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Childhood tumors are classified into 12 major diagnostic groups: leukemias, lymphomas, central nervous system (CNS) tumors, sympathetic nervous system tumors, retinoblastomas, renal tumors, liver tumors, bone tumors, soft tissue sarcomas, germ cell tumors, epithelial tumors and other and unspecified malignant cancers. Epidemiological studies have shown an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The effects of maternal lifestyle during pregnancy on embryonic and fetal development are well known effects on the subsequent risk of cancer. Several features of maternal lifestyle during pregnancy have been studied regarding their association with childhood cancer, including diet, breastfeeding, smoking and alcohol consumption and the use of cosmetics. Parental illicit drugs use has been associated with several types of childhood cancer. Lymphoma, melanoma and testicular, cervical and thyroid cancers account for the vast majority of cancers in adolescents and young adults.
A complete history and physical exam is the cornerstone of the evaluation of the infertile male. The semen analysis is critical in the initial evaluation of the infertile man and to a large extent guides further work-up. Karyotype analysis and microdeletion analysis of the Y chromosome are indicated for men with severe oligospermia or azoospermia because of the common detection of genetic anomalies in men with low sperm production. Computer-assisted semen analysis (CASA) has been developed to overcome the highly subjective nature of conventional analysis of sperm morphology and quality. The post-coital test evaluates the interaction between sperm and the cervical mucus environment in the woman. In light of an abnormal post-coital test or in cases of idiopathic infertility, antisperm antibody testing may be obtained. With a thorough understanding of the proper work-up algorithm, there is less unnecessary testing, which will benefit patients both financially and emotionally.