Health management of adults with Turner Syndrome: An attempt at multidisciplinary medical care by gynecologists in cooperation with specialists from other fields

Aim:  Since women with Turner Syndrome (TS) have various complications, they require comprehensive medical evaluation and multidisciplinary treatment. Although TS patients receive adequate care in childhood, many adults with TS do not. Since most TS adults attend gynecologists for hormone replacemen...

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Veröffentlicht in:The journal of obstetrics and gynaecology research 2011-07, Vol.37 (7), p.836-842
Hauptverfasser: Sakakibara, Hideya, Yoshida, Hiroshi, Takei, Maki, Katsuhata, Yukiko, Koyama, Makiko, Nagata, Tomoko, Ishikawa, Masahiko, Hirahara, Fumiki
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container_end_page 842
container_issue 7
container_start_page 836
container_title The journal of obstetrics and gynaecology research
container_volume 37
creator Sakakibara, Hideya
Yoshida, Hiroshi
Takei, Maki
Katsuhata, Yukiko
Koyama, Makiko
Nagata, Tomoko
Ishikawa, Masahiko
Hirahara, Fumiki
description Aim:  Since women with Turner Syndrome (TS) have various complications, they require comprehensive medical evaluation and multidisciplinary treatment. Although TS patients receive adequate care in childhood, many adults with TS do not. Since most TS adults attend gynecologists for hormone replacement therapy, we suggest gynecologists take primary responsibility for their management. In an attempt to provide TS patients with a comprehensive treatment regimen, we started multidisciplinary medical management in the Reproductive Health Clinic at Yokohama City University Hospital. To evaluate the efficacy of this medical care system, a retrospective analysis was conducted. Methods:  The clinical profiles of 57 TS patients were examined. The past histories, complications and clinical data of these patients were extracted from their medical records and examined clinically. Bone mineral density measurements of lumbar vertebrae (L2–4), anti‐thyroid antibody titer measurements, hearing tests and cardiovascular MRI were also performed. Results:  Mean follow‐up duration was 5.1 years (range, 1–8 years). At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary. Conclusion:  Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.
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Although TS patients receive adequate care in childhood, many adults with TS do not. Since most TS adults attend gynecologists for hormone replacement therapy, we suggest gynecologists take primary responsibility for their management. In an attempt to provide TS patients with a comprehensive treatment regimen, we started multidisciplinary medical management in the Reproductive Health Clinic at Yokohama City University Hospital. To evaluate the efficacy of this medical care system, a retrospective analysis was conducted. Methods:  The clinical profiles of 57 TS patients were examined. The past histories, complications and clinical data of these patients were extracted from their medical records and examined clinically. Bone mineral density measurements of lumbar vertebrae (L2–4), anti‐thyroid antibody titer measurements, hearing tests and cardiovascular MRI were also performed. Results:  Mean follow‐up duration was 5.1 years (range, 1–8 years). At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary. Conclusion:  Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.</description><identifier>ISSN: 1341-8076</identifier><identifier>EISSN: 1447-0756</identifier><identifier>DOI: 10.1111/j.1447-0756.2010.01448.x</identifier><identifier>PMID: 21410832</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adolescent ; Adult ; comprehensive health care ; Disease Management ; Female ; Follow-Up Studies ; gynecologist ; Gynecology ; hormone replacement therapy ; Humans ; Japan ; Middle Aged ; Retrospective Studies ; transition to adulthood ; Treatment Outcome ; Turner syndrome ; Turner Syndrome - physiopathology ; Turner Syndrome - therapy ; Young Adult</subject><ispartof>The journal of obstetrics and gynaecology research, 2011-07, Vol.37 (7), p.836-842</ispartof><rights>2011 The Authors. 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At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary. Conclusion:  Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.</description><subject>Adolescent</subject><subject>Adult</subject><subject>comprehensive health care</subject><subject>Disease Management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>gynecologist</subject><subject>Gynecology</subject><subject>hormone replacement therapy</subject><subject>Humans</subject><subject>Japan</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>transition to adulthood</subject><subject>Treatment Outcome</subject><subject>Turner syndrome</subject><subject>Turner Syndrome - physiopathology</subject><subject>Turner Syndrome - therapy</subject><subject>Young Adult</subject><issn>1341-8076</issn><issn>1447-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUU1v1DAQjRCIlsJfQL5xyuKPJPYicagq2IKq7aFFK3GxvM5468Wxg51VNz-Hf4rTlD3jy8x43punmVcUiOAFye_jfkGqipeY182C4vyLcy0WxxfF-anxMuesIqXAvDkr3qS0x5jwJRGvizNKKoIFo-fFn2tQbnhAnfJqBx34AQWDVHtwQ0KPNnfuD9FDRHejb2Po4BO69EgNA3T9kCPqMtK2NmnbO-tVHFEHrdXKIa0ioO2IdqMHHVzY2ZRnWo90CD1ENdjgZ4nUg7bKPfVNFkFheMiSxoJr09vilVEuwbvneFH8-Prl_uq6vLldfbu6vCl1xbAozbI27VY0uq5xQ_DSMMIorgxVhmq9pTWuBFlSytuqwYxzYpSpARghSleUYHZRfJjn9jH8PkAaZJe3AueUh3BIUvCaU0ZrkZFiRuoYUopgZB9tl1eXBMvJH7mXkw1yskFO_sgnf-QxU98_ixy2-U4n4j9DMuDzDHi0Dsb_Hiy_366mLPPLmZ-PCccTX8VfsuGM13KzXklG1-vNz7uNpOwvJiyw9A</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>Sakakibara, Hideya</creator><creator>Yoshida, Hiroshi</creator><creator>Takei, Maki</creator><creator>Katsuhata, Yukiko</creator><creator>Koyama, Makiko</creator><creator>Nagata, Tomoko</creator><creator>Ishikawa, Masahiko</creator><creator>Hirahara, Fumiki</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201107</creationdate><title>Health management of adults with Turner Syndrome: An attempt at multidisciplinary medical care by gynecologists in cooperation with specialists from other fields</title><author>Sakakibara, Hideya ; 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At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary. Conclusion:  Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21410832</pmid><doi>10.1111/j.1447-0756.2010.01448.x</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
Adult
comprehensive health care
Disease Management
Female
Follow-Up Studies
gynecologist
Gynecology
hormone replacement therapy
Humans
Japan
Middle Aged
Retrospective Studies
transition to adulthood
Treatment Outcome
Turner syndrome
Turner Syndrome - physiopathology
Turner Syndrome - therapy
Young Adult
title Health management of adults with Turner Syndrome: An attempt at multidisciplinary medical care by gynecologists in cooperation with specialists from other fields
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