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Sample records for climacteric stage women

  1. Quality of care and health-related quality of life of climacteric stage women cared for in family medicine clinics in Mexico

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    Pérez-Cuevas Ricardo

    2010-02-01

    Full Text Available Abstract Objectives 1 To design and validate indicators to measure the quality of the process of care that climacteric stage women receive in family medicine clinics (FMC. 2 To assess the quality of care that climacteric stage women receive in FMC. 3 To determine the association between quality of care and health-related quality of life (HR-QoL among climacteric stage women. Methods The study had two phases: I. Design and validation of indicators to measure the quality of care process by using the RAND/UCLA Appropriateness Method. II. Evaluation of the quality of care and its association with HR-QoL through a cross-sectional study conducted in two FMC located in Mexico City that included 410 climacteric stage women. The quality of care was measured by estimating the percentage of recommended care received (PRCR by climacteric stage women in three process components: health promotion, screening, and treatment. The HR-QoL was measured using the Cervantes scale (0-155. The association between quality of care and HR-QoL was estimated through multiple linear regression analysis. Results The lowest mean of PRCR was for the health promotion component (24.1% and the highest for the treatment component (86.6%. The mean of HR-QoL was 50.1 points. The regression analysis showed that in the treatment component, for every 10 additional points of the PRCR, the global HR-QoL improved 2.8 points on the Cervantes scale (coefficient -0.28, P Conclusion The indicators to measure quality of care for climacteric stage women are applicable and feasible in family medicine settings. There is a positive association between the quality of the treatment component and HR-QoL; this would encourage interventions to improve quality of care for climacteric stage women.

  2. Instruments to study sleep disorders in climacteric women

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    Álvaro Monterrosa-Castro

    2016-07-01

    Full Text Available To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliographical research without intervention, the available information in scientific databases. Performed in PubMed, ScienceDirect, Scopus, Ebscohos OvidSP and Health Library. The words used in this article: insomnia, adjustment sleep disorder, questionnaires, studies and menopause. Publications of all types were included. Seven scales were identified: Insomnia Severity Index, Athens Insomnia Scale, Pittsburgh Quality of sleep Index, Epworth Sleepiness Scale, Jenkins Sleep Scale, Basic Nordic Sleep Questionnaire and The St Mary's Hospital Sleep Questionnaire. There are validated scales in multiple languages and considered appropriate for studying sleep disorders.

  3. Effect of leptin level upon lipid metabolism in climacteric women

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    Peng Lijing; Yan Ruming; Sun Enhua

    2005-01-01

    To observe the relationship between leptin and obesity of climacteric women with their lipid metabolism, 110 cases of climacteric women were chosen as observation group, consisting of 69 cases obese subgroup and 45 cases non-obese group, and 60 cases of normal reproduction- age women were arranged as control group. Blood levels of leptin, INS, LDL-C, TG, HDL-C, apoA1, apoB, LH, FSH, E-2, T, and P were detected and BMI was calculated. The results showed that blood levels of leptin and INS of obese subgroup were significantly higher than those of non-obese sub-group and control group(P<0.01), and that LDL-C(5.01 mmol/L), TG(2.21mmal/L) and apoB(0.89g/L) levels in obese subgroup were significantly higher than those of control group. Furthermore, an important observation was that in climacteric women group, blood leptin level was positively and significantly correlated with insulin, BMI and several atherogenic blood lipid parameters, including LDL-C, TG and apoB. Thus, a preliminary conclusion might be reached as that the high climacteric level of leptin is associated with abnormal lipid metabolism related to atherogenity, and so leptin and lipid metabolism as a whole should be paid more attention in climateric women, especially those with obesity. (authors)

  4. ANTIHYPERTENSIVE THERAPY AND CLIMACTERIC DISORDERS IN POSTMENOPAUSAL WOMEN

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    A. A. Kirichenko

    2008-01-01

    Full Text Available Aim. To study efficacy and tolerability of antihypertensive therapy with enalapril (Berlipril®, Berlin-Chemie AG/Menarini Group and diltiazem (Altiazem® PP, Berlin-Chemie AG/Menarini Group in postmenopausal women with arterial hypertension (HT and climacteric disorders.Material and methods. 60 postmenopausal women (aged 56,8±3,9 y.o. with HT of 1-3 degrees were included into the study. They were split in two groups. Patients of the first group (30 people received enalapril (Berlipril® 20 mg/daily, patients of the second group (30 people – diltiazem (Altiazem® PP 180-360 mg/daily. Observation period was 6 months. Ambulatory blood pressure monitoring (ABPM was performed before treatment and after 3 weeks, 1, 3 and 6 months of therapy. Climacteric syndrome severity and urodynamic disorders was estimated as well as psychic status according to score of depression and anxiety.Results. Office and ambulance blood pressure decreased after 6 months of therapy in all patients of both groups. A number of complaints on headache and giddiness reduced significantly. Severity of climacteric syndrome also decreased. Enalapril (Berlipril® monotherapy and especially combined therapy with hydrochlorothiazide led to aggravation of urodinamic disorders. On the contrary both monotherapy with diltiazem (Altiazem® PP or its combination with hydrochlorothiazide had positive effect on urodinamics. Both therapies reduced depression and anxiety levels significantly.Conclusion. All spectrum of pharmacology effects should be taken into account during antihypertensive therapy of patients with climacteric disorders.

  5. Aromatherapy Massage Affects Menopausal Symptoms in Korean Climacteric Women: A Pilot-Controlled Clinical Trial

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    Hur, Myung-Haeng; Yang, Yun Seok

    2008-01-01

    This study investigated the effects of aromatherapy massage on menopausal symptoms in Korean climacteric women. Kupperman's menopausal index was used to compare an experimental group of 25 climacteric women with a wait-listed control group of 27 climacteric women. Aromatherapy was applied topically to subjects in the experimental group in the form of massage on the abdomen, back and arms using lavender, rose geranium, rose and jasmine in almond and primrose oils once a week for 8 weeks (eight times in total). The experimental group reported a significantly lower total menopausal index than wait-listed controls (P aromatherapy massage may be an effective treatment of menopausal symptoms such as hot flushes, depression and pain in climacteric women. However, it could not be verified whether the positive effects were from the aromatherapy, the massage or both. Further rigorous studies should be done with more objective measures. PMID:18830459

  6. Suan Zao Ren Tang as an Original Treatment for Sleep Difficulty in Climacteric Women: A Prospective Clinical Observation

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    Chia-Hao Yeh; Christof K. Arnold; Yen-Hui Chen; Jung-Nein Lai

    2011-01-01

    Little scientific evidence supports the efficacy of herbal medicines in the treatment of women with sleep difficulty during the climacteric period. The purpose of this study is to evaluate the efficacy and safety of Suan Zao Ren Tang (SZRT) in reducing the impact of sleep disturbance on climacteric women, as measured by Pittsburg sleep quality index (PSQI) and the World Health Organization quality of life (WHOQOL). Sixty-seven climacteric women with sleep difficulty intending to treat receive...

  7. [Kinesiotherapy effect on quality of life, sexual function and climacteric symptoms in women with fibromyalgia].

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    Lisboa, Lilian Lira; Sonehara, Elisa; Oliveira, Katia Cristina Araújo Nogueira de; Andrade, Sandra Cristina de; Azevedo, George Dantas

    2015-01-01

    To evaluate the effect of the kinesiotherapy in the quality of life, sexual function and menopause-related symptoms and compare in climacteric women with and without fibromyalgia (FM). the group was composed of 90 climacteric women divided in 2 groups: FM (47) and control (43). The patients were analyzed on their quality of life (Utian Quality of Life [UQoL]), sexual function (Sexual Quotient-Female Version [SQ-F] questionnaire) and intensity of the climacteric symptoms (Blatt-Kupperman menopausal index [BKMI]). Both groups performed pelvic floor kinesiotherapy, composed of 20 sessions, twice a week. Statistical analysis was performed using Student's t-test, mixed-design analysis of variance (ANOVA) and Cohen's Kappa. In the quality of life, an improvement was noticed in both groups for all domains analyzed. In the comparison between groups it was noticed a difference in the emotional (p=0.01), health (p=0.03) and sexual (p=0.001) domains with considerable gains verified in the control group. Improvement was also noticed in the sexual function. In the analysis between groups, FM group showed a lower score compared to the control group (p quality of life, sexual function and climacteric symptoms in women with and without fibromyalgia in the climacteric period; however, fibromyalgia seems to be a limiting factor to achieve better results in some of the aspects evaluated. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  8. Aromatherapy Massage Affects Menopausal Symptoms in Korean Climacteric Women: A Pilot-Controlled Clinical Trial

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    Myung-Haeng Hur

    2008-01-01

    Full Text Available This study investigated the effects of aromatherapy massage on menopausal symptoms in Korean climacteric women. Kupperman's menopausal index was used to compare an experimental group of 25 climacteric women with a wait-listed control group of 27 climacteric women. Aromatherapy was applied topically to subjects in the experimental group in the form of massage on the abdomen, back and arms using lavender, rose geranium, rose and jasmine in almond and primrose oils once a week for 8 weeks (eight times in total. The experimental group reported a significantly lower total menopausal index than wait-listed controls (P < 0.05. There were also significant intergroup differences in subcategories such as vasomotor, melancholia, arthralgia and myalgia (all P < 0.05. These findings suggest that aromatherapy massage may be an effective treatment of menopausal symptoms such as hot flushes, depression and pain in climacteric women. However, it could not be verified whether the positive effects were from the aromatherapy, the massage or both. Further rigorous studies should be done with more objective measures.

  9. Climacteric complaints among very low-income women from a tropical region of Brazil

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    Sebastião Freitas de Medeiros

    Full Text Available CONTEXT AND OBJECTIVE: Climacteric symptoms may vary between different countries and cultures. Socioeconomic factors and climate may be implicated. The aim of this study was to identify climacteric symptomatology among very low-income Brazilian women, living in a hot and humid region. DESIGN AND SETTING: This cross-sectional population-based study was conducted in Cuiabá, at Júlio Müller University Hospital, a tertiary institution. METHODS: The study enrolled 354 climacteric women. The variables analyzed were social class, symptomatology and abnormal concurrent conditions. The study was approved by the hospital's research ethics committee. RESULTS: Sixty-five percent of the participants (232/354 were very poor and had had little schooling. The number of symptoms per woman was 8.0 ± 5.7. Hot flushes, nervousness, forgetfulness and fatigue were each found in nearly 60.0%. Tearfulness, depression, melancholy and insomnia were also frequent. Sexual problems were reported by 25%. The most relevant concurrent abnormal conditions reported were hypertension (33.9%, obesity (26.5%, arthritis/arthrosis (15.0% and diabetes mellitus (9.6%. Hot flushes were associated with tearfulness, nervousness and forgetfulness. CONCLUSION: Brazilian climacteric women of low income and low schooling present multiple symptoms. Vasomotor and psychosexual symptoms were the most prevalent disorders. Hot flushes were associated with nervousness, forgetfulness and tearfulness.

  10. Climacteric symptoms and their relation to feminine self-concept.

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    Quiroga, A; Larroy, C; González-Castro, P

    2017-06-01

    To investigate women's subjective experiences in the climacteric transition, especially the impact of self-concept, quality of life and depression on the severity of climacteric symptoms. Non-experimental, cross-sectional study, purpose sampling. To analyze the results, we proposed a three-way interaction, in which the direct effect of depression on the severity of climacteric symptoms would be buffered by perceived sexual quality of life, and mediated by self-concept. As hypothesized, depression significantly predicted self-concept, which in turn mediated the severity of climacteric symptoms. In a second stage of the model, sexual quality of life moderated the direct effect of depression on climacteric symptoms, such that women with a better sexual quality of life would perceive less severity of climacteric symptoms than those with a less favorable sexual quality of life. Physical quality of life did not significantly buffer the direct effect of depression on climacteric symptoms, nor did vasomotor or psychosocial quality of life. Our study confirmed the impact of subjective factors such as satisfaction, self-concept, and quality of life on climacteric symptoms; specifically, we observed the moderating effect of the sexual quality of life on the previously established correlation between depression and aggravation of climacteric symptoms.

  11. Inverse correlation between the standard deviation of R-R intervals in supine position and the simplified menopausal index in women with climacteric symptoms.

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    Yanagihara, Nobuyuki; Seki, Meikan; Nakano, Masahiro; Hachisuga, Toru; Goto, Yukio

    2014-06-01

    Disturbance of autonomic nervous activity has been thought to play a role in the climacteric symptoms of postmenopausal women. This study was therefore designed to investigate the relationship between autonomic nervous activity and climacteric symptoms in postmenopausal Japanese women. The autonomic nervous activity of 40 Japanese women with climacteric symptoms and 40 Japanese women without climacteric symptoms was measured by power spectral analysis of heart rate variability using a standard hexagonal radar chart. The scores for climacteric symptoms were determined using the simplified menopausal index. Sympathetic excitability and irritability, as well as the standard deviation of mean R-R intervals in supine position, were significantly (P standard deviation of mean R-R intervals in supine position and the simplified menopausal index score. The lack of control for potential confounding variables was a limitation of this study. In climacteric women, the standard deviation of mean R-R intervals in supine position is negatively correlated with the simplified menopausal index score.

  12. Social representations elaborated by nurses about climacteric women in primary health care

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    Smithanny Barros da Silva

    2016-01-01

    Full Text Available Objective : to understand the social representations elaborated by nurses from the family health strategy concerning the assistance to climacteric women. Methods : qualitative research conducted with 28 nurses. One adopted the reference of procedural approach of the theory of social representations. The interviews were recorded and transcribed completely and processed by the Software of Lexical Analysis of co-occurrence in simple statements of a text, version 4.7. Results: nurses recognize the menopause as a phase of women’s life that needs to be assisted in its entirety, however, they showed difficulty in helping them, as they just carry out the cytological examination collection, request laboratory tests and forward them to a doctor. Conclusion: the climacteric period is a multifaceted phenomenon and the assistance to those people should be systematized from a qualified listening, in an approach that respects its uniqueness and autonomy.

  13. [Quality of life and related factors among climacteric women from south Brazil].

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    de Lorenzi, Dino R S; Saciloto, Bruno; Artico, Graziela R; Fontana, Sabrina K R

    2009-01-01

    This study aimed to evaluate the quality of life in climacteric and associated factor among women from Southeast Brazil. A cross-section study of 506 women aged between 45 and 60 years old attended at a university climacteric clinic from South Brazil from June to October 2002. Hysterectomized women, as well as hormonal therapy or hormonal contraceptive users were excluded. The quality of life was evaluated by the Women's Health Questionnaire (WHQ). Statistical analysis was performed with multiple linear regression analysis. The average of the age among the studied women was 51.3 (+/- 4.5) years old. About 15.4% were premenopausal, 34.4% perimenopausal and 50.2% postmenopausal women. The quality of life showed up deteriorated among the studied women. The factors related with quality of life were: the educational level (p < 0.01), the confirmation of smoking in the last year (p < 0.01), regular physical activity (p < 0.01), the confirmation of previous co-morbidities (p < 0.01) and the menopausal status (p < 0.01). A higher educational level, as well as the confirmation of regular physical activity led to a significant increase on their life quality. Smoking and previous clinical co-morbidities were responsible for the lower scores of quality of life. The pre-menopause was associated with a higher life quality level if compared to peri and post menopause. No differences in relation to the scores of life were identified among the perimenopausal and postmenopausal women. Nevertheless the menopausal status showed up associated to the quality of life, the results of the study pointed out that the climacteric is not just influenced by biological factors, but also by psychosocial and cultural factors.

  14. Climacteric symptoms in Quechua and Mestizo women from the Andean region of Cusco, Peru: effects of altitude and ethnicity.

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    Ojeda, Eliana; Blümel, Juan E; Vallejo, María Soledad; Lavín, Pablo

    2014-04-01

    Latin-American women present a greater severity of climacteric symptoms than women from other parts of the world. Previous studies suggest that this could be due to either its Amerindian crossbreeding or the altitude in which a huge proportion of the Latin-American population lives. To answer this question, climacteric symptoms between Peruvian women ("Hispanic-Mestizas" and "Quechuas") living in similar altitude (around 3000 MASL) were compared. This is a cross sectional descriptive study of healthy women of 40-59 years of age living in Departamento de El Cusco, Peru. Using the MRS questionnaire climacteric symptoms were assessed in 395 "Hispanic-Mestizas" (Quechua-Spaniard breeding) and 376 pure "Quechuas". The "Quechuas" compared with "Hispanic-Mestizas" have comparable similar age, but less: obesity, schooling years, cigarette smoking, use of hormonal therapy, diabetes and hypertension; and a greater: proportion of postmenopausal women and number of children. "Quechuas" showed a greater prevalence in ten of the eleven symptoms evaluated by the MRS scale, except for insomnia. The total MRS score was 14.54±7.51 vs. 9.87±6.26 (pQuechuas" had a deteriorated quality of life due to severe climacteric symptomatology, compared to only 14.2% of "Hispanic-Mestizas" women (pQuechua being (OR: 2.38, 95% CI: 1.27-4.45). Peruvian "Quechuas" women have severer climacteric symptoms than the Peruvian "Hispanic-Mestizas" who live in a comparable altitude. This could suggest that the ethnicity could be one of the factors that could explain the augmented symptoms in Latin-American climacteric woman. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Suan Zao Ren Tang as an Original Treatment for Sleep Difficulty in Climacteric Women: A Prospective Clinical Observation

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    Yeh, Chia-Hao; Arnold, Christof K.; Chen, Yen-Hui; Lai, Jung-Nein

    2011-01-01

    Little scientific evidence supports the efficacy of herbal medicines in the treatment of women with sleep difficulty during the climacteric period. The purpose of this study is to evaluate the efficacy and safety of Suan Zao Ren Tang (SZRT) in reducing the impact of sleep disturbance on climacteric women, as measured by Pittsburg sleep quality index (PSQI) and the World Health Organization quality of life (WHOQOL). Sixty-seven climacteric women with sleep difficulty intending to treat received SZRT at a rate of 4.0 g, thrice daily for four weeks (MRS < 16, n = 34; MRS ≥ 16, n = 33). After taking into account potential confounding factors, the mean PSQI total scores had fallen from 13.0 (±2.9) to 9.0 (±3.2) (95% confidence interval −4.93, −3.10). Further analyses showed that SZRT produced superior benefit of daytime dysfunction in women with severe menopausal symptoms (MRS ≥ 16). There were three of the withdrawals involved treatment-related adverse events (stomachache, diarrhea, and dizziness). Excluding women with a past history of stomachache, diarrhea, or dizziness, four weeks of therapy with SZRT appears to be a relatively safe and effective short-term therapeutic option in improving daytime function of climacteric women with poor sleep quality. PMID:21660310

  16. Suan Zao Ren Tang as an Original Treatment for Sleep Difficulty in Climacteric Women: A Prospective Clinical Observation

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    Chia-Hao Yeh

    2011-01-01

    Full Text Available Little scientific evidence supports the efficacy of herbal medicines in the treatment of women with sleep difficulty during the climacteric period. The purpose of this study is to evaluate the efficacy and safety of Suan Zao Ren Tang (SZRT in reducing the impact of sleep disturbance on climacteric women, as measured by Pittsburg sleep quality index (PSQI and the World Health Organization quality of life (WHOQOL. Sixty-seven climacteric women with sleep difficulty intending to treat received SZRT at a rate of 4.0 g, thrice daily for four weeks (MRS<16, n=34; MRS≥16, n=33. After taking into account potential confounding factors, the mean PSQI total scores had fallen from 13.0 (±2.9 to 9.0 (±3.2 (95% confidence interval −4.93, −3.10. Further analyses showed that SZRT produced superior benefit of daytime dysfunction in women with severe menopausal symptoms (MRS≥16. There were three of the withdrawals involved treatment-related adverse events (stomachache, diarrhea, and dizziness. Excluding women with a past history of stomachache, diarrhea, or dizziness, four weeks of therapy with SZRT appears to be a relatively safe and effective short-term therapeutic option in improving daytime function of climacteric women with poor sleep quality.

  17. A Cross-Cultural Comparison of Climacteric Symptoms, Self-Esteem, and Quality of Life between Mosuo Women and Han Chinese Women

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    Zhang Ying

    2017-07-01

    Full Text Available Background: The present study was designed to compare climacteric symptoms, self-esteem, and quality of life (QOL between women from two different cultures in China (Mosuo and Han Chinese and to evaluate the interaction among these variables. Mosuo is a small ethnic group in southwest China, which is described as a matriarchal society, while Han Chinese is the largest ethnic group with a patriarchal system.Methods: This cross-cultural study was conducted on 54 Mosuo women and 52 Han Chinese women between 40 and 60 years of age. The subjects were selected through convenience sampling. They answered a sociodemographic questionnaire, the Menopause Rating Scale (MRS, the Self-Esteem Scale (SES, and the 12-Item Short Form Health Survey (SF-12.Results: In our sample, Mosuo women obtained lower scores on the psychological and somato-vegetative subscales of the MRS, but higher scores on SES and the mental health-related QOL (SF-12/MCS than Han Chinese women. However, the correlation between climacteric symptoms, self-esteem, and QOL was weaker in the Mosuo group compared to the Han group. Multiple linear regressions indicated that climacteric symptoms have negatively affected women's QOL.Conclusion: In accordance with the study hypothesis, Mosuo women showed milder symptoms, a higher self-esteem, and a better QOL compared to the Han Chinese women during the climacteric. The interaction between climacteric symptoms, psychosocial variables, and QOL revealed cultural differences.

  18. Progesterone increases resistance of ophthalmic and central retinal arteries in climacteric women.

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    Souza, M A M De; Souza, B M De; Geber, S

    2013-04-01

    To evaluate the effect of a synthetic progestin on the vascular resistance of the ophthalmic and central retinal arteries in climacteric women, compared to placebo, using transorbital ultrasound with Doppler velocimetry. We performed a prospective, randomized, double-blinded, placebo-controlled study with 216 climacteric women. Subjects were randomly allocated to one of two groups: either the group receiving placebo (one pill/day for 30 days) (n = 108) or the group receiving progestin (5 mg medroxyprogesterone acetate/day for 30 days) (n = 108). Transorbital Doppler velocimetric ultrasound was performed, before and after treatment; we measured the pulsatility index, resistance index and systole/diastole ratio. The mean ages of the participants in the study group and the control group were 54 ± 6.2 years (range 48-59 years) and 55 ± 6.8 years (range 46-60 years), respectively. When we compared the effect of the progestin on the central retinal artery before and after treatment, we observed a significant increase after the treatment in all Doppler indices. The same was observed when we compared the effect of the progestin on the ophthalmic artery. In the group of women receiving placebo, the Doppler indices were similar before and after treatment. Our results demonstrate the existence of a progestogenic vasoconstrictive effect in the ophthalmic and central retinal arteries. As this study provides new data, the observed effect needs further investigations to better elucidate its extent. Moreover, our findings may be particularly useful to others interested in understanding the vascular dynamics of the cerebral vessels and to researchers running clinical trials related to hormone replacement therapy.

  19. Succinate-based preparation alleviates manifestations of the climacteric syndrome in women.

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    Peskov, A B; Maevskii, E I; Uchitel', M L; Sakharova, N Yu; Vize-Khripunova, M A

    2005-09-01

    Clinical placebo-controlled study of Enerlit-Clima (bioactive succinate-based food additive) a showed positive effect of the preparation on general clinical and psychoemotional manifestations of the climacteric syndrome. A trend to an increase in estradiol level in early pathological climacteric and normalization of the endometrial status were observed.

  20. Effects of imparting planned health education on hot flush beliefs and quality of life of climacteric women.

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    Sis Çelik, A; Pasinlioğlu, T

    2017-02-01

    The aim of the present study was to determine the effect of imparting planned health education to climacteric women on their beliefs related to hot flushes and on their quality of life. The research was conducted using pretest and post-test semi-experimental models along with a control group. Of 450 women, 255 were randomly selected and invited to participate in the study. Five people did not agree to participate in the study. Three people were also excluded from the study because they did not complete training. The research sample was comprised of 247 climacteric women (121 women in the experimental group and 126 women in the control group) who were Life Questionnaire. Three educational sessions at 2-week intervals were given to the women in the experimental group. The research was supported with an educational booklet prepared by the researchers. Training was not given to the women in the control group. After the education of the experimental group (after about 6 months), women in both groups recompleted the data collection forms, and post-test data were collected. On all the subscales, the total of the Hot Flush Beliefs Scale, and the average post-test score, the women in the experimental group scored lower than the women in the control group (the average post-test total score in the experimental group was 26.22 ± 10.09 and in control group it was 52.25 ± 15.04; p Life Questionnaire for the women in the experimental group was lower than that for the women in the control group (p life of the women in the experimental group showed an upward trend, that of the women in the control group remained the same. It was found that planned health education about the climacteric period reduced women's negative beliefs about hot flushes and enhanced their quality of life.

  1. Impact of climacteric and depressive symptoms on the quality of life of postmenopausal women

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    Iwona Ewa Pawlak

    2016-09-01

    Full Text Available Background. Quality of life consists of many elements that affect the creation of the level of QoL. Women with postmenopausal may experience a phenomenon of loneliness. This phenomenon can be caused by the effects they had on menopausal symptoms and depression from private and professional life. Objectives. The aim of the study was to determine the effect of menopausal symptoms and depression on quality of life in postmenopausal women. Material and methods . The survey was performed among 128 women after menopause. The mean age was 64.20 ± 8.61, median 65 years. The study used a questionnaire consisting of the SF-36, Kupperman Index, Beck Depression Scale and the author’s questionnaire. Results . The sense of mental health – MH women found at most, which was equal to 69.47. Meanwhile, the general level of health – HP was rated the lowest of only 46.68. Of the 128 respondents revealed menopausal symptoms at 32.81% (n = 42 of surveyed women. It has been shown statistically significant relationship between the index of climacteric, and the assessment of QoL in the SF-36 domains: RL M (emotional role functioning – (χ 2 = 24.33; p = 0.003, MH (mental health – (χ 2 = 27.27; p = 0.001, EV (vitality – (χ 2 = 24.28; p = 0.003, P (pain – (χ 2 = 25.89; p = 0.002, and the Beck Depression Inventory, and the assessment of QoL by SF-36. Conclusions . Menopausal symptoms, the presence of depression and age have a significant impact on the quality of life of women in postmenopausal period.

  2. A cross-cultural comparison of climacteric symptoms, self-esteem, and perceived social support between Mosuo women and Han Chinese women.

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    Zhang, Ying; Zhao, Xudong; Leonhart, Rainer; Nadig, Maya; Hasenburg, Annette; Wirsching, Michael; Fritzsche, Kurt

    2016-07-01

    This cross-cultural study aimed to compare climacteric symptoms, self-esteem, and perceived social support between Mosuo and Han Chinese women, and to explore the interaction between culture and climacteric symptoms. Mosuo is a Chinese minority group with a matriarchal structure, and Han Chinese is the majority ethnic group in China with a patriarchal structure. Through convenience sampling, 54 Mosuo women and 52 Han Chinese women between 40 and 60 years of age completed the sociodemographic questionnaire, the Menopause Rating Scale, the Self-Esteem Scale, and the Perceived Social Support Scale. Compared with Han Chinese women, Mosuo women scored lower on the psychological (P psychological symptoms severity. Referring to the severity of all symptoms, predictive variables were: perceived support from family (β = -0.210, P = 0.017); self-esteem (β = 0.320, P Cultural variables such as familial structure, women's self-esteem, and perceived social support were correlated with symptomatology.

  3. Prevalência e fatores associados a fogachos em mulheres climatéricas e pós-climatéricas Prevalence and factors associated with hot flashes in climacteric and post-climacteric women

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    Iândora Krolow Timm Sclowitz

    2005-04-01

    Full Text Available Com o objetivo de determinar a prevalência de fogachos e fatores associados, em mulheres entre 40 e 69 anos de idade, provenientes de uma amostra representativa da população da cidade de Pelotas, Rio Grande do Sul, Brasil, realizou-se um estudo transversal. O processo de amostragem foi em múltiplos estágios, e a coleta de dados, realizada através de entrevista e questionário auto-aplicado. Foram incluídas 879 mulheres. A prevalência ponto e a prevalência de episódio de fogachos foram, respectivamente, de 30,1% e 53,2%. Os fatores estatisticamente associados a fogachos atuais foram a categoria menopausal de pré-menopausa (RP = 2,33 e pós-menopausa (RP = 2,66; idade de 45 a 49 anos (RP = 1,34 e de 50 a 54 anos (RP = 1,42; status sócio-econômico mais baixo (RP = 2,16; não uso de anticoncepção hormonal após os 40 anos (RP = 1,40; obesidade (RP = 1,39; sobrepeso (RP = 1,32 e viver sem companheiro (RP = 0,80. Dada a alta prevalência do sintoma, é necessário que os serviços de saúde se organizem para lidar com a mulher climatérica.A cross-sectional study was conducted on the prevalence of hot flashes and associated factors among women from 40 to 69 years old, from a population-based sample in the city of Pelotas, southern Brazil. A multi-stage sampling process was used, and data were collected through an interview and a self-applied questionnaire. A total of 879 women were included. Point prevalence and lifetime prevalence were 30.1% and 53.2%, respectively. Factors associated with hot flashes were: pre-menopausal status (RP = 2.33 and post-menopausal status (RP = 2.66; age 45-49 years (RP = 1.34 and 50-54 years (RP = 1.42; lower social class (RP = 2.16; no use of a hormonal contraception method after 40 years of age (RP = 1.40; obesity (RP = 1.39 and overweight (RP = 1.32; and not having a partner (RP = 0.80. High prevalence of this symptom indicates that health facilities should be prepared to deal with problems encountered

  4. Response to Individualized Homeopathic Treatment for Depression in Climacteric Women with History of Domestic Violence, Marital Dissatisfaction or Sexual Abuse: Results from the HOMDEP-MENOP Study.

    Science.gov (United States)

    Macías-Cortés, Emma Del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

    2018-06-05

     Although individualized homeopathic treatment is effective for depression in climacteric women, there is a lack of well-designed studies of its efficacy for depression in battered women or in post-traumatic stress disorder. The aim of this study was to assess the association between individualized homeopathic treatment or fluoxetine and response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction.  One hundred and thirty-three Mexican climacteric women with moderate-to-severe depression enrolled in the HOMDEP-MENOP Study (a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial, with a 6-week follow-up study) were evaluated. Domestic violence, marital dissatisfaction and sexual abuse were assessed at baseline. Response to depression treatment was defined by a decrease of 50% or more from baseline score of Hamilton scale. Association between domestic violence, sexual abuse, and marital dissatisfaction and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratio (OR) and 95% confidence interval (CI) were calculated.  Homeopathy versus placebo had a statistically significant association with response to depression treatment after adjusting for sexual abuse (OR [95% CI]: 11.07 [3.22 to 37.96]), domestic violence (OR [95% CI]: 10.30 [3.24 to 32.76]) and marital dissatisfaction (OR [95% CI]: 8.61 [2.85 to 25.99]).  Individualized homeopathic treatment is associated with response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. Further studies should be conducted to evaluate its efficacy specifically for post-traumatic stress disorder in battered women. CLINICALTRIALS. NCT01635218,:  URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1. The Faculty of Homeopathy.

  5. Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women?

    Science.gov (United States)

    Mazaro-Costa, Renata; Andersen, Monica L; Hachul, Helena; Tufik, Sergio

    2010-11-01

    Female sexual dysfunction (FSD) is a complex and multifactorial condition. An increased incidence of FSD is especially associated with the decline of estrogen. Thus, menopause is a critical phase for FSD complaints. In this context, medicinal plants may be a therapeutic option. To identify and describe the popular and clinical uses of medicinal plants for FSD treatment in climacteric women. We highlighted the majority of the plants commonly involved with the female reproductive system including: Angelica sinensis, Cimicifuga racemosa, Ferula hermonis, Ginkgo biloba, Humulus lupulus, Lepidium meyenii, Tribulus terrestris, Trifolium pratense, and Vitex agnus-castus. This study is a narrative review of studies of plants that are possible alternative treatments for FSD. The species described have clinical and popular uses in different cultures as well as medical indications for female reproductive disturbances, mainly in climacteric women. We have also analyzed the evidence level of clinical studies. The main outcome assessed is the efficacy of plants in improving the symptoms of FSD. There is little evidence from the literature to recommend the use of medicinal plants when treating FSD. The majority of studies with a strong level of evidence are associated with the treatment of the vasomotor symptoms of menopause. Ferula hermonis, Angelica sinensis, and Gingko biloba may be suggested for arousal disorder studies. Cimicifuga racemosa, Trifolium pratense, and Vitex agnus-castus may be recommended for several FSD. Humulus lupulus and Tribulus terrestris may help with desire disorder studies. Lepidium meyenii should be studied further. Studies of these plants indicate that they may be useful as a possible alternative and/or complementary approach for studies aimed at the treatment of FSD. At this time, however, this review cannot recommend a plant that has a strong enough level of evidence for treatment of FSD. Thus, there is a need for clinical (double-blinded and

  6. Changes in Australian women's perception of the menopause and menopausal symptoms before and after the climacteric.

    Science.gov (United States)

    Abraham, S; Llewellyn-Jones, D; Perz, J

    1994-12-01

    The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be 'a relief' or 'a nuisance' significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.

  7. Climacteric women at work: What lurks behind poor occupational quality of life?

    Science.gov (United States)

    Gazibara, Tatjana; Rancic, Biljana; Radovanovic, Sanja; Kurtagic, Ilma; Nurkovic, Selmina; Kovacevic, Nikolina; Dotlic, Jelena

    2018-04-18

    Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories-below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate "good" from "poor" occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.

  8. Is complementary and alternative therapy effective for women in the climacteric period?

    Science.gov (United States)

    Kim, Mi Young; Choi, Seung Do; Ryu, Aeli

    2015-04-01

    Vasomotor symptoms start about 2 years prior to menopause in women who are approaching menopause, and early menopause symptoms appear including emotional disturbance and anxiety, followed by physical changes such as vaginal dryness, urinary incontinence and skin wrinkles. As time progresses, osteoporosis, cardiovascular diseases, and dementia occur consecutively. Hormone therapy is primarily considered for the relief of menopause symptoms in postmenopausal women. However, as hormone replacement has emerged as a therapy that increases the potential risk of thrombosis, cerebral infarction and breast cancer, complementary and alternative medicine has drawn much attention. This study aimed to examine the types and effects of evidence-based complementary and alternative therapies that are currently used.

  9. [Job performance and climacteric in female workers].

    Science.gov (United States)

    Salazar, Alide; Paravic, Tatiana

    2005-03-01

    During climacteric, the presence of disabling symptoms and the higher incidence of chronic diseases, may impair the job performance of women. To relate job performance levels with the climacteric period and associated factors in working women aged from 42 to 55 years old. In a cross-sectional and correlative design, 64 secretaries at two public organizations at the Eighth Region of Chile, were assessed using the following instruments: Menopause-Specific Quality of Life Questionnaire (University of Toronto), adapted for Chile by PROSAM, Climacteric Self-care Questionnaire, Perceived Social Support Scale and Biodemographics Variables Questionnaire. A Perception of the Job Performance Scale was applied to the persons that superintended these woman. The Department Heads or persons supervising these women, determined that most workers did their work well. The best evaluations were given by older bosses. Most women under study showed a moderate alteration of the Menopause Quality of Life. A deficit of self-care during the climacteric period was detected in 92.2%. The perceived social support from friends correlated with job performance. Menopause quality of life in its different domains had no correlation with job performance variable. No association between changes during the climacteric period and job performance was observed among women participating in this study.

  10. Mulher no climatério: reflexões sobre desejo sexual, beleza e feminilidade Women in the climacteric: reflections on sexual desire, beauty and femininity

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    Cecília Nogueira Valença

    2010-06-01

    Full Text Available O climatério é um período abrangente da vida feminina, caracterizado por alterações metabólicas e hormonais que trazem mudanças envolvendo o contexto psicossocial. Tendo como referência as alterações de sexualidade vivenciadas no climatério, este trabalho tem por objetivo refletir sobre desejo sexual, beleza e feminilidade da mulher nessa fase. A metodologia adotada consistiu em estudo bibliográfico, em livros e artigos publicados, entre 1999 e 2009. A exigência exacerbada pela beleza eterna e jovialidade é agravada no climatério, no qual o corpo feminino não tem o mesmo vigor físico pelas alterações decorrentes do envelhecimento. A mulher climatérica vive o mito da perda do desejo sexual, todavia, continua a sentir prazer, não devendo deixar de manifestar amor e sexualidade. A visão social estereotipada sobre o papel da mulher (esposa e mãe pode interferir negativamente na visão das mulheres sobre si mesmas e no seu relacionamento com as pessoas e o mundo. Nesse sentido, é importante que as mulheres tenham acesso à informação em saúde para a compreensão das mudanças do período de climatério/menopausa, contemplando e ressignificando tal fase como integrante de seus ciclos de vida e não como sinônimo de velhice, improdutividade e fim da sexualidade.The climacteric is a long period of a woman's life, characterized by metabolic and hormonal alterations that bring changes involving the psychosocial context. Having as reference the sexuality alterations experienced in the climacteric, this literature review aims to reflect on women's sexual desire, beauty and femininity in this phase. The methodology involved a bibliographic study of papers and books published between 1999 and 2009. The exaggerated need of eternal beauty and youth is aggravated in the climacteric, when the female body does not have the same physical vigor due to alterations deriving from aging. The climacteric woman lives the myth of loss of sexual

  11. Influences of climacteric in female sexual activity

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    Anthonio Alisancharles Batista de Almeida

    2016-01-01

    Full Text Available Objective: to identify complaints of sexual function related to climacteric symptoms among women in climacteric age. Methods: this is an descritive study. A sample of 330 women aged from 35 to 65 years old, with three previous Pap tests. We used a semi-structured questionnaire developed by the researchers. A descriptive statistical analysis was performed having the central tendency of proportion and measure the average as a parameter. Results: it was evidenced that 50.0% were between 35-45 years, 73.0% were sexually active, 59.4% had decreased libido, and 58.5% reported dyspareunia. Conclusion: it is necessary that the health services and professionals are aware of the influence of climacteric on women’s health to develop strategies aimed at quality of life.

  12. Estado nutricional e qualidade de vida da mulher climatérica Nutritional status and quality of life of climacteric women

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    Carin Weirich Gallon

    2012-04-01

    Full Text Available OBJETIVO: Associar a qualidade de vida com o estado nutricional da mulher climatérica. MÉTODOS: Trata-se de estudo transversal, no qual foi incluída uma amostra com 200 mulheres climatéricas, de 40 a 65 anos, que responderam a um Recordatório Alimentar de 24 horas e questões sobre fatores socioeconômicos, história clínica atual, pregressa e familiar. Para a avaliação antropométrica, foram utilizados índice de massa corpórea (IMC, circunferência da cintura (CC e relação cintura/quadril. Para avaliação da qualidade de vida, foi aplicado o MRS-menopause rating scale. RESULTADOS: A média do IMC e da CC foi de 30,1 kg/m² (obesidade grau 1 e 99 cm (risco muito aumentado para doença cardiovascular, respectivamente. Constatou-se consumo aumentado de proteínas e diminuído de fibras, cálcio e vitamina D. A comorbidade mais prevalente foi a hipertensão arterial, 48,5% faziam uso de medicação para doenças cardiovasculares e 23%, de medicações antidepressivas. Quanto à qualidade de vida, foram encontrados resultados significativos relacionados ao IMC, como também à pressão arterial. CONCLUSÕES: Uma intervenção nutricional visando corrigir ou melhorar o consumo alimentar e o perfil antropométrico poderá resultar em benefícios relativos à saúde da mulher climatérica. A prevalência de obesidade, associada com pior qualidade de vida e morbimortalidade, reforça a necessidade de existir um programa de reeducação alimentar no climatério.PURPOSE: To associate the quality of life with the nutritional status of climacteric women. METHODS: This was a cross-sectional study on a sample of 200 climacteric women aged 40 to 65 years who responded to a 24-hour food recall and to questions about socioeconomic factors and current, previous and family medical history. Body mass index (BMI, waist circumference (WC and waist-hip ratio were used for anthropometric evaluation. To assess the quality of life, we applied the MRS

  13. Dysfunctional uterine bleedings of a climacteric period

    International Nuclear Information System (INIS)

    Prilepskaya, V.N.

    1993-01-01

    Climacteric period of some women is complicated by dysfunctional uterine bleedings (DUB). Bearing in mind the fact that DUBS are caused by disorder of estrin rhysmic secretion, the paper presents the methods of differential diagnostics for investigations into functional disorders in the hypothalamus -hypophysis - ovaries - uterus system. The preference is given to roentgenologic and radioimmunologic diagnostic methods

  14. Non-climacteric ripening and sorbitol homeostasis in plum fruits.

    Science.gov (United States)

    Kim, Ho-Youn; Farcuh, Macarena; Cohen, Yuval; Crisosto, Carlos; Sadka, Avi; Blumwald, Eduardo

    2015-02-01

    During ripening fruits undergo several physiological and biochemical modifications that influence quality-related properties, such as texture, color, aroma and taste. We studied the differences in ethylene and sugar metabolism between two genetically related Japanese plum cultivars with contrasting ripening behaviors. 'Santa Rosa' (SR) behaved as a typical climacteric fruit, while the bud sport mutant 'Sweet Miriam' (SM) displayed a non-climacteric ripening pattern. SM fruit displayed a delayed ripening that lasted 120 days longer than that of the climacteric fruit. At the full-ripe stage, both cultivars reached similar final size and weight but the non-climacteric fruits were firmer than the climacteric fruits. Fully ripe non-climacteric plum fruits, showed an accumulation of sorbitol that was 2.5 times higher than that of climacteric fruits, and the increase in sorbitol were also paralleled to an increase in sucrose catabolism. These changes were highly correlated with decreased activity and expression of NAD(+)-dependent sorbitol dehydrogenase and sorbitol oxidase and increased sorbitol-6-phosphate dehydrogenase activity, suggesting an enhanced sorbitol synthesis in non-climacteric fruits. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. [Validation of a questionnaire for measurement of beliefs about the climacteric].

    Science.gov (United States)

    Chávez-Ayala, Rubén; Andrade-Palos, Patricia; Rivera-Rivera, Leonor

    2002-01-01

    To design an instrument for measuring beliefs about the social, psychological, and physiological consequences of women's climacteric stage. The study included 340 women affiliated to Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (Institute for Social Services and Security for State Workers, ISSSTE) (age mean = 49.46, (SD 7.92). The mean number of pregnancies in the sample was 3.75 (SD 2.57), and the mean number of born children was 3.21 (SD 2.19); 48% of women were premenopausal, 10.9% perimenopausal, and 40.6% postmenopausal. The instrument consisted of 25 items. A factorial analysis with Varimax rotation was carried out. Four factors were confirmed: disadvantages (alpha = 0.769), advantages (alpha = 0.839), physiological (alpha = 0.659), and psychological (alpha = 0.711). This instrument shows good internal consistency, and measures four climacteric belief groups: a) beliefs on disadvantages, b) beliefs on advantages, c) beliefs on physiological ailments, and d) beliefs on psychological symptoms. All three confirmed dimensions of the climacteric phase have been proposed in other studies.

  16. Characterisation of ethylene pathway components in non-climacteric capsicum.

    Science.gov (United States)

    Aizat, Wan M; Able, Jason A; Stangoulis, James C R; Able, Amanda J

    2013-11-28

    Climacteric fruit exhibit high ethylene and respiration levels during ripening but these levels are limited in non-climacteric fruit. Even though capsicum is in the same family as the well-characterised climacteric tomato (Solanaceae), it is non-climacteric and does not ripen normally in response to ethylene or if harvested when mature green. However, ripening progresses normally in capsicum fruit when they are harvested during or after what is called the 'Breaker stage'. Whether ethylene, and components of the ethylene pathway such as 1-aminocyclopropane 1-carboxylate (ACC) oxidase (ACO), ACC synthase (ACS) and the ethylene receptor (ETR), contribute to non-climacteric ripening in capsicum has not been studied in detail. To elucidate the behaviour of ethylene pathway components in capsicum during ripening, further analysis is therefore needed. The effects of ethylene or inhibitors of ethylene perception, such as 1-methylcyclopropene, on capsicum fruit ripening and the ethylene pathway components may also shed some light on the role of ethylene in non-climacteric ripening. The expression of several isoforms of ACO, ACS and ETR were limited during capsicum ripening except one ACO isoform (CaACO4). ACS activity and ACC content were also low in capsicum despite the increase in ACO activity during the onset of ripening. Ethylene did not stimulate capsicum ripening but 1-methylcyclopropene treatment delayed the ripening of Breaker-harvested fruit. Some of the ACO, ACS and ETR isoforms were also differentially expressed upon treatment with ethylene or 1-methylcyclopropene. ACS activity may be the rate limiting step in the ethylene pathway of capsicum which restricts ACC content. The differential expression of several ethylene pathway components during ripening and upon ethylene or 1-methylclopropene treatment suggests that the ethylene pathway may be regulated differently in non-climacteric capsicum compared to the climacteric tomato. Ethylene independent pathways may

  17. [Effects of craniocerebral hypothermia on the course of climacteric syndrome].

    Science.gov (United States)

    Grishenko, V I; Sherbina, N A; Lipko, O P

    1992-01-01

    Craniocerebral hypothermia was used in the treatment of 43 women aged 48 to 55, suffering from the climacteric syndrome of varying severity. The treatment efficacy was confirmed by EEG data and changes in blood levels of ACTH, LH, prolactin, and hydrocortisone.

  18. Laser photoacoustic system for characterization of climacteric and nonclimacteric fruits in postharvest

    Science.gov (United States)

    Giubileo, G.; Lai, A.; Piccinelli, D.; Puiu, A.

    2005-06-01

    The emission of ethylene from climacteric fruit banana (Musa x paradisiaca L.) and non climacteric fruits lemon (Citrus limon Burm. F.) at different stages of ripening (from a few days after setting to full maturity stage) by the Laser Photoacoustic Spectroscopy System, developed in ENEA Frascati, was measured. A high ethylene production rate from mature banana fruit was found, as expected for climacteric fruit. Significant differences between ethylene emitted by the lemon after setting stage and by the young fruit were observed. Also ethylene emission from lemon fruits at different ripening stages (from light green to turning and full ripe) was detected. Depending on the ripening stage, differences in ethylene emission rates were found, although the emissions were low as expected for non-climacteric fruit.

  19. [Morbidity and associated factors in climacteric women: a population based study in women with 11 or more years of formal education].

    Science.gov (United States)

    Machado, Vanessa de Souza Santos; Valadares, Ana Lúcia Ribeiro; Costa-Paiva, Lucia; Morais, Sirlei Siani; Pinto-Neto, Aarão Mendes

    2012-05-01

    To evaluate factors associated with morbidities among Brazilian women aged 40-65 years and with 11 or more years of schooling. A secondary analysis of a cross-sectional population-based study was conducted, using an anonymous self-report questionnaire completed by 377 women. Were evaluated, with this instrument, some morbidities (hypertension, diabetes, insomnia and depression) and sociodemographic, behavioral, clinical and reproductive factors. The association between morbidities and independent variables was evaluated by the χ² test. Multiple logistic regression analysis with stepwise selection criteria was used to select the major factors associated with morbid conditions. In the multiple regression analysis, insomnia was associated with bad/fair self-perception of health (OR=2.3) and nervousness (OR=5.1). Depression was associated with bad/fair self-perception of health (OR=3.7) and bad/poor leisure (OR=2.8). Hypertension was associated with obesity (OR=3.1) and being in postmenopausal (OR=2.6). Diabetes was associated with age above 50 years (OR=3.9) and obesity (OR=12.5). The prevalence of morbidities was high and a worse self-perception of health and obesity were the main factors associated with morbidity.

  20. The Influence of Climacteric Symptoms on Women’s Lives and Activities

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    Agnieszka Bień

    2015-04-01

    Full Text Available In the present study, we performed an analysis of the influence of climacteric symptoms on women’s lives and activities, i.e. their quality of life (QoL. The study was performed between October 2011 and February 2012. It included 148 women aged 44–62. The study used a diagnostic survey with questionnaires. The research instrument was the Blatt-Kupperman index. The respondents were asked to complete a questionnaire on socio-demographic data, quality of life, and the influence of climacteric symptoms on life and its various aspects. The respondents experiencing moderate or severe climacteric symptoms also had stronger feelings of failure (p = 0.005, feeling that opportunities are still available (p = 0.002, of losing their youth and beauty (p < 0.0001, compared to those who had slight or no symptoms. The intensity of climacteric symptoms significantly affects women’s lives and activities, i.e., their QoL. The reported intensity of climacteric symptoms is influenced by the respondents’ education, residence, marital status and professional activity. The more severe the climacteric symptoms, the lower the women’s quality of life, as evidenced for example by the feeling of failure and of losing one’s youth, beauty and opportunities.

  1. Autopercepción del estado de salud en climatéricas derechohabientes del Instituto Mexicano del Seguro Social Self-rated health among climacteric women affiliated to Instituto Mexicano del Seguro Social

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    Svetlana Vladislavovna-Doubova

    2008-10-01

    Full Text Available OBJETIVO: Evaluar la autopercepción del estado de salud positivo (APES + o negativo (APES - de mujeres climatéricas e identificar los factores relacionados con la APES-. MATERIAL Y MÉTODOS: Se analizó la información de 9 248 mujeres de 40 a 59 años. Las variables dependientes fueron la APES y las independientes las características generales, antecedentes ginecoobstétricos, enfermedades crónicas, actividad física, participación en programas de detección y educación. Se realizó un análisis descriptivo, bivariado y multivariado. RESULTADOS: Una proporción de 42% de las mujeres refirió APES+ y 58% APES-. Los factores vinculados con APES- fueron primaria completa o menos (RM=1.78; IC95% 1.62-1.95, no tener trabajo remunerado (RM=1.20; IC95% 1.09-1.33, menopausia (RM=1.22; IC95% 1.11-1.33, diabetes (RM=1.88; IC95% 1.65-2.13, hipertensión (RM=2.01; IC95% 1.82-2.22, actividad física irregular (RM=1.30; IC95% 1.12-1.50, sedentarismo (RM=1.395; IC95% 1.23-1.57, falta de integridad de detección (RM=0.82; IC95% 0.75-0.89 y de información sobre el climaterio por parte de los servicios de salud (RM=1.17; IC95% 1.07-1.28. CONCLUSIÓN: Los factores relacionados con APES- son múltiples y algunos, como la información acerca del climaterio y la actividad física, deben fortalecerse.OBJECTIVE: To evaluate self-rated health (SRH in climacteric women and to identify the factors associated with negative SRH. MATERIAL AND METHODS: Information from 9 248 women aged 40 to 59 years was analyzed. SRH was the dependent variable. Independent variables were demographic characteristics, history of reproductive and chronic diseases, physical activity, and participation in screening and health education programs. Data were analyzed using descriptive statistics, bivariate analysis, and logistic regression modeling. RESULTS: Forty-two percent of women reported positive SRH and 58% reported negative SRH. Factors associated with negative SRH were: low literacy

  2. Ensaio clínico placebo-controlado com isoflavonas da soja para sintomas depressivos em mulheres no climatério Placebo-controlled clinical trial with soy isoflavones for depressive symptoms in climacteric women

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    Rilva Lopes de Sousa

    2006-02-01

    Full Text Available OBJETIVOS: avaliar a eficácia do uso de isoflavonas da soja no tratamento de sintomas depressivos em mulheres com síndrome climatérica. MÉTODOS: estudo experimental placebo-controlado, randomizado e duplo-cego, com 84 pacientes climatéricas atendidas ambulatorialmente no Hospital Universitário Lauro Wanderley, em João Pessoa (PB. Na avaliação de sintomas depressivos empregou-se o Questionário de Auto-avaliação da Escala de Hamilton para Depressão (QAEH-D nas visitas pré-tratamento (VT1 e na 8ª (VT2 e na 16ª (VT3 semana pós-tratamento. O grupo experimental (GExp recebeu extrato de isoflavonas da soja, 120 mg por dia, e o controle (GCont, placebo. A comparação dos escores do QAEH-D entre os grupos em VT1, VT2 e VT3 constituiu a medida primária de eficácia (teste t, p0,05. De VT1 para VT3, evidenciou-se diferença estatisticamente significativa de 8,9% na redução dos escores entre os grupos (p=0,03. Não houve correlação da redução dos sintomas depressivos com resposta dos sintomas vasomotores (p>0,05. Houve redução das concentrações de FSH apenas no GExp (p=0,02, sem alterações do estradiol. Não ocorreram eventos adversos clinicamente relevantes. CONCLUSÕES: o efeito do extrato de isoflavonas foi superior ao do placebo, porém de pequena magnitude e apenas após 8 semanas de tratamento. Este pequeno efeito atribuído ao tratamento experimental, de boa tolerabilidade, poderá beneficiar pacientes que têm efeitos colaterais aos estrógenos ou que preferem não usar estes hormônios.PURPOSE: to evaluate the efficacy of the use of isoflavones in the treatment of depressive symptoms in climacteric women. METHODS: placebo-controlled, randomized double-blind experimental study with 84 climacteric women who were assisted at the Lauro Wanderley University Hospital Ambulatory, in João Pessoa, Paraíba, Brazil. In the evaluation of the depressive symptoms the Self-evaluation questionnare of Hamilton's rating scale for

  3. Mulheres vivenciando o climatério - DOI: 10.4025/actascihealthsci.v26i1.1633 Women in the climacteric phase - DOI: 10.4025/actascihealthsci.v26i1.1633

    Directory of Open Access Journals (Sweden)

    Raimunda Magalhães da Silva

    2004-04-01

    Full Text Available Pretendemos, neste trabalho, compreender as vivências e a realidade da mulher na fase do climatério e sua influência na qualidade de vida. A amostra constou de 25 mulheres na faixa etária de 35 a 64 anos, nos meses de abril e maio de 2003, sendo todas participantes do Grupo de Auto-Ajuda à Mulher nessa Fase do Climatério, desenvolvido no Núcleo de Atenção Médico Integrada - Nami / Unifor. Os dados foram obtidos através de uma entrevista semi-estruturada. Os resultados evidenciaram as características das mulheres, os sintomas e os problemas psicofisiológicos mais freqüentes, os quais podem estar relacionados à desinformação da mulher, a sua história de vida e ao contexto familiar e cultural. Foi evidenciada a relevância do grupo de auto-ajuda como apoio e estímulo à adaptação e à convivência solidária e também a necessidade de uma assistência de enfermagem comprometida com a informação, a educação e a promoção da saúde, tendo em vista o bem-estar e a qualidade de vida da mulher nessa fase da vidaThe aim of this work is to understand woman's experiences and reality during the climacteric phase and its influence on their quality of life. The sample consisted of 25 women from 35 to 64 years old. They are all participants in the group of Self-Counseling for woman in this phase, developed in the Nucleus of Integrated Medical Attention - NAMI / Unifor, from April to May 2003. The data were obtained through a semi-structured interview. Results showed the women's characteristics, the symptoms and the more frequent psycho-physiological problems can be related to the lack of information, to the life history and to the woman's family and cultural context. The relevance of the Self-Counseling group was evidenced as support and incentive to the adaptation and in agreement with family and social coexistence. Also, the need of an attendance of committed nursery with information, education and promotion of health was evidenced

  4. Factores relacionados con la demanda de atención médica durante el climaterio Factors related to the demand of medical attention during the climacteric

    Directory of Open Access Journals (Sweden)

    Elodia Rivas Alpízar

    2006-08-01

    Full Text Available El presente trabajo tiene como objetivo identificar los factores biológicos y sociales que determinan la solicitud de ayuda médica en mujeres de edad mediana en un área urbana. Se realizó un estudio descriptivo transversal donde se seleccionaron, mediante el muestreo por conglomerados monoetápicos, 311 mujeres atendidas en 4 consultorios del médico de la familia del policlínico Área III, en Cienfuegos. A cada mujer se le realizó una entrevista para precisar sus características sociodemográficas, presencia de síntomas climatéricos y su intensidad, condicionamiento de género y sus conocimientos sobre climaterio y menopausia, así como los factores que se relacionaron con la solicitud de atención médica, la cual fue realizada por las mujeres con edades entre 45-54 años, con nivel escolar de preuniversitario, quienes presentaron síntomas climatéricos muy molestos y poseían un conocimiento adecuado sobre climaterio/menopausia. Entre las razones para no demandar ayuda médica se encontró que el 14,7 % de las féminas refirió la falta de tiempo a pesar de tener síntomas molestos. La mayoría de las mujeres tuvo sobrecarga de género y conocimiento no adecuado sobre climaterio/menopausia. En conclusión, por primera vez en nuestro medio se reportan los factores sociales y biológicos que motivan o no atención médica durante el período del climaterio.The objective of the present paper is to identify the biological and social factors determining the request of medical attention among middle-aged women in an urban area. A descriptive cross-sectional study was conducted and 311 women that received attention in 4 family physicians' offices of the Area III Polyclinic, in Cienfuegos, were selected by single-stage conglomerate sampling. Every woman was interviewed to determine her sociodemographic characteristics, the presence of climacteric symptoms and their intensity, the gender conditioning and their knowledge on climacteric and

  5. Sintomas climatéricos e estado nutricional de mulheres na pós-menopausa usuárias e não usuárias de terapia hormonal Climacteric symptoms and nutritional status of women in post-menopause users and non-users of hormone therapy

    Directory of Open Access Journals (Sweden)

    Angela Andréia França Gravena

    2013-04-01

    Full Text Available OBJETIVO: Analisar os sintomas climatéricos e estado nutricional em mulheres na pós-menopausa, usuárias e não usuárias de terapia hormonal (TH. MÉTODOS: Estudo analítico, exploratório, tipo inquérito populacional domiciliar, realizado na área urbana do município de Maringá, Paraná, incluindo 456 mulheres com idade entre 45 e 69 anos, no período pós-menopausa. A coleta teve como base de referência os setores censitários urbanizados (368 do município, de acordo com o Censo Demográfico Brasileiro. Foi utilizada amostra aleatória simples proporcional às mulheres residentes em cada setor censitário e, por meio de visita domiciliar, aplicou-se um questionário e verificaram-se as medidas antropométricas e pressão arterial. Para avaliação dos sintomas climatéricos, foi utilizado o Índice Menopausal de Blatt e Kupperman. A variável desfecho foi o uso de TH. RESULTADOS: A média de idade foi de 58,7 anos. O excesso de peso esteve presente em 72,6% das mulheres e a obesidade abdominal em 81,4% delas. Sintomas climatéricos de intensidade leve foram evidenciados em 69,5% das mulheres. Apenas 18,4% das mulheres faziam uso de TH e eram, na sua maioria, brancas, não fumantes, sem comorbidades e sem companheiro. Usuárias de TH apresentaram menor frequência de excesso de peso e obesidade abdominal e tiveram menor prevalência de sintomas climatéricos de intensidade severa. CONCLUSÃO: O excesso de peso e a obesidade abdominal foram prevalentes na amostra estudada. Embora em menor número, as usuárias de TH apresentaram uma frequência menor de excesso de peso e sintomas climatéricos leves e intensos na pós-menopausa.PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69

  6. A Stage Approach to Career Counseling with Christian Women.

    Science.gov (United States)

    Hughes, Rosemarie Scotti; Brame, Cynthia M.; Vaughn, Lee Anne; Ward, Lisbet

    1998-01-01

    Many working married women in the U.S. are in occupations that are below their potential or are not personally satisfying. Christian women may be particularly vulnerable to role dissatisfaction. Offers a stage model for assessment of Christian women with symptoms of depression in hopes of addressing issues of role satisfaction and lessening…

  7. Age, pattern of menopause, climacteric symptoms and associated problems among urban population of Hyderabad, pakistan

    International Nuclear Information System (INIS)

    Qazi, R.A.

    2006-01-01

    To analyze the physiology of menopause in the context of the age at menopause, its pattern, climacteric symptoms and associated problems of an urban cohort. In total, 800 women of age 45-59 years, who had reached a natural menopause were interviewed. The data were collected by simple random sampling method. A pre-tested questionnaire was administered to collect the data. Physical examination including height, weight and blood pressure check was also carried out at the same time. Data were statistically analyzed through software program SPSS 10.0. The mean age at menopause of subjects was 47.16 years. Duration of climacteric ranged from 2 - 36 months in majority of cases. The marked climacteric symptoms were low backache (75%), headache (70.25%), tiredness (67.75%), limb pain (59.25%), sleep disturbance (53.75%), lack of concentration (49.5%), hot flushes (55.5%) and night sweats (45%). Other associated problems were hypertension (31.5%), ischaemic heart disease (22.25%), diabetes mellitus (15.75%), postmenopausal bleeding (10.5%) and vaginitis (4.2%), respectively. (author)

  8. Ethamsylate in the treatment of climacteric flushing.

    Science.gov (United States)

    Harrison, R F

    1981-03-01

    Ethamsylate, a non-hormonal agent acting at the capillary level, was compared with a placebo in a double-blind trial of 12 wk duration in 20 post-menopausal patients with hot flushes. Both ethamsylate and placebo patients showed fluctuations in the frequency of flushes during the trial, but there was a significant downward trend in the ethamsylate group. Capillary strength was measured but was not found to be low or to alter during the trial except in 1 patient in the placebo group. No side-effects attributable to trial medication were reported. Other symptoms recorded during the trial were probably climacteric and occurred more frequently during placebo treatment than during treatment with ethamsylate.

  9. Prevalence and factors associated with urinary incontinence in climacteric

    Directory of Open Access Journals (Sweden)

    Máyra Cecilia Dellú

    Full Text Available SUMMARY Objective: To estimate the prevalence and identify associated factors to urinary incontinence (UI in climacteric women. Method: In a cross-sectional study with a stratified random sample, 1,200 women aged between 35 and 72 years were studied, enrolled in the Family Health Strategy in the city of Pindamonhangaba, São Paulo. Urinary incontinence was investigated using the International Consultation of Incontinence Questionnaire - Short Form, while associated factors were assessed based on a self-reported questionnaire with socio-demographic, obstetric and gynecological history, morbidities and drug use. The prevalence of urinary incontinence was estimated with a 95% confidence interval (95CI and the associated factors were identified through multiple logistic regression model performed using Stata software, version 11.0. Results: Women had a mean age of 51.9 years, most were in menopause (59.4%, married (87.5%, Catholic (48.9%, and declared themselves black or brown (47.2%. The mean age of menopause of women with UI was 47.3 years. The prevalence of UI was 20.4% (95CI: 17.8-23.1%. The factors associated with UI were urinary loss during pregnancy (p=0.000 and after delivery (p=0.000, genital prolapse (p=0.000, stress (p=0.001, depression (p=0.002, and obesity (p=0.006. Conclusion: The prevalence of UI was lower but similar to that found in most similar studies. Factors associated with the genesis of UI were urinary loss during pregnancy and after delivery, genital prolapse and obesity.

  10. Depressão em mulheres climatéricas: análise de mulheres atendidas ambulatorialmente em um hospital universitário no Maranhão Depression in climacteric women: analysis of a sample receiving care at a university hospital in Maranhão, Brazil

    Directory of Open Access Journals (Sweden)

    Mari-Nilva Maia da Silva

    2008-08-01

    Full Text Available Introdução: O climatério, período de transição entre a fase reprodutiva e não-reprodutiva, ocasiona mudanças biopsicossociais nas mulheres que o vivenciam. A associação entre a maior prevalência de depressão nesse período é, no entanto, ainda controversa. O objetivo deste estudo foi avaliar a prevalência de depressão em mulheres climatéricas atendidas em um hospital universitário numa cidade da Região Nordeste do Brasil e identificar fatores associados. Método: Foi realizado um estudo prospectivo e analítico de 70 mulheres climatéricas. O diagnóstico de depressão foi dado segundo critérios diagnósticos da Classificação Internacional de Doenças em um período de seguimento mínimo de 3 meses. Foram investigadas as seguintes variáveis: escolaridade, situação conjugal, renda pessoal, gravidade da depressão segundo escala de Hamilton, presença e intensidade de sintomas climatéricos, menopausa (natural ou cirúrgica, dependência econômica do parceiro, antecedentes familiares de depressão, história prévia de depressão pós-parto, episódios depressivos e transtorno disfórico pré-menstrual, alterações da função sexual e visão positiva ou negativa da menopausa. Resultados: Um percentual de 34,3% das pacientes apresentou depressão, sendo 70,8% destas na categoria leve da escala de Hamilton. Não houve associação estatisticamente significante entre variáveis socioeconômicas, diminuição da libido e antecedentes familiares de depressão com a presença de depressão. Houve associação entre a presença de depressão e pacientes com sintomas vasomotores (p = 0,03, insônia (p Introduction: The climacteric is a transition period between reproductive and non-reproductive ages that leads to biopsychossocial changes in women who experience it. However, association between a larger prevalence of depression in this period is still controversial. The objective of this study was to assess the prevalence of

  11. Efficacy of biorhythmic transdermal combined hormone treatment in relieving climacteric symptoms: a pilot study

    Directory of Open Access Journals (Sweden)

    B Formby

    2011-02-01

    Full Text Available B Formby, F SchmidtThe Rasmus Institute for Medical Research, Program in Reproductive Endocrinology, Santa Barbara, CA, USAObjective: To evaluate the efficacy of a combination of bioidentical combined 17β-estradiol and progesterone transdermal delivery system (lipophilic emulsion-type base to relieve climacteric symptoms. The hormonal replacement was given during a period of 6 months at four different cyclic doses to mimic the normal ovary secretory pattern.Design: An open, randomized, comparative, between-patient trial conducted over 6 months in 29 menopausal women with climacteric symptoms assessed with the Kupperman index at baseline and during treatments. Saliva and serum values of 17β-estradiol and progesterone were quantitated before treatment and after 3 and 6 months. Pharmacokinetic data following transdermal administration of 17β-estradiol (0.3 mg, daily and progesterone (100 mg, daily were calculated from saliva levels using high-performance liquid chromatography analysis.Results: Improvement in climacteric symptoms was reported in 93% of women evaluated before and after 3 and 6 months of treatment. Values of saliva 17β-estradiol increased after 6 months from 0.6 ± 0.3 pg/mL to 14.1 ± 3.3 pg/mL, and the values of serum 17β-estradiol increased from 3.3 ± 2.8 pg/mL to 80.6 ± 21.9 pg/mL. Of responders, 88% characterized symptom relief as complete. No adverse health-related events were attributed to the bioidentical hormone therapy. Time to maximum saliva concentrations (Tmax, in all experimental cases, was observed after 6 hours. Baseline values were reached within 24 hours, indicating a diurnal rhythm of 17β-estradiol seen in normally cyclic women over the 24-hour period, ie, its daily biological rhythm.Conclusion: Percutaneous absorption of 17β-estradiol, as well as the absorption of progesterone, was associated with relief of climacteric symptoms. The cyclical transdermal delivery of combined bioidentical hormones may be

  12. Life satisfaction of women in early stages of fertility treatment.

    Science.gov (United States)

    Ben Shlomo, Shirley; Pascal, Mor; Taubman Ben-Ari, Orit; Azuri, Yoseph; Horowtz, Eran

    2017-01-01

    As many women perceive motherhood to be a central component of identity that enhances life satisfaction, difficulties conceiving may lead to stress. This study examined women in the early stages of fertility treatment to ascertain the relations of perceived stress, cognitive appraisal, and self-mastery to the life satisfaction of women embarking on fertility treatment and whether the associations were the same for women who were already mothers versus those who were not. Women were recruited for the study over a period of 18 months, from January 2013 to June 2014. The final sample was composed of 145 women; of these, 67 had 1 or 2 children and 78 had no children. No significant differences were found in perceived stress and life satisfaction between women with and without children. However, in the sample as a whole, higher levels of self-mastery and lower levels of stress were associated with greater life satisfaction. Moreover, the associations between self-mastery and cognitive appraisals of threat and self-efficacy were mediated by perceived stress. The findings highlight the importance of developing interventions at fertility clinics that begin at the very first point of contact to promote the psychological well-being of women being treated for infertility.

  13. [Assistance to the climacteric woman: new paradigms].

    Science.gov (United States)

    Lorenzi, Dino Roberto Soares De; Catan, Lenita Binelli; Moreira, Karen; Artico, Graziela Rech

    2009-01-01

    Population aging is a demographic reality for Brazil. Consequently, in the next years it is expected a progressive increase in seeking health care services in the country by women with complaints related to climacterium. Parallel to it, assistance at this part of woman's life has been going through a paradigm shift which has imposed to health professionals a change of attitude in relation to this stage of woman's life. Today it is acknowledged that the climacterium is influenced by biological, psychosocial and cultural factors, whose knowledge is fundamental for planning a more qualified and humanized care. This article proposes a reflection on the paradigm shifts in assistance at climacterium, highlighting important aspects as multidisciplinarity and interdisciplinarity, so as to serve better this portion of population, and provide it with more integrated and individualized care, bringing together knowledge and sensitivity, and always aiming at a better quality of life.

  14. Detection of Golden apples' climacteric peak by laser biospeckle measurements.

    Science.gov (United States)

    Nassif, Rana; Nader, Christelle Abou; Afif, Charbel; Pellen, Fabrice; Le Brun, Guy; Le Jeune, Bernard; Abboud, Marie

    2014-12-10

    In this paper, we report a study in which a laser biospeckle technique is used to detect the climacteric peak indicating the optimal ripeness of fruits. We monitor two batches of harvested Golden apples going through the ripening phase in low- and room-temperature environments, determine speckle parameters, and measure the emitted ethylene concentration using gas chromatography as reference method. Speckle results are then correlated to the emitted ethylene concentration by a principal component analysis. From a practical point of view, this approach allows us to validate biospeckle as a noninvasive and alternative method to respiration rate and ethylene production for climacteric peak detection as a ripening index.

  15. Respiration climacteric in tomato fruits elucidated by constraint-based modelling.

    Science.gov (United States)

    Colombié, Sophie; Beauvoit, Bertrand; Nazaret, Christine; Bénard, Camille; Vercambre, Gilles; Le Gall, Sophie; Biais, Benoit; Cabasson, Cécile; Maucourt, Mickaël; Bernillon, Stéphane; Moing, Annick; Dieuaide-Noubhani, Martine; Mazat, Jean-Pierre; Gibon, Yves

    2017-03-01

    Tomato is a model organism to study the development of fleshy fruit including ripening initiation. Unfortunately, few studies deal with the brief phase of accelerated ripening associated with the respiration climacteric because of practical problems involved in measuring fruit respiration. Because constraint-based modelling allows predicting accurate metabolic fluxes, we investigated the respiration and energy dissipation of fruit pericarp at the breaker stage using a detailed stoichiometric model of the respiratory pathway, including alternative oxidase and uncoupling proteins. Assuming steady-state, a metabolic dataset was transformed into constraints to solve the model on a daily basis throughout tomato fruit development. We detected a peak of CO 2 released and an excess of energy dissipated at 40 d post anthesis (DPA) just before the onset of ripening coinciding with the respiration climacteric. We demonstrated the unbalanced carbon allocation with the sharp slowdown of accumulation (for syntheses and storage) and the beginning of the degradation of starch and cell wall polysaccharides. Experiments with fruits harvested from plants cultivated under stress conditions confirmed the concept. We conclude that modelling with an accurate metabolic dataset is an efficient tool to bypass the difficulty of measuring fruit respiration and to elucidate the underlying mechanisms of ripening. © 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.

  16. Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Tai-Ho Hung

    2015-08-01

    Conclusion: Modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes experienced longer second stage labors than women 25 years ago. The 95th percentile thresholds differed between nulliparous and multiparous women with and without epidural analgesia.

  17. The ultrasound research's results of the peri menopausal women's genitals

    International Nuclear Information System (INIS)

    Dodkhoeva, M.F.; Djonova, B.Yu.; Barieva, L.S.; Djonbekova, P.A.

    2007-01-01

    The results of ultrasound research of the peri menopausal women's genitals revealed that the sizes of the ovaries of women with the climacteric syndrome are smaller that the size of ovaries of the women with the physiologic menopause

  18. A Treatment Stage Specific Approach to Improving Quality of Life for Women with Ovarian Cancer

    National Research Council Canada - National Science Library

    Avis, Nancy E; Miller, Brigitte

    2005-01-01

    This study focuses on quality of life among women with ovarian cancer. The primary objective of the study is to identify the issues that are of greatest concern to women in each of three treatment stages...

  19. The battle for centre stage: Women's football in South Africa

    DEFF Research Database (Denmark)

    Engh, Mari Haugaa

    2010-01-01

    From when the first official South African Women's National Football team was established in 1993, Banyana Banyana have been 'making it happen' for women's football in South Africa. National team players have become inspirational icons and role models for thousands of South African women and girl....... Highlighting examples of battles for power and leadership, homophobic attitudes and attempts to feminise the bodies of women footballers, this Focus illustrates the hard fought victories and disappointing losses in the history of South African women's football....

  20. Fatores Associados à Obesidade e ao Padrão Andróide de Distribuição da Gordura Corporal em Mulheres Climatéricas Factors Related to Obesity and Android Pattern of Body Fat Distribution in Climacteric Women

    Directory of Open Access Journals (Sweden)

    Diana Beatriz Filip Raskin

    2000-08-01

    Full Text Available Objetivos: descrever as características de um grupo de mulheres climatéricas, conhecer a freqüência e os fatores associados à obesidade e ao padrão andróide de distribuição da gordura corporal. Métodos: estudo observacional com 518 pacientes com idade entre 45 e 65 anos em um ambulatório de climatério. Foram considerados a idade, cor, status menopausal, tempo de menopausa, atividade física, tabagismo, dieta, etilismo, antecedentes pessoais e familiares de hipertensão, diabetes, doença cardiovascular, dislipidemia e obesidade. O índice de massa corpórea e a relação das medidas cintura/quadril foram variáveis dependentes. Na análise estatística utilizaram-se os testes de Wilcoxon, c² de Pearson, com nível de significância de 5%, e análise múltipla por regressão logística. Resultados: mais de dois terços das participantes eram não-obesas com perfil andróide e menopausadas. Aproximadamente um quarto tinha atividade física adequada, era tabagista, metade referiu dieta inadequada e um quinto era etilista. Pacientes com perfil andróide apresentaram média etária maior que mulheres com padrão ginecóide. Antecedentes pessoais de obesidade, hipertensão, diabetes e história familiar de diabetes relacionaram-se com obesidade e padrão andróide. O status pós-menopausa associou-se significativamente ao perfil andróide. Conclusões: a maioria das mulheres foram não-obesas com perfil andróide, brancas, pós-menopáusicas, sedentárias, não-tabagistas nem etilistas. Os principais fatores associados à obesidade e padrão andróide foram os antecedentes pessoais de obesidade, hipertensão arterial, diabetes, história familiar de diabetes e, particularmente, o status pós-menopausa com o perfil andróide.Purpose: to describe sociodemographic characteristics of a group of climacteric women in order to discover the frequency and the variables associated with obesity and android profile of body fat distribution. Methods

  1. Stage 1 Breast Cancer and Bone Mass in Older Women

    National Research Council Canada - National Science Library

    Schneider, Diane

    2002-01-01

    The specific aims of the study are 1) to assess the bone mineral density of women 65 years of age and older with breast cancer in comparison with the bone mineral density of same aged women with normal mammograms; 2...

  2. Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes.

    Science.gov (United States)

    Hung, Tai-Ho; Chen, Szu-Fu; Lo, Liang-Ming; Hsieh, T'sang-T'ang

    2015-08-01

    To compare the duration of second stage labor among modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes and women who delivered during the early 1990 s. Data were collected from women who underwent spontaneous labor and vaginally delivered cephalic singleton fetuses with normal neonatal outcomes at the Taipei Chang Gung Memorial Hospital, Taipei, Taiwan from 1991-1995 (Cohort 1, n = 10,721) and 2010-2014 (Cohort 2, n = 3734). We calculated the median duration and 95th percentiles of second stage labor. The women were stratified according to analgesia and parity. Multiple linear regression analysis was used to determine the association between the maternal/pregnancy characteristics and second stage labor duration. The median second stage labor duration was significantly longer for Cohort 2 than for Cohort 1. For nulliparous women, the 95th percentile second stage labor thresholds were 255 minutes and 152 minutes (Cohort 2) and 165 minutes and 107 minutes (Cohort 1) for women with and without epidural analgesia, respectively. For multiparous women, the 95th percentile second stage labor thresholds were 136 minutes and 43 minutes (Cohort 2) and 125 minutes and 39 minutes (Cohort 1) for women with and without epidural analgesia, respectively. Birth weight, maternal age at delivery, and time period (2010-2014 vs. 1991-1995) were significant factors associated with the duration of second stage labor. Modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes experienced longer second stage labors than women 25 years ago. The 95th percentile thresholds differed between nulliparous and multiparous women with and without epidural analgesia. Copyright © 2015. Published by Elsevier B.V.

  3. [Autonomic-vascular and visceral crises in patients with climacteric spondylopathy].

    Science.gov (United States)

    Altukhova, A I

    1977-01-01

    The paper deals with the results of observations over 62 patients (55 females and 7 males) from the age of 42-76 with climacteric spondilopathy. The following syndromes of the nervous system lesions were revealed: neuralgic syndrome, middle and lower thoracal radiculoneuritis, the syndrome of vegetative sympatoganglionitis, myelopathy. Special attetion was given to the specificity of the nervous system lesions in patients with climacteric spondilopathy which was characterized by a tendency to vegetative-visceral crises. The author recommends a scheme of a comprehensive treatment of patients with climacteric spondilopathy with vegetative-vascular and visceral crises. This treatment includes androgen-estrogen preparations, anabolic steroids, thyrocalcitonine and symptomatic treatment.

  4. Adverse obstetric outcomes in women with previous cesarean for dystocia in second stage of labor.

    Science.gov (United States)

    Jastrow, Nicole; Demers, Suzanne; Gauthier, Robert J; Chaillet, Nils; Brassard, Normand; Bujold, Emmanuel

    2013-03-01

    To evaluate obstetric outcomes in women undergoing a trial of labor (TOL) after a previous cesarean for dystocia in second stage of labor. A retrospective cohort study of women with one previous low transverse cesarean undergoing a first TOL was performed. Women with previous cesarean for dystocia in first stage and those with previous dystocia in second stage were compared with those with previous cesarean for nonrecurrent reasons (controls). Multivariable regressions analyses were performed. Of 1655 women, those with previous dystocia in second stage of labor (n = 204) had greater risks than controls (n = 880) to have an operative delivery [odds ratio (OR): 1.5; 95% confidence intervals (CI) 1.1 to 2.2], shoulder dystocia (OR: 2.9; 95% CI 1.1 to 8.0), and uterine rupture in the second stage of labor (OR: 4.9; 95% CI 1.1 to 23), and especially in case of fetal macrosomia (OR: 29.6; 95% CI 4.4 to 202). The median second stage of labor duration before uterine rupture was 2.5 hours (interquartile range: 1.5 to 3.2 hours) in these women. Previous cesarean for dystocia in the second stage of labor is associated with second-stage uterine rupture at next delivery, especially in cases of suspected fetal macrosomia and prolonged second stage of labor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Couple-Focused Group Intervention for Women With Early Stage Breast Cancer

    Science.gov (United States)

    Manne, Sharon L.; Ostroff, Jamie S.; Winkel, Gary; Fox, Kevin; Grana, Generosa; Miller, Eric; Ross, Stephanie; Frazier, Thomas

    2005-01-01

    This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions…

  6. [Increased oxidized LDL cholesterol levels in peritoneal fluid of women with advanced-stage endometriosis].

    Science.gov (United States)

    Polak, Grzegorz; Mazurek, Diana; Rogala, Ewelina; Nowicka, Aldona; Derewianka-Polak, Magdalena; Kotarski, Jan

    2011-03-01

    Proinflammatory and prooxidative environment in the peritoneal cavity may be involved in the pathogenesis of endometriosis. Imbalance between reactive oxygen species levels and the antioxidant capacity leads to oxidation of low-density lipoproteins (LDL). The importance of oxidized LDL (Ox-LDL) in the development of atherosclerosis is well recognized. The aim of our study was to evaluate for the presence of ox-LDL in the peritoneal fluid (PF) of women with and without endometriosis. A total of 60 women who underwent laparoscopy were divided into groups: endometriosis sufferers with minimal to mild (n 20) and moderate to severe (n 20) stages, and the reference group (n 20) with functional follicle ovarian cysts. Oxidized LDL levels were determined in the PF using enzyme immunoassay Oxidized LDL levels were detectable in all peritoneal fluid samples. Significantly increased levels of ox-LDL were observed in PF of women with stage III/IV endometriosis compared to the reference group (p = 0.03). However peritoneal fluid ox-LDL concentrations did not differ significantly between patients with minimal/mild and women with moderate/severe stage of the disease (p = 0.2). No significant difference in the PF ox-LDL concentrations was also found between women with stage I/II endometriosis and patients with follicle cysts (p = 0.3). Increased peritoneal fluid ox-LDL levels observed in women with advanced-stage endometriosis suggest the important role of oxidative stress in the pathogenesis of the disease.

  7. Counseling middle-aged women about physical activity using the stages of change.

    Science.gov (United States)

    Dearden, Jennifer S; Sheahan, Sharon L

    2002-11-01

    To discuss application of the Stages of Change theoretical framework and provide clinical tips on exercise adherence among midlife women. Included is a checklist to assist the nurse practitioner (NP) in effectively delivering the message. Review of the current scientific literature on exercise adherence and the Stages of Change model. Middle-aged women comprise a unique population. Determining the woman's readiness for change using the Stages of Change model, NPs can routinely include appropriate exercise recommendations in their practices. Nurse practitioners are in a unique position to promote healthy behaviors by counseling women in midlife about adopting an active lifestyle. Exercise counseling is an essential component of healthcare, especially among middle-aged women who are experiencing physical, emotional, and social changes.

  8. Validación de un cuestionario para la medición de las creencias sobre el climaterio Validity test of a questionnaire used to measure climacteric beliefs

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    Rubén Chávez-Ayala

    2002-09-01

    Full Text Available Objetivo. Diseñar un instrumento para medir las creencias sobre las consecuencias sociales, psicológicas y fisiológicas de la etapa del climaterio. Material y métodos. El estudio se realizó de junio a octubre de 2000 en 340 mujeres derechohabientes de la unidad de medicina familiar del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (media de edad=49.46, (DE 7.92. Se seleccionó un total de mujeres entre los 40 y 60 años de edad, en virtud del criterio de la Organización Mundial de la Salud: el promedio de edad de la menopausia es de 50 años. El promedio de embarazos en la muestra fue de 3.75 (DE 2.57, y el de hijos nacidos de 3.21 (DE 2.19. El 48.3% de las mujeres eran premenopáusicas, 10.9% perimenopáusicas y 40.6% posmenopáusicas. El instrumento contó con 25 reactivos, y la escala utilizada para evaluar las respuestas fue de tipo Likert con cinco opciones. El tipo de diseño fue observacional exploratorio, de corte transversal multivariado. Se hicieron comparaciones de medias por factor entre los grupos de mujeres premenopáusicas, perimenopáusicas y posmenopáusicas. Resultados. Se realizó un análisis factorial con rotación Varimax, confirmándose cuatro factores: desventajas, (alfa=0.769; ventajas, (alfa=0.839; fisiológico, (alfa=0.659, y psicológico, (alfa=0.711. Conclusiones. El presente instrumento tiene una buena consistencia interna, y mide cuatro grupos de creencias sobre el climaterio: a creencias de desventajas, b creencias de ventajas, c creencias sobre padecimientos fisiológicos, y d creencias de síntomas psicológicos. Las tres dimensiones confirmadas del climaterio han sido propuestas en otros estudios.Objective. To design an instrument for measuring beliefs about the social, psychological, and physiological consequences of women's climacteric stage. Material and Methods. The study included 340 women affiliated to Instituto de Seguridad y Servicios Sociales para los Trabajadores del

  9. Changes in smoking behaviour among young women over life stage transitions.

    Science.gov (United States)

    McDermott, Liane; Dobson, Annette; Russell, Anne

    2004-08-01

    To examine changes in smoking behaviour among young women over four life stages: leaving home; employment or attending college or university; marriage; and parenthood. Young women participating in the Australian Longitudinal Study on Women's Health completed postal questionnaires in 1996 and 2000. Unmarried women who moved out of their parents' home between 1996 and 2000 had higher odds of adopting smoking than those who had not lived with their parents at either time (OR 1.8, 95% CI 1.2-2.6). Married women had lower odds of resuming smoking after quitting (OR 0.4, 95% CI 0.2-0.7) than unmarried women. Women who were pregnant in 2000 had higher odds of quitting smoking (OR 3.8, 95% CI 2.5-5.6) and women who were pregnant in 1996 and not in 2000 had higher odds of starting to smoke again (OR 3.2, 95% CI 1.6-6.2) than women who were not pregnant. The odds of being a current smoker or adopting smoking were significantly greater for women who binge drank alcohol or used cannabis and other illicit drugs. Adoption, maintenance and cessation of smoking among young women is strongly related to major life stage transitions, illicit drug use and alcohol consumption. Life changes such as marriage and actual or contemplated pregnancy provide opportunities for targeted interventions to help women quit smoking and not relapse after having a baby. Legislation to control smoking on licensed premises would reduce the social pressure on women to smoke.

  10. Efeito de um programa misto de intervenção nutricional e exercício físico sobre a composição corporal e os hábitos alimentares de mulheres obesas em climatério The effects of a mixed program of nutritional intervention and physical exercise on body composition and feeding habits of obese climacteric women

    Directory of Open Access Journals (Sweden)

    Rita de Cássia de Assunção Monteiro

    2004-12-01

    Full Text Available OBJETIVO: Foi avaliar o efeito de programa misto de intervenção nutricional e exercício físico sobre a composição corporal e hábitos alimentares de mulheres obesas em climatério. MÉTODOS: Trabalhou-se com 2 grupos de 15 pessoas por 40 semanas: Grupo Dieta (intervenção nutricional e Grupo Exercício (intervenção nutricional e exercício. RESULTADO: As reduções do peso (-2,3kg para Grupo Dieta e -5,3kg para o Grupo Exercício e da circunferência da cintura (-4,8cm para Grupo Dieta e -7,6cm para Grupo Exercício, foram maiores para o Grupo Exercício. Foi verificada evolução positiva na classificação do Índice de Massa Corporal para ambos os grupos, sendo que o Grupo Exercício respondeu melhor ao tratamento. O padrão alimentar foi considerado monótono e com baixo consumo de alimentos regionais. CONCLUSÃO: O programa foi efetivo para perda de peso, em maior intensidade na presença de exercício. A educação alimentar proposta foi capaz de acarretar mudanças nos hábitos alimentares.OBJECTIVE: The effects of a mixed program of nutrition intervention and physical exercise on body composition and feeding habits were evaluated in obese climacteric women. METHODS: Thirty participants were randomly assigned in 2 groups during 40 weeks: Diet Group (nutritional intervention and Exercise Group (nutritional intervention and exercise. RESULTS: Weight reductions (Diet Group 2,3kg/Exercise Group -5,3kg and waist circunference (Diet Group -4,8cm/Exercise Group 7,6cm were greater in Exercise Group. A positive evolution was noticed in the Body Mass Index in both groups, with Exercise Group having better answer to treatment. It was observed a monotonous feeding pattern and low compliance to the consumption of regional typical foods. CONCLUSION: We concluded that the program was effective for weight loss at a higher intensity in the presence of exercise and the feeding education was able to modify the feeding habits.

  11. Features of psychoemotional state of pregnant women with missed abortion in the early stages of pregnancy

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    O.O. Bala

    2016-06-01

    Full Text Available Purpose. To determine peculiarities of psychoemotional state of pregnant women with missed abortion in the early stages of pregnancy. Patients and methods. The study included 60 women with missed abortion in the early stages of pregnancy (I group and 30 women with an advanced pregnancy to 8 weeks of gestation (II control group. To determine peculiarities of psychoemotional status of women conducted a survey according to standard methods: determination of the level of neuropsychic tension on questionnaire Nemchina, the level of anxiety according to the scale Spielberg—Hanin, the level of anxiety on a scale of Taylor—Norakidze. Results. Analysis of psychoemotional state groups have demonstrated that pregnant women with physiological course of pregnancy at an early stage (group II is characterized by a moderate level of mental stress (40.8±1.3 on a scale of Nemchina, the average level of personal and reactive anxiety (38.6±1.1 and 37.2±1.2, respectively according to the scale Spielberg—Hanin, the average anxiety level on a scale of Taylor— Norakidze. In women with the missed abortion at the early stages of pregnancy there is a high level of psychoemotional load, reactive anxiety (57.3±1.6, mental stress (of 62.6±1.4 and anxiety (31.8±2.3 years. Conclusions. The obtained results indicate the need for strong psychological support and if necessary medical assistance to women with missed abortion in the early stages of pregnancy, since the accession of psychopathological symptoms does not contribute to the psycho-emotional adaptation and can provoke the development of psychosomatic pathological syndromes in postabortion period and on the phase of rehabilitation and subsequent pregravid preparation.

  12. Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women

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    Rana F Obeidat

    2015-01-01

    Full Text Available To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council, the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers′ support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system.

  13. Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women

    Science.gov (United States)

    Obeidat, Rana F.

    2015-01-01

    To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers’ support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system. PMID:27981122

  14. Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India.

    Science.gov (United States)

    Hulland, Kristyna R S; Chase, Rachel P; Caruso, Bethany A; Swain, Rojalin; Biswal, Bismita; Sahoo, Krushna Chandra; Panigrahi, Pinaki; Dreibelbis, Robert

    2015-01-01

    Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS) across women's reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages) in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60) and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes) based on stress (high to low) and level of freedom (associated with greatest freedom to having the most restrictions). Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation) were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.

  15. Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India.

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    Kristyna R S Hulland

    Full Text Available Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS across women's reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60 and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes based on stress (high to low and level of freedom (associated with greatest freedom to having the most restrictions. Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.

  16. Changes in serum tumor necrosis factor (TNF-alpha) with kami-shoyo-san administration in depressed climacteric patients.

    Science.gov (United States)

    Ushiroyama, Takahisa; Ikeda, Atsushi; Sakuma, Kou; Ueki, Minoru

    2004-01-01

    An herbal medicine (kampo) is widely used to prevent or treat climacteric symptoms. In order to investigate the potential involvement of tumor necrosis factor (TNF)-alpha in susceptibility to mood disorder in climacteric women and to clarify the relationship between immune function and the efficacy of herbal medicine, we compared serum TNF-alpha levels in two treated groups, with and without concurrent use of herbal medicine. This study included 113 consecutive depressed menopausal patients who visited the gynecological and psychosomatic medicine outpatient clinic of the Osaka Medical College Hospital in Japan. Fifty-eight patients were administered kami-shoyo-san according to the definition of above sho. In contrast, 55 patients who were different in sho of kami-shoyo-san were administered antidepressants. Hamilton Rating Scale for depression (HAM-D) scores were determined at baseline and 12 weeks after starting treatment (endpoint). TNF-alpha concentrations were analyzed before and after 12 weeks of treatment. Kami-shoyo-san significantly increased plasma concentrations of TNF-alpha after 12 weeks of treatment, to 17.22 +/- 6.13 pg/ml from a baseline level of 14.16 +/- 6.27 pg/ml (p = 0.048). The percent change in plasma concentration of TNF-alpha differed significantly between the kami-shoyo-san therapy group and the antidepressant therapy group at 4 weeks (12.0 +/- 7.8% and -1.22 +/- 0.25%, respectively, p emotional status via the central nervous system and may be regulated by herbal medicines, although the interactions are very complex.

  17. A qualitative study exploring midlife women's stages of change from domestic violence towards freedom.

    Science.gov (United States)

    Keeling, June; Smith, Debbie; Fisher, Colleen

    2016-03-08

    Domestic Violence (DV) remains a significant global health problem for women in contemporary society. Existing literature on midlife women's experiences of domestic violence is limited and focuses on health implications. Leaving a violent relationship is a dynamic process that often requires multiple attempts and separations prior to final termination. The aim of this study was to explore the process of leaving a violent relationship for midlife women. This qualitative study involved fifteen women aged between 40-55 who had accessed residential and non-residential community support services for domestic violence within the UK. Community-based support agencies provided these women with access to letters of invitation and participant information sheet explaining the study. The women notified agency staff who contacted the research team to arrange a mutually convenient time to meet within a safe place for both the women and researchers. It was stressed to all potential participants that no identifiable information would be shared with the agency staff. Women were considered survivors of DV if they defined themselves as such. Data were gathered through semi structured interviews, transcribed verbatim and thematically analysed. Midlife women appear to differ from younger women by transitioning quickly though the stages of change, moving rapidly through the breaking free onto the maintenance stage. This rapid transition is the resultant effect of living with long-term violence causing a shift in the women's perception towards the violent partner, with an associated reclamation of power from within the violent relationship. A realisation that rapid departure from the violence may be critical in terms of personal safety, and the realisation that there was something 'wrong' within the relationship, a 'day of dawning' that had not been apparent previously appears to positively affect the trajectory of leaving. Midlife women appeared to navigate through the stages of change

  18. Arab American women's lived experience with early-stage breast cancer diagnosis and surgical treatment.

    Science.gov (United States)

    Obeidat, Rana Fakhri; Lally, Robin M; Dickerson, Suzanne S

    2012-01-01

    Currently, limited literature addresses Arab American women's responses to the impact of breast cancer and its treatments. The objective of the study was to understand the experience of being diagnosed with and undergoing surgical treatment for early-stage breast cancer among Arab American women. A qualitative interpretive phenomenological research design was used for this study. A purposive sample of 10 Arab American women who were surgically treated for early-stage breast cancer in the United States was recruited. Data were collected using individual interviews and analyzed using the Heideggerian hermeneutical methodology. Arab American women accepted breast cancer diagnosis as something in God's hands that they had no control over. Although they were content with God's will, the women believed that the diagnosis was a challenge that they should confront. The women confronted this challenge by accessing the healthcare system for treatment, putting trust in their physicians, participating when able in treatment decisions, using religious practices for coping, maintaining a positive attitude toward the diagnosis and the treatment, and seeking information. Arab American women's fatalistic beliefs did not prevent them from seeking care and desiring treatment information and options when diagnosed with breast cancer. It is important that healthcare providers encourage patients to express meanings they attribute to their illness to provide them with appropriate supportive interventions. They should also individually assess patients' decision-making preferences, invite them to participate in decision making, and provide them with tailored means necessary for such participation without making any assumptions based on patients' ethnic/cultural background.

  19. Modeling condom-use stage of change in low-income, single, urban women.

    Science.gov (United States)

    Morrison-Beedy, Dianne; Carey, Michael P; Lewis, Brian P

    2002-04-01

    This study was undertaken to identify and test a model of the cognitive antecedents to condom use stage of change in low-income, single, urban women. A convenience sample of 537 women (M=30 years old) attending two urban primary health care settings in western New York State anonymously completed questionnaires based primarily on two leading social-cognitive models, the transtheoretical model and the information-motivation-behavioral skills model. We used structural equation modeling to examine the direct and indirect effects of HIV-related knowledge, social norms of discussing HIV risk and prevention, familiarity with HIV-infected persons, general readiness to change sexual behaviors, perceived vulnerability to HIV, and pros and cons of condom use on condom-use stage of change. The results indicated two models that differ by partner type. Condom-use stage of change in women with steady main partners was influenced most by social norms and the pros of condom use. Condom-use stage of change in women with "other" types (multiple, casual, or new) of sexual partners was influenced by HIV-related knowledge, general readiness to change sexual behaviors, and the pros of condom use. These findings suggest implications for developing gender-relevant HIV-prevention interventions. Copyright 2002 Wiley Periodicals, Inc.

  20. Asian Women's Action for Resilience and Empowerment Intervention: Stage I Pilot Study.

    Science.gov (United States)

    Hahm, Hyeouk Chris; Chang, Stephanie Tzu-Han; Lee, Gloria Yoonseung; Tagerman, Michelle D; Lee, Christina S; Trentadue, Mia Pamela; Hien, Denise A

    2017-01-01

    This study describes the development and pilot test of Asian Women's Action for Resilience and Empowerment (AWARE), a culturally informed group psychotherapy intervention designed to reduce depressive symptoms, suicidality, substance use, and HIV and sexual risk behaviors among 1.5 and second generation Asian American (AA) women. To participate, AA women had to meet the criteria for posttraumatic stress disorder (PTSD) or have a history of exposure to interpersonal violence (IPV) as determined using the Clinician-Administered PTSD Scale (CAPS) and Traumatic Life Events Questionnaire (TLEQ). This article also presents the preliminary feasibility and acceptability of AWARE from its Stage I pilot study of nine Chinese, Korean, and Vietnamese American women. To foster holistic treatment, AWARE was developed based on original research findings from Stage 0 and integrated theoretical models including fractured identity theory, empowerment theory, cognitive behavioral therapy (CBT), mindfulness-based techniques, and the AIDS Risk Reduction Model (ARRM). The development of AWARE was an iterative process informed by participant feedback, which led to frequent intervention modifications for a future randomized controlled trial (RCT) in Stage II. A qualitative analysis of participant feedback informed the following modifications: further exploration of feelings, improvements in technology delivery, learning and practicing coping skills, more specific cultural tailoring related to sexual health, decreased number of sessions and increased time per session. Findings provide support for the acceptability and feasibility of AWARE as "culturally informed" for AA young women with IPV histories, high-risk behaviors, and mental health issues.

  1. An early-stage epidemic: a systematic review of correlates of smoking among Chinese women.

    Science.gov (United States)

    Ding, Ding; Gebel, Klaus; Oldenburg, Brian F; Wan, Xia; Zhong, Xuefeng; Novotny, Thomas E

    2014-08-01

    Despite the historically low smoking prevalence among Chinese women, there is a trend of future increase. We systematically reviewed the correlates of smoking among Chinese girls and women. We conducted a systematic review of literature on correlates of smoking among Chinese women using Medline and China Academic Journals databases. Following the PRISMA statement, two investigators independently searched for literature, identified and reviewed papers, assessed the quality of the papers, and extracted information. The characteristics of studies and correlates of smoking were synthesized separately for youth and adults. A total of 15 articles (11 on adults, 4 on youth) met the inclusion criteria. Based on these studies, peer smoking was the most consistent correlate of smoking among Chinese girls. Among Chinese women, partner smoking, job-related stress, and exposure to cigarettes made for women were consistent correlates of smoking. Knowledge of harms and negative attitudes towards smoking were found to be negatively associated with smoking. Overall, the evidence base for smoking among Chinese women is limited. Although smoking among Chinese women is still at an early stage, it is becoming more prevalent among specific population subgroups, such as rural-to-urban migrant workers. Although further research is needed, findings from the current study provide a roadmap for research and policy on prevention of smoking among Chinese girls and women.

  2. Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba.

    Science.gov (United States)

    Elsabagh, Sarah; Hartley, David E; File, Sandra E

    2005-03-01

    Gingko biloba has cognitive benefits both in populations suffering from dementia and after acute treatment in healthy volunteers, with some evidence indicating that those with poorer cognitive performance show greater benefit. We have previously found that 1 week of treatment with ginkgo improved attention, memory and mental flexibility in post-menopausal women, but the evidence for any beneficial effects of longer treatment is less well-established. The present study aimed to determine whether cognitive benefits, similar to those previously found after 1 week of treatment, would persist after 6 weeks of treatment, and whether those with poorer cognitive performance would benefit more. In a placebo-controlled, double-blind study, postmenopausal women (aged 51-67 years) were randomly allocated to receive a standardized extract of ginkgo (LI 1370, Lichtwer Pharma, Marlow, UK) (one capsule/day of 120 mg, n = 45) or matching placebo (n = 42) for 6 weeks. According to an established reproductive staging system, subjects were divided into those in the early (Stage +1; mean age 55 years) and late (Stage +2: mean age 61 years) stages of menopause. At baseline and after 6 weeks of treatment, subjects completed tests of mental flexibility, planning, memory and sustained attention, and ratings of mood, sleepiness, bodily and menopausal symptoms. The only significant effects of ginkgo were in the test of mental flexibility, in which there were significant menopausal stage-ginkgo interactions. This was because subjects in Stage +2 required fewer trials to complete the task and made fewer errors after ginkgo treatment, whereas those in Stage +1 showed no benefits. Subjects in Stage +2 had poorer performance at baseline compared to those in Stage +1 both in this task and the test of planning ability. The beneficial effects of ginkgo were limited to the test of mental flexibility and to those with poorer performance.

  3. Survival after early-stage breast cancer of women previously treated for depression

    DEFF Research Database (Denmark)

    Suppli, Nis Frederik Palm; Johansen, Christoffer; Kessing, Lars Vedel

    2017-01-01

    treatment of depression and risk of receiving nonguideline treatment of breast cancer were assessed in multivariable logistic regression analyses. We compared the overall survival, breast cancer-specific survival, and risk of death by suicide of women who were and were not treated for depression before......Purpose The aim of this nationwide, register-based cohort study was to determine whether women treated for depression before primary early-stage breast cancer are at increased risk for receiving treatment that is not in accordance with national guidelines and for poorer survival. Material...... and Methods We identified 45,325 women with early breast cancer diagnosed in Denmark from 1998 to 2011. Of these, 744 women (2%) had had a previous hospital contact (as an inpatient or outpatient) for depression and another 6,068 (13%) had been treated with antidepressants. Associations between previous...

  4. Influence of cigarette smoking on hormone and lipid metabolism in women in late reproductive stage

    Directory of Open Access Journals (Sweden)

    Szkup M

    2018-01-01

    Full Text Available Małgorzata Szkup,1 Anna Jurczak,2 Beata Karakiewicz,3 Artur Kotwas,3 Jacek Kopeć,4 Elżbieta Grochans1 1Department of Nursing, 2Department of Clinical Nursing, 3Department of Public Health, Pomeranian Medical University in Szczecin, Szczecin, Poland; 4School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada Background: The aim of the study was to analyze lipid and hormone metabolism, body mass index (BMI, and age parameters in late reproductive stage women in relation to cigarette smoking.Methods: The study enrolled 345 healthy late reproductive stage women living in Poland; 13.33% were smokers. The first part of the study assessed lipid metabolism (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and triglycerides and hormone metabolism (estradiol [E2], follicle-stimulating hormone [FSH], and anti-Müllerian hormone [AMH] levels in women in the early phase of the follicular menstrual cycle. The second part of study was carried out using the diagnostic survey method, with a standardized questionnaire (Primary Care Evaluation of Mental Disorders [PRIME-MD] and the authors’ own research tools.Results: The women were aged 42.3±4.5 years (mean ± SD. The BMI (24.8±4.04 kg/m2 did not differ significantly between the groups. The women who smoked cigarettes had a statistically significantly (p<0.05 lower level of HDL as well as higher LDL and triglyceride levels (p<0.05. Differences were also shown in hormone levels: non-smoking participants had statistically significantly higher levels of E2 and FSH (p<0.05. In the group of non-smoking women, age was a predictor exerting a significant positive impact on the levels of total cholesterol, LDL, triglycerides, and AMH (p<0.05. BMI contributed to a decline in HDL and triglyceride levels. In the group of smoking women, age significantly positively influenced the level of E2, and negatively influenced AMH

  5. Outcomes of physiological and active third stage labour care amongst women in New Zealand.

    Science.gov (United States)

    Dixon, Lesley; Tracy, Sally K; Guilliland, Karen; Fletcher, Lynn; Hendry, Chris; Pairman, Sally

    2013-01-01

    during the third stage of labour there are two approaches for care provision - active management or physiological (expectant) care. The aim of this research was to describe, analyse and compare the midwifery care pathway and outcomes provided to a selected cohort of New Zealand women during the third stage of labour between the years 2004 and 2008. These women received continuity of care from a midwife Lead Maternity Carer and gave birth in a variety of birth settings (home, primary, secondary and tertiary maternity units). retrospective aggregated clinical information was extracted from the New Zealand College of Midwives research database. Factors such as type of third stage labour care provided; estimated blood loss; rate of treatment (separate to prophylaxis) with a uterotonic; and placental condition were compared amongst women who had a spontaneous onset of labour and no further assistance during the labour and birth. The results were adjusted for age, ethnicity, parity, place of birth, length of labour and weight of the baby. the rates of physiological third stage care (expectant) and active management within the cohort were similar (48.1% vs. 51.9%). Women who had active management had a higher risk of a blood loss of more than 500mL, the risk was 2.761 when a woman was actively managed (95% CI: 2.441-3.122) when compared to physiological management. Women giving birth at home and in a primary unit were more likely to have physiological management. A longer labour and higher parity increased the odds of having active management. Manual removal of the placenta was more likely with active management (0.7% active management - 0.2% physiological pwomen who were given a uterotonic drug as a treatment rather than prophylaxis a postpartum haemorrhage of more than 500mL was twice as likely in the actively managed group compared to the physiological managed group (6.9% vs. 3.7%, RR 0.54, CI: 0.5, 0.6). the use of physiological care during the third stage of labour

  6. Women's job quality across family life stages: An analysis of female employees across 27 European countries

    OpenAIRE

    Piasna, A.; Plagnol, A.

    2017-01-01

    There is little empirical evidence on how working conditions affect women’s employment and fertility choices, despite a number of studies on the impact of individual-level and institutional factors. The article addresses this gap by examining how family life stages are related to particular aspects of job quality among employed women in 27 European countries. The central argument of the analysis is that high-quality jobs are conducive to both transitions to motherhood and employment after chi...

  7. Stage at diagnosis and delay in seeking medical care among women with breast cancer, delhi, India.

    Science.gov (United States)

    Pakseresht, Sedigheh; Ingle, Gopal Krishna; Garg, Suneela; Sarafraz, Nahid

    2014-12-01

    Patients with cancer often delay seeking medical advice in developing countries. It can adversely influence the outcome of disease. The present study was performed to determine the stage at diagnosis and delay in seeking medical care among women with breast cancer in Delhi, India. This was a cross-sectional study based on a census (case series) approach to reach all women (172) diagnosed with primary breast cancer "detected in surgery Out Patient Department (OPD) from January 2007 to December 2009" at Lok Nayak Hospital, Delhi, India. Patients were interviewed using a self-structure questionnaire. Seeking behavior variables were awareness of problem, first consultation, followed physician's advice, detection of problem, system of medicine and gap between knowing the problem and consultation (patient delay). Statistical Analysis was performed using the Microsoft SPSS-pc version 14.0 statistical program. The analytic methods were used (mean, standard deviation, X(2), Fisher's Exact Test, K-S, Kruskal-Wallis) for variables. All statistical tests were performed at a significance level of 5% (P cancer at the time of diagnosis. The mean duration of gap between knowing the problem and consulting a physician (patients delay) was 10.90 months. There was no significant association between stage of cancer and consultation gap. A significant association was found between the stage of breast cancer and income; women with lower income had a higher stage of breast cancer (P breast cancer. It seems necessary to design educating programs for women in both clinical and community settings, about breast cancer and early detection practices.

  8. Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery.

    Science.gov (United States)

    Matsuo, Koji; Johnson, Marian S; Im, Dwight D; Ross, Malcolm S; Bush, Stephen H; Yunokawa, Mayu; Blake, Erin A; Takano, Tadao; Klobocista, Merieme M; Hasegawa, Kosei; Ueda, Yutaka; Shida, Masako; Baba, Tsukasa; Satoh, Shinya; Yokoyama, Takuhei; Machida, Hiroko; Ikeda, Yuji; Adachi, Sosuke; Miyake, Takahito M; Iwasaki, Keita; Yanai, Shiori; Takeuchi, Satoshi; Nishimura, Masato; Nagano, Tadayoshi; Takekuma, Munetaka; Shahzad, Mian M K; Pejovic, Tanja; Omatsu, Kohei; Kelley, Joseph L; Ueland, Frederick R; Roman, Lynda D

    2018-03-01

    To examine survival of women with stage IV uterine carcinosarcoma (UCS) who received neoadjuvant chemotherapy followed by hysterectomy. This is a nested case-control study within a retrospective cohort of 1192 UCS cases. Women who received neoadjuvant chemotherapy followed by hysterectomy based-surgery for stage IV UCS (n = 26) were compared to those who had primary hysterectomy-based surgery without neoadjuvant chemotherapy for stage IV UCS (n = 120). Progression-free survival (PFS) and cause-specific survival (CSS) were examined. The most common regimen for neoadjuvant chemotherapy was carboplatin/paclitaxel (53.8%). Median number of neoadjuvant chemotherapy cycles was 4. PFS was similar between the neoadjuvant chemotherapy group and the primary surgery group (unadjusted-hazard ratio [HR] 1.19, 95% confidence interval [CI] 0.75-1.89, P = 0.45). Similarly, CSS was comparable between the two groups (unadjusted-HR 1.13, 95%CI 0.68-1.90, P = 0.64). When the types of neoadjuvant chemotherapy regimens were compared, women who received a carboplatin/paclitaxel regimen had better survival outcomes compared to those who received other regimens: PFS, unadjusted-HR 0.38, 95%CI 0.15-0.93, P = 0.027; and CSS, unadjusted-HR 0.21, 95%CI 0.07-0.61, P = 0.002. Our study found that there is no statistically significant difference in survival between women with stage IV UCS who are tolerated neoadjuvant chemotherapy and those who undergo primary surgery. © 2017 Wiley Periodicals, Inc.

  9. Breast feeding mediators among iranian women at premarital stage a population based study

    International Nuclear Information System (INIS)

    Hosseinzadeh, K.

    2017-01-01

    Objectives: To describe breastfeeding mediators among women at pre-marital stage in Iran. Methods: Using the simple randomized sampling method, 450 participants were enrolled in this population-based cross-sectional study. A structured questionnaire was used in order to collect data. Results: Eighty eight percent of the participants reported that had not met breastfeeding education previously. The available sources of information for 65% of respondents were radio and television. Seventy nine percent did not know any breastfeeding consultant. Mean score of participants' knowledge was lower than 50 score. Nearly 50% participants claimed the breastfeeding to be as a common barrier for their job and learning. Only 14% had intended to initiate breastfeeding immediately after childbearing. Mean score of perceived self efficacy about breastfeeding was less than 50 percent. Conclusion: Breastfeeding mediators among Iranian women at premarital stage are not in favorable situation. Findings of this study suggest a need for more breastfeeding education programs for Iranian women at premarital stage. (author)

  10. Association of oxidative stress biomarkers with adiposity and clinical staging in women with breast cancer.

    Science.gov (United States)

    Carioca, A A F; Verde, S M M L; Luzia, L A; Rondó, P H C; Latorre, M R D O; Ellery, T H P; Damasceno, N R T

    2015-11-01

    Breast cancer is a disease characterised by both oxidative reactions and inflammation. However, few studies have focused on the oxidative and inflammatory biomarkers. The aim of the present study was to evaluate the association between oxidative stress markers and adiposity and clinical staging, as well as the association between the oxidative and the antioxidant biomarkers of women with breast cancer. A total of 135 cases of breast cancer occurring in 2011 and 2012 were assessed. After exclusions, 101 pre- and post-menopausal women with clinical staging I to IV were eligible to participate in the study. The anthropometric evaluation was performed by collecting data on waist circumference, body mass index and body composition. The socioeconomic and clinical profiles were determined using a standard questionnaire. For the oxidative biomarkers, thiobarbituric acid reactive substances (TBARS), oxidative DNA damage (8-hydroxy-2-deoxyguanosine (8-OHdG)), low-density lipoprotein(-) (LDL(-)), autoantibody anti-LDL(-) and liposoluble antioxidants (α-tocopherol, retinol and β-carotene) were analysed. The data were analysed using differences in the mean values, correlation tests and multiple linear regression. The antioxidant levels were higher in postmenopausal women with clinical staging I and II and negative lymph nodes. The TBARS level was associated with clinical staging. Adiposity was associated with levels of retinol and 8-OHdG, whereas LDL(-), 8-OHdG and TBARS were correlated with liposoluble antioxidants after adjusting for the confounders. The adiposity and clinical staging of patients were associated with oxidative stress. The oxidative and antioxidant biomarkers showed a negative correlation in patients with breast cancer.

  11. Morbidades e fatores associados em mulheres climatéricas: estudo de base populacional em mulheres com 11 anos ou mais de escolaridade Morbidity and associated factors in climacteric women: a population based study in women with 11 or more years of formal education

    Directory of Open Access Journals (Sweden)

    Vanessa de Souza Santos Machado

    2012-05-01

    Full Text Available OBJETIVO: Avaliar os fatores associados a algumas morbidades em mulheres brasileiras de 40 a 65 anos e com 11 anos ou mais de escolaridade. MÉTODOS: Análise secundária de estudo transversal de base populacional, empregando-se um questionário anônimo e autorrespondido por 377 mulheres. Foram avaliadas, com o uso deste instrumento, algumas morbidades (hipertensão, diabetes, insônia e depressão e fatores sociodemográficos, comportamentais, clínicos e reprodutivos. A associação entre as morbidades e as variáveis independentes foi avaliada por meio do teste do Χ2. Realizou-se a regressão logística múltipla com critério de seleção stepwise para selecionar os principais fatores associados a cada uma das morbidades. RESULTADOS: Na análise múltipla, a insônia esteve associada à autopercepção da saúde péssima/ruim (OR=2,3 e ao nervosismo (OR=5,1. O relato de depressão esteve associado à autopercepção da saúde péssima/ruim (OR=3,7 e ter lazer péssimo/ruim (OR=2,8. A hipertensão apresentou-se relacionada à obesidade (OR=3,1 e a estar na pós-menopausa (OR=2,6. Já diabetes, à idade acima de 50 anos (OR=3,9 e obesidade à (OR=12,5. CONCLUSÕES: A prevalência de morbidades foi alta e pior autopercepção da saúde e obesidade foram os principais fatores associados à presença de morbidades.PURPOSE: To evaluate factors associated with morbidities among Brazilian women aged 40-65 years and with 11 or more years of schooling. METHODS: A secondary analysis of a cross-sectional population-based study was conducted, using an anonymous self-report questionnaire completed by 377 women. Were evaluated, with this instrument, some morbidities (hypertension, diabetes, insomnia and depression and sociodemographic, behavioral, clinical and reproductive factors. The association between morbidities and independent variables was evaluated by the Χ2 test. Multiple logistic regression analysis with stepwise selection criteria was used to

  12. [Calcium and bone metabolism across women's life stages. Bone metabolism of women in primary amenorrhea.

    Science.gov (United States)

    Higuchi, Tsuyoshi

    For development of the bone during adolescence, the increased estrogen plays an important role especially in young women as well as GH/IGF-Ⅰ system. Although primary amenorrhea can be caused by various pathological factors, almost of cases have a dysfunction of estrogen secretory systems. For Turner syndrome, which is well-known disease with primary amenorrhea,it is generally recommended that the estrogen therapy is started at adolescence and gradually increased up to adult dose level. Recently studies about the adequate dose of estrogen and the adequate age of adult dose in Turner syndrome revealed that intervention with adult dose of estrogen is required as soon as possible for gaining better bone mineral. In the point of view for bone fragility at the future, early diagnosis and adequate intervention for primary amenorrhea is important.

  13. Assessment of renal function during various stages of pregnancy in women

    International Nuclear Information System (INIS)

    Iqbal, S.A.; Ansari, A.K.; Akhtar, M.S.

    2003-01-01

    A study was conducted to investigate changes in renal functions during different trimesters of pregnancy in Pakistani women. For this purpose, 26 non-pregnant women (Group 1) and 63 women in different stages of pregnancy (18 in first trimester, Group II; 22 in the second trimester, Group III and 23 in the third trimester, Group IV), were selected. Blood samples were taken from all subjects for determination of serum glucose, albumin, creatinine, urea and uric acid. Similarly, urine samples were analysed for creatinine and other urinary parameters including GFR (glomerular filtration rate). Significant increase (P<0.05) was observed in urinary level of creatinine in Group 1only, while differences among women of other groups were non-significant. There was a significant rise in the rate of GFR in pregnant as compared to non-pregnant women as determined on the basis of endogenous creatinine clearance. Urine volume also increased significantly as pregnancy progressed. Serum urea decreased significantly in Groups II and IV, while creatinine remained unchanged. Serum uric acid also showed significant decrease in the first trimester but returned to control level in the 3rd trimester. Serum glucose level increased, while serum albumin decreased during pregnancy. (author)

  14. Síndrome climatérico: caracterización clínica y socio-epidemiológica Climacteric syndrome: clinical and socioepidemiological characterization

    Directory of Open Access Journals (Sweden)

    Margeris Yanes Calderón

    2004-08-01

    Full Text Available Se realizó un estudio descriptivo y transversal a 80 mujeres climatéricas, en el período comprendido entre septiembre del año 2003 y junio de 2004, con el objetivo de conocer las características clínicas y socio-epidemiológicas que tienen mayor incidencia, así como analizar la repercusión biopsicosocial del climaterio en las mujeres del consultorio 1.1 de La Puntilla, en el Policlínico Docente "Ana Betancourt", del municipio Playa, en la Ciudad de La Habana. En las pacientes estudiadas prevaleció el síndrome climatérico leve, y las enfermedades crónicas más frecuentes fueron la hipertensión arterial y la artrosis. Más del 50 % de las mujeres encuestadas se desenvuelven en un medio familiar funcional, y el 75 % refiere una buena satisfacción de sus necesidades básicas, en correspondencia con un entorno higiénico habitacional bueno, lo que guarda una estrecha relación con el nivel sociocultural y económico del area de salud investigada.A descriptive and cross-sectional study was carried out in 80 climacteric women from September 2003 to June 2004 aimed at knowing the clinical and socioepidemiological characteristics with the highest incidence, and at analyzing the biopsychosocial repercussion of the climacteric in women from the family phsycian's office 1.1, in La Puntilla, at "Ana Betancourt" Teaching Polyclinic, "Playa" municipality, Havana City. The mild climacteric syndrome prevailed in the studied patients. The most frequent chronic diseases were arterial hypertension and arthrosis. More than 50 % of the surveyed women belonged to a functional family environment, and 75. 5 % referred to a good satisfaction of their basic needs in correspondance with a good hygienic housing setting that is closely related to the sociocultural and economic level of the investigated health area.

  15. Age and stage at diagnosis: a hospital series of 11 women with intellectual disability and breast carcinoma

    International Nuclear Information System (INIS)

    Satgé, Daniel; Sauleau, Eric-André; Jacot, William; Raffi, Fernand; Azéma, Bernard; Bouyat, Jean-Claude; El Hage Assaf, Nicolas

    2014-01-01

    Breast cancer has been poorly studied in women with intellectual disability (ID), which makes designing a policy for screening the nearly 70 million women with ID in the world difficult. As no data is available in the literature, we evaluated breast cancer at diagnosis in women with ID. Women with ID were searched retrospectively among all women treated for invasive breast cancer in a single hospital over 18 years. Age at diagnosis was compared among the whole group of women. Tumor size, lymph node involvement, SBR grade, TNM classification, and AJCC stage were compared to controls matched for age and period of diagnosis using conditional logistic regression. Among 484 women with invasive breast cancer, 11 had ID. The mean age at diagnosis was 55.6 years in women with ID and 62.4 years in the other women. The mean tumor size in women with ID was 3.53 cm, compared to 1.80 cm in 44 random controls from among the 473 women without ID. Lymph node involvement was observed in 9 of the 11 women with ID compared to 12 of the controls (OR = 11.53, p = 0.002), and metastases were found in 3 of the 11 women with ID compared to 1 of the 44 controls (OR = 12.00, p = 0.031). The AJCC stage was higher in women with ID compared to controls (OR = 3.19, p = 0.010). Women with ID presented at an earlier age with tumors of a higher AJCC stage than controls despite no significant differences in tumor grade and histological type. Thus, delayed diagnosis may be responsible for the differences between disabled and non-disabled women

  16. [Approaches to the treatment of patients with climacteric disorders complicated with menopausal metabolic syndrome with cholestasis].

    Science.gov (United States)

    Gavrilova, N P; Seliverstov, P V; Tatarova, N A; Radchenko, V G

    2014-01-01

    Development of the individual comprehensive program of follow treatment of patients with climacteric disorders complicated MMS (menopausal metabolic syndrome) with cholestasis; on the basis of application of low-dose hormone replacement therapy in combination with ursodeoxycholic acid, to improve the quality of life. We observed 101 woman with climacteric syndrome, obesity and cholestasis; conducted a comprehensive clinical and laboratory examination, ultrasound of the hepatobiliary system, measurement modified menopausal index (MMI), the measurement of the quality of life on questionnaire SF-36 before treatment and after 6 and 12 months. Positive and statistically significant changes in lipid spectrum, the activity of transaminases, bilirubin and its fractions, improvement of MMI and quality of life, the indices of coagulation remained virtually unchanged. Low-dose hormone replacement therapies in combination with ursodeoxycholic acid are highly effective drugs for the treatment of menopausal syndrome, which normalize lipid profile of patients and the performance of the hepatobiliary system.

  17. Dependency of cardiovascular risk on reproductive stages and on age among middle-aged Chinese women.

    Science.gov (United States)

    Sun, Y; Ruan, X; Mueck, A O

    2017-10-01

    To assess the 10-year cardiovascular risk in middle-aged Chinese women living in the same community and the impact of reproductive aging and age. This was a cross-sectional study in the Yuetan Community of Beijing. Data on lifestyle habits, prevalence and treatment of chronic diseases with significance for cardiovascular disease (CVD) development were collected by interview. CVD risk factors were assessed by physical examination and laboratory tests. The 10-year cardiovascular risk was calculated using the Framingham 10-year risk score. STRAW +10 criteria were used for the stages of reproductive aging. A total of 536 women, aged 40-60 years, were enrolled. The incidences of hypertension, dyslipidemia, abdominal obesity, glucose intolerance and diabetes were 32.6%, 45.7%, 65.5%, 37.9% and 10.1%, respectively. After adjustment, the incidence of hypertension and diabetes increased with age and with reproductive aging. Dyslipidemia and glucose intolerance were only associated with age. Abdominal obesity was related neither to age nor to reproductive aging. The 10-year cardiovascular risk ranged from 1% to 24.8%; 11.6% of women had a moderate or high Framingham 10-year risk score. CVD risk factors were frequent and more than 10% of the women were at moderate or high risk of developing cardiovascular disease within the next 10 years. To our knowledge, this was demonstrated for the first time in middle-aged Chinese women. Thus, women should maintain a healthy lifestyle and physicians should monitor them to prevent CVD.

  18. Analysis of gene expression during the transition to climacteric phase in carnation flowers (Dianthus caryophyllus L.).

    Science.gov (United States)

    In, Byung-Chun; Binder, Brad M; Falbel, Tanya G; Patterson, Sara E

    2013-11-01

    It has been generally thought that in ethylene-sensitive plants such as carnations, senescence proceeds irreversibly once the tissues have entered the climacteric phase. While pre-climacteric petal tissues have a lower sensitivity to ethylene, these tissues are converted to the climacteric phase at a critical point during flower development. In this study, it is demonstrated that the senescence process initiated by exogenous ethylene is reversible in carnation petals. Petals treated with ethylene for 12h showed sustained inrolling and senescence, while petals treated with ethylene for 10h showed inrolling followed by recovery from inrolling. Reverse transcription-PCR analysis revealed differential expression of genes involved in ethylene biosynthesis and ethylene signalling between 10h and 12h ethylene treatment. Ethylene treatment at or beyond 12h (threshold time) decreased the mRNA levels of the receptor genes (DcETR1, DcERS1, and DcERS2) and DcCTR genes, and increased the ethylene biosynthesis genes DcACS1 and DcACO1. In contrast, ethylene treatment under the threshold time caused a transient decrease in the receptor genes and DcCTR genes, and a transient increase in DcACS1 and DcACO1. Sustained DcACS1 accumulation is correlated with decreases in DcCTR genes and increase in DcEIL3 and indicates that tissues have entered the climacteric phase and that senescence proceeds irreversibly. Inhibition of ACS (1-aminocyclopropane-1-carboxylic acid synthase) prior to 12h ethylene exposure was not able to prevent reduction in transcripts of DcCTR genes, yet suppressed transcript of DcACS1 and DcACO1. This leads to the recovery from inrolling of the petals, indicating that DcACS1 may act as a signalling molecule in senescence of flowers.

  19. Adjuvant radiation use in older women with early-stage breast cancer at Johns Hopkins.

    Science.gov (United States)

    Pollock, YaoYao G; Blackford, Amanda L; Jeter, Stacie C; Wright, Jean; Cimino-Mathews, Ashley; Camp, Melissa; Harvey, Susan; Asrari, Fariba; Schoenborn, Nancy L; Stearns, Vered

    2016-11-01

    In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. We identified women ≥70 years old treated at our institution from 2009 to 2014. We calculated radiation therapy omission rate in those meeting the guidelines. We explored associations between radiation therapy omission, year of diagnosis, and patient characteristics with Wilcoxon rank sum tests and Fisher's exact tests. A total of 667 women met the inclusion criteria, and 117 (18 %) were candidates for radiation therapy omission. Mean age among the 117 was 76.3 years (Range: 70-95). Overall radiation therapy omission rate was 36.8 %, but varied greatly by year of diagnosis (Range: 7.7-54.5 %). This variation persisted after excluding women who did not receive endocrine therapy (Mean: 39.0 %, Range: 0.0-75.0 %). Factors associated with higher radiation therapy omission rates included older age and not having pathological nodal evaluation. The radiation therapy omission rate did not vary by race, tumor type, grade, or size. The implementation of the NCCN guideline has not been consistent at our institution. Our data suggest that other tools should be considered to apply the guidelines more consistently. We have implemented a quality improvement protocol that incorporates life expectancy estimate and geriatric assessment in women meeting the NCCN guideline at our institution.

  20. Active versus expectant management for women in the third stage of labour

    Science.gov (United States)

    Begley, Cecily M; Gyte, Gillian ML; Devane, Declan; McGuire, William; Weeks, Andrew

    2014-01-01

    Background Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping and controlled cord traction to deliver the placenta. With expectant management, signs of placental separation are awaited and the placenta is delivered spontaneously. Active management was introduced to try to reduce haemorrhage, a major contributor to maternal mortality in low-income countries. Objectives To compare the effectiveness of active versus expectant management of the third stage of labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group Trials Register (15 February 2011). Selection criteria Randomised and quasi-randomised controlled trials comparing active versus expectant management of the third stage of labour. Data collection and analysis Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Main results We included seven studies (involving 8247 women), all undertaken in hospitals, six in high-income countries and one in a low-income country. Four studies compared active versus expectant management, and three compared active versus a mixture of managements. We used random-effects in the analyses because of clinical heterogeneity. There was an absence of high quality evidence for our primary outcomes. The evidence suggested that for women at mixed levels of risk of bleeding, active management showed a reduction in the average risk of maternal primary haemorrhage at time of birth (more than 1000 mL) (average risk ratio (RR) 0.34, 95% confidence interval (CI) 0.14 to 0.87, three studies, 4636 women) and of maternal haemoglobin (Hb) less than 9 g/dL following birth (average RR 0.50, 95% CI 0.30 to 0.83, two studies, 1572 women). We also found no difference in the incidence in admission of infants to neonatal units (average RR 0.81, 95% CI 0.60 to 1.11, two studies, 3207 women) nor in the incidence of infant jaundice requiring treatment (0

  1. Information Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions.

    Science.gov (United States)

    Wang, Shi-Yi; Kelly, Gabrielle; Gross, Cary; Killelea, Brigid K; Mougalian, Sarah; Presley, Carolyn; Fraenkel, Liana; Evans, Suzanne B

    2017-07-15

    To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. We surveyed (through face-to-face interview, telephone, or mail) women aged ≥65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers. Participants rated the importance (on a 4-point scale) of 24 statements describing the benefits, side effects, impact on daily life, and other issues of radiation therapy in relation to radiation therapy decision making. Participants also designated who was considered the key decision maker. The response rate was 56.4% (93 of 165). Mean age was 72.5 years, ranging from 65 to 93 years. More than 96% of participants indicated they were the main decision maker on receiving radiation therapy. There was wide variation in information needs regarding radiation therapy decision making. Participants rated a mean of 18 (range, 3-24) items as "essential." Participants rated items related to benefits highest, followed by side effects. Participants who were older than 75 years rated 13.9 questions as essential, whereas participants aged ≤74 years rated 18.7 as essential (P=.018). Older women desire information and have more agency and input in the decision-making process than prior literature would suggest. The variation in information needs indicates that future decision support tools should provide options to select what information would be of interest to the participants. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Sonography of acute appendicitis in pregnant women: diagnostic accuracy by the stage of gestation

    International Nuclear Information System (INIS)

    Kim, Sam Soo; Lee, Sang Wook; Rho, Myung Ho

    2004-01-01

    To evaluate the diagnostic accuracy of a diagnosis of acute appendicitis in pregnant women according to the trimester. A retrospective review was performed on 103 pregnant women who underwent sonography with clinically suspected acute appendicitis. The sonographic technique used involved either the graded compression or a non-compression method. All the sonograms were obtained after changing the patient's position and identifying the diseased appendix. The criterion for a sonographic diagnosis of acute appendicitis was the visualization of a non-compressible appendix with a maximal diameter ≥ 6 mm. The sonographic findings were correlated with the surgical findings and clinical follow-up. Acute appendicitis was confirmed by both the surgical and pathological findings in 48 out of 103 pregnant women. Ultrasound established the diagnosis in 34 of the 48 patients with proven appendicitis. There were false-positives in 2 patients and false-negatives in 14 patients. Among the 55 patients who had a normal appendix, 30 patients improved at the clinical follow-up and 25 patients had other intra-abdominal disorders. The diagnostic accuracy of the ultrasound was 94% in the first trimester, 81% in the second trimester, and 76% in the third trimester. The overall accuracy was found to be 84%, with a 71% sensitivity and a 96% specificity. No significant difference was found in the diagnostic accuracy of the ultrasound according to the trimester in which the acute appendicitis occurred. Therefore, regardless of the stage of gestation, sonography is a valuable procedure for diagnosing acute appendicitis

  3. The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women.

    Science.gov (United States)

    Moraloglu, Ozlem; Kansu-Celik, Hatice; Tasci, Yasemin; Karakaya, Burcu Kısa; Yilmaz, Yasar; Cakir, Ebru; Yakut, Halil Ibrahim

    2017-01-01

    To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women. This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups. The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit. In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.

  4. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort...... study of 235 women with endometrial cancer or atypical complex hyperplasia who had RALH. Surgeries were stratified into two groups: with or without pelvic lymphadenectomy. RESULTS: A total of 6% developed a grade 3 or higher complication with no significant difference (p = 0.24) between the groups...

  5. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer

    Directory of Open Access Journals (Sweden)

    Elizabeth Trice Loggers

    2016-01-01

    Full Text Available Objective. It is unknown whether advanced imaging (AI is associated with higher quality breast cancer (BC care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT versus mammogram and/or ultrasound (M-US alone and receipt of guideline concordant care (GCC using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT (OR 1.55, 95% CI 1.08–2.26, and p=0.02 and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+ BC (OR 1.74, 95% CI 1.17–2.59, and p=0.01. Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively.

  6. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine the incid......INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort....... CONCLUSION: The types and frequency of complications observed in this study resemble those reported in similar studies of RALH for malignant gynaecologic conditions. Health-care professionals treating and caring for women with early-stage endometrial cancer should know of the types and frequency of post...

  7. Effect of Zuogui Pill () on monoamine neurotransmitters and sex hormones in climacteric rats with panic attack.

    Science.gov (United States)

    Li, Xiao-Yu; Wang, Xiao-Yun

    2017-03-01

    To explore the effects of Chinese medicine prescription Zuogui Pill (, ZGP) on monoamine neurotransmitters and sex hormones in climacteric rats with induced panic attacks. Forty-eight climacteric female rats were randomized into 6 groups with 8 rats in each group: the control group, the model group, the low-, medium- and high-dose ZGP groups and the alprazolam group. Rats in the low-, medium- and high-dose ZGP groups were administered 4.725, 9.45, or 18.9 g/kg ZGP by gastric perfusion, respectively. The alprazolam group was treated by gastric perfusion with 0.036 mg/kg alprazolam. The control and model groups were treated with distilled water. The animals were pretreated once daily for 8 consecutive weeks. The behaviors of rats in the open fifield test and the elevated T-maze (ETM) were observed after induced panic attack, and the levels of brain monoamine neurotransmitters and the plasma levels of sex hormones were measured. Compared with the control group, the mean ETM escape time and the levels of 5-hydroxytryptamine (5-HT) and noradrenalin (NE) of the model group were signifificantly reduced (P<0.05), Compared with the model group, the mean ETM escape time and the 5-HT and NE levels of all the ZGP groups increased signifificantly (P<0.05 or P<0.01). However, no signifificant difference was observed in the levels of sex hormones between the groups. Pretreatment with ZGP in climacteric rats may improve the behavior of panic attack, which may be related to increased 5-HT and NE in the brain.

  8. Dynamics of general and specially trained of women-weightlifters at the stage of specialized basic training

    Directory of Open Access Journals (Sweden)

    Viktor Slobodyanuk

    2015-04-01

    Full Text Available Purpose: to determine the dynamics of the general and special training of women-weightlifters different groups weight categories for annual macrocycle at the stage of specialized basic training. Materials and Methods: indexes long jump, running 30 meters, push-ups, jumps on how Abalakova index and wrist strength athletes different schools of Ukraine. Results: found dynamic indicators of general and special training of women-weightlifters different groups weight categories at the stage of basic training six specialized schools in Ukraine. Conclusions: the results of the study provide an opportunity to consider certain indicators in planning differentiated training programs to improve the training process athletes for women-weightlifters at the stage of specialized basic training different groups weight categories in the annual macrocycle.

  9. Postmenopausal symptoms in a group of rural Xhosa women ...

    African Journals Online (AJOL)

    Background: To describe the incidence and understanding of early postmenopausal symptoms in rural Xhosa women. Methods: After written informed consent, 137 women were interviewed within five years after natural menopause using the Greene Climacteric Scale. Body mass indices were calculated, and blood levels of ...

  10. Comparison of delayed versus immediate pushing during second stage of labor for nulliparous women with epidural anesthesia.

    Science.gov (United States)

    Gillesby, Erica; Burns, Suzan; Dempsey, Amy; Kirby, Shirley; Mogensen, Kami; Naylor, Kelly; Petrella, Joann; Vanicelli, Rebecca; Whelan, Breon

    2010-01-01

    To determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue. Randomized clinical trial. Labor and delivery unit of a not-for-profit community hospital. Convenience sample of nulliparous laboring women with epidural anesthesia. Immediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation. The length of pushing, total length of the second stage, and maternal fatigue. A total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05). We found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  11. Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru.

    Science.gov (United States)

    Romanoff, Anya; Constant, Tara Hayes; Johnson, Kay M; Guadiamos, Manuel Cedano; Vega, Ana María Burga; Zunt, Joseph; Anderson, Benjamin O

    2017-11-01

    Mammographic screening is impractical in most of the world where breast cancers are first identified based on clinical signs and symptoms. Clinical breast examination may improve early diagnosis directly by finding breast cancers at earlier stages or indirectly by heightening women's awareness of breast health concerns. To investigate factors that influence time to presentation and stage at diagnosis among patients with breast cancer to determine whether history of previous clinical breast examination is associated with earlier presentation and/or earlier cancer stage at diagnosis. In this cross-sectional analysis of individual patient interviews using a validated Breast Cancer Delay Questionnaire, 113 (71.1%) of 159 women with breast cancer treated at a federally funded tertiary care referral cancer center in Trujillo, Peru, from February 1 through May 31, 2015, were studied. Method of breast cancer detection and factors that influence time to and stage at diagnosis. Of 113 women with diagnosed cancer (mean [SD] age, 54 [10.8] years; age range, 32-82 years), 105 (92.9%) had self-detected disease. Of the 93 women for whom stage was documented, 45 (48.4%) were diagnosed with early-stage disease (American Joint Committee on Cancer [AJCC] stage 0, I, or II), and 48 (51.6%) were diagnosed with late-stage disease (AJCC stage III or IV). Mean (SD) total delay from symptom onset to initiation of treatment was 407 (665) days because of patient (mean [SD], 198 [449] days) and health care system (mean [SD], 241 [556] days) delay. Fifty-two women (46.0%) had a history of clinical breast examination, and 23 (20.4%) had undergone previous mammography. Women who underwent a previous clinical breast examination were more likely to have shorter delays from symptom development to presentation compared with women who had never undergone a previous clinical breast examination (odds ratio, 2.92; 95% CI, 1.30-6.60; P = .01). Women diagnosed with shorter patient delay were more

  12. Effects of a pushing intervention on pain, fatigue and birthing experiences among Taiwanese women during the second stage of labour.

    Science.gov (United States)

    Chang, Su-Chuan; Chou, Min-Min; Lin, Kuan-Chia; Lin, Lie-Chu; Lin, Yu-Lan; Kuo, Su-Chen

    2011-12-01

    To evaluate maternal labour pain, fatigue, duration of the second stage of labour, the women's bearing-down experiences and the newborn infant Apgar scores when spontaneous pushing is used in an upright position. Quasi-experimental study. Medical centre in Taichung, Taiwan. 66 Women giving birth at the hospital, with 33 primigravidas assigned to each group. During the second stage of labour, the women in the experimental group pushed from an upright position and were given support to push spontaneously; the women in the control group pushed from a supine position and were supported via Valsalva pushing. Pain scores were recorded at two evaluation time points: at 10 cm of cervical dilation and one hour after the first pain score evaluation. One to four hours after childbirth, the trained nurses collected the fatigue and pushing experience scores. The women in the experimental group had a lower pain index (5.67 versus 7.15, p = 0.01), lower feelings of fatigue post birth (53.91 versus 69.39, p pushing intervention during the second stage of labour lessened pain and fatigue, shortened the pushing time and enhanced the pushing experience. Pushing interventions can yield increased satisfaction levels for women giving birth. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Improved survival of baby boomer women with early-stage uterine cancer: A Surveillance, Epidemiology and End Results (SEER) Study.

    Science.gov (United States)

    Elshaikh, Mohamed A; Ruterbusch, Julie; Cote, Michele L; Cattaneo, Richard; Munkarah, Adnan R

    2013-11-01

    To study the prognostic impact of baby boomer (BB) generation on survival end-points of patients with early-stage endometrial carcinoma (EC). Data were obtained from the SEER registry between 1988-2009. Inclusion criteria included women who underwent hysterectomy for stage I-II EC. Patients were divided into two birth cohorts: BB (women born between 1946 and 1964) and pre-boomers (PB) (born between 1926 and 1945). A total of 30,956 patients were analyzed. Considering that women in the PB group were older than those of the BB generation, the statistical analysis was limited to women 50-59 years of age at the time of diagnosis (n=11,473). Baby boomers had a significantly higher percentage of endometrioid histology (pgeneration compared to the PB generation (p=0.0003) with a trend for improved uterine cancer-specific survival (p=0.0752). On multivariate analysis, birth cohort (BB vs. PB) was not a significant predictor of survival end-points. Factors predictive of survival included: tumor grade, FIGO stage, African-American race, and increased number of dissected LN. Our study suggests that the survival of BB women between 50-60 years of age is better compared to women in the PB generation. As more BB patients are diagnosed with EC, further research is warranted.

  14. Technical efficiency of women's health prevention programs in Bucaramanga, Colombia: a four-stage analysis.

    Science.gov (United States)

    Ruiz-Rodriguez, Myriam; Rodriguez-Villamizar, Laura A; Heredia-Pi, Ileana

    2016-10-13

    Primary Health Care (PHC) is an efficient strategy to improve health outcomes in populations. Nevertheless, studies of technical efficiency in health care have focused on hospitals, with very little on primary health care centers. The objective of the present study was to use the Data Envelopment Analysis to estimate the technical efficiency of three women's health promotion and disease prevention programs offered by primary care centers in Bucaramanga, Colombia. Efficiency was measured using a four-stage data envelopment analysis with a series of Tobit regressions to account for the effect of quality outcomes and context variables. Input/output information was collected from the institutions' records, chart reviews and personal interviews. Information about contextual variables was obtained from databases from the primary health program in the municipality. A jackknife analysis was used to assess the robustness of the results. The analysis was based on data from 21 public primary health care centers. The average efficiency scores, after adjusting for quality and context, were 92.4 %, 97.5 % and 86.2 % for the antenatal care (ANC), early detection of cervical cancer (EDCC) and family planning (FP) programs, respectively. On each program, 12 of the 21 (57.1 %) health centers were found to be technically efficient; having had the best-practice frontiers. Adjusting for context variables changed the scores and reference rankings of the three programs offered by the health centers. The performance of the women's health prevention programs offered by the centers was found to be heterogeneous. Adjusting for context and health care quality variables had a significant effect on the technical efficiency scores and ranking. The results can serve as a guide to strengthen management and organizational and planning processes related to local primary care services operating within a market-based model such as the one in Colombia.

  15. [Equine estrogens vs. esterified estrogens in the climacteric and menopause. The controversy arrives in Mexico].

    Science.gov (United States)

    Velasco-Murillo, V

    2001-01-01

    It exists controversies about if the effects and benefits of the esterified estrogens could be similar to those informed for equines, because its chemical composition and bioavailability are different. Esterified estrogens has not delta 8,9 dehydroestrone, and its absorption and level of maximum plasmatic concentrations are reached very fast. In United States of America and another countries, esterified estrogens has been marketed and using for treatment of climacteric syndrome and prevention of postmenopausal osteoporosis, based on the pharmacopoiea of that country, but the Food and Drug administration (FDA) has not yet authorized up today, a generic version of conjugated estrogens. In Instituto Mexicano del Seguro Social (IMSS) and another institutions of health sector in Mexico, starting in year 2000, it has been used esterified estrogens for medical treatment of climacteric and menopausal conditions. For this reason, in this paper we revised the most recent information about pharmacology, chemical composition, clinical use and costs of the conjugated estrogens with the purpose to guide the decisions to purchase this kind of drugs in Mexican heath institutions.

  16. Ethylene Control Technologies in Extending Postharvest Shelf Life of Climacteric Fruit.

    Science.gov (United States)

    Zhang, Junhua; Cheng, Dong; Wang, Baobin; Khan, Iqbal; Ni, Yonghao

    2017-08-30

    Fresh fruit is important for a healthy diet. However, because of their seasonal production, regional specific cultivation, and perishable nature, it is essential to develop preservation technologies to extend the postharvest shelf life of fresh fruits. Climacteric fruit adopt spoilage because of ethylene, a key hormone associated with the ripening process. Therefore, controlling ethylene activity by following safe and effective approaches is a key to extend the postharvest shelf life of fruit. In this review, ethylene control technologies will be discussed aiming for the need of developing more innovative and effective approaches. The biosynthesis pathway will be given first. Then, the technologies determining the postharvest shelf life of climacteric fruit will be described with special attention to the latest and significant published works in this field. Special attention is given to 1-methylcyclopropene (1-MCP), which is effective in fruit preservation technologies. Finally, the encapsulation technology to improve the stability of 1-MCP will be proposed, using a potential encapsulation agent of 1-MCP, calixarene.

  17. [Wuling Capsule for climacteric patients with depression and anxiety state: a randomized, positive parallel controlled trial].

    Science.gov (United States)

    Wang, Xing-juan; Li, Ji; Zou, Qin-di; Jin, Ling

    2009-11-01

    The incidence of menopausal anxiety and depression is increasing. It can induce and aggravate a variety of somatic symptoms. Despite of the good effects of psychotropic drugs on the disease, patients' compliance is poor. Therefore, it is necessary to find a drug which is practical, effective, and easy for patients to take. To evaluate the efficacy of Wuling Capsule (WC), a Chinese herbal medicine, in treatment of female climacteric syndrome with depression and anxiety state. A total of 96 outpatients of female climacteric syndrome from Department of Gynecology of Integrated Traditional Chinese and Western Medicine, Huashan Hospital, Fudan University, Department of Gynecology of Traditional Chinese Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, and Department of Traditional Chinese Medicine, Obstetrics and Gynecology Hospital, Fudan University were included. The study was designed as a randomized, positive drug parallel controlled trial. The patients were divided into WC group (64 cases) and control group (32 cases) and were orally administered Wuling Capsule and Gengnianan Tablet, respectively. The efficacy was evaluated with Kupperman menopausal index (KMI), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS) before treatment, and after 3-week and 6-week treatment. The total response rate was 89.66% (52/58) in the WC group, which was superior to that in the control group [76.67% (23/30)]. Ridit test showed that there was a significant difference between the two groups (Pstate. Wuling Capsule is more effective to alleviate depression and anxiety as compared with Gengnianan Tablet.

  18. Personality predicts perceived availability of social support and satisfaction with social support in women with early stage breast cancer

    NARCIS (Netherlands)

    den Oudsten, Brenda L.; van Heck, Guus L.; van der Steeg, Alida F. W.; Roukema, Jan A.; de Vries, Jolanda

    2010-01-01

    This study examines the relationships between personality, on the one hand, and perceived availability of social support (PASS) and satisfaction with received social support (SRSS), on the other hand, in women with early stage breast cancer (BC). In addition, this study examined whether a stressful

  19. Couples' Support-Related Communication, Psychological Distress, and Relationship Satisfaction among Women with Early Stage Breast Cancer

    Science.gov (United States)

    Manne, Sharon; Sherman, Marne; Ross, Stephanie; Ostroff, Jamie; Heyman, Richard E.; Fox, Kevin

    2004-01-01

    This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress…

  20. The effects of age on treatment and outcomes in women with stages IB1-IIB cervical cancer.

    Science.gov (United States)

    Roque, Dario R; Cronin, Beth; Robison, Katina; Lopes, Vrishali; Rizack, Tina; Dizon, Don S

    2013-10-01

    Age may affect the treatment choice and subsequent outcome in elderly patients with cervical cancer. Given the potential for cure with either surgery or chemoradiation in early stage disease, we aimed to determine whether a patient's age influenced treatment received and the ensuing outcome. We identified 303 patients with stages IB1-IIB cervical carcinoma treated at our institution between 2000 and 2010, who were divided into two groups based on age at time of diagnosis: stage at presentation, and grade. Women ≥ 65 years of age were less likely to receive primary surgical management (p=0.03). Age did not influence disease-specific or all-cause mortality. However, women over 65 years who underwent primary surgery were at significantly increased risk of all-cause mortality compared to younger women (HR 6.53, 95% CI: 2.57-16.6). Age appears to influence treatment received by patients with stages IB1-IIB cervical cancer. Although there was no difference in cancer-specific mortality stratified by type of treatment received, surgery was associated with a 6.5-fold increased risk of all-cause mortality among women 65 years or over. © 2013.

  1. THE DIFFERENCES IN SEXUAL FUNCTION BETWEEN WOMEN AFTER CESAREAN SECTION WITH INDICATION OF SECOND STAGE DISTOCIA AND ELECTIVE INDICATION

    Directory of Open Access Journals (Sweden)

    Ricvan Dana Nindrea

    2018-03-01

    Full Text Available This research want to know the difference between a woman's sexual function after childbirth with Caesarean section on indications second stage dystocia and elective.This study is observational analytic with cross sectional design using comparative in M. Djamil General Hospital and Networking Hospital. Obtained samples are 26 women after childbirth cesarean section for second stage dystocia and 26 women after elective Caesarean section were spawned from term pregnancies that meet the inclusion and exclusion criteria. Data analysis was performed using univariate and bivariate using independent T test. The average female sexual function after cesarean section indication of second stage dystocia is 27,70 ± 8,53 and female sexual function after elective Caesarean section indications are 33,55 ± 3,18. Statistical test results are known there is a difference in sexual function between women after Caesarean section indication of second stage dystocia and elective p = 0,003 (p ≤ 0,05. There is a difference between a woman's sexual function after childbirth Caesarean section on indications second stage dystocia and elective.

  2. Effects of the stages of change model-based education and motivational interview on exercise behavior in diabetic women.

    Science.gov (United States)

    Sekerci, Yasemin Gümüs; Kitis, Yeter

    2018-05-08

    In this study, we examined the effects of exercise education and a motivational interview program, based on the stages of change model (SCM), on stage of change, using cognitive and behavioral methods, perceived benefits and barriers and self-confidence in Turkish women with diabetes. This intervention study was carried out in 2015 on 55 women selected from a family health centers' population. An exercise guide was prepared based on the SCM for the intervention group. The intervention group was followed seven times at 1-month intervals via home visits, and exercise education and the motivational interview program were conducted to identify changes in behavior. The control group received no intervention. Data were collected from both groups using a personal description form, Exercise Stages of Change Scale, Exercise Processes of Change Scale, Exercise Decisional Balance Scale, and Exercise Self-Efficacy Scale. After the exercise program, each group was re-subjected to the same scales. We used a chi-square test and independent and paired sample t-tests to analyze the data. The stages of change, using cognitive and behavioral methods, perceived benefits and self-confidence for exercise in the intervention group significantly improved compared with that in the control group (p interview program based on SCM positively affected stages of change, using cognitive and behavioral methods, perceived benefits, perceived barriers, and self-confidence for exercise behavior in women with diabetes. We conclude that the education and motivational interview program based on SCM are effective in promoting exercise habit.

  3. Impact of body mass index on breast cancer in accordance with the life-stage of women

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Reiko [Division of Medical Nutrition, Department of Healthcare, Tokyo Health Care University, Tokyo (Japan); Saji, Shigehira [Department of Target Therapy Oncology, Kyoto University Graduate School of Medicine, Kyoto (Japan); Toi, Masakazu, E-mail: toi@kuhp.kyoto-u.ac.jp [Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto (Japan)

    2012-10-04

    A large amount of epidemiological evidence suggests that the impact of body weight on breast cancer risk should be heterogeneous throughout the life-stage of women. At birth, high weight has been positively associated with an increased risk of breast cancer. While, the body mass index (a relative body weight; BMI kg/m{sup 2}) has been inversely associated with breast cancer risk among pre-menopausal women. The inverse trend had been observed in both Western and Asian population, with a relatively lower percentage of obesity and higher percentage of leanness, suggested that the inverse trend could be explained not only by the protective impact due to obesity, but also by the increased risk of breast cancer due to leanness. Among post-menopausal women, however, an elevated BMI has been positively associated with the development of breast cancer, particularly in the cases of estrogen receptor-positive (ER+) and progesterone receptor-positive (PR+) tumors. Currently, the mechanisms underlying the heterogeneous impacts between BMI on breast cancer risk and the life-stage of women remain poorly understood. We reviewed several proposed biological mechanisms that may contribute to the various impacts of relative body weight on breast cancer risk across life-stage. We also discussed the impact of BMI upon the outcome of endocrine therapy, particularly for aromatase inhibitor, in breast cancer patients. To prevent breast cancer incidence and recurrence, the desirable BMI of women may differ throughout their life-stage. To define the underlying mechanism for the various impacts of BMI in the context of breast cancer across various female life stages, further studies will be required.

  4. Impact of body mass index on breast cancer in accordance with the life-stage of women

    International Nuclear Information System (INIS)

    Suzuki, Reiko; Saji, Shigehira; Toi, Masakazu

    2012-01-01

    A large amount of epidemiological evidence suggests that the impact of body weight on breast cancer risk should be heterogeneous throughout the life-stage of women. At birth, high weight has been positively associated with an increased risk of breast cancer. While, the body mass index (a relative body weight; BMI kg/m 2 ) has been inversely associated with breast cancer risk among pre-menopausal women. The inverse trend had been observed in both Western and Asian population, with a relatively lower percentage of obesity and higher percentage of leanness, suggested that the inverse trend could be explained not only by the protective impact due to obesity, but also by the increased risk of breast cancer due to leanness. Among post-menopausal women, however, an elevated BMI has been positively associated with the development of breast cancer, particularly in the cases of estrogen receptor-positive (ER+) and progesterone receptor-positive (PR+) tumors. Currently, the mechanisms underlying the heterogeneous impacts between BMI on breast cancer risk and the life-stage of women remain poorly understood. We reviewed several proposed biological mechanisms that may contribute to the various impacts of relative body weight on breast cancer risk across life-stage. We also discussed the impact of BMI upon the outcome of endocrine therapy, particularly for aromatase inhibitor, in breast cancer patients. To prevent breast cancer incidence and recurrence, the desirable BMI of women may differ throughout their life-stage. To define the underlying mechanism for the various impacts of BMI in the context of breast cancer across various female life stages, further studies will be required.

  5. Radiation Therapy in Treating Post-Menopausal Women With Early Stage Breast Cancer Undergoing Surgery

    Science.gov (United States)

    2017-06-07

    Ductal Breast Carcinoma In Situ; Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; Invasive Cribriform Breast Carcinoma; Invasive Ductal Carcinoma, Not Otherwise Specified; Lobular Breast Carcinoma In Situ; Mucinous Breast Carcinoma; Papillary Breast Carcinoma; Progesterone Receptor Positive; Stage I Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIC Breast Cancer; Tubular Breast Carcinoma

  6. Low-income women with early-stage breast cancer: physician and patient decision-making styles.

    Science.gov (United States)

    McVea, K L; Minier, W C; Johnson Palensky, J E

    2001-01-01

    Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study. Copyright 2001 John Wiley & Sons, Ltd.

  7. The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma.

    Science.gov (United States)

    Gerestein, C G; Eijkemans, M J C; de Jong, D; van der Burg, M E L; Dykgraaf, R H M; Kooi, G S; Baalbergen, A; Burger, C W; Ansink, A C

    2009-02-01

    Prognosis in women with ovarian cancer mainly depends on International Federation of Gynecology and Obstetrics stage and the ability to perform optimal cytoreductive surgery. Since ovarian cancer has a heterogeneous presentation and clinical course, predicting progression-free survival (PFS) and overall survival (OS) in the individual patient is difficult. The objective of this study was to determine predictors of PFS and OS in women with advanced stage epithelial ovarian cancer (EOC) after primary cytoreductive surgery and first-line platinum-based chemotherapy. Retrospective observational study. Two teaching hospitals and one university hospital in the south-western part of the Netherlands. Women with advanced stage EOC. All women who underwent primary cytoreductive surgery for advanced stage EOC followed by first-line platinum-based chemotherapy between January 1998 and October 2004 were identified. To investigate independent predictors of PFS and OS, a Cox' proportional hazard model was used. Nomograms were generated with the identified predictive parameters. The primary outcome measure was OS and the secondary outcome measures were response and PFS. A total of 118 women entered the study protocol. Median PFS and OS were 15 and 44 months, respectively. Preoperative platelet count (P = 0.007), and residual disease statistic of 0.63. Predictive parameters for OS were preoperative haemoglobin serum concentration (P = 0.012), preoperative platelet counts (P = 0.031) and residual disease statistic of 0.67. PFS could be predicted by postoperative residual disease and preoperative platelet counts, whereas residual disease, preoperative platelet counts and preoperative haemoglobin serum concentration were predictive for OS. The proposed nomograms need to be externally validated.

  8. Increased levels of proteins of the acute inflammatory phase in the peritoneal fluid of women with advanced stages of endometriosis.

    Science.gov (United States)

    Polak, Grzegorz; Barczyński, Bartłomiej; Bednarek, Wiesława; Kwaśniewski, Wojciech; Wertell, Iwona; Derewianka-Polak, Magdalena; Makara-Studzińska, Marta; Kotarski, Jan

    2015-06-01

    Most investigators agree that endometriosis is associated with a state of subclinical, non-infectious peritoneal inflammation. The objective of the study was to assess concentrations of two markers of the acute inflammatory phase proteins, haptoglobin and ceruloplasmin, in peritoneal fluid of endometriotic women. 229 women who underwent diagnostic or therapeutic laparoscopy were included in the study Minimal, mild, moderate and severe endometriosis according to ASRM was confirmed in 119 women (study groups), whereas 110 patients suffered from simple serous or dermoid ovarian cysts (reference groups). Haptoglobin and ceruloplasmin concentrations in the peritoneal fluid samples aspirated during laparoscopy were measured using commercially available radial immunodiffusion kits. The concentration of haptoglobin in the peritoneal fluid of women with endometriosis was significantly higher as compared to patients with serous and dermoid ovarian cysts. Significantly higher haptoglobin level was observed in patients with severe and moderate endometriosis as compared to women from both reference groups. No significant difference in the peritoneal fluid ceruloplasmin levels was found between patients with endometriosis and women from reference groups. However, it was noted that ceruloplasmin levels are higher in the subgroup of patients with severe endometriosis as compared to both reference groups and women with mild disease. Our results support the hypothesis that endometriosis is associated with subclinical inflammation within the peritoneal cavity It may be speculated that pro-inflammatory stimuli strong enough to cause an increase in acute inflammatory phase proteins peritoneal fluid concentrations are observed only in the advanced stages of the disease.

  9. Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern Florida.

    Science.gov (United States)

    Vargas, Sara; Antoni, Michael H; Carver, Charles S; Lechner, Suzanne C; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B; Glück, Stefan; DerHagopian, Robert P

    2014-12-01

    Sleep disruption and fatigue are ubiquitous among cancer patients and are sources of stress that may compromise treatment outcomes. Previously, we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Patients were randomized to CBSM (n= 120) or a 1-day psychoeducation control group (n= 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer.

  10. Identification of first-stage labor arrest by electromyography in term nulliparous women after induction of labor.

    Science.gov (United States)

    Vasak, Blanka; Graatsma, Elisabeth M; Hekman-Drost, Elske; Eijkemans, Marinus J; Schagen van Leeuwen, Jules H; Visser, Gerard H A; Jacod, Benoit C

    2017-07-01

    Worldwide induction and cesarean delivery rates have increased rapidly, with consequences for subsequent pregnancies. The majority of intrapartum cesarean deliveries are performed for failure to progress, typically in nulliparous women at term. Current uterine registration techniques fail to identify inefficient contractions leading to first-stage labor arrest. An alternative technique, uterine electromyography has been shown to identify inefficient contractions leading to first-stage arrest of labor in nulliparous women with spontaneous onset of labor at term. The objective of this study was to determine whether this finding can be reproduced in induction of labor. Uterine activity was measured in 141 nulliparous women with singleton term pregnancies and a fetus in cephalic position during induced labor. Electrical activity of the myometrium during contractions was characterized by its power density spectrum. No significant differences were found in contraction characteristics between women with induced labor delivering vaginally with or without oxytocin and women with arrested labor with subsequent cesarean delivery. Uterine electromyography shows no correlation with progression of labor in induced labor, which is in contrast to spontaneous labor. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Dose-Dependent Effects of the Cimicifuga racemosa Extract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Ruediger Schellenberg

    2012-01-01

    Full Text Available Extracts from Cimicifuga racemosa (CR, synonym Actaea racemosa have shown efficacy in trials in women with menopausal symptoms. Yet, dose dependency remains unclear. Therefore, 180 female outpatients with climacteric complaints were treated for 12 weeks in a randomized, double-blind, placebo-controlled, 3-armed trial (CR extract Ze 450 in 6.5 mg or 13.0 mg, or placebo. Primary outcome was the difference in menopausal symptoms (vasomotor, psychological, and somatic, assessed by the Kupperman Menopausal Index between baseline and week 12. Secondary efficacy variables were patients’ self-assessments of general quality of life (QoL, responder rates, and safety. Compared to placebo, patients receiving Ze 450 showed a significant reduction in the severity of menopausal symptoms in a dose-dependent manner from baseline to endpoint (mean absolute differences 17.0 (95% CI 14.65–19.35 score points, P<0.0001 for 13.0 mg; mean absolute differences 8.47 (95% CI 5.55–11.39 score points, P=0.0003 for 6.5 mg. QoL and responder rates corresponded with the main endpoint. Changes in menopausal symptoms and QoL were inversely correlated. Reported adverse events and clinical laboratory testing did not raise safety concerns. The CR extract Ze 450 is an effective and well-tolerated nonhormonal alternative to hormone treatment for symptom relief in menopausal women.

  12. Scientific production about the sexuality of women in climacteric: an integrative review

    Directory of Open Access Journals (Sweden)

    Estela Rodrigues Paiva Alves

    2015-04-01

    Full Text Available Objetivo: Analisar a produção científica publicada sobre sexualidade de mulheres no climatério. Metódos: Revisão integrativa de abordagem bibliométrica, realizada através de consulta online, avançada e sistemática na Biblioteca Virtual de Saúde, utilizando-se a técnica da metapesquisa. Resultados: Os autores estavam vinculados a 20 instituições, 53,2% eram médicos, 61,7% eram doutores. O país com maior número de autores foi o Brasil. O tema mais abordado foi a função sexual. A maioria das publicações era quantitativa, ocorreram em 2008 e foram publicados no idioma português brasileiro. O nível de evidência mais frequente foi o quatro. A aplicação da lei de Bradford resultou em três zonas de produtividade. Conclusão: Observou-se a necessidade de mais pesquisas qualitativas, principalmente na área de enfermagem, além de estudos com maior poder de evidência, assim como mais investimentos em outras regiões do Brasil.

  13. Resting energy expenditure and body composition in bedridden institutionalized elderly women with advanced-stage pressure sores.

    Science.gov (United States)

    Sergi, Giuseppe; Coin, Alessandra; Mulone, Silvana; Castegnaro, Eugenio; Giantin, Valter; Manzato, Enzo; Busetto, Luca; Inelmen, Emine Meral; Marin, Sara; Enzi, Giuliano

    2007-03-01

    Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size. The study involved 52 institutionalized bedridden elderly women (aged 83.7 +/- 6.3 years), divided into two groups: 23 with advanced-stage (stage 3 and 4) PS and 29 without PS. Albumin, prealbumin, and retinol-binding protein were measured in all patients, and fat-free mass (FFM) and fat mass (FM) were obtained by dual-energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry and predicted with the Harris-Benedict formula. PS area and volume were also measured. The elderly women with and without PS were comparable in age, FFM, and FM. Mean albumin, prealbumin, and retinol-binding protein values were lower in cases with PS. Unadjusted mean REE was significantly higher in patients with PS (1212.3 +/- 236.7 vs 1085.5 +/- 161.3 kcal/d; p 110% of the predicted REE, was seen in 74% of patients with PS and 38% of controls. The difference between measured and predicted REE (DeltaREE) correlated with PS volume (r = 0.58; p elderly women are associated with a hypermetabolic state that is influenced by the volume of the PS.

  14. Identification of a Predictive Biomarker for the Beneficial Effect of Keishibukuryogan, a Kampo (Japanese Traditional Medicine, on Patients with Climacteric Syndrome

    Directory of Open Access Journals (Sweden)

    Takao Namiki

    2014-01-01

    Full Text Available Keishibukuryogan (KBG; Guizhi-Fuling-Wan in Chinese is one of the Kampo (Japanese traditional medicines used to treat patients with climacteric syndrome. KBG can be used by patients who cannot undergo hormone replacement therapy due to a history of breast cancer. We evaluated whether cytosine-adenine (CA repeat polymorphism of the estrogen receptor β gene can be a predictor of the beneficial effect of KBG on climacteric syndrome. We also investigated the relationship between CA repeat polymorphism, the patients’ profiles, and the therapeutic effect. We found that CA was an SS, SL, or LL genotype according to the number of repeats. We studied 39 consecutive patients with climacteric disorders who took KBG for 12 weeks. The diagnosis of climacteric disorders was made on the basis of the Kupperman index. KBG significantly improved the patients’ climacteric symptoms (i.e., vasomotor symptoms in the patients with the LL genotype and melancholia in the patients with the SL genotype. No relationship between the patients’ profiles and CA repeat polymorphism was recognized. CA repeat polymorphism could thus be a potential biomarker to predict the efficacy of KBG in climacteric syndrome, and its use will help to reduce the cost of treating this syndrome by focusing the administration of KBG on those most likely to benefit from it.

  15. Attitudinal Differences toward Women Managers by Students at Different Stages of Their Business Education

    Science.gov (United States)

    Adeyemi-Bello, Tope; Tomkiewicz, Joseph

    2013-01-01

    There are numerous research studies that have investigated the attitude toward women managers across the globe. Most of the findings indicate that positive and negative attitudes toward women managers can be influenced, among other things, by cultural variables. The goal of this study was to determine if there are differences in the attitude of…

  16. The religiousness as a way of coping with anxiety in women with breast cancer at different disease stages.

    Science.gov (United States)

    Janiszewska, Justyna; Buss, Tomasz; de Walden-Gałuszko, Krystyna; Majkowicz, Mikołaj; Lichodziejewska-Niemierko, Monika; Modlińska, Aleksandra

    2008-12-01

    Anxiety is an unpleasant emotion affecting patients with cancer, and there are various ways of coping with it. Little is known about the relationship between the anxiety level and physical, somatic or spiritual (e.g. religiousness) factors in breast cancer patients at different stages of the disease. The purpose of the study was to assess the intensity of anxiety at different stages of breast cancer, to define the relationship between religiousness and physical (somatic) condition and anxiety in the study subjects and to find out if religiousness is an effective coping strategy at any breast cancer stage. The study involved 180 women aged between 28 and 77, who were qualified to one of five study groups, according to their disease stage. The following research instruments were used: the State-Trait Anxiety Inventory (STAI), Scale of Personal Religiousness, the Rotterdam Symptom Checklist as well as medical history and data from patients' medical records. There is a significant correlation between state anxiety and trait anxiety measured by STAI in study groups. Breast cancer stage differentiates the study groups in respect of revealed anxiety level. Somatic condition has no significant impact on the intensity of anxiety in terminal breast cancer patients. Amongst the studied variables, only religiousness is an important factor that influences the anxiety level of end-stage cancer patients. The obtained results allow us to conclude that: (a) religiousness is an effective factor of coping with anxiety only of the end-stage breast cancer patients; (b) cancer stage is a differentiating factor in respect of revealed anxiety level in study subjects; (c) exacerbation of somatic symptoms does not influence the anxiety level in terminal cancer patients and at disease-free period.

  17. Association of Fatigue with Perceived Stress in Chinese Women with Early Stage Breast Cancer Awaiting Adjuvant Radiotherapy.

    Science.gov (United States)

    Ho, Rainbow T H; Kwan, Tracy T C; Cheung, Irene K M; Chan, Caitlin K P; Lo, Phyllis H Y; Yip, Paul S F; Luk, Mai-Yee; Chan, Cecilia L W

    2015-08-01

    Cancer-related fatigue (CRF) is common in women with breast cancer, but little is known of its relationship with perceived stress. We conducted a cross-sectional study to explore the associations of CRF with perceived stress, anxiety, depression, pain and sleep quality in 133 Chinese women (aged 25-68 years) with early stage breast cancer. The majority of women had completed surgery and chemotherapy and were awaiting radiotherapy. Self-administered questionnaires consisting of the Brief Fatigue Inventory, Perceived Stress Scale-10, Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index were used to collect data. Forty-five per cent of the women were severely fatigued. Compared with local healthy women and US breast cancer patients, the group's mean perceived stress score was significantly higher (both p stress (β = 0.18, p = 0.032), higher anxiety (β = 0.30, p stress was partially mediated by anxiety, suggesting a possible pathway from cancer and cancer treatment to CRF via stress appraisals and emotional distress. The findings indicate the importance of monitoring the psychological status of patients during treatment. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Review of Factors Influencing Women's Choice of Mastectomy Versus Breast Conserving Therapy in Early Stage Breast Cancer: A Systematic Review.

    Science.gov (United States)

    Gu, Jeffrey; Groot, Gary; Boden, Catherine; Busch, Angela; Holtslander, Lorraine; Lim, Hyun

    2018-01-03

    We have performed a narrative synthesis. A literature search was conducted between January 2000 and June 2014 in 7 databases. The initial search identified 2717 articles; 319 underwent abstract screening, 67 underwent full-text screening, and 25 final articles were included. This review looked at early stage breast cancer in women only, excluding ductal carcinoma in situ and advanced breast cancer. A conceptual framework was created to organize the central constructs underlying women's choices: clinicopathologic factors, physician factors, and individual factors with subgroups of sociodemographic, geographic, and personal beliefs and preferences. This framework guided our review's synthesis and analysis. We found that larger tumor size and increasing stage was associated with increased rates of mastectomy. The results for age varied, but suggested that old and young extremes of diagnostic age were associated with an increased likelihood of mastectomy. Higher socioeconomic status was associated with higher breast conservation therapy (BCT) rates. Resident rural location and increasing distance from radiation treatment facilities were associated with lower rates of BCT. Individual belief factors influencing women's choice of mastectomy (mastectomy being reassuring, avoiding radiation, an expedient treatment) differed from factors influencing choice of BCT (body image and femininity, physician recommendation, survival equivalence, less surgery). Surgeon factors, including female gender, higher case numbers, and individual surgeon practice, were associated with increased BCT rates. The decision-making process for women with early stage breast cancer is complicated and affected by multiple factors. Organizing these factors into central constructs of clinicopathologic, individual, and physician factors may aid health-care professionals to better understand this process. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Clinical significance of determination of changes of serum SF, folic acid and vitamin B12 levels in pregnant women of different gestational stages

    International Nuclear Information System (INIS)

    Jiang Hua

    2007-01-01

    Objective: To explore the changes of serum SF, FA and Vitamin Bn levels in pregnant women of different gestational stages. Methods: Levels of serum SF, fore acid and Vitamin B 12 were detected with RIA in 132 pregnant women of different gestational stages and 35 controls (non-pregant women). Results: Serum SF, folic acid and VitB 12 levels were significantly lower in pregnant women of 2nd and 3rd trimester than those in controls (P l2 levels were low in late pregnancy predisposing to development anemia. (authors)

  20. Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor.

    Science.gov (United States)

    Hamdamian, Sepideh; Nazarpour, Soheila; Simbar, Masoumeh; Hajian, Sepideh; Mojab, Faraz; Talebi, Atefeh

    2018-03-01

    Reducing labor pain and anxiety is one of the most important goals of maternity care. This study aimed to assess the effects of aromatherapy with Rosa damascena on pain and anxiety in the first stage of labor among nulliparous women. This was a randomized clinical trial of 110 nulliparous women. The eligible participants were randomly assigned to two groups of aromatherapy and control in an Iranian maternity hospital. The participants received 0.08 mL of Rosa damascena essence in the aromatherapy group and 0.08 mL of normal saline in the control group, every 30 min. Pain was measured 3 times, once each at three stages of cervical dilation (4-5, 6-7, and 8-10 cm). Anxiety was measured twice, once each at two stages of cervical dilation (4-7 and 8-10 cm). The tools for data collection were the Spielberger anxiety questionnaire, numerical pain rating scale, demographic and obstetric questionnaire, and an observational checklist. Data analyses included the t-test, Mann-Whitney U test and Chi-square test. Severity of labor pain and severity of anxiety were used as primary outcome measures. Labor and delivery characteristics (including number of contractions, duration of contractions in second stage, Bishop score, augmentation by oxytocin, Apgar score, and mode of delivery), demographic characteristics, and fertility information were used as secondary outcome measures. Pain severity in the group receiving aromatherapy with R. damascena was significantly lower than in the control group after treatment at each pain assessment (cervical dilation of 4-5, 6-7, and 8-10 cm; P labor. Aromatherapy with R. damascena is a convenient and effective method for pain and anxiety reduction during the first stage of labor. Iranian Registry of Clinical Trial: IRCT201306258801N3. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

  1. Personality predicts perceived availability of social support and satisfaction with social support in women with early stage breast cancer.

    Science.gov (United States)

    Den Oudsten, Brenda L; Van Heck, Guus L; Van der Steeg, Alida F W; Roukema, Jan A; De Vries, Jolanda

    2010-04-01

    This study examines the relationships between personality, on the one hand, and perceived availability of social support (PASS) and satisfaction with received social support (SRSS), on the other hand, in women with early stage breast cancer (BC). In addition, this study examined whether a stressful event (i.e., diagnosis) is associated with quality of life (QOL), when controlling for PASS and SRSS. Women were assessed on PASS and SRSS (World Health Organization QOL assessment instrument-100) before diagnosis (time 1) and 1 (time 2), 3 (time 3), 6 (time 4), 12 (time 5), and 24 months (time 6) after surgical treatment. Personality (neuroticism extraversion openness five-factor inventory and state trait anxiety inventory-trait scale) and fatigue (fatigue assessment scale) were assessed at time 1. Agreeableness and fatigue predicted PASS and SRSS at time 5 and time 6. Trait anxiety had a negative effect on SRSS (ss = -0.22, p personality factors substantially influence the way women with early stage BC perceive social support. Knowledge about these underlying mechanisms of social support is useful for the development of tailor-made interventions. Professionals should be aware of the importance of social support. They should check whether patients have sufficient significant others in their social environment and be sensitive to potential discrepancies patients might experience between availability and adequacy of social support.

  2. Profile of prognostic factors in 1022 Indian women with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Dinshaw, Ketayun A.; Budrukkar, Ashwini N.; Chinoy, Roshan F.; Sarin, Rajiv; Badwe, Rajendra M.S.; Hawaldar, Rohini; Shrivastava, Shyam Kishore

    2005-01-01

    Purpose: The outcome of breast cancer treatment can vary in different geographic and ethnic groups. A multivariate analysis was performed for various prognostic factors in 1022 Indian women with pathologic Stage I-II breast cancer treated between 1980 and 2000 with standard breast-conserving therapy with or without systemic adjuvant therapy. Methods and Materials: At a mean follow-up of 53 months, the outcomes studied were local failure, locoregional failure, and distant failure, overall survival (OS), and disease-free survival (DFS). Results: The median pathologic tumor size was 3 cm (range, 1-5 cm), and axillary lymph node metastasis was present in 39% of women. The actuarial 5- and 10-year OS and DFS rate was 87% and 77% and 76% and 68%, respectively. Lymphovascular emboli or invasion (LVI) was the strongest independent adverse factor for all failure and survival (local failure, hazard ratio 2.85; 95% confidence interval, 1.68-4.83; OS; hazard ratio, 2.01, 95% confidence interval, 1.35-2.99). Lymph node metastasis was also an independent adverse factor for local failure, locoregional failure, distant failure, DFS, and OS (hazard ratio, 1.55, 95% confidence interval, 1.04-2.30). Age ≤40 years increased the incidence of local recurrence, and patients with inner quadrant tumors had inferior DFS. The incidence of LVI was significantly greater in women with lymph node metastases than in node-negative women (p < 0.001) and in women with Grade 3 tumors than in those with Grade 1 or 2 tumors (p = 0.001). Conclusion: In Indian women, LVI was the strongest independent prognostic factor for OS, DFS, and local recurrence, irrespective of nodal status and systemic adjuvant treatment. Although LVI may not be a contraindication for BCT, as has been proposed by certain groups, it is necessary to define its role in prospective studies in determining local and systemic treatment

  3. Fat necrosis in women with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy

    International Nuclear Information System (INIS)

    Budrukkar, Ashwini; Jagtap, Vikas; Kembhavi, Seema; Munshi, Anusheel; Jalali, Rakesh; Seth, Tanuja; Parmar, Vani; Raj Upreti, Ritu; Badwe, Rajendra; Sarin, Rajiv

    2012-01-01

    Purpose: To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it. Methods and materials: Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters. Results: At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4–62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p = 0.04). Conclusions: Actuarial FN rate of 18% at 5 years in our study was comparable to other reported series of FN. Median time of detection of FN was 24 months. Higher volume of excision resulted in an increased incidence of fat necrosis.

  4. Comorbidity between personality disorders and depressive symptomatology in women: A cross-sectional study of three different transitional life stages.

    Science.gov (United States)

    Enfoux, Aurore; Courtois, Robert; Duijsens, Inge; Reveillere, Christian; Senon, Jean Louis; Magnin, Guillaume; Voyer, Melanie; Montmasson, Helene; Camus, Vincent; El-Hage, Wissam

    2013-08-01

    This study assessed the prevalence of personality disorders (PDs), according to DSM-IV criteria, in relation to depressive symptomatology at three different periods of life in female subjects. Depressive symptoms and personality disorders were assessed in a sample of 568 women from three different transitional stages: 134 students, 314 primiparous women after childbirth and 120 women diagnosed with breast cancer. Depressive symptoms were assessed by the Hospital Depression and Anxiety Scale in the first and third groups and by the Edinburgh Post-natal Depression Scale in the second group, whereas PDs were assessed by the French version of the Vragenlijst voor Kenmerken van de Persoonlijkheid. Depressive symptomatology and rates of PD (20.4% and 6.3%) were equivalent in the three groups. The prevalence of PD was higher in the depressed group compared with the non-depressed group, with more paranoid, borderline, avoidant, obsessive-compulsive, schizotypal, antisocial, dependent and histrionic PD. Our findings support the hypothesis that PDs are more frequently associated with depressive symptoms. Borderline and avoidant PDs were more prevalent among young women. All cluster C PD (dependent, avoidant and obsessive-compulsive) co-occurred significantly with depressive symptoms. Copyright © 2013 John Wiley & Sons, Ltd.

  5. CCDC22 gene polymorphism is associated with advanced stages of endometriosis in a sample of Brazilian women.

    Science.gov (United States)

    de Oliveira Francisco, Daniela; de Paula Andres, Marina; Gueuvoghlanian-Silva, Bárbara Yasmim; Podgaec, Sergio; Fridman, Cintia

    2017-07-01

    Based on the assumption that genetic factors are involved in the etiology of endometriosis, this study aimed to investigate the possibility of rs498679 (TLR4 gene), rs1799964 (TNF-α gene), rs3024496 (IL-10 gene), and rs2294021 (CCDC22 gene) polymorphisms being associated with the occurrence of this disease in a sample of Brazilian women. We conducted a case-control study with 100 women with histological confirmation of endometriosis (endometriosis group) and 100 women submitted to laparoscopy for benign disorders, in which the absence of endometriosis was confirmed (control group). All samples were genotyped by real-time PCR technique for rs498679, rs1799964, rs3024496, and rs2294021 polymorphisms. No significant difference was observed in genotypic or allelic frequencies between control and endometriosis groups for rs498679 (TLR4 gene), rs1799964 (TNF-α gene), rs3024496 (IL-10 gene), neither when comparing endometriosis subgroups (I-II versus III-IV). On the other hand, significant difference between stages I-II and III-IV of the disease was found in genotypic and allelic frequencies for the rs2294021 (CCDC22 gene) SNP (p = 0.048 and p = 0.017, respectively). Our results suggest that the rs2294021 (CCDC22 gene) polymorphism could be associated with increased susceptibility to endometriosis in Brazilian women when the allele C is present. In order to clarify this result, further studies should be conducted on a larger population.

  6. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival

    International Nuclear Information System (INIS)

    Le, Gem M; O'Malley, Cynthia D; Glaser, Sally L; Lynch, Charles F; Stanford, Janet L; Keegan, Theresa HM; West, Dee W

    2005-01-01

    Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects. We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco–Oakland, in Seattle–Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnosed with early or unstaged first primary breast cancer between 1983 and 1989, treated with mastectomy. The women were followed for a median of 12.4 years (n = 4968). Breast implant usage was validated by medical record review. Cox proportional hazards models were used to estimate hazard rate ratios for survival time until death due to breast cancer or other causes for women with and without breast implants, adjusted for relevant patient and tumor characteristics. Twenty percent of cases received postmastectomy breast implants, with silicone gel-filled implants comprising the most common type. Patients with implants were younger and more likely to have in situ disease than patients not receiving implants. Risks of breast cancer mortality (hazard ratio, 0.54; 95% confidence interval, 0.43–0.67) and nonbreast cancer mortality (hazard ratio, 0.59; 95% confidence interval, 0.41–0.85) were lower in patients with implants than in those patients without implants, following adjustment for age and year of diagnosis, race/ethnicity, stage, tumor grade, histology, and radiation therapy. Implant type did not appear to influence long-term survival. In a large, population-representative sample, breast implants following mastectomy do not appear to confer any survival disadvantage following early-stage breast cancer in women younger than 65 years old

  7. Stereotypes of women in different stages of their reproductive life: data from Mexico and the United States.

    Science.gov (United States)

    Marván, Ma Luisa; Islas, Martha; Vela, Laura; Chrisler, Joan C; Warren, Elyse A

    2008-08-01

    College students from Mexico and the United States (n = 349) were surveyed to explore stereotypes regarding women in different menstrual cycle phases and other stages of reproductive life. Participants from both countries defined a premenstrual or menstrual woman as irritable and moody and a menopausal woman as old and irritable. A woman with a hysterectomy was defined as sad, and only Americans used other words that did not have any negative connotation. Participants used some positive adjectives to describe other stages. For example, a pregnant woman was defined as happy, but only by Mexicans. Finally, a woman with a young baby was defined in both countries as happy; however, Americans implied that having a baby is complicated. The findings are discussed in light of sociocultural differences and similarities.

  8. Staging of women with breast cancer after introduction of sentinel node guided axillary dissection

    DEFF Research Database (Denmark)

    Tvedskov, Tove Filtenborg

    2012-01-01

    Today, sentinel lymph node dissection (SLND) has replaced axillary lymph node dissection (ALND) as standard procedure for staging of the axilla in the treatment of breast cancer. SLND can accurately stage the axilla by removing on average only two lymph nodes. Only in case of metastatic spread...... was not significantly different in the two periods, whereas the proportion of patients with micrometastases increased significantly from 5.1% to 9.0%. However, the proportion of patients offered adjuvant systemic treatment due to positive nodal status as the only high-risk criterion did only increase from 7.8% to 8...

  9. Genetic variants at 1p11.2 and breast cancer risk: a two-stage study in Chinese women.

    Directory of Open Access Journals (Sweden)

    Yue Jiang

    Full Text Available BACKGROUND: Genome-wide association studies (GWAS have identified several breast cancer susceptibility loci, and one genetic variant, rs11249433, at 1p11.2 was reported to be associated with breast cancer in European populations. To explore the genetic variants in this region associated with breast cancer in Chinese women, we conducted a two-stage fine-mapping study with a total of 1792 breast cancer cases and 1867 controls. METHODOLOGY/PRINCIPAL FINDINGS: Seven single nucleotide polymorphisms (SNPs including rs11249433 in a 277 kb region at 1p11.2 were selected and genotyping was performed by using TaqMan® OpenArray™ Genotyping System for stage 1 samples (878 cases and 900 controls. In stage 2 (914 cases and 967 controls, three SNPs (rs2580520, rs4844616 and rs11249433 were further selected and genotyped for validation. The results showed that one SNP (rs2580520 located at a predicted enhancer region of SRGAP2 was consistently associated with a significantly increased risk of breast cancer in a recessive genetic model [Odds Ratio (OR  =  1.66, 95% confidence interval (CI  =  1.16-2.36 for stage 2 samples; OR  =  1.51, 95% CI  =  1.16-1.97 for combined samples, respectively]. However, no significant association was observed between rs11249433 and breast cancer risk in this Chinese population (dominant genetic model in combined samples: OR  =  1.20, 95% CI  =  0.92-1.57. CONCLUSIONS/SIGNIFICANCE: Genotypes of rs2580520 at 1p11.2 suggest that Chinese women may have different breast cancer susceptibility loci, which may contribute to the development of breast cancer in this population.

  10. Differentiated Evaluation of Extract-Specific Evidence on Cimicifuga racemosa's Efficacy and Safety for Climacteric Complaints.

    Science.gov (United States)

    Beer, A-M; Neff, A

    2013-01-01

    Past reviews on Cimicifuga racemosa (CR) without differentiation between extracts, quality, and indication altogether led to inconsistent data. Therefore, for the first time, we meet the requirements of the system's logic of evidence-based phytotherapy by taking into consideration extracts, pharmaceutical quality (reflected in a regulatory status as medicinal product), and indication. A literature search for clinical studies examining CR's efficacy and safety for menopausal complaints was conducted. The results were sorted by type of extract, regulatory status, and indication. Accordingly, Oxford Levels of Evidence (LOE) and Grades of Recommendation (GR) were determined. CR extracts demonstrated a good to very good safety in general, on estrogen-sensitive organs and the liver. However, only registered CR medicinal products were able to prove their efficacy. Best evidence was provided by the isopropanolic CR extract (iCR): the multitude of studies including more than 11,000 patients demonstrated consistent confirmatory evidence of LOE 1b (LOE 1a for safety) leading to GR A. The studies on the ethanolic extract BNO 1055 including more than 500 patients showed exploratory evidence of LOE 2b resulting in GR B. A positive benefit-risk profile is stated and limited to Cimicifuga racemosa products holding a marketing authorisation for treating climacteric complaints.

  11. Breast and cervical cancers diagnosed and stage at diagnosis among women served through the National Breast and Cervical Cancer Early Detection Program.

    Science.gov (United States)

    Miller, Jacqueline W; Royalty, Janet; Henley, Jane; White, Arica; Richardson, Lisa C

    2015-05-01

    To assess cancers diagnosed and the stage of cancer at the time of diagnosis among low-income, under-insured, or uninsured women who received services through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Using the NBCCEDP database, we examined the number and percent of women diagnosed during 2009-2011 with in situ breast cancer, invasive breast cancer, and invasive cervical cancer by demographic and clinical characteristics, including age, race and ethnicity, test indication (screening or diagnostic), symptoms (for breast cancer), and screening history (for cervical cancer). We examined these characteristics by stage at diagnosis, a new variable included in the database obtained by linking with state-based central cancer registries. There were 11,569 women diagnosed with invasive breast cancer, 1,988 with in situ breast cancer, and 583 with invasive cervical cancer through the NBCCEDP. Women who reported breast symptoms or who had diagnostic mammography were more likely to be diagnosed with breast cancer, and at a later stage, than those who did not have symptoms or who had screening mammography. Women who had been rarely or never screened for cervical cancer were more likely to be diagnosed with cervical cancer, and at a later stage, than women who received regular screenings. Women served through the NBCCEDP who have not had prior screening or who have symptoms were more often diagnosed with late-stage disease.

  12. Health behaviors of postmenopausal women

    Directory of Open Access Journals (Sweden)

    Maria Jasińska

    2014-03-01

    Full Text Available Introduction: Health status and health-related quality of life of postmenopausal women are issues, which nowadays pose a serious challenge to many domains of science. Climacteric symptoms which occur at this stage of life, lower its quality and make a negative contribution to self-reported health status, are mostly observed in a particular group of women. Evaluation of health behaviors performed using a standardized questionnaire, the Health Behavior Inventory (HBI, may help establish a comprehensive diagnosis of women’s health, and thus select effective interventions. A systemic approach to menopause assumes that full fitness of women and good quality of their lives can be maintained not only by means of pharmacotherapy but also other forms of action, especially health education oriented towards changes in the lifestyle and promotion of healthy behaviors. The aim of this study is to perform a HBI-based assessment of women’s health behaviors in such categories as healthy eating habits (HEH, preventive behaviors (PB, positive mental attitudes (PMA, and health practices (HP. Material and methods: The study involved 151 healthy postmenopausal women. A research tool was a standardized questionnaire, the Health Behavior Inventory (HBI. Results: The surveyed women obtained 70% of the maximum score on average, which suggests a medium level of health behaviors in this group. The levels of health behaviors in the categories of positive mental attitudes and health practices significantly differed between older women and their younger counterparts (higher levels were observed among older respondents. There were also significant differences in the levels of healthy behaviors between women with secondary and higher education (those better educated declared healthy behaviors more often. There was no correlation between the level of health behaviors and the BMI of the surveyed women. Conclusions : Older women attached greater

  13. Expression profiling of cervical cancers in Indian women at different stages to identify gene signatures during progression of the disease

    International Nuclear Information System (INIS)

    Thomas, Asha; Mahantshetty, Umesh; Kannan, Sadhana; Deodhar, Kedar; Shrivastava, Shyam K; Kumar-Sinha, Chandan; Mulherkar, Rita

    2013-01-01

    Cervical cancer is the second most common cancer among women worldwide, with developing countries accounting for >80% of the disease burden. Although in the West, active screening has been instrumental in reducing the incidence of cervical cancer, disease management is hampered due to lack of biomarkers for disease progression and defined therapeutic targets. Here we carried out gene expression profiling of 29 cervical cancer tissues from Indian women, spanning International Federation of Gynaecology and Obstetrics (FIGO) stages of the disease from early lesion (IA and IIA) to progressive stages (IIB and IIIA–B), and identified distinct gene expression signatures. Overall, metabolic pathways, pathways in cancer and signaling pathways were found to be significantly upregulated, while focal adhesion, cytokine–cytokine receptor interaction and WNT signaling were downregulated. Additionally, we identified candidate biomarkers of disease progression such as SPP1, proliferating cell nuclear antigen (PCNA), STK17A, and DUSP1 among others that were validated by quantitative real-time polymerase chain reaction (qRT-PCR) in the samples used for microarray studies as well in an independent set of 34 additional samples. Integrative analysis of our results with other cervical cancer profiling studies could facilitate the development of multiplex diagnostic markers of cervical cancer progression

  14. Psychosocial factors and mortality in women with early stage endometrial cancer.

    Science.gov (United States)

    Telepak, Laura C; Jensen, Sally E; Dodd, Stacy M; Morgan, Linda S; Pereira, Deidre B

    2014-11-01

    Psychosocial factors have previously been linked with survival and mortality in cancer populations. Little evidence is available about the relationship between these factors and outcomes in gynaecologic cancer populations, particularly endometrial cancer, the fourth most common cancer among women. This study examined the relationship between several psychosocial factors prior to surgical resection and risk of all-cause mortality in women with endometrial cancer. The study utilized a non-experimental, longitudinal design. Participants were 87 women (Mage  = 60.69 years, SDage  = 9.12 years) who were diagnosed with T1N0-T3N2 endometrial cancer and subsequently underwent surgery. Participants provided psychosocial data immediately prior to surgery. Survival statuses 4-5 years post-diagnoses were abstracted via medical record review. Cox regression was employed for the survival analysis. Of the 87 women in this sample, 21 women died during the 4- to 5-year follow-up. Adjusting for age, presence of regional disease and medical comorbidity severity (known biomedical prognostic factors), greater use of an active coping style prior to surgery was significantly associated with a lower probability of all-cause mortality, hazard ratio (HR) = 0.78, p = .04. Life stress, depressive symptoms, use of self-distraction coping, receipt of emotional support and endometrial cancer quality of life prior to surgery were not significantly associated with all-cause mortality 4-5 years following diagnosis. Greater use of active coping prior to surgery for suspected endometrial cancer is associated with lower probability of all-cause mortality 4-5 years post-surgery. Future research should attempt to replicate these relationships in a larger and more representative sample and examine potential behavioural and neuroendocrine/immune mediators of this relationship. What is already known on this subject? Psychosocial factors have previously been linked with clinical outcomes in a

  15. Men and women show similar survival outcome in stage IV breast cancer.

    Science.gov (United States)

    Wu, San-Gang; Zhang, Wen-Wen; Liao, Xu-Lin; Sun, Jia-Yuan; Li, Feng-Yan; Su, Jing-Jun; He, Zhen-Yu

    2017-08-01

    To evaluate the clinicopathological features, patterns of distant metastases, and survival outcome between stage IV male breast cancer (MBC) and female breast cancer (FBC). Patients diagnosed with stage IV MBC and FBC between 2010 and 2013 were included using the Surveillance, Epidemiology, and End Results program. Univariate and multivariate Cox regression analyses were used to analyze risk factors for overall survival (OS). A total of 4997 patients were identified, including 60 MBC and 4937 FBC. Compared with FBC, patients with MBC were associated with a significantly higher rate of estrogen receptor-positive, progesterone receptor-positive, unmarried, lung metastases, and a lower frequency of liver metastases. Univariate and multivariate analyses showed no significant difference in OS between MBC and FBC. In the propensity score-matched population, there was also no difference in survival between MBC and FBC. Multivariate analysis of MBC showed that OS was longer for patients aged 50-69 years and with estrogen receptor-positive disease. There was no significant difference in survival outcome between stage IV MBC and FBC, but significant differences in clinicopathological features and patterns of metastases between the genders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Association of the severity of diabetes-related complications with stage of breast cancer at diagnosis among elderly women with pre-existing diabetes.

    Science.gov (United States)

    Alenzi, Ebtihag O; Madhavan, S Suresh; Tan, Xi

    2018-01-01

    This study assessed the association between the severity of diabetes complications using diabetes complications severity index (DCSI) and stage of breast cancer (BC) at diagnosis among elderly women with pre-existing diabetes and incident BC. Using Surveillance, Epidemiology and End Results-Medicare data, we identified women with incident BC during 2004-2011 and pre-existing diabetes (N = 7729). Chi-square tests were used to test for group differences in stage of BC at diagnosis. Multinomial logistic regression was used to examine the associations between the severity of diabetes complications and stage of BC at diagnosis. Overall, women with a DCSI = 2 and a DCSI ≥ 3 were more likely to be diagnosed at advanced stages as compared to those with no diabetes complications. In full adjusted association (after adding BC screening to the analysis model), the severity of diabetes complications was no longer an independent predictor of advanced stages at diagnosis. However, women with a DCSI = 2 were 26% more likely to be diagnosed at stage I (versus stage 0) of BC at diagnosis as compared to those without diabetes complications (OR 1.26, 95% CI 1.03-1.53). The increased likelihood of having advanced-stage BC at diagnosis associated with severity of diabetes-related complications appears to be mediated by lower rates of breast cancer screening among elderly women with pre-existing diabetes complications. Therefore, reducing disparity in receiving breast cancer screening among elderly women with diabetes may reduce the risk of advanced-stage breast cancer diagnosis.

  17. [Benefits of moderate beer consumption at different stages of life of women].

    Science.gov (United States)

    Pérez Medina, Tirso; de Argila Fernández-Durán, Nuria; Pereira Sánchez, Augusto; Serrano González, Lucía

    2015-07-18

    Beer is a natural beverage low calorie, low degree of alcohol, no fats or sugars and a significant amount of carbohydrates, vitamins, and proteins. Beneficial health qualities are based on the presence in the beer of antioxidant compounds (polyphenols), which reduce the presence of free radicals in the organism, and phytoestrogens, elements biosimilars to natural estrogens. In pregnant women, beer, obviously alcohol-free, presents elements in its composition that differ it from other fermented beverages as it is the folic acid, vitamin necessary to prevent defects of the neural tube in the fetus or regulate homocysteine. With regard to breastfeeding, beer alcohol-free supplementation increases the antioxidant activity in breast milk and therefore reduces the oxidative stress of the newborn after birth In menopause, the presence of antioxidants, vitamins, nutrients, and dietetic fiber, as well as phytoestrogens, is highly beneficial in the prevention of pathologies arising from the decline in estrogens. Osteoporosis also is effectively combated by the beer. The intake of beer, favors a greater bone mass in women, irrespective of their gonadal status. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Clinical significance of determination of changes of serum SF, folic acid and vitamin B{sub 12} levels in pregnant women of different gestational stages

    Energy Technology Data Exchange (ETDEWEB)

    Hua, Jiang [Taizhou City Women and Children Health Station, Jiangsu, Taizhou (China)

    2007-10-01

    Objective: To explore the changes of serum SF, FA and Vitamin Bn levels in pregnant women of different gestational stages. Methods: Levels of serum SF, fore acid and Vitamin B{sub 12} were detected with RIA in 132 pregnant women of different gestational stages and 35 controls (non-pregant women). Results: Serum SF, folic acid and VitB{sub 12} levels were significantly lower in pregnant women of 2nd and 3rd trimester than those in controls (P<0.01), but expect in pregnant women of 1st trimester. Conclusion: Serum SF, folio acid and Vitamin B{sub l2} levels were low in late pregnancy predisposing to development anemia. (authors)

  19. The effects of tibolone on vaginal blood flow, sexual desire and arousability in postmenopausal women

    NARCIS (Netherlands)

    Laan, E.; van Lunsen, R. H.; Everaerd, W.

    2001-01-01

    AIMS: To compare the effects of 3 months' tibolone treatment with the effects of placebo on sexual function (in particular, vaginal blood flow, and sexual desire and arousability) and climacteric symptoms in postmenopausal women. METHODS: A randomized, double-blind, cross-over study was conducted in

  20. Can Locoregional Treatment of the Primary Tumor Improve Outcomes for Women With Stage IV Breast Cancer at Diagnosis?

    International Nuclear Information System (INIS)

    Nguyen, David H.A.; Truong, Pauline T.; Alexander, Cheryl; Walter, Caroline V.; Hayashi, Emily; Christie, Jennifer; Lesperance, Mary

    2012-01-01

    Purpose: To examine the effect of locoregional treatment (LRT) of the primary tumor on survival in patients with Stage IV breast cancer at diagnosis. Methods and Materials: The study cohort comprised 733 women referred to the British Columbia Cancer Agency between 1996 and 2005 with newly diagnosed clinical or pathologic M1 breast cancer. Tumor and treatment characteristics, overall survival (OS), and locoregional progression-free survival were compared between patients treated with (n = 378) and without (n = 355) LRT of the primary disease. Multivariable analysis was performed with Cox regression modeling. Results: The median follow-up time was 1.9 years. LRT consisted of surgery alone in 67% of patients, radiotherapy alone in 22%, and both in 11%. LRT was used more commonly in women with age <50 years, Eastern Cooperative Oncology Group (ECOG) performance status 0–1, Stage T1–2 tumors, N0–1 disease, limited M1 burden, and asymptomatic M1 disease (all p < 0.05). Systemic therapy was used in 92% of patients who underwent LRT and 85% of patients who did not. In patients treated with LRT compared with those without LRT, the 5-year OS rates were 21% vs. 14% (p < 0.001), and the rates of locoregional progression-free survival were 72% vs. 46% (p < 0.001). Among 378 patients treated with LRT, the rates of 5-year OS were higher in patients with age <50, ECOG performance status 0–1, estrogen receptor–positive disease, clear surgical margins, single subsite, bone-only metastasis, and one to four metastatic lesions (all p < 0.003). On multivariable analysis, LRT was associated with improved OS (hazard ratio, 0.78; 95% confidence interval, 0.64–0.94, p = 0.009). Conclusion: Locoregional treatment of the primary disease is associated with improved survival in some women with Stage IV breast cancer at diagnosis. Among those treated with LRT, the most favorable rates of survival were observed in subsets with young age, good performance status, estrogen receptor

  1. The effect of inflatable obstetric belts in nulliparous pregnant women receiving patient-controlled epidural analgesia during the second stage of labor.

    Science.gov (United States)

    Kim, Jong-Woon; Kim, Yoon Ha; Cho, Hye Yon; Shin, Hee-Young; Shin, Jong Chul; Choi, Sea Kyung; Lee, Keun-Young; Song, Ji-Eun; Lee, Pil-Ryang

    2013-11-01

    The aim of this study was to evaluate the effect of inflatable obstetric belts on uterine fundal pressure in the management of the second stage of labor. Between July 2009 and December 2010, 188 nulliparous women with a singleton pregnancy at term were enrolled and only one dropped. The participants were randomized to receive either standard care (control group, n = 91) or uterine fundal pressure by the Labor Assister (Baidy M-520/Curexo, Inc., Seoul, Korea; active group, n = 97) during the second stage of labor in addition to standard care. The Labor Assister is an inflatable obstetric belt that is synchronized to apply constant fundal pressure during a uterine contraction. The primary endpoint was duration of the second stage of labor in women who delivered vaginally (control, n = 80 versus active, n = 93). It was not analyzed in women who delivered by cesarean section (n = 14) and delivered precipitously (n = 1). The secondary outcomes are perinatal outcomes and perineal laceration. Participants received patient-controlled epidural analgesia. The 93 women in the active group spent less time in the second stage of labor when compared to the 80 women in the control group (46.51 ± 28.01 min versus 75.02 ± 37.48 min, p labor without complications in nulliparous women who receive patient-controlled epidural analgesia.

  2. Personal and socio-psychological characteristics of women of reproductive age, operated on for symptomatic endometriod desease, at the stage of pregnancy planning

    Directory of Open Access Journals (Sweden)

    T. P. Chuieva-Pavlovska

    2017-10-01

    Full Text Available Endometrioid disease occurs in every tenth woman of reproductive age and often leads not only to physical discomfort, but also frustrates them psychosocially, reduces professional, psychosocial and reproductive adaptation in general. The aim: to reveal the personal and psychosocial characteristics of women at the stage of pregnancy planning, operated on for symptomatic endometriosis, in connection with the task of optimizing the management and improvement of pregnancy outcomes. Material and methods. Under observation, there were 123 women operated on for symptomatic endometriosis, 125 somatically and gynecologically conditionally healthy fertile women. All the women were going to plan a pregnancy. The diagnosis of endometriosis in all cases was identified histologically. The psychosocial and personal characteristics of these women at the stage of pregnancy planning were studied. Conclusions.  The peculiarities of the personal and psychosocial characteristics of women at the stage of pregnancy planning, operated on for symptomatic endometriosis, are unfavorable child-parent relations, destructive relationships with their own mother, complicated course of pregnancy in the mother, high personal anxiety, impaired sex and age identification in women, inadequate (infantile, disadaptive forms of responding to stressful situations, emotional instability.

  3. The effects of stair climbing on arterial stiffness, blood pressure, and leg strength in postmenopausal women with stage 2 hypertension.

    Science.gov (United States)

    Wong, Alexei; Figueroa, Arturo; Son, Won-Mok; Chernykh, Oksana; Park, Song-Young

    2018-02-12

    Menopause is accompanied by a progressive arterial stiffening associated with increases in blood pressure (BP) and decline in muscular function. It is crucial to prevent or reduce the negative effects of menopause on vascular and muscular function by implementing appropriate lifestyle interventions, such as exercise training. We examined the effects of a stair climbing (SC) regimen on arterial stiffness (pulse wave velocity [PWV]), BP, and leg strength in postmenopausal women with stage 2 hypertension. Using a parallel experimental design, participants were randomly assigned to either SC (n = 21) or nonexercising control group (n = 20) for 12 weeks. Participants in the SC group trained 4 d/wk, climbing 192 steps 2 to 5 times/d. Participants' brachial-to-ankle PWV (baPWV), BP, and leg strength were measured at baseline and after 12 weeks of their assigned intervention. There was a significant group by time interaction (P hypertensive postmenopausal women. The decrease in arterial stiffness partially explained the improvements in SBP and leg strength. SC may be an effective intervention in the prevention and treatment of menopause/aging-related vascular complications and muscle weakness.

  4. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study.

    Science.gov (United States)

    Briese, Volker; Stammwitz, Ute; Friede, Michael; Henneicke-von Zepelin, Hans-Heinrich

    2007-08-20

    To evaluate usage pattern, effectiveness and safety of Black cohosh alone or in fixed combination with St. John's wort on menopausal symptoms in general clinical practice. Prospective, controlled open-label observational study of 6141 women at 1287 outpatient gynecologists in Germany. Subjects were treated with recommended doses of study therapies, with treatment chosen by the participating physicians. Patients were followed up for 6 months, optionally 12 months. The primary effectiveness variable was Menopause Rating Scale (MRS) subscore PSYCHE at Month 3 evaluated by ANCOVA. The treatment groups were comparable at baseline, excepting the main MRS score and the PSYCHE score (monotherapy: 0.31+/-0.22; combination therapy: 0.42+/-0.23). Reductions from baseline were seen with both regimens for all variables. The changes in the primary variable remained significantly different between groups (p<0.001) when adjusted for differences at baseline with the combination therapy being superior: from 0.37 (adjusted) to 0.25 (95% CI: 0.24-0.25) and 0.23 (95% CI: 0.22-0.23) at Month 3 in the monotherapy and combination-therapy groups, respectively. The improvement by both therapies was maintained at 6 and 12 months. The rate of possibly treatment-related adverse events was 0.16%, all non-serious. The results support the effectiveness and tolerability profiles of two Black cohosh-based therapies for menopausal symptoms in general practice. They were used differentially: the monotherapy for neurovegetative symptoms, the combination for patients with more pronounced mood complaints. The fixed combination of Black cohosh and St. John's wort was superior to Black cohosh alone in alleviating climacteric mood symptoms.

  5. Human breast tissue disposition and bioactivity of limonene in women with early stage breast cancer

    Science.gov (United States)

    Miller, Jessica A.; Lang, Julie E.; Ley, Michele; Nagle, Ray; Hsu, Chiu-Hsieh; Thompson, Patricia A; Cordova, Catherine; Waer, Amy; Chow, H.-H. Sherry

    2013-01-01

    Limonene is a bioactive food component found in citrus peel oil that has demonstrated chemopreventive and chemotherapeutic activities in preclinical studies. We conducted an open label pilot clinical study to determine the human breast tissue disposition of limonene and its associated bioactivity. We recruited forty-three women with newly diagnosed operable breast cancer electing to undergo surgical excision to take 2 grams of limonene daily for 2 – 6 weeks before surgery. Blood and breast tissue were collected to determine drug/metabolite concentrations and limonene-induced changes in systemic and tissue biomarkers of breast cancer risk or carcinogenesis. Limonene was found to preferentially concentrate in the breast tissue, reaching high tissue concentration (mean=41.3 μg/g tissue) while the major active circulating metabolite, perillic acid, did not concentrate in the breast tissue. Limonene intervention resulted in a 22% reduction in cyclin D1 expression (P=0.002) in tumor tissue but minimal changes in tissue Ki67 and cleaved caspase 3 expression. No significant changes in serum leptin, adiponectin, TGF-β1, IGFBP-3 and IL-6 levels were observed following limonene intervention. There was a small but statistically significant post-intervention increase in IGF-1 levels. We conclude that limonene distributed extensively to human breast tissue and reduced breast tumor cyclin D1 expression that may lead to cell cycle arrest and reduced cell proliferation. Further placebo-controlled clinical trials and translational research are warranted to establish limonene’s role for breast cancer prevention or treatment. PMID:23554130

  6. Human breast tissue disposition and bioactivity of limonene in women with early-stage breast cancer.

    Science.gov (United States)

    Miller, Jessica A; Lang, Julie E; Ley, Michele; Nagle, Ray; Hsu, Chiu-Hsieh; Thompson, Patricia A; Cordova, Catherine; Waer, Amy; Chow, H-H Sherry

    2013-06-01

    Limonene is a bioactive food component found in citrus peel oil that has shown chemopreventive and chemotherapeutic activities in preclinical studies. We conducted an open-label pilot clinical study to determine the human breast tissue disposition of limonene and its associated bioactivity. We recruited 43 women with newly diagnosed operable breast cancer electing to undergo surgical excision to take 2 grams of limonene daily for two to six weeks before surgery. Blood and breast tissue were collected to determine drug/metabolite concentrations and limonene-induced changes in systemic and tissue biomarkers of breast cancer risk or carcinogenesis. Limonene was found to preferentially concentrate in the breast tissue, reaching high tissue concentration (mean = 41.3 μg/g tissue), whereas the major active circulating metabolite, perillic acid, did not concentrate in the breast tissue. Limonene intervention resulted in a 22% reduction in cyclin D1 expression (P = 0.002) in tumor tissue but minimal changes in tissue Ki67 and cleaved caspase-3 expression. No significant changes in serum leptin, adiponectin, TGF-β1, insulin-like growth factor binding protein-3 (IGFBP-3), and interleukin-6 (IL-6) levels were observed following limonene intervention. There was a small but statistically significant postintervention increase in insulin-like growth factor I (IGF-I) levels. We conclude that limonene distributed extensively to human breast tissue and reduced breast tumor cyclin D1 expression that may lead to cell-cycle arrest and reduced cell proliferation. Furthermore, placebo-controlled clinical trials and translational research are warranted to establish limonene's role for breast cancer prevention or treatment.

  7. Quality of Life in Women with Stage 1 Stress Urinary Incontinence after Application of Conservative Treatment—A Randomized Trial

    Directory of Open Access Journals (Sweden)

    Magdalena Ptak

    2017-05-01

    Full Text Available Stress urinary incontinence (SUI influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life to determine the quality of life (QoL in various domains in patients with stage 1 SUI. The study included 140 perimenopausal women subjected to urodynamic tests at the Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Police (Poland in 2013–2015. The study subjects were divided into two groups, A and B. Each patient completed two questionnaires, an original survey developed by the authors and the validated ICIQ LUTS QoL. Two exercise programs, each lasting for 3 months and consisting of 4 weekly sessions, were recommended to the study subjects. The program for Group A included exercises for pelvic floor muscles (PFM with simultaneous tension of the transverse abdominal muscle (TrA, and the program for Group B, PFM exercises without TrA tension. After completing the exercise programs, patients with stage 1 SUI, both from Group A and from Group B, showed a significant improvement in most QoL domains measured with ICIQ LUTS QoL. However, more beneficial effects of the training were observed in the group subjected to PFM exercises with TrA tension.

  8. [The university stage does not favor the healthy life style in women students from Granada].

    Science.gov (United States)

    Gallardo-Escudero, Alba; Muñoz Alférez, María José; Planells del Pozo, Elena María; López Aliaga, Inmaculada

    2014-11-15

    The university stage involves a series of emotional, physiological and environmental changes that will determine consumer patterns that, in many cases, will be maintained and will affect their health. The aim of this study is to analyze the lifestyle (alcohol and tobacco consumption, and levels of physical activity) of female students at the University of Granada. Several authors have noted that the student population is particularly vulnerable to develop risk customs and habits, since the period of university studies is often the time when students take first responsibility for determining their own styles and customs, which in many cases will be maintained throughout its entire life. This is a cross / descriptive and analytical study in which 55 students participated in two age groups (18-24 and 25-31 years). A lifestyle-questionnaire was applied to evaluate the type and frequency of alcohol consumption, number of cigarettes smoked daily and physical activity levels (sedentary, light, moderate and severe). Alcohol consumption is higher in the older group, and preferably drinks beer and wine; however the younger group shows a pattern of consumption centered on the weekends being preferably consumed distilled beverages. A third of the population smokes with an increase in the number of cigarettes as age increases. There is a positive correlation between snuff and alcohol. A direct positive correlation between tobacco and alcohol was observed. The 88.9% of lesser age group and 52.7% of higher age group show a sedentary-low physical activity. The need to sensitize the college female population on the benefits of no-consumption of alcohol and snuff, and regular physical exercise is suggested. It would also be advisable to develop protocols of educational intervention in universities promoting healthy living habits. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. The Effect of Simvastatin on Breast Cancer Cell Growth in Women With Stage I-II Breast Cancer

    Science.gov (United States)

    2018-03-02

    Invasive Breast Carcinoma; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

  10. Effects of delayed pushing during the second stage of labor on postpartum fatigue and birth outcomes in nulliparous women.

    Science.gov (United States)

    Lai, Man-Lung; Lin, Kuan-Chia; Li, Hsin Yang; Shey, Kuang-Shing; Gau, Meei-Ling

    2009-03-01

    This article studied differences in postpartum fatigue and birth outcomes between women who pushed immediately and those who delayed pushing during the second stage of labor. Data were collected from primiparous women in their 38th to 42nd gestational week who did not receive epidural analgesia during labor and were free of complications during pregnancy. Using a quasi-experimental design, 72 participants selected by convenient sampling were assigned based on individual participant's preference to either an experimental or control group. For the experimental group, pushing was delayed until the point after full cervical dilation at which (a) the mother felt a strong physical pushing reflex, (b) the fetal head had both descended to at least the +1 level in the pelvis and turned to the occiput anterior position, and (c) uterine contractions were at least 30 mmHg. For the control group, the physician instructed mothers to begin pushing after full cervical dilation at the point when the fetal head was in the occiput anterior position and uterine contractions were at least 30 mmHg. The authors administered the Modified Fatigue Symptom Checklist at 1 and 24 hr after delivery to measure participant's fatigue levels. Birth outcomes were assessed based on medical chart data. Findings showed a significant difference between the two groups in terms of 1- and 24-hr postpartum fatigue scores. The duration of the second labor stage (experimental group, 70.31 +/- 37.17 min; control group, 129.06 +/- 75.69 min) also differed significantly. The group that pushed immediately recorded higher cesarean and instrument-assisted birth rates. No significant differences were observed in terms of perineal tears, maternal/neonatal complications, or neonatal Apgar scores. Results of this study provide important insights for caregivers working in the delivery room and suggest that current care procedures change to include the delayed pushing during the second stage of labor. By delaying pushing

  11. Use of the prone position in radiation treatment for women with early stage breast cancer

    International Nuclear Information System (INIS)

    Algan, Oezer; Fowble, Barbara; McNeeley, Shawn; Fein, Douglas

    1998-01-01

    Purpose: The prone position has been advocated for women with large pendulous breasts undergoing breast-conserving treatment with radiation therapy. However, there is no information in the literature regarding the coverage of the target volume with this technique. The purpose of this study was to evaluate the effectiveness of the prone treatment position in including at least the biopsy cavity with a 2-cm margin. Methods and Materials: Eleven consecutive patients who underwent CT simulation in the prone position were included in this study. Patients underwent CT simulation in the prone position using a flat platform containing an aperture for the breast to hang through in a dependent fashion. CT slices were 5-mm thick taken at 3-mm intervals. The biopsy cavity was localized and outlined on sequential CT images using the surgical clips (when present) as well as the residual seroma. A 2-cm margin was included around the biopsy cavity to define the minimal target volume (mTV). Lateral fields were used for treatment planning. The beam arrangements were considered adequate if the mTV was totally included in the lateral fields. Results: Median age of the patient population was 55 years. Bra sizes ranged from 36A-44DD. The majority of patients had mammographically detected T1 lesions. Median volume of the biopsy cavity was 48 cm 3 . Five of 11 (45%) patients underwent reexcision of the biopsy cavity, and 6 of 11 (55%) had surgical clips placed in the biopsy cavity. Overall, 8 of 11 (73%) patients did not have the entire mTV included in the lateral opposed tangential fields in the prone position. This was especially true in patients whose biopsy cavity extended down to the chest wall. There were no other clinical factors that could predict for the adequacy of coverage in the prone position. Conclusion: Special attention must be paid to the location of the surgical clips to determine the proximity of the biopsy cavity to the chest wall, or CT simulation should be performed

  12. Disorders of bone-mineral metabolism and their correction with women who have body weight deficiency at pregravid stage and during pregnancy

    Directory of Open Access Journals (Sweden)

    L. P. Shelestova

    2017-10-01

    Full Text Available The processes in bone-mineral metabolism provide normal course of pregnancy, labour and fetus development, women with body weight deficiency are at risk reduction of bone tissue mineral density, progressing of osteopenia and osteoporosis. This shows the necessity of medical and preventive measures that have the aim to correct calcium- phosphorus and bone metabolism with women who have body weight deficiency. Aim. To elaborate and to evaluate medical and preventive measures that have the aim to correct disorders in bone-mineral metabolism with women who have body weight deficiency at pregravid stage and during pregnancy. Materials and methods. The efficiency of adding combined medicine of calcium carbonate and cholecalciferol and dietary nourishment to traditional treatment that affected the state of bone-mineral metabolism with women who have body weight deficiency at pregravid stage and during pregnancy was studied. Results. With women who have body weight deficiency at pregravid stage and during pregnancy it is noted statistically considerable reduction in blood of total calcium and bone tissue markers that grows with the course of gestation. The changes in mineral density of bone tissue can be seen from the existence of osteopenic syndrome at pregravid stage that occurs with every third woman who has body weight deficiency and with every second before labour. The use of elaborated medical and preventive measures including combined medicine of calcium carbonate and cholecalciferol allows to normalize the indexes of bone-mineral metabolism with women who have body weight deficiency. Conclusions. Women with body weight deficiency already at pregravid stage have disorders in bone metabolism and coming of pregnancy lead to aggravation of bone metabolism disorders. The additional use of combined medicine of calcium carbonate and cholecalciferol and dietary nourishment made the indexes of calcium-phosphorus and bone metabolism better and osteopenic

  13. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  14. Development of Patients’ Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    International Nuclear Information System (INIS)

    Wong, Jennifer; D’Alimonte, Laura; Angus, Jan; Paszat, Larry; Metcalfe, Kelly; Whelan, Tim; Llewellyn-Thomas, Hilary; Warner, Eiran; Franssen, Edmee; Szumacher, Ewa

    2012-01-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor–positive progesterone receptor–positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients’ decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor–positive progesterone receptor–positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients’ satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option’s benefits, risks, and side effects tailored to the patient’s clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], −7.18; 95% confidence interval [CI], −13.50 to 12.59); increased clarity of the benefits and risks (AMD, −10.86; CI, −20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88–10.28) after using the PtDA. General trends were also reported in the patients’ choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may

  15. Aroma volatiles obtained at harvest by HS-SPME/GC-MS and INDEX/MS-E-nose fingerprint discriminate climacteric behaviour in melon fruit.

    Science.gov (United States)

    Chaparro-Torres, Libia A; Bueso, María C; Fernández-Trujillo, Juan P

    2016-05-01

    Melon aroma volatiles were extracted at harvest from juice of a climacteric near-isogenic line (NIL) SC3-5-1 with two quantitative trait loci (QTLs) introgressed which produced climacteric behaviour and its non-climacteric parental (PS) using two methodologies of analysis: static headspace solid phase micro-extraction (HS-SPME) by gas chromatography-mass spectrometry (GC-MS) and inside needle dynamic extraction (INDEX) by MS-based electronic nose (MS-E-nose). Of the 137 volatiles compounds identified, most were found at significantly higher concentrations in SC3-5-1 than in PS in both seasons. These volatiles were mostly esters, alcohols, sulfur-derived esters and even some aldehydes and others. The number of variables with high correlation values was reduced by using correlation network analysis. Partial least squares-discriminant analysis (PLS-DA) achieved the correct classification of PS and SC3-5-1. The ions m/z 74, 91, 104, 105, 106 and 108, mainly volatile derivatives precursor phenylalanine, were the most discriminant in SC3-5-1 and PS. As many as 104 QTLs were mapped in season 1 and at least 78 QTLs in each season with an effect above the PS mean. GC-MS gave better discrimination than E-nose. Most of the QTLs that mapped in both seasons enhanced aroma volatiles associated with climacteric behaviour. © 2015 Society of Chemical Industry.

  16. Breast Cancer Mortality in African-American and Non-Hispanic White Women by Molecular Subtype and Stage at Diagnosis: A Population-Based Study.

    Science.gov (United States)

    Tao, Li; Gomez, Scarlett Lin; Keegan, Theresa H M; Kurian, Allison W; Clarke, Christina A

    2015-07-01

    Higher breast cancer mortality rates for African-American than non-Hispanic White women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients. We obtained data for all invasive breast cancers diagnosed between January 1, 2005, and December 31, 2012, and followed through December 31, 2012, among 93,760 non-Hispanic White and 9,738 African-American women in California. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were used to calculate relative hazard (RH) and 95% confidence intervals (CI) for breast cancer-specific mortality. After adjustment for patient, tumor, and treatment characteristics, outcomes were comparable by race for stage I or IV cancer regardless of subtype, and HR(+)/HER2(+) or HR(-)/HER2(+) cancer regardless of stage. We found substantially higher hazards of breast cancer death among African-American women with stage II/III HR(+)/HER2(-) (RH, 1.31; 95% CI, 1.03-1.65; and RH, 1.39; 95% CI, 1.10-1.75, respectively) and stage III triple-negative cancers relative to Whites. There are substantial racial/ethnic disparities among patients with stages II/III HR(+)/HER2(-) and stage III triple-negative breast cancers but not for other subtype and stage. These data provide insights to assess barriers to targeted treatment (e.g., trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. ©2015 American Association for Cancer Research.

  17. Determinants of stage at diagnosis of breast cancer in Nigerian women: sociodemographic, breast cancer awareness, health care access and clinical factors.

    Science.gov (United States)

    Jedy-Agba, Elima; McCormack, Valerie; Olaomi, Oluwole; Badejo, Wunmi; Yilkudi, Monday; Yawe, Terna; Ezeome, Emmanuel; Salu, Iliya; Miner, Elijah; Anosike, Ikechukwu; Adebamowo, Sally N; Achusi, Benjamin; Dos-Santos-Silva, Isabel; Adebamowo, Clement

    2017-07-01

    Advanced stage at diagnosis is a common feature of breast cancer in Sub-Saharan Africa (SSA), contributing to poor survival rates. Understanding its determinants is key to preventing deaths from this cancer in SSA. Within the Nigerian Integrative Epidemiology of Breast Cancer Study, a multicentred case-control study on breast cancer, we studied factors affecting stage at diagnosis of cases, i.e. women diagnosed with histologically confirmed invasive breast cancer between January 2014 and July 2016 at six secondary and tertiary hospitals in Nigeria. Stage was assessed using clinical and imaging methods. Ordinal logistic regression was used to examine associations of sociodemographic, breast cancer awareness, health care access and clinical factors with odds of later stage (I, II, III or IV) at diagnosis. A total of 316 women were included, with a mean age (SD) of 45.4 (11.4) years. Of these, 94.9% had stage information: 5 (1.7%), 92 (30.7%), 157 (52.4%) and 46 (15.3%) were diagnosed at stages I, II, III and IV, respectively. In multivariate analyses, lower educational level (odds ratio (OR) 2.35, 95% confidence interval: 1.04, 5.29), not believing in a cure for breast cancer (1.81: 1.09, 3.01), and living in a rural area (2.18: 1.05, 4.51) were strongly associated with later stage, whilst age at diagnosis, tumour grade and oestrogen receptor status were not. Being Muslim (vs. Christian) was associated with lower odds of later stage disease (0.46: 0.22, 0.94). Our findings suggest that factors that are amenable to intervention concerning breast cancer awareness and health care access, rather than intrinsic tumour characteristics, are the strongest determinants of stage at diagnosis in Nigerian women.

  18. Local Recurrence in Women With Stage I Breast Cancer: Declining Rates Over Time in a Large, Population-Based Cohort

    Energy Technology Data Exchange (ETDEWEB)

    Canavan, Joycelin, E-mail: canavanjoycelin@gmail.com [Radiation Therapy Program and Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, British Columbia (Canada); Truong, Pauline T.; Smith, Sally L. [Radiation Therapy Program and Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, British Columbia (Canada); Lu, Linghong; Lesperance, Mary [Department of Mathematics and Statistics, University of Victoria, British Columbia (Canada); Olivotto, Ivo A. [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary (Canada)

    2014-01-01

    Purpose: To evaluate whether local recurrence (LR) risk has changed over time among women with stage I breast cancer treated with breast-conserving therapy. Methods and Materials: Subjects were 5974 women aged ≥50 years diagnosis with pT1N0 breast cancer from 1989 to 2006, treated with breast-conserving surgery and radiation therapy. Clinicopathologic characteristics, treatment, and LR outcomes were compared among 4 cohorts stratified by year of diagnosis: 1989 to 1993 (n=1077), 1994 to 1998 (n=1633), 1999 to 2002 (n=1622), and 2003 to 2006 (n=1642). Multivariable analysis was performed, with year of diagnosis as a continuous variable. Results: Median follow-up time was 8.6 years. Among patients diagnosed in 1989 to 1993, 1994 to 1998, 1999 to 2002, and 2003 to 2006, the proportions of grade 1 tumors increased (16% vs 29% vs 40% vs 39%, respectively, P<.001). Surgical margin clearance rates increased from 82% to 93% to 95% and 88%, respectively (P<.001). Over time, the proportions of unknown estrogen receptor (ER) status decreased (29% vs 10% vs 1.2% vs 0.5%, respectively, P<.001), whereas ER-positive tumors increased (56% vs 77% vs 86% vs 86%, respectively, P<.001). Hormone therapy use increased (23% vs 23% vs 62% vs 73%, respectively, P<.001), and chemotherapy use increased (2% vs 5% vs 10% vs 13%, respectively, P<.001). The 5-year cumulative incidence rates of LR over the 4 time periods were 2.8% vs 1.7% vs 0.9% vs 0.8%, respectively (Gray's test, P<.001). On competing risk multivariable analysis, year of diagnosis was significantly associated with decreased LR (hazard ratio, 0.92 per year, P=.0003). Relative to grade 1 histology, grades 2, 3, and unknown were associated with increased LR. Hormone therapy use was associated with reduced LR. Conclusion: Significant changes in the multimodality management of stage I breast cancer have occurred over the past 2 decades. More favorable-risk tumors were diagnosed, and margin clearance and systemic therapy use

  19. Local Recurrence in Women With Stage I Breast Cancer: Declining Rates Over Time in a Large, Population-Based Cohort

    International Nuclear Information System (INIS)

    Canavan, Joycelin; Truong, Pauline T.; Smith, Sally L.; Lu, Linghong; Lesperance, Mary; Olivotto, Ivo A.

    2014-01-01

    Purpose: To evaluate whether local recurrence (LR) risk has changed over time among women with stage I breast cancer treated with breast-conserving therapy. Methods and Materials: Subjects were 5974 women aged ≥50 years diagnosis with pT1N0 breast cancer from 1989 to 2006, treated with breast-conserving surgery and radiation therapy. Clinicopathologic characteristics, treatment, and LR outcomes were compared among 4 cohorts stratified by year of diagnosis: 1989 to 1993 (n=1077), 1994 to 1998 (n=1633), 1999 to 2002 (n=1622), and 2003 to 2006 (n=1642). Multivariable analysis was performed, with year of diagnosis as a continuous variable. Results: Median follow-up time was 8.6 years. Among patients diagnosed in 1989 to 1993, 1994 to 1998, 1999 to 2002, and 2003 to 2006, the proportions of grade 1 tumors increased (16% vs 29% vs 40% vs 39%, respectively, P<.001). Surgical margin clearance rates increased from 82% to 93% to 95% and 88%, respectively (P<.001). Over time, the proportions of unknown estrogen receptor (ER) status decreased (29% vs 10% vs 1.2% vs 0.5%, respectively, P<.001), whereas ER-positive tumors increased (56% vs 77% vs 86% vs 86%, respectively, P<.001). Hormone therapy use increased (23% vs 23% vs 62% vs 73%, respectively, P<.001), and chemotherapy use increased (2% vs 5% vs 10% vs 13%, respectively, P<.001). The 5-year cumulative incidence rates of LR over the 4 time periods were 2.8% vs 1.7% vs 0.9% vs 0.8%, respectively (Gray's test, P<.001). On competing risk multivariable analysis, year of diagnosis was significantly associated with decreased LR (hazard ratio, 0.92 per year, P=.0003). Relative to grade 1 histology, grades 2, 3, and unknown were associated with increased LR. Hormone therapy use was associated with reduced LR. Conclusion: Significant changes in the multimodality management of stage I breast cancer have occurred over the past 2 decades. More favorable-risk tumors were diagnosed, and margin clearance and systemic therapy use

  20. Patient, hospital, and neighborhood factors associated with treatment of early-stage breast cancer among Asian American women in California

    Science.gov (United States)

    Gomez, Scarlett Lin; Press, David J.; Lichtensztajn, Daphne; Keegan, Theresa H. M.; Shema, Sarah J.; Le, Gem M.; Kurian, Allison W.

    2012-01-01

    Background Clinical guidelines recommend breast conserving surgery (BCS) with radiation as a viable alternative to mastectomy for treatment of early-stage breast cancer. Yet, Asian Americans (AA) are more likely than other groups to have mastectomy or omit radiation after BCS. Methods We applied polytomous logistic regression and recursive partitioning (RP) to analyze factors associated with mastectomy, or BCS without radiation, among 20,987 California AAs diagnosed with stage 0–II breast cancer from 1990–2007. Results The percentage receiving mastectomy ranged from 40% among US-born Chinese to 58% among foreign-born Vietnamese. Factors associated with mastectomy included tumor characteristics such as larger tumor size, patient characteristics such as older age and foreign birthplace among some AA ethnicities, and additional factors including hospital (smaller hospital size, not NCI cancer center, low socioeconomic status (SES) patient composition, and high hospital AA patient composition) and neighborhood characteristics (ethnic enclaves of low SES). These hospital and neighborhood characteristics were also associated with BCS without radiation. Through RP, the highest mastectomy subgroups were defined by tumor characteristics such as size and anatomic location, in combination with diagnosis year and nativity. Conclusions Tumor characteristics and, secondarily, patient, hospital and neighborhood factors, are predictors of mastectomy and omission of radiation following BCS among AAs. Impact By focusing on interactions among patient, hospital, and neighborhood factors in the differential receipt of breast cancer treatment, our study identifies subgroups of interest for further study, and translation into public health and patient-focused initiatives to ensure that all women are fully informed about treatment options. PMID:22402290

  1. PROBLEMATIC ISSUES OF DIAGNOSTICS AND THERAPY OF NON-PSYCHOTIC MENTAL DISORDERS IN FEMALE PATIENTS OF CLIMACTERIC AGE WITH HYSTERICAL SYMPTOM COMPLEX (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Ye. V. Lukiyanova

    2013-01-01

    Full Text Available In the article, problematic questions of diagnostics and therapy of non-psychotic mental disorders (NPMD in female patients of climacteric age with hysterical symptom complex are considered. Efficacy of psychotherapy (PT in NPMD, hypnopsychotherapy in hysterical states: hysterical neurosis, neurasthenia and obsessive-compulsive neurosis is indicated. In treatment of NPMD, PT by creative selfexpression is successfully used. It is highlighted that PT forms conscious-critical attitude of patients toward themselves. Combination of PT with physiotherapy in hysterical conversional symptoms has been described. In hysterical manifestations neuroleptics are recommended, in neurotic depressions – antidepressants of mild action. In severe hysterical state, psychopharmacotherapy (PPhT with tranquilizers and neuroleptics is applied on long-term basis. Stable recovery in dissociative and hysterical disorders has been shown. In vegetovascular disorders in structure of climacteric syndrome (CS vinpocetine, in psychoemotional manifestations phenibut was administered. In therapy of hysterical neurosis, “minor neuroleptics”, hypnosuggestive therapy, social rehabilitation were applied. Effective group PT of psychogenically conditioned disorders in asthenicand anxiety-depressive symptoms is effective. Complex therapy of NPMD in hysterical and asthenic neurosis, obsessive-compulsive neurosis has been suggested. Organization of specialized preventive examinations for early revealing of persons with personality pathology is based. Efficacy of a number of medications in periand post-menopause – SSRIs and gabapentin, during menopause paroxetine, in depressions of non-psychotic level – pyrazidol, coaxil, in neurotic hypochondriasis sulpiride and quetiapine, diazepam, in climacteric vegetative and mental disorders hormone replacement therapy (HRT, hormonal therapy, PPhT and PT, in neurovegetative symptoms of CS – antidepressants, in psychovegetative syndromes

  2. Myocardial infarction among women with early-stage breast cancer treated with conservative surgery and breast irradiation

    International Nuclear Information System (INIS)

    Rutqvist, Lars E.; Liedberg, Anette; Hammar, Niklas; Dalberg, Kristina

    1998-01-01

    Purpose: To assess the possible impact of the irradiation on the risk of acute myocardial infarction among breast cancer patients treated with conservative surgery and postoperative radiation therapy. Methods and Materials: The incidence of and mortality from acute myocardial infarction was assessed in a group of 684 women with early-stage breast cancer diagnosed during 1976-1987 who had been treated with breast conserving surgery plus postoperative radiation therapy given with tangential photon fields. In 94% of the patients the total dose was between 48-52 Gy given with 2 Gy daily fractions 5 days per week for a total treatment period of about 4 (1(2)) - 5 (1(2)) weeks. In 88% of the patients the target volume included the breast parenchyma alone. In the remaining patients regional nodal areas were also irradiated. A concurrent group of 4,996 breast cancer patients treated with mastectomy without postoperative radiation therapy was used as a reference. Results: After a median follow-up of 9 years (range: 5-16 years) 12 conservatively treated patients (1.8%) had developed an acute myocardial infarction and 5 (0.7%) had died due to this disease. The age-adjusted relative hazard of acute myocardial infarction for the conservative group vs. the mastectomy group was 0.6 (95% C.I.: 0.4-1.2) and for death due to this disease 0.4 (0.2-1.1). The incidence of acute myocardial infarction among the conservatively treated women was similar irrespective of tumor laterality. Conclusions: There was no indication of an increased risk of acute myocardial infarction with the radiation therapy among the women treated with conservative surgery. However, due to the small number of events the study could not exclude the possibility that cardiac problems may arise in some patients with left-sided cancers who have their heart located anteriorly in the mediastinum. Individual, three-dimensional dose planning represents one method to identify such patients and is basic to technical changes

  3. The relationship between SF-6D utility scores and lifestyle factors across three life stages: evidence from the Australian Longitudinal Study on Women's Health.

    Science.gov (United States)

    Kanesarajah, Jeeva; Waller, Michael; Whitty, Jennifer A; Mishra, Gita D

    2017-06-01

    To investigate how SF-6D utility scores change with age between generations of women and to quantify the relationship of SF-6D with lifestyle factors across life stages. Up to seven waves of self-reported, longitudinal data were drawn for the 1973-1978 (young, N = 13772), 1946-1951 (mid-age, N = 12792), 1921-1926 (older, N = 9972) cohorts from the Australian Longitudinal Study on Women's Health. Mixed effects models were employed for analysis. Young and mid-age women had similar average SF-6D scores at baseline (0.63-0.64), which remained consistent over the 16-year period. However, older women had lower scores at baseline at 0.57 which steadily declined over 15 years. Across cohorts, low education attainment, greater difficulty in managing income, obesity, physical inactivity, heavy smoking, no alcohol consumption, and increasing stress levels were associated with lower SF-6D scores. The magnitude of effect varied between cohorts. SF-6D scores were lower amongst young women with high-risk drinking behaviours than low-risk drinkers. Mid-age women, who were underweight, never married, or underwent surgical menopause also reported lower SF-6D scores. Older women who lived in remote areas, who were ex-smokers, or were underweight, reported lower SF-6D scores. The SF-6D utility score is sensitive to differences in lifestyle factors across adult life stages. Gradual loss of physical functioning may explain the steady decline in health for older women. Key factors associated with SF-6D include physical activity, body mass index, menopause status, smoking, alcohol use, and stress. Factors associated with poorer SF-6D scores vary in type and magnitude at different life stages.

  4. The central nervous system of the fetus in pregnant women after organ-preserving treatment of precancer and early stages of cervical cancer

    International Nuclear Information System (INIS)

    Egorov, O.O.

    2015-01-01

    Magnetic resonance imaging is a promising method of research in tocology. The use of MRI for the first time with high precision anatomical interpretation to diagnose the state of the Central nervous system of the fetus in pregnant women after organ-preserving treatment of precancerous cervical disease and early stages of cervical cancer

  5. [Calcium and bone metabolism across women's life stages. Pathophysiology, adiagnosis and treatment of post-pregnancy osteoporosis.

    Science.gov (United States)

    Kurabayashi, Takumi

    Post-pregnancy osteoporosis is a rare condition with little known pathophysiology. Most cases are diagnosed in the late stage of pregnancy or in the post-partum while breastfeeding, particularly in first pregnancy. Vertebral fractures are most commonly observed and characterized by prolonged severe pain and functional limitations. Measurements of bone mineral density(BMD)of the lumbar spine and proximal femur with dual energy X-ray absorptiometry(DXA)are the clinical methods most commonly used for no fracture women. Conventional radiography will confirm the fracture in most cases, and magnetic resonance(MR), which can be safely used during pregnancy, is effective in detecting vertebral fractures and bone marrow edema. Although the bone resorption increased at the end of pregnancy and lactation, the bone formation increases and the bone structure is almost recovered after cessation of lactating in postpartum. There is much uncertainty about whether pharmacological treatments should be used for osteoporosis that presents during pregnancy and lactation. This is partly because of the lack of a firm evidence base for treatment and also because there is a spontaneous recovery of bone mass and strength after pregnancy or weaning.

  6. Surgery Should Complement Endocrine Therapy for Elderly Postmenopausal Women with Hormone Receptor-Positive Early-Stage Breast Cancer

    Directory of Open Access Journals (Sweden)

    Olivier Nguyen

    2012-01-01

    Full Text Available Introduction. Endocrine therapy (ET is an integral part of breast cancer (BC treatment with surgical resection remaining the cornerstone of curative treatment. The objective of this study is to compare the survival of elderly postmenopausal women with hormone receptor-positive early-stage BC treated with ET alone, without radiation or chemotherapy, versus ET plus surgery. Materials and Methods. This is a retrospective study based on a prospective database. The medical records of postmenopausal BC patients referred to the surgical oncology service of two hospitals during an 8-year period were reviewed. All patients were to receive ET for a minimum of four months before undergoing any surgery. Results. Fifty-one patients were included and divided in two groups, ET alone and ET plus surgery. At last follow-up in exclusive ET patients (n=28, 39% had stable disease or complete response, 22% had progressive disease, of which 18% died of breast cancer, and 39% died of other causes. In surgical patients (n=23, 78% were disease-free, 9% died of recurrent breast cancer, and 13% died of other causes. Conclusions. These results suggest that surgical resection is beneficial in this group and should be considered, even for patients previously deemed ineligible for surgery.

  7. Exploring the role nurses play at different stages of the birthing process. Developing strong and long-term relationships with women by examining relationship-building stages prior to delivery, during delivery, and after delivery.

    Science.gov (United States)

    Peltier, J W; Schibrowski, J A; Westfall, J

    2000-01-01

    The health care community is becoming increasingly aware of the need to develop strong and long-term relationships with the women who make up the majority of the health care market. The perceived quality of obstetric care positively impacts future revenue streams by creating "family" loyalty for an umbrella of other health services offered by the provider organization. This article examines the differential impact that various service performance dimensions have on women's perceptions of quality for different stages of the birthing process, and how relationship-marketing principles can be utilized to develop loyal partnerships. The three distinct relationship-building stages are examined--birthing experiences prior to delivery, during delivery, and after delivery--along with their implications for perceptions of quality analyzed.

  8. The Experience of Robotic-Assisted Laparoscopic Hysterectomy for Women Treated for Early-Stage Endometrial Cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Palle, Connie; Moeller, Ann M

    2016-01-01

    , the women did not consider themselves surviving cancer patients but as cured. The women searched for information from various sources, for example, the Internet and the online patient chart, to prepare for surgery and to come to terms with the diagnosis. CONCLUSIONS: Although the women had confidence...... activity is needed. Individualized information about anatomical changes after surgery is warranted, preferably using anatomical drawings. Potentially, the women could benefit from attending a nursing clinic during the first postoperative months....

  9. Development and pilot testing of a Decision Aid (DA) for women with early-stage breast cancer considering contralateral prophylactic mastectomy.

    Science.gov (United States)

    Ager, B; Jansen, J; Porter, D; Phillips, K A; Glassey, R; Butow, P

    2018-05-22

    Describe the development, acceptability and feasibility of a Decision Aid (DA) for women with early-stage breast cancer (BC) at average contralateral breast cancer (CBC) risk considering contralateral prophylactic mastectomy (CPM). The DA was developed using the International Patient Decision Aid Standards (IPDAS) and the Ottawa Decision Support Framework. It provides evidence-based information about CPM in a booklet format combining text, graphs and images of surgical options. Twenty-three women with a history of early-stage breast cancer were interviewed in person or over the phone using a 'think aloud approach'. Framework analysis was used to code and analyse data. Twenty-three women participated in the study. Mean age of participants was 58.6 years and time since diagnosis ranged from 14 months to 21 years. Five women had CPM and eighteen had not. Women strongly endorsed the DA. Many felt validated by a section on appearance and found information on average risk of recurrence and metastases helpful, however, noted the importance of discussing personal risk with their surgeon. Many requested more information on surgery details (time taken, recovery) and costs of the different options. The DA was acceptable to women, including the format, content and proposed implementation strategies. Practical and financial issues are important to women in considering treatment options. Women appreciate information about CPM at diagnosis and emphasised the importance of discussing potential downsides of the procedure in addition to benefits. The DA was considered acceptable to facilitate such discussions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Clinically evident fat necrosis in women treated with high-dose-rate brachytherapy alone for early-stage breast cancer

    International Nuclear Information System (INIS)

    Wazer, David E.; Lowther, David; Boyle, Teresa; Ulin, Kenneth; Neuschatz, Andrew; Ruthazer, Robin; DiPetrillo, Thomas A.

    2001-01-01

    Purpose: To investigate the incidence of and variables associated with clinically evident fat necrosis in women treated on a protocol of high-dose-rate (HDR) brachytherapy alone without external-beam whole-breast irradiation for early-stage breast carcinoma. Methods and Materials: From 6/1997 until 8/1999, 30 women diagnosed with Stage I or II breast carcinoma underwent surgical excision and postoperative irradiation via HDR brachytherapy implant as part of a multi-institutional clinical Phase I/II protocol. Patients eligible included those with T1, T2, N0, N1 (≤3 nodes positive), M0 tumors of nonlobular histology with negative surgical margins, no extracapsular lymph-node extension, and a negative postexcision mammogram. Brachytherapy catheters were placed at the initial excision, re-excision, or at the time of axillary sampling. Direct visualization, surgical clips, ultrasound, or CT scans assisted in delineating the target volume defined as the excision cavity plus 2-cm margin. High activity 192 Ir (3-10 Ci) was used to deliver 340 cGy per fraction, 2 fractions per day, for 5 consecutive days to a total dose of 34 Gy to the target volume. Source position and dwell times were calculated using standard volume optimization techniques. Dosimetric analyses were performed with three-dimensional postimplant dose and volume reconstructions. The median follow-up of all patients was 24 months (range, 12-36 months). Results: Eight patients (crude incidence of 27%) developed clinically evident fat necrosis postimplant in the treated breast. Fat necrosis was determined by clinical presentation including pain and swelling in the treated volume, computed tomography, and/or biopsy. All symptomatic patients (7 of 8 cases) were successfully treated with 3 to 12 months of conservative management. Continuous variables that were found to be associated significantly with fat necrosis included the number of source dwell positions (p=0.04), and the volume of tissue which received

  11. Updated clinical recommendations for the use of tibolone in Asian women

    OpenAIRE

    Huang, K-E.; Baber, R.

    2010-01-01

    Tibolone, which is indicated for the relief of climacteric symptoms and the prevention of osteoporosis in postmenopausal women, has a tissue-specific mode of action different to that of conventional hormone replacement therapy (HRT). A large proportion of Asian postmenopausal women experience symptoms that most frequently include musculoskeletal pain, insomnia, forgetfulness, hot flushes and sexual dysfunction, and there is a need to address their specific requirements. Recent studies show th...

  12. Upright versus lying down position in second stage of labour in nulliparous women with low dose epidural: BUMPES randomised controlled trial.

    Science.gov (United States)

    2017-10-18

    Objective  To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down. Design  Multicentre pragmatic individually randomised controlled trial. Setting  41 UK hospital labour wards. Participants  3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia. Interventions  Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions. Main outcome measures  The primary outcome was spontaneous vaginal birth. Women were analysed in the groups into which they were randomly allocated, regardless of position recorded at any time during the second stage of labour (excluding women with no valid consent, who withdrew, or who did not reach second stage before delivery). Secondary outcomes included mode of birth, perineal trauma, infant Apgar score women were randomised and 3093 (95.6%) included in the primary analysis (1556 in the upright group and 1537 in the lying down group). Significantly fewer spontaneous vaginal births occurred in women in the upright group: 35.2% (548/1556) compared with 41.1% (632/1537) in the lying down group (adjusted risk ratio 0.86, 95% confidence interval 0.78 to 0.94). This represents a 5.9% absolute increase in the chance of spontaneous vaginal birth in the lying down group (number needed to treat 17, 95% confidence interval 11 to 40). No evidence of differences was found for most of the secondary maternal, neonatal, or longer term outcomes including instrumental vaginal delivery (adjusted risk ratio 1.08, 99% confidence interval 0.99 to 1.18), obstetric anal sphincter injury (1.27, 0.88 to 1.84), infant Apgar score labour results in more spontaneous vaginal births in nulliparous women with

  13. Ten-year results of the treatment of early-stage breast carcinoma in elderly women using breast-conserving surgery and definitive breast irradiation

    International Nuclear Information System (INIS)

    Solin, Lawrence J.; Schultz, Delray J.; Fowble, Barbara L.

    1995-01-01

    Purpose: The optimal management of breast cancer in elderly women is not well established. Therefore, the present study was undertaken to evaluate the outcome of breast cancer in elderly women treated with breast-conserving surgery and definitive breast irradiation. Methods and Materials: An analysis was performed of 558 women age ≥ 50 years treated with breast-conserving surgery and definitive breast irradiation for Stages I-II invasive carcinoma of the breast. Of the 558 total women, there were 173 elderly women age ≥ 65 years and a comparison group of 385 women age 50-64 years. Treatment for all women included complete gross excision of the primary tumor, pathologic axillary lymph node staging, and definitive breast irradiation. Adjuvant systemic chemotherapy was used in 18% (102 out of 558) of the overall group. Adjuvant tamoxifen was used in 17% (94 out of 558) of the overall group. The median follow-up after treatment was 6.2 years (mean = 6.4 years; range 0.1-15.4 years). Results: Elderly patients age ≥ 65 years and patients age 50-64 years were both found to have tumors with adverse prognostic features, including clinical T2 lesions (43 vs. 34%, respectively; p = 0.055), estrogen receptor negativity (9 vs. 16%, respectively; p = 0.13), and progesterone receptor negativity (17 vs. 21%, respectively; p = 0.50). Pathologic axillary lymph node staging showed that 24% of the elderly women were node positive, including 8% with four or more positive nodes, which was not different from women age 50-64 years (p = 0.23). There was no difference between the two age groups for the rate of deaths from breast cancer at 10 years (13 vs. 13%, respectively; p = 0.71). However, there was a significant difference between the two age groups for the rate of deaths from intercurrent disease at 10 years (11 vs. 2%, respectively; p = 0.0006). There were no differences between the two age groups for the 10-year rates of overall survival (77 vs. 85%, respectively; p = 0

  14. Re: What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour?

    DEFF Research Database (Denmark)

    Boie, Sidsel; Glavind, Julie; Uldbjerg, Niels

    2017-01-01

    The authors pose the question - What is the best treatment to reduce the need for caesarean section in nulliparous women at term with delayed first stage of labour? and state in their paper that "There is no consensus on the optimal dose regimen of oxytocin for delay in the first stage of labour...... in nulliparous women at term (37-42 weeks’ gestation) to reduce unplanned caesarean section and increase vaginal birth with minimal adverse events". However, they describe only low and high dose oxytocin regimens and fail to acknowledge that no oxytocin at all is associated with a spontaneous delivery just...... as often as when oxytocin is given (1,2) or that discontinuation of oxytocin once the active phase of labour is reached can result in higher spontaneous delivery rates than continuing oxytocin (3,4). The paper in its list of trials (box 2) only describes those addressing high and low dose oxytocin, which...

  15. Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis.

    Science.gov (United States)

    Roux, Pauline; Perrin, Jeanne; Mancini, Julien; Agostini, Aubert; Boubli, Léon; Courbiere, Blandine

    2017-07-01

    To assess the factors associated with a poor prognosis for a cumulative IVF live birth rate (LBR) in women with stage III and IV endometriosis according to the revised classification of the American Fertility Society (rAFS). A retrospective cohort study was conducted between January 1, 2010, and December 31, 2014, in our Reproductive Medicine Center. We analyzed different factors associated with a poor prognosis for a cumulative IVF LBR in women with rAFS stage III and IV endometriosis. A total of 101 patients were included, representing 232 IVF-ICSI cycles and 212 embryo transfers. The primary endpoint was the cumulative LBR per cycle and per patient. The cumulative LBR per cycle was 14.7% (n = 34) and that per patient was 31.7% (n = 32). The cumulative LBR was significantly decreased by active smoking [ adj OR = 3.4, 95% CI (1.12-10.60), p = 0.031], poor ovarian response (POR) according to the Bologna criteria [ adj OR = 11.5, 95% CI (1.37-96.83), p = 0.024], and rAFS stage IV [ adj OR = 3.2, 95% CI (1.13-8.95), p = 0.024]. The cumulative LBR per women was 59.4% without factors associated with a poor prognosis and 25.6% in the case of one factor, and it decreased to 7.7% in the case of two or three factors (p endometriosis had a negative impact on the IVF-ICSI cumulative LBR for women with rAFS stage III and IV endometriosis. Because smoking dramatically decreases the LBR with endometriosis, stopping smoking before IVF-ICSI should be strongly advised.

  16. A systematic review and meta-analysis of the safety, feasibility and effect of exercise in women with stage II+ breast cancer.

    Science.gov (United States)

    Singh, Ben; Spence, Rosalind R; Steele, Megan L; Sandler, Carolina X; Peake, Jonathan M; Hayes, Sandra C

    2018-05-03

    To systematically evaluate the safety, feasibility and effect of exercise among women with stage II+ breast cancer. CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published prior to March 1, 2017. Randomised, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. There were no differences in adverse events between exercise and usual care (risk difference: feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardised mean difference range: 0.17-0.77, pfeasibility and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional and distant breast cancer. Copyright © 2018. Published by Elsevier Inc.

  17. Non-Destructive Assessment of Aroma Volatiles from a Climacteric Near-Isogenic Line of Melon Obtained by Headspace Stir-Bar Sorptive Extraction

    Directory of Open Access Journals (Sweden)

    Juan Pablo Fernández-Trujillo

    2013-08-01

    Full Text Available A climacteric aromatic near-isogenic line (NIL of melon (Cucumis melo L. SC3-5-1 contained an introgression of the non-climacteric Korean cultivar “Shongwan Charmi” accession PI 161375 (SC in the genetic background of the non-climacteric cultivar “Piel de Sapo” (PS. The aroma production was monitored during ripening at 21 °C in intact fruit using headspace sorptive bar extraction (HSSE. Bars were composed of polydimethylsiloxane (PDMS and aromas were desorbed and analyzed by gas-chromatography mass-spectrometry. The aromatic profile was composed of 70 aromatic compounds plus 21 alkanes with a predominance of esters, particularly acetate (2-methylbutyl acetate, 2-methylpropyl acetate, hexyl acetate, and phenylmethyl acetate. Some compounds were severely affected by postharvest time. The acetate esters (3-methylbutyl acetate, butan-2-yl acetate and phenylmethyl acetate decreased with ripening and sulfur-derived compounds (S-methyl butanethioate and S-methyl 3-methylbutanethioate increased gradually with ripening. A few compounds increased at the senescence phase (propyl ethanoate. Other compounds such as hexadecanoic acid showed a marked decrease after harvest, some decreasing from a relative maximum at harvest (2-methylpropyl hexanoate; n-hexanoic acid; nonanoic acid.

  18. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer : A prospective study

    NARCIS (Netherlands)

    Keyzer-Dekker, Claudia M. G.; de Vries, Jolanda; Mertens, Marlies C.; Roukema, Jan A.; van der Steeg, Alida F. W.

    ObjectivesHigh trait anxiety (HTA) determines depressive symptoms and state anxiety in women with breast cancer (BC) or benign breast disease (BBD). Before implementing screening for psychological counselling in these women, it is important to evaluate whether high state anxiety and depressive

  19. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer : A prospective study

    NARCIS (Netherlands)

    Keyzer-Dekker, C.M.G.; de Vries, J.; Mertens, M.C.; Roukema, J.A.; van der Steeg, A.F.W.

    2014-01-01

    Objectives High trait anxiety (HTA) determines depressive symptoms and state anxiety in women with breast cancer (BC) or benign breast disease (BBD). Before implementing screening for psychological counselling in these women, it is important to evaluate whether high state anxiety and depressive

  20. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer: a prospective study

    NARCIS (Netherlands)

    Keyzer-Dekker, Claudia M. G.; de Vries, Jolanda; Mertens, Marlies C.; Roukema, Jan A.; van der Steeg, Alida F. W.

    2014-01-01

    High trait anxiety (HTA) determines depressive symptoms and state anxiety in women with breast cancer (BC) or benign breast disease (BBD). Before implementing screening for psychological counselling in these women, it is important to evaluate whether high state anxiety and depressive symptoms are

  1. Ambivalent sexism and attitudes toward women in different stages of reproductive life: a semantic, cross-cultural approach.

    Science.gov (United States)

    Chrisler, Joan C; Gorman, Jennifer A; Marván, Maria Luisa; Johnston-Robledo, Ingrid

    2014-01-01

    College students in southeastern Mexico (n = 185) and the northeastern United States (n = 96) utilized a semantic differential scale to rate subtypes of women: a menstruating woman, a menopausal woman, a pregnant woman, a premenstrual woman, a woman with a hysterectomy, a teenage girl, a woman in love, and a woman with a young baby. Americans reported significantly more negative attitudes than Mexicans did toward a menstruating woman, a premenstrual woman, a teenage girl, and a pregnant woman. Participants chose more positive words to describe a teenage girl, a woman in love, a pregnant woman, and a woman with a young baby, which is suggestive of a pronatal bias. Participants also completed the Ambivalent Sexism Inventory (ASI). Men scored significantly higher than women on hostile sexism. Mexicans scored significantly higher than Americans on both hostile and benevolent sexism. Sexism scores are related to attitudes toward premenstrual, menstruating, and menopausal women; women with a hysterectomy; and women with a young baby.

  2. The Impact of Comorbidities on Outcomes for Elderly Women Treated With Breast-Conservation Treatment for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    Harris, Eleanor E.R.; Hwang, W.-T.; Urtishak, Sandra L.; Plastaras, John; Kinosian, Bruce; Solin, Lawrence J.

    2008-01-01

    Purpose: Breast cancer incidence increases with age and is a major cause of morbidity and mortality in elderly women, but is not well studied in this population. Comorbidities often impact on the management of breast cancer in elderly women. Methods and Materials: From 1979 to 2002, a total of 238 women aged 70 years and older with Stage I or II invasive carcinoma of the breast underwent breast-conservation therapy. Outcomes were compared by age groups and comorbidities. Median age at presentation was 74 years (range, 70-89 years). Age distribution was 122 women (51%) aged 70-74 years, 71 women (30%) aged 75-79 years, and 45 women (19%) aged 80 years or older. Median follow-up was 6.2 years. Results: On outcomes analysis by age groups, 10-year cause-specific survival rates for women aged 70-74, 75-79, and 80 years or older were 74%, 81%, and 82%, respectively (p = 0.87). Intercurrent deaths at 10 years were significantly higher in older patients: 20% in those aged 70-74 years, 36% in those aged 75-79 years, and 53% in those 80 years and older (p = 0.0005). Comorbidities were not significantly more common in the older age groups and did not correlate with cause-specific survival adjusted for age. Higher comorbidity scores were associated with intercurrent death. Conclusions: Older age itself is not a contraindication to standard breast-conservation therapy, including irradiation. Women of any age with low to moderate comorbidity indices should be offered standard breast-conservation treatment if otherwise clinically eligible

  3. A comparative study of proliferative activity and tumor stage of pregnancy-associated melanoma (PAM) and non-PAM in gestational age women.

    Science.gov (United States)

    Merkel, Emily A; Martini, Mary C; Amin, Sapna M; Yélamos, Oriol; Lee, Christina Y; Sholl, Lauren M; Rademaker, Alfred W; Guitart, Joan; Gerami, Pedram

    2016-01-01

    The influence of pregnancy on the development, progression, and prognosis of melanoma is controversial. We sought to compare clinical characteristics, histologic features, and proliferative activity in pregnancy-associated melanoma (PAM) and melanoma in nonpregnant women of reproductive age (non-PAM). In this retrospective cohort study, we reviewed medical records and pathology reports from women given a diagnosis of melanoma between 2006 and 2015. We also examined tumor proliferation rates using mitotic count and 2 immunohistochemical markers of proliferation, phosphohistone H3 and Ki-67. In 50 PAM and 122 non-PAM cases, a diagnosis of melanoma in situ was associated with PAM. Among invasive melanomas, there was no difference in proliferative activity between groups. Pregnancy status was also not associated with age at diagnosis, tumor site, Breslow depth, Clark level, ulceration, or overall stage. This was a retrospective study with a small sample size of mostly patients with early-stage melanoma. In our study of primarily early-stage melanoma, pregnancy did not have a significant impact on tumor proliferation. Particularly for patients given a diagnosis of stage I melanoma who are undergoing close surveillance, a history of PAM should not outweigh traditional factors, such as advanced maternal age, in planning future pregnancies. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Stages of change of behavior in women on a multi-professional program for treatment of obesity.

    Science.gov (United States)

    Bevilaqua, Cheila Aparecida; Pelloso, Sandra Marisa; Marcon, Sonia Silva

    2016-10-10

    to ascertain the effectiveness of an intervention program in relation to anthropometric measurements and stage of readiness for behavioral change in women with excess weight. the intervention group (IG) was made up of 13 women, and the control group (CG), by 20. The intervention lasted 16 weeks, and included the practice of guided physical activity three times a week, and health education once a week. The application of the questionnaire on stage of readiness for behavioral change, and the anthropometric evaluations, were undertaken at two points - before and after the period of intervention. The statistical analysis involved tests of comparison and association. in general, at the first point, the participants in the two groups were predisposed to make changes in what they ate and in their physical activity. However, significant difference was only observed in relation to weight, body mass index (BMI), waist circumference and waist-hip ratio and readiness for change among the members of the intervention group. the intervention programmed was effective in weight loss, reduction of waist circumference and waist-hip ratio, and in changing behaviors related to the practicing of physical exercise and eating habits. verificar a efetividade de um programa de intervenção sobre medidas antropométricas e o estágio de prontidão para mudança de comportamento em mulheres com excesso de peso. o grupo intervenção (GI) foi constituído por 13 mulheres e o grupo controle por 20. A intervenção teve duração de 16 semanas e incluiu prática de atividade física orientada três vezes na semana e educação em saúde uma vez na semana. A aplicação do questionário de estágio de prontidão para mudança de comportamento e as avaliações antropométricas foram realizadas em dois momentos, antes e após o período de intervenção. A análise estatística envolveu testes de comparação e associação. em geral, no momento inicial, as participantes dos dois grupos estavam

  5. Depression in climacteric women: analysis of a sample receiving care at a university hospital in Maranhão, Brazil

    OpenAIRE

    Silva, Mari-Nilva Maia da; Brito, Luciane Maria Oliveira; Chein, Maria Bethânia da Costa; Brito, Luiz Gustavo Oliveira; Navarro, Paula Andréa de Albuquerque Salles

    2008-01-01

    Introdução: O climatério, período de transição entre a fase reprodutiva e não-reprodutiva, ocasiona mudanças biopsicossociais nas mulheres que o vivenciam. A associação entre a maior prevalência de depressão nesse período é, no entanto, ainda controversa. O objetivo deste estudo foi avaliar a prevalência de depressão em mulheres climatéricas atendidas em um hospital universitário numa cidade da Região Nordeste do Brasil e identificar fatores associados. Método: Foi realizado um estudo prospec...

  6. Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer.

    Science.gov (United States)

    Den Oudsten, Brenda L; Van Heck, Guus L; Van der Steeg, Alida F W; Roukema, Jan A; De Vries, Jolanda

    2010-06-01

    Few studies have prospectively assessed the impact of breast cancer (BC) on women's sexual lives. Therefore, this study examines the determinants of quality of sexual life (QOSL), sexual functioning (SF), and sexual enjoyment (SE) at 6 and 12 months after surgical treatment. All participants completed a measure of QOSL (The World Health Organization Quality of Life assessment instrument-100 (WHOQOL-100)-facet Sexual Activity) before diagnosis (Time-1), and 1 (Time-2), 3 (Time-3), 6 (Time-4) and 12 months (Time-5) after surgical treatment. At Time-1, women also completed questionnaires on personality (The State Trait Anxiety Inventory-trait, NEO-FFI), body image and self-esteem (WHOQOL-100), depressive symptoms (Center for Epidemiological Studies-Depression Scale), and fatigue (Fatigue Assessment Scale). Furthermore, SF and SE (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer module) were measured from Time-2 onwards. At baseline, the analysis included 223 women with early stage BC. Clinical factors did not predict QOSL, SF or SE. In the final analyses, trait anxiety predicted QOSL and SF at Time-4 (p'swomen with a mastectomy did not differ from women with breast conserving therapy. Mainly personality and psychological factors affect patients' sexuality after surgical treatment. Clinical factors did not predict QOSL, SF or SE. More knowledge in this field will help professionals to identify women who are at risk of experiencing sexual problems and consequently will contribute to provide adequate support. (c) 2009 John Wiley & Sons, Ltd.

  7. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer: a prospective study.

    Science.gov (United States)

    Keyzer-Dekker, Claudia M G; de Vries, Jolanda; Mertens, Marlies C; Roukema, Jan A; van der Steeg, Alida F W

    2014-11-01

    High trait anxiety (HTA) determines depressive symptoms and state anxiety in women with breast cancer (BC) or benign breast disease (BBD). Before implementing screening for psychological counselling in these women, it is important to evaluate whether high state anxiety and depressive symptoms are determined by (the threat of) having BC or solely by HTA. Therefore, we compared women with a lump in the breast with women with gallstone disease (GD). Women diagnosed with BC (n = 152), BBD (n = 205), and GD (n = 128) were included in a prospective longitudinal study. Questionnaires concerning trait anxiety (baseline), state anxiety, and depressive symptoms were completed before diagnosis was known (BC and BBD) or the laparoscopic cholecystectomy and 6 months later. Pre-diagnosis BC patients scored higher on state anxiety (p = .001) and depressive symptoms (p anixety, it is important to evaluate whether high state anxiety and depressive symptoms are determined by (the threat of) having BC or solely by HTA. What does this study add? To our knowledge, this is the first study comparing women who are confronted with the possibility of having a life-threatening disease, that is, BC, with women who were not suspected of having a life-threatening disease, that is, GD. This study reveals that the severity of diagnosis (BC) in combination with HTA determined the level of state anxiety and depressive symptoms. Therefore, we recommend identifying women with HTA and offering them a tailor-made follow-up protocol during and after the diagnostic process for BC or BBD. © 2013 The British Psychological Society.

  8. Detection and treatment of Fiebig stage I HIV-1 infection in young at-risk women in South Africa: a prospective cohort study.

    Science.gov (United States)

    Dong, Krista L; Moodley, Amber; Kwon, Douglas S; Ghebremichael, Musie S; Dong, Mary; Ismail, Nasreen; Ndhlovu, Zaza M; Mabuka, Jenniffer M; Muema, Daniel M; Pretorius, Karyn; Lin, Nina; Walker, Bruce D; Ndung'u, Thumbi

    2018-01-01

    HIV incidence among young women in sub-Saharan Africa remains high and their inclusion in vaccine and cure efforts is crucial. We aimed to establish a cohort of young women detected during Fiebig stage I acute HIV infection in whom treatment was initiated immediately after diagnosis to advance research in this high-risk group. 945 women aged 18-23 years in KwaZulu-Natal, South Africa, who were HIV uninfected and sexually active consented to HIV-1 RNA testing twice a week and biological sampling and risk assessment every 3 months during participation in a 48-96 week life-skills and job-readiness programme. We analysed the effect of immediate combination antiretroviral therapy (ART) on viraemia and immune responses, sexual risk behaviour, and the effect of the socioeconomic intervention. 42 women were diagnosed with acute HIV infection between Dec 1, 2012, and June 30, 2016, (incidence 8·2 per 100 person-years, 95% CI 5·9-11·1), of whom 36 (86%) were diagnosed in Fiebig stage I infection with a median initial viral load of 2·97 log 10 copies per mL (IQR 2·42-3·85). 23 of these 36 women started ART at a median of 1 day (1-1) after detection, which limited the median peak viral load to 4·22 log 10 copies per mL (3·27-4·83) and the CD4 nadir to 685 cells per μL (561-802). ART also suppressed viral load (to women, prevented seroconversion, as shown with western blotting. 385 women completed the 48 week socioeconomic intervention, of whom 231 were followed up for 1 year. 202 (87%) of these 231 women were placed in jobs, returned to school, or started a business. Frequent HIV screening combined with a socioeconomic intervention facilitated sampling and risk assessment before and after infection. In addition to detection of acute infection and immediate treatment, we established a cohort optimised for prevention and cure research. Bill & Melinda Gates Foundation, National Institute of Allergy and Infectious Diseases, International AIDS Vaccine Initiative, Wellcome

  9. Childhood Trauma and Two Stages of Alcohol Use in African American and European American Women: Findings from a Female Twin Sample.

    Science.gov (United States)

    Sartor, Carolyn E; Grant, Julia D; Few, Lauren R; Werner, Kimberly B; McCutcheon, Vivia V; Duncan, Alexis E; Nelson, Elliot C; Madden, Pamela A F; Bucholz, Kathleen K; Heath, Andrew C; Agrawal, Arpana

    2017-09-05

    The current investigation assessed for moderating effects of childhood trauma on genetic and environmental contributions to timing of alcohol use initiation and alcohol use disorder in African American (AA) and European American (EA) women. Data were drawn from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a longitudinal female twin study. Childhood trauma was defined alternately as child maltreatment and more broadly to include other events (e.g., witnessing violence). Phenotypic associations between childhood trauma and alcohol outcomes were estimated using logistic regression analyses. Twin modeling was conducted to test for moderating effects of childhood trauma on the contributions of genetic and environmental factors to timing of initiation and alcohol use disorder. Under both definitions, childhood trauma was associated with early initiation (relative risk ratios: 1.90, 1.72) and alcohol use disorder (odds ratios: 1.92, 1.76). Yet gene by environment effects were observed only for child maltreatment and timing of initiation in EA women, with heritable influences less prominent in those who had experienced child maltreatment (0.35, 95% CI: 0.05-0.66 vs. 0.52, 95% CI: 0.30-0.73). We found more similarities than differences in the association of childhood trauma with alcohol outcomes across racial/ethnic groups, trauma type, and stages of alcohol use. However, findings suggest that the relative contribution of genetic factors to alcohol outcomes differs by childhood maltreatment history in EA women specifically in the earliest stage of alcohol use.

  10. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

    Science.gov (United States)

    Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

    2014-01-01

    Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

  11. Early-stage breast cancer is not associated with the risk of marital dissolution in a large prospective study of women.

    Science.gov (United States)

    Laitala, V S; Saarto, T; Einiö, E K; Martikainen, P; Silventoinen, K

    2015-07-28

    As breast cancer and its treatment are likely to interfere with traditional expectations of womanhood, it may affect marital stability. The risk of marital dissolution was analysed with respect to diagnosis of early-stage (T1-4N0-3M0) breast cancer in a cohort of 134 435 married Finnish women followed for a median of 17.0 married years. Age, socioeconomic status, education, number of children, duration of marriage and earlier marriages were taken into account and the effects of surgery, chemotherapy, radiotherapy and endocrine therapy were analysed separately. Women with a diagnosis of early-stage breast cancer did not show increase in marital dissolution (hazard ratio=0.96, 95% confidence interval=0.79-1.17). Neither the type of surgical procedure nor any of the oncologic treatments was associated with an increase in the risk of divorce. Any evidence of excess risk of marital breakdown after the diagnosis of early-stage breast cancer and its treatment was not demonstrated.

  12. Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age.

    Science.gov (United States)

    Jiang, Xuan; Yang, Jiaxin; Yu, Mei; Xie, Weimin; Cao, Dongyan; Wu, Ming; Pan, Lingya; Huang, Huifang; You, Yan; Shen, Keng

    2017-08-15

    Fertility-sparing surgery is indicated for patients with stage I epithelial ovarian cancers. We sought to evaluate the clinical outcomes and oncofertility in a cohort of patients of reproductive age with stage I epithelial ovarian cancer (EOC). Overall, 108 patients of reproductive age (≤ 40 years) diagnosed with stage I EOC who were treated at Peking Union Medical College Hospital between 1999 and 2013 were included in the study. The Kaplan-Meier model and Cox regression analyses were used for the survival analysis. The type of surgery included fertility-sparing surgery (FSS) (48.1%) and radical surgery (RS) (51.9%). After a median follow-up of 83 months, we observed that grade 3 or clear-cell carcinoma was the only independent risk factor for disease-free survival and tumor-specific survival in the multivariate analysis. Patients with grade 3 or clear-cell carcinoma tended to be older than 30 years, have endometriosis, and undergo RS (p Fertility-sparing surgery did not affect disease-free survival or tumor-specific survival among patients of reproductive age with stage I EOC and among high-risk patients with stage IC2-3, grade 3, or clear-cell carcinoma. Thirty-four out of 52 (65.4%) FSS patients attempted to get pregnant. Twenty-eight (82.4%) achieved a successful pregnancy with a full-term delivery. Grade 3 or clear-cell carcinoma was the only independent risk factor for survival of patients of reproductive age with stage I EOC. FSS can be safely performed on patients of reproductive age with grade 1-2, stage I EOC. The safety of FSS for grade 3 and clear-cell carcinoma warrants further investigation.

  13. Social support networks and depression of women suffering from early-stage breast cancer: a case control study.

    Science.gov (United States)

    Gagliardi, Cristina; Vespa, Anna; Papa, Roberta; Mariotti, Carlo; Cascinu, Stefano; Rossini, Simonetta

    2009-01-01

    The aim of this study was to investigate the areas of depression, anxiety, and social support using the structural model of the social network. By comparing the networks of two samples of breast cancer sufferers and healthy control participants, it was possible to identify differences in their relationships, in the shape of the networks themselves, and in the levels of depression and anxiety. Women with breast cancer described smaller and denser networks, including mainly kins whereas the healthy women included more friends, coworkers, and leisure companions. The levels of anxiety and depression were higher in women with breast cancer. Social network and social support measure correlated differently with depression and anxiety in the two groups.

  14. What is the current status of ovarian suppression/ablation in women with premenopausal early-stage breast cancer?

    Science.gov (United States)

    Higgins, Michaela J; Davidson, Nancy E

    2009-01-01

    The role of ovarian suppression/ablation (OS/OA) in premenopausal women with hormone receptor-positive breast cancer has been evolving for more than a century. It is clear that OS/OA is an effective adjuvant therapy for these women, but despite numerous studies enrolling thousands of women, many unanswered questions remain. In particular, a major question is whether additional benefit is gained with combination treatment comprising luteinizing hormone-releasing hormone (LH-RH) agonists and tamoxifen over tamoxifen alone. Ongoing trials also are assessing the coupling of aromatase inhibitors (traditionally contraindicated in these patients because of paradoxic stimulation of estrogen production) and LH-RH agonists. Any potential disease-free or overall survival advantage of combination treatment must be balanced against a possible increase in adverse effects and impairment of quality of life. This review focuses on new data on how to incorporate OS/OA into the rational treatment of this challenging patient population.

  15. ACR Appropriateness Criteria® Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women.

    Science.gov (United States)

    Moy, Linda; Bailey, Lisa; D'Orsi, Carl; Green, Edward D; Holbrook, Anna I; Lee, Su-Ju; Lourenco, Ana P; Mainiero, Martha B; Sepulveda, Karla A; Slanetz, Priscilla J; Trikha, Sunita; Yepes, Monica M; Newell, Mary S

    2017-05-01

    Women and health care professionals generally prefer intensive follow-up after a diagnosis of breast cancer. However, there are no survival differences between women who obtain intensive surveillance with imaging and laboratory studies compared with women who only undergo testing because of the development of symptoms or findings on clinical examinations. American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines state that annual mammography is the only imaging examination that should be performed to detect a localized breast recurrence in asymptomatic patients; more imaging may be needed if the patient has locoregional symptoms (eg, palpable abnormality). Women with other risk factors that increase their lifetime risk for breast cancer may warrant evaluation with breast MRI. Furthermore, the quality of life is similar for women who undergo intensive surveillance compared with those who do not. There is little justification for imaging to detect or rule out metastasis in asymptomatic women with newly diagnosed stage I breast cancer. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Prevalence and risk of depressive symptoms 3-4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer

    DEFF Research Database (Denmark)

    Christensen, Søren; Zachariae, Robert; Jensen, Anders Bonde

    2009-01-01

    surgery for breast cancer, and to identify clinical risk factors while adjusting for pre-cancer sociodemographic factors, comorbidity, and psychiatric history. PATIENTS AND METHODS: The study cohort consists of 4917 Danish women, aged 18-70 years, receiving standardized treatment for early stage invasive...... breast cancer during the 2 1/2 year study period. Of these, 3343 women (68%) participated in a questionnaire study 12-16 weeks following surgery. Depressive symptoms (Beck's Depression Inventory II) and health-related behaviors were assessed by questionnaire. The Danish Breast Cancer Cooperative Group...... prognostic information. Physical functioning, smoking, alcohol use, and BMI were also independently associated with depressive symptoms. CONCLUSION: Risk factors for depressive symptoms were primarily restricted to pre-cancer conditions rather than disease-specific conditions. Special attention should...

  17. Effect of Inhalation of Aroma of Geranium Essence on Anxiety and Physiological Parameters during First Stage of Labor in Nulliparous Women: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Fahimeh Rashidi Fakari

    2015-06-01

    Full Text Available Introduction: Anxiety increases significantly during labor, especially among nulliparous women. Such anxiety may affect the progress of labor and physiological parameters. The use of essential oils of aromatic plants, or aromatherapy, is a non-invasive procedure that can decrease childbirth anxiety. This study examined the effect of inhalation of the aroma of geranium essential oil on the level of anxiety and physiological parameters of nulliparous women in the first stage of labor. Methods: In study, was carried out on 100 nulliparous women admitted to Bent al-Hoda Hospital in the city of Bojnord in North Khorasan province of Iran during 2012-2013. The women were randomly assigned to two groups of equal size, one experimental group (geranium essential oil and one control (placebo group. Anxiety levels were measured using Spielberger’s questionnaire before and after intervention. Physiological parameters (systolic and diastolic blood pressure, respiratory rate, pulse rate were also measured before and after intervention in both groups. Data analysis was conducted using the x2 test, paired t-test, Mann-Whitney U test, and Wilcox on test on SPSS 11.5. Results: The mean anxiety score decreased significantly after inhalation of the aroma of geranium essential oil. There was also a significant decrease in diastolic blood pressure.Conclusion: Aroma of essential oil of geraniums can effectively reduce anxiety during labor and can be recommended as a non-invasive anti-anxiety aid during childbirth.

  18. Health beliefs and stages of changes to improve behaviors among obese and overweight women undergoing preconception care

    Directory of Open Access Journals (Sweden)

    Zahra Malverdy

    2016-01-01

    Conclusions: Results showed that a health belief model could be a predictor of weight adjustment behaviors including nutrition and physical activity behaviors. Therefore, educational interventions based on a health belief model could be effective for improvement of these behaviors in obese and overweight women under preconception care.

  19. Does stage of cancer, comorbidity or lifestyle factors explain educational differences in survival after endometrial cancer? A cohort study among Danish women diagnosed 2005-2009.

    Science.gov (United States)

    Seidelin, Ulla Holten; Ibfelt, Else; Andersen, Ingelise; Steding-Jessen, Marianne; Høgdall, Claus; Kjær, Susanne Krüger; Dalton, Susanne Oksbjerg

    2016-06-01

    Several studies have documented an association between socioeconomic position and survival from gynaecological cancer, but the mechanisms are unclear. The aim of this study was to examine the association between level of education and survival after endometrial cancer among Danish women; and whether differences in stage at diagnosis and comorbidity contribute to the educational differences in survival. Women with endometrial cancer diagnosed between 2005 and 2009 were identified in the Danish Gynaecological Cancer Database, with information on clinical characteristics, surgery, body mass index (BMI) and smoking status. Information on highest attained education, cohabitation and comorbidity was obtained from nationwide administrative registries. Logistic regression models were used to determine the association between level of education and cancer stage and Cox proportional hazards model for analyses of overall survival. Of the 3638 patients identified during the study period, 787 had died by the end of 2011. The group of patients with short education had a higher odds ratio (OR) for advanced stage at diagnosis, but this was not statistically significant (adjusted OR 1.20; 95% CI 0.97-1.49). The age-adjusted hazard ratio (HR) for dying of patients with short education was 1.47 (CI 95% 1.17-1.80). Adjustment for cohabitation status, BMI, smoking and comorbidity did not change HRs, but further adjustment for cancer stage yielded a HR of 1.36 (1.11-1.67). Early detection in all educational groups might reduce social inequalities in survival, however, the unexplained increased risk for death after adjustment for prognostic factors, warrants increased attention to patients with short education in all age groups throughout treatment and rehabilitation.

  20. Optimal debulking targets in women with advanced stage ovarian cancer: a retrospective study of immediate versus interval debulking surgery.

    Science.gov (United States)

    Altman, Alon D; Nelson, Gregg; Chu, Pamela; Nation, Jill; Ghatage, Prafull

    2012-06-01

    The objective of this study was to examine both overall and disease-free survival of patients with advanced stage ovarian cancer after immediate or interval debulking surgery based on residual disease. We performed a retrospective chart review at the Tom Baker Cancer Centre in Calgary, Alberta of patients with pathologically confirmed stage III or IV ovarian cancer, fallopian tube cancer, or primary peritoneal cancer between 2003 and 2007. We collected data on the dates of diagnosis, recurrence, and death; cancer stage and grade, patients' age, surgery performed, and residual disease. One hundred ninety-two patients were included in the final analysis. The optimal debulking rate with immediate surgery was 64.8%, and with interval surgery it was 85.9%. There were improved overall and disease-free survival rates for optimally debulked disease (advanced stage ovarian cancer, the goal of surgery should be resection of disease to microscopic residual at the initial procedure. This results in improved overall survival than lesser degrees of resection. Further studies are required to determine optimal surgical management.

  1. Birthing positions during second stage of labor and long-term psychological outcomes in low-risk women

    NARCIS (Netherlands)

    Jonge, A. de; Rijnders, M.E.B.; Diem, M.T. van; Scheepers, P.L.H.; Lagro-Janssen, A.L.M.

    2011-01-01

    PURPOSE: To examine the long-term influence of birthing positions during the second stage of labor, as well as other factors, on birth satisfaction, self-esteem (based on the Rosenberg Self-esteem Scale [RSE]) and emotional well-being (based on the Edinburgh Postnatal Depression Scale [EPDS]). STUDY

  2. Women

    OpenAIRE

    Annesley, Claire; Himmelweit, Susan

    2011-01-01

    This chapter examines the government's approach to fairness in its Comprehensive Spending Review and shows that it fails to acknowledge that men and women start from unequal positions, and that there are many barriers to social mobility other than lack of educational qualifications.\\ud Unequal employment opportunities and unpaid caring responsibilities are given as two examples. As a result women rely on public services to be able to combine care with employment and so cuts in public services...

  3. [Calcium and bone metabolism across women's life stages. Exercise and sport to increase bone strength in accordance with female lifecycle.

    Science.gov (United States)

    Iwamoto, Jun

    Among females who require the strategies for preventing osteoporosis, appropriate exercise and sport through all their life are important to increase or maintain bone mass. However, the type of exercise and sport applied to females is different in accordance with the lifecycle. Jumping exercise increases bone mineral content(BMC)in prepubescent children(premenarcheal girls). Bone mineral density(BMD)is higher in adolescent athletes who are engaged in weight-bearing activities. Jumping exercise, muscle strengthening exercise, and weight-bearing plus muscle strengthening exercises increase BMD in young adults and premenopausal women. Walking, aerobic weight-bearing exercise, muscle strengthening exercise, and weight-bearing plus muscle strengthening exercises maintain or increase BMD in postmenopausal women. Thus, appropriate exercise and sport in accordance with the lifecycle are important strategies for preventing osteoporosis in females.

  4. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival

    OpenAIRE

    Le, Gem M; O'Malley, Cynthia D; Glaser, Sally L; Lynch, Charles F; Stanford, Janet L; Keegan, Theresa HM; West, Dee W

    2004-01-01

    Background Few studies have examined the effect of breast implants after mastectomy on long-term survival in breast cancer patients, despite growing public health concern over potential long-term adverse health effects. Methods We analyzed data from the Surveillance, Epidemiology and End Results Breast Implant Surveillance Study conducted in San Francisco?Oakland, in Seattle?Puget Sound, and in Iowa. This population-based, retrospective cohort included women younger than 65 years when diagnos...

  5. The value of complementary and alternative medicine in the treatment of climacteric symptoms: results of a survey among German gynecologists.

    Science.gov (United States)

    von Studnitz, Friederike S G; Eulenburg, Christine; Mueck, Alfred O; Buhling, Kai J

    2013-10-01

    The present study aims to detect the attitude and experience towards complementary and alternative medicine (CAM) in the treatment of climacteric disorders among gynecologists in Germany. A self-administered questionnaire, containing 15 questions, was sent to all gynecologists in private practice in Germany (n=9589). Gynecologists were asked about their experience with several forms of CAM. They were asked to rate different procedures as "effective", "sometimes effective" or "unimportant". The response rate was 33.7% (n=3227). We report on 2549 (26.6%) eligible questionnaires. Well-known therapies were black cohosh (Cimicifuga racemosa), chaste tree (Vitex agnus castus) and St. John's wort. More than 98% had had experiences with these therapies. Fewer experiences were stated with hormone-yoga (42.9%), acupuncture (29.1%) and homeopathy (21.6%). The most effective alternative therapy rated was an alteration of lifestyle with 54.4% (n=1325) stating it was effective and 35.7% (n=871) stating it was sometimes effective. Only 3.9% (n=96) prescribed no efficacy to a change of lifestyle. Other treatments rated as effective were St. John's wort (25.0%, n=606) and Black cohosh (21.1%, n=527). Agents regarded most ineffective were hormone-yoga (4.7%, n=109), acupuncture (10.3%, n=243) and homeopathy (10.6%, n=250). Female gynecologists were more likely to vote for a therapy to be effective compared to their male colleagues. German gynecologists seem to have made positive experiences with CAM when observing their patients, in general. An alteration of lifestyle is seen as the most effective alternative therapy in menopause. Due to their widespread use, possible side effect of natural agents should be excluded. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Development of Metal-Organic Framework for Gaseous Plant Hormone Encapsulation To Manage Ripening of Climacteric Produce.

    Science.gov (United States)

    Zhang, Boce; Luo, Yaguang; Kanyuck, Kelsey; Bauchan, Gary; Mowery, Joseph; Zavalij, Peter

    2016-06-29

    Controlled ripening of climacteric fruits, such as bananas and avocados, is a critical step to provide consumers with high-quality products while reducing postharvest losses. Prior to ripening, these fruits can be stored for an extended period of time but are usually not suitable for consumption. However, once ripening is initiated, they undergo irreversible changes that lead to rapid quality loss and decay if not consumed within a short window of time. Therefore, technologies to slow the ripening process after its onset or to stimulate ripening immediately before consumption are in high demand. In this study, we developed a solid porous metal-organic framework (MOF) to encapsulate gaseous ethylene for subsequent release. We evaluated the feasibility of this technology for on-demand stimulated ripening of bananas and avocados. Copper terephthalate (CuTPA) MOF was synthesized via a solvothermal method and loaded with ethylene gas. Its crystalline structure and chemical composition were characterized by X-ray diffraction crystallography, porosity by N2 and ethylene isotherms, and morphology by electron microscopy. The MOF loaded with ethylene (MOF-ethylene) was placed inside sealed containers with preclimacteric bananas and avocados and stored at 16 °C. The headspace gas composition and fruit color and texture were monitored periodically. Results showed that this CuTPA MOF is highly porous, with a total pore volume of 0.39 cm(3)/g. A 50 mg portion of MOF-ethylene can absorb and release up to 654 μL/L of ethylene in a 4 L container. MOF-ethylene significantly accelerated the ripening-related color and firmness changes of treated bananas and avocados. This result suggests that MOF-ethylene technology could be used for postharvest application to stimulate ripening just before the point of consumption.

  7. Childhood Sexual Abuse and Two Stages of Cigarette Smoking in African-American and European-American Young Women

    Science.gov (United States)

    Sartor, Carolyn E.; Grant, Julia D.; Duncan, Alexis E.; McCutcheon, Vivia V.; Nelson, Elliot C.; Calvert, Wilma J.; Madden, Pamela A.F.; Heath, Andrew C.; Bucholz, Kathleen K.

    2016-01-01

    Objective The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. Methods Data were drawn from a same-sex female twin study of substance use (n=3,521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). Results After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazards ratio (HR)=1.43, 95% confidence intervals (CI): 1.26–1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26–2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI:1.21–2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI:1.23–8.89 to HR=1.16, CI:0.71–1.92 for regular smoking ≤15). Conclusions CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women. PMID:27131220

  8. The N-glycan processing enzymes α-mannosidase and β-D-N-acetylhexosaminidase are involved in ripening-associated softening in the non-climacteric fruits of capsicum

    Science.gov (United States)

    Ghosh, Sumit; Meli, Vijaykumar S.; Kumar, Anil; Thakur, Archana; Chakraborty, Niranjan; Chakraborty, Subhra; Datta, Asis

    2011-01-01

    Excessive softening of fruits during the ripening process leads to deterioration. This is of significant global importance as softening-mediated deterioration leads to huge postharvest losses. N-glycan processing enzymes are reported to play an important role during climacteric fruit softening: however, to date these enzymes have not been characterized in non-climacteric fruit. Two ripening-specific N-glycan processing enzymes, α-mannosidase (α-Man) and β-D-N-acetylhexosaminidase (β-Hex), have been identified and targeted to enhance the shelf life in non-climacteric fruits such as capsicum (Capsicum annuum). The purification, cloning, and functional characterization of α-Man and β-Hex from capsicum, which belong to glycosyl hydrolase (GH) families 38 and 20, respectively, are described here. α-Man and β-Hex are cell wall glycoproteins that are able to cleave terminal α-mannose and β-D-N-acetylglucosamine residues of N-glycans, respectively. α-Man and β-Hex transcripts as well as enzyme activity increase with the ripening and/or softening of capsicum. The function of α-Man and β-Hex in capsicum softening is investigated through RNA interference (RNAi) in fruits. α-Man and β-Hex RNAi fruits were approximately two times firmer compared with the control and fruit deterioration was delayed by approximately 7 d. It is shown that silencing of α-Man and β-Hex enhances fruit shelf life due to the reduced degradation of N-glycoproteins which resulted in delayed softening. Altogether, the results provide evidence for the involvement of N-glycan processing in non-climacteric fruit softening. In conclusion, genetic engineering of N-glycan processing can be a common strategy in both climacteric and non-climacteric species to reduce the post-harvest crop losses. PMID:21030387

  9. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Johnson, Sarah A; Figueroa, Arturo; Navaei, Negin; Wong, Alexei; Kalfon, Roy; Ormsbee, Lauren T; Feresin, Rafaela G; Elam, Marcus L; Hooshmand, Shirin; Payton, Mark E; Arjmandi, Bahram H

    2015-03-01

    Postmenopausal women have a high prevalence of hypertension and often develop arterial stiffness thereby increasing cardiovascular disease risk. Although antihypertensive drug therapies exist, increasing numbers of people prefer natural therapies. In vivo studies and a limited number of clinical studies have demonstrated the antihypertensive and vascular-protective effects of blueberries. To examine the effects of daily blueberry consumption for 8 weeks on blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension. This was an 8-week, randomized, double-blind, placebo-controlled clinical trial. Forty-eight postmenopausal women with pre- and stage 1-hypertension recruited from the greater Tallahassee, FL, area participated. Participants were randomly assigned to receive either 22 g freeze-dried blueberry powder or 22 g control powder. Resting brachial systolic and diastolic blood pressures were evaluated and arterial stiffness was assessed using carotid-femoral pulse wave velocity and brachial-ankle pulse wave velocity. C-reactive protein, nitric oxide, and superoxide dismutase were measured at baseline, 4 weeks, and 8 weeks. Statistical analysis was performed using a split plot model of repeated measures analysis of variance. After 8 weeks, systolic blood pressure and diastolic blood pressure (131±17 mm Hg [Pblueberry powder group, whereas there were no changes in the group receiving the control powder. Nitric oxide levels were greater (15.35±11.16 μmol/L; Pblueberry powder group at 8 weeks compared with baseline values (9.11±7.95 μmol/L), whereas there were no changes in the control group. Daily blueberry consumption may reduce blood pressure and arterial stiffness, which may be due, in part, to increased nitric oxide production. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  10. Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

    International Nuclear Information System (INIS)

    Reinertsen, Kristin Valborg; Cvancarova, Milada; Wist, Erik; Bjoro, Trine; Dahl, Alv A.; Danielsen, Turi; Fossa, Sophie D.

    2009-01-01

    Purpose: A possible association between thyroid diseases (TD) and breast cancer (BC) has been debated. We examined prevalence and development of TD in women after multimodal treatment for Stage II/III BC compared with women from a general population. Secondarily, we explored the impact of two different radiotherapy (RT) techniques (standardized field arrangements vs. computed tomography [CT]-based dose planning) on TD in BC patients examined 35-120 months after primary BC treatment. Methods and Materials: A total of 403 BC patients completed a questionnaire about TD and had blood samples taken for analyses of thyroid function. All had undergone postoperative RT with or without (2%) adjuvant systemic treatment. The results in the BC patients were compared with a cancer-free, age-matched control group from a general population (CGr). Results: There was higher prevalence of self-reported hypothyroidism in the BC patients as compared with the CGr (18% vs. 6%, p < 0.001). The raised prevalence was predominantly due to a substantial increase in the development of hypothyroidism after BC diagnosis, whereas the prevalence of hypothyroidism before BC diagnosis was similar to that observed in the CGr. Patients treated with CT-based RT showed a trend for increased post-BC development of hypothyroidism as compared with those treated with standardized field arrangements (p = 0.08). Conclusions: Hypothyroidism is significantly increased in women after multimodal treatment for Stage II/III BC. Radiation to the thyroid gland may be a contributing factor. BC patients should be routinely screened for hypothyroidism.

  11. When to stop pushing: effects of duration of second-stage expulsion efforts on maternal and neonatal outcomes in nulliparous women with epidural analgesia.

    Science.gov (United States)

    Le Ray, Camille; Audibert, François; Goffinet, François; Fraser, William

    2009-10-01

    The purpose of this study was to assess the influence of the duration of active second-stage labor on maternal and neonatal outcomes. Secondary analysis of the Pushing Early Or Pushing Late with Epidural trial that included 1862 nulliparous women with epidural analgesia who were in the second stage of labor. According to duration of active second-stage labor, we estimated the proportion of spontaneous vaginal deliveries (SVD) with a newborn infant without signs of asphyxia (5-minute Apgar score > or =7 and arterial pH >7.10). We also analyzed maternal and neonatal outcomes according to the duration of expulsive efforts. Relative to the first hour of expulsive efforts, the chances of a SVD of a newborn infant without signs of asphyxia decreased significantly every hour (1- to 2-hour adjusted odds ratio, 0.4; 95% confidence interval [CI], 0.3-0.6; 2- to 3-hour adjusted odds ratio, 0.1; 95% CI, 0.09-0.2; >3-hour adjusted odds ratio, 0.03; 95% CI, 0.02-0.05). The risk of postpartum hemorrhage and intrapartum fever increased significantly after 2 hours of pushing. Faced with a decreasing probability of SVD and increased maternal risk of morbidity after 2 hours, we raise the question as to whether expulsive efforts should be continued after this time.

  12. Reflections on sexuality during the climacteric Reflexiones sobre la sexualidad durante la vivencia del climaterio Reflexões sobre a sexualidade durante a vivência do climatério

    Directory of Open Access Journals (Sweden)

    Roselane Gonçalves

    2009-04-01

    Full Text Available Qualitative and phenomenological study based on reports of women between 48 and 55 years old with spontaneous menopause for 12 months or more. Results evidenced five theme categories that were analyzed and interpreted based on Maurice Merleau-Ponty's theoretical-philosophical reference framework. Among the categories that emerged from reports, the theme "reflecting on sexuality" was emphasized, and is presented with a view to understanding the existential aspects of the climacteric experience, focusing on the exercise of sexuality.Se trata de un estudio cualitativo de abordaje fenomenológico, realizado a partir del relato de mujeres con edad entre 48 y 55 años que habían presentado menopausia espontánea hace 12 meses o más. Los resultados mostraron cinco categorías temáticas que fueron analizadas e interpretadas con base en el marco teórico filosófico de Maurice Merleau-Ponty. Entre las categorías que surgieron de los relatos sobresalió el tema" Reflexionando sobre la sexualidad" que será presentado con el objetivo de comprender los aspectos existenciales de la vivencia del climaterio con énfasis en la sexualidad.Estudo qualitativo de abordagem fenomenológica, realizado a partir do depoimento de mulheres entre 48 e 55 anos que haviam apresentado menopausa espontânea há 12 meses ou mais. Os resultados evidenciaram cinco categorias temáticas que foram analisadas e interpretadas à luz do referencial teórico filosófico de Maurice Merleau-Ponty. Dentre as categorias que emergiram dos depoimentos destacou-se o tema: "refletindo sobre a sexualidade", que será apresentado com o objetivo de compreender os aspectos existenciais da vivência do climatério com ênfase no exercício da sexualidade.

  13. Incidence of chemotherapy- and chemoradiotherapy-induced amenorrhea in premenopausal women with stage II/III colorectal cancer.

    Science.gov (United States)

    Wan, Juefeng; Gai, Ya; Li, Guichao; Tao, Zhonghua; Zhang, Zhen

    2015-03-01

    The incidence rates of colorectal cancer (CRC) in young individuals are increasing. There has been a significant improvement in overall survival in CRC because of advances in adjuvant chemotherapy and chemoradiotherapy over the past decades. However, these procedures may compromise the function of the reproductive system, and ovarian failure and premature menopause may occur. The objective of this analysis was to determine the incidence of long-term amenorrhea (≥ 12 months) in women with CRC aged 40 years and younger after adjuvant treatment. The authors identified 162 premenopausal women with CRC aged 40 years or younger who were treated with adjuvant chemotherapy and chemoradiotherapy at Fudan University Shanghai Cancer Center from January 2008 to December 2012. One hundred twenty-three patients met all eligibility criteria and had sufficient follow-up for evaluation. The median age at diagnosis in patients with colon and rectal cancers was, respectively, 36 and 35 years (range, 17-40 and 24-40 years). All patients had regular menses before treatment; 3 patients with colon cancer (4.2%) experienced long-term amenorrhea, and 48 patients with rectal cancer (94.1%) experienced long-term amenorrhea. The incidence of amenorrhea was significantly lower in patients with colon cancer (4.2%; 3 of 72) than in patients with rectal cancer (94.1%; 48 of 51) (P amenorrhea in patients with colon and rectal cancers was 4.2% and 94.1%, respectively. We believe our data support the fact that young female patients with CRC, especially those with rectal cancer who are scheduled to undergo pelvic irradiation, should be counseled regarding fertility preservation options, including ovarian transposition and cryopreservation of ovarian tissue, embryo, or oocyte. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Representações médicas e de gênero na promoção da saúde no climatério/menopausa Medicals and gender's representations on health promotion in climacteric/menopause

    Directory of Open Access Journals (Sweden)

    Eliana Azevedo Pereira de Mendonça

    2004-01-01

    Full Text Available Ao analisar práticas educativas na assistência à mulher no climatério numa unidade ambulatorial no Rio de Janeiro, observamos que as construções de gênero operam de forma incisiva nas vivências das usuárias, que, por meio de imagens, símbolos e representações, expressaram o sentimento de perda em várias direções: insegurança diante dos sintomas de natureza física e psicológica antes não vivenciados; menos-valia pelo desprezo às suas queixas; medo do desconhecido quanto às representações negativas da menopausa. Tornar inteligíveis as representações sociais de um dado grupo sobre o objeto menopausa implica analisar a eficácia dos discursos em relação às mudanças fisiológicas da mulher nessa fase e iniciar um processo de troca entre população e profissionais no sentido de (reconstruí-las a partir da crítica às representações dominantes que sustentam relações de poder, favorecendo a expressão dos sentimentos e emoções, de maneira a possibilitar à mulher ser sujeito ativo de sua saúde e ampliar o olhar e a sensibilidade dos profissionais da saúde.Having focusing on an interdisciplinary activity in climacteric women's attention in a health public organization in Rio de Janeiro between 1990-1995, we have observed that the gender's construction had a significant influence in women's daily lives and that most of them had a negative social representation of the menopause. They talked about their fears of the menopause consequences. When we know social representations about menopause, we can access the effectiveness of the discourse about women's physicals and psychological changes during this period life and establish more efficient and communicative exchanges between all the people concerned and the health workers to build new social representations, and help women to express the emotions resulting from the "battle of mind" fought in all their relationships. This would firstly enable them to take an active

  15. Conhecimento, percepções e assistência à saúde da mulher no climatério Conocimiento, percepciones y asistencia a la salud de la mujer en lo climaterio Knowledge, perceptions and assistance to woman's health in the climacteric

    Directory of Open Access Journals (Sweden)

    Neiva Iolanda de Oliveira Berni

    2007-06-01

    Full Text Available As vivências do climatério foram o objeto deste estudo, em pesquisa descritivo-qualitativa com mulheres das cidades de Canoas e Porto Alegre, RS. A coleta de informações utilizou entrevista semi-estruturada em 15 mulheres entre 41 e 59 anos de idade. A interpretação e análise basearam-se na análise de conteúdo. As mulheres expressam confusão sobre o significado do climatério, relacionando-o aos sintomas que associam ao envelhecimento. Reconhecem tratar-se de uma fase da vida com aspectos também positivos e a vivem sem maiores preocupações.As percepções das mulheres sobre o climatério são fragmentadas e a assistência médica o trata como doença passível de tratamento. Portanto, o profissional enfermeiro, pela presença interativa constante na vida dessas mulheres, pode ajudar a desmistificar e ressignificar esse processo na vida da mulher.Las vivencias del climaterio fueron el objeto de este estudio, en investigación descriptiva-cualitativa con mujeres de las ciudades de Canoas y Porto Alegre, RS. La recolección de informaciones utilizó entrevista semiestructurada con 15 mujeres entre 41 y 59 años de edad. La interpretación y el análisis se basaran en el análisis de contenido. Las mujeres expresan confusión acerca del significado de climaterio, relacionándolo con los síntomas que asociados al envejecimiento. Reconocen tratarse de una fase de la vida con aspectos también positivos y la viven sin mayores preocupaciones. Las percepciones de las mujeres acerca del climaterio son fragmentadas y la asistencia médica lo trata como enfermedad factible de tratamiento. Por lo tanto, el profesional enfermero, por su presencia interactiva constante en la vida de esas mujeres, puede ayudar a desmistificar y a re-significar ese proceso en la vida de la mujer.The experience of the climacteric period is the object of the present descriptive-qualitative study with women from the cities of Canoas and Porto Alegre, RS. The

  16. Histologic parameters predictive of disease outcome in women with advanced stage ovarian carcinoma treated with neoadjuvant chemotherapy.

    Science.gov (United States)

    Samrao, Damanzoopinder; Wang, Dan; Ough, Faith; Lin, Yvonne G; Liu, Song; Menesses, Teodulo; Yessaian, Annie; Turner, Nicole; Pejovic, Tanja; Mhawech-Fauceglia, Paulette

    2012-12-01

    The use of neoadjuvant chemotherapy followed by tumor reduction surgery, also called interval debulking surgery (IDS), is considered an alternative therapeutic regimen for selected patients with advanced stage epithelial ovarian cancer (EOC). Although minimal residual disease has been proven to be a prognostic factor in traditional cytoreduction for advanced stage EOC, predictive factors after IDS still remain unexplored. The aim of this study was to determine the prognostic value of post-neoadjuvant histologic changes with clinical outcome. Three pathologists evaluated 67 cases for the following parameters: fibrosis, necrosis, residual tumor, and inflammation. The Cohen's kappa statistic was used to measure agreement among pathologists. Univariate and multivariate Cox proportional hazards models were used to determine the association between histologic parameters and recurrence-free survival (RFS) and overall survival (OS). There was substantial to almost perfect agreement among the three pathologists in all four histologic parameters (k ranged from 0.65 to 0.97). Fibrosis was associated with longer RFS (P = 0.0257) with a median of 20 months for tumors with fibrosis (3+) versus 12 months for tumors with fibrosis (1+, 2+) and longer OS (P = 0.0249) with a median of 51 months for tumors with fibrosis (3+) versus 32 months for tumors with fibrosis (1+, 2+). Our results revealed that patients with tumors exhibiting fibrosis (1+, 2+), as well as necrosis (0, 1+), had significant shorter RFS and OS (P = 0.059 and P = 0.0234, respectively). We suggest that the assessment of fibrosis and necrosis should be implemented in pathologic evaluation and prospectively validated in future studies.

  17. Selection of the Optimal Herbal Compositions of Red Clover and Pomegranate According to Their Protective Effect against Climacteric Symptoms in Ovariectomized Mice

    Directory of Open Access Journals (Sweden)

    Su Jin Kang

    2016-07-01

    Full Text Available This study aimed to ascertain the optimal range of red clover dry extracts (RC and dried pomegranate concentrate powder (PCP to induce anti-climacteric effects. Thus, the dose ranges showing protective effect of mixed formulae consisting of RC and PCP were examined in ovariectomized mice. At 28 days after bilateral ovariectomy (OVX, mixed herbal compositions (RC:PCP = 1:1, 1:2, 1:4, 1:8, 2:1, 4:1, and 8:1 were administered orally, at 120 mg/kg once daily for 84 days. We evaluated that RC and PCP mixture attenuate OVX-caused obesity, hyperlipidemia, hepatic steatosis, and osteoporosis. Compared to OVX-induced control mice, body weight and abdominal fat weight in OVX-induced mice were significantly decreased, concomitantly with increase of uterus weight by RC:PCP mixture. Additionally, significant increases in serum estradiol levels were observed in all RC:PCP-treated mice. RC:PCP mixture also showed protective effect against OVX-induced hyperlipidemia, hepatic steatosis. Total body and femur mean bone mineral density (BMD, osteocalcin, bALP contents were effectively increased by RC:PCP mixture. Taken together, RC:PCP mixture (2:1, 1:1, and 4:1 has remarkable protective effects against the changes induced by OVX. In particular, RC:PCP mixture (2:1 shows the strongest effect and may be considered as a potential protective agent against climacteric symptoms.

  18. Perceptions, Expectations, and Attitudes about Communication with Physicians among Chinese American and non-Hispanic White Women with Early-Stage Breast Cancer

    Science.gov (United States)

    Wang, Judy Huei-yu; Adams, Inez F.; Pasick, Rena J.; Gomez, Scarlett L.; Allen, Laura; Ma, Grace X.; Lee, Michael X.; Huang, Ellen

    2013-01-01

    Purpose Asian Americans have consistently reported poorer communication with physicians compared with non-Hispanic Whites (NHW). This qualitative study sought to elucidate the similarities and differences in communication with physicians between Chinese and NHW breast cancer survivors. Methods Forty-four Chinese and 28 NHW women with early-stage breast cancer (stage 0-IIa) from the Greater Bay Area Cancer Registry participated in focus group discussions or individual interviews. We oversampled Chinese women because little is known about their cancer care experiences. In both interview formats, questions explored patients’ experiences and feelings when communicating with physicians about their diagnosis, treatment, and follow-up care. Results Physician empathy at the time of diagnosis was important to both ethnic groups; however, during treatment and follow-up care, physicians’ ability to treat cancer and alleviate physical symptoms was a higher priority. NHW and US-born Chinese survivors were more likely to assert their needs, whereas Chinese immigrants accepted physician advice even when it did not alleviate physical problems (e.g., pain). Patients viewed all physicians as the primary source for information about cancer care. Many Chinese immigrants sought additional information from primary care physicians and stressed optimal communication over language concordance. Conclusions Physician empathy and precise information were important for cancer patients. Cultural differences such as the Western emphasis on individual autonomy vs. Chinese emphasis on respect and hierarchy can be the basis for the varied approaches to physician communication we observed. Interventions based on cultural understanding can foster more effective communication between immigrant patients and physicians ultimately improving patient outcomes. PMID:23903797

  19. Long-term radiation sequelae after breast-conserving therapy in women with early-stage breast cancer: an observational study using the LENT-SOMA scoring system

    International Nuclear Information System (INIS)

    Fehlauer, Fabian; Tribius, Silke; Hoeller, Ulrike; Rades, Dirk; Kuhlmey, Antje; Bajrovic, Amira; Alberti, Winfried

    2003-01-01

    Purpose: To evaluate the long-term toxicity after breast-conserving therapy in women with early-stage breast cancer. Methods and Materials: Late toxicity according to the late effects of normal tissue-subjective, objective, management, and analytic (LENT-SOMA) criteria and cosmetic outcome (graded by physicians) were evaluated in 590 of 2943 women with early-stage breast cancer who were irradiated between 1983 and 1995 using the following fractionation schedules: group A, 1983-1987, 2.5 Gy 4x/wk to 60 Gy; group B, 1988-1993, 2.5 Gy 4x/wk to 55 Gy, group C, 1994-1995, 2.0 Gy 5x/wk to 55 Gy. Results: LENT-SOMA Grade 3-4 toxicity was observed as follows: group A (median follow-up 171 months; range 154-222 months), fibrosis 16% (7 of 45), telangiectasia 18% (8 of 45), and atrophy 4% (2 of 45); group B (median follow-up 113 months; range 78-164 months), pain 2% (8 of 345), fibrosis 10% (34 of 345), telangiectasia 10% (33 of 345), arm edema 1% (2 of 345), and atrophy 8% (27 of 345); and group C (median follow-up 75 months, range 51-96 months, n = 200), occurrence of Grade 3-4 late morbidity ≤2%. The cosmetic outcome was very good to acceptable in 78% (35 of 45) of patients in group A, 83% (286 of 345) in group B, and 94% (187 of 200) in group C. Conclusion: In our population, the long-term side effects after breast-conserving therapy were not rare, but were mainly asymptomatic. The LENT-SOMA breast module is a practical tool to assess radiation-induced long-term toxicity

  20. Clinicopathological Characteristics and Prognosis of Papillary Thyroid Carcinoma in Naturally Menopausal Women with Various Durations of Premenarche, Reproductive Periods, and Postmenopausal Stages

    Directory of Open Access Journals (Sweden)

    Xuhang Zhu

    2017-01-01

    Full Text Available Background. Papillary thyroid cancer (PTC exhibits a higher incidence in women. Due to various ages at menarche and menopause, estrogen levels vary, which may account for the differences in the occurrence, development, and prognosis of female patients with PTC. Objective. The aim of this study was to investigate the association between various durations in different estrogen levels and PTC and to provide important information to guide clinical management and treatment of this disease. Methods. First, we selected naturally menopausal female study subjects diagnosed with PTC at Zhejiang Cancer Hospital from 2007 to 2012 and then compared the differences in clinicopathological characteristics and prognosis among subjects with various lengths of premenarche, reproductive periods, and postmenopausal stages. Results. We found that all patients showed a significantly higher incidence of tumor multicentricity and intrathyroidal dissemination as the time after menopause increased. Additionally, women with shorter (38 reproductive lives had increased recurrence rates of PTC. Conclusions. In this study, we did not find any relationship of self-reported menarche and menopausal ages with the prognosis of PTC patients. More importantly, natural postmenopausal PTC patients with shorter or longer reproductive life, compared to the normal groups, had a higher rate of cancer recurrence and the patients with these characteristics could be recommended a more aggressive surgical treatment.

  1. The impact of endocrine therapy on sexual dysfunction in postmenopausal women with early stage breast cancer: encouraging results from a prospective study.

    Science.gov (United States)

    Frechette, Dominique; Paquet, Lise; Verma, Shailendra; Clemons, Mark; Wheatley-Price, Paul; Gertler, Stan Z; Song, Xinni; Graham, Nadine; Dent, Susan

    2013-08-01

    The goal of this project was to investigate the contentious issue of a possible effect of endocrine therapy (ET) on sexual dysfunction (SD) in postmenopausal early stage breast cancer survivors. To date, few studies have assessed sexual functioning prior to initiating ET and none have taken sexual distress into account when reporting the prevalence of ET-induced SD. We report the findings of a study on the change in SD (defined as experiencing sexual problems causing distress) during the first 6 months of ET usage. Between January 2009 and May 2011, 118 patients entered the study and 66 completed questionnaires prior to initiation of ET and after 6 months of use. Sexual functioning (SF) was evaluated with the female sexual function index while sexual distress was assessed with the female sexual distress scale (FSDS-R). Gynecological symptoms were measured with the FACT-B ES subscale. Over time, the level of gynecological symptoms increased (p problem (85 %) and the percentage who were sexually distressed (30 %) remained the same across time. Importantly, the change in the prevalence of SD between baseline (24 %) and 6 months (29 %) was not statistically significant. Women experiencing SD at baseline were more likely to experience SD after 6 months of ET usage (OR = 7.4, 95 % CI = 1.5-36.9) than women who had no SD prior to initiating ET. The observation that SF remained stable across time is encouraging news. However, longer follow-up and the inclusion of women who were premenopausal at diagnosis are needed to determine the potential influence of extended duration of ET (e.g., at least 5 years) on SD. Further studies, including assessing the impact of early identification of patients at risk of developing SD and timely intervention, are warranted.

  2. Knowledge, non-use, use and source of information on contraceptive methods among women in various stages of reproductive age in rural Lagos, Southwest Nigeria.

    Science.gov (United States)

    Afolabi, Bamgboye M; Ezedinachi, Emmanuel Nu; Arikpo, Iwara; Ogunwale, Abiodun; Ganiyu, Damilola Fatimah; Abu, Rashidat A; Ajibade, Adewunmi A

    2015-01-01

    Contraceptives are advocated to be used against unwanted pregnancy and sexually transmitted diseases as unsafe abortion contributes to high maternal mortality in Nigeria while unwanted pregnancies have terminated the educational development of many females. This questionnaire-based survey aimed to describe the knowledge, nonuse, and use of various contraceptive methods among women in different child-bearing age groups in rural Lagos, Nigeria. Between 2012 and 2013, 816 females in rural communities within Lagos State were surveyed for their knowledge, source of information, and use of contraceptives. They were grouped into early, mid, and late reproductive age. Statistical analysis of data harvested from respondents was carried out using STATA 13 software. In all, 816 females in different stages of reproductive age were involved in the study, among whom 19% were single, 78% married, 3% divorced, and 0.5% widowed. About 6% had no formal education, while the majority (81%) were of the Yoruba ethnic group. Married respondents were approximately thrice more likely to know of contraceptives than single respondents ( χ 2 =29.9, P =0.000, odds ratio =2.9, 95% confidence interval =1.9, 4.2). Condom use was the most widely known and used method of contraceptive regardless of marital status and reproductive age status. Information about contraceptives was mainly from health facilities among married and divorced women and from school or educational institution among singles. Overall prevalence of contraceptive use was 51.9%. Nonuse of contraceptives was 43% among married women and 67% among singles. Knowledge of contraceptive method was negatively associated with marital status ( t =-2.24, P =0.025) but positively associated with source of information on contraceptives ( t =20.00, P =0.000). Use of contraceptives was positively associated with stage of reproductive age ( t =1.94, P =0.05) and source of information on contraceptives ( t =11.22, P =0.000), but negatively

  3. Second cancers after conservative surgery and radiation for stages I-II breast cancer: identifying a subset of women at increased risk

    International Nuclear Information System (INIS)

    Fowble, Barbara; Hanlon, Alexandra; Freedman, Gary; Nicolaou, Nicos; Anderson, Penny

    2001-01-01

    Purpose: To assess the risk and patterns of second malignancy in a group of women treated with conservative surgery and radiation in a relatively contemporary manner for early-stage invasive breast cancer, and to identify a subgroup of these women at increased risk for a second cancer. Methods and Materials: From 1978 to 1994, 1,253 women with unilateral Stage I-II breast cancer underwent wide excision, axillary dissection, and radiation. The median follow-up was 8.9 years, with 446 patients followed for ≥10 years. The median age was 55 years. Sixty-eight percent had T1 tumors and 74% were axillary-node negative. Radiation was directed to the breast only in 78%. Adjuvant therapy consisted of chemotherapy in 19%, tamoxifen in 19%, and both in 8%. Factors analyzed for their association with the cumulative incidence of all second malignancies, contralateral breast cancer, and non-breast cancer malignancy were: age, menopausal status, race, family history, obesity, smoking, tumor size, location, histology, pathologic nodal status, region(s) treated with radiation, and the use and type of adjuvant therapy. Results: One hundred seventy-six women developed a second malignancy (87 contralateral breast cancers at a median interval of 5.8 years, and 98 non-breast cancer malignancies at a median interval of 7.2 years). Nine women had both a contralateral breast cancer and non-breast cancer second malignancy. The 5- and 10-year cumulative incidences of a second malignancy were 5% and 16% for all cancers, 3% and 7% for contralateral breast cancer, 3% and 8%, for all second non-breast cancer malignancies, and 1% and 5%, respectively, for second non-breast cancer malignancies, excluding skin cancers. Patient age was a significant factor for contralateral breast cancer and non-breast cancer second malignancy. Young age was associated with an increased risk of contralateral breast cancer, while older age was associated with an increased the risk of a second non-breast cancer

  4. Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

    Energy Technology Data Exchange (ETDEWEB)

    Shirvani, Shervin M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona (United States); Jiang, Jing [Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Likhacheva, Anna [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona (United States); Hoffman, Karen E.; Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Caudle, Abigail [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-06-01

    Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 with Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008

  5. Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

    International Nuclear Information System (INIS)

    Shirvani, Shervin M.; Jiang, Jing; Likhacheva, Anna; Hoffman, Karen E.; Shaitelman, Simona F.; Caudle, Abigail; Buchholz, Thomas A.; Giordano, Sharon H.; Smith, Benjamin D.

    2016-01-01

    Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 with Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008

  6. Evaluation Of Hormone Profile And Dexa Values in Premenopausal, Perimenopausal and Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Esra Esen

    2005-09-01

    Full Text Available This study was carried out in 130 women, between 44-55 ages, admitted to outpatient clinic of Physical Medicine and Rehabilitation Department of Trakya University Medical Faculty in order to make. comparison of hormone profile and DEXA values of premenopausal, perimenopausal, and postmenopausal women . Three groups were allocated according to climacteric symptoms and menopause condition. Premenopausal group consisted of women who had regular menstruation and did not have any climacteric symptoms , perimenopausal group consisted of women who had menstruation disorder and climacteric symptoms within one year and postmenopausal group consisted of women who had last menstruation within more than one year and less than 5 years. Women who had prior osteoporosis diognosis and treatment, hormone replacement therapy, surgical menopause and menopause duration more than 5 years were excluded from the study. Age, body weight ,height, hormone profile including estradiol (E2, progesterone (P, follicule stimulating hormone (FSH, luteinizing hormone (LH, parathyroid hormone (PTH, thyroid hormones (T3, T4, thyroid stimulating hormone (TSH and DEXA values representing bone mineral density (BMD of both groups were evaluated. In peri and postmenopausal groups, E2, P, FSH and LH values were significantly lower, while there was no significant difference for PTH and thyroid hormone levels comparing to premenopausal group. For DEXA values, T scores of L2-L4, L2, L3, L4, femur neck, trochanter, Wards and Z scores of femur neck, Wards area were significantly lower in peri and postmenopausal groups. It was demonstrated paralel to literature that BMD decreased in peri and early postmenopausal women associated with hormone profile changes, mainly lower E2.

  7. From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India.

    Science.gov (United States)

    Baker, Kelly K; Padhi, Bijaya; Torondel, Belen; Das, Padmalaya; Dutta, Ambarish; Sahoo, Krushna Chandra; Das, Bhabani; Dreibelbis, Robert; Caruso, Bethany; Freeman, Matthew C; Sager, Lauren; Panigrahi, Pinaki

    2017-01-01

    Women face greater challenges than men in accessing water, sanitation, and hygiene (WASH) resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations. In fully adjusted models, RTI symptoms were less common in women using a latrine without water for defecation versus open defecation (Odds Ratio (OR) = 0.69; Confidence Interval (CI) = 0.48, 0.98) and those walking shorter distances to a bathing location (OR = 0.79, CI = 0.63, 0.99), but there was no association between using a latrine with a water source and RTIs versus open defecation (OR = 1.09; CI = 0.69, 1.72). Unexpectedly, RTI symptoms were more common for women bathing daily with soap (OR = 6.55, CI = 3.60, 11.94) and for women washing their hands after defecation with soap (OR = 10.27; CI = 5.53, 19.08) or ash/soil/mud (OR = 6.02; CI = 3.07, 11.77) versus water only or no hand washing. WASH practices of girls and women varied across reproductive life stages, but the associations between WASH practices and RTI symptoms were not moderated by or confounded by life stage status. This study provides new evidence that WASH access and practices are associated with self-reported reproductive tract infection symptoms in rural Indian girls and women from different reproductive life stages. However, the counterintuitive directions of effect for soap use highlights that causality and mechanisms of effect cannot

  8. From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India

    Science.gov (United States)

    Padhi, Bijaya; Torondel, Belen; Das, Padmalaya; Dutta, Ambarish; Sahoo, Krushna Chandra; Freeman, Matthew C.; Sager, Lauren; Panigrahi, Pinaki

    2017-01-01

    Women face greater challenges than men in accessing water, sanitation, and hygiene (WASH) resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations. In fully adjusted models, RTI symptoms were less common in women using a latrine without water for defecation versus open defecation (Odds Ratio (OR) = 0.69; Confidence Interval (CI) = 0.48, 0.98) and those walking shorter distances to a bathing location (OR = 0.79, CI = 0.63, 0.99), but there was no association between using a latrine with a water source and RTIs versus open defecation (OR = 1.09; CI = 0.69, 1.72). Unexpectedly, RTI symptoms were more common for women bathing daily with soap (OR = 6.55, CI = 3.60, 11.94) and for women washing their hands after defecation with soap (OR = 10.27; CI = 5.53, 19.08) or ash/soil/mud (OR = 6.02; CI = 3.07, 11.77) versus water only or no hand washing. WASH practices of girls and women varied across reproductive life stages, but the associations between WASH practices and RTI symptoms were not moderated by or confounded by life stage status. This study provides new evidence that WASH access and practices are associated with self-reported reproductive tract infection symptoms in rural Indian girls and women from different reproductive life stages. However, the counterintuitive directions of effect for soap use highlights that causality and mechanisms of effect cannot

  9. Association of Locoregional Control With High Body Mass Index in Women Undergoing Breast Conservation Therapy for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    Bergom, Carmen; Kelly, Tracy; Bedi, Meena; Saeed, Hina; Prior, Phillip; Rein, Lisa E.; Szabo, Aniko; Wilson, J. Frank; Currey, Adam D.; White, Julia

    2016-01-01

    Purpose: Obesity, as measured by the body mass index (BMI), is a risk factor for distant recurrence and decreased survival in breast cancer. We sought to determine whether the BMI correlated with local recurrence and reduced survival in a cohort of predominantly obese women treated with breast conservation therapy. Methods and Materials: From 1998 to 2010, 154 women with early-stage invasive breast cancer and 39 patients with ductal carcinoma in situ underwent prone whole breast irradiation. Cox proportional hazards regression, Kaplan-Meier methods with the log-rank test, and multivariate analysis were used to explore the association of the outcomes with the BMI. Results: The median patient age was 60 years, and the median follow-up duration was 73 months. The median BMI was 33.2 kg/m 2 ; 91% of the patients were overweight (BMI ≥25 kg/m 2 ) and 69% of the patients were clinically obese (BMI ≥30 kg/m 2 ). The BMI was significantly associated with the locoregional recurrence-free interval for patients with invasive cancer and ductal carcinoma in situ (hazard ratio [HR], 1.09; P=.047). Also, a trend was seen for increased locoregional recurrence with a higher BMI (P=.09) for patients with invasive disease, which was significant when examining the outcomes with a BMI stratified by the median value of 33.2 kg/m 2 (P=.008). A greater BMI was also significantly associated with decreased distant recurrence-free interval (HR, 1.09; P=.011) and overall survival (HR, 1.09; P=.004); this association remained on multivariate analysis (distant recurrence-free interval, P=.034; overall survival, P=.0007). Conclusions: These data suggest that the BMI might affect the rate of locoregional recurrence in breast cancer patients. A higher BMI predicted a worse distant recurrence-free interval and overall survival. The present investigation adds to the increasing evidence that BMI is an important prognostic factor in early-stage breast cancer treated with breast conservation

  10. Association of Locoregional Control With High Body Mass Index in Women Undergoing Breast Conservation Therapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bergom, Carmen; Kelly, Tracy; Bedi, Meena; Saeed, Hina; Prior, Phillip [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Rein, Lisa E.; Szabo, Aniko [Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wilson, J. Frank; Currey, Adam D. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); White, Julia, E-mail: Julia.White@osumc.edu [Department of Radiation Oncology, James Cancer Hospital, Ohio State University Comprehensive Cancer Center, Columbus, Ohio (United States)

    2016-09-01

    Purpose: Obesity, as measured by the body mass index (BMI), is a risk factor for distant recurrence and decreased survival in breast cancer. We sought to determine whether the BMI correlated with local recurrence and reduced survival in a cohort of predominantly obese women treated with breast conservation therapy. Methods and Materials: From 1998 to 2010, 154 women with early-stage invasive breast cancer and 39 patients with ductal carcinoma in situ underwent prone whole breast irradiation. Cox proportional hazards regression, Kaplan-Meier methods with the log-rank test, and multivariate analysis were used to explore the association of the outcomes with the BMI. Results: The median patient age was 60 years, and the median follow-up duration was 73 months. The median BMI was 33.2 kg/m{sup 2}; 91% of the patients were overweight (BMI ≥25 kg/m{sup 2}) and 69% of the patients were clinically obese (BMI ≥30 kg/m{sup 2}). The BMI was significantly associated with the locoregional recurrence-free interval for patients with invasive cancer and ductal carcinoma in situ (hazard ratio [HR], 1.09; P=.047). Also, a trend was seen for increased locoregional recurrence with a higher BMI (P=.09) for patients with invasive disease, which was significant when examining the outcomes with a BMI stratified by the median value of 33.2 kg/m{sup 2} (P=.008). A greater BMI was also significantly associated with decreased distant recurrence-free interval (HR, 1.09; P=.011) and overall survival (HR, 1.09; P=.004); this association remained on multivariate analysis (distant recurrence-free interval, P=.034; overall survival, P=.0007). Conclusions: These data suggest that the BMI might affect the rate of locoregional recurrence in breast cancer patients. A higher BMI predicted a worse distant recurrence-free interval and overall survival. The present investigation adds to the increasing evidence that BMI is an important prognostic factor in early-stage breast cancer treated with

  11. Comparison of menopause healthcare considerations between Japanese and Filipino women living in local communities.

    Science.gov (United States)

    Matsuo, Hiroya; Yamanaka, Rie; Senba, Naomi; Beltran, Ruth; Ladines-Llave, Cecilia; Blanco-Capito, Loudes

    2012-12-13

    To investigate the involvement of psychological/social factors in the condition of climacteric disturbance in Japan and the Philippines, we examined the menopausal symptoms and psychological/social factors in menopausal women living in local communities and compared among both countries whether differences in culture, lifestyle, etc. affected the condition of climacteric disturbance. High percentages of Japanese women reported mental symptoms, while relatively high percentages of Filipino women also experienced motor neurological symptoms in addition to psychoneurological symptoms. Japanese and Filipino women were found to have different stressors: a high percentage of the Japanese women had problems involving human relationships, such as providing nursing care, while a high percentage of the Filipino women had household problems, including husband's health and financial problems. Stress severity was associated with SMI scores in both countries. A poorer marital relationship in Japan than in the Philippines and an association between marital relationship and SMI scores were found. The present study suggests the association of differences in psychological/social factors between Japanese and Filipino women with differences in menopausal symptoms.

  12. Alterations in Circulating miRNA Levels following Early-Stage Estrogen Receptor-Positive Breast Cancer Resection in Post-Menopausal Women

    DEFF Research Database (Denmark)

    Kodahl, Annette R; Zeuthen, Pernille; Binder, Harald

    2014-01-01

    INTRODUCTION: Circulating microRNAs (miRNAs) exhibit remarkable stability and may serve as biomarkers in several clinical cancer settings. The aim of this study was to investigate changes in the levels of specific circulating miRNA following breast cancer surgery and evaluate whether these altera...... and could potentially be used to monitor whether all cancer cells have been removed at surgery and/or, subsequently, whether the patients develop recurrence.......INTRODUCTION: Circulating microRNAs (miRNAs) exhibit remarkable stability and may serve as biomarkers in several clinical cancer settings. The aim of this study was to investigate changes in the levels of specific circulating miRNA following breast cancer surgery and evaluate whether...... these alterations were also observed in an independent data set. METHODS: Global miRNA analysis was performed on prospectively collected serum samples from 24 post-menopausal women with estrogen receptor-positive early-stage breast cancer before surgery and 3 weeks after tumor resection using global LNA...

  13. Fertility preservation with ovarian stimulation and time to treatment in women with stage II-III breast cancer receiving neoadjuvant therapy.

    Science.gov (United States)

    Chien, A Jo; Chambers, Julia; Mcauley, Fiona; Kaplan, Tessa; Letourneau, Joseph; Hwang, Jimmy; Kim, Mi-Ok; Melisko, Michelle E; Rugo, Hope S; Esserman, Laura J; Rosen, Mitchell P

    2017-08-01

    To determine whether fertility preservation with ovarian stimulation (OS) results in treatment delay in breast cancer (BC) patients receiving neoadjuvant therapy (NAT). This is a retrospective study of women screened for the prospective neoadjuvant ISPY2 trial at the University of California San Francisco. All patients were years old, p = 0.06), and more likely to be childless (79.4 vs 31.2%, p 40 days, with no significant difference between STIM and control groups (mean 39.8 days vs 40.9 days, p = 0.75). Mean time from diagnosis to fertility consultation was 16.3 days. With median follow-up of 79 months, 16 (19.5%) patients have recurred or died from BC. Rates of pCR, recurrence, and death were similar in both groups. Six of 34 STIM patients have undergone embryo transfer, resulting in one patient with two live births. Fertility preservation with OS can be performed in the neoadjuvant setting without delay in initiation of systemic therapy and should be discussed with all early-stage BC patients of reproductive age.

  14. Knowledge, non-use, use and source of information on contraceptive methods among women in various stages of reproductive age in rural Lagos, Southwest Nigeria

    Directory of Open Access Journals (Sweden)

    Afolabi BM

    2015-05-01

    Full Text Available Bamgboye M Afolabi,1 Emmanuel NU Ezedinachi,2 Iwara Arikpo,2 Abiodun Ogunwale,3 Damilola Fatimah Ganiyu,1 Rashidat A Abu,1 Adewunmi A Ajibade1 1Health, Environment and Development Foundation, Yaba, Lagos, Nigeria; 2Institute of Tropical Disease and Research, University of Calabar, Calabar, Nigeria; 3Project Hope, Washington, DC, USA Background: Contraceptives are advocated to be used against unwanted pregnancy and sexually transmitted diseases as unsafe abortion contributes to high maternal mortality in Nigeria while unwanted pregnancies have terminated the educational development of many females. Objective: This questionnaire-based survey aimed to describe the knowledge, nonuse, and use of various contraceptive methods among women in different child-bearing age groups in rural Lagos, Nigeria. Materials and methods: Between 2012 and 2013, 816 females in rural communities within Lagos State were surveyed for their knowledge, source of information, and use of contraceptives. They were grouped into early, mid, and late reproductive age. Statistical analysis of data harvested from respondents was carried out using STATA 13 software. Results: In all, 816 females in different stages of reproductive age were involved in the study, among whom 19% were single, 78% married, 3% divorced, and 0.5% widowed. About 6% had no formal education, while the majority (81% were of the Yoruba ethnic group. Married respondents were approximately thrice more likely to know of contraceptives than single respondents (χ2=29.9, P=0.000, odds ratio =2.9, 95% confidence interval =1.9, 4.2. Condom use was the most widely known and used method of contraceptive regardless of marital status and reproductive age status. Information about contraceptives was mainly from health facilities among married and divorced women and from school or educational institution among singles. Overall prevalence of contraceptive use was 51.9%. Nonuse of contraceptives was 43% among married women

  15. The treatment of gastroesophageal reflux disease in menopausal women suffering from diabetes mellitus type II

    Directory of Open Access Journals (Sweden)

    Semikina Т.М.

    2016-12-01

    Full Text Available Purpose: to develop criteria for the selection of optimal tactics of supporting treatment of nonerosive gastroesophageal reflux disease with proton pump inhibitors in menopausal women suffering from diabetes mellitus type II. Material and Methods. 186 patients aged 45-59 who suffer from gastroesophageal reflux disease have been followed up, 46 of which suffer from diabetes mellitus type II as well. The climacteric syndrome's morbidity has been assessed in accordance with the modified menopause index; the level of glycated hemoglobin has been measured by the Abbott analyzer produced in the USA. Results. It is established that irrespective of the supporting treatment, the gastroesophageal reflux disease remittance was shorter in direct proportion with increase of the HbA1c level and the value of the modified menopause index in menopausal women suffering from diabetes mellitus type II. Conclusion. When the climacteric syndrome was mild or moderate, taking 20 mg Omeprazole once a day and "on demand" has comparable results, therefore this group of women prefer the "on demand" regimen as it lowers the risk of osteoporosis progression and further bone fracture. Taking 20 mg Omeprazole once a day, every other day, and "on demand" allows the disease remittance to prolong for a year and longer in less than 30% of women suffering from severe climacteric syndrome and having HbA1c>9.0%; however, this number may grow up to 70% of women in case they follow medical advice and reduce their carbohydrate input to 11 carbohydrate units and less.

  16. Reproductive hormone levels and anthropometry in postmenopausal women with polycystic ovary syndrome (PCOS): a 21-year follow-up study of women diagnosed with PCOS around 50 years ago and their age-matched controls.

    Science.gov (United States)

    Schmidt, Johanna; Brännström, Mats; Landin-Wilhelmsen, Kerstin; Dahlgren, Eva

    2011-07-01

    The hormonal and anthropometric profile of premenopausal women with polycystic ovary syndrome (PCOS) is well described, but there is a lack of data concerning changes in these variables into the postmenopausal period. Our objective was to examine whether PCOS women differ from normal women regarding levels of reproductive hormones, anthropometry, and presence of hirsutism/climacteric symptoms also after menopause. In this prospective study, women with PCOS (61-79 yr) and age-matched controls, examined in 1987, were reinvestigated at a university hospital. Twenty-five PCOS patients (Rotterdam criteria) and 68 controls (randomly allocated from the Gothenburg WHO MONICA study) participated. Reexamination and hormonal measurements were done 21 yr after previous visit. FSH, LH, TSH, thyroid peroxidase antibodies, prolactin, estrone, estradiol, SHBG, androstenedione, total testosterone, dehydroepiandrosterone sulfate, free androgen index, and anthropometry were determined. Presence of climacteric symptoms, hirsutism, and menopausal age were recorded. PCOS women had higher free androgen index (P = 0.001) but lower FSH (P PCOS and controls. Women with PCOS reported hirsutism more frequently (P symptoms (P PCOS women differ from controls with regard to levels of certain reproductive hormones also after menopause, but the established premenopausal increase in waist to hip ratio in PCOS patients disappeared after menopause, mainly due to weight gain among controls. A novel finding was the lower prevalence of hypothyroidism in PCOS women.

  17. Short-Course Hypofractionated Radiation Therapy With Boost in Women With Stages 0 to IIIa Breast Cancer: A Phase 2 Trial

    International Nuclear Information System (INIS)

    Ahlawat, Stuti; Haffty, Bruce G.; Goyal, Sharad; Kearney, Thomas; Kirstein, Laurie; Chen, Chunxia; Moore, Dirk F.; Khan, Atif J.

    2016-01-01

    Purpose: Conventionally fractionated whole-breast irradiation (WBI) with a boost takes approximately 6 to 7 weeks. We evaluated a short course of hypofractionated (HF), accelerated WBI in which therapy was completed in 3 weeks inclusive of a sequential boost. Methods and Materials: We delivered a whole-breast dose of 36.63 Gy in 11 fractions of 3.33 Gy over 11 days, followed by a lumpectomy bed boost in 4 fractions of 3.33 Gy delivered once daily for a total of 15 treatment days. Acute toxicities were scored using Common Terminology Criteria for Adverse Events version 4. Late toxicities were scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale. Cosmesis was scored using the Harvard Cosmesis Scale. Our primary endpoint was freedom from locoregional failure; we incorporated early stopping criteria based on predefined toxicity thresholds. Cosmesis was examined as a secondary endpoint. Results: We enrolled 83 women with stages 0 to IIIa breast cancer. After a median follow-up of 40 months, 2 cases of isolated ipsilateral breast tumor recurrence occurred (2 of 83; crude rate, 2.4%). Three-year estimated local recurrence-free survival was 95.9% (95% confidence interval [CI]: 87.8%-98.7%). The 3-year estimated distant recurrence-free survival was 97.3% (95% CI: 89.8%-99.3%). Three-year secondary malignancy-free survival was 94.3% (95% CI: 85.3%-97.8%). Twenty-nine patients (34%) had grade 2 acute toxicity, and 1 patient had a late grade 2 toxicity (fibrosis). One patient had acute grade 3 dermatitis, whereas 2 patients experienced grade 3 late skin toxicity. Ninety-four percent of evaluable patients had good or excellent cosmesis. Conclusions: Our phase 2 institutional study offers one of the shortest courses of HF therapy, delivered in 15 fractions inclusive of a sequential boost. We demonstrated expected low toxicity and high local control rates with good to excellent cosmetic outcomes. This

  18. Cost-effectiveness of a 21-gene recurrence score assay versus Canadian clinical practice in women with early-stage estrogen- or progesterone-receptor-positive, axillary lymph-node negative breast cancer

    International Nuclear Information System (INIS)

    Hannouf, Malek B; Xie, Bin; Brackstone, Muriel; Zaric, Gregory S

    2012-01-01

    A 21-gene recurrence score (RS) assay may inform adjuvant systematic treatment decisions in women with early stage breast cancer. We sought to investigate the cost effectiveness of using the RS-assay versus current clinical practice (CCP) in women with early-stage estrogen- or progesterone-receptor-positive, axilliary lymph-node negative breast cancer (ER+/ PR + LN- ESBC) from the perspective of the Canadian public healthcare system. We developed a Markov model to project the lifetime clinical and economic consequences of ESBC. We evaluated adjuvant therapy separately in post- and pre-menopausal women with ER+/ PR + LN- ESBC. We assumed that the RS-assay would reclassify pre- and post-menopausal women among risk levels (low, intermediate and high) and guide adjuvant systematic treatment decisions. The model was parameterized using 7 year follow up data from the Manitoba Cancer Registry, cost data from Manitoba administrative databases, and secondary sources. Costs are presented in 2010 CAD. Future costs and benefits were discounted at 5%. The RS-assay compared to CCP generated cost-savings in pre-menopausal women and had an ICER of $60,000 per QALY gained in post-menopausal women. The cost effectiveness was most sensitive to the proportion of women classified as intermediate risk by the RS-assay who receive adjuvant chemotherapy and the risk of relapse in the RS-assay model. The RS-assay is likely to be cost effective in the Canadian healthcare system and should be considered for adoption in women with ER+/ PR + LN- ESBC. However, ongoing assessment and validation of the assay in real-world clinical practice is warranted

  19. Setting Quality Improvement Priorities for Women Receiving Systemic Therapy for Early-Stage Breast Cancer by Using Population-Level Administrative Data.

    Science.gov (United States)

    Enright, Katherine A; Taback, Nathan; Powis, Melanie Lynn; Gonzalez, Alejandro; Yun, Lingsong; Sutradhar, Rinku; Trudeau, Maureen E; Booth, Christopher M; Krzyzanowska, Monika K

    2017-10-01

    Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. Individual QMs within a panel of 15 QMs previously developed to assess the quality of systemic therapy across four domains (access, treatment delivery, toxicity, and safety) were ranked on interinstitutional variation in performance (using interquartile range) and the number of patients who were affected; then the two rankings were averaged for a summative priority ranking. Results We identified 28,427 patients with EBC who were treated at 84 institutions. The use of computerized physician electronic order entry for chemotherapy, emergency room visits or hospitalizations during chemotherapy, and timely receipt of chemotherapy were identified as the QMs that had the largest potential to improve quality of care at a system level within this cohort. Conclusion A simple ranking system based on interinstitutional variation in performance and patient volume can be used to identify high-priority areas for quality improvement from a population perspective. This approach is generalizable to other health care systems that use QMs to drive improvement.

  20. Randomized sham-controlled pilot trial of weekly electro-acupuncture for the prevention of taxane-induced peripheral neuropathy in women with early stage breast cancer.

    Science.gov (United States)

    Greenlee, Heather; Crew, Katherine D; Capodice, Jillian; Awad, Danielle; Buono, Donna; Shi, Zaixing; Jeffres, Anne; Wyse, Sharon; Whitman, Wendy; Trivedi, Meghna S; Kalinsky, Kevin; Hershman, Dawn L

    2016-04-01

    To investigate the effect of electro-acupuncture (EA) as a non-pharmacological intervention to prevent or reduce chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing chemotherapy of taxane. Women with stage I-III breast cancer scheduled to receive taxane therapy were randomized to receive a standardized protocol of 12 true or sham EA (SEA) weekly treatments concurrent with taxane treatment. Subjects completed the Brief Pain Inventory-Short Form (BPI-SF), Functional Assessment of Cancer Therapy-Taxane neurotoxicity subscale (FACT-NTX), and other assessments at baseline and weeks 6, 12, and 16. A total of 180 subjects were screened, 63 enrolled and 48 completed week 16 assessments. Mean age was 50 with 25 % white, 25 % black, and 43 % Hispanic; 52 % had no prior chemotherapy. At week 12, both groups reported an increase in mean BPI-SF worst pain score, but no mean differences were found between groups (SEA 2.8 vs. EA 2.6, P = .86). By week 16, the SEA group returned to baseline, while the EA group continued to worsen (SEA 1.7 vs. EA 3.4, P = .03). The increase in BPI-SF worst pain score was 1.62 points higher in the EA group than in the SEA group at week 16 (P = .04). In a randomized, sham-controlled trial of EA for prevention of taxane-induced CIPN, there were no differences in pain or neuropathy between groups at week 12. Of concern, subjects on EA had a slower recovery than SEA subjects. Future studies should focus on EA for treatment as opposed to prevention of CIPN.

  1. TOWARDS COLLABORATION BETWEEN PUBLIC WELFARE AGENCIES AND MASS ENTERTAINMENT MEDIA TO BRING ABOUT A TURNING POINT STAGE IN THE LIVES OF BATTERED WOMEN

    Directory of Open Access Journals (Sweden)

    Nourit Segev

    2010-06-01

    Full Text Available This article examines the promoting and impeding factors that advance the turning point in thelives of battered women. The subject is important because of the contribution of the turning pointstage to the ability of women to leave the violent relationship and the way in which the publicwelfare agencies become involved in order to help the victim to advance towards the turning point.The article also reviews the influence of the entertainment media in shaping the positions of thepublic regarding marital violence, the presentation of battered women in the media, and theconnection between their media presentation and their advancement towards the turning point inreality.The research is based on a combination of qualitative and quantitative data, and focuses on contentanalysis. The qualitative content analysis included 40 journal articles, 1 documentary film and onedrama series, the personal interviews included 8 social workers and 6 journalists, and the focusgroup included 8 battered women. The findings indicate an awareness of battered women in thevarious media, and of a gap between the perception of social workers and the journalists regardingthe role of the media in raising social problems.The article calls for cooperation between the media and the professionals in order to construct messages of empowerment that will enable women to advance towards the turning point in theirlives.

  2. Stage design

    International Nuclear Information System (INIS)

    Shacter, J.

    1975-01-01

    A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage

  3. Staging Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    and lived as people are “staging themselves” (from below). Staging mobilities is a dynamic process between “being staged” (for example, being stopped at traffic lights) and the “mobile staging” of interacting individuals (negotiating a passage on the pavement). Staging Mobilities is about the fact...

  4. Hormonas del eje hipotálamo-hipófisis gonadal y síndrome climatérico Hormones of the hypothalamic-hypophyseal gonadal axis and climacteric syndrome

    Directory of Open Access Journals (Sweden)

    Daysi Navarro Despaigne

    2007-12-01

    Full Text Available Las manifestaciones clínicas del síndrome climatérico (SC se consideran expresión de los cambios neuroendocrinos consecutivos al cese de la función reproductiva, por tanto, sería de esperar que la intensidad del SC tenga relación con el hipoestrogenismo o los niveles de gonadotropinas. Con el objetivo de relacionar niveles de estradiol y gonadotropinas con la intensidad de los síntomas climatéricos, se realizó un estudio descriptivo transversal entre septiembre de 2005 y agosto de 2006 en un grupo constituido por 48 mujeres posmenopáusicas provenientes de la Clínica de Climaterio y Osteoporosis del INE, con edades entre 41 y 59 años, sanas y sin tratamiento hormonal de reemplazo. Para la evaluación del SC se utilizó la escala de Pérez Piñeiro, y se determinaron niveles plasmáticos de FSH y LH mediante ensayo inmunoradiométrico (IRMA y de estradiol por radioinmunoensayo (RIA. Se utilizaron la media, desviación estándar, y la mediana. Para el análisis de correlación se utilizó la prueba de rango de signo de Wilcoxon y el test de Mann-Whitney. La mediana de los niveles de FSH fueron de 77,0 UI/L y los de LH de 37,7 UI/L, los valores medios de estradiol fueron de 14,8 pmol/L. Respecto a la intensidad de los síntomas climatéricos, el grado ligero fue el más frecuente (50 %, seguido del moderado (33,3 % y finalmente el severo (16,7 %. No se encontró correlación entre los niveles de gonadotropinas ni estradiol con el grado de severidad de los síntomas climatéricos. En conclusión, no se demostró que el patrón hormonal del eje hipotálamo hipofiso ovárico posterior a la menopausia influyera en la intensidad de los síntomas climatéricos.The clinical manifestations of the climacteric syndrome (CS are considered as an expression of the endocrine changes following the cessation of the reproductive function, so there must be a relation between the intensity of the CS and hypoestrogenism or the gonadotropin levels. In order

  5. Adjuvant Chemotherapy and Trastuzumab Is Safe and Effective in Older Women With Small, Node-Negative, HER2-Positive Early-Stage Breast Cancer.

    Science.gov (United States)

    Cadoo, Karen A; Morris, Patrick G; Cowell, Elizabeth P; Patil, Sujata; Hudis, Clifford A; McArthur, Heather L

    2016-12-01

    The benefit of adjuvant trastuzumab with chemotherapy is well established for women with higher risk human epidermal growth factor receptor 2-positive (HER2 + ) breast cancer. However, its role in older patients with smaller, node-negative tumors is less clear. We conducted a retrospective, sequential cohort study of this population to describe the impact of trastuzumab on breast cancer outcomes and cardiac safety. Women ≥ 55 years with ≤ 2 cm, node-negative, HER2 + breast cancer were identified and electronic medical records reviewed. A no-trastuzumab cohort of 116 women diagnosed between January 1, 1999 and May 14, 2004 and a trastuzumab cohort of 128 women diagnosed between May 16, 2006 and December 31, 2010 were identified. Overall survival and distant relapse-free survival were estimated by Kaplan-Meier methods. The median ages of the trastuzumab and no-trastuzumab cohorts were 62 and 64 years, respectively. More patients in the trastuzumab cohort had grade III (P = .001), lymphovascular invasion (P = .001), or estrogen receptor-negative (P cancers. The majority of the trastuzumab cohort received chemotherapy versus one-half of the no-trastuzumab cohort (98% vs. 53%; P women in the trastuzumab cohort and 1 in the no-trastuzumab cohort developed symptomatic heart failure. There were no cardiac-related deaths in either arm. Following adjuvant trastuzumab with chemotherapy, selected older women with small, node-negative, HER2 + breast cancers have excellent disease control. The rate of cardiac events is low. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Psychometric properties of the Finnish version of the Women's Health Questionnaire.

    Science.gov (United States)

    Katainen, Riina E; Engblom, Janne R; Vahlberg, Tero J; Polo-Kantola, Päivi

    2017-08-01

    The Women's Health Questionnaire (WHQ) is a validated and commonly used instrument for measuring climacteric-related symptoms. A revised version was previously developed. However, validation in a Finnish population is lacking. As it is important to use qualified instruments, we performed a validation study of the WHQ in a Finnish population. In all, 3,421 women, aged 41 to 54 years, formed the study population. In the original 36-item WHQ, the items were rated on a 1 to 4 scale and on a binary scale (0-1). The scaling of the revised 23-item WHQ was 0 to 100. We evaluated the psychometric properties (internal consistency, correlations between the symptom domains, factor structure, and sampling adequacy) in all three versions. For the 1 to 4 scale and on the revised version of the WHQ, the internal consistency was acceptable (the Cronbach's α coefficients >0.70) for most of the domains. On the binary scale, the majority of the coefficient values were below the acceptable level. The original symptom domains, especially those on the revised version, were recognizable from the factors in the exploratory factor analysis, but there were some limitations. The Kaiser-Meyer-Olkin values were high. The WHQ is a valid instrument for measuring climacteric-related symptoms in Finnish middle-aged women. The psychometric properties of the revised 23-item WHQ were as good or even better than those of the original 36-item WHQ. Thus, we encourage use of the revised version.

  7. A structural model for stress, coping, and psychosocial adjustment: A multi-group analysis by stages of survivorship in Korean women with breast cancer.

    Science.gov (United States)

    Jang, Miyoung; Kim, Jiyoung

    2018-04-01

    Prospective studies have examined factors directly affecting psychosocial adjustment during breast cancer treatment. Survivorship stage may moderate a direct effect of stress on psychosocial adjustment. This study aimed to examine relationships between stress, social support, self-efficacy, coping, and psychosocial adjustment to construct a model of the effect pathways between those factors, and determine if survivorship stage moderates those effects. Six hundred people with breast cancer completed questionnaires. Examined stages of survivorship after treatment were as follows: acute (i.e., 5 years). Stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), self-efficacy (New General Self Efficacy Scale), coping (Ways of Coping Checklist), and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report-Korean Version) were measured. Self-efficacy significantly correlated with psychosocial adjustment in the acute survival stage (γ = -0.37, P psychosocial adjustment was greater in the acute (γ = -0.42, P psychosocial adjustment was stronger in the lasting survival stage (β = 0.42, P psychosocial adjustment of female breast cancer patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Are stage IV vestibular schwannomas preoperatively different from other stages?

    Science.gov (United States)

    Tringali, Stéphane; Dubreuil, Christian; Zaouche, Sandra; Ferber-Viart, Chantal

    2008-01-01

    The aim of this study was to focus on the clinical and paraclinical symptoms of patients suffering from Stage IV vestibular schwannomas (VSs). In this prospective study, we included 734 patients who have VS and candidates for operation. Patients were classified as having Stage I, II, III, or IV tumors according to Tos criteria as evaluated by magnetic resonance imaging. PREOPERATIVE CLINICAL EVALUATION: We recorded the occurrence of complaints (%) and duration (yr) of hearing loss, tinnitus, and balance disorder. Preoperative paraclinical evaluation included pure-tone (PTA) and speech audiometry, auditory brainstem response (ABR) patterns, and vestibular deficit at videonystamography (VNG). Continuous variables were compared between Stage IV and other stages using analysis of variance. Qualitative variables expressed as a percentage of presence were compared between Stage IV and other stages using percentage comparison. Quantitative Parameters. Patients with Stage IV VS were significantly younger as compared with patients with other stages. Stage IV hearing loss was greater compared with other stages at 250 and 500 Hz but smaller at 2,000 and 8,000 Hz. We found no difference in the loss of PTA between Stage IV and the other stages. Speech discriminancy score was smaller in Stage IV. The durations of hearing loss, tinnitus, and balance disorders were similar whatever the tumor stage. Auditory brainstem response patterns showed no difference in Wave III latency between Stage IV VS and other stages, whereas Wave V latency and V-I interval were higher in Stage IV. Both ABR threshold and VNG caloric deficit were higher in Stage IV VS compared with other stages. Qualitative Parameters. The percentage of patients with Stage IV was lower than that with Stages II and III. The percentage of men and women was similar in all stages. The occurrence of hearing loss was similar in all stages, whereas that of tinnitus was lower in Stage IV compared with Stages I and II. In

  9. Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer

    NARCIS (Netherlands)

    den Oudsten, Brenda L.; van Heck, Guus L.; van der Steeg, Alida F. W.; Roukema, Jan A.; de Vries, Jolanda

    2010-01-01

    Few studies have prospectively assessed the impact of breast cancer (BC) on women's sexual lives. Therefore, this study examines the determinants of quality of sexual life (QOSL), sexual functioning (SF), and sexual enjoyment (SE) at 6 and 12 months after surgical treatment. All participants

  10. Trading stages

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2012-01-01

    Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied ...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

  11. Markers of iron status are associated with stage of pregnancy and acute-phase response, but not with parity among pregnant women in Guinea-Bissau

    DEFF Research Database (Denmark)

    Kæstel, Pernille; Aaby, Peter; Ritz, Christian

    2015-01-01

    While prenatal Fe supplementation prevents maternal Fe deficiency and anaemia, it is uncertain whether it improves infant health outcomes, at least when taken by Fe-replete women. Inflammation as well as physiological changes complicates the assessment of Fe status during pregnancy. In the present...... pregnancy. Using cut-off values for Fe deficiency as established in non-pregnant individuals, 52 % of the women had sTfR levels >2·3 mg/l, while only 25 % had serum ferritin levels 2·3 mg/l decreased to 47 % after adjustment for elevated serum CRP and ACT levels. On the contrary, the proportion of serum...... ferritin pregnancy-specific cut-offs since increased erythropoiesis is expected in response to increased plasma volume of pregnancy. The present study further underlines the need to adjust...

  12. Optimizing the number of cleavage stage embryos to transfer on day 3 in women 38 years of age and older: a Society for Assisted Reproductive Technology database study.

    Science.gov (United States)

    Stern, Judy E; Goldman, Marlene B; Hatasaka, Harry; MacKenzie, Todd A; Surrey, Eric S; Racowsky, Catherine

    2009-03-01

    To determine the optimal number of day 3 embryos to transfer in women >or=38 years by conducting an evidence-based evaluation. Retrospective analysis of 2000-2004 national SART data. National writing group. A total of 36,103 day 3 embryo transfers in women >or=38 years undergoing their first assisted reproductive technology cycle. None. Logistic regression was used to model the probability of pregnancy, delivery, and multiple births (twin or high order) based on age- and cycle-specific parameters. Pregnancy rates, delivery rates, and multiple rates increased up to transfer of three embryos in 38-year-olds and four in 39-year-olds; beyond this number, only multiple rates increased. In women >or=40 years, delivery rates and multiple rates climbed steadily with increasing numbers transferred. Multivariate analysis confirmed the statistically significant effect of age, number of oocytes retrieved, and embryo cryopreservation on delivery and multiple rates. Maximum FSH level was not an independent predictor by multivariate analysis. Use of intracytoplasmic sperm injection was associated with lowered delivery rate. No more than three or four embryos should be transferred in 38- and 39-year-olds, respectively, whereas up to five embryos could be transferred in >or=40-year-olds. Numbers of embryos to transfer should be adjusted according to number of oocytes retrieved and availability of excess embryos for cryopreservation.

  13. Serum concentrations of insulin-like growth factor-1, members of the TGF-beta superfamily and follistatin do not reflect different stages of dynapenia and sarcopenia in elderly women.

    Science.gov (United States)

    Hofmann, Marlene; Halper, Barbara; Oesen, Stefan; Franzke, Bernhard; Stuparits, Petra; Tschan, Harald; Bachl, Norbert; Strasser, Eva-Maria; Quittan, Michael; Ploder, Martin; Wagner, Karl-Heinz; Wessner, Barbara

    2015-04-01

    There is a high need for blood-based biomarkers detecting age-related changes in muscular performance at an early stage. Therefore, we investigated whether serum levels of growth and differentiation factor-15 (GDF-15), activin A, myostatin, follistatin, and insulin-like growth factor-1 (IGF-1) would reflect age- and physical performance-related differences between young (22-28 years) and elderly (65-92 years) females. Isokinetic peak torque of knee extension (PTE) was measured in young females to obtain reference values for the discrimination of different stages of age-associated muscle weakness. Additionally, elderly women were screened for sarcopenia using the algorithm of the European Working Group on Sarcopenia in Older People (low muscle mass in addition to low PTE and/or low walking speed). IGF-1 levels were higher and GDF-15 levels were lower in young females in comparison to the elderly (p sarcopenia in elderly women. However, due to the associations of IGF-1 and GDF-15 with correlates of muscle mass and function, these parameters remain promising candidates in a potential set of blood-based biomarkers to diagnose sarcopenia and/or dynapenia. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. A mulher coronariopata no climatério após a menopausa: implicações na qualidade de vida The post menopausal climacteric woman with coronary artery disease: implications to quality of life

    Directory of Open Access Journals (Sweden)

    M.E.C. DE S. FAVARATO

    2001-12-01

    coronary artery disease (CAD proved by angiography undergoing treatment at The Heart Institute (InCor - University of São Paulo Medical School, Brazil (CAD group. This group was compared with 50 women (55.1±5.4 years old without clinical evidence of coronary artery disease (control group from a primary health care center, Centro de Saúde Escola Geraldo de Paula Souza, São Paulo - FSP- USP. The quality of life was assessed by a structured interview and by Medical outcomes study 36-item short-form health survey (SF-36 validated to the Brazilian population. RESULTS: They were homogenous regarding age of the last menstruation period: 49±3.9 years old in CAD and 49.2±3 years old in controls. The groups were also similar in education level, marital status (64% of CAD and 45% of controls were married; and 18% of CAD and 24% of controls were widowhood. The active working satatus was more frequent in controls than in CAD (52% vs. 14%; p= 0.0001. Both groups showed similar perceptions in their sexual experience. The evaluation of quality of life by SF-36 showed better scores for the control group in: physical functioning (84 vs. 50.5, role physical (84 vs. 45,5 , general health (87.2 vs. 59.1, vitality (69.7 vs. 51,4, p<0.0001; and total score of mental components (70.4 vs. 58.6, p = 0.028. CONCLUSION: Coronary artery disease alters the quality of life of climacteric women by limiting the physical capacity to perform ordinary daily activities and by intensifying emotional conflicts usually present in this phase of life.

  15. Comparison of 18F-FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer: a follow-up study.

    Science.gov (United States)

    Sawicki, Lino M; Kirchner, Julian; Grueneisen, Johannes; Ruhlmann, Verena; Aktas, Bahriye; Schaarschmidt, Benedikt M; Forsting, Michael; Herrmann, Ken; Antoch, Gerald; Umutlu, Lale

    2018-04-01

    To evaluate the diagnostic performance of 18 F-FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone. Seventy-one consecutive women (54 ± 13 years, range: 25-80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1-3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar's chi 2 test. Differences in diagnostic confidence were assessed by Wilcoxon test. Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy management based on evaluation of local recurrence and distant metastatic spread.

  16. Clinical outcomes of prospectively treated 140 women with early stage breast cancer using accelerated partial breast irradiation with 3 dimensional computerized tomography based brachytherapy

    International Nuclear Information System (INIS)

    Budrukkar, Ashwini; Gurram, Lavanya; Upreti, Ritu Raj; Munshi, Anusheel; Jalali, Rakesh; Badwe, Rajendra; Parmar, Vani; Shet, Tanuja; Gupta, Sudeep; Wadasadawala, Tabassum; Sarin, Rajiv

    2015-01-01

    Purpose: To study the clinical outcomes of women with early breast cancer (EBC) treated with accelerated partial breast irradiation (APBI) with multicatheter interstitial brachytherapy (MIB) using 3 dimensional computerized tomography (3DCT) based planning. Materials and methods: During August 2005 to January 2013, 140 women with EBC were treated prospectively with APBI using high dose rate (HDR) MIB. After 3DCT based planning patients were treated to a dose of 34 Gy/10 #/1 week with bid regimen. Results: Median age was 57 years and tumor size 2 cm (range: 0.6–3.2 cm). Infiltrating duct carcinoma (IDC) was the most common histology; grade III tumors were seen in 82%. Median dose homogeneity index (DHI) was 0.76 (range: 0.49–0.85). The median coverage index (CI) of the cavity was 90% (61.4–100) and 80.5% (53.6–97.4) for planning target volume (PTV). Median follow up was 60 months (1–102 months). The 5 and 7 year local control rates (LC) were 97% and 92% respectively. Her2 positivity was the only prognostic factor which had an adverse impact on LC (p = 0.01). Five and 7 year disease free survival (DFS) and overall survival (OAS) were 93%, 84%, 97.5% and 89% respectively. Good to excellent cosmetic outcomes at last follow up were seen in 87 (77%) women. Conclusions: 3DCT based MIB results in excellent long term outcomes and good to excellent cosmesis. Her2 positivity has an adverse impact on LC rates

  17. Estadiamento inicial dos casos de câncer de mama e colo do útero em mulheres brasileiras Initial staging of breast and cervical cancer in Brazilian women

    Directory of Open Access Journals (Sweden)

    Luiz Claudio Santos Thuler

    2005-11-01

    nas regiões onde estes hospitais estão localizados houve melhora na detecção precoce destes tipos de câncer.PURPOSE: to analyze time trends in the clinical staging at the moment of diagnosis in patients with breast and cervix cancer based on data produced by the Brazilian Public Health System (SUS. METHODS: in the first part of this study we identified the published documents describing clinical staging of patients at the moment of diagnosis. Considering their scarcity and poor representativity we conducted the second part of this study through an active search for information. A form was sent via regular mail to all cancer centers in the country (n=173 requesting information about the tumor site and stage at diagnosis by year, in the period of 1995-2002. The statistical analysis was performed using the "R" statistical package. The results are reported as percentage and boxplots. RESULTS: in the first part of the study (1990-1994 we described data from 18 hospitals concerning 7,458 patients with breast cancer and 7,216 patients with cervix cancer. The median of the percentage of cancers diagnosed at an advanced stage (stages III or IV was 52.6 and 56.8%, respectively. In the second part of the study (1995-2002 data were collected from 89 cancer hospitals and 7 chemotherapy or radiotherapy clinics. There was a total of 43,442 cases of breast cancer and 29,263 of cervix cancer. The response rate based on the potential contact list was 55%. The median percentage of patients in advanced stage was 45.3% for breast cancer and 42.5% for cervix cancer. CONCLUSIONS: few studies have examined the time trends in staging of cancer at diagnosis in Brazilian hospitals. Data obtained from Hospital Cancer Registries showed that in the last decade there was a reduction in the percentage of cervix and breast cancer at the advanced stage. This reduction can be due to an improvement in early detection of these cancers.

  18. O olhar dos responsáveis pela política de saúde da mulher climatérica La mirada de los responsables por la política de la salud de la mujer climatérica The look of the responsible ones for the politics of health of woman climacterics

    Directory of Open Access Journals (Sweden)

    Queli Lisiane Castro Pereira

    2009-06-01

    Regional Co-ordination's Health of Rio Grande do Sul, in the perspective of the Responsible ones for the politics of woman's health. The search of climacterics was characterized for being in function of the symptoms and typical complaints of this phase and, doubts how much to a possible gestation. It has necessary looking for practices the constitutional law of the completeness, preserving the rights already conquered by the women and to extend the attendants services, so that they can correspond in such a way quantitative as qualitatively to the demands, to the necessities of promotion, prevention and recovery of the health of the users of the brazilian system of health.

  19. Staging atmospheres

    DEFF Research Database (Denmark)

    Bille, Mikkel; Bjerregaard, Peter; Sørensen, Tim Flohr

    2015-01-01

    The article introduces the special issue on staging atmospheres by surveying the philosophical, political and anthropological literature on atmosphere, and explores the relationship between atmosphere, material culture, subjectivity and affect. Atmosphere seems to occupy one of the classic...

  20. Improved survival for women with stage I breast cancer in south-east Sweden: A comparison between two time periods before and after increased use of adjuvant systemic therapy

    International Nuclear Information System (INIS)

    Johansson, Patrik; Fohlin, Helena; Arnesson, Lars-Gunnar

    2009-01-01

    Purpose. Continuous minor steps of improvement in the management of breast cancer have resulted in decreased mortality rates during the last decades. The aim of this study was to compare the clinical outcome of patients with stage I breast cancer diagnosed during two time periods that differed with respect to adjuvant systemic therapy. Material and methods. The studied population consisted of all women < 60 years of age, who were diagnosed breast cancer stage I between 1986 and 1999 in south-east Sweden, a total of 1 407 cases. The cohort was divided into two groups based on the management programmes of 1986 and 1992, hereafter referred to as Period 1 and Period 2. Before 1992 the only adjuvant systemic therapy recommended was tamoxifen for hormone receptor positive patients aged 50 years or older. During Period 2 the use of adjuvant treatment was extended to younger patients at high risk, identified by a high tumour S-phase fraction, with either hormonal or cytotoxic treatment. Results. The estimated distant recurrence-free survival rate was significantly higher during Period 2 than during Period 1 (p = 0.008). Subgroup analysis showed that the most evident reduction of distant recurrence risk was among hormone receptor-negative patients (HR = 0.58, 95% CI 0.31-1.09, p = 0.09) and among patients with a high tumour S-phase fraction (HR = 0.53, 0.30-0.93, p = 0.028). The risk reduction between the periods was still statistically significant in multivariate analysis when adjusting for different tumour characteristics and treatment modalities, indicating an influence of other factors not controlled for. One such factor may be the duration of tamoxifen treatment, which likely was more frequently five years during Period 2 than during Period 1. Conclusions. We conclude that the causes of the increase in distant recurrence free survival for women with breast cancer stage I are complex. The results support though that high-risk subgroups of stage I breast cancer patients

  1. Room temperature stable carbetocin for the prevention of postpartum haemorrhage during the third stage of labour in women delivering vaginally: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Widmer, Mariana; Piaggio, Gilda; Abdel-Aleem, Hany; Carroli, Guillermo; Chong, Yap-Seng; Coomarasamy, Arri; Fawole, Bukola; Goudar, Shivaprasad; Hofmeyr, G Justus; Lumbiganon, Pisake; Mugerwa, Kidza; Nguyen, Thi My Huong; Qureshi, Zahida; Souza, Joao Paulo; Gülmezoglu, A Metin

    2016-03-17

    Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality. We describe a randomized, double-blind non-inferiority trial comparing a newly developed room temperature stable formulation of carbetocin to the standard intervention (oxytocin) for the prevention of PPH after vaginal birth. Approximately 30,000 women delivering vaginally will be recruited across 22 centres in 10 countries. The primary objectives are to evaluate the non-inferiority of room temperature stable carbetocin (100 μg intramuscular) versus oxytocin (10 IU intramuscular) in the prevention of PPH and severe PPH after vaginal birth. The primary endpoints are blood loss ≥500 mL or the use of additional uterotonics (composite endpoint required by drug regulatory authorities) and blood loss ≥1,000 mL (WHO requirement). Non-inferiority will be assessed using a two-sided 95 % confidence interval for the relative risk of the above endpoints for room temperature stable carbetocin versus oxytocin. The upper limit of the two-sided 95 % confidence interval for the relative risk for the composite endpoint of blood loss ≥500 mL or the use of additional uterotonics, and for the endpoint of blood loss ≥1,000 mL, will be compared to a non-inferiority margin of 1.16 and 1.23, respectively. If the upper limit is below the corresponding margin, non-inferiority will have been demonstrated. The safety analysis will include all women receiving treatment. Safety and tolerability will be assessed by a review of adverse events, by conducting inferential testing

  2. Randomized Control Trial: Evaluating Aluminum-Based Antiperspirant Use, Axilla Skin Toxicity, and Reported Quality of Life in Women Receiving External Beam Radiotherapy for Treatment of Stage 0, I, and II Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Linda C., E-mail: Linda.watson@albertahealthservices.ca [Department of Interdisciplinary Practice, Community Oncology, Alberta Health Services-Cancer Care, Calgary, AB (Canada); Gies, Donna [Department of Radiation Oncology Nursing, Tom Baker Cancer Centre, Alberta Health Services-Cancer Care, Calgary, AB (Canada); Thompson, Emmanuel [Department of Mathematics and Statistics, University of Calgary Faculty of Science, Calgary, AB (Canada); Thomas, Bejoy [Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services-Cancer Care, Calgary, AB (Canada); Department of Psychosocial Oncology, University of Calgary Faculty of Medicine, Calgary, AB (Canada)

    2012-05-01

    Purpose: Standard skin care instructions regarding the use of antiperspirants during radiotherapy to the breast varies across North America. Women have articulated that when instructed to not use antiperspirant, the potential for body odor is distressing. Historical practices and individual opinions have often guided practice in this field. The present study had 2 purposes. To evaluate whether the use of aluminum-based antiperspirant while receiving external beam radiotherapy for stage 0, I, or II breast cancer will increase axilla skin toxicity and to evaluate whether the use of antiperspirant during external beam radiotherapy improves quality of life. Methods: A total of 198 participants were randomized to either the experimental group (antiperspirant) or control group (standard care-wash only). The skin reactions in both groups were measured weekly and 2 weeks after treatment using the National Cancer Institute Common Toxicity Criteria Adverse Events, version 3, toxicity grading criteria. Both groups completed the Functional Assessment for Chronic Illness Therapy's questionnaire for the breast population quality of life assessment tool, with additional questions evaluating the effect of underarm antiperspirant use on quality of life before treatment, immediately after treatment, and 2 weeks after treatment during the study. Results: The skin reaction data were analyzed using the generalized estimating equation. No statistically significant difference was seen in the skin reaction between the 2 groups over time. The quality of life data also revealed no statistically significant difference between the 2 groups over time. Conclusions: Data analysis indicates that using antiperspirant routinely during external beam radiotherapy for Stage 0, I, or II breast cancer does not affect the intensity of the skin reaction or the self-reported quality of life. This evidence supports that in this particular population, there is no purpose to restrict these women from

  3. Randomized Control Trial: Evaluating Aluminum-Based Antiperspirant Use, Axilla Skin Toxicity, and Reported Quality of Life in Women Receiving External Beam Radiotherapy for Treatment of Stage 0, I, and II Breast Cancer

    International Nuclear Information System (INIS)

    Watson, Linda C.; Gies, Donna; Thompson, Emmanuel; Thomas, Bejoy

    2012-01-01

    Purpose: Standard skin care instructions regarding the use of antiperspirants during radiotherapy to the breast varies across North America. Women have articulated that when instructed to not use antiperspirant, the potential for body odor is distressing. Historical practices and individual opinions have often guided practice in this field. The present study had 2 purposes. To evaluate whether the use of aluminum-based antiperspirant while receiving external beam radiotherapy for stage 0, I, or II breast cancer will increase axilla skin toxicity and to evaluate whether the use of antiperspirant during external beam radiotherapy improves quality of life. Methods: A total of 198 participants were randomized to either the experimental group (antiperspirant) or control group (standard care-wash only). The skin reactions in both groups were measured weekly and 2 weeks after treatment using the National Cancer Institute Common Toxicity Criteria Adverse Events, version 3, toxicity grading criteria. Both groups completed the Functional Assessment for Chronic Illness Therapy’s questionnaire for the breast population quality of life assessment tool, with additional questions evaluating the effect of underarm antiperspirant use on quality of life before treatment, immediately after treatment, and 2 weeks after treatment during the study. Results: The skin reaction data were analyzed using the generalized estimating equation. No statistically significant difference was seen in the skin reaction between the 2 groups over time. The quality of life data also revealed no statistically significant difference between the 2 groups over time. Conclusions: Data analysis indicates that using antiperspirant routinely during external beam radiotherapy for Stage 0, I, or II breast cancer does not affect the intensity of the skin reaction or the self-reported quality of life. This evidence supports that in this particular population, there is no purpose to restrict these women from using

  4. Combined effects of goserelin and tamoxifen on estradiol level, breast density, and endometrial thickness in premenopausal and perimenopausal women with early-stage hormone receptor-positive breast cancer: a randomised controlled clinical trial.

    Science.gov (United States)

    Yang, H; Zong, X; Yu, Y; Shao, G; Zhang, L; Qian, C; Bian, Y; Xu, X; Sun, W; Meng, X; Ding, X; Chen, D; Zou, D; Xie, S; Zheng, Y; Zhang, J; He, X; Sun, C; Yu, X; Ni, J

    2013-08-06

    This study is to investigate the effects of geserelin+tamoxifen (TAM) on estradiol level, breast density (BD), endometrial thickness (ET), and blood lipids in premenopausal and perimenopausal women with hormone receptor-positive early-stage breast cancer. This study recruited 110 premenopausal and perimenopausal patients with hormone receptor-positive early-stage breast cancer between 22 June 2008 and 31 December 2009 and randomly assigned them to receive either goserelin plus TAM or TAM alone for 1.5 years. Blood levels of sex hormones and lipids and ET were determined at 0, 3, 6, 12, and 18 months. Contralateral BD was also measured at 0, 12, and 18 months. Five participants dropped out of the goserelin plus TAM group, and two participants dropped out of the TAM-alone group before initiation of endocrine therapy. The rest of patients received scheduled treatment and 3 years of median follow-up. No serious adverse effects were observed, and only two local recurrences have been observed in these patients. Estradiol level and BD were lower in the goserelin plus TAM group than in the TAM-alone group (Pwomen in the TAM-alone group exhibited endometrial thickening over the course of the study. Furthermore, no significant differences in blood lipid levels were reported between the two groups. The data from the current study demonstrated that the addition of goserelin to TAM results in downregulation of estradiol level, followed by significant reduction in BD and ET in premenopausal and perimenopausal women with hormone receptor-positive breast cancer, which may eventually lead to better outcome in these patients.

  5. Side effects associated with ultrarapid cytochrome P450 2D6 genotype among women with early stage breast cancer treated with tamoxifen.

    Science.gov (United States)

    Rolla, R; Vidali, M; Meola, S; Pollarolo, P; Fanello, M R; Nicolotti, C; Saggia, C; Forti, L; Agostino, F D; Rossi, V; Borra, G; Stratica, F; Alabiso, O; Bellomo, G

    2012-01-01

    The side effects of tamoxifen, a drug widely used for the treatment and the prevention of recurrence in patients with estrogen receptor positive breast cancers (ER+), have been reported in clinical trials, but to date no information is available on their possible association with an increased enzymatic activity of CYP2D6 (ultra-metabolizers, UMs). The aim of this study was therefore to evaluate the association between the presence of multiple functional CYP2D6 alleles and the occurrence of side effects. 61 women with ER+ breast cancer receiving tamoxifen monotherapy were investigated in order to assess the relationships between CYP2D6 UM phenotype and side effects. Genotyping of 16 CYP2D6 polymorphisms was performed using a new DNA microarray technology. A highly significant difference was detected (41.2% of difference, 95% CI 6 - 61%, Fisher's exact test, p = 0.030) between the numbers of Ultrarapid Metabolizer patients (UM; high activity) with two or more adverse drug reactions to tamoxifen (7/9; 77.8%), compared to the number of Extensive Metabolizers (EM; normal activity), Intermediate Metabolizers (IM; reduced activity), and Poor Metabolizers (PM; no activity) with at least two side effects (19/52, 36.5%). A similar difference was also observed comparing the two groups (UM vs EM-IM-PM) for the number of side effects (median and inter quartile range, IQR: AM/EM/IM 1, IQR 0-2 vs. ULTRA 2, IQR 2-4; Mann-Whitney p = 0.005). Our results suggest a new association between CYP2D6 gene duplication and side effects to tamoxifen, indicating a possible role of CYP2D6 in their occurrence.

  6. Long-term results of breast-conserving treatment for early-stage breast cancer in Japanese women from multicenter investigation

    International Nuclear Information System (INIS)

    Ohsumi, Shozo; Takashima, Shigemitsu; Sakamoto Goi

    2003-01-01

    Although many clinical data regarding breast-conserving treatment have already been reported from European and North American countries, few clinical data with long-term follow-up have been reported from Japan. We collected information on therapeutic and possible or developed prognostic factors and follow-up data for Japanese women who had received breast-conserving treatment consisting of wide excision of the primary tumor, axillary dissection and radiotherapy for unilateral breast cancer considered suitable for breast-conserving treatment from 18 Japanese major breast cancer treating hospitals; 1561 patients were registered. The median follow-up period was 77 months. Five-year disease-free and overall survival rates were 89.4 and 95.9%, respectively. The 5-year local recurrence-free rate was 96.3%. The patients with histologically positive margins (P<0.0001) or estrogen receptor negative tumor (P=0.0340) or younger than 40 years old (P<0.0001) developed statistically significantly more local recurrences. Adjuvant endocrine therapy was essential for the estrogen receptor positive patients to have a lower local recurrence rate. Endocrine therapy did not change the local recurrence rate among estrogen receptor negative patients at all. Multivariate analysis showed histological margin status and the combination of estrogen receptor status and endocrine therapy were independent prognostic factors for local recurrence. The 5-year local recurrence rate of Japanese breast cancer patients who were treated with breast-conserving treatment using radiotherapy was 3.7%. Independent prognostic factors for local recurrence were histological margin status and the combination of estrogen receptor status and adjuvant endocrine therapy. (author)

  7. Better survival after breast-conserving therapy compared to mastectomy when axillary node status is positive in early-stage breast cancer: a registry-based follow-up study of 6387 Norwegian women participating in screening, primarily operated between 1998 and 2009.

    Science.gov (United States)

    Hartmann-Johnsen, Olaf Johan; Kåresen, Rolf; Schlichting, Ellen; Nygård, Jan F

    2017-07-03

    Recent registry studies on early-stage breast cancer have shown better survival rates when women underwent breast-conserving therapy (BCT) compared with mastectomy (MTX). The aim of this study is to investigate women participating in screening, in all four stages of early breast cancer (T1N0M0, T2N0M0, T1N1M0, and T2N1M0), as to whether there is a survival benefit when women undergo BCT compared to MTX. A cohort of 6387 women aged 50-69, with primary-operated breast cancer from January 1998 to December 2009, participating in screening and followed-up until the end of 2010. Life tables were calculated by stages (pT1N0M0, pT2N0M0, pT1N1M0, and pT2N1M0), surgery groups (BCT and MTX), and screening detection (first screening, later screening, or interval cancer). Cox regression was used to calculate hazard ratios (HR) between BCT and MTX in crude and adjusted analyses. In stage T1N1M0, women who underwent MTX had an HR of 2.91 (95% CI 1.30-6.48) for breast cancer death compared to women who underwent BCT, after adjusting for screening detection, years of diagnosis, age at diagnosis, histology, grade, and hormone receptor status. For all other TNM categories of early breast cancer, there was no difference in survival. 10-year breast cancer-specific survival (BCSS) in T1N0M0 was 98% for women undergoing BCT and 96% for women undergoing MTX. 10-year BCSS in T1N1M0 was 97% for women undergoing BCT and 89% for women undergoing MTX. For women participating in screening, there is a benefit of BCT over MTX in stage T1N1M0. No such effects were observed in the other early stages of breast cancer.

  8. Comparison of {sup 18}F-FDG PET/MRI and MRI alone for whole-body staging and potential impact on therapeutic management of women with suspected recurrent pelvic cancer. A follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, Lino M.; Kirchner, Julian; Schaarschmidt, Benedikt M.; Antoch, Gerald [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Grueneisen, Johannes; Forsting, Michael; Umutlu, Lale [University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Ruhlmann, Verena; Herrmann, Ken [University Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Aktas, Bahriye [University Duisburg-Essen, Medical Faculty, Department of Obstetrics and Gynecology, Essen (Germany)

    2018-04-15

    To evaluate the diagnostic performance of {sup 18}F-FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone. Seventy-one consecutive women (54 ± 13 years, range: 25-80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1-3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar's chi{sup 2} test. Differences in diagnostic confidence were assessed by Wilcoxon test. Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p < 0.01). In contrast to PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p < 0.001). PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p < 0.001) and diagnostic confidence in the categorization of malignant lesions compared with MRI alone (2.7 ± 0.5 vs. 2.4 ± 0.7, p < 0.001). PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy

  9. Radical surgery for early stage cervical cancer

    NARCIS (Netherlands)

    Derks, M.

    2017-01-01

    Cervical cancer is one of the most common malignancies in women worldwide. Due to an effective screening programme, in the Netherlands cervical cancer is often detected in early stages of disease. For early stage (International Federation of Gynaecology and Obstetrics (FIGO) stage IB/IIA) cervical

  10. Endogenous sex hormones and memory performance in middle-aged Greek women with subjective memory complaints.

    Science.gov (United States)

    Armeni, Eleni; Apostolakis, Michail; Christidi, Foteini; Rizos, Demetrios; Kaparos, George; Panoulis, Konstantinos; Augoulea, Areti; Alexandrou, Andreas; Karopoulou, Evangelia; Zalonis, Ioannis; Triantafyllou, Nikolaos; Lambrinoudaki, Irene

    2018-02-01

    The changing hormonal milieu during the menopausal transition may contribute to the development of memory disorders. We aimed to assess the association of sex hormones with memory function in a sample of Greek middle-aged women. This pilot study included 44 women with subjective memory complaints. Memory performance was evaluated using the Hopkins Verbal Learning Test (HVLT), the Brief Visuospatial Memory test (BVMT), and the verbal digits backwards test (VSPAN), to assess verbal, visuospatial, and working memory performance, respectively. Menopausal symptoms were assessed using the Green Climacteric Scale. VSPAN backwards scores were positively associated with log-transformed free androgen index (logFAI), in models adjusted for age, education, log-transformed free estrogen index (logFEI), hypertension, and the intensity of menopausal symptoms. BVMT total scores were predicted by logFAI (b-coefficient = 0.424, p value = 0.002), education, and combined climacteric symptomatology, in a model adjusted for age, logFEI, and hypertension. Women with circulating estradiol above the median value of 10 pg/mL had better total HTLV total scores compared to women with estradiol values below the median (HTLV total scores, estradiol ≤ 10 pg/mL vs. > 10 pg/mL: 24.2 ± 3.6 vs. 30.0 ± 7.9, p value = 0.007 unadjusted). This association was affected by education and remained independent of menopausal symptoms and testosterone levels, education, and hypertension (model R 2 = 22.3%; b-coefficient = 0.318, p value = 0.024). Endogenous total estradiol is associated with verbal episodic memory, while logFAI is associated with working memory performance and visuospatial episodic memory in this sample of postmenopausal women. These associations were not influenced by age, education, or menopausal symptoms. Larger studies are necessary to evaluate the significance of our findings.

  11. Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP study: a randomized, double-dummy, double-blind, placebo-controlled trial.

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    Emma Del Carmen Macías-Cortés

    Full Text Available Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression.A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test.After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points. Fluoxetine was not different from placebo in Greene Climacteric Scale.Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only

  12. Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP study): a randomized, double-dummy, double-blind, placebo-controlled trial.

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    Macías-Cortés, Emma Del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

    2015-01-01

    Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression. A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity) were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test). After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points). Fluoxetine was not different from placebo in Greene Climacteric Scale. Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only. Homeopathy, but

  13. Sexual dysfunction prevalence in a group of pre- and postmenopausal Mexican women

    Science.gov (United States)

    Núñez, Flor de Durazno Casillas

    2018-01-01

    Introduction To determine the prevalence of sexual dysfunction in pre and postmenopausal women. Material and methods A cross-sectional, descriptive, comparative study was done in climacteric women from 40 to 59 years of age. Female sexual function was evaluated with the female sexual function index (FSFI) on the day of consultation. The comparison between pre and postmenopausal women and between those with or without sexual dysfunction was done with Mann Whitney U test, χ2, and Spearman’s correlation analysis was done. Results One hundred and ten women were studied, 55 were premenopausal (group 1) and 55 postmenopausal (group 2). The median of age in group 1 was 46 (40-58) years and in group 2 it was 53 (45-60) years. Premenopausal women had higher education level than postmenopausal women (p < 0.023). From those sexually active, 62.1% had sexual dysfunction. No statistically significant difference was found in education level, religion and marital status between women with or without sexual dysfunction. No difference in sexual dysfunction was found between premenopausal (62.1%) and postmenopausal (62.5%) women, but greater sexual dysfunction was found starting from 50 years age. Age negatively correlated with FSFI score (ρ = –0.324, p < 0.001). Conclusion In postmenopausal women, those older had a greater impairment in sexual function.

  14. Freqüência da atividade sexual em mulheres menopausadas Factors related to frequency of sexual activity of postmenopausal women

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    Dino Roberto Soares De Lorenzi

    2006-08-01

    Full Text Available OBJETIVO: Identificar os fatores relacionados à freqüência da atividade sexual entre mulheres pós-menopáusicas. MÉTODOS: Estudo transversal de 206 mulheres pós-menopáusicas entre 45 e 60 anos atendidas em um serviço universitário da região Sul do Brasil entre junho e outubro de 2002. A atividade sexual foi avaliada pelo número de relações sexuais no último mês e a sintomatologia climatérica pelo Índice de Kupperman. Na análise estatística, fez-se regressão linear múltipla. RESULTADOS: Das mulheres pesquisadas, 176 (85% eram sexualmente ativas. Cerca de 60,6% relataram diminuição da atividade sexual após a menopausa, o que atribuíram principalmente à impotência sexual do parceiro (41,7%. Aproximadamente 25,7% negaram satisfação com o intercurso sexual. Na análise por regressão linear múltipla, associaram-se à atividade sexual a idade (pOBJECTIVE: To identify factors related to the frequency of sexual activity of postmenopausal women METHODS: A cross-section study of 206 postmenopausal women between 45 and 60 years of age was made at a university health care service in the South of Brazil between June and October 2002. Evaluations were made of sexual activity according to the number of sexual intercourses in the previous month and the climacteric symptoms using the Kupperman index. Statistical analysis was performed with multiple linear regression analysis. RESULTS: Of those surveyed 176 (85% women were sexually active. Although 60.6% reported a decrease in sexual activity after menopause, mostly attributing it to the husband's sexual impotence (41.7%. Approximately 25.7% stated they had no satisfaction with sexual intercourse. By means of multiple linear regression analysis the following aspects were associated to sexual activity: age (p<0.1, degree of sexual satisfaction (p=0.01, and climacteric symptomatology (p=0.02. As age increased the climacteric symptoms were more intense and sexual activity was less

  15. Avanços na elucidação dos mecanismos de ação de Cimicifuga racemosa (L. Nutt. nos sintomas do climatério Advances on the elucidation of mechanisms of action of Cimicifuga racemosa (L. Nutt. in climacteric symptoms

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    A.G. Silva

    2009-01-01

    Full Text Available O objetivo deste trabalho foi levantar os avanços ocorridos para a compreensão da atuação terapêutica de Cimicifuga racemosa, um fitoterápico utilizado no tratamento dos sintomas do climatério em mulheres nas quais a terapia de reposição hormonal (TRH é contra-indicada. A revisão bibliográfica possibilitou concluir que existem quatro principais hipóteses para esclarecer a base mecanística de ação: indução de apoptose por meio da ativação de caspases, inibição do ciclo celular em G1 por alteração de proteínas reguladoras, efeito central em receptor 5HT e ação estrogênica evidenciada pela inibição seletiva dos receptores nicotínicos da acetilcolina. Porém, é incipiente a produção científica abordando as bases moleculares que sustentem os referidos mecanismos de ação. Ainda há necessidade de elucidação quanto à possível existência de pelo menos mais um receptor estrogênico que possa ser o alvo de ligação para as substâncias ativas de C. racemosa, bem como avançar no conhecimento da atividade reguladora seletiva de receptores estrogênicos já evidenciada em estudos de farmacologia experimental.The aim of this survey was to assemble the advances in the comprehension of the therapeutic action of Cimicifuga racemosa, a phytotherapic drug used in the treatment of climacteric symptoms in women to whom the usual hormonal replacement therapy (HRT is counter-indicated. This literature review led to the conclusion that there are four main hypotheses to elucidate the mechanistic basis of action: apoptosis induction by means of caspase activation, cell cycle inhibition at G1 step through disturbance of regulatory proteins, central effect on 5HT receptors, and estrogenic action evidenced by selective inhibition of nicotinic acetylcholine receptors. However, scientific literature is still incipient in supporting the molecular bases for the previously proposed mechanisms of action. There is also the need to

  16. Evaluation of bone alterations in the jaws of HIV-infected menopausal women

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    Bruno Vieira Caputo

    2013-06-01

    Full Text Available The advent of highly active antiretroviral therapy (HAART has caused a reduction in mortality, thus contributing to an increase in the number of women with HIVࢧAIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I and women with no known HIV infection (Group II. Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI, Panoramic Mandibular Index (PMI and Antegonial Depth (AD. A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054 and AD (p < 0.0001 for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003. Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.

  17. A measurement-specific quality-of-life satisfaction during premenopause, perimenopause and postmenopause in Arabian Qatari women

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    Abdulbari Bener

    2014-01-01

    Full Text Available Objective: The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction in the state of Qatar for the premenopausal, menopause and postmenopausal period.Design: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires and face-to-face interviews were performed.Setting: Primary Health Care (PHC Centers in Qatar.Materials and Methods: A multistage sampling design was used and a representative sample of 1,500 women aged 40-60 years were included during July 2012 and November 2013, and 1,158 women agreed to participate (77.2% and responded to the study.Results: The mean age and standard deviation of the subjects was 50.9 ± 6.1. The median age of natural menopause in the present study was 49 years [mean and standard deviation 49.9 ± 2.7]. The rate of consanguineous marriages in the sample was found to be 30.3%. There were statistically significance differences between menopausal stages with regard to ethnicity, education level, occupation, type of housing condition, and consanguinity. There were statistically significance differences between menopausal stages concerning BMI groups, Systolic BP, Diastolic BP, physical activity, parity, and sheesha smoking habits. Meanwhile, the present study revealed that the most common disease was found to be diabetes mellitus (11.4%, followed by hypertension (6.6%, asthma (5.6% and CHD (2.5%, and the majority of subjects (69.5% had no specific disease. The most frequent symptom was "aches in the back and neck" (49.2%, night sweat (37.2%, low backache (35.7%, feeling nervous (35.4% followed by "aches in the muscles/joints" (34.6%, hot flashes (33.3%, decreased social activities (28.3%, decreased leisure activities (47.6%, difficulty sleeping (28.9%, mood swings (25.4%, and decreased concentration (28.3%, sexual activity (24.1% and total energy level (26

  18. A measurement-specific quality-of-life satisfaction during premenopause, perimenopause and postmenopause in Arabian Qatari women.

    Science.gov (United States)

    Bener, Abdulbari; Falah, Anas

    2014-07-01

    The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction in the state of Qatar for the premenopausal, menopause and postmenopausal period. A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires and face-to-face interviews were performed. Primary Health Care (PHC) Centers in Qatar. A multistage sampling design was used and a representative sample of 1,500 women aged 40-60 years were included during July 2012 and November 2013, and 1,158 women agreed to participate (77.2%) and responded to the study. The mean age and standard deviation of the subjects was 50.9 ± 6.1. The median age of natural menopause in the present study was 49 years [mean and standard deviation 49.9 ± 2.7]. The rate of consanguineous marriages in the sample was found to be 30.3%. There were statistically significance differences between menopausal stages with regard to ethnicity, education level, occupation, type of housing condition, and consanguinity. There were statistically significance differences between menopausal stages concerning BMI groups, Systolic BP, Diastolic BP, physical activity, parity, and sheesha smoking habits. Meanwhile, the present study revealed that the most common disease was found to be diabetes mellitus (11.4%), followed by hypertension (6.6%), asthma (5.6%) and CHD (2.5%), and the majority of subjects (69.5%) had no specific disease. The most frequent symptom was aches in the back and neck (49.2%), night sweat (37.2%), low backache (35.7%), feeling nervous (35.4%) followed by aches in the muscles/joints (34.6%), hot flashes (33.3%), decreased social activities (28.3%), decreased leisure activities (47.6%), difficulty sleeping (28.9%), mood swings (25.4%), and decreased concentration (28.3%), sexual activity (24.1%) and total energy level (26.7%). The lowest reported symptoms were facial hair at 16

  19. Síndrome climatérico asociado a la hipertensión arterial en mujeres de edad mediana Climacteric syndrome associated with arterial hypertension in middle-aged females

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    Miguel Lugones Botell

    2008-03-01

    Full Text Available Se realizó un estudio de casos y controles en el Consultorio Médico No. 5 del Policlínico Universitario "26 de Julio" del municipio Playa en el período comprendido desde el 1ro. de abril de 2006 al 30 de junio del propio año. Se inició a partir del análisis del registro de dispensarización, con el objetivo de poder identificar a todas las pacientes hipertensas crónicas esenciales, comprendidas entre las edades de 40 a 59 años. Por cada mujer hipertensa dispensarizada, se seleccionó un control normotensa de igual edad y raza aparente, para de esta forma valorar cómo se presentaban las manifestaciones del síndrome climatérico en ambos grupos. Como criterio de exclusión se estableció lo siguiente: mujeres diabéticas o con complicaciones renales o del sistema nervioso central, con el fin de evitar incorporar mujeres hipertensas de carácter secundario, así como tampoco se incluyeron a aquellas con algún tipo de menopausia artificial. Se concluyó que las manifestaciones del síndrome climatérico estuvieron presentes en ambos grupos, pero con mayor predominio en las mujeres hipertensas, y con diferencias significativas en algunos de los síntomas como la ansiedad, la cefalea, las palpitaciones, la irritabilidad y los calambres.A case-control study was conducted at the Family Physician's Office No. 5 of "26 de Julio" Teaching Polyclinic, in Playa municipality, from April 1 to June 30, 2006. It was started from the analysis of the categorization register aimed at identifying all the chronic essential hypertensive females aged 40-59. Per every categorized hypertensive female, a normotensive control with the same age and apparent race was selected to assess the manifestations of the climacteric syndrome in both groups. Diabetic females or with renal or central nervous system complications were excluded to avoid the incorporation of hypertensive females of secondary character. Those females with some type of artificial menopause were

  20. [Analysis of relationships between perimenopausal symptoms and professional functioning and life satisfaction--Subjective perception of the dependence in women aged 40+].

    Science.gov (United States)

    Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta

    2015-01-01

    The aim of the study was to analyse and present the opinions of women in perimenopause on subjectively perceived symptoms characteristic of the climacteric period, and connected with their professional functioning, as well as to evaluate the effects of selected variables on the incidence and severity of these symptoms and the women's life satisfaction. The study included 250 professionally active women in perimenopausal age (40-57 years). The study used the Satisfaction with Life Scale (SWLS) to evaluate life satisfaction of women and the Kupperman Index (KI) as quantitative and qualitative self-assessment of climacteric symptoms. The authors also used a questionnaire of their own design that contains an index of defined symptoms of perimenopause, which warrants the use of Pareto-Lorenz analysis. The obtained results prove the presence of statistically significant correlations between the occurrence and severity of menopausal symptoms and the place of enployment (p=0.04912), gynecological care (p=0.00325), hormone replacement therapy (HRT) (p=0.01523) and assessment of life satisfaction (p=0.0325). Among the symptoms particularly influencing effective professional functioning, women pointed out hot flashes, irritability, reduced concentration and coordination, sleep disturbances, and increased sweating. There is a statistically significant correlation between the woman's place of employment, gynecological care, HRT, the evaluation of life satisfaction and the severity of perimenopausal symptoms. A set of symptoms whose presence and severity influence the sense of life satisfaction and evaluation of professional functioning was observed. Among the most frequently reported symptoms that exert an adverse effect on professional functioning of women are: hot flushes, irritability, reduced concentration and coordination, sleep disturbances, and increased sweating. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH study: A study protocol of an ongoing multi-centre randomised controlled clinical trial

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    Borud Einar K

    2007-02-01

    Full Text Available Abstract Background After menopause, 10–20% of all women have nearly intolerable hot flushes. Long term use of hormone replacement therapy involves a health risk, and many women seek alternative strategies to relieve climacteric complaints. Acupuncture is one of the most frequently used complementary therapies in Norway. We designed a study to evaluate whether Traditional Chinese Medicine acupuncture-care together with self-care is more effective than self-care alone to relieve climacteric complaints. Methods/Design The study is a multi-centre pragmatic randomised controlled trial with two parallel arms. Participants are postmenopausal women who document ≥7 flushes/24 hours and who are not using hormone replacement therapy or other medication that may influence flushes. According to power calculations 200 women are needed to detect a 50% reduction in flushes, and altogether 286 women will be recruited to allow for a 30% dropout rate. The treatment group receives 10 sessions of Traditional Chinese Medicine acupuncture-care and self-care; the control group will engage in self-care only. A team of experienced Traditional Chinese Medicine acupuncturists give acupuncture treatments. Discussion The study tests acupuncture as a complete treatment package including the therapeutic relationship and expectation. The intervention period lasts for 12 weeks, with follow up at 6 and 12 months. Primary endpoint is change in daily hot flush frequency in the two groups from baseline to 12 weeks; secondary endpoint is health related quality of life, assessed by the Women's Health Questionnaire. We also collect data on Traditional Chinese Medicine diagnoses, and we examine treatment experiences using a qualitative approach. Finally we measure biological variables, to examine potential mechanisms for the effect of acupuncture. The study is funded by The Research Council of Norway.

  2. Psychometric attributes of the Cervantes short-form questionnaire for measuring health-related quality of life in menopausal women.

    Science.gov (United States)

    Coronado, Pluvio J; Sánchez-Borrego, Rafael; Ruiz, Miguel A; Baquedano, Laura; Sánchez, Sonia; Argudo, Cristina; Fernández-Abellán, Mariela; González, Silvia; Iglesias, Eva; Calleja, Jackie; Presa, Jesus; Duque, Alfonso; Ruiz, Fernando; Otero, Borja; Rejas, Javier

    2016-02-01

    To analyse the psychometric properties of the Cervantes scale short-form (SF) in the peri- and post-menopausal periods. Outpatients women 45-65 years with menstrual problems associated with the climacteric syndrome were analysed. Original and SF versions of the Cervantes scale were administered along with the EuroQol-5D (EQ-5D) and work productivity and activity impairment questionnaire (WPAI) scales. Conceptual model, burden of administration, feasibility, reliability, criteria validity and construct validity were assessed. 317 women [55.7±5.3 years (mean±standard deviation)] were recruited: 75.4% were post- and 22.3% were peri-menopausal. The Cervantes-SF was completed in 2.5±1.6min, and 86% answered all items. Cronbach's α was 0.820, and ranged from 0.510 (Aging) to 0.918 (Vasomotor Symptoms) for individual dimensions. The scale structure matched the structure of the original version, χ(2)/(degrees of freedom)=3.6, Comparative Fit Index=0.848, Tucker-Lewis Index=0.850, and root mean square error of approximation=0.099, although differences were found between sexual activity statuses. Criteria validity was good (r=0.890), concurrent validity was congruent with a priori hypothesis using either the EQ-5D or the WPAI scales. The scale discriminated significantly the severity of both vasomotor and genital climacteric associated symptoms. The Cervantes-SF has shown good psychometric properties for measuring Health related quality of life in peri- and post-menopausal women who regularly attended gynaecology clinics in Spain. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Climateric: fatigue or third stage of the general adaptation syndrome Climaterio: fatiga o tercera etapa del síndrome de adaptación general

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    William Alvarez Gaviria

    2004-09-01

    Full Text Available The origin of climacteric has been subject of debate. Most opinions agree in that it arises exclusively from natural selection. In this paper the author argues that, besides this reason there is another, even more important; for him, climacteric is the final response to fatigue or the third stage of the general adaptation syndrome, just as in elderly people there is a loss of the capacity of proliferation of fibroblasts and lack of response to insulin. From a genetic point of view, this corresponds to an antagonic pleiotropy: the genetic program that has made the human adrenergic and corticotropic systems hyperactive, has also caused that they do not reach senescence intact. High concentrations of stress hormones during youth and adulthood in humans, as compared to chimpanzees, gorillas and orangutans, and the hormonal cascade reactions elicited by them are meaningfully related to our most conspicuous illnesses, our genotype/phenotype and, in the long term, with climacteric. Se ha conjeturado a menudo sobre las razones del climaterio y la mayoría de los autores sostiene que es un fenómeno que surge exclusivamente de la selección natural. Aquí asumimos que, aunque esa sea parte de la explicación, no es la razón primordial. Así como con la edad se da la pérdida, por ejemplo, de la capacidad proliferativa de los fibroblastos y de la sensibilidad a la insulina, el climaterio podría corresponder no más que a la fatiga o tercera etapa del Síndrome de Adaptación General. En un enfoque genético correspondería, pues, a una pleiotropía antagónica: el programa genético que ha hecho hiperactivos a los sistemas adrenérgico y corticotrópico del ser humano, evitaría también que llegara incólume al punto final de senescencia. Las altas concentraciones de hormonas de estrés en la juventud y la edad adulta que distinguen a nuestra especie, comparada con el chimpancé, el gorila y el orangután, y las reacciones hormonales en cascada que

  4. Profile of bazedoxifene/conjugated estrogens for the treatment of estrogen deficiency symptoms and osteoporosis in women at risk of fracture

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    Rossini M

    2013-07-01

    Full Text Available Maurizio Rossini,1 Stefano Lello,2 Ignazio Sblendorio,3 Ombretta Viapiana,1 Elena Fracassi,1 Silvano Adami,1 Davide Gatti11Department of Medicine, Rheumatology Unit, University of Verona, Italy; 2Endocrinological Gynecology, Pathophysiology of Menopause and Osteoporosis, Dermopathic Institute of Immacolata, Roma, Italy; 3Medical Coach Italia Center, Bari, ItalyAbstract: Decreasing levels of estrogens during menopause are associated with reduced bone density and an increased risk of osteoporosis. Many women also experience bothersome vasomotor and vaginal symptoms during the menopausal transition. Results of systematic reviews and meta-analyses of randomized controlled trials have shown that both systemic estrogen therapy or hormone therapy (estrogen combined with a progestin are useful to prevent bone loss, and they are the most effective treatment for such climacteric symptoms as hot flushes, sweating, vaginal dryness, and dyspareunia. Unfortunately, estrogen therapy and hormone therapy increase the risk of endometrial and breast cancer, respectively. The selective estrogen receptor modulators (SERMs result in positive estrogenic effects on bone, with no negative effects on the endometrium and breast but do not provide relief from postmenopausal symptoms. The combination of a SERM with estrogen as a tissue selective estrogen complex (TSEC is a new strategy for the prevention of bone loss and the treatment of climacteric symptoms. This combination is particularly interesting from a clinical point of view, taking into account that estrogen alone did not increase breast cancer risk by the Women's Health Initiative. TSEC is hypothesized to provide the benefits of estrogen-alone therapy, with an improved tolerability profile because the SERM component can make possible the elimination of progestin. The objective of this review was to critically evaluate the evidence from the reports published to date on the use of bazedoxifene (a third

  5. The impact of menopause on work ability in women with severe menopausal symptoms.

    Science.gov (United States)

    Geukes, Marije; van Aalst, Mariëlle P; Robroek, Suzan J W; Laven, Joop S E; Oosterhof, Henk

    2016-08-01

    To measure the impact of menopause on work ability in women with severe menopausal symptoms. This cross-sectional study compared the work ability of a sample of otherwise healthy employed Dutch women (n=205) with that of a sample of first-time attendees of a menopause clinic (n=60); both groups were aged 44-60 years. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used. Logistic regression analyses were used to examine whether women with severe menopausal symptoms were more likely to have low work ability (defined as a score work ability than their healthy counterparts: 76.7% versus 30.2% (OR 8.4, 95% CI 4.1-17.2). Over three-quarters of symptomatic menopausal women report serious problems in dealing with the physical and mental demands of their work (recorded here as low work ability); hence these women might be at risk of prolonged sickness absence from work. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Prevalence of hormone replacement therapy in a sample of middle-aged women

    DEFF Research Database (Denmark)

    Pedersen, S H; Jeune, B

    1988-01-01

    A survey based on a postal questionnaire sent to a random sample of Danish women aged 40-59 yr living on the island of Fünen (n = 401, response rate = 79%) revealed that the overall prevalence of the use of hormone replacement therapy (HRT) was 16%, the highest rate being in the 50-54 age group (21......%). Among post-menopausal women the rate was 21% and it was highest of all (37%) in those who had undergone an artificial menopause. The median age at the start of treatment was 44.3 yr among the artificial menopause and 48.9 yr among the natural menopause subjects. About half of the women were treated...... with natural oestrogen alone and over a third with cyclic natural oestrogen in combination with progestogens. Almost one-third of the women had consulted their doctor about climacteric complaints and two-thirds of these were current or past users of HRT. The women had ambiguous feelings towards HRT...

  7. Women in Science : Current Status & Proposal

    Indian Academy of Sciences (India)

    ranjeetha

    Private research institutes(over 100 employees) .... women scientists in various stages of career development to obtain ... Develop mentoring and networking opportunities for female ... Allow young women scientists to receive academic.

  8. Prostate cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000397.htm Prostate cancer staging To use the sharing features on this ... trials you may be able to join How Prostate Cancer Staging is Done Initial staging is based on ...

  9. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content.

    Science.gov (United States)

    Brooks, Nicole A; Wilcox, Gisela; Walker, Karen Z; Ashton, John F; Cox, Marc B; Stojanovska, Lily

    2008-01-01

    To examine the estrogenic and androgenic activity of Lepidium meyenii (Maca) and its effect on the hormonal profile and symptoms in postmenopausal women. Fourteen postmenopausal women completed a randomized, double-blind, placebo-controlled, crossover trial. They received 3.5 g/day of powered Maca for 6 weeks and matching placebo for 6 weeks, in either order, over a total of 12 weeks. At baseline and weeks 6 and 12 blood samples were collected for the measurement of estradiol, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin, and the women completed the Greene Climacteric Scale to assess the severity of menopausal symptoms. In addition, aqueous and methanolic Maca extracts were tested for androgenic and estrogenic activity using a yeast-based hormone-dependent reporter assay. No differences were seen in serum concentrations of estradiol, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin between baseline, Maca treatment, and placebo (P > 0.05). The Greene Climacteric Scale revealed a significant reduction in scores in the areas of psychological symptoms, including the subscales for anxiety and depression and sexual dysfunction after Maca consumption compared with both baseline and placebo (P Maca as no physiologically significant activity was observed in yeast-based assays employing up to 4 mg/mL Maca extract (equivalent to 200 mg/mL Maca). Preliminary findings show that Lepidium meyenii (Maca) (3.5 g/d) reduces psychological symptoms, including anxiety and depression, and lowers measures of sexual dysfunction in postmenopausal women independent of estrogenic and androgenic activity.

  10. Doença arterial coronária no climatério e exclusão social Coronary artery disease in climacteric and social exclusion

    Directory of Open Access Journals (Sweden)

    Sônia Lima Medeiros

    2007-04-01

    disease (that is responsible for the highest number of deaths in the city of São Paulo has been neglected. This is an area of great importance and social impact especially in developing countries. Women, in particular, are living longer now, and they may face the disease and survive many years after menopause. In Brazil, research about this theme is in its early phases and the importance of CAD in women still is underestimated, even when statistical data show that it has been increasing. This descriptive research aimed to establish the relationship between the socio-economic-cultural profile and social exclusion indicators in women after menopause and with CAD in treatment at the Coronary Diseases clinic of Instituto Dante Pazzanese de Cardiologia. The results could help us to better understand the disease and the patients' needs and point out effective actions to guide secondary prevention programs. The dialog between different areas of knowledge, such as Medicine, History, and Social Work, enabled a broad understanding of the studied phenomena, bringing to light social exclusion and gender discrimination aspects experienced by the patients that, till that time, had not been known and valued by the multidisciplinary team.

  11. MR staging accuracy for endometrial cancer based on the new FIGO stage

    International Nuclear Information System (INIS)

    Shin, Kyung Eun; Park, Byung Kwan; Kim, Chan Kyo; Bae, Duk Soo; Song, Sang Yong; Kim, Bohyun

    2011-01-01

    Background: Magnetic resonance imaging (MRI) has been frequently used to determine a preoperative treatment plan for gynecologic cancers. However, the MR accuracy for staging an endometrial cancer is not satisfactory based on the old FIGO staging system. Purpose: To evaluate MR accuracy for staging endometrial cancer using the new FIGO staging system. Material and Methods: Between January 2005 and May 2009, 199 women underwent surgery due to endometrial cancer. In each patient, an endometrial cancer was staged using MR findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparison. Histopathologic findings were used as a standard of reference. Results: The accuracy of MRI in the staging of endometrial carcinoma stage I, II, III, and IV using the old FIGO staging system were 80% (159/199), 89% (178/199), 90% (179/199), and 99% (198/199), respectively, compared to 87% (174/199), 97% (193/199), 90% (179/199), and 99% (198/199), respectively, when using the new FIGO staging criteria. The overall MR accuracy of the old and new staging systems were 51% (101/199) and 81% (161/199), respectively. Conclusion: MRI has become a more useful tool in the preoperative staging of endometrial cancers using the new FIGO staging system compared to the old one with increased accuracy

  12. Women's Health

    Science.gov (United States)

    Women have unique health issues. And some of the health issues that affect both men and women can affect women differently. Unique issues ... and men also have many of the same health problems. But these problems can affect women differently. ...

  13. Between Stage and Screen

    NARCIS (Netherlands)

    Tornqvist, Egil

    1996-01-01

    Ingmar Bergman is worldwide known as a film and stage director. Yet no-one has attempted to compare his stage and screen activities. In Between stage and screen Egil Tornqvist examines formal and thematical correspondences and differences between a number of Bergman's stage, screen, and radio

  14. Summary Stage 2018 - SEER

    Science.gov (United States)

    Access this manual of codes and coding instructions for the summary stage field for cases diagnosed January 1, 2018 and forward. 2018 version applies to every site and/or histology combination, including lymphomas and leukemias. Historically, also called General Staging, California Staging, and SEER Staging.

  15. Respuesta sexual de la mujer de edad mediana con diabetes mellitus Sexual response of middle-aged women with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Adriana Agramonte Machado

    2002-12-01

    Full Text Available Se realizó un estudio descriptivo transversal para describir las características de la respuesta sexual de la mujer con diabetes mellitus (DM, se emplearon cuestionarios autoadministrados (Sexualidad y el Inventario de Depresión de Beck y fueron evaluadas 180 mujeres de la mediana edad (90 con DM y 90 sin DM registradas en 31 consultorios de médicos de familia de 3 policlínicos del municipio Plaza de la Revolución. En cada mujer se precisó: datos generales necesarios para caracterización sociodemográfica, etapa climatérica, presencia de depresión y frecuencia de relaciones sexuales (RS, nivel de satisfacción con las RS, deseo y excitación sexual y orgasmos, y en las mujeres con DM, las características de la enfermedad y la auto percepción de la influencia de la misma sobre su sexualidad. Se comprobó que las mujeres con DM tenían: 1. Niveles menores de deseo y excitación sexual y mayor frecuencia de trastornos sexuales, 2. Mayor frecuencia de orgasmo, 3. Parejas sexuales con mayor frecuencia de disfunciones sexuales, 4. En su mayoría están satisfechas con la frecuencia de sus RS. En conclusión, la respuesta sexual de la mujer con DM difiere cuantitativamente de la mujer sin DM, se necesitarán nuevos estudios que permitan profundizar en las causas de estas diferencias.A cross-sectional descriptive study was conducted to describe the characteristics of the sexual response of women with diabetes mellitus (DM. Self-administered questionnaries (Sexuality and Beck's Depression Inventory were applied. 180 middle-aged women (90 with DM and 90 without DM registered in 31 family physician offices from 3 polyclinics of Plaza de la Revolución municipality were evaluated. The following information was obtained for each woman: general data necessary for the sociodemographic characterization, climacteric stage, presence of depression and frequency of sexual relations (SR, level of satisfaction with SR, sexual desire and excitement, and

  16. Analysis of CYP1A1 and COMT polymorphisms in women with cervical cancer.

    Science.gov (United States)

    Kleine, J P; Camargo-Kosugi, C M; Carvalho, C V; Silva, F C; Silva, I D C G

    2015-12-29

    The aim of this case-control study was to obtain a comprehensive panel of genetic polymorphisms present only in genes (cytochrome P-450 1A1--CYP1A1 and catechol-O-methyl transferase--COMT) within the metabolic pathway of sex steroids and determine their possible associations with the presence or absence of cervical cancer. Genotypes of 222 women were analyzed: a) 81 with cancer of the cervix treated at the Cancer Hospital Alfredo Abram, between June 2012 and May 2013, with diagnosis confirmed surgically and/or through histomorphological examination; and b) 141 healthy women who assisted at the Endocrine Gynecology and Climacteric Ambulatory, Department of Gynecology, UNIFESP-EPM. These polymorphisms were detected by polymerase chain reaction amplification-restriction fragment length polymorphism analysis and visualized on 3% agarose gels stained with ethidium bromide. We found a significant association between the frequency of the CYP1A1 polymorphism and the development of cervical cancer. A statistical difference was observed between patient and control groups for CYP1A1 polymorphism genotype distributions (P 0.05) or between other risk variables analyzed. The CYP1A1 gene involved in the metabolic pathway of sex steroids might influence the emergence of pathological conditions such as cervical cancer in women who carry a mutated allele, and result in 1.80 and 13.46 times increased risk for women with heterozygous or homozygous mutated genotypes, respectively.

  17. Health related quality of life of women in TEACH, a randomised placebo controlled adjuvant trial of lapatinib in early stage Human Epidermal Growth Factor Receptor (HER2) overexpressing breast cancer

    DEFF Research Database (Denmark)

    Boyle, Frances M; Smith, Ian E; O'Shaughnessy, Joyce

    2015-01-01

    BACKGROUND: To evaluate health related quality of life (HRQOL) in TEACH, a phase III randomized placebo controlled trial of 12 months of adjuvant lapatinib in HER2 positive (HER2+) early breast cancer which demonstrated marginal benefit in disease-free survival. METHODS: Women on TEACH completed...... (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health), and in patients discontinuing therapy. A five-point change was deemed a Minimally Clinically Important Difference (MCID). Response analysis compared the proportion of patients...... significant incidences of diarrhoea and rash in lapatinib treated patients. At six months, women receiving lapatinib had more significant reductions (p placebo) in social functioning. Early treatment discontinuations were more frequent on lapatinib (32% versus 18%), and were associated with more...

  18. Seven Stages of Alzheimer's

    Science.gov (United States)

    ... Disease > Stages Overview What Is Dementia? What Is Alzheimer's? Younger/Early Onset Facts and Figures Know the 10 Signs Stages Inside the Brain: An Interactive Tour Risk Factors Diagnosis Treatments Myths Clinical Studies Research Brain Donation ...

  19. Ovarian Cancer Stage II

    Science.gov (United States)

    ... peritoneal cancer; the first panel (stage IIA) shows cancer inside both ovaries that has spread to the uterus and fallopian tube. The second panel (stage IIB) shows cancer inside both ovaries that has spread to the colon. The third ...

  20. Late-Stage Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  1. Stages and Behaviors

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  2. Early-Stage Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  3. Cervical Cancer Stage IIIB

    Science.gov (United States)

    ... by the cancer. This blockage can cause the kidney to enlarge or stop working. Stage IIIB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

  4. Breast cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

  5. Staging of Lung Cancer

    Science.gov (United States)

    ... LUNG CANCER MINI-SERIES #2 Staging of Lung Cancer Once your lung cancer is diagnosed, staging tells you and your health care provider about ... at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV ...

  6. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  7. Ovarian Cancer Stage IIIC

    Science.gov (United States)

    ... Stage IIIC Description: Drawing of stage IIIC shows cancer inside both ovaries that has spread to the omentum. The cancer ... lymph nodes behind the peritoneum. In stage IIIC, cancer is found in one or both ovaries or fallopian tubes and has spread to the ...

  8. Cervical Cancer Stage IIIA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

  9. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

  10. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

  11. Cervical Cancer Stage IB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

  12. Female Sexual Function During the Menopausal Transition in a Group of Iranian Women

    Directory of Open Access Journals (Sweden)

    Tahereh Eftekhar

    2016-08-01

    Full Text Available Objective: To determine the prevalence of sexual problems in Iranian women and association of sexual dysfunction with menopausal symptoms.Materials and methods: In this cross-sectional study, 151 married women with the age of 40-60 yearsold who were referred for treatmentto Department of Gynecology in Vali-e-Asr Hospital (Tehran, Iran from April to July 2012, were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI questionnaire.Menopause rating scale (MRS was developed for the diagnosis and quantification of climacteric symptoms.Results: Total frequency of sexual dysfunction was 53% with the domains of lubrication, arusal and desire being commonly affected 62%, 70% and 98.5% of cases respectively. There is a relationship between severity of somatic and urogenital symptoms with sexual dysfunction (p = 0.03, p = 0.00 respectively.Conclusion: A considerable percentage of women experienced sexual dysfunctions in this period. Somatic and urogenital symptoms during the menopausal period could be a factor to maintain or intensity of sexual dysfunctions.

  13. A randomized trial of diet and physical activity in women treated for stage II—IV ovarian cancer: Rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES): An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study☆,☆☆

    Science.gov (United States)

    Thomson, Cynthia A.; Crane, Tracy E.; Miller, Austin; Garcia, David O.; Basen-Engquist, Karen; Alberts, David S.

    2016-01-01

    Ovarian cancer is the most common cause of gynecological cancer death in United States women. Efforts to improve progression free survival (PFS) and quality of life (QoL) after treatment for ovarian cancer are necessary. Observational studies suggest that lifestyle behaviors, including diet and physical activity, are associated with lower mortality in this population. The Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES) NRG 0225 study is a randomized, controlled trial designed to test the hypothesis that a 24 month lifestyle intervention will significantly increase PFS after oncological therapy for stage II-IV ovarian cancer. Women are randomized 1:1 to a high vegetable and fiber, low-fat diet with daily physical activity goals or an attention control group. Secondary outcomes to be evaluated include QoL and gastrointestinal health. Moreover an a priori lifestyle adherence score will be used to evaluate relationships between adoption of the diet and activity goals and PFS. Blood specimens are collected at baseline, 6, 12 and 24 months for analysis of dietary adherence (carotenoids) in addition to mechanistic biomarkers (lipids, insulin, telomere length). Women are enrolled at NRG clinic sites nationally and the telephone based lifestyle intervention is delivered from The University of Arizona call center by trained health coaches. A study specific multi-modal telephone, email, and SMS behavior change software platform is utilized for information delivery, coaching and data capture. When completed, LIVES will be the largest behavior-based lifestyle intervention trial conducted among ovarian cancer survivors. PMID:27394382

  14. Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neoadjuvant Therapy in Women with Stage I–III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue

    Directory of Open Access Journals (Sweden)

    Désirée Lötzke

    2016-01-01

    Full Text Available This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neoadjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI (n=45 or for a physical exercise intervention (PEI (n=47. Measurements were obtained before (t0 and after the intervention (t1 as well as 3 months after finishing intervention (t2 using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p<0.05 but not under YI (t0 to t2. Regarding quality of life (EORTC QLQ-C30 a direct effect (t0 to t1; p<0.001 of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p<0.001 were observed at both t1 and t2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t1 nor for t2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

  15. [Health for women; women for health].

    Science.gov (United States)

    1992-12-01

    This document describes a proposed new health policy for Colombian women. The rationale for the new policy, known as "Health for women, women for health", is discussed, and the general and specific objectives, program description, actions and strategies are presented for each of 5 subprograms. The subprograms cover health promotion and self-care for women, reproductive and sexual health care, prevention of abuse and services for women and children who are victims of violence, mental health, and occupational health Changes in Colombian society and living conditions and in the role of women over the past few decades have been reflected in changing epidemiologic profiles, life expectancy, and demands placed on health services. The Health for women, women for health policy takes into account social discrimination against women and its impact on female health. The subprogram of health promotion and self-care is intended to complement, reinforce, and broaden preventive interventions already offered by the health services. The subprogram will require a mobile interdisciplinary team to conduct educational campaigns and to coordinate activities. Promotional actions include staff training in a gender focus on health and health policy for women, development of a health manual for women, and a mass media campaign on self-care for women. The subprogram for reproductive health and sexuality will reorient existing maternal health services away from their emphasis on increasing coverage of prenatal care, promoting births in health facilities, and actions to reduce infant mortality and toward services appropriate to the different phases of the female reproductive cycle. The subprogram will include provision of family planning services, preventing and managing high risk pregnancies, providing adequate care in maternity centers for labor and delivery, and preventing avoidable maternal deaths. Reviewing and revising existing legislation to protect reproductive health is among proposed

  16. Multiple stage railgun

    International Nuclear Information System (INIS)

    Aaland, K.; Hawke, R.S.; Scudder, J.K.

    1982-01-01

    A multiple stage magnetic railgun accelerator for accelerating a projectile by movement of a plasma arc along the rails. The railgun is divided into a plurality of successive rail stages which are sequentially energized by separate energy sources as the projectile moves through the bore of the railgun. Propagation of energy from an energized rail stage back towards the breech end of the railgun can be prevented by connection of the energy sources to the rails through isolation diodes. Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails into electrically isolated rail sections. In such case means are used to extinguish the arc at the end of each energized stage and a fuse or laser device is used to initiate a new plasma arc in the next energized rail stage

  17. The influence of a physical activity program on the body and the cardio vascular parameters of premenopausal women

    Directory of Open Access Journals (Sweden)

    Almudena Ramírez Balas

    2012-07-01

    Full Text Available During the life cycle of a woman's body figure is changed gradually, but on reaching middle age, as a result of follicular loss of ovarian function among others, are emphasized the physiological changes and increase health risk and welfare. Androgyny in association with obesity increases the risk for diabetes, hypertension, dyslipidemia, atherosclerosis, cardiovascular disease, gallstones, osteoarthritis, arthritis, cancers and other disorders of female middle age. Physical activity has gained importance increasing in therapy in the climacteric. It has demonstrated the positive effects of exercise on cardiovascular disease and weight maintenance. This study investigates the influence of a physical activity program for five months on cardiovascular risk factors like high blood pressure and body composition in premenopausal women. The study included 20 premenopausal women, separated into two groups: younger than 35 years (n = 10, and over 35 years (n = 10. The experimental subjects underwent an assessment of blood pressure and body composition before and after an aerobic training. Results indicate greater extent in reducing diastolic blood pressure and body fat in over 35 years premenopausal women. Therefore, performing aerobics, step and toning improves factors cardiovascular risk as high blood pressure and body composition in over 35 premenopausal women.

  18. Knowledge and Perception of Menopause and Climacteric ...

    African Journals Online (AJOL)

    Uche

    Abstract. Background: Menopause alters the physiological, biochemical and psychological environment of a woman. Thus the knowledge and perception of its symptomatology is invaluable to enable appropriate adjustment to this natural phenomenon. Objective: The objective of this study was to determine the knowledge ...

  19. Estrogen therapy: from women's choice to women's preference.

    Science.gov (United States)

    Lachowsky, M

    2002-06-01

    The climacteric is not an illness, but the menopause is an event that troubles a woman's present life and puts her future life at risk. One would like to think that, for the woman of the new millennium, the menopause has simply become what it is: a feminine milestone that marks the transition and path to another period of life. She appears younger than her mother was at her age, she has given birth when she decided to, she has had the number of children she wanted, and her social and professional roles are well defined. Nevertheless, none of this makes much difference--the 'change of life' is still something difficult to live through, a bend to negotiate, each woman going at her own pace, using her own means, with the cards that life has already dealt her. Where do we gynecologists come in, what part have we to play in our patients' lives? Sometimes, we need to be less discreet and ask some of those questions women may have trouble voicing aloud. Let us try to help them to talk about their mood changes, the changes in their body, and their anxiety about osteoporosis and aging. Shame or fear of ridicule are still often among the ideas on the menopause and, by preventing honest answers from being given, often modify the scientific statistics on menopausal women--especially as women are often at a loss to know which of the different opinions to believe. The media air their news, the medical community offers its dissent, while friends recount frightening stories. Between the danger of offending Mother Nature and the risk of missing out on the progress of science, what is the right modus operandi that helps to add quality to the quantity of life still there to be enjoyed after the menopause? The doctor-patient relationship is of the utmost importance here, since an atmosphere of confidence and trust is the basis of mutual comprehension. By understanding the patient's needs, her desires, and her ways of coping with the situation, the physician will enable her to accept

  20. Turbine stage model

    International Nuclear Information System (INIS)

    Kazantsev, A.A.

    2009-01-01

    A model of turbine stage for calculations of NPP turbine department dynamics in real time was developed. The simulation results were compared with manufacturer calculations for NPP low-speed and fast turbines. The comparison results have shown that the model is valid for real time simulation of all modes of turbines operation. The model allows calculating turbine stage parameters with 1% accuracy. It was shown that the developed turbine stage model meets the accuracy requirements if the data of turbine blades setting angles for all turbine stages are available [ru

  1. Rural African women and development.

    Science.gov (United States)

    Kabadaki, K

    1994-01-01

    70-90% of Africans still live in rural areas, and 25-30% of rural households are headed by women. Standards of living in rural areas are lower than in urban areas. Rural African women's involvement in development is in its initial stages, and social development for women is likely to be slow. Increasing women's opportunities for education is a means of promoting social justice and fairness. Schools should offer courses of practical value for those not planning on higher education and special programs and career counseling for gifted girls. Women's organizations, African leaders, and other influential parties should aggressively create awareness about the oppressive aspects of traditional attitudes, beliefs, and views about women. Laws on ownership of property, inheritance, access to credit, and employment must be equitable and enforced. Consciousness-raising among rural women is an effective means of encouraging rural women to seek and assume new roles and for questioning unreasonable expectations and norms. Women's professional associations serve important functions and fulfill the need for role models. The quality of rural women's life is effectively improved through formulation of policies relevant to women's needs and problems and improve rural conditions. Women should have fair representation at local and national levels of government. Women's role in agriculture is likely to be enhanced through improved transportation systems, electricity supply, and introduction of intermediate technology. This assessment of rural African women's contributions to economic growth emphasizes women's involvement in farming and the informal sector and their lack of equal remuneration or low wages. Illiteracy places women in a disadvantaged position when competing for employment in the formal sector. Lack of access to credit and limits on credit are other obstacles in the informal sector. The reduced participation of rural women in the formal and informal sector is due to lack of

  2. Second-stage primary Caesarean deliveries: Are maternal ...

    African Journals Online (AJOL)

    variables were nonsignificant. None of the women or their babies needed readmission to hospital or transfer to an intensive care unit. Table I: Demographic data of mother and neonate following Caesarean delivery in the first and second stages of labour. Demographics. Caesarean delivery 2nd stage (n = 53). Caesarean.

  3. Breast cancer relapse stage I and II

    International Nuclear Information System (INIS)

    Perez Braojos, Ines; Diaz Gestoso, Yadira; Franco Odio, Sonia; Samuel Gonzalez, Victor

    2009-01-01

    Breast cancer has always been the most common malignancy in women and is the leading cause of death in women, study relapses Stages I and II therapeutic guidelines applied in the service Mastology the 1985 - 1989, was our first objective, the database used was Clinical history, which gave us all the material necessary, treatments were: In tumors up to 3 cm node-conserving surgery plus treatment N0 with ionizing radiation on the breast tangential C0G0 in tumors greater than 3 cm or less with N1 was modified radical mastectomy according to node status for the study of the part and the receiver adjuvant treatment conducted. (Author)

  4. Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

    Science.gov (United States)

    García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

    2016-01-01

    Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Stages of Penile Cancer

    Science.gov (United States)

    ... under a microscope . Stage II In stage II , cancer has spread: to connective tissue just under the skin of the penis . Also, ... spread to one lymph node in the groin . Cancer has also spread: to connective tissue just under the skin of the penis . Also, ...

  6. Maca reduces blood pressure and depression, in a pilot study in postmenopausal women.

    Science.gov (United States)

    Stojanovska, L; Law, C; Lai, B; Chung, T; Nelson, K; Day, S; Apostolopoulos, V; Haines, C

    2015-02-01

    Lepidium meyenii (Maca) has been used for centuries for its fertility-enhancing and aphrodisiac properties. In an Australian study, Maca improved anxiety and depressive scores. The effects of Maca on hormones, lipids, glucose, serum cytokines, blood pressure, menopausal symptoms and general well-being in Chinese postmenopausal women were evaluated. A randomized, double-blind, placebo-controlled, cross-over study was conducted in 29 postmenopausal Hong Kong Chinese women. They received 3.3 g/day of Maca or placebo for 6 weeks each, in either order, over 12 weeks. At baseline, week 6 and week 12, estradiol, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), thyroid stimulating hormone (TSH), full lipid profiles, glucose and serum cytokines were measured. The Greene Climacteric, SF-36 Version 2, Women's Health Questionnaire and Utian Quality of Life Scales were used to assess the severity of menopausal symptoms and health-related quality of life. There were no differences in estradiol, FSH, TSH, SHBG, glucose, lipid profiles and serum cytokines amongst those who received Maca as compared to the placebo group; however, significant decreases in diastolic blood pressure and depression were apparent after Maca treatment. Maca did not exert hormonal or immune biological action in the small cohort of patients studied; however, it appeared to reduce symptoms of depression and improve diastolic blood pressure in Chinese postmenopausal women. Although results are comparable to previous similar published studies in postmenopausal women, there might be a cultural difference among the Chinese postmenopausal women in terms of symptom reporting.

  7. Increased menopausal symptoms among Afro-Colombian women as assessed with the Menopause Rating Scale.

    Science.gov (United States)

    Monterrosa, Alvaro; Blumel, Juan E; Chedraui, Peter

    2008-02-20

    Increased frequency and severity of menopausal symptoms have been associated to black race. However, this situation has not been described in any Latin American population. Compare frequency and severity of menopausal symptoms among Afro and non-Afro Hispanic Colombian climacteric women. In this cross-sectional study, healthy Afro and non-Afro-Colombian women aged 40-59 years were asked to fill out the Menopause Rating Scale (MRS) questionnaire in order to compare symptom frequency and intensity. A total of 578 women were surveyed (201 Afro-Colombian and 377 non-Afro-Colombian). Mean age of the whole sample was 47.9+/-5.9 years (median 47), with no differences among studied groups in terms of age, parity, and hormone therapy (HT) use. Intensity of menopausal symptoms, assessed with the total MRS score, was found to be significantly higher among Afro-Colombian women (10.6+/-6.7 vs. 7.5+/-5.7, p=0.0001), which was due to higher somatic and psychological subscale scores. In this group, the frequency of somatic symptoms, heart discomfort and muscle and joint problems, was found to be higher than in non-Afro-Colombian women (38.8% vs. 26.8% and 77.1% vs. 43.5%, respectively, pColombian ones presented more bladder problems (24.9% vs. 14.9%, p=0.005). After adjusting for confounding factors, logistic regression analysis determined that black race increased the risk for presenting higher total MRS scorings (OR: 2.31; CI 95%: 1.55-3.45, p=0.0001). Despite the limitations of this study, as determined with the MRS Afro-Colombian women exhibited more impaired quality of life (QoL) when compared to non-Afro-Colombian ones, due to a higher rate and severity of menopausal somatic and psychological symptoms.

  8. Women Scientists in the Leaking Pipeline: Barriers to the Commercialisation of Scientific Knowledge by Women

    Directory of Open Access Journals (Sweden)

    Dominika Polkowska

    2013-05-01

    Full Text Available The modern literature explaining the under-representation of women in science often relate to the shortage of women ‘in the pipeline’. The pipeline flows from one stage to another, and the flow of women diminishes over the stages. Speaking of the stages of career during which women scientists ‘leak’ the most, the commercialisation of science as one of the ultimate stages should be taken into consideration. The primary objective of this paper is to discuss barriers to the commercialisation of scientific knowledge by women. The collected extensive literature allows to pinpoint the reason why scientific career or success fail to provide a springboard for the practical use of knowledge. Analysed research, indicate only some of the barriers, meanwhile this paper collects most of ‘experienced’ obstacles and shows them in ‘leaking pipeline’ context. Barriers originate in at least two sources: women themselves and external factors beyond women’s control.

  9. Influence of menopausal symptoms on perceived work ability among women in a Nigerian University.

    Science.gov (United States)

    Olajubu, A O; Olowokere, A E; Amujo, D O; Olajubu, T O

    2017-12-01

    This study investigated the menopausal symptoms experienced by women of menopausal age in Ekiti State, Nigeria and the influence on their perceived work ability. A descriptive cross-sectional research design was employed and the study was conducted among 200 working-class women aged 45 years and above who had experienced at least 12 continuous months of amenorrhea in Ekiti State University, Ado Ekiti. A semi-structured questionnaire adapted from the Greene Climacteric Scale and the work ability index was used to assess menopausal symptoms and work ability, respectively. The prevalence of menopausal symptoms in this study was 96.5%. The commonest menopausal symptom experienced by the respondents was muscle pain (81.5%), followed by sweating at night (80%), while spells of crying were the least (27.5%). Out of the symptoms, hot flushes were rated most severe followed by sweating at night, while crying spells were also the least severe symptom. Only 27% expressed excellent work ability. The Pearson correlation coefficient showed a negative significant relationship (r = -0.311, p work ability. The study concluded that menopausal symptoms had a negative influence on work ability of the respondents.

  10. Satisfacción de mujeres en etapa climatérica en Brisas del Golfo, República Bolivariana de Venezuela (2005-2007 Satisfaction of women in climateric stage in Brisas del Golfo, República Boliviariana de Venezuela (2005-2007

    Directory of Open Access Journals (Sweden)

    María Isabel Capote Bueno

    2012-03-01

    Full Text Available Introducción: el climaterio es el tiempo durante el cual, se pasa de la vida reproductiva a la no reproductiva, y comprende casi un tercio de la vida femenina; el estudio de cómo perciben las mujeres, este llamado complejo periodo, se considera necesario para brindar atención especial a su salud. Objetivo: describir la satisfacción personal de las mujeres en la etapa climatérica. Métodos: se realizó un estudio descriptivo en Brisas del Golfo, Estado Sucre, entre julio de 2005 y julio de 2007; el universo estuvo constituido por 256 mujeres entre los 45 y 59 años de edad. Se realizó un muestreo intencional y la muestra quedó constituida por 80 mujeres. Para la obtención de la información se aplicó una encuesta cerrada, como instrumento medidor de satisfacción personal, validada por la Universidad de La Habana (ISP-RELEBA. Resultados: el 81,3 % de las mujeres, refieren que disfrutan cuando tienen relaciones sexuales, el 74,5 % tienen metas comunes que alcanzar con su pareja, al 65 % les satisface ser la responsable del cuidado y atención de sus familiares, entre el 93,8 y 75 % de las mujeres, tienen un proyecto de vida y el 96,3 %, está satisfecha con la familia que ha logrado formar. Conclusiones: la gran mayoría de las mujeres climatéricas, tienen una visión positiva de su vida en pareja, con metas comunes, perciben gran bienestar por ser las responsables del cuidado y la atención de sus familiares, se sienten satisfechas con la familia que han logrado formar, y perciben bienestar, lo cual repercute de forma positiva en su salud.Introduction: climateric is the time in which women change of the reproductive status to that non-reproductive and account for a third of the female life; the study on how women perceive this so called complicated period is considered necessary to offer a special care to health. Objective: to describe the personal satisfaction of women in climateric stage. Methods: a descriptive study was conducted in

  11. Staging for vulvar cancer.

    Science.gov (United States)

    Hacker, Neville F; Barlow, Ellen L

    2015-08-01

    Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  12. Autocuidado de mujeres en etapa de menopausia en Toluca, Mexico Autocuidado de mulheres na etapa da menopausa em Toluca, México Self care of women in the menopause stage in Toluca, Mexico

    Directory of Open Access Journals (Sweden)

    María Dolores Martínez Garduño

    2008-03-01

    úde.The woman in the menopause is exposed to risk factors that increase with the self-care. The objective was to identify self care practices in the menopause. Quantitative study, exploratory, with a sample of simple random probability, using the EPI INFO 2000, with 95% trust limit, 5% maximum error, in 354 women. Was observed a self-care deficit, mostly in alimentary habits, showing overweight and obesity (27%; the noise it is a factor that interfere in the sleep, the average sleep was about 5 to 7 hours; 40% don’t do physical exercise; 17.9% don’t do the uterine cervical cancer examination; 37.7% don’t do the breast self exam, without social security. 52.3% only go to the doctor when is ill. The frequent manifestations in the climatery are irregular bleeding, suffocation, fatigue and lack of libido. There aren’t enough information in this group of women, being the nurse who must assume the function of health educator.

  13. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...... the second procedure, when operations were staged less than 3 weeks apart. A correlation between these hypertensive episodes and the occurrence of new neurologic symptoms could not be shown. However, as this correlation has been proved in several other reports, bilateral carotid endarterectomy is advised...... to be staged at least 3 weeks apart. In addition, a conservative attitude towards contralateral asymptomatic lesions is proposed....

  14. Staging of lung cancer.

    Science.gov (United States)

    de Groot, Patricia M; Carter, Brett W; Betancourt Cuellar, Sonia L; Erasmus, Jeremy J

    2015-06-01

    Primary lung cancer is the leading cause of cancer mortality in the world. Thorough clinical staging of patients with lung cancer is important, because therapeutic options and management are to a considerable degree dependent on stage at presentation. Radiologic imaging is an essential component of clinical staging, including chest radiography in some cases, computed tomography, MRI, and PET. Multiplanar imaging modalities allow assessment of features that are important for surgical, oncologic, and radiation therapy planning, including size of the primary tumor, location and relationship to normal anatomic structures in the thorax, and existence of nodal and/or metastatic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Stages of Retinoblastoma

    Science.gov (United States)

    ... of the ultrasound monitor . The picture can be printed to be looked at later. MRI (magnetic resonance ... procedures may be used in the staging process: Bone scan : A procedure to check if there are ...

  16. Multiple Stages 2

    DEFF Research Database (Denmark)

    Andreasen, John

    Multiple stages 2: theatrical futures, set design, community plays, cultural capitals, democracy & drama, WWII dramas, performance on adoption, promenade about emigration, qualities in political theatre, performance analysis, dramaturgical education, Toulmin Variations...

  17. Stages of ores formation

    International Nuclear Information System (INIS)

    Khasanov, A.Kh.

    1988-01-01

    Deposit formation (especially endogenous) is the complicated, multi-stage and long process. Establishment of deposit formation succession, age-specific correlations of minerals and aggregates have a high importance at solving genetic questions. Studying of minerals correlations and mineral aggregates, succession of their crystallization and other observations let restore the history of deposit formation, pick up in it different on duration and physical and chemical conditions stages

  18. Normalization: A Preprocessing Stage

    OpenAIRE

    Patro, S. Gopal Krishna; Sahu, Kishore Kumar

    2015-01-01

    As we know that the normalization is a pre-processing stage of any type problem statement. Especially normalization takes important role in the field of soft computing, cloud computing etc. for manipulation of data like scale down or scale up the range of data before it becomes used for further stage. There are so many normalization techniques are there namely Min-Max normalization, Z-score normalization and Decimal scaling normalization. So by referring these normalization techniques we are ...

  19. Staging with spatial filters

    International Nuclear Information System (INIS)

    Glaze, J.

    1974-01-01

    It is known that small scale beam instabilities limit the focusable energy that can be achieved from a terawatt laser chain. Spatial filters are currently being used on CYCLOPS to ameliorate this problem. Realizing the full advantage of such a filter, however, may require certain staging modifications. A staging methodology is discussed that should be applicable to the CYCLOPS, 381, and SHIVA systems. Experiments are in progress on CYCLOPS that will address directly the utility of the proposed approach

  20. First Stage Acceptance Test

    Science.gov (United States)

    1960-01-01

    This photograph shows the intense smoke and fire created by the five F-1 engines from a test firing of the Saturn V first stage (S-1C) in the S-1C test stand at the Marshall Space Flight Center. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  1. Representaciones socio-culturales sobre la menopausia: Vivencias del proceso en mujeres residentes en Albacete (España Socio-cultural representations about menopause: Experiences of the process in resident women in Albacete, Spain

    Directory of Open Access Journals (Sweden)

    Angélica Gómez Martínez

    2008-09-01

    Full Text Available Objetivo: Acercamiento a las representaciones sociales constitutivas de un fenómeno biológico-biográfico denominado climaterio, mediante los significados atribuidos por medio de los saberes, actitudes y comportamientos socioculturales de las mujeres en este periodo de su vida. Metodología: Estudio cualitativo mediante siete grupos focales (37 mujeres. Población de estudio: mujeres entre 45-55 años, residentes en la ciudad de Albacete. Resultados: proceso identificado con la edad biológica de las mujeres, con atributos negativos por su relación con el envejecimiento. Se relaciona también con la imagen social de la mujer y los roles socioculturales asignados clásicamente a este colectivo. Esta combinación de factores las conduce hacia un periodo de su vida tildado como "edad crítica", construcción en la que priman elementos biográficos sobre biológicos. Conclusión: Reconocer la "Variabilidad" de la vivencia del proceso. Esto entraría en conflicto con la actual tendencia biomédica, de protocolizar ciertas etapas relacionadas con el ciclo vital de las personas, intentando generar adscripciones unitarias basadas en entidades médicas construidas con fines operativos e instrumentales. Reconocer la "Vulnerabilidad" que supone la confluencia de diversas circunstancias, que las conducen, no sólo a enfrentarse con cambios físicos, emocionales y socioculturales, propios de esta etapa, sino a la realización de una evaluación retrospectiva crítica y profunda de la experiencia de vida, de la autobiografía.Objective: Approach to the social representations constituent of a biological-biographical phenomenon denominated climacteric, by means of the meanings attributed through socio-cultural knowledge, attitudes and behaviours of the woman in this period of their life. Methodology: Qualitative study by means of seven focal groups (37 women. Population of study: women between 45-55 years, residents in the city of Albacete. Results: Process

  2. Women's series: by women, for women?

    NARCIS (Netherlands)

    Kuitert, L.; Spiers, J.

    2011-01-01

    One of the striking phenomena in the 19th century publishing history is the abundant publication of publisher''s series. This contribution concerns series specifically meant for women. The focus is on Dutch literary series for women, mostly 19th century.

  3. Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

    Science.gov (United States)

    2017-05-03

    Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  4. Women boxers

    DEFF Research Database (Denmark)

    Gems, Gerald; Pfister, Gertrud Ursula

    2014-01-01

    of women as the weak sex. Vaudeville provided women with an opportunity to present physical performances that surpassed the restrictions placed on women within the mainstream middle-class society. This article includes biographical sketches of some of the outstanding female boxers of the era by drawing......This article fills a gap in the very limited literature on women's boxing by examining the gendered space in which women engaged in the sport as participants in saloons, vaudeville theatres and the prize ring. In doing so, they challenged the contemporary gender order and disputed the notion...

  5. Status of women microbiologists.

    Science.gov (United States)

    Kashket, E R; Robbins, M L; Leive, L; Huang, A S

    1974-02-08

    The general picture that emerges from this study is that the woman microbiologist, upon entering the professional job market, faces (i) slower advancement; (ii) restricted extramural recognition; and (iii) fewer positions of a supervisory or administrative nature, when compared to men. Most striking is the salary differential, which increases with increasing educational level, with increasing rank, and with increasing seniority. From the beginning of her professional training, the woman microbiologist feels handicapped by lack of encouragement and proper role models. She generally receives little advice regarding her professional future and rarely feels pushed to take the most challenging position. Should she be married, she feels that her mobility is severely restricted. Even though the subjective nature of these feelings may be interpreted as projections of failure, subtle inducements for women to stay at lower levels may well exist, in addition to more objective measurements, such as lower salary levels and slower professional advancement. Despite these handicaps, professional women continue to work. As a group, they work for the same reasons that men do, they work as long and as hard as men do, and they remain at their positions as long as men do. Women and men rate themselves equally as to job performance, degree of independence, and publication rate. On the basis of this study, it should not be surprising that women professionals are less visible than men and that only a small proportion of women become what is considered successful by the usual external criteria. If women were to receive continued encouragement, scientific contact, and professional recognition at each stage of their professional lives, they would undoubtedly become more visible. The lack of encouragement and selfconfidence leading to isolation, which then leads to lack of recognition, is a vicious circle that must be broken for the woman professional. This can be done most easily for the

  6. Gender equity and women's empowerment.

    Science.gov (United States)

    1999-04-01

    This article focuses on the improvements in women's status in China. The trend started as early as in the 1950s, when the Chinese Constitution declared that women should enjoy equal rights with men in political, economic, cultural, social and family life, and the legitimate rights of women and children are protected by law. This principle is also reflected in other laws and regulations such as Marriage Law and Law on Health of Mother and Infant. In addition, the Law on Protection of Rights and Interests of Women, which came into effect in 1992, marked a new stage of legislation on women's rights. Over the past few years, women have participated in political affairs, in which they accounted for 16.8% of the total number of representatives in the 15th Congress of the Chinese Communist Party, 21.8% in the ninth National People's Congress, and 15.5% in the ninth Chinese People's Political Consultative Conference. However, this does not mean that women have gained an equal right of participation with their male counterparts. Moreover, although the women's education level is rising constantly, it still compares unfavorably with men. Another indicator of enhanced women's status is the great number of women in the workforce, and in their increasing capacity to participate in household decision-making.

  7. Breast cancer in young women.

    Science.gov (United States)

    Radecka, Barbara; Litwiniuk, Maria

    2016-01-01

    Breast cancer (BC) in young women is rare, affecting only 4-6% of women under the age of 40. Regardless, BC remains the most common malignancy among younger patients. Recently, a significant increase in BC rates has been observed among pre-menopausal subjects. Breast cancer in young women requires special attention due to its specific morphologic and prognostic characteristics and unique aspects, including fertility preservation and psychosocial issues (e.g. its impact on family life and career). Young women are more likely to have tumors with higher incidence of negative clinicopathologic features (higher histological grade, more lymph node positivity, lower estrogen receptor (ER) positivity, higher rates of Her2/neu overexpression). Also, they tend to be diagnosed at more advanced stages of the disease. That, in turn, contributes to less favorable prognosis as compared to older women. Young women are generally treated similarly to older patients. Surgical management includes mastectomy or breast-conserving surgery, followed by radiation therapy (younger women have higher local recurrence rates than older women, especially after breast-conserving therapy). Although the basics of chemotherapy are the same for patients of all ages, younger women have some special considerations. It is important to consider options for fertility preservation before starting systemic treatment. Patients should have access to genetic testing as their results may affect the choice of therapy. Younger women and their families should receive adequate psychological support and counselling.

  8. Changes of endocrine and ultrasound markers as ovarian aging in modifying the Stages of Reproductive Aging Workshop (STRAW) staging system with subclassification of mid reproductive age stage.

    Science.gov (United States)

    Ding, Ting; Luo, Aiyue; Jiang, Jingjing; Du, Xiaofang; Yang, Shuhong; Lai, Zhiwen; Shen, Wei; Lu, Yunping; Ma, Ding; Wang, Shixuan

    2013-01-01

    To demonstrate the changes of ovarian aging markers across the Stages of Reproductive Aging Workshop (STRAW) stages and modify it with subclassification of mid reproductive age stage (MR). Healthy females were classified according to the STRAW system. Serum basal FSH, LH, E2, and anti-Müllerian hormone (AMH) were detected, FSH/LH ratio calculated, and antral follicle counts (AFCs) determined in follicular phase. Progression through the whole STRAW stages under MR stage subdivided is associated with elevations in FSH, LH, FSH/LH ratio and decreases in E2, AMH and AFCs (p age in MR stage. 0.982 ng/ml AMH and 3 antral follicles (low level of MR 25-30 years) were set as cutoffs to distinguish MR stage into early mid reproductive age (EMR) and late mid reproductive age (LMR) stages. The women in EMR stage compared with LMR could retrieve more oocytes in IVF treatment (p stage, demonstrating disparate reproductive aging period with reduced ovarian reserve in young age across the STRAW stages.

  9. Stages of Pregnancy

    Science.gov (United States)

    ... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...

  10. Composers on stage

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

    A trend on the scene of contemporary music is composers going on stage, performing their pieces themselves. Within a discourse of popular music, this is more the rule than exception, but when it comes to the context of contemporary scored music, the historical and aesthetic context differs......, and something quite different is undergoing. This paper intends to discuss three examples of performances in which the composer’s appearance on stage was an important part of the piece, - both when it came to the role as a performer and as an individual person – as representer and presenter. The paper intends...

  11. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  12. Assistência à mulher climatérica: novos paradigmas Atención a la mujer climatérica: nuevos paradigmas Assistance to the climacteric woman: new paradigms

    Directory of Open Access Journals (Sweden)

    Dino Roberto Soares De Lorenzi

    2009-04-01

    Full Text Available O envelhecimento populacional é uma realidade demográfica brasileira. Como conseqüência, espera-se, nos próximos anos, um aumento progressivo na procura dos serviços de saúde por mulheres com queixas relacionadas ao climatério. Paralelamente, a assistência ao climatério tem passado por uma modificação de paradigmas, impondo aos profissionais de saúde uma mudança de atitude. Reconhece-se que o climatério é influenciado tanto por fatores biológicos, como por fatores psicossociais e culturais, cujo conhecimento é fundamental para uma assistência mais qualificada e humanizada. Este artigo propõe refletir sobre as mudanças de paradigmas na assistência ao climatério, destacando a multidisciplinaridade e interdisciplinaridade, no sentido acolher melhor essa parcela da população e proporcionar-lhe um cuidado integral e individualizado, aproximando o saber da sensibilidade, voltado a uma melhor qualidade vida.Envejecimiento poblacional es una realidad demográfica brazilian. Consecuentementese espera un aumento progresivo de la búsqueda en los servicios de salud del país por mujeres con quejas relacionadas al climaterio. La asistencia al climaterio ha pasado por un cambio de paradigmas que han impuesto a los profesionales de la salud. El climaterio es influenciado por factores biológicos, factores psicosociales y culturales, cuyo conocimiento es fundamental para la planificación de una asistencia. Artículo se propone reflexionar sobre los cambios de paradigmas, el abordaje multidisciplinario e interdisciplinario, en el sentido de recibir mejor esta parcela de la población y proporcionarle un cuidado integral e individualizado, aproximando el saber de la sensibilidad, y el tener como objetivo a una mejor calidad de vida.Population aging is a demographic reality for Brazil. Consequently, in the next years it is expected a progressive increase in seeking health care services in the country by women with complaints related to

  13. Linac project - actual stage

    International Nuclear Information System (INIS)

    Carlin Filho, N.

    1990-01-01

    The actual development stage of Pelletron accelerator to study heavy ion reactions, nuclear structures and applied nuclear physics is presented. The construction of acceleration systems able to provide beams of several mass and energies up to 20 MeV/A, is discussed, describing acceleration structures and implemented systems. (M.C.K.)

  14. Stagings of Divine Power

    DEFF Research Database (Denmark)

    Holm, Bent

    2011-01-01

    Based on a combination of performativity and historicity royal Danish ceremonilality is analysed with a special regard to coronation ceremonies as a manifestation of the idea of godgiven royal power. Point of departure is the coronation of Christian 4. in 1596 and the theme of stagings of power...

  15. "Stage 40" Handbook.

    Science.gov (United States)

    Mill River Union High School, North Clarendon, VT.

    The policies, purposes, and guidelines of "Stage 40," an educational repertory company for students, are presented in this paper, which also explains how the company functions. The paper discusses the company's history, the relationship between the company and academics, and the responsibilities of a company member. Letters by the board…

  16. Stage theta pinch experiments

    International Nuclear Information System (INIS)

    Linford, R.K.; Downing, J.N.; Gribble, R.F.; Jacobson, A.R.; Platts, D.A.; Thomas, K.S.

    1975-01-01

    The Staged Theta Pinch program is designed to study the technological and physics problems associated with producing fat plasmas and separating the implosion heating from the adiabatic compression. Several methods of implosion heating are discussed. Circuit diagrams and theoretical magnetic field behavior are described for the STP and resonant heating experiments. (MOW)

  17. World Stage Design

    Index Scriptorium Estoniae

    2005-01-01

    12-19. III Torontos rahvusvaheline lavakujunduse, kostüümi ning valgus- ja helikujunduse näitus, mis toimub samaaegselt OISTATi (International Organization of Scenographers, Theatre Architects and Technicians) maailmakongressiga ja USITT (United States Institute for Theatre Technology) üritustega (konverents, Stage Expo). Eestit esindab lavakujunduse kategoorias Lilja Blumenfeld-Luhse

  18. stage/page/play

    DEFF Research Database (Denmark)

    context. Contributors: Per Brask, Dario Fo, Jette Barnholdt Hansen, Pil Hansen, Sven Åke Heed, Ulla Kallenbach, Sofie Kluge, Annelis Kuhlmann, Kela Kvam, Anna Lawaetz, Bent Flemming Nielsen, Franco Perrelli, Magnus Tessing Schneider, Antonio Scuderi. stage/page/play is published as a festschrift...

  19. Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women.

    Science.gov (United States)

    Blümel, Juan E; Chedraui, Peter; Aedo, Sócrates; Fica, Juan; Mezones-Holguín, Edward; Barón, Germán; Bencosme, Ascanio; Benítez, Zully; Bravo, Luz M; Calle, Andrés; Flores, Daniel; Espinoza, María T; Gómez, Gustavo; Hernández-Bueno, José A; Laribezcoa, Fiorella; Martino, Mabel; Lima, Selva; Monterrosa, Alvaro; Mostajo, Desiree; Ojeda, Eliana; Onatra, William; Sánchez, Hugo; Tserotas, Konstatinos; Vallejo, María S; Witis, Silvina; Zúñiga, María C

    2015-01-01

    The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30 kg/m(2). Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. PET/CT staging of T1-stage non-small cell lung cancer

    International Nuclear Information System (INIS)

    Salman, K. A.; Steinmann, C. H.; Von Schulthess, G. K.; Steinert, H. C.; Sukumar, V. P.

    2009-01-01

    Full text:Purpose: To evaluate the value of PET/CT in detecting occult metastases in patients with T 1 -stage non-small cell lung cancer (NSCLC). Method: Patients with proven NSCLC and T 1 -stage ( c m) were retrospectively analyzed. In all patients a whole-body 18 F-FDG PET/CT scan for initial staging was performed. The PET/CT findings were compared with all available clinical information, intra-operative findings and the histopathological results. Results: 95 patients (39 men, 56 women; age range, 19-85 years) were analyzed in our study. PET/CT in 68-95 patients correctly excluded mediastinal and distant metastases. In 17/95 patients (18%) mediastinal lymph-node metastases were proven (N 2 n=15; N 3 n=2). PET/CT correctly detected in 10/17 patients (58.8%) mediastinal nodal disease. The smallest mediastinal lymph-node metastasis detected by PET/CT had a size of 0.7 c m. In 7 patients PET/CT missed N 2 -stage. In three of these patients the SUVmax of the primary was c m. Only in one missed N 2 -stage metastasis was sized > 1.0 c m. The tumor histology (adenocarcinoma, squamous cell carcinoma) and location of the primary (central, periphery) did not influence the missed N 2 -stage by PET/CT. PET/CT diagnosed correctly N 3 -stage in 2 patients. 10/95 patients (10.5%) had distant metastases. PET/CT detected unknown M 1 -stage in 4/10 patients. In one patient a metastasis of the parietal pleura was missed by PET/CT. Conclusion: In our study, 28% patients with T 1 -stage NSCLC showed mediastinal or distant metastases. PET/CT was efficient in the detection of occult metastases. However, the sensitivity of PET/CT in mediastinal staging was only 64%.

  1. Influência dos sintomas climatéricos sobre a função sexual de mulheres de meia-idade Influence of menopausal symptoms on sexual function in middle-aged women

    Directory of Open Access Journals (Sweden)

    Patrícia Uchôa Leitão Cabral

    2012-07-01

    Full Text Available OBJETIVO: Avaliar a influência dos sintomas climatéricos na função sexual de mulheres de meia-idade. MÉTODOS: Estudo populacional de corte transversal, com amostra de 370 mulheres entre 40 e 65 anos, atendidas nas Unidades Básicas de Saúde da cidade de Natal, no estado do Rio Grande do Norte, Brasil. Aplicou-se um questionário referente s características sociodemográficas, clínicas e comportamentais das mulheres. A função sexual foi avaliada pelo Female Sexual Function Index (FSFI, enquanto os sintomas do climatério pelo Menopause Rating Scale (MRS. RESULTADOS: No grupo estudado, 67% das mulheres apresentaram risco de disfunção sexual (FSFI≤26,5. Todos os domínios do FSFI (desejo, excitação, lubrificação, orgasmo, satisfação e dor apresentaram escores mais baixos nas mulheres com risco de disfunção sexual (pPURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI, while the menopause symptoms by the Menopause Rating Scale (MRS. RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5. All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain were lower in women with risk for sexual dysfunction (p<0.001. The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001. Logistic regression analysis revealed that the likelihood of

  2. Psychiatric morbidity in perimenopausal women

    Directory of Open Access Journals (Sweden)

    Biswajit L Jagtap

    2016-01-01

    Full Text Available Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

  3. Lymphadenectomy in surgical stage I epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Svolgaard, Olivia; Lidegaard, Ojvind; Nielsen, Marie Louise S

    2014-01-01

    OBJECTIVE: To identify the extent of lymphadenectomy performed in women presenting with epithelial ovarian cancer macroscopically confined to the ovary. Furthermore, the effect of lymphadenectomy on overall survival is evaluated. DESIGN: A prospective nationwide case-only study. SETTING: Denmark...... 2005-2011. SAMPLE: All women registered in the nationwide Danish Gynecologic Cancer Database from 1 January 2005 to 1 May 2011, presenting with a tumor macroscopically confined to the ovary without visible evidence of abdominal spread at the time of the initial exploration (surgical stage I). METHOD......: Descriptive and survival analyses of data from Danish Gynecologic Cancer Database. MAIN OUTCOME MEASURES: The annual proportion of women with surgical stage I disease who received lymphadenectomy and the survival in the two groups. RESULTS: Of 2361 women with epithelial ovarian cancer, 627 were identified...

  4. Effect of stage of initial labor dystocia on vaginal birth after cesarean success.

    Science.gov (United States)

    Lewkowitz, Adam Korrick; Nakagawa, Sanae; Thiet, Mari-Paule; Rosenstein, Melissa Greer

    2015-12-01

    The objective of the study was to examine whether the stage of labor dystocia causing a primary cesarean delivery (CD) affects a trial of labor after cesarean (TOLAC) success. This was a retrospective cohort study of women who had primary CD of singleton pregnancies for first- or second-stage labor dystocia and attempted TOLAC at a single hospital between 2002 and 2014. We compared TOLAC success rates between women whose primary CD was for first- vs second-stage labor dystocia and investigated whether the effect of prior dystocia stage on TOLAC success was modified by previous vaginal delivery (VD). A total of 238 women were included; nearly half (49%) achieved vaginal birth after cesarean (VBAC). Women with a history of second-stage labor dystocia were more likely to have VBAC compared with those with first-stage dystocia, although this trend was not statistically significant among the general population (55% vs 45%, adjusted odds ratio, 1.4, 95% confidence interval, 0.8-2.5]). However, among women without a prior VD, those with a history of second-stage dystocia did have statistically higher odds of achieving VBAC than those with prior first-stage dystocia (54% vs 38%, adjusted odds ratio, 1.8 [95% confidence interval, 1.0-3.3], P for interaction = .043). Nearly half of women with a history of primary CD for labor dystocia will achieve VBAC. Women with a history of second-stage labor dystocia have a slightly higher VBAC rate, seen to a statistically significant degree in those without a history of prior VD. TOLAC should be offered to all eligible women and should not be discouraged in women with a prior second-stage arrest. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Calibration of Nanopositioning Stages

    Directory of Open Access Journals (Sweden)

    Ning Tan

    2015-12-01

    Full Text Available Accuracy is one of the most important criteria for the performance evaluation of micro- and nanorobots or systems. Nanopositioning stages are used to achieve the high positioning resolution and accuracy for a wide and growing scope of applications. However, their positioning accuracy and repeatability are not well known and difficult to guarantee, which induces many drawbacks for many applications. For example, in the mechanical characterisation of biological samples, it is difficult to perform several cycles in a repeatable way so as not to induce negative influences on the study. It also prevents one from controlling accurately a tool with respect to a sample without adding additional sensors for closed loop control. This paper aims at quantifying the positioning repeatability and accuracy based on the ISO 9283:1998 standard, and analyzing factors influencing positioning accuracy onto a case study of 1-DoF (Degree-of-Freedom nanopositioning stage. The influence of thermal drift is notably quantified. Performances improvement of the nanopositioning stage are then investigated through robot calibration (i.e., open-loop approach. Two models (static and adaptive models are proposed to compensate for both geometric errors and thermal drift. Validation experiments are conducted over a long period (several days showing that the accuracy of the stage is improved from typical micrometer range to 400 nm using the static model and even down to 100 nm using the adaptive model. In addition, we extend the 1-DoF calibration to multi-DoF with a case study of a 2-DoF nanopositioning robot. Results demonstrate that the model efficiently improved the 2D accuracy from 1400 nm to 200 nm.

  6. Empowering Women

    OpenAIRE

    UNCTAD; World Bank

    2018-01-01

    This note addresses practices for reducing gender inequalities and for empowering women to make a positive contribution to development through agricultural investments. Women make a crucial contribution to the agriculture sector and account for over 40 percent of agricultural labor in developing countries. However, they are frequently marginalized and their contributions under-acknowledged...

  7. Women's studies

    Science.gov (United States)

    Carlowicz, Michael

    On March 31, 1997, the Association for Women Geoscientists will award two Chrysalis Scholarships to women who have returned to school after an interruption in their education for a year or longer. The $750 awards will be given to geoscience master's or Ph.D. candidates to cover expenses in finishing their theses.The application deadline is February 28, 1997.

  8. Summary Staging Manual 2000 - SEER

    Science.gov (United States)

    Access this manual of codes and coding instructions for the summary stage field for cases diagnosed 2001-2017. 2000 version applies to every anatomic site. It uses all information in the medical record. Also called General Staging, California Staging, and SEER Staging.

  9. Intervention group as a resource of Occupational Therapy: an experience with menopausal women

    Directory of Open Access Journals (Sweden)

    Soraya Diniz Rosa

    2013-08-01

    Full Text Available Intervention group as a resource of Occupational Therapy is the main theme of this study. Herein we present an experience carried out in two universities in the areas of occupational therapy, pharmacy and medicine, more specifically in the field of gynecology regarding the care of climacteric woman. The first intervention occurred in 2004 with trainees of the occupational therapy course and medical school residents. However, the study was restarted in 2010 with expansion to the human resources and knowledge areas. The methodology was based on the transcripts of the remarks made after each group meeting, which was coordinated by the Occupational Therapy. Results showed that the intervention group process has helped participants in the understanding of this stage of life and has interfered in the changing of habits and attitudes, with great improvement in daily life organization. We concluded that the use of intervention group as a resource of Occupational Therapy and the liaison with other areas are of great importance because they enable the construction of a unique treatment plan for the group, given the contribution from each clinical area.

  10. WOMEN IN CARCERE AND ADULT EDUCATION

    Directory of Open Access Journals (Sweden)

    Maria Cristina Silva

    2017-06-01

    Full Text Available This article is part of our study conducted in the doctorate. We have divided the text in three stages as follows: the first a brief contextualization on female prisons and women in jail, at second stage, I present short stories of five women living in the prison in which I try to bring their everyday lives lived in the prison and in the last step I tract of the relationship of these detainees with the school and the schooling processes. At the end I trace some considerations and final questions about women in prison.

  11. Fertility in midlife women.

    Science.gov (United States)

    Yoldemir, T

    2016-06-01

    Reduced maternal fertility is the consequence of depletion of follicles with maternal aging. In a 35-year-old woman, approximately 9.1% of the residual follicle pool disappears annually without entering into the growing stage, whereas, in a 45-year-old woman, this number triples. After the age of 35 years, the frequency of aneuploidies in oocytes increases sharply. Roughly 50-70% of mature oocytes from a 40-year-old woman have chromosomal abnormalities. The clinical pregnancy and implantation rates are lower in midlife women. Various controlled ovarian stimulation interventions have been suggested for the management of women in advanced age, most of whom are likely to be poor-responder patients. Currently, systematic reviews and meta-analyses suggest that there is insufficient evidence to recommend most of the treatments proposed to improve pregnancy rates in these poor responders. Minimal stimulation or natural cycle in vitro fertilization may be offered, without compromising the already existing pregnancy results.

  12. Michael Jackson's Sound Stages

    OpenAIRE

    Morten Michelsen

    2012-01-01

    In order to discuss analytically spatial aspects of recorded sound William Moylan’s concept of ‘sound stage’ is developed within a musicological framework as part of a sound paradigm which includes timbre, texture and sound stage. Two Michael Jackson songs (‘The Lady in My Life’ from 1982 and ‘Scream’ from 1995) are used to: a) demonstrate the value of such a conceptualisation, and b) demonstrate that the model has its limits, as record producers in the 1990s began ignoring the conventions of...

  13. Staging Mobilities / Designing Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    2015-01-01

    , and systems 'hosting' these multiple and complex mobilities are designed and how they are staging these in terms of their physical layout. By analysing specific cases of ‘mobilities design’ related to the four modes of moving; Walk, Bike, Train, and Car, the book uncover important and until now neglected...... is more than movement between point A and B. It explores how the movement of people, goods, information, and signs influences human understandings of self, other and the built environment. Moving towards a new understanding of the relationship between movement, interaction and environments, the project...

  14. Stages of chaotic synchronization.

    Science.gov (United States)

    Tang, D. Y.; Dykstra, R.; Hamilton, M. W.; Heckenberg, N. R.

    1998-09-01

    In an experimental investigation of the response of a chaotic system to a chaotic driving force, we have observed synchronization of chaos of the response system in the forms of generalized synchronization, phase synchronization, and lag synchronization to the driving signal. In this paper we compare the features of these forms of synchronized chaos and study their relations and physical origins. We found that different forms of chaotic synchronization could be interpreted as different stages of nonlinear interaction between the coupled chaotic systems. (c) 1998 American Institute of Physics.

  15. Correlation of Menopausal Symptoms and Quality of Life with Physical Performance in Middle-Aged Women.

    Science.gov (United States)

    Silva, Rívea Trindade da; Câmara, Saionara Maria Aires da; Moreira, Mayle Andrade; Nascimento, Rafaela Andrade do; Vieira, Mariana Carmem Apolinário; Morais, Maria Socorro Medeiros de; Maciel, Álvaro Campos Cavalcanti

    2016-06-01

    Introduction Some studies have investigated the influence of hormonal deficits and menopausal status in muscle disorders of women. However, it has not been investigated the relationship of both climacteric symptoms and the perception of quality of life with physical performance. Objective To evaluate the correlation of menopausal symptoms and quality of life with physical performance in middle-aged women. Methods This cross-sectional study was performed from April to November 2013 in the municipality of Parnamirim, in the Brazilian state, Rio Grande do Norte. The sample was composed of 497 women aged 40-65 years. The Menopause Rating Scale (MRS) and the Utian Quality of Life (UQOL) questionnaire were used to evaluate menopausal symptoms and quality of life respectively. Measures of physical performance included handgrip strength, knee extensor and flexor strengths (using an isometric dynamometer), gait speed, and chair stand test. The correlation between menopausal symptoms and quality of life with physical performance was assessed by Pearson's correlation coefficient with significance set at p correlation between handgrip strength and somatic MRS score (p = 0.002) and total MRS score (p = 0.03). There was a significant correlation between knee flexor strength and sit-to-stand time and all menopausal symptom areas (p correlation between physical performance of the knee flexors and quality of life items including occupational (p = 0.001), emotional (p = 0.005), and total UQOL (p = 0.01), but a negative correlation with sit-to-stand time and all quality of life domains (p < 0.05). Conclusion A greater intensity of menopausal symptoms and worse quality of life were related with worse physical performance. Thus, preventive measures should be implemented to avoid adverse effects on physical performance at more advanced ages. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  16. Family, Religion, and Work among Arab American Women

    Science.gov (United States)

    Ghazal Read, Jen'nan

    2004-01-01

    Using data from a national survey of 501 Arab American women, this study examines the extent to which family behavior mediates the influence of religion on women's labor force activity. Prior research on families has largely overlooked the role of religion in influencing women's labor force decisions, particularly at different stages of the life…

  17. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

    Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation ...... the diverse matters of concern into a coherent product or service concept, and 2) in the same process move these diverse holders of the matters of concern into a translated actor network which carry or support the concept.......Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation...... and public private innovation partnerships. Based on a case study of a collaborative design process in a large electronics company the paper points to the key importance of staging and navigation of collaborative innovation process. Staging and navigation is presented as a combined activity: 1) to translate...

  18. Fire on Stage

    Directory of Open Access Journals (Sweden)

    Nicholas Daly

    2017-12-01

    Full Text Available The nineteenth century theatre was fire-prone, to say the least. Across the century there were more than 1,100 major conflagrations in the world’s theatres, and countless smaller fires. In Great Britain almost every theatre seems to have burned down at some point. And yet, despite, or perhaps in part because of, this appalling record, fires were a staple feature of stage spectacle. Some plays placed them at the very centre of the entertainment, and as the century went on stage fires became more and more elaborate. Actual or simulated conflagrations were conjured up using a diverse array of technologies, some of them very simple, some depending on the most recent scientific discoveries. Here, I give a short tour of these technologies and their use in the plays of the period, and suggest some of the pleasures that they offered. While onstage flames could draw people in, offering an experience of immersive suspense, for instance, they also interrupted the dramatic flow, reminding audiences that they were seeing a performance, getting something for their money. To this extent, we are reminded that nineteenth-century drama provided something of a mixed and spectacular ‘theatre of attractions’, closer at times to the circus than to the novel.

  19. Women's health

    Science.gov (United States)

    ... Nurse midwives This list may not be all-inclusive. References Freund K. Approach to women's health. In: ... of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed ...

  20. women's entrepreneurship

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-17

    May 17, 2016 ... It describes the economic benefits to women's economic empowerment, .... Public procurement makes up a significant proportion of a ...... vides a comparison of cost effectiveness of programs), Cho and Honorati (2013),.

  1. Leibniz's women.

    Science.gov (United States)

    Fara, Patricia

    2004-12-01

    Enlightenment natural philosophers were linked to one another in an extended correspondence network, but the female participants in this international Republic of Letters are rarely mentioned. Gottfried Leibniz relied on several such women not only for financial patronage, but also for intellectual stimulation. Although this hardworking and underpaid librarian at the Hanoverian Court is now one of the world's most famous mathematical philosophers, the women on whom he depended for ideas as well as support have been largely forgotten.

  2. Involving women.

    Science.gov (United States)

    Agbo, J

    1994-01-01

    I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

  3. The management of menopause in women with a history of endometriosis: a systematic review.

    Science.gov (United States)

    Gemmell, L C; Webster, K E; Kirtley, S; Vincent, K; Zondervan, K T; Becker, C M

    2017-07-01

    Endometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women. The aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT. Four electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to 'menopause' and 'endometriosis'. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria. We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing

  4. Role of pelvic lymphadenectomy in stage 1A endometrial carcinoma ...

    African Journals Online (AJOL)

    Introduction: Endometrial cancer is the commonest gynecological cancer mostly affecting women in the postmenopausal age group. There is a debate regarding the need of pelvic lymphadenectomy in managing stage 1A diagnosed preoperatively, we try to evaluate this need. Objective: To evaluate the role of pelvic ...

  5. SEOM clinical guidelines in early-stage breast cancer 2015.

    Science.gov (United States)

    Garcia-Saenz, J A; Bermejo, B; Estevez, L G; Palomo, A G; Gonzalez-Farre, X; Margeli, M; Pernas, S; Servitja, S; Rodriguez, C A; Ciruelos, E

    2015-12-01

    Breast cancer is a major public health problem. Despite remarkable advances in early diagnosis and treatment, one in three women may have metastases since diagnosis. Better understanding of prognostic and predictive factors allows us to select the most appropriate adjuvant therapy in each patient. In these guidelines, we summarize current evidence for the medical management of early-stage breast cancer.

  6. SEOM clinical guidelines in early-stage breast cancer 2015

    OpenAIRE

    Garcia-Saenz, J. A.; Bermejo, B.; Estevez, L. G.; Palomo, A. G.; Gonzalez-Farre, X.; Margeli, M.; Pernas, S.; Servitja, S.; Rodriguez, C. A.; Ciruelos, E.

    2015-01-01

    Breast cancer is a major public health problem. Despite remarkable advances in early diagnosis and treatment, one in three women may have metastases since diagnosis. Better understanding of prognostic and predictive factors allows us to select the most appropriate adjuvant therapy in each patient. In these guidelines, we summarize current evidence for the medical management of early-stage breast cancer.

  7. Effects of repeated mammographic screening on breast cancer stage distribution

    International Nuclear Information System (INIS)

    Fagerberg, G.; Baldetorp, L.; Groentoft, O.; Lundstroem, B.; Maanson, J.C.; Nordenskjoeld, B.

    1985-01-01

    A randomised controlled trial of mass screening for breast cancer by single-view mammography was begun in Sweden in 1977. All women aged 40 and older and resident in the counties of Koppaberg and Oestergoetland were enrolled. The present report is confined to the Oestergoetland study, which started in 1978 and comprised 92934 women. After randomisation, which was done on the basis of communities rather than individuals, 47001 women were allocated to the study group and offered repeated mammographic screening; 45933 were allocated to the control group. As compliance among women over 74 years of age was poor these were excluded from the present report. The yearly incidence of stage II or more advanced breast cancers after the initial screening round up to and including the second was reduced by 40 per cent in the study group compared with the controls. This effect was less marked in the age group 40-49. After 5.5 years average from the date of entry the absolute number of women with stage II-IV disease in the control group exceeded that for the study group by 44, whereas there was a large excess of cancer in situ and stage I cancer in the study group. (orig.)

  8. Staging Lung Cancer: Metastasis.

    Science.gov (United States)

    Shroff, Girish S; Viswanathan, Chitra; Carter, Brett W; Benveniste, Marcelo F; Truong, Mylene T; Sabloff, Bradley S

    2018-05-01

    The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Waste glass melting stages

    International Nuclear Information System (INIS)

    Anderson, L.D.; Dennis, T.; Elliott, M.L.; Hrma, P.

    1994-01-01

    Three simulated nuclear waste glass feeds, consisting of dried waste and glass frit, were heat treated for 1 hour in a gradient furnace at temperatures ranging from approximately 600 degrees C to 1000 degrees C. Simulated melter feeds from the Hanford Waste Vitrification Plant (HWVP), the Defense Waste Processing Facility (DWPF), and Kernforschungszentru Karlsruhe (KfK) in Germany were used. The samples were thin sectioned and examined by optical microscopy to investigate the stages of the conversion from feed to glass. Various phenomena were seen, such as frit softening, bubble formation, foaming, bubble motion and removal, convective mixing, and homogenization. The behavior of different feeds was similar, although the degree of gas generation and melt homogenization varied. 2 refs., 8 tabs

  10. Waste glass melting stages

    International Nuclear Information System (INIS)

    Anderson, L.D.; Dennis, T.; Elliott, M.L.; Hrma, P.

    1993-04-01

    Three different simulated nuclear waste glass feeds, consisting of dried waste and glass frit, were heat treated for 1 hour in a gradient furnace at temperatures ranging from approximately 600 degrees C--1000 degrees C. Simulated melter feeds from the Hanford Waste Vitrification Plant (HWVP), the Defense Waste Processing Facility (DWPF), and Kernforschungszentrum Karlsruhe (KfK) in Germany were used. The samples were thin-sectioned and examined by optical microscopy to investigate the stages of the conversion from feed to glass. Various phenomena were seen, such as frit softening, bubble formation, foaming, bubble motion and removal, convective mixing, and homogenization. Behavior of different feeds was similar, although the degree of gas generation and melt homogenization varied

  11. Staging Sociotechnical Spaces

    DEFF Research Database (Denmark)

    Clausen, Christian; Yoshinaka, Yutaka

    2007-01-01

    The management of innovation and product development is increasingly facing complex challenges of staging design processes across heterogeneous organisational spaces, with multiple actor-concerns and sources of knowledge. This paper addresses how insights from the Actor-Network Theory and political...... is elaborated as being an occasioning as well as a result of socio-technical choices and processes, and points to the role of socio-material as well as discursive practices, which frame and render particular spaces open to management and to the coordination of knowledge flows and ideas in early phases...... of product development. The concept of socio-technical spaces is further illustrated through actual examples from industry dealing with early conceptualisation in product development and the role played by management concepts in the configuration of spaces....

  12. Stage II Seminoma

    International Nuclear Information System (INIS)

    Sagerman, R.H.; Kotlove, D.J.; Regine, W.; Chung, C.T.; King, G.A.; Dalai, P.S.

    1988-01-01

    Between 1966 and 1985, 32 patients with stage II (21 A,11 B) testicular seminoma were treated with postorchiectomy irradiation to the retroperitoneal and ipsilateral iliac nodes; 28 received elective mediastinal-supraclavicular irradiation. The median follow-up was 8 1/2 years; 29 patients were followed up for over 3 years and 24 for over 5 years. Twenty-eight patients remain alive and well and four have die, two of a second primary cancer. Two patients developed recurrent seminoma in the mediastinum; these patients showed a variant lymphangiographic pattern. Both remain well after further irradiation or irradiation plus chemotherapy. A third patient developed nonseminomatous ''recurrence'' in the radiation field and is well after chemotherapy

  13. Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero

    2011-01-01

    Cervical cancer is the second most common cancer among women in Sudan, with more than two-thirds of all women with invasive cervical cancer being diagnosed at an advanced stage (stages III and IV). The lack of a screening program for cervical cancer in Sudan may contribute to the late presentation...... of this cancer, but other factors potentially associated with advanced stages of cervical cancer at diagnosis are unknown. The purpose of this research was to investigate the relationship between age, marital status, ethnicity, health insurance coverage, residence in an urban vs a rural setting, and stage (at...... diagnosis) of cervical cancer in Sudan....

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... Information by Audience For Women Women's Health Topics Women and Diabetes Share Tweet Linkedin Pin it More ... women during pregnancy. Diabetes and Pregnancy (CDC) Diverse Women in Clinical Trials Campaign Clinical trials can help ...

  15. Women in Cities.

    Science.gov (United States)

    Hurst, Liz

    1982-01-01

    Suggesting that women are at a disadvantage in cities and towns, discusses experiences of women at home, working women, women traveling, shopping, and growing old in cities. Includes suggestions for studying women in cities. (JN)

  16. Timing and Stages of Puberty

    Science.gov (United States)

    ... and stages of puberty Timing and stages of puberty Adolescence and puberty can be so confusing! Here’s some info on what to expect and when: Puberty in girls usually starts between the ages of ...

  17. End-stage kidney disease

    Science.gov (United States)

    ... stage; Kidney failure - end stage; ESRD; ESKD Images Kidney anatomy References Fogarty DG, Taal MW. A stepped care approach to the management of chronic kidney disease. In: Skorecki K, Chertow GM, Marsden PA, ...

  18. COOLING STAGES OF CRYOGENIC SYSTEMS

    OpenAIRE

    Троценко, А. В.

    2011-01-01

    The formalized definition for cooling stage of low temperature system is done. Based on existing information about the known cryogenic unit cycles the possible types of cooling stages are single out. From analyses of these stages their classification by various characteristics is suggested. The results of thermodynamic optimization of final throttle stage of cooling, which are used as working fluids helium, hydrogen and nitrogen, are shown.

  19. Dilemmas in Lung Cancer Staging.

    Science.gov (United States)

    Vlahos, Ioannis

    2018-05-01

    The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  20. Science on stage

    CERN Multimedia

    2005-01-01

    During the opening ceremony, the audience was dazzled by a juggling show involving dramatic light effects. They also took away with them a teacher's sheet explaining some of the scientific concepts involved in juggling. Science teachers can sometimes be quite humorous when it comes to explaining serious matters, as those who took part in the 'Science on Stage' festival held at CERN from 21 to 25 November were able to see for themselves. The 500 or so participants from 27 different countries, mostly science teachers but also some university lecturers, science outreach specialists and students, had the opportunity to share their experience of the teaching of science. They also attended presentations and shows, took part in workshops and visited a fair with stands offering ideas on how to make school science lessons more appealing. The festival, organised by the EIROforum (a partnership between CERN, EFDA, ESA, ESO, EMBL, ESRF and ILL), marked the end of two years of projects for the promotion of science in vir...

  1. Staged theta pinch experiments

    International Nuclear Information System (INIS)

    Linford, R.K.; Downing, J.N.; Gribble, R.F.; Jacobson, A.R.; Platts, D.A.; Thomas, K.S.

    1976-01-01

    Two implosion heating circuits are being experimentally tested. The principal experiment in the program is the 4.5-m-long Staged Theta Pinch (STP). It uses two relatively low energy (50kJ and 100 kJ), high voltage (125 kV) capacitor banks to produce the theta pinch plasma inside the 20 cm i.d. quartz discharge tube. A lower voltage (50 kV), higher energy (750 kJ) capacitor bank is used to contain the plasma and provide a variable amount of adiabatic compression. Because the experiment produces a higher ratio of implosion heating to compressional heating than conventional theta pinches, it should be capable of producing high temperature plasmas with a much larger ratio of plasma radius to discharge tube radius than has been possible in the past. The Resonant Heating Experiment (RHX) in its initial configuration is the same as a 0.9-m-long section of the high voltage part of the STP experiment and all the plasma results here were obtained with the experiment in that configuration. Part of the implosion bank will be removed and a low inductance crowbar added to convert it to the resonant heating configuration. (U.K.)

  2. Women and x-rays

    Energy Technology Data Exchange (ETDEWEB)

    Dunkley, P A; Stewart, J H

    1976-01-01

    When a woman comes to an X-Ray Department it is usually necessary to know the present stage of her menstrual cycle. X-Rays may have an adverse effect on the embryo, especially in early pregnancy. However, exposure to X-Rays at any stage may be associated with a slightly increased incidence of malignant disease in childhood. The International Commission on Radiological Protection recommends that in women of child-bearing age (in some cases as young as 11 years), non-urgent diagnostic radiography be confined to the preovulatory phase of the menstrual cycle: that is, 14 days following the first day of the last menstrual period.

  3. Mixed adenosquamous histology is associated with poorer survival of cervical cancer stage 1b

    DEFF Research Database (Denmark)

    Lauszus, Finn; Tjessem, Ingvild; Al-Far, Hanine M

    2016-01-01

    Background: Evaluation of histopathological factors for women with radical hysterectomy a.m. Okabayashi for cervical cancer in stage 1bwith similar pre- and postoperative treatment Methods: Data on 141 women with cervical cancer stage 1b were revised. The local patient registry, data charts...... and adenomatous type (pmixed versus pure type). Five year’s survival rate was 40 % (2-78 %) for mixed type and 92 % (87-97 %) for pure type. The mixed type was associated with glandular metastasis (p

  4. Rebellious Women

    DEFF Research Database (Denmark)

    Madsen, Peter

    2010-01-01

    At the background of a short presentation of concepts of discourse (in particular in Jürgen Habermas and Michel Foucault) and of the concept of shari'a a Spanish court case against an imam in reference to his publication on Women in Islam, where sura 4 verse 34 of the Quran is a central reference...

  5. Women's Worlds

    Science.gov (United States)

    Daniels, Arlene Kaplan

    1978-01-01

    The women's movement may show us some of the changes to come in the content and form of the social sciences. Among issues which will be increasingly addressed are those of work and the family, personal growth and social responsibility, and the emotional component in rational, objective, and scientific enterprise. (Author/GC)

  6. Women's worth.

    Science.gov (United States)

    Bloch, N

    1992-01-01

    Jill Conway is a feminist historian, writer, teacher, and now-emerita 1st woman president of Smith College. She claims that women today still suffer from a great deal of oppression. Women around the world are currently in a disadvantage position. In 7 countries women do not have the right to vote. In the US less that .5% of top executives are women. The wage gap in the US between 1939 and 1989 has only shrunk $.10, from $.58-$.68. Conway points out that we are all constrained by our social mores, generational attitudes, political events, and economic circumstances. Few people are able to overcome these things in the way that they live their lives. Conway questions the validity of history written from a male dominated point of view. Around the world the value of women's work is almost always lower than that of men. India is just 1 example, there 75% of women are illiterate and 1/2 the population lives in poverty based on a caste system. Female literacy tripled in the 1st 30 years of independence and by 1981 it had reached 25%. The literacy gap is actually growing in India Today with 44% of girls aged 6 to 11, who are eligible to attend school, not doing so. Rural poverty keeps them at home because their domestic work is more valuable than their education. Other cultural tradition compound the problem: arranged marriages often result in motherhood for 14 year old girls. This is done for many reasons, 1 of which is crop failure insurance. When 2 families are combined through marriage, their total land share grows and they are thus more likely to have enough to eat. Education is just 1 necessary step. Developed nations must realize the realities that exist in the countries they provide aid for. In Africa for example, 70% of continent's food is produced by women. Yet the aid programs of the past have only been designed to offer assistant to men and create jobs for men.

  7. Transcriptomic analysis of the late stages of grapevine (Vitis vinifera cv. Cabernet Sauvignon) berry ripening reveals significant induction of ethylene signaling and flavor pathways in the skin.

    Science.gov (United States)

    Cramer, Grant R; Ghan, Ryan; Schlauch, Karen A; Tillett, Richard L; Heymann, Hildegarde; Ferrarini, Alberto; Delledonne, Massimo; Zenoni, Sara; Fasoli, Marianna; Pezzotti, Mario

    2014-12-19

    the ethylene signaling pathway of this nonclimacteric fruit were statistically significant in the late stages of ripening when the production of transcripts for important flavor and aroma compounds were at their highest. Ethylene transcription factors known to play a role in leaf senescence also appear to play a role in fruit senescence. Ethylene may play a bigger role than previously thought in this non-climacteric fruit.

  8. Effects of an Interdisciplinary Practice Bundle for Second-Stage Labor on Clinical Outcomes.

    Science.gov (United States)

    Garpiel, Susan J

    2018-04-09

    There is renewed interest in second-stage labor practices as recent evidence has challenged historical perspectives on safe duration of secondstage labor. Traditional practices and routine interventions during second-stage have uncertain benefit for low-risk women and may result in cesarean birth. The purpose of this quality improvement project was to implement an interdisciplinary second-stage practice bundle to promote safe outcomes including method of birth and women's birth experience. Standardized second-stage labor evidence-based practice recommendations structured into a 5 Ps practice bundle (patience, positioning, physiologic resuscitation, progress, preventing urinary harm) were implemented across 34 birthing hospitals in Trinity Health system. Significant improvements were observed in second-stage practices. Association of Women's Health, Obstetric and Neonatal Nurses' perinatal nursing care quality measure Second-Stage of Labor: Mother-Initiated Spontaneous Pushing significantly improved [pre-implementation 43% (510/1,195), post-implementation 76% (1,541/2,028), p labor practices derived from the Association of Women's Health, Obstetric and Neonatal Nurses and American College of Nurse-Midwives professional guidelines achieved our goals of safely reducing primary cesarean birth among low-risk nulliparous women, and optimizing maternal and fetal outcomes associated with labor and birth. By minimizing routine interventions, nurses support physiologic birth and improve women's birth satisfaction.

  9. MR imaging for staging of cervical carcinoma: Update

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seong Kuk; Kim, Dong Won [Dong A University Hospital, Busan(Korea, Republic of)

    2017-08-15

    Uterine cervical cancer is globally the third most common cancer among women, and shows high mortality with invasive cervical carcinoma. Early detection of the disease, its correct staging, and treatment are therefore of great importance. The staging system updated in 2009 by the International Federation of Gynecology and Obstetrics (FIGO), is commonly used for planning the treatment. However, there are significant inaccuracies in the FIGO staging system. Accurate tumor staging is very important to decide the treatment strategy. Although not included in the staging system, magnetic resonance (MR) imaging is a valuable tool for local staging of the disease, and is useful in assessing the spread of the tumor and metastatic lymph nodes, thereby becoming a more accurate substitute for clinical staging of cervical carcinoma. In addition, it is capable of assessing the disease response to surgery or chemoradiation. This review briefly describes the role of MR imaging and the basic MR scanning protocol in evaluating cervical carcinoma. The MR findings with staging, and MR evaluation of treatment response, are further addressed.

  10. Prolactin and cortisol levels in women with endometriosis

    Directory of Open Access Journals (Sweden)

    A.P. Lima

    2006-08-01

    Full Text Available Endometriosis is a progressive estrogen-dependent disease affecting women during their reproductive years. The objective of the present study was to investigate whether endometriosis is associated with stress parameters. We determined cortisol and prolactin levels in serum, peritoneal and follicular fluid from infertile women with endometriosis and fertile women without the disease. The extent of the disease was staged according to the revised American Fertility Society classification (1997. Serum and peritoneal fluid were collected from 49 women aged 19 to 39 years undergoing laparoscopy. Eighteen women had stage I-II endometriosis and 10 had stage III-IV. Controls were 21 women undergoing laparoscopy for tubal sterilization. Follicular fluid was obtained from 39 women aged 25-39 years undergoing in vitro fertilization (21 infertile women with endometriosis and 18 infertile women without endometriosis. Serum prolactin levels were significantly higher in infertile women with stage III-IV endometriosis (28.9 ± 2.1 ng/mL than in healthy controls (13.2 ± 2.1 ng/mL. Serum cortisol levels were significantly higher in infertile women with stage III-IV endometriosis (20.1 ± 1.3 ng/mL than in controls (10.5 ± 1.4 ng/mL. Cortisol and prolactin levels in follicular fluid and peritoneal fluid did not differ significantly between groups. The high levels of cortisol and prolactin in the serum from women with endometriosis might contribute to the subfertility frequently associated with the disease. Moreover, since higher levels of cortisol and prolactin are often associated with stress, it is probable that stress might contribute to the development of endometriosis and its progression to advanced stages of the disease.

  11. Staged Repository Development Programmes

    International Nuclear Information System (INIS)

    Isaacs, T

    2003-01-01

    Programs to manage and ultimately dispose of high-level radioactive wastes are unique from scientific and technological as well as socio-political aspects. From a scientific and technological perspective, high-level radioactive wastes remain potentially hazardous for geological time periods-many millennia-and scientific and technological programs must be put in place that result in a system that provides high confidence that the wastes will be isolated from the accessible environment for these many thousands of years. Of course, ''proof'' in the classical sense is not possible at the outset, since the performance of the system can only be known with assurance, if ever, after the waste has been emplaced for those geological time periods. Adding to this challenge, many uncertainties exist in both the natural and engineered systems that are intended to isolate the wastes, and some of the uncertainties will remain regardless of the time and expense in attempting to characterize the system and assess its performance. What was perhaps underappreciated in the early days of waste management and repository program development were the unique and intense reactions that the institutional, political, and public bodies would have to repository program development, particularly in programs attempting to identify and then select sites for characterization, design, licensing, and ultimate development. Reactions in most nations were strong, focused, unrelenting, and often successful in hindering, derailing, and even stopping national repository programs. The reasons for such reactions and the measures to successfully respond to them are still evolving and continue to be the focus of many national program and political leaders. Adaptive Staging suggests an approach to repository program development that reflects the unique challenges associated with the disposal of high-level radioactive waste. The step-wise, incremental, learn-as-you-go approach is intended to maximize the

  12. Effects of Meditation-Based Stress Reduction in Younger Women with Breast Cancer

    National Research Council Canada - National Science Library

    Hebert, James

    1997-01-01

    ... (NEP) developed specifically for BRIDGES; and 3) a usual care control group. The 180 women under age 65 with Stage I or Stage II breast cancer enrolling into this randomized trial are being evaluated for: 1...

  13. Effects of Meditation-Based Stress Reduction in Younger Women with Breast Cancer

    National Research Council Canada - National Science Library

    Hebert, James

    1998-01-01

    ... (NEP) developed specifically for BRIDGES; and 3) a usual care control group. The 180 women under age 65 with Stage I or Stage II breast cancer enrolling into this randomized trial are being evaluated for: 1...

  14. Staged membrane oxidation reactor system

    Science.gov (United States)

    Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

    2012-09-11

    Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

  15. The Effects of Problem-Focused Group Counseling for Early-Stage Gynecologic Cancer Patients.

    Science.gov (United States)

    Wenzel, Lari B.; And Others

    1995-01-01

    Compared the effect of a 5-week group counseling treatment to an information-only control condition for 37 women with early-stage gynecologic cancer. Women completed various measures related to mood, adjustment, and coping one week before treatment, at the last session, and at one month follow up. Differences are reported. (JBJ)

  16. Effect of hydronephrosis on survival in advanced stage cervical cancer.

    Science.gov (United States)

    Goklu, Mehmet Rıfat; Seckin, Kerem Doga; Togrul, Cihan; Goklu, Yasemin; Tahaoglu, Ali Emre; Oz, Murat; Ertas, Ibrahim Egemen

    2015-01-01

    Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (phydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (pHydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

  17. Locally advanced breast cancer (stage III and stage IV)

    International Nuclear Information System (INIS)

    Baracat, F.F.; Grabert, H.; Lima, G.R. de; Pontes, M.; Ferraro, O.; Santana, A.; Brook, E.S.

    1987-01-01

    The results concerning to the treatment of 193 patients with locally advanced breast cancer-stage III and stage IV are analysed. All the patients were treated with radical radiotherapy plus total mastectomy about 6 weeks later; 53 pacients received also chemotherapy (CMF - 12 courses) and 52 were oophorectomized. (M.A.C) [pt

  18. Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS).

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M; Brinton, Eliot A; Budoff, Mathew J; Cedars, Marcelle I; Hodis, Howard N; Lobo, Rogerio A; Manson, Joann E; Merriam, George R; Miller, Virginia M; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S Mitchell; Taylor, Hugh S

    2013-04-01

    To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Cross-sectional analysis. Multicenter, randomized controlled trial. Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). None. Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E2 levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E2, CAC, and CIMT were assessed. In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E2. Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. NCT00154180. Published by Elsevier Inc.

  19. Self-Reported Menopausal Symptoms, Coronary Artery Calcification and Carotid Intima-Media Thickness in Recently Menopausal Women Screened for the Kronos Early Estrogen Prevention Study (KEEPS)

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M.; Brinton, Eliot A.; Budoff, Mathew J.; Cedars, Marcelle I.; Hodis, Howard N.; Lobo, Rogerio A.; Manson, JoAnn E.; Merriam, George R.; Miller, Virginia M.; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S. Mitchell; Taylor, Hugh S.

    2012-01-01

    Objective To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Setting Multi-center, randomized controlled trial. Patients Recently menopausal women (n=868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). Design Cross sectional analysis. Interventions None Main Outcome Measures Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum estradiol (E2) levels and measures of atherosclerosis were assessed. Atherosclerosis was quantified using Coronary Artery Calcium (CAC) Agatston scores (n=771) and Carotid Intima-Media Thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, estradiol (E2), CAC, and CIMT were assessed. Results In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations (p=0.09) and depression (p=0.07) approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness and E2. Conclusions Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine if baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. PMID:23312232

  20. Second stage gasifier in staged gasification and integrated process

    Science.gov (United States)

    Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

    2015-10-06

    A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

  1. CT staging of renal cell carcinoma

    International Nuclear Information System (INIS)

    Spina, Juan C.; Garcia, Adriana T.; Rogondino, Jose; Spina, Juan C. h; Vidales, Valeria; Troiani, Guillermo; Iotti, Alejandro; Venditti, Julio

    2002-01-01

    Objective: To assess the usefulness of computerized tomography (CT) in the characterization of renal masses, in order to stage them, determine their prognosis and their appropriate clinical and/or surgical management. Material and Methods: Between 1988 and 2001, we selected 63 patients with renal tumors that had been examined by pathology. Patient's ages ranged from 16 to 88 years (25 women, 38 men). The studies were performed with a sequential helical CT, using 5 mm thickness sections every 5mm evaluating the cortico medullar and nephrographic phases. Renal tumors were characterized and staged without any knowledge about the pathological findings; subsequently the tomographic characteristics were compared to such findings. The following characteristics were evaluated: 1) mixed solid-cystic nature; 2) size; 3) borders; 4) enhancement; 5) necrosis; 6) hemorrhage; 7) central scar; 8) presence of fat; 9) collecting system; 10) capsular invasion; 11) perirenal fat invasion; 12) vessels; 13) Gerota's fascia; 14) lymph nodes; and 15) local and/or distant metastases. Results: Of the 63 tumors, 2 were complicated cysts; of the 61 remaining tumors, 10 were angiomyolipomas, 1 was a renal lymphoma, 1 was a focal xantogranulomatose pyelonephritis, 1 was a metanephric adenoma, 3 papillary renal cell carcinoma (RCC), 4 transitional cell tumors, 4 oncocytomas, 37 clear cell renal carcinoma. The CT could correctly characterize the 2 cystic tumors as such, as well as the 9 angiomyolipomas and the 4 transitional cell tumors. The 48 other tumors (1 angiomyolipoma, 1 lymphoma, 1 focal xantogranulomatose pyelonephritis, 1 metanephric adenoma, 3 papillary RCC, 4 oncocytomas, and 37 cell renal carcinomas) remaining were characterized as renal adenocarcinomas and CT staged. Conclusion: CT is a useful method to characterize renal masses since it determines their solid-cystic or fatty structure; aiding in many cases to define a surgical treatment. For the CT staging of renal tumors, the

  2. Stages of endometriosis: Does it affect in vitro fertilization outcome

    Directory of Open Access Journals (Sweden)

    Sonja Pop-Trajkovic

    2014-06-01

    Conclusion: The American Society for Reproductive Medicine classification of endometriosis is useful in predicting IVF outcome. Advanced endometriosis means a worse prognosis for IVF treatment compared to milder stages or tubal factor infertility. The decreased fertilization rate in Stage I/II endometriosis might be a cause of subfertility in these women, as a result of a hostile environment caused by the disease.

  3. Down-staging of breast cancer in the pre-screening era ...

    African Journals Online (AJOL)

    We aimed to investigate the stage of breast cancer at first diagnosis and assess possible determinants of late-stage presentation. A consecutive series of women with newly diagnosed breast cancer at Chris Hani Baragwanath Academic Hospital (CHBAH), Soweto, South Africa were analysed. We retrospectively reviewed ...

  4. Endometriosis: frequency and correlation between symptomatology and disease stage

    International Nuclear Information System (INIS)

    Mehmud, G.; Akhtar, T.; Sadia, S.

    2007-01-01

    To determine the frequency of endometriosis in general gynecological and infertile women presenting to hospital and to correlate symptomatology and stage of disease. Fifty patients with diagnosis of endometriosis on laparoscopy were included in the study. The degree of pain symptoms was graded according to 1-4 point verbal rating scale designed by Biberoglu and Behrman. Endometriosis was staged according to Revised American Fertility Society (R-AFS) scoring on laparoscopy. Correlation coefficient-Spearman rank order correlation test was applied to analyze data. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). There was a significant positive correlation between chronic pelvic pain and R-AFS scoring. Increasing severity of pelvic pain was also positively correlated with presence of endometrioma and complete obliteration of pouch of Douglas. No correlation between dysmenorrhoea and R-AFS scoring could be detected. Dysmenorrhoea was strongly and positively correlated with the presence of superficial implants. Dyspareunia was found to have positive correlation with R-AFS score and also with complete obliteration of pouch of Douglas. The frequency of endometriosis in infertile women was 24% (33) and in women with general gynecological complaints, it was 23% (17). Chronic pelvic pain and dyspareunia had strong positive correlation with R-AFS score while dysmenorrhoea had no such correlation. (author)

  5. Women's Club

    CERN Multimedia

    CERN Women's Club

    2012-01-01

     Coffee Morning Tuesday 7th February 2012, 9:00 – 11:00 Bldg 504 (Restaurant n°2 – DSR) 1st Floor, Club Room 3 Presentation of cheque to Terre des Hommes Those interested in helping should come along. New arrivals and all members are cordially invited.You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/

  6. Women's club

    CERN Multimedia

    Club des cernoises

    2012-01-01

    Coffee MorningTuesday 9th October 2012, 9:00 – 11:00 Bldg 504 (Restaurant No 2 – DSR) 1st Floor, Club Room 3 Presentation of the charity to benefit from the Christmas Sale “Nous aussi”. Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://cern.ch/Club-WomensClub/

  7. Women's Club

    CERN Multimedia

    Women's Club

    2014-01-01

        CERN WOMEN’S CLUB Coffee Morning Tuesday 8th Avril 2014, 9:30 – 14:00 Bldg 504 (Restaurant No 2 – DSR) Ground Floor Spring Jumble Sale   Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://cern.ch/Club-WomensClub/

  8. Women's Club

    CERN Document Server

    Club des Cernoises

    2012-01-01

    Coffee Morning   Tuesday 24th  April 2012, 9:00 – 14:00 Bldg 504, Ground Floor Spring Jumble Sale   Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/

  9. Grassroots Women

    Directory of Open Access Journals (Sweden)

    Rebecca Kay

    2004-01-01

    Full Text Available The economic, social and political changes that have occurred in Russia over the last 10 years have had a profound effect on Russian women’s lives. Economic reform has brought poverty, insecurity and high levels of anxiety and stress to much of the population, both male and female. The impact of these changes on women was amplified in the early 1990s by their structural positioning both within the workforce and within the population, brought about by the legacies of the Soviet planned economy, Soviet attitudes to gender and long established demographic trends. Alongside these historical influences, ‘new’ essentialist attitudes towards gender and the appropriate roles and responsibilities of women in post-Soviet Russian society have been strongly promoted through the media, political and social discourses, imposing new pressures and dilemmas on many post-Soviet Russian women. Numerous women’s organisations have been established in Russia since the early 1990s, many of them with a specific remit of helping Russian women to overcome the upheavals and hardships which they face. Struggling to survive themselves with very few resources and minimal external support, Russia’s grassroots women’s organisations have nonetheless offered practical help and advice and emotional support and solidarity to their members. This paper is based on the findings of a period of intensive fieldwork carried out in 1995-6 with grassroots women’s organisations in Moscow and three Russian provincial centres. It will present the aims, activities and impact of the groups studied. It will also investigate the ways in which these groups and their membership positioned themselves in relation to the development of essentialist attitudes and opinions on gender within Russia on the one hand, and a dialogue with ‘western’ feminist theory and practice on the other.

  10. Effects of estradiol valerate associated with cyproterone acetate on some clinical and sexuality-related aspects in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Edmund Chada Baracat

    2008-09-01

    Full Text Available Objective: To evaluate the clinical effects of estrogen-progestin therapy in postmenopausal women, with particular emphasis on climacteric symptoms and sexuality. Methods: A prospective, blind, randomized, single-center, crossover, placebo-controlled study was carried out for 12 consecutive months in 40 postmenopausal women with a mean age of 52.2 years, with no contraindication to hormone therapy and with an intact uterus. The patients were divided into two groups: during the first six-month period of the study, one group received estradiol valerate 2 mg/day for 21 days/month associated with cyproterone acetate 1 mg/day in the last ten days of therapy (Climene™; the other group received one placebo tablet/day for 21 days/month. The treatments were then reversed, and the patients were followed-up for another six-month period. In the statistical analysis, the group receiving hormone therapy was denoted Group A, and the group receiving placebo Group B, regardless of the sequence in which the patient received the drug. Menopausal symptoms and sexuality were evaluated. Crossover analysis of variance and the McNemar test were used for statistical analysis. Rresults: A significant reduction was found in hot flashes and insomnia in the patients of Group A (the group that received hormone therapy. In this group, a significant improvement was also detected regarding sexual interest, communication with partner and ability to reach orgasm during penetration. Regarding the other issues, no statistically significant differences were detected. Cconclusions: There was a significant improvement in menopausal symptoms and sexuality in the group of women that used hormone therapy.

  11. Women's Health Topics

    Science.gov (United States)

    ... Information by Audience For Women Women's Health Topics Women's Health Topics Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print National Women's Health Week May 13 - 19, 2018 Join us ...

  12. Factors influencing late stage of breast cancer at presentation in a district Hospital - Segamat Hospital, Johor.

    Science.gov (United States)

    Cheng, M L; Ling, D Y; Nanu P, K P; Nording, H; Lim, C H

    2015-06-01

    In Malaysia, late stage presentation of breast cancer (stage III or IV) has been a healthcare problem that varies geographically throughout the country. This study aims to understand the factors influencing late stage of breast cancer at presentation among Malaysian women in Segamat Hospital, Johor, which is a district hospital. A retrospective descriptive study was conducted on secondary data of all newly diagnosed breast cancer women from 1st August 2011 to 28th February 2014. Secondary data includes age, ethnicity, marital status, family history, education level, occupation, presenting symptom, duration of symptom, tumour size, tumour pathology, tumour grading, oestrogen, progesterone and HER-2 receptor status were collected and analysed using SPSS version 20.0.0. In total, data from 52 women was analysed and two women were excluded for incompleteness as these women defaulted. Late stage at presentation was 59.6% of all new cases (17.3% stage III and 42.3% stage IV). The commonest age group of all women diagnosed with breast cancer was in the 5th decade. Majority of them were Malay, married and housewives with no family history of breast cancer. The statistically significant factors associated with late stage at presentation include Malay ethnicity (p=0.019), presenting symptoms other than breast lump (p=0.047), and duration of breast lump more than 3 months (p=0.009). The study demonstrated presentation at late stage of breast cancer is a major health concern among Malaysian women in district hospital. This may be attributed to different sociocultural beliefs, strong belief in complementary and alternative medicine, lack of awareness, and difficult accessibility to healthcare services.

  13. Disparity in Breast Cancer Late Stage at Diagnosis in Missouri: Does Rural Versus Urban Residence Matter?

    Science.gov (United States)

    Williams, Faustine; Thompson, Emmanuel

    2016-06-01

    Despite the fact that black women have a lower incidence of breast cancer compared to white women, black women experience higher death rates than any other group. We examined the stage of breast cancer presentation by race and geographic region using population-based breast cancer incidence in all 115 counties in the state of Missouri. We used 2003-2008 breast cancer incidence data from Missouri Cancer Registry and Research Center. County of residence was categorized as urban or rural using the rural-urban continuum code. We computed the conditional proportion of stage at diagnosis by race and metropolitan status and also used Pearson's chi-squared test with Yates' continuity correction to determine statistical significance of association. Results of the study indicate that a greater proportion of black women (38.8 %) compared to white women (30.2 %) were diagnosed with more advanced breast metastasis. Our results further suggest that stage at diagnosis depended on county of residence or metropolitan status (p = .04). Women living in non-metropolitan counties were slightly more likely to have late-stage breast cancer than their metropolitan counterparts (32.0 vs 30.7 %). Overall, black women had 1.5-fold increased odds of late-stage breast cancer diagnosis compared to their white counterparts (OR = 1.50; 95 % CI, 1.39, 1.63; p diagnosis among women living in non-metropolitan or rural counties was over 11 % higher compared with their metropolitan or urban counterpart. The current study corroborates previous findings that the risk of late-stage breast cancer diagnosis was higher among women residing in non-metropolitan rural counties.

  14. Making decentralization work for women in Uganda

    OpenAIRE

    Lakwo, A.

    2009-01-01

    This book is about engendering local governance. It explores the euphoria with which Uganda's decentralization policy took centre stage as a sufficient driver to engender local development responsiveness and accountability. Using a case study of AFARD in Nebbi district, it shows first that decentralized governance is gendered and technocratic as grassroots women's effective participation is lacking. Second, it shows that the insertion of women in local governance is merely a symbolic politica...

  15. Women's club

    CERN Document Server

    Club des Cernoises

    2012-01-01

        CWC – Chinese Women's Community at CERN With an increasing number of Chinese people working at CERN, there are also surely an increasing number of Chinese women in the area, who are not always familiar with the environment, languages, or the people. In the context of the CERN Women’s Club, let's meet together and chat about integrating into the local community, available activities, commerce’s, restaurants, etc. It is also obviously a good opportunity to meet new friends. Everyone is welcome to join us to meet for tea, coffee, and a chat. We will meet every 3rd Tuesday of the month, starting on 20th March 2012, in building 504 (Restaurant 2) in room E-005. 20th March at 9-11am 17th April at 9-11am 22nd May at 9-11am 19th June at 9-11am For more details contact Mme Jean RODERICK, +41 (0) 76 426 61 08, jean.chow.roderick@gmail.com http://club-womensclub.web.cern.ch/Club-WomensClub/     CWC-華人茶敍 越來�...

  16. Women's Club

    CERN Multimedia

    Club des Cernoises

    2012-01-01

    Coffee Morning Tuesday 13th  March 2012, 9:00 – 11:00 - Bldg 504 (Restaurant No 2 – DSR) - 1st Floor, Club Room 3. German Theme Those interested in helping should come along. New arrivals and all members are cordially invited. You can enrol for membership, renew membership, find out about and sign up for our activities. Visit our website: http://club-womensclub.web.cern.ch/Club-WomensClub/     CWC – Chinese Women's Community at CERN With an increasing number of Chinese people working at CERN, there are also surely an increasing number of Chinese women in the area, who are not always familiar with the environment, languages, or the people. In the context of the CERN Women’s Club, let's meet together and chat about integrating into the local community, available activities, commerce’s, restaurants, etc. It is also obviously a good opportunity to meet new friends. Everyone is welcome to join us to meet fo...

  17. A stage is a stage is a stage: a direct comparison of two scoring systems.

    Science.gov (United States)

    Dawson, Theo L

    2003-09-01

    L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

  18. Why the Scientific Pipeline Is Still Leaking? Women Scientists and Their Work-Life Balance in Poland

    Science.gov (United States)

    Polkowska, Dominika

    2014-01-01

    In the contemporary scholarly discourse, the under-representation of women in science is often explained by the phenomenon of women "in the pipeline". The pipeline carries a flow from one stage to another, and the flow of women diminishes between the stages. Based on the literature and qualitative studies, it can be inferred that one of…

  19. Multiple stage miniature stepping motor

    International Nuclear Information System (INIS)

    Niven, W.A.; Shikany, S.D.; Shira, M.L.

    1981-01-01

    A stepping motor comprising a plurality of stages which may be selectively activated to effect stepping movement of the motor, and which are mounted along a common rotor shaft to achieve considerable reduction in motor size and minimum diameter, whereby sequential activation of the stages results in successive rotor steps with direction being determined by the particular activating sequence followed

  20. Lernpunkt Deutsch--Stage 1.

    Science.gov (United States)

    Theil, Elvira

    1997-01-01

    Evaluates the first stage of "Lernpunkt Deutsch," a new three-stage German course designed for upper elementary and early secondary school. Describes the publisher's package of materials and the appropriateness of the course, utility of the different package elements, format of the materials, and assesses whether the course provides pedagogically…

  1. A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value.

    Science.gov (United States)

    Lu, Karen H; Skates, Steven; Hernandez, Mary A; Bedi, Deepak; Bevers, Therese; Leeds, Leroy; Moore, Richard; Granai, Cornelius; Harris, Steven; Newland, William; Adeyinka, Olasunkanmi; Geffen, Jeremy; Deavers, Michael T; Sun, Charlotte C; Horick, Nora; Fritsche, Herbert; Bast, Robert C

    2013-10-01

    A 2-stage ovarian cancer screening strategy was evaluated that incorporates change of carbohydrate antigen 125 (CA125) levels over time and age to estimate risk of ovarian cancer. Women with high-risk scores were referred for transvaginal ultrasound (TVS). A single-arm, prospective study of postmenopausal women was conducted. Participants underwent an annual CA125 blood test. Based on the Risk of Ovarian Cancer Algorithm (ROCA) result, women were triaged to next annual CA125 test (low risk), repeat CA125 test in 3 months (intermediate risk), or TVS and referral to a gynecologic oncologist (high risk). A total of 4051 women participated over 11 years. The average annual rate of referral to a CA125 test in 3 months was 5.8%, and the average annual referral rate to TVS and review by a gynecologic oncologist was 0.9%. Ten women underwent surgery on the basis of TVS, with 4 invasive ovarian cancers (1 with stage IA disease, 2 with stage IC disease, and 1 with stage IIB disease), 2 ovarian tumors of low malignant potential (both stage IA), 1 endometrial cancer (stage I), and 3 benign ovarian tumors, providing a positive predictive value of 40% (95% confidence interval = 12.2%, 73.8%) for detecting invasive ovarian cancer. The specificity was 99.9% (95% confidence interval = 99.7%, 100%). All 4 women with invasive ovarian cancer were enrolled in the study for at least 3 years with low-risk annual CA125 test values prior to rising CA125 levels. ROCA followed by TVS demonstrated excellent specificity and positive predictive value in a population of US women at average risk for ovarian cancer. Copyright © 2013 American Cancer Society.

  2. Celebrate Women's History.

    Science.gov (United States)

    Leonard, Carolyn M.; Baradar, Mariam

    This teachers' guide to activities celebrating Women's History Month focuses on women whose important contributions have been omitted from history textbooks. Women's History Month grew from a 1977 celebration of Women's History Week and is intended to bring women's history into the school curriculum. International Women's Day, celebrated on March…

  3. Stage measurement at gaging stations

    Science.gov (United States)

    Sauer, Vernon B.; Turnipseed, D. Phil

    2010-01-01

    Stream and reservoir stage are critical parameters in the computation of stream discharge and reservoir volume, respectively. In addition, a record of stream stage is useful in the design of structures that may be affected by stream elevation, as well as for the planning for various uses of flood plains. This report describes equipment and methodology for the observation, sensing, and recording of stage in streams and reservoirs. Although the U.S. Geological Survey (USGS) still uses the traditional, basic stilling-well float system as a predominant gaging station, modern electronic stage sensors and water-level recorders are now commonly used. Bubble gages coupled with nonsubmersible pressure transducers eliminate the need for stilling wells. Submersible pressure transducers have become common in use for the measurement of stage in both rivers and lakes. Furthermore, noncontact methods, such as radar, acoustic, and laser methods of sensing water levels, are being developed and tested, and in the case of radar, are commonly used for the measurement of stage. This report describes commonly used gaging-station structures, as well as the design and operation of gaging stations. Almost all of the equipment and instruments described in this report will meet the accuracy standard set by the USGS Office of Surface Water (OSW) for the measurement of stage for most applications, which is ±0.01 foot (ft) or 0.2 percent of the effective stage. Several telemetry systems are used to transmit stage data from the gaging station to the office, although satellite telemetry has become the standard. These telemetry systems provide near real-time stage data, as well as other information that alerts the hydrographer to extreme or abnormal events, and instrument malfunctions.

  4. Study shows women fail to land top grants

    Science.gov (United States)

    Jenner, Nicola

    2014-05-01

    Women in the UK are less successful than men at securing research council funding at almost every stage of their careers, according to an analysis published by Research Councils UK (RCUK) - the umbrella organization for the country's seven research councils.

  5. Reentry Women and Feminist Therapy: A Career Counseling Model.

    Science.gov (United States)

    Christian, Connie; Wilson, Jean

    1985-01-01

    Using the tenets of feminist therapy, presents a career counseling model for reentry women. Describes goals, intervention strategies, and feminist tenets for each of three stages: stabilization; personal growth; and action. (MCF)

  6. Influence of glucose on the leukocyte response in women athletes ...

    African Journals Online (AJOL)

    Influence of glucose on the leukocyte response in women athletes during ... South African Journal for Research in Sport, Physical Education and Recreation ... Total WBC counts were raised at all stages in all three trials when compared with ...

  7. Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement

    International Nuclear Information System (INIS)

    Bingham, Brian; Orton, Andrew; Boothe, Dustin; Stoddard, Greg; Huang, Y. Jessica; Gaffney, David K.; Poppe, Matthew M.

    2017-01-01

    Purpose: To evaluate the survival benefit of adding vaginal brachytherapy (BT) to pelvic external beam radiation therapy (EBRT) in women with stage III endometrial cancer. Methods and Materials: The National Cancer Data Base was used to identify patients with stage III endometrial cancer from 2004 to 2013. Only women who received adjuvant EBRT were analyzed. Women were grouped according to receipt of BT. Logistic regression modeling was used to identify predictors of receiving BT. Log–rank statistics were used to compare survival outcomes. Cox proportional hazards modeling was used to evaluate the effect of BT on survival. A propensity score–matched analysis was also conducted among women with cervical involvement. Results: We evaluated 12,988 patients with stage III endometrial carcinoma, 39% of whom received EBRT plus BT. Women who received BT were more likely to have endocervical or cervical stromal involvement (odds ratios 2.03 and 1.77; P<.01, respectively). For patients receiving EBRT alone, the 5-year survival was 66% versus 69% with the addition of BT at 5 years (P<.01). Brachytherapy remained significantly predictive of decreased risk of death (hazard ratio 0.86; P<.01) on multivariate Cox regression. The addition of BT to EBRT did not affect survival among women without cervical involvement (P=.84). For women with endocervical or cervical stromal invasion, the addition of BT significantly improved survival (log–rank P<.01). Receipt of EBRT plus BT was associated with improved survival in women with positive and negative surgical margins, and receiving chemotherapy did not alter the benefit of BT. Propensity score–matched analysis results confirmed the benefit of BT among women with cervical involvement (hazard ratio 0.80; P=.01). Conclusions: In this population of women with stage III endometrial cancer the addition of BT to EBRT was associated with an improvement in survival for women with endocervical or cervical stromal invasion.

  8. Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Bingham, Brian [Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee (United States); Orton, Andrew; Boothe, Dustin [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Stoddard, Greg [Division of Epidemiology, University of Utah, Salt Lake City, Utah (United States); Huang, Y. Jessica; Gaffney, David K. [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Poppe, Matthew M., E-mail: Matthew.poppe@hci.utah.edu [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States)

    2017-04-01

    Purpose: To evaluate the survival benefit of adding vaginal brachytherapy (BT) to pelvic external beam radiation therapy (EBRT) in women with stage III endometrial cancer. Methods and Materials: The National Cancer Data Base was used to identify patients with stage III endometrial cancer from 2004 to 2013. Only women who received adjuvant EBRT were analyzed. Women were grouped according to receipt of BT. Logistic regression modeling was used to identify predictors of receiving BT. Log–rank statistics were used to compare survival outcomes. Cox proportional hazards modeling was used to evaluate the effect of BT on survival. A propensity score–matched analysis was also conducted among women with cervical involvement. Results: We evaluated 12,988 patients with stage III endometrial carcinoma, 39% of whom received EBRT plus BT. Women who received BT were more likely to have endocervical or cervical stromal involvement (odds ratios 2.03 and 1.77; P<.01, respectively). For patients receiving EBRT alone, the 5-year survival was 66% versus 69% with the addition of BT at 5 years (P<.01). Brachytherapy remained significantly predictive of decreased risk of death (hazard ratio 0.86; P<.01) on multivariate Cox regression. The addition of BT to EBRT did not affect survival among women without cervical involvement (P=.84). For women with endocervical or cervical stromal invasion, the addition of BT significantly improved survival (log–rank P<.01). Receipt of EBRT plus BT was associated with improved survival in women with positive and negative surgical margins, and receiving chemotherapy did not alter the benefit of BT. Propensity score–matched analysis results confirmed the benefit of BT among women with cervical involvement (hazard ratio 0.80; P=.01). Conclusions: In this population of women with stage III endometrial cancer the addition of BT to EBRT was associated with an improvement in survival for women with endocervical or cervical stromal invasion.

  9. Fundal pressure during the second stage of labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Vogel, Joshua P; Cuthbert, Anna; Singata, Mandisa

    2017-03-07

    Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage or the need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms. There is a need for objective evaluation of the effectiveness and safety of fundal pressure in the second stage of labour. To determine if fundal pressure is effective in achieving spontaneous vaginal birth, and preventing prolonged second stage or the need for operative birth, and to explore maternal and neonatal adverse effects related to fundal pressure. We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials of fundal pressure (manual or by inflatable belt) versus no fundal pressure in women in the second stage of labour with singleton cephalic presentation. Two or more review authors independently assessed potential studies for inclusion and quality. We extracted data using a pre-designed form. We entered data into Review Manager 5 software and checked for accuracy. Nine trials are included in this updated review. Five trials (3057 women) compared manual fundal pressure versus no fundal pressure. Four trials (891 women) compared fundal pressure by means of an inflatable belt versus no fundal pressure. It was not possible to blind women and staff to this intervention. We assessed two trials as being at high risk of attrition bias and another at high risk of reporting bias. All other trials were low or unclear for other risk of bias

  10. Researcher Women

    OpenAIRE

    Katalin Lipták

    2016-01-01

    I think that the equal opportunity and the underprivileged marginal labour-market layers’ significance play an important role in the economics of our days, so the women’s labour-market participation. Analysing the Hungarian data lines, we can see that the women’s labour-market participation significantly lags behind the men’s. I wish to prove with a questionnaire survey that in the North-Hungarian region the women’s labour-market situation and the career opportunities of the researcher women ...

  11. Eating behaviours among young women.

    Science.gov (United States)

    Abraham, S F; Mira, M; Beumont, P J; Sowerbutts, T D; Llewellyn-Jones, D

    1983-09-03

    Disordered eating and weight-control behaviour is becoming increasingly common among adolescent girls. We studied four groups of young women aged between 15 and 27 years (106 school and university students, 50 ballet school students, 22 patients suffering from anorexia nervosa and 44 patients with bulimia). Our results suggest that most young women diet at some time and lose more than three kg in weight; that they may experience episodes of binge eating and "picking" behaviour; and that they wish to be thinner irrespective of their current body weight. Twenty per cent of young women may fulfil the criteria for an eating disorder (bulimia or anorexia nervosa) at some stage, however briefly, and about 7% abuse laxatives or diuretics in order to achieve a fashionably slim figure. We suggest that most young women may pass through a phase of what is currently called disordered eating, and that this is part of normal development and may not necessarily require treatment. The incidence of disordered eating is greater in those young women who are under pressure to maintain a low body weight.

  12. Breast cancer stage at diagnosis: is travel time important?

    Science.gov (United States)

    Henry, Kevin A; Boscoe, Francis P; Johnson, Christopher J; Goldberg, Daniel W; Sherman, Recinda; Cockburn, Myles

    2011-12-01

    Recent studies have produced inconsistent results in their examination of the potential association between proximity to healthcare or mammography facilities and breast cancer stage at diagnosis. Using a multistate dataset, we re-examine this issue by investigating whether travel time to a patient's diagnosing facility or nearest mammography facility impacts breast cancer stage at diagnosis. We studied 161,619 women 40 years and older diagnosed with invasive breast cancer from ten state population based cancer registries in the United States. For each woman, we calculated travel time to their diagnosing facility and nearest mammography facility. Logistic multilevel models of late versus early stage were fitted, and odds ratios were calculated for travel times, controlling for age, race/ethnicity, census tract poverty, rural/urban residence, health insurance, and state random effects. Seventy-six percent of women in the study lived less than 20 min from their diagnosing facility, and 93 percent lived less than 20 min from the nearest mammography facility. Late stage at diagnosis was not associated with increasing travel time to diagnosing facility or nearest mammography facility. Diagnosis age under 50, Hispanic and Non-Hispanic Black race/ethnicity, high census tract poverty, and no health insurance were all significantly associated with late stage at diagnosis. Travel time to diagnosing facility or nearest mammography facility was not a determinant of late stage of breast cancer at diagnosis, and better geographic proximity did not assure more favorable stage distributions. Other factors beyond geographic proximity that can affect access should be evaluated more closely, including facility capacity, insurance acceptance, public transportation, and travel costs.

  13. Impact of Life-Cycle Stage and Gender on the Ability to Balance Work and Family Responsibilities.

    Science.gov (United States)

    Higgins, Christopher; And Others

    1994-01-01

    Examined impact of gender and life-cycle stage on three components of work-family conflict using sample of 3,616 respondents. For men, levels of work-family conflict were moderately lower in each successive life-cycle stage. For women, levels were similar in two early life-cycle stages but were significantly lower in later life-cycle stage.…

  14. Researcher Women

    Directory of Open Access Journals (Sweden)

    Katalin Lipták

    2016-12-01

    Full Text Available I think that the equal opportunity and the underprivileged marginal labour-market layers’ significance play an important role in the economics of our days, so the women’s labour-market participation. Analysing the Hungarian data lines, we can see that the women’s labour-market participation significantly lags behind the men’s. I wish to prove with a questionnaire survey that in the North-Hungarian region the women’s labour-market situation and the career opportunities of the researcher women lags behind the men’s slightly. Based on my research, beyond the women’s traditional home tasks have appeared the claims for work derives from the employment, so the double burden is put into practice, too. we can explain with the difficulties of the compatibility of childbearing and the work, the undertaking extra limited tasks of the workplace, providing extra performance which is sensible for the women, that in the North-Hungarian region the female career path move more slowly than the men’s.

  15. Evaluating the Stage Learning Hypothesis.

    Science.gov (United States)

    Thomas, Hoben

    1980-01-01

    A procedure for evaluating the Genevan stage learning hypothesis is illustrated by analyzing Inhelder, Sinclair, and Bovet's guided learning experiments (in "Learning and the Development of Cognition." Cambridge: Harvard University Press, 1974). (Author/MP)

  16. The Staging of the Turk

    DEFF Research Database (Denmark)

    Holm, Bent

    2013-01-01

    An analytical and contextualized presentation of the figure of the Turk on the Danish stage in the 18. century with a specific focus on the interaction between the actual commercial and military circumstances on the one hand and the performative representations on the other hand. How far did the ...... the staged image reflect the actual circumstances and how far was it an internal self-reflection?...

  17. Two stages of economic development

    OpenAIRE

    Gong, Gang

    2016-01-01

    This study suggests that the development process of a less-developed country can be divided into two stages, which demonstrate significantly different properties in areas such as structural endowments, production modes, income distribution, and the forces that drive economic growth. The two stages of economic development have been indicated in the growth theory of macroeconomics and in the various "turning point" theories in development economics, including Lewis's dual economy theory, Kuznet...

  18. [Peritoneal fluid iron levels in women with endometriosis].

    Science.gov (United States)

    Polak, Grzegorz; Wertel, Iwona; Tarkowski, Rafał; Kotarski, Jan

    2010-01-01

    Endometriosis is characterized by a cyclic hemorrhage within the peritoneal cavity. Accumulating data suggests that iron homeostasis in the peritoneal cavity may be disrupted by endometriosis. The aim of our study was to evaluate iron levels in peritoneal fluid (PF) of women with and without endometriosis. Seventy-five women were studied: 50 women with endometriosis and, as a reference group, 25 patients with functional follicle ovarian cysts. Iron concentrations in the PF were measured using a commercially available colorimetric assay kit. Iron concentrations were significantly higher in PF from women with endometriosis as compared to the reference group. Patients with stages III/IV endometriosis had significantly higher PF iron concentrations than women with stages I/II of the disease. Disrupted iron homeostasis in the peritoneal cavity of women with endometriosis plays a role in the pathogenesis of the disease.

  19. Staged regenerative sorption heat pump

    Science.gov (United States)

    Jones, Jack A. (Inventor)

    1995-01-01

    A regenerative adsorbent heat pump process and system for cooling and heating a space. A sorbent is confined in a plurality of compressors of which at least four are first stage and at least four are second stage. The first stage operates over a first pressure region and the second stage over a second pressure region which is higher than the first. Sorbate from the first stage enters the second stage. The sorbate loop includes a condenser, expansion valve, evaporator and the compressors. A single sorbate loop can be employed for single-temperature-control such as air conditioning and heating. Two sorbate loops can be used for two-temperature-control as in a refrigerator and freezer. The evaporator temperatures control the freezer and refrigerator temperatures. Alternatively the refrigerator temperature can be cooled by the freezer with one sorbate loop. A heat transfer fluid is circulated in a closed loop which includes a radiator and the compressors. Low temperature heat is exhausted by the radiator. High temperature heat is added to the heat transfer fluid entering the compressors which are desorbing vapor. Heat is transferred from compressors which are sorbing vapor to the heat transfer fluid, and from the heat transfer fluid to the compressors which are desorbing vapor. Each compressor is subjected to the following phases, heating to its highest temperature, cooling down from its highest temperature, cooling to its lowest temperature, and warming up from its lowest temperature. The phases are repeated to complete a cycle and regenerate heat.