International Journal of General Medicine (May 2022)
The Influence of Living in Rural Areas on the Evolution and Management of Pediatric Ovarian Cystic Lesions: A Retrospective Study on a Cohort from South Eastern Romania
Abstract
Ioana Anca Stefanopol,1,2,* Liliana Baroiu,3,4 Sergiu Chirila,5 Magdalena Miulescu,6,* Lucreţia Anghel,3,7 Luiza Nechita,3,* Ciprian Adrian Dinu,8,* Victorita Stefanescu,3 Carmen Bobeica,1,* Alexandru Nechifor,3,* Alin Laurenţiu Tatu3,9– 11 1Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania; 2Department of Pediatric Surgery and Orthopedy, “Sf Ioan” Clinical Emergency Hospital for Children, Galati, Romania; 3Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania; 4Infectious Diseases Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania; 5Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University, Constanta, Romania; 6Research Center in the Functional Cardiorespiratory and Neuromotor Exploration, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania; 7Internal Medicine Department, “sf Andrew the Apostle” County Emergency Clinical Hospital, Galati, Romania; 8Dental Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania; 9Research Center in the Field of Medical and Pharmaceutical Sciences, Reform-UDJ, Galati, Romania; 10Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania; 11Multidisciplinary Integrated Center of Dermatological Interface Research MIC DIR, Galati, Romania*These authors contributed equally to this workCorrespondence: Liliana Baroiu, Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 47 Domnească Street, Galati, 800010, Romania, Tel +40723201241, Email [email protected] Sergiu Chirila, Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University, 1 University Alee, Campus B, Constanta, 900470, Romania, Tel +407213320668, Email [email protected]: The incidence of ovarian cystic lesions (OCLs) in pediatric patients has been increasing in recent years. An early diagnosis is mandatory for a favourable prognosis but it depends on the primary medical care services and on the socioeconomic status of the patient. The present study aims at assessing the prevalence and the age-specific frequencies of pediatric OCLs, as well as identifying disparities between subjects in the urban and the rural areas, in order to explore the extent to which OCLs occurrence, diagnosis, evolution and treatment differ in the case of patients living in rural areas.Methods: A 3-year retrospective study was conducted between 2017 and 2019. All the female patients aged between 0 and 18 with OCLs ≥ 10 mm (N = 488), diagnosed and treated at “Sf.Ioan” Clinical Emergency Hospital for Children in Galaţi were included in the study. The Chi2 test was used for comparing the distributions of frequencies, and the t-Student test was used for comparing the means of any two normally distributed variables. The statistical significance threshold (p) was set at 0.05.Results: The prevalence of OCLs ≥ 10 mm was 14.85%, 47.13% of the subjects originating in rural area (p = 0.62). Different from the urban areas, the rural ones are characterised by a lower proportion of patients with BMI ≥ 25 (p = 0.002), larger OCLs mean size (p = 0.278), a more frequent complex aspect on ultrasonography (p = 0.01), and a smaller number of general physician referrals (p = 0.005). Moreover, a higher proportion of rural patients were intraoperatively diagnosed with OCLs (p = 0.044), had complicated OCLs (p = 0.012) and had their OCLs surgically treated OCLs (p < 0.01).Conclusion: Taking into consideration the socio-economic situation of south eastern Romania, patients living in rural areas have proven exposed to a higher risk of presenting with larger, complex and complicated OCLs, which most often require surgical treatment.Keywords: ovarian cyst, rural population, incidence, body mass index, management, torsion