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result sql = Clinical features, investigations and management of adolescents with polycystic ovary syndrome.
Clinical features, investigations and management of adolescents with polycystic ovary syndrome.char = <;code = 60
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char = r;code = 114
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = 5;code = 53
char = %;code = 37
char = );code = 41
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = r;code = 114
char = s;code = 115
char = u;code = 117
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = m;code = 109
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 8;code = 56
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = g;code = 103
char = i;code = 105
char = r;code = 114
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = 3;code = 51
char = 2;code = 50
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 7;code = 55
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = j;code = 106
char = o;code = 111
char = r;code = 114
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 1;code = 49
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 8;code = 56
char = ;code = 32
char = [;code = 91
char = 8;code = 56
char = 2;code = 50
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = w;code = 119
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = b;code = 98
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = a;code = 97
char = b;code = 98
char = o;code = 111
char = l;code = 108
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = s;code = 115
char = y;code = 121
char = n;code = 110
char = d;code = 100
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = ;code = 32
char = (;code = 40
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = d;code = 100
char = y;code = 121
char = s;code = 115
char = l;code = 108
char = i;code = 105
char = p;code = 112
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = s;code = 115
char = u;code = 117
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = b;code = 98
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = f;code = 102
char = i;code = 105
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = s;code = 115
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = t;code = 116
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = B;code = 66
char = l;code = 108
char = o;code = 111
char = o;code = 111
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 3;code = 51
char = 8;code = 56
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = f;code = 102
char = a;code = 97
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = s;code = 115
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = g;code = 103
char = l;code = 108
char = u;code = 117
char = c;code = 99
char = o;code = 111
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 7;code = 55
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = i;code = 105
char = g;code = 103
char = l;code = 108
char = y;code = 121
char = c;code = 99
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 2;code = 50
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 1;code = 49
char = .;code = 46
char = ;code = 32
char = O;code = 79
char = n;code = 110
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = u;code = 117
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 2;code = 50
char = 8;code = 56
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 1;code = 49
char = 5;code = 53
char = %;code = 37
char = );code = 41
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = o;code = 111
char = ;code = 32
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = e;code = 101
char = r;code = 114
char = w;code = 119
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = l;code = 108
char = v;code = 118
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = s;code = 115
char = o;code = 111
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = c;code = 99
char = y;code = 121
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = I;code = 73
char = n;code = 110
char = v;code = 118
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = f;code = 102
char = f;code = 102
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = w;code = 119
char = h;code = 104
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = t;code = 116
char = w;code = 119
char = e;code = 101
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = g;code = 103
char = y;code = 121
char = n;code = 110
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = M;code = 77
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = [;code = 91
char = 8;code = 56
char = 3;code = 51
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = e;code = 101
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = m;code = 109
char = a;code = 97
char = c;code = 99
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
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char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = :;code = 58
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = i;code = 105
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = (;code = 40
char = 2;code = 50
char = 1;code = 49
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 6;code = 54
char = 2;code = 50
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = d;code = 100
char = r;code = 114
char = o;code = 111
char = x;code = 120
char = y;code = 121
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = u;code = 117
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = d;code = 100
char = r;code = 114
char = a;code = 97
char = w;code = 119
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = e;code = 101
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = (;code = 40
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 2;code = 50
char = 6;code = 54
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = t;code = 116
char = w;code = 119
char = o;code = 111
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 6;code = 54
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = i;code = 105
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
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result sql = BACKGROUND : Polycystic ovary syndrome (PCOS) is defined as chronic anovulation with evidence of hyperandrogenism, after the exclusion of secondary causes. It is commonly linked to obesity and the presence of the metabolic syndrome.
OBJECTIVES : To review the clinical features and medical assessment of adolescents referred for PCOS to gynecology or endocrinology services at The Hospital for Sick Children (Toronto, Ontario).
METHODS : A chart review was conducted of all adolescents with PCOS referred during a one-year period. Measures included clinical findings, investigations and management.
RESULTS : Forty-one adolescent girls, with a mean age +/- SD of 14.7+/-1.5 years, were reviewed. Common presenting complaints were menstrual irregularities in 35 of 41 girls (85%) and hirsutism in 28 of 41 girls (68%), with 32 of 41 adolescents (78%) having more than one complaint. The majority (31 of 38 [82%]) were overweight or obese. Features associated with the metabolic syndrome (hypertension, dyslipidemia, insulin resistance and obesity) were identified in some adolescents, but were not consistently assessed. Blood pressure was assessed in 38 adolescents, fasting plasma glucose in 27, triglycerides in 22 and cholesterol in 21. Only four of 28 adolescents (15%) who underwent pelvic ultrasound demonstrated ovarian cysts. Investigations and management differed somewhat between endocrinologists and gynecologists. Most adolescents (34 of 41 [83%]) received pharmacological treatment: oral contraceptive pill (21 of 34 [62%]); intermittent medroxyprogesterone acetate to induce withdrawal bleeding (nine of 34 [26%]); metformin (two of 34 [6%]); or oral contraceptive pill and antiandrogen (two of 34 [6%]).
CONCLUSIONS : Adolescents with PCOS are at risk of developing metabolic abnormalities. Polycystic ovaries were not a consistent finding. The most commonly prescribed treatment was the oral contraceptive pill. Greater attention should be placed on screening adolescents with PCOS for diabetes, hypertension and dyslipidemia, allowing for earlier identification and management of potentially modifiable cardiovascular risk factors.
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result sql = Clinical features, investigations and management of adolescents with polycystic ovary syndrome.
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char = e;code = 101
char = d;code = 100
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = f;code = 102
char = e;code = 101
char = r;code = 114
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = P;code = 80
char = C;code = 67
char = O;code = 79
char = S;code = 83
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = g;code = 103
char = y;code = 121
char = n;code = 110
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = y;code = 121
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = v;code = 118
char = i;code = 105
char = c;code = 99
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = H;code = 72
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = S;code = 83
char = i;code = 105
char = c;code = 99
char = k;code = 107
char = ;code = 32
char = C;code = 67
char = h;code = 104
char = i;code = 105
char = l;code = 108
char = d;code = 100
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = T;code = 84
char = o;code = 111
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = o;code = 111
char = ,;code = 44
char = ;code = 32
char = O;code = 79
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = o;code = 111
char = );code = 41
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = M;code = 77
char = E;code = 69
char = T;code = 84
char = H;code = 72
char = O;code = 79
char = D;code = 68
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = A;code = 65
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = t;code = 116
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = e;code = 101
char = w;code = 119
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = d;code = 100
char = u;code = 117
char = c;code = 99
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = P;code = 80
char = C;code = 67
char = O;code = 79
char = S;code = 83
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = f;code = 102
char = e;code = 101
char = r;code = 114
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = u;code = 117
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = -;code = 45
char = y;code = 121
char = e;code = 101
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = o;code = 111
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = M;code = 77
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = l;code = 108
char = u;code = 117
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = n;code = 110
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = v;code = 118
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = S;code = 83
char = U;code = 85
char = L;code = 76
char = T;code = 84
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = F;code = 70
char = o;code = 111
char = r;code = 114
char = t;code = 116
char = y;code = 121
char = -;code = 45
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = g;code = 103
char = i;code = 105
char = r;code = 114
char = l;code = 108
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = ;code = 32
char = S;code = 83
char = D;code = 68
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 1;code = 49
char = 4;code = 52
char = .;code = 46
char = 7;code = 55
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = 1;code = 49
char = .;code = 46
char = 5;code = 53
char = ;code = 32
char = y;code = 121
char = e;code = 101
char = a;code = 97
char = r;code = 114
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = v;code = 118
char = i;code = 105
char = e;code = 101
char = w;code = 119
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = C;code = 67
char = o;code = 111
char = m;code = 109
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = u;code = 117
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = r;code = 114
char = r;code = 114
char = e;code = 101
char = g;code = 103
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 3;code = 51
char = 5;code = 53
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = g;code = 103
char = i;code = 105
char = r;code = 114
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 8;code = 56
char = 5;code = 53
char = %;code = 37
char = );code = 41
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = r;code = 114
char = s;code = 115
char = u;code = 117
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = m;code = 109
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 8;code = 56
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = g;code = 103
char = i;code = 105
char = r;code = 114
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = 3;code = 51
char = 2;code = 50
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 7;code = 55
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = j;code = 106
char = o;code = 111
char = r;code = 114
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 1;code = 49
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 8;code = 56
char = ;code = 32
char = [;code = 91
char = 8;code = 56
char = 2;code = 50
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = w;code = 119
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = b;code = 98
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = a;code = 97
char = b;code = 98
char = o;code = 111
char = l;code = 108
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = s;code = 115
char = y;code = 121
char = n;code = 110
char = d;code = 100
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = ;code = 32
char = (;code = 40
char = h;code = 104
char = y;code = 121
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = d;code = 100
char = y;code = 121
char = s;code = 115
char = l;code = 108
char = i;code = 105
char = p;code = 112
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = i;code = 105
char = a;code = 97
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = s;code = 115
char = u;code = 117
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = b;code = 98
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = f;code = 102
char = i;code = 105
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = s;code = 115
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = o;code = 111
char = t;code = 116
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = B;code = 66
char = l;code = 108
char = o;code = 111
char = o;code = 111
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 3;code = 51
char = 8;code = 56
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = f;code = 102
char = a;code = 97
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = p;code = 112
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char = a;code = 97
char = s;code = 115
char = m;code = 109
char = a;code = 97
char = ;code = 32
char = g;code = 103
char = l;code = 108
char = u;code = 117
char = c;code = 99
char = o;code = 111
char = s;code = 115
char = e;code = 101
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char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 7;code = 55
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = r;code = 114
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char = g;code = 103
char = l;code = 108
char = y;code = 121
char = c;code = 99
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 2;code = 50
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = 2;code = 50
char = 1;code = 49
char = .;code = 46
char = ;code = 32
char = O;code = 79
char = n;code = 110
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = u;code = 117
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 2;code = 50
char = 8;code = 56
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 1;code = 49
char = 5;code = 53
char = %;code = 37
char = );code = 41
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = o;code = 111
char = ;code = 32
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = e;code = 101
char = r;code = 114
char = w;code = 119
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = l;code = 108
char = v;code = 118
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = s;code = 115
char = o;code = 111
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = c;code = 99
char = y;code = 121
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = I;code = 73
char = n;code = 110
char = v;code = 118
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = f;code = 102
char = f;code = 102
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = w;code = 119
char = h;code = 104
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = t;code = 116
char = w;code = 119
char = e;code = 101
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = n;code = 110
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = g;code = 103
char = y;code = 121
char = n;code = 110
char = e;code = 101
char = c;code = 99
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = M;code = 77
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 1;code = 49
char = ;code = 32
char = [;code = 91
char = 8;code = 56
char = 3;code = 51
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;code = 32
char = r;code = 114
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char = c;code = 99
char = e;code = 101
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = m;code = 109
char = a;code = 97
char = c;code = 99
char = o;code = 111
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char = o;code = 111
char = g;code = 103
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = t;code = 116
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char = e;code = 101
char = a;code = 97
char = t;code = 116
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = :;code = 58
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char = o;code = 111
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
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char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
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char = p;code = 112
char = i;code = 105
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = (;code = 40
char = 2;code = 50
char = 1;code = 49
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 6;code = 54
char = 2;code = 50
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = m;code = 109
char = i;code = 105
char = t;code = 116
char = t;code = 116
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char = n;code = 110
char = t;code = 116
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = d;code = 100
char = r;code = 114
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char = x;code = 120
char = y;code = 121
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char = r;code = 114
char = o;code = 111
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = r;code = 114
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char = n;code = 110
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char = a;code = 97
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char = e;code = 101
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = e;code = 101
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char = t;code = 116
char = o;code = 111
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char = i;code = 105
char = n;code = 110
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char = u;code = 117
char = c;code = 99
char = e;code = 101
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char = t;code = 116
char = h;code = 104
char = d;code = 100
char = r;code = 114
char = a;code = 97
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char = a;code = 97
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char = ;code = 32
char = b;code = 98
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char = e;code = 101
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char = d;code = 100
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char = n;code = 110
char = e;code = 101
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 2;code = 50
char = 6;code = 54
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
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char = m;code = 109
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char = t;code = 116
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
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char = n;code = 110
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char = (;code = 40
char = t;code = 116
char = w;code = 119
char = o;code = 111
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 6;code = 54
char = %;code = 37
char = ];code = 93
char = );code = 41
char = ;;code = 59
char = ;code = 32
char = o;code = 111
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char = o;code = 111
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char = a;code = 97
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char = c;code = 99
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char = a;code = 97
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char = i;code = 105
char = v;code = 118
char = e;code = 101
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char = p;code = 112
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char = l;code = 108
char = ;code = 32
char = a;code = 97
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char = a;code = 97
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char = a;code = 97
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char = e;code = 101
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char = t;code = 116
char = w;code = 119
char = o;code = 111
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 3;code = 51
char = 4;code = 52
char = ;code = 32
char = [;code = 91
char = 6;code = 54
char = %;code = 37
char = ];code = 93
char = );code = 41
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
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char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
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char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = C;code = 67
char = O;code = 79
char = N;code = 78
char = C;code = 67
char = L;code = 76
char = U;code = 85
char = S;code = 83
char = I;code = 73
char = O;code = 79
char = N;code = 78
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = A;code = 65
char = d;code = 100
char = o;code = 111
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char = e;code = 101
char = s;code = 115
char = c;code = 99
char = e;code = 101
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char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = P;code = 80
char = C;code = 67
char = O;code = 79
char = S;code = 83
char = ;code = 32
char = a;code = 97
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = s;code = 115
char = k;code = 107
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char = v;code = 118
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char = p;code = 112
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char = g;code = 103
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = a;code = 97
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char = o;code = 111
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char = i;code = 105
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char = a;code = 97
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char = m;code = 109
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = e;code = 101
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char = .;code = 46
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char = P;code = 80
char = o;code = 111
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char = y;code = 121
char = c;code = 99
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char = s;code = 115
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char = i;code = 105
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char = e;code = 101
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char = a;code = 97
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char = p;code = 112
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char = l;code = 108
char = l;code = 108
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char = G;code = 71
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char = a;code = 97
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char = e;code = 101
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char = w;code = 119
char = i;code = 105
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char = h;code = 104
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char = P;code = 80
char = C;code = 67
char = O;code = 79
char = S;code = 83
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char = f;code = 102
char = o;code = 111
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char = ;code = 32
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char = f;code = 102
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char = a;code = 97
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char = e;code = 101
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char = f;code = 102
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char = c;code = 99
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
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result sql = BACKGROUND : Polycystic ovary syndrome (PCOS) is defined as chronic anovulation with evidence of hyperandrogenism, after the exclusion of secondary causes. It is commonly linked to obesity and the presence of the metabolic syndrome.
OBJECTIVES : To review the clinical features and medical assessment of adolescents referred for PCOS to gynecology or endocrinology services at The Hospital for Sick Children (Toronto, Ontario).
METHODS : A chart review was conducted of all adolescents with PCOS referred during a one-year period. Measures included clinical findings, investigations and management.
RESULTS : Forty-one adolescent girls, with a mean age +/- SD of 14.7+/-1.5 years, were reviewed. Common presenting complaints were menstrual irregularities in 35 of 41 girls (85%) and hirsutism in 28 of 41 girls (68%), with 32 of 41 adolescents (78%) having more than one complaint. The majority (31 of 38 [82%]) were overweight or obese. Features associated with the metabolic syndrome (hypertension, dyslipidemia, insulin resistance and obesity) were identified in some adolescents, but were not consistently assessed. Blood pressure was assessed in 38 adolescents, fasting plasma glucose in 27, triglycerides in 22 and cholesterol in 21. Only four of 28 adolescents (15%) who underwent pelvic ultrasound demonstrated ovarian cysts. Investigations and management differed somewhat between endocrinologists and gynecologists. Most adolescents (34 of 41 [83%]) received pharmacological treatment: oral contraceptive pill (21 of 34 [62%]); intermittent medroxyprogesterone acetate to induce withdrawal bleeding (nine of 34 [26%]); metformin (two of 34 [6%]); or oral contraceptive pill and antiandrogen (two of 34 [6%]).
CONCLUSIONS : Adolescents with PCOS are at risk of developing metabolic abnormalities. Polycystic ovaries were not a consistent finding. The most commonly prescribed treatment was the oral contraceptive pill. Greater attention should be placed on screening adolescents with PCOS for diabetes, hypertension and dyslipidemia, allowing for earlier identification and management of potentially modifiable cardiovascular risk factors.
Publication: Paediatr Child Health 2005 Dec ;10(10)::602-8.
Publication Date: 2005 Dec
Study Author(s): Orsino, Angela;Van Eyk, Nancy;Hamilton, Jill;
Institution: Divisions of General Paediatrics.
Shortcut link to this study:
Publication Date: 2005 Dec
Study Author(s): Orsino, Angela;Van Eyk, Nancy;Hamilton, Jill;
Institution: Divisions of General Paediatrics.
Shortcut link to this study:
BACKGROUND : Polycystic ovary syndrome (PCOS) is defined as chronic anovulation with evidence of hyperandrogenism, after the exclusion of secondary causes. It is commonly linked to obesity and the presence of the metabolic syndrome.
OBJECTIVES : To review the clinical features and medical assessment of adolescents referred for PCOS to gynecology or endocrinology services at The Hospital for Sick Children (Toronto, Ontario).
METHODS : A chart review was conducted of all adolescents with PCOS referred during a one-year period. Measures included clinical findings, investigations and management.
RESULTS : Forty-one adolescent girls, with a mean age +/- SD of 14.7+/-1.5 years, were reviewed. Common presenting complaints were menstrual irregularities in 35 of 41 girls (85%) and hirsutism in 28 of 41 girls (68%), with 32 of 41 adolescents (78%) having more than one complaint. The majority (31 of 38 [82%]) were overweight or obese. Features associated with the metabolic syndrome (hypertension, dyslipidemia, insulin resistance and obesity) were identified in some adolescents, but were not consistently assessed. Blood pressure was assessed in 38 adolescents, fasting plasma glucose in 27, triglycerides in 22 and cholesterol in 21. Only four of 28 adolescents (15%) who underwent pelvic ultrasound demonstrated ovarian cysts. Investigations and management differed somewhat between endocrinologists and gynecologists. Most adolescents (34 of 41 [83%]) received pharmacological treatment: oral contraceptive pill (21 of 34 [62%]); intermittent medroxyprogesterone acetate to induce withdrawal bleeding (nine of 34 [26%]); metformin (two of 34 [6%]); or oral contraceptive pill and antiandrogen (two of 34 [6%]).
CONCLUSIONS : Adolescents with PCOS are at risk of developing metabolic abnormalities. Polycystic ovaries were not a consistent finding. The most commonly prescribed treatment was the oral contraceptive pill. Greater attention should be placed on screening adolescents with PCOS for diabetes, hypertension and dyslipidemia, allowing for earlier identification and management of potentially modifiable cardiovascular risk factors.
OBJECTIVES : To review the clinical features and medical assessment of adolescents referred for PCOS to gynecology or endocrinology services at The Hospital for Sick Children (Toronto, Ontario).
METHODS : A chart review was conducted of all adolescents with PCOS referred during a one-year period. Measures included clinical findings, investigations and management.
RESULTS : Forty-one adolescent girls, with a mean age +/- SD of 14.7+/-1.5 years, were reviewed. Common presenting complaints were menstrual irregularities in 35 of 41 girls (85%) and hirsutism in 28 of 41 girls (68%), with 32 of 41 adolescents (78%) having more than one complaint. The majority (31 of 38 [82%]) were overweight or obese. Features associated with the metabolic syndrome (hypertension, dyslipidemia, insulin resistance and obesity) were identified in some adolescents, but were not consistently assessed. Blood pressure was assessed in 38 adolescents, fasting plasma glucose in 27, triglycerides in 22 and cholesterol in 21. Only four of 28 adolescents (15%) who underwent pelvic ultrasound demonstrated ovarian cysts. Investigations and management differed somewhat between endocrinologists and gynecologists. Most adolescents (34 of 41 [83%]) received pharmacological treatment: oral contraceptive pill (21 of 34 [62%]); intermittent medroxyprogesterone acetate to induce withdrawal bleeding (nine of 34 [26%]); metformin (two of 34 [6%]); or oral contraceptive pill and antiandrogen (two of 34 [6%]).
CONCLUSIONS : Adolescents with PCOS are at risk of developing metabolic abnormalities. Polycystic ovaries were not a consistent finding. The most commonly prescribed treatment was the oral contraceptive pill. Greater attention should be placed on screening adolescents with PCOS for diabetes, hypertension and dyslipidemia, allowing for earlier identification and management of potentially modifiable cardiovascular risk factors.
PMID: 19668673
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