工作者重症相关操作水平,减少相关并发症。.
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  • 文章类型: Journal Article
    世界医学和生物学超声联合会(WFUMB)促进了该多参数超声文档的开发。第2部分是关于使用可用工具进行超声定量肝脏脂肪含量的指导。这些是衰减系数,后向散射系数,和声音的速度。所有这些都使用超声波束的原始数据来估计肝脏脂肪含量。本指南旨在帮助读者理解它们的工作原理和解释结果。讨论了混杂因素,并提出了一种标准化的测量采集协议来减轻这些影响。这些建议是基于已发表的研究和专家意见,但没有正式分级,因为在起草本文件时,证据仍然很低。
    The World Federation for Ultrasound in Medicine and Biology (WFUMB) has promoted the development of this document on multiparametric ultrasound. Part 2 is a guidance on the use of the available tools for the quantification of liver fat content with ultrasound. These are attenuation coefficient, backscatter coefficient, and speed of sound. All of them use the raw data of the ultrasound beam to estimate liver fat content. This guidance has the aim of helping the reader in understanding how they work and interpret the results. Confounding factors are discussed and a standardized protocol for measurement acquisition is suggested to mitigate them. The recommendations were based on published studies and experts\' opinion but were not formally graded because the body of evidence remained low at the time of drafting this document.
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  • 文章类型: Journal Article
    目的:颈部是各种病因的孤立性囊性颈肿块(SCNM)的常见部位,包括先天性的,炎症,和肿瘤。在成年人中,主要病灶是排除恶性肿瘤.这项研究的目的是回顾性分析可用的诊断技术在成年患者中鉴别良恶性SCNM的准确性。该研究旨在开发新的临床实践指南,以评估和管理SCNM。
    方法:主要预测变量是细针穿刺细胞学(FNAC)的诊断效用,超声(U/S),多层计算机断层扫描,和磁共振成像。研究的终点是区分良性和恶性SCNM的总体诊断准确性。最终诊断基于组织病理学。
    结果:该研究包括79例成年患者:男性55例(69.62%),女性24例(30.38%)(P<0.05)。演示时的平均年龄为42.1岁(范围:18-84岁)。孤立性囊性颈肿块分布在颈前区30例(37.97%),颈后外侧区49例(62.03%)(P<0.05)。颈后外侧区的恶性SCNM发生率明显高于颈前区[19/49(38.78%)对1/30(3.33%)](P<0.05)。U/S+FNAC与U/S+FNAC+多层螺旋CT和/或磁共振成像组在良恶性SCNM鉴别方面差异无统计学意义(40/42对36/37,P>0.05)。2例记录“侵犯颈部”。
    结论:应采用系统的调查方案来评估成年SCNM患者。
    OBJECTIVE: The neck region is a common site for solitary cystic neck mass (SCNM) of various etiologies, including congenital, inflammatory, and neoplastic. In adults, the primary focus is excluding malignancy. The objective of this study was to retrospectively analyze the accuracy of available diagnostic technologies for the differentiation of benign and malignant SCNM in adult patients. The study aimed to develop new clinical practice guidelines for evaluating and managing SCNM.
    METHODS: The primary predictive variables were the diagnostic utilities of fine-needle aspiration cytology (FNAC), ultrasound (U/S), multislice computed tomography, and magnetic resonance imaging. The study\'s endpoint was the overall diagnostic accuracy in differentiating between benign and malignant SCNM. The final diagnosis was based on histopathology.
    RESULTS: The study included 79 adult patients: 55 (69.62%) male and 24 (30.38%) female ( P <0.05). The mean age at presentation was 42.1 years (range: 18-84 years). Solitary cystic neck mass was distributed in the anterior neck region in 30 (37.97%) patients and the posterolateral neck regions in 49 (62.03%) patients ( P <0.05). The posterolateral neck regions had a significantly higher rate of malignant SCNM than the anterior neck region [19/49 (38.78%) versus 1/30 (3.33%)] ( P <0.05). There was no statistically significant difference between the U/S+FNAC and U/S+FNAC+multislice computed tomography and/or magnetic resonance imaging groups in differentiating benign and malignant SCNM (40/42 versus 36/37, P >0.05). \"Violated neck\" was recorded in 2 cases.
    CONCLUSIONS: A systematic investigation protocol should be applied to evaluate adult patients with SCNM.
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  • 文章类型: Journal Article
    子宫内膜异位症是一种普遍且可能使人衰弱的疾病,主要影响生育年龄的个体。并且通常有很大的诊断延迟。当患者报告慢性盆腔疼痛或有不孕症时,US通常是使用的一线成像模式。子宫内膜异位症的常见症状。除了子宫内膜瘤的可视化,在常规的经阴道US图像中,声科医师通常不了解子宫内膜异位症.鉴于大量文献描述了在美国描述子宫内膜异位症的技术,超声放射科医师协会召集了一个多学科专家小组,提出旨在改进子宫内膜异位症筛查流程的建议.该小组由子宫内膜异位症的成像和管理专家组成,包括放射科医生,超声波检查者,妇科医生,生殖内分泌学家,和微创妇科外科医生。综合文献综述结合改良的Delphi技术达成了共识。该声明定义了目标筛查人群,描述了增强骨盆US的技术,在美国建立子宫内膜异位症的直接和间接观察,创建一个观察性评分和报告系统,并对额外的成像和患者管理提出建议。小组建议后室经阴道US,观察子宫和卵巢的相对位置,和子宫滑动标志的操作,以提高子宫内膜异位症的检测。这些额外的技术可以在5分钟或更短的时间内进行,并最终可以减少有风险患者子宫内膜异位症诊断的延迟。
    Endometriosis is a prevalent and potentially debilitating condition that mostly affects individuals of reproductive age, and often has a substantial diagnostic delay. US is usually the first-line imaging modality used when patients report chronic pelvic pain or have issues of infertility, both common symptoms of endometriosis. Other than the visualization of an endometrioma, sonologists frequently do not appreciate endometriosis on routine transvaginal US images. Given a substantial body of literature describing techniques to depict endometriosis at US, the Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts to make recommendations aimed at improving the screening process for endometriosis. The panel was composed of experts in the imaging and management of endometriosis, including radiologists, sonographers, gynecologists, reproductive endocrinologists, and minimally invasive gynecologic surgeons. A comprehensive literature review combined with a modified Delphi technique achieved a consensus. This statement defines the targeted screening population, describes techniques for augmenting pelvic US, establishes direct and indirect observations for endometriosis at US, creates an observational grading and reporting system, and makes recommendations for additional imaging and patient management. The panel recommends transvaginal US of the posterior compartment, observation of the relative positioning of the uterus and ovaries, and the uterine sliding sign maneuver to improve the detection of endometriosis. These additional techniques can be performed in 5 minutes or less and could ultimately decrease the delay of an endometriosis diagnosis in at-risk patients.
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  • 文章类型: English Abstract
    Ultrasound-guided thermal ablation of papillary thyroid cancer (PTC) has been promoted in clinical practice over the past few years. Thermal ablation has the advantages of being minimally invasive, effective, and safe. However, current guidelines and consensus only focus on low-risk papillary thyroid microcarcinoma. With growing clinical application and accumulating scientific research in thermal ablation for PTC, there is considerable evidence to demonstrate that thermal ablation can treat larger PTC tumors and benefit more patients with PTC. To expand the indications and standardize the technical details and perioperative patient management for PTC ablation, experts from the Society of Tumor Ablation Therapy of the Chinese Anti-Cancer Association, the Ablation Expert Committee of the Chinese Society of Clinical Oncology (CSCO), Chinese Medical Doctor Association College of Interventionalists Tumor Ablation Committee, and Chinese Bethune Spirit Research Association Endocrinology and Diabetes Branch Interventional Endocrine Committee discussed and developed a consensus on thermal ablation of PTC based on the latest research results. This consensus aims to promote the rapid development of thermal ablation for PTC in the clinic.
    超声引导下甲状腺乳头状癌热消融治疗已经在临床推广。热消融技术具有微创、安全、有效等优势,但是目前的指南或共识仅局限于低危甲状腺微小乳头状癌。随着临床广泛应用和科研数据的积累,越来越多的证据表明热消融可以治疗较大肿瘤,服务更多甲状腺乳头状癌患者。为了拓展甲状腺乳头状癌热消融治疗的适应证、规范技术细节和围手术期患者管理方案,由中国抗癌协会肿瘤消融治疗专业委员会、中国临床肿瘤学会(CSCO)肿瘤消融专家委员会、中国医师协会介入医师分会肿瘤消融专业委员会、白求恩精神研究会内分泌和糖尿病学分会介入内分泌专业委员会组织国内相关专家,结合目前甲状腺乳头状癌热消融治疗的最新研究进展,讨论制订了本甲状腺乳头状癌热消融治疗专家共识,以推动超声引导下甲状腺乳头状癌热消融治疗在临床的快速发展。.
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  • 文章类型: Journal Article
    目的:为了解加拿大子宫内膜异位症诊断的影响和方法提供一种当代方法。
    方法:个人,家庭,社区,卫生保健提供者,以及受影响的卫生保健管理人员,照顾病人,或管理子宫内膜异位症服务的交付。
    方法:详细的病史有助于子宫内膜异位症的诊断,考试,与有子宫内膜异位症护理经验的提供者进行影像学检查。手术病理评估证实了子宫内膜异位症的诊断;然而,对于那些诊断通过影像学检查得到证实的人来说,这是不需要的。
    结果:有必要解决子宫内膜异位症的早期认识,以促进及时获得护理和支持。面向公众的教育,受影响的个人和家庭,卫生保健提供者,和卫生保健管理人员对于减少诊断和治疗的延误至关重要。
    结果:提高对诊断的影响和方法的认识和教育,可能有助于子宫内膜异位症患者和家庭及时获得护理。早期和适当的护理可能有助于减轻医疗保健系统的负担;然而,改进的临床评估可能需要初始投资。
    方法:每个部分都采用了独特的搜索策略,该策略代表了与重点领域相关的文献中可用的证据。本指南各部分的文献检索在附录A中列出,并包括本文中描述的已发表系统综述的信息。
    方法:这些建议是由一个国家专家小组通过为期两年的迭代共识过程进行两轮审查后制定的。有关该过程的更多详细信息在附录B中共享。作者使用建议等级评估对证据的质量和建议的强度进行了评估,开发和评估(等级)方法。见附录C(表C1定义和表C2强和有条件建议的解释)。
    本指南旨在支持参与子宫内膜异位症影响者的医疗保健提供者和政策制定者以及支持他们所需的系统。
    结论:子宫内膜异位症的影响和诊断更新了加拿大卫生保健提供者和决策者的指南。
    OBJECTIVE: To provide a contemporary approach to the understanding of the impact and methods for the diagnosis of endometriosis in Canada.
    METHODS: Individuals, families, communities, health care providers, and health care administrators who are affected by, care for patients with, or manage delivery of services for endometriosis.
    METHODS: The diagnosis of endometriosis is facilitated by a detailed history, examination, and imaging tests with providers who are experienced in endometriosis care. Surgical evaluation with pathology confirms a diagnosis of endometriosis; however, it is not required for those whose diagnosis was confirmed with imaging.
    RESULTS: There is a need to address earlier recognition of endometriosis to facilitate timely access to care and support. Education directed at the public, affected individuals and families, health care providers, and health care administrators are essential to reduce delays in diagnosis and treatment.
    RESULTS: Increased awareness and education about the impact and approach to diagnosis may support timely access to care for patients and families affected by endometriosis. Earlier and appropriate care may support a reduced health care system burden; however, improved clinical evaluation may require initial investments.
    METHODS: Each section was reviewed with a unique search strategy representative of the evidence available in the literature related to the area of focus. The literature searches for each section of this guideline are listed in Appendix A and include information from published systematic reviews described in the text.
    METHODS: The recommendations were developed following two rounds of review by a national expert panel through an iterative 2-year consensus process. Further details on the process are shared in Appendix B. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix C (Table C1 for definitions and Table C2 for interpretations of strong and conditional recommendations).
    UNASSIGNED: This guideline is intended to support health care providers and policymakers involved in the care of those impacted by endometriosis and the systems required to support them.
    CONCLUSIONS: Endometriosis impact and diagnosis updated guidelines for Canadian health care providers and policymakers.
    CONCLUSIONS: RECOMMENDATIONS.
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  • 文章类型: Review
    背景:护理点超声(POCUS)已成为许多专业临床实践中的重要工具,但其在法国全科医学中的使用和影响仍有待探索。
    目的:本研究的目的是在有经验的法国全科医生中就4个解剖区域的全科相关POCUS技能列表达成共识。
    方法:我们使用两轮Delphi方法获得了共识。通过进行文献综述得出了最初的技能清单。要对每个技能进行评分,我们用了9分的李克特量表.专家之间的互动会议在德尔福回合之间举行。POCUS全科医生被定义为具有超声理论培训的全科医生,他们经常进行超声检查,谁已经执行超声超过五年和/或参与提供超声培训。
    结果:11名法国全科医生在4个解剖区域筛选了83项技能:腹部,泌尿生殖系统,血管,妇产科。就36项POCUS技能在全科医学中的适用性达成了协议。有17个技能具有强有力的适当协议(“7-9”等级的100%)和19个技能具有相对协议(“5-9”等级的100%)。
    结论:这些技能可以作为法国以及其他具有类似医疗保健系统的国家在全科医学中使用POCUS的指南和课程的基础。
    BACKGROUND: Point-of-Care Ultrasound (POCUS) has become an important tool in the clinical practice of many specialties, but its use and impact in General Practice in France remains to be explored.
    OBJECTIVE: The objective of this study is to obtain a consensus among experienced French general practitioners on a list of relevant POCUS skills in General Practice in 4 anatomical regions.
    METHODS: We used a two-round Delphi method to obtain a consensus. An initial list of skills was drawn by conducting a literature review. To rate each skill, we used a nine-point Likert scale. An interactive meeting between experts took place between Delphi rounds. POCUS experts in General Practice were defined as general practitioners with theoretical training in ultrasound who regularly perform ultrasound, who have performed ultrasound for more than five years and/or are involved in providing ultrasound training.
    RESULTS: 11 French general practitioners screened 83 skills in 4 anatomical regions: abdominal, urogenital, vascular, gynecology and obstetrics. An agreement was obtained for 36 POCUS skills as to their appropriateness in General Practice. There were 17 skills with a strong appropriate agreement (100% of \"7-9\" ratings) and 19 skills with a relative agreement (100% of \"5-9\" ratings).
    CONCLUSIONS: These skills could serve as a basis for guidelines on the use and curriculum of POCUS in General Practice in France as well as in other countries with similar healthcare systems.
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  • 文章类型: Journal Article
    目的:根据2003年鹿特丹标准诊断为多囊卵巢综合征(PCOS)的青少年的特征是什么,根据国际循证指南,谁不符合诊断?
    结论:与对照组相比,具有PCOS特征但不符合循证指南青少年标准的青少年表现出不利的代谢特征,并且与符合青少年标准的青少年具有相当大的代谢和激素特征.
    背景:基于国际证据的PCOS指南建议不应使用超声诊断妇科年龄<8岁的女孩的PCOS。到目前为止,很少有研究根据鹿特丹标准对诊断为PCOS但不符合更新指南诊断的女孩的临床特征进行评估.
    方法:这是一项回顾性研究,和受试者从2004年到2022年接受护理。
    方法:根据2003年鹿特丹标准和健康对照诊断患有PCOS的青春期女孩。所有参与者都在月经初潮后2至8年之间。
    结果:在根据鹿特丹标准诊断为PCOS的315名女孩中,月经不调(IM)/高雄激素血症(HA)/多囊卵巢(PCO),IM/HA,HA/PCO,IM/PCO表型占206(65.4%),30(9.5%),12(3.8%),67名(21.3%)参与者,分别。根据循证指南,79名具有HA/PCO或IM/PCO表型的女孩(25.1%)未被诊断为PCOS,并与国际准则保持一致;他们被指定为“高危”组。不出所料,符合循证指南青少年标准的女孩表现出最差的代谢特征(广泛性或中心性肥胖程度,胰岛素抵抗的频率,前驱糖尿病或糖尿病,和代谢综合征)和多毛症评分高于高危人群或对照组。大约90%的高危人群没有超重或肥胖,这与控件相似。然而,他们表现出更糟糕的代谢特征,血压升高,甘油三酯,和胰岛素抵抗参数高于对照组;此外,这些情况与符合青少年标准的女孩相似。在女孩符合青少年标准的情况下,风险组的血清LH水平和LH/FSH比相似地升高。
    结论:我们无法评估对照组的激素或超声参数。
    结论:与常规鹿特丹标准相比,最近的国际循证指南-避免超声在青少年PCOS诊断中的应用-仍然提供了识别处于危险中的年轻女孩的机会,与这项研究的结果一致。对该青少年人群的实用方法包括建立IM或HA(未显示超声)并指定“处于危险中”的PCOS状态,并定期检查新出现或恶化的PCOS相关症状或代谢异常,随后的重新评估包括超声或抗苗勒管激素,初潮后8年一次.
    背景:本研究未获得资助。作者没有利益冲突要披露。
    背景:不适用。
    OBJECTIVE: What are the characteristics of adolescents diagnosed with polycystic ovary syndrome (PCOS) based on the 2003 Rotterdam criteria, but who do not meet the diagnosis according to the international evidence-based guideline?
    CONCLUSIONS: Adolescents who had features of PCOS but did not meet the evidence-based guideline adolescent criteria exhibited unfavorable metabolic profiles compared to controls and shared considerable metabolic and hormonal features with adolescents who did meet the adolescent criteria.
    BACKGROUND: The international evidence-based PCOS guideline recommended that ultrasound should not be used for the diagnosis of PCOS in girls with a gynecological age of <8 years. Thus far, few studies have evaluated the clinical characteristics of the girls diagnosed with PCOS based on the Rotterdam criteria but who do not meet the diagnosis according to the updated guideline.
    METHODS: This is a retrospective study, and subjects attended for care from 2004 to 2022.
    METHODS: Adolescent girls with PCOS diagnosed according to the 2003 Rotterdam criteria and healthy controls. All participants were between 2 and 8 years since menarche.
    RESULTS: Of the 315 girls diagnosed with PCOS according to the Rotterdam criteria, those with irregular menstruation (IM)/hyperandrogenism (HA)/polycystic ovary (PCO), IM/HA, HA/PCO, and IM/PCO phenotypes accounted for 206 (65.4%), 30 (9.5%), 12 (3.8%), and 67 (21.3%) participants, respectively. According to the evidence-based guideline, 79 girls (25.1%) with the HA/PCO or IM/PCO phenotypes were not diagnosed with PCOS, and aligned to the international guideline; they were designated as the \'at-risk\' group. As expected, the girls meeting the evidence-based guideline adolescent criteria showed the worst metabolic profiles (degree of generalized or central obesity, frequency of insulin resistance, prediabetes or diabetes, and metabolic syndrome) and higher hirsutism scores than the at-risk group or controls. Approximately 90% of the at-risk group were not overweight or obese, which was similar to the controls. However, they showed worse metabolic profiles, with higher blood pressure, triglyceride, and insulin resistance parameters than controls; furthermore, these profiles were similar to those of the girls meeting the adolescent criteria. The at-risk group showed similarly elevated serum LH levels and LH/FSH ratio with the girls meeting adolescent criteria.
    CONCLUSIONS: We could not evaluate hormonal or ultrasound parameters in controls.
    CONCLUSIONS: Compared to the conventional Rotterdam criteria, the recent international evidence-based guideline-avoiding ultrasound in PCOS diagnosis in adolescents-still gives the opportunity to identify young girls at risk, aligned to the findings in this study. A practical approach to this adolescent population would involve establishing IM or HA (with ultrasound not indicated) and designating \'at-risk\' PCOS status with regular check-ups for newly developed or worsening PCOS-related symptoms or metabolic abnormalities, with subsequent reassessment including ultrasound or anti-Müllerian hormone, once 8 years post-menarche.
    BACKGROUND: No funding was received in support of this study. The authors have no conflicts of interest to disclose.
    BACKGROUND: N/A.
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