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Sample records for women subsequently diagnosed

  1. Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism.

    Science.gov (United States)

    Nelson, David B; Casey, Brian M; McIntire, Donald D; Cunningham, F Gary

    2014-01-01

    To evaluate subsequent pregnancy outcomes in women previously identified during an index pregnancy to have subclinical hypothyroidism (SCH). From 2000 to 2003, thyroid analytes were measured in 17,298 women. Using their index pregnancy thyroid-analyte classification, pregnancy outcomes were compared between the returning cohorts. There were 6,985 women previously screened and subsequently delivered at our hospital though 2011 with 230 (3.3%) designated to have SCH and 6,645 (95.1%) euthyroid. Significant differences between the two cohorts included risk for diabetes (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.2 to 2.7, p = 0.005), gestational diabetes (OR 1.74, 95% CI 1.13 to 2.69, p = 0.015), and stillbirth (OR 3.5, 95% CI 1.05 to 11.68, p = 0.042). After adjustment, the increased likelihood of diabetes (adjusted OR 1.58, 95% CI 1.04 to 2.40, p = 0.032) and stillbirth (adjusted OR 3.41, 95% CI 1.01 to 11.49, p = 0.048) persisted. Women identified during a previous pregnancy with SCH are at increased risk for some adverse perinatal outcomes during a subsequent pregnancy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Nursing diagnoses in women deprived of freedom

    National Research Council Canada - National Science Library

    Izabelle de Freitas Ferreira; Tatiane Gomes Guedes; Sheila Coelho Ramalho Vasconcelos Morais; José Cristovam Martins Vieira; Marcelle Guimarães de Mello; Francisca Márcia Pereira Linhares

    2016-01-01

    ...: the diagnoses are related to factors that compromise the biopsychosocial health. The nurse, health staff member in the prison setting, must recognize and assess the individual and collective needs of women deprived of freedom. The inference of nursing diagnoses, based on clinical reasoning, contributes to a humanized, empathic and special care.

  3. Nursing diagnoses in women deprived of freedom

    Directory of Open Access Journals (Sweden)

    Izabelle de Freitas Ferreira

    2016-05-01

    Full Text Available Objective: to analyze the nursing diagnoses profile of women deprived of freedom, using the International Classification for Nursing® Practice version 1.0. Methods: a descriptive study, conducted with 186 women deprived of freedom. Nursing Diagnoses were extrapolated based on the clinical data of the participants, collected through a structured form and clinical reasoning. Results: there were 44 nursing diagnostic statements, among the most common, there were: infection risk (70.9%; fluid intake, decreased (61.2%; Sleep, impaired (60.7%; tobacco abuse, started (51.6%; health seeking behavior, committed (50.0%. Conclusion: the diagnoses are related to factors that compromise the biopsychosocial health. The nurse, health staff member in the prison setting, must recognize and assess the individual and collective needs of women deprived of freedom. The inference of nursing diagnoses, based on clinical reasoning, contributes to a humanized, empathic and special care.

  4. Subsequent pregnancies in women with previous gestational syphilis.

    Science.gov (United States)

    Hebmuller, Marjorie Garlow; Fiori, Humberto Holmer; Lago, Eleonor Gastal

    2015-09-01

    This study included data on syphilis-positive pregnant women seen for delivery or miscarriage, between 1997 and 2004, in Sao Lucas Hospital, Porto Alegre, RS. Their subsequent obstetric outcomes were studied, until December 2011, to see if the disease recurred. From 450 pregnant women with positive syphilis serology, seen from 1997 to 2004, 166 had at least one more obstetric attendance until December 2011, with 266 new obstetric outcomes. Congenital syphilis (CS) was demonstrated in 81.9% of the initial pregnancies and in 68.4% of the subsequent ones. The main causes of CS in subsequent pregnancies were a negative VDRL that turned positive at delivery, and undocumented treatment. VDRL titers were higher than 1:4 in 50.4% of the initial and 13.3% of the subsequent pregnancies (p syphilis in a preceding pregnancy. No or inadequate prenatal care was the main risk factor for CS, both in initial and in subsequent pregnancies. These data suggest that non-infected neonates could have been defined as CS cases because of insufficient information about the mother's history.

  5. Maternal and fetal Doppler velocimetry in women diagnosed with ...

    African Journals Online (AJOL)

    Forty women diagnosed with FOC (FOC group) and 45 women with W‑DEQ scores <85 (control group) underwent Doppler waveform analysis and the pulsatility index (PI) and resistance index (RI) values for uterine, umbilical, and mid cerebral arteries were recorded. Results: Both groups had similar PI and RI values for ...

  6. The lived experiences of rural women diagnosed with the human ...

    African Journals Online (AJOL)

    2017-09-26

    Sep 26, 2017 ... Background: In South Africa, pregnant women are diagnosed with human immunodeficiency virus (HIV) at antenatal clinics and simultaneously initiated on antiretroviral treatment (ART). An HIV diagnosis together with the initiation of ART has an emotional impact that may influence how pregnant women ...

  7. The lived experiences of rural women diagnosed with the human ...

    African Journals Online (AJOL)

    An HIV diagnosis together with the initiation of ART has an emotional impact that may influence how pregnant women cope with pregnancy and their adherence to a treatment plan. The aim of the study was to explore the lived experiences of women diagnosed with HIV in the antenatal period in a rural area in the Eastern ...

  8. Hope as experienced in women newly diagnosed with gynaecological cancer

    DEFF Research Database (Denmark)

    Hammer, Kristianna; Mogensen, Ole; Hall, Elisabeth O C

    2009-01-01

    at a gynaecological department of a Danish university hospital. The women, aged 24-87 (median 52yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer. RESULTS: Hope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received......AIM: This article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer. METHOD: Fifteen women were interviewed the day they were receiving the diagnosis...... cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being...

  9. Prolonged job strain and subsequent risk of cancer in women

    DEFF Research Database (Denmark)

    Vesterlund, Gitte K.; Høeg, Beverley L.; Johansen, Christoffer

    2017-01-01

    busyness and speed, and low control in both 1993 and 1999. Information on cancer diagnosis was obtained from the Danish Cancer Registry. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for overall cancer as well as subgroups of virus immune-related, hormone......Background: The role of psychological stress in cancer risk is continuously debated. Stress at work is the most common form of stress and previous studies have shown inconsistent results regarding cancer risk. In this longitudinal study, we examined the association between prolonged job strain...... across six years and subsequent cancer risk. Methods and materials: We used data from 6571 cancer-free women from the Danish Nurse Cohort aged 45–70 years at inclusion, and self-reported questionnaires on job strain at baseline in 1993 and again in 1999. Prolonged job strain was defined as high job...

  10. Smoking and mortality in women diagnosed with breast cancer

    DEFF Research Database (Denmark)

    Sollie, Martin; Bille, Camilla

    2017-01-01

    Background: It is evident that smoking is causing disease and increased mortality in general. Recently published data are now suggesting that smoking might increase both the overall mortality in women diagnosed with breast cancer but also increase their risk of dying from their breast cancer. Met...

  11. [Frequent nursing diagnoses and interventions for women under critical care].

    Science.gov (United States)

    Oliveira, Mirna Fontenele de; Freitas, Maria Célia de

    2009-01-01

    This study aimed at identifying the most frequent Nursing Diagnoses and propose interventions for women under critical care into a maternal intensive care unit in a public hospital in Fortaleza, CE, Brazil. Retrospective study conducted with women's hospital health records. Ten Nursing Diagnoses were elaborated, being four risk: risk of infection, risk of unbalance of liquids volume, risk of aspiration, risk of damaged skin integrity and six real: altered maternity, impaired physical mobility, anxiety and impaired verbal communication. For the referred Nursing Diagnoses, nursing interventions are proposed according to the link between NANDA, NIC and NOC. It was concluded that the use of ND is a necessary technology for the Nursing reality, as it makes possible the integral care.

  12. GAD65 autoantibodies in women with gestational or insulin dependent diabetes mellitus diagnosed during pregnancy

    DEFF Research Database (Denmark)

    Petersen, J S; Dyrberg, Torben Bech; Damm, P

    1996-01-01

    We have studied the presence of GAD65 autoantibodies in women with insulin-dependent diabetes mellitus (IDDM) (n = 28) or gestational diabetes (GDM) (n = 139) diagnosed during pregnancy and investigated the temporal relationship between these autoantibodies and the subsequent recurrence or develo......We have studied the presence of GAD65 autoantibodies in women with insulin-dependent diabetes mellitus (IDDM) (n = 28) or gestational diabetes (GDM) (n = 139) diagnosed during pregnancy and investigated the temporal relationship between these autoantibodies and the subsequent recurrence...... positive GDM patients subsequently developed IDDM after a median of 14 months (range 4-34). GAD65 autoantibodies were present in 50% (14 of 28) of sera from women with IDDM diagnosed during pregnancy. The non-insulin-requiring remission period was significantly shorter in GAD65 autoantibody positive...... patients (median 0.5 years [range 0-6.0 years]) than in GAD65 antibody negative patients (median 2.6 years; range 0-9.7 years; p pregnancy may be useful for predicting the clinical course...

  13. Smoking and mortality in women diagnosed with breast cancer

    DEFF Research Database (Denmark)

    Sollie, Martin; Bille, Camilla

    2017-01-01

    Background: It is evident that smoking is causing disease and increased mortality in general. Recently published data are now suggesting that smoking might increase both the overall mortality in women diagnosed with breast cancer but also increase their risk of dying from their breast cancer....... Methods: A systematic review and meta-analysis on smoking status in women diagnosed with breast cancer, their mortality rate and cause of death. Based on all cohort studies published within the last ten years. Results: Twelve studies met our inclusion criteria, and 400,944 women diagnosed with primary...... invasive breast cancer was included. Hazard ratio (HR) for breast cancer associated death in former smokers was 1.02 (0.93, 1.12) and for current smokers 1.28 (1.17, 1.41) when compared to never smokers. For all-cause death, the HR for former smokers was 1.12 (1.04, 1.19), and for current smokers 1.52 (1...

  14. Normative identity construction among women diagnosed with a gambling disorder.

    Science.gov (United States)

    Gavriel-Fried, Belle; Peled, Einat; Ajzenstadt, Mimi

    2015-03-01

    Women with a gambling problem bear a negative social stigma. Based on the theory of symbolic interactionism, this study examined the construction of social identities by 17 Israeli women diagnosed with a gambling disorder. Interpretive interactionist analysis revealed how they construct their identity through correspondence with patterns of behavior that are perceived as normative, and identified 3 major themes: "I'm not actually a gambler" (the presentation of a multidimensional identity comprising other identities besides that of a gambler); "Staying normative during gambling"; and "I have changed" (reformed gamblers' presentation of themselves as having changed for the better). The findings underscore the complex dialogue behind the identity construction put forward by women with a gambling problem, their yearning to be perceived by society as normative women and to fit in despite their stigmatized behavior, and the tension they feel in society's relationship toward them. The findings also suggest that practitioners who work with women gamblers may want to pay attention to the power relations shaping identity construction in an interview setting, and look more closely at the women's awareness of the stigma they bear and the complex processes that make up their multidimensional identity. (c) 2015 APA, all rights reserved).

  15. Stalking Victimization among College Women and Subsequent Help-Seeking Behaviors

    Science.gov (United States)

    Buhi, Eric R.; Clayton, Heather; Surrency, Heather Hepler

    2009-01-01

    Objective: The authors examined the incidence of stalking victimization and subsequent help-seeking behaviors among college women. Participants and Methods: A stratified random sample of college women (N = 391) completed an anonymous Internet-based questionnaire in spring 2006. Results: One-fifth of women reported stalking victimization while…

  16. The lived experiences of rural women diagnosed with the human ...

    African Journals Online (AJOL)

    2017-09-26

    92, DOI: ... Although the participants had to accept the harsh reality of being diagnosed with HIV and experienced loneliness and the support of only a few ..... thoughts, the feelings of isolation and the fear from loved ones.

  17. Psychological distress and cognitive coping in pregnant women diagnosed with cancer and their partners

    NARCIS (Netherlands)

    Vandenbroucke, Tineke; Han, Sileny N; Van Calsteren, Kristel; Wilderjans, Tom F; Van den Bergh, B.R.H.; Claes, Laurence; Amant, Frédéric

    2017-01-01

    Objective: A cancer diagnosis during pregnancy may be considered as an emotional challenge for pregnant women and their partners. We aimed to identify women and partners at risk for high levels of distress based on their coping profile. Methods: Sixty-one pregnant women diagnosed with cancer and

  18. Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer.

    Science.gov (United States)

    Landmark, Bjorg T; Wahl, Astrid

    2002-10-01

    The aim of this qualitative study was to describe from the perspective of 10 women (aged 39-69 years), their experience of living with breast cancer. Although there is increasing research into a variety of aspects associated with breast cancer, there is a continuing need for research to increase nurses' understanding of how women experience living with newly diagnosed breast cancer. Following ethical approval, open-ended interviews were analysed, using methods influenced by Grounded Theory. Verifiability and empirical grounding of the theory was established through use of the constant comparative method. Existential issues arose as an important aspect of living with newly diagnosed breast cancer. The will to live emerged as the central theme. All energy was channelled into a tenacious fight for life. Furthermore, results revealed other aspects in the women's awareness of living with breast cancer, such as their experiences in relation to emotional reactions, bodily physical changes, their female identity, meaningful activities and their social network. An understanding of how women experience their new and changed life situation is important to the support nurses give in the process of healing. Nurses need this knowledge to be better able to assist women and their families in their development of coping strategies.

  19. Women in special hospitals: understanding the presenting behaviour of women diagnosed with borderline personality disorder.

    Science.gov (United States)

    Wilkins, T M; Warner, S

    2001-08-01

    This paper critically examines the development of the concept of borderline personality disorder (BPD) in terms of the assumed centrality of abnormal early environments and abusive relationships. It is suggested that if BPD is conceptualized as an expression of past experiences in adult life, information regarding early histories can assist in 'making sense' of later behaviour. The aim of this review therefore is to explore how histories of women diagnosed as BPD, within a High Secure Psychiatric Hospital, may facilitate an interpretation of the 'adaptive' nature of presenting 'symptomology'. Case note material is utilized to gain insight into specific aspects of childhood experiences that have been documented, and are thus deemed significant. These findings support the perception that the role of the early environment and associated relationships are significant within written accounts of women diagnosed as having BPD. By exploring the links between trauma and BPD, this article suggests that an understanding of the effects of trauma and the importance of relationships can offer a way forward for self-reflection and future care.

  20. The relationship between age at drinking onset and subsequent binge drinking among women

    DEFF Research Database (Denmark)

    Eliasen, Marie; Kaer, Susanne K; Munk, Christian

    2009-01-01

    BACKGROUND: To examine the association between age at drinking onset and subsequent binge drinking, and to examine whether there are differences in this association between four countries. METHODS: The data consisted of 68,539 women aged 18-47 years randomly selected from the general population i...

  1. Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Gilså Hansen, Dorte; Mariet, Hagedoorn,

    Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial.......Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial....

  2. Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Gilså Hansen, Dorte; Hariet, Hagedoorn,

    Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial......Hand-in-Hand. Psychological Intervention for Women Newly Diagnosed with Cancer and their Partners. A Randomized Controlled Trial...

  3. Long-term trajectories of psychological adaptation among women diagnosed with gynecological cancers.

    Science.gov (United States)

    Manne, Sharon; Rini, Christine; Rubin, Stephen; Rosenblum, Norman; Bergman, Cynthia; Edelson, Mitchell; Hernandez, Enrique; Carlson, John; Rocereto, Thomas

    2008-07-01

    Women diagnosed with gynecological cancers may cope with a difficult treatment regimen that includes multiple abdominal surgeries and courses of chemotherapy and/or radiation. Little attention has been paid to identifying what factors place women at risk for long-term problems with psychological adaptation. The goal of the present study was to identify a set of demographic, medical, and predisposing factors as well as cognitive and social processing strategies that predict the trajectory of psychological distress and well-being among women diagnosed with gynecological cancer. One hundred thirteen women on active treatment for gynecological cancer completed measures at baseline, 3, 6, and 9 months afterward. Women with poorer physician-rated performance status and self-reported functional impairment, women who were Caucasian, women who have received previous psychological treatments, women who were less expressive of positive emotions, women who had unsupportive friends and family, and women who were less able to find something positive in the cancer experience reported poorer adaptation. This study identified a set of risk factors for poor long-term psychological adaptation among women diagnosed with gynecological cancers. Healthcare professionals working with these women can use these risk factors to screen for patients who may require additional psychological services.

  4. Diagnostic delay, quality of life and patient satisfaction among women diagnosed with endometrial or ovarian cancer

    DEFF Research Database (Denmark)

    Robinson, Kirstine M; Christensen, Karl Bang; Ottesen, Bent

    2012-01-01

    This study investigates the association between diagnostic delay (total delay), quality of life (QoL) and patient satisfaction, and the associations between QoL and patient satisfaction scores and survival for women diagnosed with ovarian or endometrial cancer.......This study investigates the association between diagnostic delay (total delay), quality of life (QoL) and patient satisfaction, and the associations between QoL and patient satisfaction scores and survival for women diagnosed with ovarian or endometrial cancer....

  5. Psychological distress among women with newly diagnosed breast cancer

    DEFF Research Database (Denmark)

    Mertz, Birgitte; Bistrup, Pernille Envold; Johansen, Christoffer

    2012-01-01

    PURPOSE: Psychological distress is common in the cancer continuum. Our objectives were to determine the prevalence of distress and to investigate the related problems and the characteristics of women with breast cancer who experienced psychological distress at the time of diagnosis. METHODS: We...... thermometer' to measure psychological distress and the accompanying 'problem list' to identify related problems. Logistic regression models with 95% confidence intervals were used to estimate the associations between psychological distress, age, social support and domains on the problem list. RESULTS...

  6. Human papillomavirus (HPV) vaccination and subsequent sexual behaviour: Evidence from a large survey of Nordic women

    DEFF Research Database (Denmark)

    Hansen, Bo T.; Kjaer, Susanne K.; Arnheim-Dahlstrom, Lisen

    2014-01-01

    OBJECTIVE: To assess whether recipients and non-recipients of the human papillomavirus (HPV) vaccine subsequently differ in terms of sexual risk taking behaviour. DESIGN: Cross-sectional survey. Sequential analyses constructed from self-reported age at vaccination, age at first intercourse and age...... received the HPV vaccine before or at the same age as sexual debut versus women who did not receive the HPV vaccine. RESULTS: HPV vaccination did not result in younger age at first intercourse. Women who received the HPV vaccine before or at the same age as sexual debut did not have more sexual partners...... than did non-vaccinees. Non-use of contraception during first intercourse was more common among non-vaccinees than among HPV vaccinees. The results were similar for organized catch-up and opportunistic vaccinees. CONCLUSION: Women who received the HPV vaccine before or at the same age as sexual debut...

  7. The experiences and perceptions of women diagnosed with breast cancer during pregnancy

    Directory of Open Access Journals (Sweden)

    Sophie Rees

    2016-01-01

    Full Text Available Objective: Although much has been documented about the experience of breast cancer, the accounts of young women have been relatively neglected, despite that around 20% of the breast cancer diagnoses occur in women under the age of 50. In particular, the voices of young women diagnosed during pregnancy are missing from research. Breast cancer is the most common cancer associated with pregnancy, and it is diagnosed in about 1 in 3000 pregnancies. Methods: This study presents data from three women drawn from a larger study of women who had been diagnosed under the age of 45 and had completed their treatment for breast cancer. Semi-structured qualitative interviews were undertaken, with a methodology informed by social constructionist grounded theory and feminism. Results: The findings here report the ways that having breast cancer during pregnancy disrupted taken-for-granted assumptions about their pregnancies, new motherhood, and their future life course, and how this occurred within the context of gendered ideas about femininity and motherhood. Conclusions: Breast cancer during pregnancy has a far-reaching impact on young women's lives, and women affected may need practical support in caring for young children, and counselling may be appropriate. Further research is needed in this important area.

  8. Height Loss Predicts Subsequent Hip Fracture in Men and Women of the Framingham Study

    Science.gov (United States)

    Hannan, Marian T.; Broe, Kerry E.; Cupples, L. Adrienne; Dufour, Alyssa B.; Rockwell, Margo; Kiel, Douglas P.

    2013-01-01

    Background Although height is a risk factor for osteoporotic fracture, current risk assessments do not consider height loss. Height loss may be a simple measurement that clinicians could use to predict fracture or need for further testing. Objective To examine height loss and subsequent hip fracture, evaluating both long-term adult height loss and recent height loss. Methods Prospective cohort of 3,081 adults from the Framingham Heart Study. Height was measured biennially since 1948, and cohort followed for hip fracture through 2005. Adult height loss from middle-age years across 24 years and recent height loss in elderly years were considered. Cox proportional hazard regression was used to estimate association between height loss and risk of hip fracture. Results Of 1,297 men and 1,784 women, mean baseline age was 66y (SD7.8). Average height loss for men was 1.06 inches (0.76), and for women was 1.12 inches (0.84). 11% of men and 15% of women lost ≤ 2 inches of height. Mean follow-up was 17y during which 71 men and 278 women had incident hip fractures. For each 1-inch of height loss, HR=1.4 in men (95%CI: 1.00, 1.99), and 1.04 in women (95%CI: 0.88, 1.23). Men and women who lost ≤ 2 inches of height had increased fracture risk (compared to 0 to height loss in elders significantly increased the risk of hip fracture, 54% in men and 21% in women (95%CI: 1.14, 2.09; 1.03, 1.42, respectively). Conclusions Adult height loss predicted hip fracture risk in men in our study. Recent height loss in elderly men and women predicted risk of hip fracture. PMID:22072590

  9. Outcome of pregnancy in women diagnosed with idiopathic polyhydramnios.

    Science.gov (United States)

    Khan, Sarwat; Donnelly, Jennifer

    2017-02-01

    Polyhydramnios is present in approximately 2% of pregnancies and it has been associated with a variety of adverse pregnancy outcomes. The aim of our study was to evaluate the association between polyhydramnios and adverse pregnancy outcomes. This was a retrospective case control study of 288 singleton pregnancies delivered in the Rotunda Hospital, Dublin, between 2013 and 2014. Polyhydramnios was defined as: (i) amniotic fluid index (AFI) ≥ 25 cm; (ii) maximal vertical pocket (MVP) of ≥8 cm; and (iii) a gestational age-specific threshold for AFI. Demographic information, obstetric and neonatal outcomes were obtained by review of hospital databases. Exclusion criteria included gestational or pre-existing diabetes, multiple pregnancy, carrying a fetus with structural or chromosomal abnormalities, Rhesus factor isoimmunisation, and TORCH screen positive. Outcomes were compared with outcomes of those without polyhydramnios. A total of 8798 deliveries occurred during the study period. The frequency of polyhydramnios was 1.6%. One hundred and forty-four women were selected in each group. There was no significant difference in preterm deliveries, low birth weight, low Apgar score at one minute and five minutes and perinatal mortality. However, increase in caesarean delivery rate (43.1% vs 21.5%), number of fetal distresses (17.4% vs 6.9%) and number of neonatal intensive care unit (NICU) admissions (17.4% vs 4.9%) were observed in our study. In conclusion, idiopathic polyhydramnios is associated with specific adverse outcomes, such as higher rate of caesarean delivery, fetal distress and NICU admissions. Therefore, close surveillance of these pregnancies is required, especially near term. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Fish consumption and subsequent change in body weight in European women and men

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; Dethlefsen, Claus; Due, Karen M

    2013-01-01

    Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish...... consumption and subsequent change in body weight. Women and men (n 344 757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5·0 years. Linear and logistic regression were used to investigate the associations between fish consumption...... and subsequent change in body weight. Among women, the annual weight change was 5·70 (95 % CI 4·35, 7·06), 2·23 (95 % CI 0·16, 4·31) and 11·12 (95 % CI 8·17, 14·08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal...

  11. Hope pictured in drawings by women newly diagnosed with gynecological cancer

    DEFF Research Database (Denmark)

    Hammer, Kristianna; Hall, Elisabeth; Mogensen, Ole

    2013-01-01

    BACKGROUND:: In mysterious ways, hope makes life meaningful even in chaotic and uncontrolled situations. When a woman is newly diagnosed with gynecologic cancer, hope is ineffable and needs exploring. Drawings help express ineffable phenomena. OBJECTIVE:: The aim of the study was to explore how...... women newly diagnosed with gynecologic cancer express the meaning of hope in drawings. METHOD:: Participants were 15 women who on the same day had received the diagnosis of gynecologic cancer. They were between 24 and 87 years (median, 52 years) with a variety of gynecologic cancer diagnoses. Data from...... through metaphors and incorporates internal, external, and relational aspects. With other words, inner willpower, experiences in open nature, and closeness to loved ones contribute to hope when newly diagnosed with gynecologic cancer. IMPLICATION FOR PRACTICE:: The use of drawings in clinical situations...

  12. Symptomatic menopausal transition and subsequent bipolar disorder among midlife women with major depression: a nationwide longitudinal study.

    Science.gov (United States)

    Chen, Li-Chi; Yang, Albert C; Su, Tung-Ping; Bai, Ya-Mei; Li, Cheng-Ta; Chang, Wen-Han; Chen, Tzeng-Ji; Tsai, Shih-Jen; Chen, Mu-Hong

    2017-06-01

    Previous studies suggested that menopausal transition played an important role in the clinical course of major depression and bipolar disorder. However, the role of symptomatic menopausal transition in diagnostic conversion from major depression to bipolar disorder was still unknown. Using the Taiwan National Health Insurance Research Database, 50,273 midlife women aged between 40 and 60 years in 2002∼2008 with major depression were enrolled in our study and divided into two subgroups based on the presence (n = 21,120) or absence (n = 29,153) of symptomatic menopausal transition. Subjects who had subsequent bipolar disorder during the follow-up were identified. Midlife women with major depression and symptomatic menopausal transition had a higher incidence of the diagnostic conversion to bipolar disorder (7.3 vs. 6.6%, p = 0.003) than those with major depression alone. Cox regression analysis after adjusting for demographic data and psychiatric comorbidities further showed that symptomatic menopausal transition was associated with an increased risk of developing bipolar disorder (HR 1.14, 95% CI 1.07∼1.23) among midlife women with major depression. Sensitivity test after excluding the 1-year and 3-year observation exhibited the consistent findings (HR 1.18, 95% CI 1.09∼1.28; HR 1.20, 95% CI 1.08∼1.34). Midlife women with the dual diagnoses of major depression and symptomatic menopausal transition had an increased risk of the diagnostic conversion to bipolar disorder compared to those with major depression alone. Further studies may be required to investigate the underlying mechanisms among menopausal transition and the diagnostic conversion from major depression to bipolar disorder.

  13. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H

    2009-01-01

    OBJECTIVE: To assess the diagnostic value of transvaginal sonographic (TVS) measurement of endometrial thickness for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding (AUB). METHODS: A random selection from the Danish Civil Registration System was made: 1660 women...... of endometrial thickness is a poor diagnostic test, but is apparently efficacious in excluding focal intrauterine pathology, especially in postmenopausal women. The 4-5-mm threshold conventionally used to exclude endometrial malignancy in women with postmenopausal bleeding is not transferable to women without...... aged 20-74 years were invited to participate and 686 women were eligible and accepted inclusion (429 pre- and 257 postmenopausal). The women underwent TVS measurement of endometrial thickness and saline contrast sonohysterography (SCSH). Hysteroscopic resection with histopathology (gold standard...

  14. Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada.

    Science.gov (United States)

    Shen, G X; Shafer, L A; Martens, P J; Sellers, E; Torshizi, A A; Ludwig, S; Phillips-Beck, W; Heaman, M; Prior, H J; McGavock, J; Morris, M; Dart, A B; Campbell, R; Dean, H J

    2016-09-01

    Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, gestational diabetes and the development of subsequent diabetes among mothers remains unclear. After excluding known pre-existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post-partum diabetes among women in Manitoba (1981-2011) via a historical prospective cohort database study. We analysed administrative data in the Population Health Research Data Repository using Kaplan-Meier survival analysis and Cox proportional hazards regression. Gestational diabetes was diagnosed in 11 906 of 404 736 deliveries (2.9%), 6.7% of FN and 2.2% of non-FN pregnant women (P women than among non-FN women (P women with gestational diabetes within the follow-up period. The hazard ratio of gestational diabetes for post-partum diabetes was 10.6 among non-FN women and 5.4 among FN women. Other factors associated with a higher risk of diabetes included lower family income among FN and non-FN women and rural/remote residences among FN women. Among non-FN women, urban residence was associated with a higher risk of diabetes. Gestational diabetes increases post-partum diabetes in FN and non-FN women. FN women had substantially more gestational diabetes or post-partum diabetes than non-FN women, partially due to socio-economic and environmental barriers. Reductions in gestational diabetes and socio-economic inequalities are required to prevent diabetes in women, particularly in FN population. © 2015 Diabetes UK.

  15. Low prevalence of laboratory-confirmed malaria in clinically diagnosed adult women from the Wakiso district of Uganda.

    Science.gov (United States)

    Yegorov, Sergey; Galiwango, Ronald M; Ssemaganda, Aloysious; Muwanga, Moses; Wesonga, Irene; Miiro, George; Drajole, David A; Kain, Kevin C; Kiwanuka, Noah; Bagaya, Bernard S; Kaul, Rupert

    2016-11-14

    The malaria burden in sub-Saharan Africa (SSA) has fallen substantially. Nevertheless, malaria remains a serious health concern, and Uganda ranks third in SSA in total malaria burden. Epidemiological studies of adult malaria in Uganda are scarce and little is known about rates of malaria in non-pregnant adult women. This pilot study assessed malaria prevalence among adult women from Wakiso district, historically a highly malaria endemic region. Adult women using public health services were screened for malaria, HIV and pregnancy. A physician-selected subset of women presenting to the Outpatient Department of Entebbe General Hospital (EGH) with current fever (axillary temperature ≥37.5 °C) or self-reporting fever during the previous 24 h, and a positive thick smear for malaria in the EGH laboratory were enrolled (n = 86). Women who self-identified as pregnant or HIV-positive were excluded from screening. Malaria infection was then assessed using HRP2/pLDH rapid diagnostic tests (RDTs) in all participants. Repeat microscopy and PCR were performed at a research laboratory for a subset of participants. In addition, 104 women without a history of fever were assessed for asymptomatic parasitaemia using RDT, and a subset of these women screened for parasitaemia using microscopy (40 women) and PCR (40 women). Of 86 women diagnosed with malaria by EGH, only two (2.3%) had malaria confirmed using RDT, subsequently identified as a Plasmodium falciparum infection by research microscopy and PCR. Subset analysis of hospital diagnosed RDT-negative participants detected one sub-microscopic infection with Plasmodium ovale. Compared to RDT, sensitivity, specificity and PPV of hospital microscopy were 100% (CI 19.8-100), 0% (CI 0-5.32) and 2.33% (CI 0.403-8.94) respectively. Compared to PCR, sensitivity, specificity and PPV of hospital microscopy were 100% (CI 31.0-100), 0% (CI 0-34.5) and 23.1% (CI 6.16-54.0), respectively. No malaria was detected among asymptomatic women

  16. The lived experiences of rural women diagnosed with the human immunodeficiency virus in the antenatal period.

    Science.gov (United States)

    Fords, Genevieve Marion; Crowley, Talitha; van der Merwe, Anita S

    2017-12-01

    In South Africa, pregnant women are diagnosed with human immunodeficiency virus (HIV) at antenatal clinics and simultaneously initiated on antiretroviral treatment (ART). An HIV diagnosis together with the initiation of ART has an emotional impact that may influence how pregnant women cope with pregnancy and their adherence to a treatment plan. The aim of the study was to explore the lived experiences of women diagnosed with HIV in the antenatal period in a rural area in the Eastern Cape province of South Africa. A qualitative approach with a descriptive phenomenological design was utilised. The study applied purposive sampling to select participants from a local community clinic in the Eastern Cape. Ten semistructured interviews were conducted, transcribed and analysed using Colaizzi's framework. Four themes formed the essential structure of the phenomenon being investigated: a reality that hits raw, a loneliness that hurts, hope for a fractured tomorrow and support of a few. Although the participants had to accept the harsh reality of being diagnosed with HIV and experienced loneliness and the support of only a few people, they had hope to live and see the future of their children. Women diagnosed with HIV during pregnancy are ultimately concerned with the well-being of their unborn children, and this concern motivates their adherence to ART. Women's lived experiences are situated in their unique sociocultural context, and although some known challenges remain, counselling and support strategies need to be informed by exploring context-specific issues and involving the local community.

  17. Oxidative stress and antioxidant status in women with gestational diabetes mellitus diagnosed by IADPSG criteria.

    Science.gov (United States)

    Shang, Min; Zhao, Junpeng; Yang, Lei; Lin, Li

    2015-08-01

    The relationship between oxidative stress and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria diagnosed gestational diabetes mellitus GDM isn't well known. Our aim is to evaluate the oxidative stress in women diagnosed by the IADPSG criteria versus the American Diabetes Association (ADA) criteria in China. Malondialdehyde (MDA), 8-isoprostane (8IsoP), xanthine oxidize (XO), lipid peroxides (LPO), superoxide dismutase (SOD), glutathione peroxidase (GPX), total antioxidant capacity (TAC), vitamin C (Vc) and vitamins E (Ve) were determined in maternal and cord plasma and placenta of 68 pregnant women. Among these, 28 were diagnosed with GDM while the other 40 were controls. The maternal, cord and placental MDA, XO and 8IsoP levels were significantly higher while SOD and TAC levels were significantly lower in GDM women by either criterion (P stress is present in women diagnosed by IADPSG but to a lesser degree than by ADA. All these women should be monitored and perhaps antioxidant supplemented. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan, Malaysia.

    Science.gov (United States)

    Yusuf, Azlina; Ahmad, Zulkifli; Keng, Soon Lean

    2013-01-01

    Breast cancer is the leading cause of cancer-related death among women in Malaysia. A diagnosis is very stressful for women, affecting all aspects of their being and quality of life. As such, there is little information on quality of life of women with breast cancer across the different ethnic groups in Malaysia. The purpose of this study was to examine the quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan. A descriptive study involved 58 Malays and 15 Chinese women newly diagnosed with breast cancer prior to treatment. Quality of life was measured using the Malay version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast-specific module (QLQ-BR23). Socio-demographic and clinical data were also collected. All the data were analyzed using SPSS version 20.0. Most of the women were married with at least a secondary education and were in late stages of breast cancer. The Malay women had lower incomes (p=0.046) and more children (p=0.001) when compared to the Chinese women. Generally, both the Malay and Chinese women had good functioning quality-of-life scores [mean score range: 60.3-84.8 (Malays); 65.0-91.1 (Chinese)] and global quality of life [mean score 60.3, SD 22.2 (Malays); mean score 65.0, SD 26.6 (Chinese)]. The Malay women experienced more symptoms such as nausea and vomiting (p=0.002), dyspnoea (p=0.004), constipation (p<0.001) and breast-specific symptoms (p=0.041) when compared to the Chinese. Quality of life was satisfactory in both Malays and Chinese women newly diagnosed with breast cancer in Kelantan. However, Malay women had a lower quality of life due to high general as well as breast-specific symptoms. This study finding underlined the importance of measuring quality of life in the newly diagnosed breast cancer patient, as it will provide a broader picture on how a cancer diagnosis impacts multi-ethnic patients. Once health care

  19. Cardiometabolic risk after weight loss and subsequent weight regain in overweight and obese postmenopausal women.

    Science.gov (United States)

    Beavers, Daniel P; Beavers, Kristen M; Lyles, Mary F; Nicklas, Barbara J

    2013-06-01

    Little is known about the effect of intentional weight loss and subsequent weight regain on cardiometabolic risk factors in older adults. The objective of this study was to determine how cardiometabolic risk factors change in the year following significant intentional weight loss in postmenopausal women, and if observed changes were affected by weight and fat regain. Eighty, overweight and obese, older women (age = 58.8±5.1 years) were followed through a 5-month weight loss intervention and a subsequent 12-month nonintervention period. Body weight/composition and cardiometabolic risk factors (blood pressure; total, high-density lipoprotein, and low-density lipoprotein cholesterol; triglycerides; fasting glucose and insulin; and Homeostatic Model Assessment of Insulin Resistance) were analyzed at baseline, immediately postintervention, and 6- and 12-months postintervention. Average weight loss during the 5-month intervention was 11.4±4.1kg and 31.4% of lost weight was regained during the 12-month follow-up. On average, all risk factor variables were significantly improved with weight loss but regressed toward baseline values during the year subsequent to weight loss. Increases in total cholesterol, triglycerides, glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance during the postintervention follow-up were significantly (p weight and fat mass regain. Among women who regained weight, model-adjusted total cholesterol (205.8±4.0 vs 199.7±2.9mg/dL), low-density lipoprotein cholesterol (128.4±3.4 vs 122.7±2.4mg/dL), insulin (12.6±0.7 vs 11.4±0.7mg/dL), and Homeostatic Model Assessment of Insulin Resistance (55.8±3.5 vs 50.9±3.7mg/dL) were higher at follow-up compared with baseline. For postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile.

  20. Fanconi anemia in brothers initially diagnosed with VACTERL association with hydrocephalus, and subsequently with Baller-Gerold syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rossbach, H.C.; Granan, N.H.; Rossi, A.R.; Barbosa, J.L. [Univ. of South Florida, St. Petersburg, FL (United States)] [and others

    1996-01-02

    Two brothers with presumed Baller-Gerold syndrome, one of whom was previously diagnosed with the association of vertebral, cardiac, renal, limb anomalies, anal atresia, tracheo-esophageal fistula (VACTERL) association with hydrocephalus, were evaluated for chromosome breakage because of severe thrombo cytopenia in one of them. Spontaneous and clastogen-induced breakage was markedly increased in both patients as compared to control individuals. Clinical manifestations and chromosome breakage, consistent with Fanconi anemia, in patients with a prior diagnosis of either Baller-Gerold syndrome, reported earlier in one other patient, or with VACTERL association with hydrocephalus, recently reported in 3 patients, underline the clinical heterogeneity of Fanconi anemia and raise the question of whether these syndromes are distinct disorders or phenotypic variations of the same disease. 12 refs., 3 figs., 1 tab.

  1. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy.

    Science.gov (United States)

    Traylor, Jessica; Chandrasekaran, Suchitra; Limaye, Meghana; Srinivas, Sindhu; Durnwald, Celeste P

    2016-01-01

    The objective of this study is to evaluate a woman's risk perception for future cardiovascular disease (CVD) after being diagnosed with a hypertensive disorder of pregnancy. A prospective cohort of women diagnosed with a hypertensive disorder of pregnancy (HDP) was studied. Each woman completed two surveys, one prior to hospital discharge and one 2 weeks later, designed to assess knowledge of and risk perception for future CVD based on their recent diagnosis of a HDP. Rates of postpartum depression were also assessed. Of the 146 subjects included, 28% were diagnosed with preeclampsia with severe features, 52.1% with preeclampsia with mild features, and 19.9% had chronic hypertension. Women with severe features and those delivering preterm were more likely to report a perception of increased risk of both recurrent HDP in a future pregnancy (p = 0.004 and 0.005, respectively) and hypertension later in life (p = 0.01 and 0.03, respectively). Women delivering preterm were more likely to report an accurate perception of increased risk of myocardial infarction and stroke compared to those delivering at term (p = 0.006 and 0.002, respectively). Disease severity and preterm delivery were associated with a higher likelihood of the perception of an increased risk for both recurrent HDP and hypertension in the future. Only preterm delivery was associated with a higher risk perception for stroke and myocardial infarction. Interventions targeted at improved health awareness in women diagnosed with HDP are warranted.

  2. Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer

    Directory of Open Access Journals (Sweden)

    Rock Cheryl L

    2006-03-01

    Full Text Available Abstract Background The criterion-related validity and measurement bias of the long form of the International Physical Activity Questionnaire (IPAQ was compared to the 7-Day Physical Activity Recall (PAR. Methods Participants were women who have been diagnosed with breast cancer and enrolled in the ongoing Women's Healthy Eating and Living Study. Women (N = 159, average age 57 years wore an accelerometer for one week and then completed the IPAQ or the PAR. Results The validity correlation of the PAR was significantly higher (p Conclusion The PAR was superior to the IPAQ in terms of validity, measurement bias, and screening statistics.

  3. Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer

    Science.gov (United States)

    Johnson-Kozlow, Marilyn; Sallis, James F; Gilpin, Elizabeth A; Rock, Cheryl L; Pierce, John P

    2006-01-01

    Background The criterion-related validity and measurement bias of the long form of the International Physical Activity Questionnaire (IPAQ) was compared to the 7-Day Physical Activity Recall (PAR). Methods Participants were women who have been diagnosed with breast cancer and enrolled in the ongoing Women's Healthy Eating and Living Study. Women (N = 159, average age 57 years) wore an accelerometer for one week and then completed the IPAQ or the PAR. Results The validity correlation of the PAR was significantly higher (p ACSM physical activity guideline. Conclusion The PAR was superior to the IPAQ in terms of validity, measurement bias, and screening statistics. PMID:16579852

  4. Prevalence of Known Risk Factors in Women Diagnosed with Breast Cancer at Inmol Hospital, Lahore, Punjab.

    Science.gov (United States)

    Mansha, Muhammad; Saleem, Maryam; Wasim, Muhammad; Tariq, Muhammad

    2016-01-01

    Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (≤46) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (risk category.

  5. Improving self-esteem in women diagnosed with Turner syndrome: results of a pilot intervention.

    Science.gov (United States)

    Chadwick, Paul M; Smyth, Arlene; Liao, Lih-Mei

    2014-06-01

    To evaluate a brief intervention to improve the self esteem of women diagnosed with Turner syndrome (TS). Prospective observational study. Turner Syndrome Support Society, UK. 30 women aged 18-60 years. A 1-day psychology workshop targeting problems of self-esteem in women diagnosed with TS. The workshop drew on cognitive-behavioral therapy and narrative therapy skills and emphasized increased self-awareness of interpersonal difficulties and improved capacity for self-management. Rosenberg Self-esteem Scale (RSS); Hospital Anxiety and Depression Scale (HADS); bespoke user experiences questionnaire. All 30 women provided baseline data, 27/30 provided immediate post-intervention data and 22/30 provided follow-up data at 3 months. The intervention improved RSS and HADS scores at 3 months. Generic skills-based psychological interventions have the potential to be adapted to provide brief and low-cost interventions to improve self-esteem and reduce psychological distress in women diagnosed with TS. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. Prognosis for women diagnosed with melanoma during, before, or after pregnancy: Weighing the evidence

    Directory of Open Access Journals (Sweden)

    Sarah P. Todd

    2017-03-01

    Full Text Available Approximately one third of women who are diagnosed with malignant melanoma are of childbearing age. Therefore, it is not surprising that some studies have found malignant melanoma to be one of the most common malignancies diagnosed in pregnant women. The impact of pregnancy-related hormonal changes on melanoma development and progression remains controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. Additionally, hormone receptors are found on some melanomas. Unfortunately, many of the past and even recent studies that have been published and are reviewed herein did not uniformly use appropriate control groups, account for confounding covariates, or employ appropriate statistical analysis, which makes it difficult to rely on the conclusions they reach. However, a review of the better controlled and preponderant studies demonstrates that pregnancy-associated melanomas are not associated with a poorer prognosis.

  7. Experiences of Batswana women diagnosed with both HIV/AIDS and cervical cancer

    Directory of Open Access Journals (Sweden)

    T. Molefe

    2009-09-01

    Full Text Available The central phenomenon of interest to the authors was the experiences of Batswana women who have been diagnosed with both HIV/AIDS and cervical cancer. They wanted to know how these women and their families coped with the burden of the two ‘fatal’ diseases. This interest was brought about by the current surge in cervical cancer cases in the country, and the relationship between the two diseases. There is scant literature on the experiences of women with the dual diagnosis of HIV/AIDS and cervical cancer. The purpose of the study was to explore the experiences of Batswana women who are diagnosed with both HIV/AIDS and cervical cancer. The research question was ‘What are the experiences of Batswana women diagnosed with both HIV/AIDS and cervical cancer?’ A phenomenological descriptive qualitative research design was therefore appropriate to answer the research question.Semi-structured interviews and field notes were used to collect data. One-to-one interviews were conducted with six women diagnosed with the two diseases. Both convenience and purposive sampling techniques were used in selection of participants. The seven procedural steps proposed by Collaizi (1978 were utilized in data analysis as the study was based on the phenomenology approach. The findings revealed that HIV/AIDS and cervical cancer are chronic illnesses that can instill chronic emotional pain. Reactions to diagnosis with these diseases include pain, fear or intense sadness. Coping with these conditions can be facilitated by different strategies such as acceptance, having hope, support from others and positive thinking. Support can come from children, family members, informal or formal groups and health service providers.

  8. Emotional suppression and depressive symptoms in women newly diagnosed with early breast cancer.

    Science.gov (United States)

    Li, Lingyan; Yang, Yanjie; He, Jincai; Yi, Jinyao; Wang, Yuping; Zhang, Jinqiang; Zhu, Xiongzhao

    2015-10-24

    Patients with breast cancer usually present varying levels of depressive symptoms. Emotional suppression, as a coping style, refers to an individual's ability to consciously control expression of negative emotions. Thus, emotional suppression is an important psychological factor related to depressive symptoms in patients with breast cancer. It has long been considered that compared to European and American women, Chinese women are more likely to ascribe to norms of negative emotion control for smooth social interaction. However, there is paucity of research focusing on emotional suppression among Chinese women with breast cancer. Thus the aims of the current study were (1) to investigate the incidence of depressive symptoms in women newly diagnosed with early breast cancer in Mainland China, and (2) to examine the relationships between emotional suppression and depressive symptoms in these patients. The Center for Epidemiological Studies Depression Scale (CES-D), the Beck Anxiety Inventory (BAI) and the Chinese version of the Courtauld Emotional Control Scale (CECS) were used to assess the level of depressive symptoms, anxiety symptoms and emotional suppression respectively in 247 women with early breast cancer and 362 healthy women. Analyses of variance were conducted to investigate group differences on depressive symptoms and emotional suppression. Bivariate correlations and Hierarchical regression analyses were performed to examine the effect of emotional suppression on depressive symptoms in participants after controlling the impact of group membership and anxiety level. (1) The incidence rates of clinical and severe depressive symptoms in patients were 36.4 and 36.0 % respectively. (2) Patients scored significantly higher than healthy women on CECS. (3) The scores on CECS were significantly associated with the total CES-D scores in all participants; Anger suppression significantly predicted the total CES-D scores. The majority of women newly diagnosed with

  9. Characteristics of and differences between Pasifika women and New Zealand European women diagnosed with breast cancer in New Zealand.

    Science.gov (United States)

    Brown, Charis; Lao, Chunhuan; Lawrenson, Ross; Tin Tin, Sandar; Schaaf, Michelle; Kidd, Jacquie; Allan-Moetaua, Anne; Herman, Josephine; Raamsroop, Reena; Campbell, Ian; Elwood, Mark

    2017-12-15

    Breast cancer in New Zealand-based Pasifika women is a significant issue. Although Pasifika women have a lower incidence of breast cancer compared to New Zealand European women, they have higher breast cancer mortality and lower five-year survival. The aim of this study was to describe the characteristics and tumour biology of Pasifika women and to compare New Zealand European women to identify what factors impact on early (Stage 1 and 2) vs advanced stage (Stage 3 and 4) at diagnosis. Data on all Pasifika and New Zealand European women diagnosed with breast cancer (C50) during the period 1 June 2000 to 31 May 2013 was extracted from the Auckland and Waikato Breast Cancer Registries. Descriptive tables and Chi-square test were used to examine differences in characteristics and tumour biology between Pasifika and New Zealand European women. Logistic regression was used to identify factors that contributed to an increased risk of advanced stage at diagnosis. A significantly higher proportion of Pasifika women had advanced disease at diagnosis compared to New Zealand European women (33.3% and 18.3%, respectively). Cancer biology in Pasifika women was more likely to be: 1) HER2+, 2) ER/PR negative and 3) have a tumour size of ≥50mm. Pasifika women live in higher deprivation areas of 9-10 compared to New Zealand European women (55% vs 14%, respectively) and were less likely to have their cancer identified through screening. Logistic regression showed that if Pasifika women were on the screen-detected pathway they had similar odds (not sig.) of having advanced disease at diagnosis to New Zealand European women. Mode of detection, deprivation, age and some biological factors contributed to the difference in odds ratio between Pasifika and New Zealand European women. For those of screening age, adherence to the screening programme and improvements in access to earlier diagnosis for Pasifika women under the current screening age have the potential to make a substantial

  10. Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses

    DEFF Research Database (Denmark)

    Rundblad, Lucas; Zwisler, Ann Dorthe; Johansen, Pernille Palm

    2017-01-01

    perceived sexual difficulties and associated factors in a mixed population of men and women newly diagnosed with heart disease and provide insight into sexual counseling and information given by health care professionals. Methods This article reports on a cross-sectional, questionnaire study sent...... (OR = 3.00, 95% CI = 1.51–5.95). A total of 48.6% of men and 58.8% of women did not feel informed about sexuality, and 18.1% of men and 10.3% of women were offered sexual counseling. Clinical Implications Heart disease increases the risk of sexual difficulties and there is a need for improved...... information and counseling about sex and relationships for patients. Strengths and Limitations This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual difficulties without...

  11. Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT)

    DEFF Research Database (Denmark)

    Schou Karlsen, Nikoline Marie; Karlsen, Mona Aarenstrup; Høgdall, Estrid

    2016-01-01

    OBJECTIVE: The aim of the study was to evaluate the rate of relapse as well as disease-free, overall, and disease-specific survival in women with borderline ovarian tumour (BOT). Furthermore, the study aims to identify the clinical parameters correlated to relapse. METHODS: National clinical data...... of women diagnosed with BOT from January 2005 to January 2013 constituted the basis for our study population. The prognostic influence of clinical variables was evaluated using univariate and multivariate analyses. RESULTS: A total of 1143 women were eligible for analysis, with 87.9% in FIGO stage I and 12...... presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. CONCLUSIONS...

  12. Health literacy and physical activity in women diagnosed with breast cancer.

    Science.gov (United States)

    Plummer, Leigh C; Chalmers, Kerry A

    2017-10-01

    Physical activity after a diagnosis of breast cancer is associated with many health benefits. Health literacy has been shown to relate to physical activity, but there is limited research on this relationship. The aim of this study was to explore the relationship between health literacy and physical activity in women diagnosed with breast cancer. Specifically, we examined which of Nutbeam's 3 levels of health literacy (functional, interactive, and critical health literacy) predicted physical activity in women who have completed treatment for breast cancer. Participants were women (N = 36) who had attended a local cancer care centre for breast cancer treatment. During a telephone interview conducted 6 to 18 months after completion of treatment, women completed a measure of health literacy and reported on their engagement in physical activity. Results showed that health literacy predicted physical activity after breast cancer treatment. Of the 3 levels of health literacy proposed by Nutbeam, functional health literacy was shown to be the most important predictor of physical activity. These findings highlight the role of health literacy in physical activity in women diagnosed with breast cancer and have implications for targeted supportive physical activity interventions. Copyright © 2016 John Wiley & Sons, Ltd.

  13. A challenge to the menopause stereotype: young Australian women's reflections of 'being diagnosed' as menopausal.

    Science.gov (United States)

    Boughton, Maureen; Halliday, Lesley

    2008-12-01

    This paper reports on a qualitative study designed to examine (i) possible explanations for difficulties young Australian women (under 40 years) encountered in the process of gaining a diagnosis of premature menopause and (ii) to address issues underpinning this aspect of menopause. Drawing on hermeneutic phenomenology, face-to-face interviews were carried out with 35 women who consented to share their experiences of 'being diagnosed' with premature menopause. The participants responded to an advertisement in a newspaper article, a radio announcement or through a menopause support centre. While all participants were located in Australia, larger numbers were from the metropolitan areas of Sydney, New South Wales, and Perth, Western Australia. This research reports that the process of finding an explanation for the physical and emotional symptoms the women were experiencing was very complex. The findings varied regarding the psychological and physical symptoms experienced, described feelings, and reasons that led to a diagnosis of menopause. This paper suggests that the age of the women and the non-specific symptoms experienced by them contributed significantly to the delay and uncertainty surrounding the experience of being diagnosed with premature menopause. There was uncertainty of the origin of symptoms, which led the women to feel as though they were 'going insane' or that it was 'all in their heads'. This frequently led to symptoms of menopause being attributed (by health professionals) to a psychiatric basis and menopause being overlooked for varying lengths of time.

  14. Decision-support networks of women newly diagnosed with breast cancer.

    Science.gov (United States)

    Wallner, Lauren P; Li, Yun; McLeod, M Chandler; Hamilton, Ann S; Ward, Kevin C; Veenstra, Christine M; An, Lawrence C; Janz, Nancy K; Katz, Steven J; Hawley, Sarah T

    2017-10-15

    Little is known about the size and characteristics of the decision-support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. A population-based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision-support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0-3 or more) was compared across patient-level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P support networks were associated with more deliberative surgical treatment decisions (P breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895-903. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Social-cognitive processes associated with fear of recurrence among women newly diagnosed with gynecological cancers.

    Science.gov (United States)

    Myers, Shannon B; Manne, Sharon L; Kissane, David W; Ozga, Melissa; Kashy, Deborah A; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norman; Morgan, Mark; Graff, John J

    2013-01-01

    This cross sectional study aimed to characterize fears of recurrence among women newly diagnosed with gynecologic cancer. The study also evaluated models predicting the impact of recurrence fears on psychological distress through social and cognitive variables. Women (N=150) who participated in a randomized clinical trial comparing a coping and communication intervention to a supportive counseling intervention to usual care completed baseline surveys that were utilized for the study. The survey included the Concerns about Recurrence Scale (CARS), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and measures of social (holding back from sharing concerns and negative responses from family and friends) and cognitive (positive reappraisal, efficacy appraisal, and self-esteem appraisal) variables. Medical data was obtained via medical chart review. Moderate-to-high levels of recurrence fears were reported by 47% of the women. Younger age (p<.01) and functional impairment (p<.01) correlated with greater recurrence fears. A social-cognitive model of fear of recurrence and psychological distress was supported. Mediation analyses indicated, that as a set, the social and cognitive variables mediated the association between fear of recurrence and both depression and cancer-specific distress. Holding back and self-esteem showed the strongest mediating effects. Fears of recurrence are prevalent among women newly diagnosed with gynecologic cancer. Social and cognitive factors play a role in women's adaptation to fears and impact overall psychological adjustment. These factors may be appropriate targets for intervention. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Modifiable risk factors and survival in women diagnosed with primary breast cancer

    DEFF Research Database (Denmark)

    Hellmann, Sophie Sell; Thygesen, Lau Caspar; Tolstrup, Janne Schurmann

    2010-01-01

    This study examines the impact of smoking, body mass index, alcohol consumption, hormone replacement therapy, and physical activity on all-cause mortality among 528 Danish women diagnosed with primary breast cancer. Participants were women enrolled in the Copenhagen City Heart Study. Prospective...... intake, smoking, physical activity, body mass index, and hormone replacement therapy. The study shows that smoking for total mortality [hazard ratio, 1.16; 95% confidence interval, 1.05-1.29] and obesity for both total mortality (1.61; 1.12-2.33) and breast cancer-specific mortality (1.82; 1...

  17. Impact of subsequent birth and delivery mode for women with previous OASIS: systematic review and meta-analysis.

    Science.gov (United States)

    Webb, Sara S; Yates, Derick; Manresa, Margarita; Parsons, Matthew; MacArthur, Christine; Ismail, Khaled M K

    2017-04-01

    Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth. In a pregnancy following OASIS women may be keen to avoid an elective caesarean section, yet cautious about pursuing another vaginal birth that may result in further damage to the pelvic floor and possible long-term anal incontinence. This review aimed to evaluate the impact of subsequent birth and its mode on anal incontinence (AI) and/or quality of life (QoL), for women with previous OASIS. Searches of MEDLINE, EMBASE, CINAHL, and AMED from inception to February 2016 were undertaken with selection criteria of any study evaluating the effect of a subsequent birth on AI and/or QoL in women with previous OASIS. Where possible, data were extracted to populate 2 × 2 tables and allow meta-analysis relating to the impact of subsequent birth on AI and/or QoL. Twenty-seven non-randomised studies were included. Meta-analysis of 14 studies (977 women) did not demonstrate any significant associations between AI in women with previous OASIS and subsequent birth or its mode. Impact on QoL was reported in 12 studies (912 women); however, difference in outcome reporting precluded data meta-analysis. Comparisons of outcomes and effective synthesis were limited by sample size, quality and heterogeneity of the studies included. Consequently, the optimal mode of delivery for women with previous OASIS is still not known and better data are needed.

  18. The Strives, Struggles, and Successes of Women Diagnosed With ADHD as Adults

    OpenAIRE

    Langvik, Eva; Holthe, Mira Elise Glaser

    2017-01-01

    The objective of the study was to aid an understanding of women’s experiences of living with attention deficit hyperactivity disorder (ADHD), with special consideration of the role of stigma and gender-specific issues. Semistructured in-depth interviews were conducted with five women aged 32 to 50 years, all diagnosed with ADHD as adults. The interviews were analyzed in accordance with thematic analysis. The data analyses were centered around five core themes: (a) from unidentified childhood ...

  19. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review

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    Anne L Harrison

    2016-10-01

    Full Text Available Question: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? Design: A systematic review of randomised trials. Participants: Pregnant women diagnosed with gestational diabetes mellitus. Intervention: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Outcome measures: Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. Results: This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD –0.33 mmol/L, 95% CI –0.49 to –0.17 and lowered fasting blood glucose (MD –0.31 mmol/L, 95% CI –0.56 to –0.05 when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30 minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Conclusion: Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. Registration: PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016 Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review. Journal

  20. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.

    Science.gov (United States)

    Harrison, Anne L; Shields, Nora; Taylor, Nicholas F; Frawley, Helena C

    2016-10-01

    Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

  1. Use of Chinese Medicine and Subsequent Surgery in Women with Uterine Fibroid: A Retrospective Cohort Study

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    Shan-Yu Su

    2012-01-01

    Full Text Available Background. Chinese medicine (CM has been used to relieve symptoms relevant to uterine fibroids. Objective. This study investigated the association between the use of CM and the incidence of uterine surgery in women with uterine fibroids. Subjects and Methods. This retrospective cohort study extracted records for 16,690 subjects diagnosed with a uterine fibroid between 2000 and 2003 from the National Health Insurance reimbursement database. The risk factors for surgery were examined via Cox proportional hazard analysis, and the difference in incidence of surgery between CM users and nonusers was compared using incidence rate ratios (IRRs derived from Poisson's models. Results. After an average follow-up period of 4.5 years, the cumulative incidence of uterine surgery was significantly lower in CM users than CM nonusers (P<0.0001. Compared to CM nonusers, CM users were more unlikely to undergo uterine surgery (adjusted hazard ratio = 0.18, 95% confidence interval (CI = 0.17, 0.19. The incidence of surgery in CM users was dramatically different from that for CM nonusers (IRR = 0.17, 95% CI = 0.16, 0.18. Conclusion. The risk of uterine surgery among fibroid patients who used CM was significantly decreased, implying an effective treatment of fibroid-related symptoms provided by CM.

  2. Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care

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    Johansson Sven-Erik

    2008-06-01

    Full Text Available Abstract Background Only half of all depressions are diagnosed in Primary Health Care (PHC. Depression can remain undetected for a long time and entail high costs for care and low quality of life for the individuals. Drop in clinic is a common form of organizing health care; however the visits are short and focus on solving the most urgent problems. The aim of this study was to investigate the prevalence and severity of depression among women visiting the GPs' drop in clinic and to identify possible clues for depression among women. Methods The two-stage screening method with "high risk feedback" was used. Beck's Depression Inventory (BDI was used to screen 155 women visiting two GPs' drop in clinic. Women who screened positive (BDI score ≥10 were invited by the GP to a repeat visit. Major depression (MDD was diagnosed according to DSM-IV criteria and the severity was assessed with Montgomery-Asberg Depression Rating Scale (MADRS. Women with BDI score Results The two-stage method worked well with a low rate of withdrawals in the second step, when the GP invited the women to a repeat visit. The prevalence of depression was 22.4% (95% CI 15.6–29.2. The severity was mild in 43%, moderate in 53% and severe in 3%. The depressed women mentioned mental symptoms significantly more often (69% than the controls (15% and were to a higher extent sick-listed for a longer period than 14 days. Nearly one third of the depressed women did not mention mental symptoms. The majority of the women who screened as false positive for depression had crisis reactions and needed further care from health professionals in PHC. Referrals to a psychiatrist were few and revealed often psychiatric co-morbidity. Conclusion The prevalence of previously undiagnosed depression among women visiting GPs' drop in clinic was high. Clues for depression were identified in the depressed women's symptom presentation; they often mention mental symptoms when they visit the GP for somatic

  3. Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

    Science.gov (United States)

    Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

    2015-09-01

    The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Rumination, psychological distress and post-traumatic growth in women diagnosed with breast cancer.

    Science.gov (United States)

    Soo, H; Sherman, K A

    2015-01-01

    Rumination, the repetitive and recursive rehearsal of cognitive content, has been linked to depression and anxiety in physically well populations, and to post-traumatic growth (PTG) in physical illness populations. Women diagnosed with breast cancer may experience both psychological distress and PTG. As rumination may influence outcomes through distinct pathways, this study investigated the association of intrusion, brooding and instrumental subcomponents of rumination with psychological distress and PTG in the breast cancer context. Women diagnosed with primary breast cancer (n = 185), mean age 55.98 years (SD = 9.26), completed an online survey including the Multi-dimensional Rumination in Illness Scale, Depression Anxiety and Stress Scales, Post-traumatic Growth Inventory, Medical Outcomes Social Support Survey, demographic and health-related questions. As predicted, regression analyses indicated that brooding was positively related to depression, anxiety and stress, but was also negatively related to the PTG dimensions of new possibilities and spiritual growth. Partially supporting the study hypotheses, intrusion was positively associated with stress and the PTG of relating to others and new possibilities. As hypothesised, instrumental rumination was positively associated with all five dimensions of PTG. Rumination is a key consideration in both positive and negative psychological responses of women diagnosed with breast cancer. Associations of specific components of rumination with varying psychological outcomes suggest differential paths by which the specific subcomponents of rumination exert this influence. Copyright © 2014 John Wiley & Sons, Ltd.

  5. [Assessment of current eating habits in women diagnosed with breast tumours and changes introduced after diagnosis].

    Science.gov (United States)

    Kucharska, Alicja; Królikowska, Ewa; Sińska, Beata

    Intrroduction: Incorrect eating habits are a significant risk factor for breast tumours. An appropriate diet is a vital part in the treatment of such a disorder. The aim of the study was to assess current eating habits in women diagnosed with breast tumours and the changes introduced after diagnosis. The survey was conducted among 200 women aged 59±11.2 with a diagnosed breast tumour. An original survey questionnaire was used to assess the respondents' dietary habits. Questions pertained to the frequency of consumption of certain food groups, changes in diet since the moment of diagnosis and sources of knowledge about nutrition. A number of current incorrect eating habits became apparent (namely, low frequency of eating wholemeal products, legumes, fish, vegetables, fruit and high frequency of eating sweets), as well as many beneficial changes introduced after the diagnosis (more frequent consumption of wholemeal products, poultry, vegetables and fruit and lower frequency of consumption of red meat, meat preserves, sweets, sweetened drinks and alcohol), with no difference in age, education or time elapsed since the diagnosis. Less than one third of respondents have received nutrition advice after their diagnosis. In spite of the beneficial changes in dietary habits there is a need for widely available, reliable nutrition education amongst all women diagnosed with a breast tumour.

  6. Treatment With Diet and Exercise for Women With Gestational Diabetes Mellitus Diagnosed Using IADPSG Criteria.

    Science.gov (United States)

    Kgosidialwa, Oratile; Egan, Aoife M; Carmody, Louise; Kirwan, Breda; Gunning, Patricia; Dunne, Fidelma P

    2015-12-01

    Prevalence of gestational diabetes mellitus (GDM) and obesity continue to increase. This study aimed to ascertain whether diet and exercise is a successful intervention for women with GDM and whether a subset of these women have comparable outcomes to those with normal glucose tolerance (NGT). This was a retrospective cohort study of five antenatal centers along the Irish Atlantic seaboard of 567 women diagnosed with GDM and 2499 women with NGT during pregnancy. Diet and exercise therapy on diagnosis of GDM were prescribed and multiple maternal and neonatal outcomes were examined. Infants of women with GDM were more likely to be hypoglycemic (adjusted odds ratio [aOR], 7.25; 95% confidence interval [CI], 2.94-17.9) at birth. They were more likely to be admitted to the neonatal intensive care unit (aOR, 2.16; 95% CI, 1.60-2.91). Macrosomia and large-for-gestational-age rates were lower in the GDM group (aOR, 0.48; 95% CI, 0.37-0.64 and aOR, 0.61; 95% CI, 0.46-0.82, respectively). There was no increase in small for gestational age among offspring of women with GDM (aOR, 0.81; 95% CI, 0.49-1.34). Women with diet-treated GDM and body mass index (BMI) diabetes status. Medical nutritional therapy and exercise for women with GDM may be successful in lowering rates of large for gestational age and macrosomia without increasing small-for-gestational-age rates. Women with GDM and a BMI less than 25 kg/m(2) had outcomes similar to those with NGT suggesting that these women could potentially be treated in a less resource intensive setting.

  7. Social-Cognitive Processes Associated with Fear of Recurrence Among Women Newly Diagnosed with Gynecological Cancers

    Science.gov (United States)

    Myers, Shannon B.; Manne, Sharon L; Kissane, David W.; Ozga, Melissa; Kashy, Deborah A.; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norman; Morgan, Mark; Graff, John J.

    2012-01-01

    Objective This cross sectional study aimed to characterize fears of recurrence among women newly diagnosed with gynecologic cancer. The study also evaluated models predicting the impact of recurrence fears on psychological distress through social and cognitive variables. Methods Women (N = 150) who participated in a randomized clinical trial comparing a coping and communication intervention to a supportive counseling intervention to usual care completed baseline surveys that were utilized for the study. The survey included the Concerns about Recurrence Scale (CARS), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and measures of social (holding back from sharing concerns and negative responses from family and friends) and cognitive (positive reappraisal, efficacy appraisal, and self-esteem appraisal) variables. Medical data was obtained via medical chart review. Results Moderate-to-high levels of recurrence fears were reported by 47% of the women. Younger age (p fears. A social-cognitive model of fear of recurrence and psychological distress was supported. Mediation analyses indicated that as a set, the social and cognitive variables mediated the association between fear of recurrence and both depression and cancer-specific distress. Holding back and self-esteem showed the strongest mediating effects. Conclusion Fears of recurrence are prevalent among women newly diagnosed with gynecologic cancer. Social and cognitive factors play a role in women’s adaptation to fears and impact overall psychological adjustment. These factors may be appropriate targets for intervention. PMID:23088925

  8. Resilience, Positive Coping, and Quality of Life Among Women Newly Diagnosed With Gynecological Cancers.

    Science.gov (United States)

    Manne, Sharon L; Myers-Virtue, Shannon; Kashy, Deborah; Ozga, Melissa; Kissane, David; Heckman, Carolyn; Rubin, Stephen C; Rosenblum, Norman

    2015-01-01

    Resilience has been linked to psychological adaptation to many challenging life events. The goal was to examine 3 coping strategies--expressing positive emotions, positive reframing of the cancer experience, and cultivating a sense of peace and meaning in life--as potential mechanisms by which resilience translates to quality of life among women recently diagnosed with gynecological cancer. This cross-sectional study utilized baseline data from women diagnosed with gynecological cancer participating in an ongoing randomized clinical trial (n = 281; mean age, 55 years; 80% were white). Participants completed measures of resilience, positive emotional expression, positive reappraisal, cultivating a sense of peace and meaning, and quality of life. Univariate and multiple mediation analyses were conducted. Greater resilience was related to higher quality of life (P resilience and quality of life. When considered as a set, cultivating a sense of peace and meaning had the strongest indirect effect (b = 0.281, SE = 0.073, P resilient women may report higher quality of life during gynecological cancer diagnosis because they are more likely to express positive emotions, reframe the experience positively, and cultivate a sense of peace and meaning in their lives. Interventions promoting a sense of purpose in one's life and facilitating expression of positive emotions may prove beneficial, particularly for women reporting higher levels of resilience.

  9. Resilience, positive coping, and quality of life among women newly diagnosed with gynecological cancers

    Science.gov (United States)

    Manne, Sharon; Myers-Virtue, Shannon; Kashy, Deborah; Ozga, Melissa; Kissane, David; Heckman, Carolyn; Rubin, Stephen C.; Rosenblum, Norman

    2014-01-01

    Background Resilience has been linked to psychological adaptation to many challenging life events. Objective The goal was to examine three coping strategies - expressing positive emotions, positive reframing of the cancer experience, and cultivating a sense of peace and meaning in life - as potential mechanisms by which resilience translates to quality of life among women recently diagnosed with gynecological cancer. Method This cross-sectional study utilized baseline data from women diagnosed with gynecological cancer participating in an ongoing randomized clinical trial (N = 281; Mage = 55, 80% Caucasian). Participants completed measures of resilience, positive emotional expression, positive reappraisal, and cultivating a sense of peace and meaning, and quality of life. Univariate and multiple mediation analyses were conducted. Results Greater resilience was related to higher quality of life (p coping strategies, as a set, accounted for 62.6% of the relationship between resilience and quality of life. When considered as a set, cultivating a sense of peace and meaning had the strongest indirect effect (b = .281, se = .073, p < .05). Conclusion The findings suggested that resilient women may report higher quality of life during gynecological cancer diagnosis because they are more likely to express positive emotions, reframe the experience positively, and cultivate a sense of peace and meaning in their lives. Implications for Practice Interventions promoting a sense of purpose in one’s life and facilitating expression of positive emotions may prove beneficial, particularly for women reporting higher levels of resilience. PMID:25521911

  10. Determinants of Multimethod Contraceptive Use in a Sample of Adolescent Women Diagnosed with Psychological Disorders

    Directory of Open Access Journals (Sweden)

    Delia L. Lang

    2011-01-01

    Full Text Available Objective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders. Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use. Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use. Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.

  11. Reproduction among 1975 Sardinian women and men diagnosed with major mood disorders.

    Science.gov (United States)

    Tondo, L; Lepri, B; Baldessarini, R J

    2011-04-01

    Disability varies in patients with major affective disorders [type I and II bipolar disorders (BPD) and recurrent unipolar major depressive disorder (UP-MDD)]. It may include reproductive functioning, which has rarely been studied systematically. We compared information acquired over several years pertaining to marital/reproductive status among 1975 systematically evaluated, treated, and followed women (n = 1351) and men (n = 624) diagnosed with DSM-IV type I (n = 300) or II BPD (n = 223), or MDD (n = 1452). We compared factors between patients with vs. without children and associated with fertility rate (children/fertile years × 100), using standard bivariate methods followed by multivariate modeling. Childless patients were younger at illness onset, more likely men, diagnosed with type I BPD, more educated, and unmarried, but similar in many aspects of clinical history to those with children. Fertility rate ranked: BP-I women. Mood-disorder patients had 17% fewer children/person than in the comparable general population of Sardinia. Among mood-disorder patients, fertility appeared to decline in Sardinia in recent decades, more in men than women. Type I BPD was associated with lower fertility than BP-II or UP-MDD, consistent with their relatively high levels of other disabilities. © 2011 John Wiley & Sons A/S.

  12. Objectively measured physical activity predicts subsequent energy intake in 300 women.

    Science.gov (United States)

    Tucker, Larry A

    2017-01-01

    To determine if 7 d physical activity (PA) predicts energy intake over the same days and if PA on a given day predicts energy intake on the same day, the next day or subsequent days. A 7 d prospective investigation. PA was measured using accelerometers worn for seven consecutive days. During the same week, total energy intake (including alcohol) was assessed using weighed food records. Twenty cities in the USA. Three hundred middle-aged women. After controlling for the covariates, energy intake was 36 (se 8) kJ higher for each additional 100000 activity counts (F=19·0, Penergy intake of 8364 (sd 1235) kJ/d (1998 (sd 295) kcal/d), those with Moderate PA (n 150) consumed 8523 (sd 1264) kJ/d (2036 (sd 302) kcal/d) and those with High PA (n 75) consumed 9079 (sd 1473) kJ/d (2169 (sd 352) kcal/d; F=6·4, P=0·0019), a 5023 kJ/d (1200 kcal/d) difference between the High and Low PA groups. PA on a given day was predictive of energy consumption on the same day on four of the seven monitored days, and was predictive of energy intake the next day, with five of six associations significant. PA was not consistently predictive of energy intake on days beyond the next day. Over 7 d, PA and energy consumption tend to be positively related. Considered day to day, increased PA is weakly associated with increased energy intake the following day and, to a lesser extent, the same day. Therefore, managing weight by increasing PA may not result in the energy deficit expected.

  13. Traditional Chinese medicine diagnoses in a sample of women with fibromyalgia

    Science.gov (United States)

    Mist, Scott D; Wright, Cheryl L; Jones, Kim Dupree; Carson, James W

    2012-01-01

    Background Traditional Chinese medicine (TCM) offers various treatment modalities guided by TCM diagnoses. In the United States, acupuncture is a commonly employed TCM method for treating a variety of chronic illnesses. Three systematic reviews have been reported recently, reaching differing conclusions about the efficacy of acupuncture for the treatment of fibromyalgia (FM). Among the FM acupuncture studies considered in these reviews, none used TCM diagnosis as an inclusion/exclusion criterion or adjusted treatment based on TCM diagnosis. Overlooking TCM diagnosis may be a reason for such disparate results. Primary study objective To obtain TCM diagnoses in a sample of women meeting 1990 American College of Rheumatology criteria for FM who were recruited for a yoga study and to investigate whether there is significant variability. Methods/design Two TCM practitioners conducted baseline TCM diagnostic examinations on 56 women with FM. A consensus diagnosis was reached based on standardised history, palpation and examination. Canonical discriminate analysis identified two baseline items which predicted TCM diagnosis. Setting School of Nursing, Oregon Health & Science University. Participants Women, ages 23–75, with FM recruited to a yoga intervention study Results Three primary TCM diagnoses were found in the population: Qi and Blood Deficiency (46.4%, CI 33.0% to 60.36%), Qi and Blood Stagnation (26.8%, CI 15.8% to 40.3%), and Liver Qi Stagnation (19.6%, CI 10.2% to 32.4%). Conclusion It is likely that previous studies of FM were treating a heterogeneous study population where variable results might be expected. Future acupuncture studies should either control for TCM diagnosis or consider its usefulness as an inclusion/exclusion criterion. PMID:22026964

  14. Traditional Chinese medicine diagnoses in a sample of women with fibromyalgia.

    Science.gov (United States)

    Mist, Scott D; Wright, Cheryl L; Jones, Kim Dupree; Carson, James W

    2011-12-01

    Traditional Chinese medicine (TCM) offers various treatment modalities guided by TCM diagnoses. In the United States, acupuncture is a commonly employed TCM method for treating a variety of chronic illnesses. Three systematic reviews have been reported recently, reaching differing conclusions about the efficacy of acupuncture for the treatment of fibromyalgia (FM). Among the FM acupuncture studies considered in these reviews, none used TCM diagnosis as an inclusion/exclusion criterion or adjusted treatment based on TCM diagnosis. Overlooking TCM diagnosis may be a reason for such disparate results. To obtain TCM diagnoses in a sample of women meeting 1990 American College of Rheumatology criteria for FM who were recruited for a yoga study and to investigate whether there is significant variability. Two TCM practitioners conducted baseline TCM diagnostic examinations on 56 women with FM. A consensus diagnosis was reached based on standardised history, palpation and examination. Canonical discriminate analysis identified two baseline items which predicted TCM diagnosis. School of Nursing, Oregon Health & Science University. Women, ages 23-75, with FM recruited to a yoga intervention study. Three primary TCM diagnoses were found in the population: Qi and Blood Deficiency (46.4%, CI 33.0% to 60.36%), Qi and Blood Stagnation (26.8%, CI 15.8% to 40.3%), and Liver Qi Stagnation (19.6%, CI 10.2% to 32.4%). It is likely that previous studies of FM were treating a heterogeneous study population where variable results might be expected. Future acupuncture studies should either control for TCM diagnosis or consider its usefulness as an inclusion/exclusion criterion.

  15. Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer

    Science.gov (United States)

    Wu, Zijing; Liu, Ye; Li, Xuelian; Li, Xiaohan

    2016-01-01

    Purpose Resilience is the individual’s ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer. Methods A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation), Herth Hope Index (HHI), and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience. Results The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI), and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, Presilience and explained 50.1% of the total variance in resilience. Conclusions Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation, and age. PMID:27936196

  16. Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Zijing Wu

    Full Text Available Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer.A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC, Social Support Rating Scale (SSRS, Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation, Herth Hope Index (HHI, and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience.The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI, and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, P<0.001, educational level of junior college or above (β = 0.272, P<0.001, educational level of high school (β = 0.235, P<0.001, avoidance (β = 0.220, P<0.001, confrontation (β = 0.187, P = 0.001, and age (β = -0.108, P = 0.037 significantly affected resilience and explained 50.1% of the total variance in resilience.Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation

  17. Psychological Distress and Resilience in Women Diagnosed with Breast Cancer in Greece

    Science.gov (United States)

    Fradelos, Evangelos C; Papathanasiou, Ioanna V; Veneti, Aikaterini; Daglas, Aristides; Christodoulou, Eleni; Zyga, Sofia; Kourakos, Michael

    2017-09-27

    Background: Breast cancer is the most frequent type of cancer among women worldwide, especially in developed countries. To be diagnosed with breast cancer and undergo cancer treatment can be a very stressful event. It is estimated that one-third of cancer patients are dealing with psychological problems, such as anxiety and depression and resilience is a way of coping and overcome life stressors such cancer diagnosis. Purpose: The purpose of this study was to examine resilience in women diagnosed with breast cancer and its association with depression and anxiety. Methods: A cross-sectional study was conducted, 144 women diagnosed with breast cancer answered a questionnaire consisted of four parts: Sociodemographic data, the Patient Health Questionnaire Two-Item Depression Scale, the Generalized Anxiety Disorder Questionnaire and the Connor-Davidson Resilience Scale 25. Results: The majority of the sample belongs to age group 51- 60 years, with the mean age of 53.5 SD±11.7 years. The 59.5% of patients were residents of an urban area, 56.8% were married and 36.5% has 2 children. The mean value of CD-RISC25 was 65.3 SD±17.9, meaning a moderate resilience of cancer patients. The 54.5% of respondents indicated a depressed mood. The anxiety severity measured with the GAD-2, where the mean was 2.1 and 46.8% of patients suffered from high anxiety. Conclusions: According to our results, resilience can negative influence depressive symptomatology. Moreover, lower levels of depression can lead to fewer anxiety symptoms. Creative Commons Attribution License

  18. Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.

    Science.gov (United States)

    Wu, Zijing; Liu, Ye; Li, Xuelian; Li, Xiaohan

    2016-01-01

    Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer. A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation), Herth Hope Index (HHI), and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience. The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI), and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, Presilience and explained 50.1% of the total variance in resilience. Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation, and age.

  19. Intraindividual variability in reaction time before and after neoadjuvant chemotherapy in women diagnosed with breast cancer.

    Science.gov (United States)

    Yao, Christie; Rich, Jill B; Tirona, Kattleya; Bernstein, Lori J

    2017-12-01

    Women treated with chemotherapy for breast cancer experience subtle cognitive deficits. Research has focused on mean performance level, yet recent work suggests that within-person variability in reaction time performance may underlie cognitive symptoms. We examined intraindividual variability (IIV) in women diagnosed with breast cancer and treated with neoadjuvant chemotherapy. Patients (n = 28) were assessed at baseline before chemotherapy (T1), approximately 1 month after chemotherapy but prior to surgery (T2), and after surgery about 9 months post chemotherapy (T3). Healthy women of similar age and education (n = 20) were assessed at comparable time intervals. Using a standardized regression-based approach, we examined changes in mean performance level and IIV (eg, intraindividual standard deviation) on a Stroop task and self-report measures of cognitive function from T1 to T2 and T1 to T3. At T1, women with breast cancer were more variable than controls as task complexity increased. Change scores from T1 to T2 were similar between groups on all Stroop performance measures. From T1 to T3, controls improved more than women with breast cancer. IIV was more sensitive than mean reaction time in capturing group differences. Additional analyses showed increased cognitive symptoms reported by women with breast cancer from T1 to T3. Specifically, change in language symptoms was positively correlated with change in variability. Women with breast cancer declined in attention and inhibitory control relative to pretreatment performance. Future studies should include measures of variability, because they are an important sensitive indicator of change in cognitive function. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Premarital Sex, Premarital Cohabitation, and the Risk of Subsequent Marital Dissolution among Women.

    Science.gov (United States)

    Teachman, Jay

    2003-01-01

    Examines association between intimate premarital relationships and subsequent marital dissolution. Results suggest neither premarital sex nor premarital cohabitation by itself indicate either preexisting characteristics or subsequent relationship environments that weaken marriages. Findings are consistent with the notion that premarital sex and…

  1. Role of newer methods of diagnosing genital tuberculosis in infertile women

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    Geetika Goel

    2013-01-01

    Full Text Available Genital tuberculosis is an important under-diagnosed factor of infertility. A vast majority of cases are asymptomatic and diagnosing them will help in treating such patients. We conducted a retrospective study in a tertiary care hospital of Delhi with an aim to compare different methods i.e., histopathological examination (HPE, acid-fast bacilli (AFB smears, Lowenstein-Jensen (LJ culture, BACTEC culture and polymerase chain reaction deoxyribonucleic acid (PCR-DNA for diagnosing endometrial tuberculosis in infertile women. The data from 546 samples of endometrial biopsy histopathology, AFB smears and LJ culture was collected and then analyzed. Of these, HPE for tuberculosis was positive in 13, LJ culture in 10, AFB smear was positive in one case. BACTEC and PCR-DNA were feasible for 90 patients and PCR-DNA was positive in 20 and BACTEC in eight patients. Out of 20 patients with PCR positive results, 15 were only PCR positive and were subjected to hyster-laparoscopy and five had evidence of tuberculosis. Thus, none of the available tests can pick up all cases of genital tuberculosis, but conventional methods i.e., histopathology and LJ culture still has an important role in the diagnosis of endometrial tuberculosis in government setups where BACTEC and PCR are not performed routinely due to lack of resources.

  2. Evidence of Stage Shift in Women Diagnosed With Ovarian Cancer During Phase II of the United Kingdom Familial Ovarian Cancer Screening Study.

    Science.gov (United States)

    Rosenthal, Adam N; Fraser, Lindsay S M; Philpott, Susan; Manchanda, Ranjit; Burnell, Matthew; Badman, Philip; Hadwin, Richard; Rizzuto, Ivana; Benjamin, Elizabeth; Singh, Naveena; Evans, D Gareth; Eccles, Diana M; Ryan, Andy; Liston, Robert; Dawnay, Anne; Ford, Jeremy; Gunu, Richard; Mackay, James; Skates, Steven J; Menon, Usha; Jacobs, Ian J

    2017-05-01

    Purpose To establish the performance of screening with serum cancer antigen 125 (CA-125), interpreted using the risk of ovarian cancer algorithm (ROCA), and transvaginal sonography (TVS) for women at high risk of ovarian cancer (OC) or fallopian tube cancer (FTC). Patients and Methods Women whose estimated lifetime risk of OC/FTC was ≥ 10% were recruited at 42 centers in the United Kingdom and underwent ROCA screening every 4 months. TVS occurred annually if ROCA results were normal or within 2 months of an abnormal ROCA result. Risk-reducing salpingo-oophorectomy (RRSO) was encouraged throughout the study. Participants were observed via cancer registries, questionnaires, and notification by centers. Performance was calculated after censoring 365 days after prior screen, with modeling of occult cancers detected at RRSO. Results Between June 14, 2007, and May 15, 2012, 4,348 women underwent 13,728 women-years of screening. The median follow-up time was 4.8 years. Nineteen patients were diagnosed with invasive OC/FTC within 1 year of prior screening (13 diagnoses were screen-detected and six were occult at RRSO). No symptomatic interval cancers occurred. Ten (52.6%) of the total 19 diagnoses were stage I to II OC/FTC (CI, 28.9% to 75.6%). Of the 13 screen-detected cancers, five (38.5%) were stage I to II (CI, 13.9% to 68.4%). Of the six occult cancers, five (83.3%) were stage I to II (CI, 35.9% to 99.6%). Modeled sensitivity, positive predictive value, and negative predictive value for OC/FTC detection within 1 year were 94.7% (CI, 74.0% to 99.9%), 10.8% (6.5% to 16.5%), and 100% (CI, 100% to 100%), respectively. Seven (36.8%) of the 19 cancers diagnosed cancers diagnosed > 1 year after screening ended (CI, 72.7% to 99.9%; P cancers diagnosed cancers subsequently diagnosed (CI, 46.5% to 90.3%; P = .09). Conclusion ROCA-based screening is an option for women at high risk of OC/FTC who defer or decline RRSO, given its high sensitivity and significant stage shift

  3. Differential Effects of Women's Child Sexual Abuse and Subsequent Sexual Revictimization.

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    Wyatt, Gail Elizabeth; And Others

    1992-01-01

    Examined differential effects of sexual revictimization in community sample of 248 African-American and white women, ages 18 to 36. Findings suggest that unintended pregnancies and abortions were significantly associated with sexual revictimization. Women who reported more than one incident in both childhood and adulthood were also likely to have…

  4. The Experiences of Late-Diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype

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    Bargiela, Sarah; Steward, Robyn; Mandy, William

    2016-01-01

    We used Framework Analysis to investigate the female autism phenotype and its impact upon the under-recognition of autism spectrum conditions (ASC) in girls and women. Fourteen women with ASC (aged 22-30 years) diagnosed in late adolescence or adulthood gave in-depth accounts of: "pretending to be normal"; of how their gender led various…

  5. Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer.

    Science.gov (United States)

    Rizzo, Monica; Lund, Mary Jo; Mosunjac, Marina; Bumpers, Harvey; Holmes, Leslie; O'Regan, Ruth; Brawley, Otis W; Gabram, Sheryl

    2009-07-01

    Stage III breast cancers account for about 6% to 7% of all invasive breast cancers diagnosed annually in the United States. In African American (AA) women, the incidence of stage III breast cancers is almost double that in Caucasian women. The aim of this study was to correlate age, receptor status, nuclear grade, and differences in treatment modalities for stage III breast cancer in an inner-city hospital serving a large AA population. A retrospective review was performed for all stage III primary breast cancers diagnosed and or treated from 2000 to 2006. : Of 840 primary invasive breast cancers, the authors identified 107 as stage III, 40.2% IIIA, 32.7% IIIB, 16.8% T4D, and 10.3% IIIC. The majority of the patients were AA (n = 93, 86.9%). Stage IIIC patients were younger (P < .05). Triple negative tumors (TNT) accounted for 29.0%. TNT were more likely among the inflammatory breast cancers (50.0%) compared with the other 3 groups (P < .05). Twenty-two patients (20.5%) refused chemotherapy, and 24 of the 91 patients (26.3%) who should have received chest wall radiation refused. There was no difference in race, marital status, religion, or age in the patients that refused chemotherapy or radiation therapy versus the majority of patients in this series who received standard care. Stage III breast cancers in AA women have distinct clinical characteristics. A high number of these patients refused chemotherapy and radiation therapy. Reasons for refusal need to be better defined so strategies can be implemented to improve compliance for these advanced stage patients.

  6. Emotional processing during psychotherapy among women newly diagnosed with a gynecological cancer.

    Science.gov (United States)

    Manne, Sharon L; Myers-Virtue, Shannon; Darabos, Katie; Ozga, Melissa; Heckman, Carolyn; Kissane, David; Rotter, David

    2017-08-01

    Our aim was to compare changes in emotional processing by women newly diagnosed with gynecological cancer enrolled in either a coping and communication skills intervention (CCI) or a supportive counseling (SC) intervention. We examined the association between in-session emotional processing and patient-rated therapeutic progress. Three therapy sessions with 201 patients were rated for the depth of emotional processing (peak and mode) during emotion episodes (EEs) using the Experiencing Rating Scale (EXP). Participants completed measures of dispositional emotional expressivity, depressive symptoms, and cancer-related distress before treatment began, as well as ratings of perceived progress in therapy after each session. Peak EXP ratings averaged between 2.7 and 3.1, indicating that women discussed events, their emotional reactions, and their private experiences in sessions. A small proportion of patients had high levels of processing, indicating deeper exploration of the meaning of their feelings and experiences. Women in SC were able to achieve a higher level of emotional processing during the middle and later sessions, and during cancer-related EEs in the later session. However, emotional processing was not significantly associated with a patient's perceived therapeutic progress with SC. In the CCI group, higher levels of emotional processing were associated with greater session progress, suggesting that it may play an important role in patient-rated treatment outcomes. Newly diagnosed gynecological cancer patients are able to attend to their emotions and personal experiences, particularly when discussing cancer-related issues during both short-term SC and prescriptive coping skills interventions.

  7. [Pregnancy as an opportunity to diagnose human-immunodeficiency virus immigrant women in Catalonia].

    Science.gov (United States)

    Soriano-Arandes, Antoni; Noguera-Julian, Antoni; López-Lacort, Mónica; Soler-Palacín, Pere; Mur, Antonio; Méndez, María; Mayol, Lluís; Vallmanya, Teresa; Almeda, Jesús; Carnicer-Pont, Dolors; Casabona, Jordi; Fortuny, Claudia

    2016-09-05

    Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014. A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014. HIV-MTCT rate was estimated using a Bayesian logistic regression model. R and WinBUGS statistical software were used. The analysis included 909 pregnant women, 1,009 pregnancies, and 1,032 children. Data on maternal origin was obtained in 79.4% of women, of whom 32.7% were immigrants, with 53.0% of these from sub-Saharan Africa. The overall HIV-MTCT rate was 1.4% (14/1,023; 95% CI; 0.8-2.3). The risk of MTCT-HIV was 10-fold lower in women with good virological control (P=.01), which was achieved by two-thirds of them. The proportion of immigrants was significantly higher in the period 2008-2014 (PCatalonia. Although most immigrant women were diagnosed during pregnancy, the rate of MTCT-HIV was no different from the Spanish-born women. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  8. The utility of clinical decision tools for diagnosing osteoporosis in postmenopausal women with rheumatoid arthritis

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    Brand Caroline

    2008-01-01

    Full Text Available Abstract Background Patients with rheumatoid arthritis have a higher risk of low bone mineral density than normal age matched populations. There is limited evidence to support cost effectiveness of population screening in rheumatoid arthritis and case finding strategies have been proposed as a means to increase cost effectiveness of diagnostic screening for osteoporosis. This study aimed to assess the performance attributes of generic and rheumatoid arthritis specific clinical decision tools for diagnosing osteoporosis in a postmenopausal population with rheumatoid arthritis who attend ambulatory specialist rheumatology clinics. Methods A cross-sectional study of 127 ambulatory post-menopausal women with rheumatoid arthritis was performed. Patients currently receiving or who had previously received bone active therapy were excluded. Eligible women underwent clinical assessment and dual-energy-xray absorptiometry (DXA bone mineral density assessment. Clinical decision tools, including those specific for rheumatoid arthritis, were compared to seven generic post-menopausal tools to predict osteoporosis (defined as T score Results One hundred and twenty seven women participated. The median age was 62 (IQR 56–71 years. Median disease duration was 108 (60–168 months. Seventy two (57% women had no record of a previous DXA examination. Eighty (63% women had T scores at femoral neck or lumbar spine less than -1. The area under the ROC curve for clinical decision tool prediction of T score Conclusion There was limited utility of clinical decision tools for predicting osteoporosis in this patient population. Fracture prediction tools that include risk factors independent of BMD are needed.

  9. [Quality of life and depressiveness of women patients diagnosed with ovarian cancer treated with surgery and after previous adjuvant therapy].

    Science.gov (United States)

    Smorag, Leszek; Florkowski, Antoni; Nowacka, Agata; Zboralsk, Krzysztof; Przybyszewska, Monika; Macander, Marian; Sławińska, Anna; Wierzbiński, Piotr

    2014-10-01

    In the present study undertaken to assess the quality of life and depression of women patients diagnosed with ovarian cancer. The aim of the study was to assess quality of life and severity of depression of women diagnosed with ovarian cancer treated with surgery, and then underwent adjuvant radio or chemotherapy treatment. The principle of study was to included on random selection 42 women diagnosed with ovarian cancer who were treated surgically, and then subjected to adjuvant therapy. Quality of life was based on patient self-assessment using the EORTC QLQ C-30 form. The severity of depression was assessed by the Beck Depression Scale. Our results showed that in the vast majority the quality of life of women with ovarian cancer who develop depression, evaluate their own quality of life at a low level. In contrast patients who did not get depressed in most cases evaluated their own quality of life at the average level. In studies it has been shown that patients manifesting symptoms of depression compared to women not having these symptoms differ in a statistically significant way, in terms of quality of life. The results indicate that women diagnosed with ovarian cancer who have demonstrated the co-existence of depression presented a lower quality of life. The study indicates that in the majority of cases the severity of depression of patients diagnosed with ovarian cancer were mild.

  10. Incidence of depression and anxiety among women newly diagnosed with breast or genital organ cancer in Germany.

    Science.gov (United States)

    Jacob, Louis; Kalder, Matthias; Kostev, Karel

    2017-10-01

    To analyze the incidence of depression and anxiety among women newly diagnosed with breast or genital organ cancer (BC or GOC) in Germany. A total of 29 366 women initially diagnosed with BC or GOC between 2005 and 2014 were available for analysis. The main outcome measure was the incidence of depression and anxiety among women newly diagnosed with BC or GOC within 5 years after the first cancer diagnosis in German gynecologist practices. Demographic and clinical data included age, type of cancer, and presence of metastases at diagnosis. The incidence rate of depression and anxiety per 100 person-years was calculated. We performed a multivariate regression model to analyze the association between depression and the variables of interest. In total, 7994 women were diagnosed with depression/anxiety (81.3% had BC and 18.7% had GOC). The incidence of depression and anxiety was 8.8 per 100 person-years in women with BC. In individuals with GOC, the incidence of depression/anxiety was 5.9 per 100 person-years. Breast cancer was associated with a 1.41-fold increase in the risk of developing depression or anxiety as compared with GOC. Patients with metastases also had a higher risk of being depressed and anxious than others (odds ratio = 1.40). Finally, women in the age groups of 41 to 50, 51 to 60, and 61 to 70 years were at a higher risk of depression/anxiety than women in the age group of 71 to 80 years (odds ratios equal to 1.50, 1.38, and 1.22). Women diagnosed with BC were at a higher risk of developing depression or anxiety than women with GOC. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Physical domestic violence and subsequent contraceptive adoption among women in rural India.

    Science.gov (United States)

    Stephenson, Rob; Jadhav, Apoorva; Hindin, Michelle

    2013-03-01

    This study examines the relationship between male to female physical domestic violence and contraceptive adoption among women in four economically and culturally distinct areas of India. Data from India's 1998-1999 National Family Health Survey-2 and a follow-up survey in 2002-2003 for which the same women in four states were reinterviewed are analyzed. The focus of the analysis is on how baseline exposure to physical domestic violence is associated with the intersurvey adoption of contraception. Women who experience physical violence from their husbands are significantly less likely to adopt contraception in the intersurvey period, although this relationship varies by State. This study builds upon previous work by using an indicator of physical domestic violence exposure that is measured before contraceptive adoption, thus allowing the identification of how exposure to violence shapes the adoption of contraception. The results demonstrate that for women living in Bihar and Jharkhand there is a clear negative relationship between physical domestic violence and a woman's adoption of contraception; this relationship was not found for women in Maharashtra and Tamil Nadu. The results point to the need to include domestic violence screening and referral services into family planning services.

  12. Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women.

    Science.gov (United States)

    Gould Rothberg, Bonnie E; Magriples, Urania; Kershaw, Trace S; Rising, Sharon Schindler; Ickovics, Jeannette R

    2011-01-01

    Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by the Institute of Medicine. Women aged 14-25 receiving prenatal care and delivering singleton infants at term (n = 427). Medical record review and 4 structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Only 22% of participants gained gestational weight within Institute of Medicine guidelines. There were 62% that exceeded maximum recommendations-more common among those overweight/obese (body mass index ≥25.0; P weight gain and retention documented among smokers and women with pregnancy-induced hypertension; breastfeeding promoted postpartum weight loss (all P weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD

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    Janet C'de Baca

    2014-03-01

    Full Text Available Personality Disorders (PDs impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD range from 45%–79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%, Hispanic (27%, and African American (9%, mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046 then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046, and a cluster C PD with sexual trauma (p = 0.004, demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.

  14. Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies

    Science.gov (United States)

    2013-01-01

    Background Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association. However, the direction of any association is poorly understood and the potential causal-relationship is unknown. Methods We examined the association between overweight/obesity, defined by body mass index (BMI) asthma at least one year after BMI assessment. We sought to explore potential effect modification by sex. PubMed and Embase were searched using keywords and restricted to subjects aged 0–18 years. There were no date or language restrictions. From each study we extracted: authors, publication date, location, overweight/obesity definitions, asthma definitions, number of participants, recruitment duration, description of cohort, follow-up time, adjusted effect estimates (with 95% CI) and estimates of subgroup analysis. Results Six prospective cohort studies which focused on children asthma (RR = 1.35; 95% CI = 1.15, 1.58). In boys, the combined RR of overweight on asthma was significant (RR = 1.41; 95% CI = 1.05, 1.88). For girls, when BMI was defined by Z-score, the combined RR of overweight on asthma was also significant (RR = 1.19; 95% CI = 1.06, 1.34). The combined risk ratio (RR) of obesity was associated with asthma in both boys and girls (RR = 1.50; 95% CI = 1.22, 1.83), in boys only (RR = 1.40; 95% CI = 1.01, 1.93) and in girls only (RR = 1.53; 95% CI = 1.09, 2.14). Conclusions Overweight and, especially, obese children are at increased risk of subsequent physician diagnosed asthma in comparison to normal weight children. Except for sex, no studies reported any other potential effect modifiers. The observed sex effects were inconsistent. PMID:23941287

  15. Will Women Diagnosed with Breast Cancer Provide Biological Samples for Research Purposes?

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    Shelley A Harris

    Full Text Available Little is known about the response rates for biological sample donation and attitudes towards control recruitment, especially in younger women. The goals of this pilot study were to determine in women recently diagnosed with breast cancer, the proportion of cases willing to provide biological samples and for purposes of control recruitment, contact information for friends or colleagues.A population-based sample of breast cancer cases (n = 417, 25-74 years was recruited from the Ontario Cancer Registry in 2010 and self-administered questionnaires were completed to determine willingness to provide samples (spot or 24-hr urine, saliva, blood and contact information for friends/colleagues for control recruitment. Using Χ2 analyses of contingency tables we evaluated if these proportions varied by age group (<45 and 45+ and other factors such as ethnicity, education, income, body mass index (BMI, smoking status and alcohol consumption.Cases were willing to provide blood samples, by visiting a clinic (62% or by having a nurse visit the home (61%. Moreover, they would provide saliva (73%, and morning or 24-hr urine samples (66% and 52%. Younger cases (≤45 were 3 times (OR more likely more than older cases to agree to collect morning urine (95% CI: 1.15-8.35. Only 26% of cases indicated they would provide contact information of friends or work colleagues to act as controls. Educated cases were more likely to agree to provide samples, and cases who consumed alcohol were more willing to provide contact information. Ethnicity, income, BMI and smoking had little effect on response rates.Reasonable response rates for biological sample collection should be expected in future case controls studies in younger women, but other methods of control selection must be devised.

  16. Diet during adolescence is a trigger for subsequent development of dysmenorrhea in young women.

    Science.gov (United States)

    Fujiwara, Tomoko

    2007-09-01

    Recently many young women in Japan have been restricting their dietary intake for cosmetic purposes. In this study, the relation between diet and menstrual disorders was investigated by responses to a questionnaire. Subjects ranging from 18 to 20 years old were recruited from 716 female students at Ashiya College. Dietary habits were classified into group I (having no experience with dieting), group II (those currently on a diet) and group III (those with a history of dieting). The intensity of dysmenorrhea was classified into three grades. All participants were divided into two groups as having regular or irregular menstruation. The frequency of irregular menstruation in group II was higher than that in the other groups, while group III had higher intensity of dysmenorrhea than the other groups. These findings suggest that diet during adolescence has long-lasting adverse effects on reproductive function in young women.

  17. The Prevalence of Group B Streptococcus Colonization in Iranian Pregnant Women and Its Subsequent Outcome

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    Mahboobeh Shirazi

    2014-01-01

    Full Text Available Background: Group B streptococcus colonization in pregnant women usually has no symptoms, but it is one of the major factors of newborn infection in developed countries. In Iran, there is a little information about the prevalence of maternal colonization and newborns infected by group B streptococcus. In order to find the necessary information to create a protocol for prevention and treatment of group B streptococcus infection in newborns, we conducted a study of its prevalence among Iranian pregnant women and its vertical transmission to their newborns. Materials and Methods: This is a cross-sectional descriptive and analytic study performed at Prenatal Care Clinic of the Sarem Hospital from 2009 to 2011. The pregnant women with the gestational age of 35-37 weeks were enrolled in the study. The vaginal culture for group B streptococcus was done for 980 mothers based on our protocol. Among 980 mothers, 48 were shown positive vaginal culture; however, 8 cases among these 48 mothers were positive for both vaginal and urine culture. Babies with mothers showing positive vaginal culture were screened for infection using complete blood count /blood culture (B/C and C-reactive protein (CRP. Then, a complete sepsis workup was performed for babies with any signs of infection in the first 48 hours after birth, and they received antibiotic therapy if necessary. All collected data were analyzed (SPSS version 15. Results: Among 980 pregnant women with vaginal culture, 48 cases had positive group B streptococcus cultures among which 8 mothers also had positive group B streptococcus urine culture. Our findings revealed that 22 (50% symptomatic neonates were born from the mothers with positive vaginal culture for group B streptococcus. About 28 of them (63% had absolute neutrophil count more than normal, and 4 (9.1 % newborns were omitted from the study. Therefore, 50% of neonates showed clinical feature, whereas para-clinical test was required to detect the

  18. Temporal Patterns of Cervical Cancer Screening Among Danish Women 55 Years and Older Diagnosed With Cervical Cancer

    DEFF Research Database (Denmark)

    Hammer, Anne; Hee, Lene; Blaakær, Jan

    2018-01-01

    OBJECTIVE: The aim of the study was to describe the screening history in postmenopausal women diagnosed with cervical cancer during 1990-2013 by age and screening period. MATERIALS AND METHODS: This hospital-based cohort study included women 55 years and older diagnosed with cervical cancer...... at Aarhus University Hospital, Denmark, during 1990-2013. Information on their previous history of cervical cancer screening was obtained from the Danish Pathology Databank. RESULTS: Overall, 47.0% (95% CI = 42.6-51.4) had no record of screening before their cervical cancer diagnosis. This proportion...... and in women aged 55 to 64 years. Of cases with a record of screening within 5 years, 84.6% (95% CI = 14.5-21.2) had a normal cytology result, whereas only 8.8% (95% CI = 2.9-14.7) had high-grade squamous intraepithelial lesion or worse. CONCLUSIONS: Cervical cancer in older women may partly be attributed...

  19. Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.

    Science.gov (United States)

    Gehlbach, Stephen; Saag, Kenneth G; Adachi, Jonathan D; Hooven, Fred H; Flahive, Julie; Boonen, Steven; Chapurlat, Roland D; Compston, Juliet E; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L; LaCroix, Andrea Z; Netelenbos, J Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Sambrook, Philip N; Silverman, Stuart; Siris, Ethel S; Watts, Nelson B; Lindsay, Robert

    2012-03-01

    Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women aged ≥55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures, respectively, since age 45 years. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no previous fractures, women with 1, 2, or ≥3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio [HR] = 7.3) and hip (HR = 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, and previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture. Women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development. © 2012 American Society for Bone and Mineral Research

  20. Postpartum follow-up in women diagnosed with subclinical hypothyroidism during pregnancy

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    K Neelaveni

    2017-01-01

    Full Text Available Background: Management guidelines about the thyroid disease in pregnancy are silent about the postpartum course of new onset subclinical hypothyroidism (SCH. Hence, we analyzed the 2 years outcome of SCH diagnosed during pregnancy. Materials and Methods: We conducted this retrospective study using the medical records of patients with new onset SCH during pregnancy between 2010 and 2013 (n = 718. Patients who stopped their levothyroxine after delivery with a 2-year follow-up record were included. We excluded patients with known thyroid disorders and continuous use of drugs that affect the thyroid results. The patients were divided into two groups (Group 1 – euthyroid and Group 2 – hypothyroid based on the final outcome after 2 years. The data were analyzed using appropriate statistical methods and a P < 0.05 was considered statically significant. Results: A total of 559 (77.8% women stopped levothyroxine after delivery, and the final follow-up data were available for 467 patients only. At the end of 2 years, 384 (82.2% remained euthyroid, and the remaining 83 (17.8% developed hypothyroidism. SCH and overt hypothyroidism were seen in 22 and 61 patients, respectively. Group 2 patients had higher mean age (25.5 vs. 23.6 years, goiter (51 vs. 2%, initial thyroid stimulating hormone (7.9 vs. 5.1 μIU/mL, and thyroid antibody positivity (76 vs. 13% (P < 0.001. Conclusion: The majority of patients with SCH during pregnancy remain euthyroid after delivery. Advanced age, goiter, positive family history, and thyroid autoimmunity increase the future risk of hypothyroidism in patients with SCH diagnosed during pregnancy.

  1. Utility of Preoperative CA125 Assay in the Management Planning of Women Diagnosed with Uterine Cancer

    Directory of Open Access Journals (Sweden)

    N. Povolotskaya

    2014-01-01

    Full Text Available Objective. This study assesses the role of preoperative serum CA125 levels in the planning treatment options for women diagnosed with uterine cancer. Material and Method. Ninety five consecutive patients diagnosed with uterine cancer during a four-year period were identified. Age ranged from 35 to 89 years with a mean age of 69 years. The preoperative CA125 levels were dichotomised at 28 U/mL (using ROC analysis to identify the best discriminating threshold for 5-year survival. This level was then correlated with preoperative prognostic indicators: patient age, tumour grade, and histopathological tumour cell type. Survival data was plotted using Kaplan-Meier curves and analysed using the log-rank test. Univariate and multivariate analysis were performed to identify the predictors of overall survival. Results. The mean age of patients was 69 years (range: 35–89. On univariate analysis, the use of preoperative CA125 levels of greater or less than 28 U/mL correlated significantly with age (P=0.01, the grade of disease (P=0.02 and unfavourable tissue type (P=0.03. This threshold CA125 level had a sensitivity of 75%, specificity of 76%, positive predictive value of 35% and negative predicative value of 96.25%, and a likelihood ratio of 3.12 for predicting nodal disease. Using a threshold of preoperative CA125 level of 28 U/mL (area under curve: 0.60 was also a significant predictor of 5-year survival (log-rank test, P=0.01. Using Cox multivariate survival analysis to identify predictive preoperative factors overall, unfavourable cell type was the strongest predictor of survival (Chi square = 36.5, df = 4, and P=0.001, followed by preoperative CA125 level (CA125 > 28 U/mL, P=0.011 and unfavourable preoperative grade (P=0.017. Amongst patients with a favourable histological tissue type (endometrioid, preoperative CA125 levels predicted overall survival (Chi square = 6.039, df = 2, P=0.02; however unfavourable preoperative

  2. Predictors of Post-Release Research Retention and Subsequent Reenrollment for Women Recruited While Incarcerated

    Science.gov (United States)

    Goshin, Lorie S.; Byrne, Mary W.

    2011-01-01

    Correctional facilities are prime targets for nursing interventions to decrease health disparities, but challenges to post-release follow-up limit use of the longitudinal research designs needed to fully examine intervention effects. Using an adapted version of the Behavioral Model for Vulnerable Populations, we determined predictors of 1year post-release study retention and subsequent reenrollment an average of 3 years later in 88 mother and child dyads recruited from a state prison nursery. Predisposing characteristics and enabling factors emerged as strong predictors of loss to follow-up. Female research participants can be successfully retained years after release from a correctional facility. Understanding the barriers and facilitators to post-release follow-up supports the creation of theoretically informed strategies to retain formerly incarcerated populations. PMID:22105494

  3. Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women

    DEFF Research Database (Denmark)

    Toftager, M; Bogstad, J; Løssl, K

    2017-01-01

    , subjects were allocated to treatment and 1023 women started standardized ART protocols with recombinant human follitropin-β (rFSH) stimulation. Day-2 SET was planned and additional embryos were frozen and used in subsequent frozen-thawed cycles. All......STUDY QUESTION: Are cumulative live birth rates (CLBRs) similar in GnRH-antagonist and GnRH-agonist protocols for the first ART cycle including all subsequent frozen-thaw cycles from the same oocyte retrieval? SUMMARY ANSWER: The chances of at least one live birth following utilization of all fresh...... and frozen embryos after the first ART cycle are similar in GnRH-antagonist and GnRH-agonist protocols. WHAT IS KNOWN ALREADY: Reproductive outcomes of ART treatment are traditionally reported as pregnancies per cycle or per embryo transfer. However, the primary concern is the overall chance of a live birth...

  4. Perinatal outcomes in a subsequent pregnancy among women who have experienced recurrent miscarriage: a retrospective cohort study.

    Science.gov (United States)

    Field, K; Murphy, D J

    2015-05-01

    Is a history of three or more miscarriages associated with adverse perinatal outcomes in a subsequent pregnancy? Recurrent miscarriage is associated with an increased risk of adverse perinatal outcomes, including preterm birth, very preterm birth and perinatal death, in a subsequent pregnancy. Published data are conflicting with some studies reporting an increase in adverse perinatal outcomes in association with prior recurrent miscarriage while others report little or no increase. Large-scale population-based studies have been lacking. We performed a retrospective cohort study of 30 053 women with a singleton pregnancy who booked for antenatal care and delivery between January 2008 and July 2011. All women who attended a university affiliated hospital in Ireland had a detailed obstetric history taken, recording the outcome of all previous pregnancies. We compared the obstetric and perinatal outcomes of 2030 women (6.8%) who had a history of three or more miscarriages (recurrent miscarriage) with the outcomes of 28 023 women (93.2%) who did not. Logistic regression analyses were performed, adjusting for potential confounding factors. Women with a history of recurrent miscarriage were more likely to be obese, to have undergone assisted conception, to have had a previous perinatal death, and to be delivered by scheduled Caesarean section. Recurrent miscarriage was associated with an increased incidence of preterm birth (perinatal death (1.2 versus 0.5%, adjOR 2.66; 95% CI 1.70-4.14). The results were similar for both primary and secondary recurrent miscarriage. This is a retrospective cohort study and while regression analyses adjusted for potential confounding factors, residual confounding may persist. The strict definition of recurrent miscarriage is three consecutive miscarriages and while each woman in the study group had three or more miscarriages, they were only confirmed to be consecutive in the primary RM group. The affected women have not been categorized

  5. Prediction of subsequent miscarriage risk in women who present with a viable pregnancy at the first early pregnancy scan.

    Science.gov (United States)

    Stamatopoulos, Nicole; Lu, Chuan; Casikar, Ishwari; Reid, Shannon; Mongelli, Max; Hardy, Nigel; Condous, George

    2015-10-01

    performance of the new model compared to the Oates model gave an AUC of 0.887 vs 0.861 for the training set and 0.816 vs 0.734 for the test set (P-value age in the presence of clots PV increases the probability of subsequent miscarriage. Whereas, in women with a higher EHR in the presence of an increased GS volume/CRL ratio, the likelihood of subsequent miscarriage is reduced. This new model outperforms the previously published model developed in our unit. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. Racial and Ethnic Differences in Substance Use Diagnoses, Comorbid Psychiatric Disorders, and Treatment Initiation among HIV-Positive and HIV-Negative Women in an Integrated Health Plan

    OpenAIRE

    Storholm, Erik D.; Silverberg, Michael J.; Satre, Derek D.

    2016-01-01

    Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a racial/ethnically diverse sample of HIV-positive women (N=228) and a demographically similar cohort of HIV-negative women (N=693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northe...

  7. Negative psychological consequences of breast cancer among recently diagnosed ethnically diverse women.

    Science.gov (United States)

    Tejeda, Silvia; Stolley, Melinda R; Vijayasiri, Ganga; Campbell, Richard T; Estwing Ferrans, Carol; Warnecke, Richard B; Rauscher, Garth H

    2017-12-01

    Breast cancer has psychological consequences that impact quality of life. We examined factors associated with negative psychological consequences of a breast cancer diagnosis, in a diverse sample of 910 recently diagnosed patients (378 African American, 372 white, and 160 Latina). Patients completed an in-person interview as part of the Breast Cancer Care in Chicago study within an average of 4 months from diagnosis. The Cockburn negative psychological consequences of breast cancer screening scale was revised to focus on a breast cancer diagnosis. Path analysis assessed predictors of psychological consequences and potential mediators between race/ethnicity and psychological consequences. Compared to white counterparts, bivariate analysis showed African American (β = 1.4, P psychological consequences. Strongest predictors (P psychological consequences was unmet social support. African American and Latina women reported greater psychological consequences related to their breast cancer diagnosis; this disparity was mediated by differences in unmet social support. Social support represents a promising point of intervention. Copyright © 2017 John Wiley & Sons, Ltd.

  8. [Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia].

    Science.gov (United States)

    Terzi, Rabia; Terzi, Hasan; Kale, Ahmet

    2015-01-01

    In this study, we aimed to investigate the presence of premenstrual syndrome (PMS), primary dysmenorrhea (PD) and depression among women with fibromyalgia (FM) and healthy females and to determine possible factors related with PMS and PD in FM. The present study was conducted on 98 female patients diagnosed with FM and 102 age and sex-matched healthy controls. All patients were evaluated for premenstrual syndrome (PMS) and primary dysmenorrhea (PD). Premenstrual syndrome was assessed among the patients for the presence of one or more affective or somatic symptoms within the five days preceding menses. The diagnosis of primary dysmenorrhea was defined as having abdominal pain or lower back pain lasting at least two days during a menstrual period. Dysmenorrhea was assessed via visual analog scale. Dysmenorrhea was rated via Multidimensional Scoring System. The Hamilton depression scale was applied to all patients. Primary dysmenorrhea was established in 41% of FM patients and 28% of the control group. A statistically significant difference was found in PD between the two groups (p=0.03). PMS was established in 42% of the FM patients and 25% of the control group. A statistically significant difference was found in PMS between the two groups (p=0.03). There is an increased frequency of premenstrual syndrome and dysmenorrhea in FM patients. The patients with high symptom severity scores and high depression scores among the FM patients are at risk of PMS and PD. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  9. Socio-demographic factors, comorbidity and diagnostic delay among women diagnosed with cervical, endometrial or ovarian cancer

    DEFF Research Database (Denmark)

    Robinson, Kirstine Magtengaard; Christensen, K B; Ottesen, B

    2011-01-01

    patient delays were associated with diagnosis with a greater risk of experiencing long delays among women diagnosed with cervical and endometrial cancer as opposed to ovarian cancer. The risk of experiencing long GP referral delays was associated with residential area, with a greater risk of long delays...... diagnosed with cervical and endometrial cancer as opposed to ovarian cancer, and with working as opposed to being retired. In conclusion, this study found that socio-demographic factors and comorbidity play a role in the probability of experiencing long delays. If delays in diagnosis are to be reduced......This study investigates the association between socio-demographic factors, comorbidity and diagnostic delay among gynaecological cancer patients. A questionnaire was sent to 1052 women diagnosed with cervical, endometrial or ovarian cancer between October 2006 and December 2007 in Denmark. Long...

  10. Influence of psychical trauma through transgenerational transfer on the development of traumatic reactions in women with diagnosed breast cancer.

    Science.gov (United States)

    Anton, Sanda; Tomanović, Katarina; Mrdenović, Slobodan; Katinić, Krizo; Gugić, Damir; Topić, Jelena

    2011-09-01

    Earlier experience of psychological trauma of a close person can through a transgenerational transfer influence traumatic reactions of a person going through a trauma at present, resulting in a repetition of earlier traumatic experiences and a development of a variety of mental disturbances. Purpose of our study was to evaluate the influence of transgenerational transfer on the development of Posttraumatic stress disorder (PTSD) in women with diagnosed breast cancer that had a family member with diagnosed cancer. The sample mainly consisted of 120 women treated in a Department of Oncology, Osijek University Hospital Center with diagnosis of newly discovered breast cancer, during the conduction of radio therapy having values Hamilton depression scale (HAM-D) from > or = 8 to HAM-A) from > or = 17 to HAM-A) and Hamilton's scale for depression evaluation (HAM-D) were used. Results show that 61 (51%) of patients have a family member with diagnosed cancer. The average total value on LASC for examinees that had a family member with diagnosed cancer was slightly higher (22.92) in comparison to those who had no such family member (20.88). No statistically significant connection was found between having a family member with diagnosed cancer and the average total value on LASC. Although no connection was established between having a family member with diagnosed cancer and the average value on LASC in women with diagnosed breast cancer, transgenerational transfer of emotions seems to be important in their traumatic reactions, but it is still insufficiently researched and it is a challenge for future researches leaving many complicated issues open.

  11. Dietary fiber and subsequent changes in body weight and waist circumference in European men and women.

    Science.gov (United States)

    Du, Huaidong; van der A, Daphne L; Boshuizen, Hendriek C; Forouhi, Nita G; Wareham, Nicolas J; Halkjaer, Jytte; Tjønneland, Anne; Overvad, Kim; Jakobsen, Marianne Uhre; Boeing, Heiner; Buijsse, Brian; Masala, Giovanna; Palli, Dominique; Sørensen, Thorkild I A; Saris, Wim H M; Feskens, Edith J M

    2010-02-01

    Dietary fiber may play a role in obesity prevention. Until now, the role that fiber from different sources plays in weight change had rarely been studied. Our aim was to investigate the association of total dietary fiber, cereal fiber, and fruit and vegetable fiber with changes in weight and waist circumference. We conducted a prospective cohort study with 89,432 European participants, aged 20-78 y, who were free of cancer, cardiovascular disease, and diabetes at baseline and who were followed for an average of 6.5 y. Dietary information was collected by using validated country-specific food-frequency questionnaires. Multiple linear regression analysis was performed in each center studied, and estimates were combined by using random-effects meta-analyses. Adjustments were made for follow-up duration, other dietary variables, and baseline anthropometric, demographic, and lifestyle factors. Total fiber was inversely associated with subsequent weight and waist circumference change. For a 10-g/d higher total fiber intake, the pooled estimate was -39 g/y (95% CI: -71, -7 g/y) for weight change and -0.08 cm/y (95% CI: -0.11, -0.05 cm/y) for waist circumference change. A 10-g/d higher fiber intake from cereals was associated with -77 g/y (95% CI: -127, -26 g/y) weight change and -0.10 cm/y (95% CI: -0.18, -0.02 cm/y) waist circumference change. Fruit and vegetable fiber was not associated with weight change but had a similar association with waist circumference change when compared with intake of total dietary fiber and cereal fiber. Our finding may support a beneficial role of higher intake of dietary fiber, especially cereal fiber, in prevention of body-weight and waist circumference gain.

  12. Effect of clomifene citrate plus metformin and clomifene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome: randomised double blind clinical trial

    NARCIS (Netherlands)

    Moll, Etelka; Bossuyt, Patrick M. M.; Korevaar, Johanna C.; Lambalk, Cornelis B.; van der Veen, Fulco

    2006-01-01

    OBJECTIVE: To compare the effectiveness of clomifene citrate plus metformin and clomifene citrate plus placebo in women with newly diagnosed polycystic ovary syndrome. DESIGN: Randomised clinical trial. SETTING: Multicentre trial in 20 Dutch hospitals. PARTICIPANTS: 228 women with polycystic ovary

  13. Impact of borderline-subclinical hypothyroidism on subsequent pregnancy outcome in women with unexplained recurrent pregnancy loss.

    Science.gov (United States)

    Uchida, Sayaka; Maruyama, Tetsuo; Kagami, Maki; Miki, Fumie; Hihara, Hanako; Katakura, Satomi; Yoshimasa, Yushi; Masuda, Hirotaka; Uchida, Hiroshi; Tanaka, Mamoru

    2017-06-01

    Because subclinical hypothyroidism (thyroid-stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine-treated women before pregnancy. The purpose of this study was to determine whether borderline-subclinical hypothyroidism (borderline-SCH; 2.5 borderline-SCH, and euthyroidism (0.3 ≤ TSH ≤ 2.5 IU/mL). All women had normal serum free thyroxine (T4) and did not receive levothyroxine before or during the subsequent pregnancy. There were no significant differences in age, number of previous pregnancy losses, number of live births, or body mass index between the borderline-SCH (n = 56) and the euthyroid (n = 261) groups, but the rate of ANA positivity differed significantly (53.6% vs 33.7%, respectively; P = 0.005). The subsequent pregnancy rate did not differ between the two groups (55.4%, 31/56 vs 51.3%, 134/261, respectively). The pregnancy loss rate (borderline-SCH than the euthyroid group (29.0%, 9/31 vs 17.9%, 24/134), although not significantly so (P = 0.16). Although some subset of uRPL is though to be due to as-yet-unidentified cause(s), borderline-SCH is unlikely to be involved in uRPL. © 2017 Japan Society of Obstetrics and Gynecology.

  14. Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Sarah E Neil-Sztramko

    2014-12-01

    Full Text Available Question: What are typical values of physical function for women diagnosed with breast cancer and how do these compare to normative data? Design: Systematic review with meta-analysis. Participants: Women diagnosed with breast cancer who were before, during or after treatment. Outcome measures: Physical function was divided into three categories: aerobic capacity, upper and lower extremity muscular fitness, and mobility. Measures of aerobic capacity included field tests (6-minute walk test, 12-minute walk tests, Rockport 1-mile test, and 2-km walk time and submaximal/maximal exercise tests on a treadmill or cycle ergometer. Measures of upper and lower extremity muscular fitness included grip strength, one repetition maximum (bench, chest or leg press, muscle endurance tests, and chair stands. The only measure of mobility was the Timed Up and Go test. Results: Of the 1978 studies identified, 85 were eligible for inclusion. Wide ranges of values were reported, reflecting the range of ages, disease severity, treatment type and time since treatment of participants. Aerobic fitness values were generally below average, although 6-minute walk time was closer to population norms. Upper and lower extremity strength was lower than population norms for women who were currently receiving cancer treatment. Lower extremity strength was above population norms for women who had completed treatment. Conclusion: Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms. Assessment of values for lower extremity strength is less conclusive. As more research is published, expected values for sub-groups by age, treatment, and co-morbidities should be developed. [Neil-Sztramko SE, Kirkham AA, Hung SH, Niksirat N, Nishikawa K Campbell KL (2014 Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review. Journal of Physiotherapy 60: 189–200

  15. Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review.

    Science.gov (United States)

    Neil-Sztramko, Sarah E; Kirkham, Amy A; Hung, Stanley H; Niksirat, Negin; Nishikawa, Kei; Campbell, Kristin L

    2014-12-01

    What are typical values of physical function for women diagnosed with breast cancer and how do these compare to normative data? Systematic review with meta-analysis. Women diagnosed with breast cancer who were before, during or after treatment. Physical function was divided into three categories: aerobic capacity, upper and lower extremity muscular fitness, and mobility. Measures of aerobic capacity included field tests (6-minute walk test, 12-minute walk tests, Rockport 1-mile test, and 2-km walk time) and submaximal/maximal exercise tests on a treadmill or cycle ergometer. Measures of upper and lower extremity muscular fitness included grip strength, one repetition maximum (bench, chest or leg press), muscle endurance tests, and chair stands. The only measure of mobility was the Timed Up and Go test. Of the 1978 studies identified, 85 were eligible for inclusion. Wide ranges of values were reported, reflecting the range of ages, disease severity, treatment type and time since treatment of participants. Aerobic fitness values were generally below average, although 6-minute walk time was closer to population norms. Upper and lower extremity strength was lower than population norms for women who were currently receiving cancer treatment. Lower extremity strength was above population norms for women who had completed treatment. Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms. Assessment of values for lower extremity strength is less conclusive. As more research is published, expected values for sub-groups by age, treatment, and co-morbidities should be developed. [Neil-Sztramko SE, Kirkham AA, Hung SH, Niksirat N, Nishikawa K Campbell KL (2014) Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review.Journal of Physiotherapy60: 189-200]. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

  16. [Evaluation of eating habits and nutritional behaviors of women in the perimenopausal period with the diagnosed celiac disease].

    Science.gov (United States)

    Friedrich, Mariola; Podlaszewska, Grazyna; Kuchlewska, Magdalena

    2012-01-01

    The aim of this study was to evaluate eating habits and nutritional behaviors of women in the perimenopausal period with celiac disease diagnosed within the last 4 years. The study covered a group of 26 women, at the age of 51-54 years, with celiac disease diagnosed in the last 4 years and staying on a gluten-free diet for 6 months to 4 years and agreed to participate in this studies. Information of nutrition were collected from the women, who, after an appropriate instruction, recorded the timing, type and amount of food consumed in the three days a week, selected at random. The amount of consumed portions was defined on the basis of the "Book of portions, products and dishes". The menus (78) were recorded in April and May. Collected data were prepared, based on a computer program Dietetyk 2009 Prof. The analysis of results achieved in this study enabled concluding that--from the viewpoint of the diagnosed disease--the nutritional patterns of the women were very appropriate. However, it failed to meet basic nutritional guidelines, which was reflected in, among other things, unsatisfactory intake of vegetables, fruits, oils and water, and in excessive intake of protein of animal origin. In addition, it did not cover demands resulting from the perimenopausal period the surveyed women were in, which is likely to facilitate, e.g. disorders in lipid metabolism and water-mineral balance, as well as development of osteoporosis. The general picture of behaviors, including the nutritional ones, pointed to a strong predominance of the diagnosed disease but also to the need of compensating for the resultant restrictions, with the latter being perceived by the surveyed women as health-promoting actions.

  17. Consumption of dark chocolate attenuates subsequent food intake compared with milk and white chocolate in postmenopausal women.

    Science.gov (United States)

    Marsh, Channa E; Green, Daniel J; Naylor, Louise H; Guelfi, Kym J

    2017-09-01

    Chocolate has a reputation for contributing to weight gain due to its high fat, sugar and calorie content. However, the effect of varying concentrations of cocoa in chocolate on energy intake and appetite is not clear. To compare the acute effect of consuming an isocaloric dose of dark, milk and white chocolate on subsequent energy intake, appetite and mood in postmenopausal women. Fourteen healthy postmenopausal women (57.6 ± 4.8yr) attended an introductory session followed by three experimental trials performed in a counterbalanced order at a standardised time of day, each separated by one week. Ad libitum energy intake, perceived appetite, mood and appetite-related peptides were assessed in response to consumption of 80% cocoa [dark chocolate], 35% cocoa [milk chocolate] and cocoa butter [white chocolate] (2099 kJ), prepared from a single-origin cacao bean. Ad libitum energy intake was significantly lower following dark (1355 ± 750 kJ) compared with both milk (1693 ± 969 kJ; P = 0.008) and white (1842 ± 756 kJ; P = 0.001) chocolate consumption. Blood glucose and insulin concentrations were transiently elevated in response to white and milk chocolate consumption compared with the dark chocolate (P chocolate (dark and milk) compared with white chocolate (P  0.05). Dark chocolate attenuates subsequent food intake in postmenopausal women, compared to the impact of milk and white chocolate consumption. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: association with mental health diagnoses.

    Science.gov (United States)

    Cohen, Beth E; Maguen, Shira; Bertenthal, Daniel; Shi, Ying; Jacoby, Vanessa; Seal, Karen H

    2012-09-01

    An increasing number of women serve in the military and are exposed to trauma during service that can lead to mental health problems. Understanding how these mental health problems affect reproductive and physical health outcomes will inform interventions to improve care for women veterans. We analyzed national Department of Veterans Affairs (VA) data from women Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001, through December 31, 2010 (n = 71,504). We used ICD-9 codes to categorize veterans into five groups by mental health diagnoses (MH Dx): Those with no MH Dx, posttraumatic stress disorder (PTSD), depression, comorbid PTSD and depression, and a MH Dx other than PTSD and depression. We determined the association between mental health category and reproductive and other physical health outcomes defined by ICD-9 codes. Categories included sexually transmitted infections, other infections (e.g., urinary tract infections), pain-related conditions (e.g., dysmenorrhea and dsypareunia), and other conditions (e.g., polycystic ovarian syndrome, infertility, sexual dysfunction). Models were adjusted for sociodemographic and military service factors. There were 31,481 patients (44%) who received at least one mental health diagnosis. Women veterans with any mental health diagnosis had significantly higher prevalences of nearly all categories of reproductive and physical disease diagnoses (p mental health diagnoses had significantly greater prevalences of several important reproductive and physical health diagnoses. These results provide support for VA initiatives to address mental and physical health concerns and improve comprehensive care for women veterans. Published by Elsevier Inc.

  19. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ...

  20. A Trial to Maximize the Accuracy of Military Womens Genitourinary Self-Diagnoses

    Science.gov (United States)

    2013-04-08

    diagnoses and providers’ (N=5) clinical diagnoses to DNA-probe analysis for evidence of Gardnerella species, Trichomonas vaginalis , and Candida species in...vaginal itching, to differentiate between bacterial/ Trichomonas , and yeast vaginitis.7 The research plan was to compare women’s (N=715) self

  1. Cancer-Related Concerns among Women Newly Diagnosed with Gynecological Cancer: An Exploration of Age Group Differences

    Science.gov (United States)

    Myers Virtue, Shannon; Manne, Sharon L.; Ozga, Melissa; Kissane, David; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norm; Graff, John J.

    2014-01-01

    Objective The study aimed to characterize cancer-related concerns among women newly diagnosed with gynecological cancer from a developmental life stage perspective. The study compared degree of cancer-related concern between young women (≤ 45 years), middle age women (46–64 years), and older women (≥ 65 years). Methods/Materials Data from women (N =243) diagnosed with primary gynecological cancer who were participating in a randomized control trial were analyzed. Women completed a measure that assessed degree of concern in twelve cancer-related domains (physical functioning, cancer treatment, emotional functioning, sexual functioning, disease progression/death, own well-being, partner well-being, relationship with spouse/partner, body image, relationship with others, employment, and finances). Multivariate comparisons were made between the three age groups on the cancer-related concerns. Results There were age group differences in overall cancer-related concern and specific cancer-related domains. Young women reported the greatest cancer-related concern (p < .001). They reported greater concern over emotional functioning (p < .001) and sexual functioning (p < .001) compared to the middle and older age groups. Older women reported less concern over the impact of cancer on finances (p = 007). There were no differences between age groups in concern over physical impairment, cancer treatment, disease progression/death, own well-being, partner well-being, relationship with spouse/partner, body image, and relationship with others. Conclusions Age may play an important role in the impact of a gynecological cancer diagnosis in domains of functioning, specifically emotional functioning, sexual functioning, and finances. Other cancer-related areas may represent more universal degree of impact. Professionals may benefit form considering the impact of cancer from a developmental life stage perspective. PMID:24346489

  2. Holding back sharing concerns, dispositional emotional expressivity, perceived unsupportive responses and distress among women newly diagnosed with gynecological cancers.

    Science.gov (United States)

    Manne, Sharon; Myers, Shannon; Ozga, Melissa; Kissane, David; Kashy, Debby; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norm

    2014-01-01

    Little attention has been paid to the role of holding back sharing concerns in the psychological adaptation of women newly diagnosed with gynecological cancers. The goal of the present study was to evaluate the role of holding back concerns in psychosocial adjustment and quality of life, as well as a possible moderating role for emotional expressivity and perceived unsupportive responses from family and friends. Two hundred forty-four women diagnosed with gynecological cancer in the past 8 months completed measures of holding back, dispositional emotional expressivity, perceived unsupportive responses from family and friends, cancer-specific distress, depressive symptoms and quality of life. Emotional expressivity moderated the association between holding back and cancer-specific distress and quality of life, but not depressive symptoms. Greater holding back was more strongly associated with higher levels of cancer-related distress among women who were more emotionally expressive than among women who were less expressive. Perceived unsupportive responses did not moderate the associations between holding back and psychosocial outcomes. Holding back sharing concerns was more common in this patient population than other cancer populations. Dispositional expressivity played a role in how harmful holding back concerns was for women, while unsupportive responses from family and friends did not. © 2014.

  3. Holding Back Sharing Concerns, Dispositional Emotional Expressivity, Perceived Unsupportive Responses, and Distress Among Women Newly-Diagnosed with Gynecological Cancers

    Science.gov (United States)

    Manne, Sharon; Myers, Shannon; Ozga, Melissa; Kissane, David; Kashy, Debby; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norm

    2013-01-01

    Objective Little attention has been paid to the role of holding back sharing concerns in the psychological adaptation of women newly diagnosed with gynecological cancers. The goal of the present study was to evaluate the role of holding back concerns in psychosocial adjustment and quality of life, as well as a possible moderating role for emotional expressivity and perceived unsupportive responses from family and friends. Method Two hundred forty four women diagnosed with gynecological cancer in the past eight months completed measures of holding back, dispositional emotional expressivity, perceived unsupportive responses from family and friends, cancer-specific distress, depressive symptoms, and quality of life. Results Emotional expressivity moderated the association between holding back and cancer- specific distress and quality of life, but not depressive symptoms. Greater holding back was more strongly associated with higher levels of cancer-related distress among women who were more emotionally expressive than among women who were less expressive. Perceived unsupportive responses did not moderate the associations between holding back and psychosocial outcomes. Conclusion Holding back sharing concerns was more common in this patient population than other cancer populations. Dispositional expressivity played a role in how harmful holding back concerns was for women, while unsupportive responses from family and friends did not. PMID:24211156

  4. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype

    OpenAIRE

    Bargiela, S.; Steward, R.; Mandy, W.

    2016-01-01

    We used Framework Analysis to investigate the female autism phenotype and its impact upon the under-recognition of autism spectrum conditions (ASC) in girls and women. Fourteen women with ASC (aged 22-30 years) diagnosed in late adolescence or adulthood gave in-depth accounts of: 'pretending to be normal'; of how their gender led various professionals to miss their ASC; and of conflicts between ASC and a traditional feminine identity. Experiences of sexual abuse were widespread in this sample...

  5. Insurance coverage among women diagnosed with a gynecologic malignancy before and after implementation of the Affordable Care Act.

    Science.gov (United States)

    Moss, Haley A; Havrilesky, Laura J; Chino, Junzo

    2017-09-01

    The Patient Protection and Affordable Care Act (ACA) included provisions to expand insurance coverage by expanding Medicaid eligibility, providing subsidies of private coverage and enforcing an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among women diagnosed with a gynecologic malignancy. Using Surveillance, Epidemiology, and End Results 18 registries database, women newly diagnosed with cervical, uterine or ovarian cancer between 2008 and 2014 were identified. Insurance rates were examined before and after the passage of the ACA (2011) as well as before (January 2011-December 2013) versus after (January 2014-December 2014) Medicaid expansion to examine the impact of specific provisions. Rates of insurance were then compared between states that elected for expansion of Medicaid in 2014 vs. those states that had not. Among 181,866 diagnosed with cervical, uterine or ovarian cancer, there was a significant increase in patients enrolled in Medicaid after 2011. Between 2011 and 2014, there was a significant decrease in the rates of uninsured for all cancer types (p=0.001). Uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer (6% to 3% and 8% to 4% respectively, p≤0.001), and by 25% in cervical cancer (8.9% to 6.7%, p=0.001) after January 2014. Decreases in the rate of the uninsured and associated increases in insurance coverage were only observed in states which expanded Medicaid coverage (p≤0.001). The Affordable Care Act resulted in expanded insurance coverage for women diagnosed with a gynecologic cancer, however, the impact was significantly increased in states which increased their Medicaid eligibility in 2014. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Prolonged job strain and subsequent risk of cancer in women - a longitudinal study, based on the Danish Nurse Cohort.

    Science.gov (United States)

    Vesterlund, Gitte K; Høeg, Beverley L; Johansen, Christoffer; Heitmann, Berit L; E Bidstrup, Pernille

    2017-02-01

    The role of psychological stress in cancer risk is continuously debated. Stress at work is the most common form of stress and previous studies have shown inconsistent results regarding cancer risk. In this longitudinal study, we examined the association between prolonged job strain across six years and subsequent cancer risk. We used data from 6571 cancer-free women from the Danish Nurse Cohort aged 45-70 years at inclusion, and self-reported questionnaires on job strain at baseline in 1993 and again in 1999. Prolonged job strain was defined as high job busyness and speed, and low control in both 1993 and 1999. Information on cancer diagnosis was obtained from the Danish Cancer Registry. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for overall cancer as well as subgroups of virus immune-related, hormone-related, digestive and lung cancers according to level of prolonged job strain. The women were followed from 1 January 2000 until cancer diagnosis, emigration, death or 31 December 2013 (mean follow-up 13 years) and models were adjusted for potential confounders. Effect modification was examined according to working nightshifts and full time. No significant differences in the risk of overall cancer or any of the cancer subgroups were identified in relation to prolonged busyness, speed, influence, or overall job strain. Effect modification by working full time was observed when examining job influence in relation to overall cancer risk, and by working nightshifts when examining job influence in relation to hormone related cancer risk. However, none of the associations were significant in stratified analyses. We found no evidence of an increased risk of any cancer among women with prolonged job strain. Since a large proportion of cancer patients perceive psychological stress as a possible cause of their cancer disease, it is of importance to communicate these findings to the public.

  7. Psychometric properties of the Purpose-In-Life Test and age-related differences among women diagnosed with eating disorders.

    Science.gov (United States)

    García-Alandete, Joaquín; Ros, Montserrat Cañabate; Salvador, José Heliodoro Marco; Rodríguez, Sandra Pérez

    2017-12-21

    The aim of this study was to analyze the psychometric properties of the Purpose-In-Life Test (PIL), as well as the age-related differences in meaning in life in women diagnosed with eating disorders. Participants were 250 Spanish women diagnosed with eating disorders who ranged from 12 to 60 years old. Confirmatory Factor Analysis, descriptive analyses, estimation of the internal consistency of the PIL, correlations between the PIL and the Beck Hopelessness Scale (BHS), Overweight Preoccupation Scale (OPS), and Body Investment Scale (BIS), and age differences were calculated. A 19-item model that showed a good fit and internal consistency, a negative correlation between the PIL and both the BHS and OPS, and a positive correlation with the BIS, as well as significant differences between the adolescents and the mature adults, were found. It would be advisable to increase the inclusion of meaning in life in psychotherapeutic interventions with women diagnosed with eating disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Effects of advanced nursing care on quality of life and cost outcomes of women diagnosed with breast cancer.

    Science.gov (United States)

    Ritz, L J; Nissen, M J; Swenson, K K; Farrell, J B; Sperduto, P W; Sladek, M L; Lally, R M; Schroeder, L M

    2000-07-01

    To evaluate quality of life (QOL) and cost outcomes of advanced practice nurses' (APNs') interventions with women diagnosed with breast cancer. Randomized clinical trial. Integrated healthcare system in a midwestern suburban community. 210 women with newly diagnosed breast cancer with an age range of 30-85 years. The control group (n = 104) received standard medical care. The intervention group (n = 106) received standard care plus APN interventions based on Brooten's cost-quality model and the Oncology Nursing Society's standards of advanced practice in oncology nursing QOL was measured using the Functional Assessment of Cancer Therapy, Mishel Uncertainty in Illness Scale and Profile of Mood States at seven intervals over two years. Information about costs (charges and reimbursement) was collected through billing systems. Uncertainty, mood states, well-being, charges, and reimbursement. Uncertainty decreased significantly more from baseline in the intervention versus control group at one, three, and six months after diagnosis (p = 0.001, 0.026, and 0.011, respectively), with the strongest effect on subscales of complexity, inconsistency, and unpredictability. Unmarried women and women with no family history of breast cancer benefited from nurse interventions in mood states and well-being. No significant cost differences were found. APN interventions improved some QOL indicators but did not raise or lower costs. The first six months after breast cancer diagnosis is a critical time during which APN interventions can improve QOL outcomes. More research is necessary to define cost-effective interventions.

  9. Beyond the baby blues: perspectives of women diagnosed with a mood disorder on children, pregnancy and medication.

    Science.gov (United States)

    Paterson, Amelia; Parker, Gordon; Fletcher, Kathryn; Graham, Rebecca

    2013-04-01

    The aim of this study was to explore the views of women diagnosed with a mood disorder about children, medication and pregnancy. Female patients from the Black Dog Institute were invited to complete a questionnaire regarding their views about pregnancy, children and medication during pregnancy. Diagnostic groupings were derived by assessing DSM-IV criteria for mood disorders. Unipolar and bipolar patient responses were analysed to determine any differences between groups. Women with bipolar disorder were more concerned than those with a unipolar condition about the impact pregnancy would have on their mood, as well as the potential for their offspring to inherit a mood condition. Both groups of women expressed concerns regarding the child-rearing environment, and stated that knowing the risk their child could have of developing a mood disorder would encourage them to be more vigilant parents. While both groups were concerned about the environment in which they would raise their child and wanted to be vigilant parents, women diagnosed with a bipolar condition expressed stronger opinions regarding the impact that their pregnancy could have on their mood disorder, and passing the mood disorder onto their children.

  10. Racial and Ethnic Differences in Substance Use Diagnoses, Comorbid Psychiatric Disorders, and Treatment Initiation among HIV-Positive and HIV-Negative Women in an Integrated Health Plan.

    Science.gov (United States)

    Storholm, Erik David; Silverberg, Michael J; Satre, Derek D

    2016-01-01

    Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a diverse sample of HIV-positive women (n = 228) and a demographically similar cohort of HIV-negative women (n = 693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. HIV-positive women were less likely to initiate SUD treatment. Significant racial/ethnic differences were found among both HIV-positive and HIV-negative women with respect to SUD diagnosis type and diagnosis of comorbid psychiatric disorders. Among the HIV-negative women, rates of SUD treatment initiation were lower for black women than for white or Latina women. Multivariable logistic regression models showed that alcohol, cannabis, and opiate diagnoses were predictive of SUD treatment initiation for both cohorts, while amphetamine diagnoses, comorbid depressive disorder, and being white or Latina were predictive of SUD treatment initiation for HIV-negative, but not HIV-positive, women. Findings suggest that clinicians need to be aware of differences in substances of abuse, comorbid psychiatric disorders, and to consider the demographic and social factors that may contribute to differences in SUD treatment initiation among HIV-positive and HIV-negative women.

  11. Value of cervical cytology in diagnosing endometrial carcinoma in women with postmenopausal bleeding

    NARCIS (Netherlands)

    van Doom, Helena C.; Opmeer, Brent C.; Kooi, G. Sjarlot; Ewing-Graham, Patrica C.; Kruitwagen, Roy F. P. M.; Mol, Ben W. J.

    2009-01-01

    OBJECTIVE: To assess the accuracy of the cervical smear in the diagnosis of endometrial cancer in women with postmenopausal bleeding, with an emphasis on the diagnostic relevance of normal endometrial cells. STUDY DESIGN: Women presenting with abnormal postmenopausal bleeding, not using hormone

  12. Group-based trajectory modeling of fear of disease recurrence among women recently diagnosed with gynecological cancers.

    Science.gov (United States)

    Manne, Sharon L; Myers-Virtue, Shannon; Kissane, David; Ozga, Melissa L; Kashy, Deborah A; Rubin, Stephen C; Rosenblum, Norman G; Heckman, Carolyn J

    2017-11-01

    Fear of cancer recurrence is an important clinical phenomenon and is associated with decrements in life domains. The study goals were to characterize patterns of global fear of recurrence (FOR) and 4 domains of fear (health, role, womanhood, and death worry) over time in women who were diagnosed with gynecological cancer and to identify demographic, medical, and psychological predictors of FOR. One hundred eighteen women participating in the usual care arm of a randomized trial completed the Concerns about Recurrence scale as well as measures of depressive symptoms, cancer-specific distress, coping, coping efficacy, and social network responses at 4 time points. The majority of the sample was diagnosed with stage 3 ovarian cancer. Group-based trajectory modeling identified subgroups of women with high-stable (49.1%), high-decreasing (25.3%), and low-stable (25.5%) trajectories for global FOR. For role worries, 3 similar group trajectories were identified. For health worries, modeling identified subgroups with high-decreasing (19.1%) and low-increasing (80.9%) trajectories. For womanhood worries, modeling identified subgroups with high-increasing (15.7%) and low-decreasing (84.2%) trajectories. Young age, metastatic cancer, depression, cancer distress, holding back, and lower coping efficacy were associated with the high-stable global FOR and at least 1 domain of FOR. Almost half of the women recently diagnosed with gynecological cancer evidence persistently elevated FOR over the 6-month period postdiagnosis. Psychological interventions to reduce FOR may be more effective if they focus on teaching patients coping skills, as well as greater comfort expressing cancer-specific concerns to others. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Prognosis of women with primary breast cancer diagnosed during pregnancy: Results from an international collaborative study

    NARCIS (Netherlands)

    F. Amant (Frédéric); G. von Minckwitz (G.); S.N. Han (Sileny); M. Bontenbal (Marijke); A. Ring (Alistair); J. Giermek (Jerzy); H. Wildiers (Hans); T. Fehm (Tanja); S.C. Linn (Sabine); B. Schlehe (Bettina); P. Neven (Patrick); P. Westenend (Pieter); V. Müller (Volkmar); K. van Calsteren (Kristel); B. Rack (Brigitte); V. Nekljudova (Valentina); N. Harbeck (Nadia); M. Untch (Michael); P.O. Witteveen (Petronella); K. Schwedler (Kathrin); C. Thomssen (Christoph); B. Van Calster (Ben); S. Loibl (Sibylle)

    2013-01-01

    textabstractPurpose: We aimed to determine the prognosis of patients with breast cancer diagnosed during pregnancy (BCP). Patients and Methods: In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and

  14. Acquired auditory agnosia in childhood and normal sleep electroencephalography subsequently diagnosed as Landau-Kleffner syndrome: a report of three cases.

    Science.gov (United States)

    van Bogaert, Patrick; King, Mary D; Paquier, Philippe; Wetzburger, Catherine; Labasse, Catherine; Dubru, Jean-Marie; Deonna, Thierry

    2013-06-01

      We report three cases of Landau-Kleffner syndrome (LKS) in children (two females, one male) in whom diagnosis was delayed because the sleep electroencephalography (EEG) was initially normal.   Case histories including EEG, positron emission tomography findings, and long-term outcome were reviewed.   Auditory agnosia occurred between the age of 2 years and 3 years 6 months, after a period of normal language development. Initial awake and sleep EEG, recorded weeks to months after the onset of language regression, during a nap period in two cases and during a full night of sleep in the third case, was normal. Repeat EEG between 2 months and 2 years later showed epileptiform discharges during wakefulness and strongly activated by sleep, with a pattern of continuous spike-waves during slow-wave sleep in two patients. Patients were diagnosed with LKS and treated with various antiepileptic regimens, including corticosteroids. One patient in whom EEG became normal on hydrocortisone is making significant recovery. The other two patients did not exhibit a sustained response to treatment and remained severely impaired.   Sleep EEG may be normal in the early phase of acquired auditory agnosia. EEG should be repeated frequently in individuals in whom a firm clinical diagnosis is made to facilitate early treatment. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  15. How to diagnose equal opportunities between women and men in organizations

    National Research Council Canada - National Science Library

    Amaia Lusa; Carme Martínez; Maria Dolors Calvet; Olga Pons; Marta Tura

    2009-01-01

    .... Even today, it is rare to find women at the top level in companies. The path to equal opportunities is long and the only way to improve the situation is by means of appropriate equal opportunities plans...

  16. Association between gastrointestinal events and osteoporosis treatment initiation in women diagnosed with osteoporosis in France: a retrospective analysis.

    Science.gov (United States)

    Cortet, Bernard; Modi, Ankita; Tang, Jackson; Fan, Chun-Po Steve; Sajjan, Shiva; Weaver, Jessica Papadopoulos

    2016-04-30

    A substantial portion of women diagnosed with osteoporosis (OP) do not initiate pharmacotherapy to reduce fracture risk. In clinical practice, gastrointestinal (GI) events have been linked with OP therapy discontinuation. However, there is limited research examining GI events as barrier to treatment initiation following an OP diagnosis. The objective of this study was to examine the association between gastrointestinal (GI) events and osteoporosis (OP) treatment initiation among post-menopausal women diagnosed with osteoporosis in France. A retrospective claims analysis of the Mediplus France database during 1997 to 2010 identified women aged ≥ 55 with an OP diagnosis and without prior OP treatment (first diagnosis date was defined as the index date). GI events were identified during the 1 year pre-index and up to 1 year post-index. OP treatment initiation post-index was identified based on the presence of claims for any bisphosphonate (BIS) or non-BIS OP medication within 1 year post-index. Multivariate models (logistic regression, Cox proportional hazards regression and discrete choice) adjusted for pre-index patient characteristics were used to assess the association of pre- and post-index GI events with the likelihood of initiating OP treatment, and the type of treatment initiated (BIS vs. non-BIS). A total of 10,292 women (mean age 70.3 years) were identified; only 25% initiated OP treatment. Post-index GI events occurred in 11.5% of patients, and were associated with a 75.7% lower likelihood of initiating OP treatment. Among treated patients, a discrete choice model estimated that patients with post-index GI events were 34.6% less likely to receive BIS vs non-BIS as compared to patients without post-index GI events. Among women aged ≥ 55 years with an OP diagnosis, post-index GI events were associated with a lower likelihood of OP treatment initiation.

  17. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  18. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study

    Science.gov (United States)

    Patel, Ansha; Sharma, P. S. V. N.; Narayan, Pratapkumar; Binu, V. S.; Dinesh, N.; Pai, Praveena Joglekar

    2016-01-01

    BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were “semi-structured questionnaire” compiled by the authors, “ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines),” and “Psychological Evaluation Test for infertility.” STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties. PMID:27110075

  19. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study.

    Science.gov (United States)

    Patel, Ansha; Sharma, P S V N; Narayan, Pratapkumar; Binu, V S; Dinesh, N; Pai, Praveena Joglekar

    2016-01-01

    According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)," and "Psychological Evaluation Test for infertility." Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties.

  20. Progression of thyroid diseases in women with thyroid gland disorder diagnosed during pregnancy

    OpenAIRE

    Krejčová, Simona

    2010-01-01

    Diploma thesis is based on a four-year study the goal which was to demonstrate on a group of pregnant and postpartum women the frequency and severity of thyroid disease in pregnancy and after childbirth, and thus support the introduction of screening of function thyreidopathias into normal practice within screening for congenital defects in first trimester of pregnancy. In 3937 sera from women in the 10th - 12 week of pregnancy were, with informed consent of pregnant, determined TSH and anti ...

  1. Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses.

    Directory of Open Access Journals (Sweden)

    Martha L Carvour

    Full Text Available Neurologic complications of human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS.Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population.Women (n=27 had significantly poorer outcomes than men (n=198 in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35, and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men. Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women.The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

  2. Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses.

    Science.gov (United States)

    Carvour, Martha L; Harms, Jerald P; Lynch, Charles F; Mayer, Randall R; Meier, Jeffery L; Liu, Dawei; Torner, James C

    2015-01-01

    Neurologic complications of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS). Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population. Women (n=27) had significantly poorer outcomes than men (n=198) in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35), and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men). Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women. The survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

  3. Pretreatment Differences in Intraindividual Variability in Reaction Time between Women Diagnosed with Breast Cancer and Healthy Controls.

    Science.gov (United States)

    Yao, Christie; Rich, Jill B; Tannock, Ian F; Seruga, Bostjan; Tirona, Kattleya; Bernstein, Lori J

    2016-05-01

    Chemotherapy has adverse effects on cognitive performance in women treated for breast cancer, but less is known about the period before chemotherapy. Studies have focused on mean level of performance, yet there is increasing recognition that variability in performance within an individual is also an important behavioral indicator of cognitive functioning and underlying neural integrity. We examined intraindividual variability (IIV) before chemotherapy and surgery in women diagnosed with breast cancer (n=31), and a healthy control group matched on age and education (n=25). IIV was calculated across trials of a computerized Stroop task, including an examination of the slowest and fastest trials of reaction time (RT) responses. The groups were equivalent on overall accuracy and speed, and participants in both groups were less accurate and slower on incongruent trials compared with congruent trials. However, women with breast cancer became more variable with increased task difficulty relative to healthy controls. Among the slowest RT responses, women with breast cancer were significantly more variable than healthy controls on incongruent trials. This suggests that a specific variability-producing process (e.g., attentional lapses) occurs in task conditions that require executive control (e.g., incongruent trials). Results are consistent with other evidence of executive dysfunction among women treated for breast cancer. These findings highlight the importance of pretreatment assessment and show that variability in performance provides information about cognition that measures of central tendency do not.

  4. The unrecognized burden of cardiovascular risk factors in women newly diagnosed with endometrial cancer: A prospective case control study.

    Science.gov (United States)

    Kitson, Sarah J; Lindsay, Jennifer; Sivalingam, Vanitha N; Lunt, Mark; Ryan, Neil A J; Edmondson, Richard J; Rutter, Martin K; Crosbie, Emma J

    2018-01-01

    Cardiovascular disease is a major cause of death in endometrial cancer survivors. The aim of this study was to determine whether women newly diagnosed with endometrial cancer have a higher prevalence of cardiovascular risk factors than the general population. The prevalence of adequately treated and unrecognized/inadequately treated cardiovascular risk factors and the corresponding 10-year cardiovascular risk by QRISK2 score was measured in 150 consecutive women undergoing primary treatment for endometrioid endometrial cancer in the North West of England, and 746 age and ethnicity-matched control women from the Health Survey for England 2014. Women with endometrial cancer had higher proportions of obesity (BMI≥30 60.7% vs. 32.4%, pendometrial cancer cases had a higher prevalence of incident hyperglycemia (57.2%vs.11.5%, p4.5 (26.7%vs.13.7%, pendometrial cancer have a higher prevalence of cardiovascular risk factors than women without the disease. Early identification and treatment of these risk factors could improve outcomes for endometrial cancer survivors. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  5. 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.

  6. Association between adjuvant chemotherapy and risk of acute kidney injury in elderly women diagnosed with early-stage breast cancer.

    Science.gov (United States)

    Li, Shuling; Liu, Jiannong; Virnig, Beth A; Collins, Allan J

    2017-02-01

    We studied elderly Medicare enrollees newly diagnosed with early-stage breast cancer to examine the association between adjuvant chemotherapy and acute kidney injury (AKI). Using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we conducted a retrospective cohort study including women diagnosed with stages I-III breast cancer at ages 66-89 years between 1992 and 2007. We performed one-to-one matching on time-dependent propensity score on the day of adjuvant chemotherapy initiation within 6 months after the first cancer-directed surgery based on the estimated probability of chemotherapy initiation at each day for each patient, using a Cox proportional hazards model. We estimated the cumulative incidence of AKI using Kaplan-Meier methods. We used Cox proportional hazards models to evaluate the association between chemotherapy and the risk of AKI, and compared the risk among major chemotherapy types. The study included 28,048 women. The 6-month cumulative incidence of AKI was 0.80% for chemotherapy-treated patients, compared with 0.30% for untreated patients (P associated with a nearly threefold increased risk of AKI [hazard ratio (HR) 2.73; 95% CI 1.8-4.1]. Compared with anthracycline-based chemotherapy, the HRs (95% CIs) were 1.66 (0.94-2.91), 0.88 (0.53-1.47), and 1.15 (0.57-2.32) for taxane-based, CMF, and other chemotherapy, respectively. Our findings showed that adjuvant chemotherapy was associated with increased risk of AKI in elderly women diagnosed with early-stage breast cancer. The risk seemed to vary by regimen type, but the differences were not statistically significant.

  7. The prognosis of women diagnosed with breast cancer before, during and after pregnancy: a meta-analysis.

    Science.gov (United States)

    Hartman, Emily K; Eslick, Guy D

    2016-11-01

    Previous meta-analyses have examined the prognosis of women with pregnancy-associated breast cancer (PABC) as well as pregnancy that follows breast cancer diagnosis. Since then, many additional studies have been performed. We conducted an updated meta-analysis to examine the prognosis for women who become pregnant before, during and after a diagnosis of breast cancer. We also performed analyses on the various subgroups within PABC such as pregnancy and postpartum cases, as well as on time periods postpartum. We identified studies that reported on overall (OS) and disease-free survival (DFS) in patients diagnosed with breast cancer during pregnancy or up to 5 years postpartum from four electronic databases. We also identified studies that reported on OS and DFS where pregnancy up to 5 years occurred after a breast cancer diagnosis. 41 studies met our inclusion criteria (cases = 4929; controls = 61,041) for pregnancy occurring during or before breast cancer diagnosis. There was an overall increased risk of death amongst patients compared to non-pregnant controls [HR 1.57; 95 % CI 1.35-1.82]. Subgroup analysis indicated poor survival outcomes for those diagnosed either during pregnancy or postpartum (PABC) [HR 1.46; 95 % CI 1.17-1.82] as well as those diagnosed during pregnancy alone [HR 1.47; 95 % CI 1.04-2.08]. Those diagnosed postpartum had the poorest overall survival [HR 1.79; 95 % CI 1.39-2.29]. Similarly, patients with PABC had decreased DFS compared to controls [HR 1.51; 95 % CI 1.22-1.88]. Those diagnosed postpartum were the most at risk of disease progression or relapse [HR 1.86; 95 % CI 1.17-2.93]. 19 studies met our inclusion criteria (cases = 1829; controls = 21,907) for pregnancy following breast cancer diagnosis. Such women had a significantly reduced risk of death compared to those who did not become pregnant [pHR 0.63; 95 % CI 0.51-0.79]. A subgroup analysis to account for the "healthy mother effect" generated similar results [pHR 0

  8. Plasma Protein Profiles Differ Between Women Diagnosed with Cervical Intraepithelial Neoplasia (CIN 1 and 3

    Directory of Open Access Journals (Sweden)

    Edward E. Partridge

    2006-01-01

    Full Text Available Early detection of precancerous cells in the cervix and their clinical management is the main purpose of cervical cancer prevention and treatment programs. Cytological findings or testing for high risk (HR-human papillomavirus (HPV are inadequately sensitive for use in triage of women at high risk for cervical cancer. The current study is an exploratory study to identify candidate surface-enhanced laser desorption/ionization (SELDI time of flight (TOF mass spectrometry (MS protein profiles in plasma that may distinguish cervical intraepithelial neoplasia (CIN 3 from CIN 1 among women infected with HR-HPV. We evaluated the SELDI-TOF-MS plasma protein profiles of HR-HPV positive 32 women with CIN 3 (cases and 28 women with CIN1 (controls. Case-control status was kept blinded and triplicates of each sample and quality control plasma samples were randomized and after robotic sample preparations were run on WCX2 chips. After alignment of mass/charge (m-z values, an iterative method was used to develop a classifier on a training data set that had 28 cases and 22 controls. The classifier developed was used to classify the subjects in a test data set that has six cases and six controls. The classifier separated the cases from controls in the test set with 100% sensitivity and 100% specificity suggesting the possibility of using plasma SELDI protein profiles to identify women who are likely to have CIN 3 lesions.

  9. Salivary flow rates among women diagnosed with benign and malignant tumors.

    Science.gov (United States)

    Napeñas, Joel J; Miles, Leslie; Guajardo-Streckfus, Cynthia; Streckfus, Charles F

    2013-01-01

    The purpose of this study was to compare salivary flow rates (SWS) among patients diagnosed with benign and varying malignant solid tumors with the comparison group, prior to the initiation of any treatment. An evaluation of the results found that mean baseline SWS flow rates were higher for healthy patients (1.55 ml/min) when compared to patients diagnosed with benign tumors (1.13 ml/min), breast cancer (1.09 ml/min), and reproductive carcinomas (0.94 ml/min). The overall model (F = 7.76; p flow rates. The results suggest that salivary secretion is lower among both benign and malignant tumor subjects prior to the initiation of treatment. Salivary evaluations of subjects prior to treatment may be useful in identifying individuals at risk for oral complications during chemotherapy. ©2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  10. Changes in social function and body image in women diagnosed with breast cancer undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Sabrina Nunes Garcia

    2017-05-01

    Full Text Available The objective of this study was to investigate the impairment of social and emotional functions, body image and future perspective in women with breast cancer undergoing chemotherapeutic treatment. This is a longitudinal research conducted from October 2012 to October 2013 at the chemotherapy unit of a private institution of Oncology located in Curitiba, PR, Brazil. Sociodemographic and clinical questionnaires were applied, Quality of Life Questionnaire Core 30 e Quality of Life Questionnaire – Breast Cancer Module, to 48 women subjected for the first time to chemotherapy, in three different stages of the treatment. Analysis with Friedman`s, Spearman and Kruskal-Wallis nonparametric tests was performed. Changes were observed in social function and body image, which compromised quality of life significantly. Results can subsidize the planning of and adjustments to the care provided to these women by considering the perception about the impact of therapy on QL and their perspectives.

  11. The psychological profile and affective response of women diagnosed with unexplained infertility undergoing in vitro fertilization.

    Science.gov (United States)

    Aisenberg Romano, Gabi; Ravid, Hila; Zaig, Inbar; Schreiber, Shaul; Azem, Foad; Shachar, Izhak; Bloch, Miki

    2012-12-01

    It has been hypothesized that unexplained infertility may be related to specific personality and coping styles. We studied two groups of women with explained infertility (EIF, n = 63) and unexplained infertility (UIF, n = 42) undergoing an in vitro fertilization (IVF) cycle. Women completed personality and coping style questionnaires prior to the onset of the cycle, and state depression and anxiety scales before and at two additional time points during the cycle. Almost no in-between group differences were found at any of the measured time points in regards to the Minnesota Multiphasic Personality Inventory-2 validity and clinical scales, Illness Cognitions and Life Orientation Test, or for the situational measures. The few differences found suggest a more adaptive, better coping, and functioning defensive system in women with EIF. In conclusion, we did not find any clinically significant personality differences or differences in depression or anxiety levels between women with EIF and UIF during an IVF cycle. Minor differences found are probably a reaction to the ambiguous medical situation with its uncertain prognosis, amplifying certain traits which are not specific to one psychological structure but rather to the common experience shared by the group. The results of this study do not support the possibility that personality traits are involved in the pathophysiology of unexplained infertility.

  12. E-Cigarettes for Immediate Smoking Substitution in Women Diagnosed with Cervical Dysplasia and Associated Disorders

    Directory of Open Access Journals (Sweden)

    Shirley A. James

    2016-03-01

    Full Text Available The aim of this study was to determine if 31 women with cervical dysplasia and associated conditions exacerbated by smoking would be successful substituting cigarettes with their choice of either nicotine replacement therapy (NRT or electronic cigarettes (EC. Women received motivational interviewing and tried both NRT and ECs, choosing one method to use during a six-week intervention period. Daily cigarette consumption was measured at baseline, six, and 12 weeks, with differences analyzed by the Wilcoxon signed-rank test. Study analysis consisted only of women choosing to use ECs (29/31, as only two chose NRT. At the 12-week follow-up, the seven day point prevalence abstinence from smoking was 28.6%, and the median number of cigarettes smoked daily decreased from 18.5 to 5.5 (p < 0.0001. The median number of e-cigarette cartridges used dropped from 21 at the six-week follow-up to 12.5 at the 12-week follow-up. After initiating EC use, women at risk for cervical cancer were able to either quit smoking or reduce the number of cigarettes smoked per day. Although a controlled trial with a larger sample size is needed to confirm these initial results, this study suggests that using ECs during quit attempts may reduce cigarette consumption.

  13. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7)

    DEFF Research Database (Denmark)

    Oza, Amit M; Cook, Adrian D; Pfisterer, Jacobus

    2015-01-01

    BACKGROUND: The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results of the ...

  14. Women and children exposed to domestic violence: themes in maternal interviews about their children's psychiatric diagnoses.

    Science.gov (United States)

    Kearney, Joan A

    2010-02-01

    Twelve mothers who had experienced domestic violence and whose children had received psychiatric diagnoses before school age were interviewed. An attachment based tool, the Reaction to Diagnosis Interview, was employed as it accesses maternal representational content. Using psychodynamic and attachment based models as a theoretical framework, content analysis was performed and four thematic categories emerged from the data: intense negative emotionality and suffering; diminished cognitive coping and dysregulation; preoccupation with trauma related material; and constricted causal attributions. Thematic categories as well as inter-relationships among themes are described and discussed in terms of current literature.

  15. Health literacy and fear of cancer progression in elderly women newly diagnosed with breast cancer--A longitudinal analysis.

    Science.gov (United States)

    Halbach, Sarah Maria; Enders, Anna; Kowalski, Christoph; Pförtner, Timo-Kolja; Pfaff, Holger; Wesselmann, Simone; Ernstmann, Nicole

    2016-05-01

    This study aims to investigate the distribution of health literacy levels and the association of health literacy with fear of cancer progression (FoP) over the course of cancer treatment in a sample of elderly women newly diagnosed with breast cancer. The analyses are part of a prospective, multicenter cohort-study (PIAT) that took place in Germany between 2013 and 2014. Elderly women (aged 65 years and older) newly diagnosed with breast cancer completed validated measures of health literacy and FoP directly after the breast cancer surgery and 40 weeks later. Multivariate random-effects regression analysis for longitudinal data was applied to estimate the association of health literacy with FoP considering socio-demographic, clinical and psychosocial characteristics of the patients. About half of the elderly breast cancer patients in our sample were classified as having limited health literacy (inadequate and problematic levels). Inadequate and problematic health literacy were significantly associated with higher levels of FoP in the elderly breast cancer patients. Limited health literacy is an independent risk factor for increased FoP. Enhancing health literacy could contribute to reducing patients' cancer-related fears. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. The Investigation of Symptoms and Diagnoses of Adult-Attention Deficit/ Hyperactivity Disorder in Women with Iron Deficiency Anemia.

    Science.gov (United States)

    Demirci, Kadir; Yildirim Baş, Funda; Arslan, Bahriye; Salman, Zeliha; Akpinar, Abdullah; Demirdaş, Arif

    2017-03-01

    The aim of this study was to investigate symptoms and diagnoses of Adult-Attention Deficit/Hyperactivity Disorder (ADHD) in women with iron deficiency anemia, to evaluate relationship between ADHD with clinical features and to compare with the women without iron deficiency anemia. Eighty-three newly diagnosed iron deficiency anemia patients and 70 healthy controls were included in this study. All participants were assessed using a sociodemographic form, Structured Clinical Interview I (SCID-I), Wender Utah Rating Scale (WURS); Moreover, participants having WURS scores 36 and above were also assessed using the Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria. In the study, 22.9% of patients with iron deficiency anemia and 12.9% of healthy controls were found to have WURS scores 36 and above. Fifteen patients (18.1%) in iron deficiency anemia group and two patients (2.9%) in control group had adult ADHD, when they were evaluated with Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria (p=0.007). The patients with iron deficiency anemia had significantly higher WURS scores compared to controls (p=0.002). The levels of iron and ferritin had negative correlation (r=-0.166, p<0.05; r=-0.255, p<0.01, respectively) and the levels of serum iron binding capacity had positive correlation (r=0.255, p<0.01) with the scores of WURS. The prevalence of adult ADHD is higher than those reported for general population in patients with iron deficiency anemia. Early diagnose and treatment of adult ADHD may positively contribute to the patients with iron deficiency anemia.

  17. Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses

    OpenAIRE

    Martha L Carvour; Jerald P Harms; Lynch, Charles F.; Randall R Mayer; Meier, Jeffery L.; Dawei Liu; Torner, James C.

    2015-01-01

    Objectives Neurologic complications of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS). Methods Retrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neuro...

  18. Anxiety depression and perception of control in women diagnosed with HIV/aids

    OpenAIRE

    López Martinez, Javier; Ossa Toro, Ana Maria

    2010-01-01

    Nowadays there is a significant increasing number of women with HIV cases. New medications have been developed to increase the amount of live but life quality remains as the problem because some psychological variables have a high impact on the infection process. With in the most important findings there is a considerable number of participants with high anxiety scores. Some people had high depression levels and in a smaller, but not less significative number they had low perception of contro...

  19. E-Cigarettes for Immediate Smoking Substitution in Women Diagnosed with Cervical Dysplasia and Associated Disorders.

    Science.gov (United States)

    James, Shirley A; Meier, Ellen M; Wagener, Theodore L; Smith, Katherine M; Neas, Barbara R; Beebe, Laura A

    2016-03-04

    The aim of this study was to determine if 31 women with cervical dysplasia and associated conditions exacerbated by smoking would be successful substituting cigarettes with their choice of either nicotine replacement therapy (NRT) or electronic cigarettes (EC). Women received motivational interviewing and tried both NRT and ECs, choosing one method to use during a six-week intervention period. Daily cigarette consumption was measured at baseline, six, and 12 weeks, with differences analyzed by the Wilcoxon signed-rank test. Study analysis consisted only of women choosing to use ECs (29/31), as only two chose NRT. At the 12-week follow-up, the seven day point prevalence abstinence from smoking was 28.6%, and the median number of cigarettes smoked daily decreased from 18.5 to 5.5 (p risk for cervical cancer were able to either quit smoking or reduce the number of cigarettes smoked per day. Although a controlled trial with a larger sample size is needed to confirm these initial results, this study suggests that using ECs during quit attempts may reduce cigarette consumption.

  20. The Treatment Decision-Making Process: Age Differences in a Sample of Women Recently Diagnosed with Nonrecurrent Early-Stage Breast Cancer.

    Science.gov (United States)

    Petrisek, Ann C.; Laliberte, Linda L.; Allen, Susan M.; Mor, Vincent

    1997-01-01

    Using retrospective, self-report data collected from women recently diagnosed with breast cancer (N=179), examines the influence of age differences in the treatment decision-making process. Findings indicate that older women were less likely than their younger counterparts to have desired participation in therapy selection or sought out medical…

  1. A new, preoperative, MRI-based scoring system for diagnosing malignant axillary lymph nodes in women evaluated for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    He, Ni, E-mail: 61684754@qq.com [Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China); Xie, Chuanmiao, E-mail: xiechm@sysucc.org.cn [Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China); Wei, Weidong, E-mail: weiwd@sysucc.org.cn [Department of Breast, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China); Pan, Changchuan, E-mail: 1253719670@qq.com [Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China); Wang, Wenyan, E-mail: 7344362@qq.com [College of Electronic Engineering, Guangxi Normal University, Guilin 541004 (China); Lv, Ning, E-mail: 409109980@qq.com [Department of Breast, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China); Wu, Peihong, E-mail: mit@caca.sina.net [Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou 510060 (China)

    2012-10-15

    Objective: Malignant axillary lymph nodes are an important predictor for breast cancer recurrence, but invasive dissection or biopsy is required for the diagnosis. We determined whether and how malignant nodes could be diagnosed preoperatively with magnetic resonance (MR) imaging. Materials and methods: We obtained MR images of all women evaluated for breast cancer at the Sun Yat-Sen University Cancer Center in 2010 and correlated the image characteristics of each axillary node with the pathologic diagnosis of the same node. Results: We analyzed 251 nodes (117 benign; 134 malignant) from 136 women (mean age, 44 years; range, 20–67). Mean diameter of the nodes was 18 mm (range, 5–58 mm). With pathologic diagnosis as the reference standard, MRI-based interpretations were 66.4% sensitive, 94% specific, and 79% accurate. Diameter, pathologic type, apparent diffusion coefficient value (ADC, b = 500 and 800), time-intensity curve (TIC) type of breast tumors correlated with node metastasis; ADC value (b = 500 and 800), TIC type, early enhancement rate, long-axis, short-axis, shape, margin and the location of nodes correlated with node metastasis (P < 0.001 for all). Tumor immunohistochemistry results for estrogen receptors, progesterone receptors, c-erbB-2, vascular endothelial growth factor, and Ki67 were not. An MRI-based lymph node scoring system based on these correlations had a specificity of 91%, a sensitivity of 93%, and an area under the ROC curve of 0.95 (P < 0.001). Conclusion: Metastatic axillary lymph nodes can be accurately diagnosed by MR in women with early breast cancer preoperatively and non-invasively. The scoring system appears to be superior to current methods.

  2. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy

    DEFF Research Database (Denmark)

    de Haan, Jorine; Verheecke, Magali; Van Calsteren, Kristel

    2018-01-01

    BACKGROUND: Awareness is growing that cancer can be treated during pregnancy, but the effect of this change on maternal and neonatal outcomes is unknown. The International Network on Cancer, Infertility and Pregnancy (INCIP) registers the incidence and maternal, obstetric, oncological, and neonatal...... outcomes of cancer occurring during pregnancy. We aimed to describe the oncological management and obstetric and neonatal outcomes of patients registered in INCIP and treated in the past 20 years, and assess associations between cancer type or treatment modality and obstetric and neonatal outcomes. METHODS......: This descriptive cohort study included pregnant patients with cancer registered from all 37 centres (from 16 countries) participating in the INCIP registry. Oncological, obstetric, and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between Jan 1, 1996, and Nov...

  3. Oncological Management and Pregnancy Outcomes in Women Diagnosed With Cancer During Pregnancy

    DEFF Research Database (Denmark)

    Verheecke, Magali; Van Calsteren, Kristel; Fruscio, Robert

    2017-01-01

    Aims The effect of the increased awareness of the potential to treat cancer during pregnancy is currently unknown. Therefore we aimed to analyse the oncological management and the obstetrical and neonatal outcomes of patients treated in the last 20 years by members of the International Network...... on Cancer, Infertility and Pregnancy (INCIP). Method Oncologic, obstetric and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between 1996 and 2016 were collected from the INCIP database. These data were evaluated with descriptive and multivariable...... analysis for the most common obstetrical and neonatal complications (preterm pre-labour rupture of membranes (PPROM) and/or contractions, small-for-gestational-age (SGA), and neonatal intensive care unit (NICU) admission). Results 1170 patients were included from 37 centres in 16 countries, including 955...

  4. Auto-antibodies and their association with clinical findings in women diagnosed with microscopic colitis.

    Directory of Open Access Journals (Sweden)

    Bodil Roth

    Full Text Available BACKGROUND: Microscopic colitis (MC is a disease manifested by diarrhoea and is divided into collagenous and lymphocytic colitis. The aetiology is unknown, but auto-immunity is suggested. Auto-antibodies have been only rarely examined in this entity. The aim of the study was to examine the prevalence of auto-antibodies, and to examine associations between the presence of antibodies and clinical findings. METHODS AND FINDINGS: Women with MC verified by biopsy and younger than 73 years, at any Department of Gastroenterology, in the district of Skåne, between 2002 and 2010 were invited to participate in this study. The patients were asked to complete both a questionnaire describing their medical history and the Gastrointestinal Symptom Rating Scale (GSRS. Blood samples were collected. Anti-nuclear antibodies (ANA, anti-neutrophil cytoplasmic antibodies (ANCA, anti-Saccharomyces cerevisiae antibodies (ASCA, and antibodies against glutamic acid decarboxylase (anti-GAD, islet antigens-like insulin 2 (anti-IA2, thyroid peroxidase (anti-TPO, and thyrotropin receptor (TRAK were analysed. Of 240 women identified, 133 were finally included in the study, median age 63 (59-67 years. Apart from the MC diagnosis, 52% also suffered from irritable bowel syndrome, 31% from hypertension and 31% from allergy. The prevalence of ANA (14%, ASCA IgG (13%, and anti-TPO antibodies (14% for these patients was slightly higher than for the general population, and were found together with other concomitant diseases. Patients had more of all gastrointestinal symptoms compared with norm values, irrespective of antibody expression. CONCLUSIONS: Women with MC have a slightly increased prevalence of some auto-antibodies. These antibodies are not associated with symptoms, but are expressed in patients with concomitant diseases, obscuring the pathophysiology and clinical picture of MC.

  5. [Evaluation of mortality after the analysis of the screening history in women diagnosed with infiltrating cervical cancer].

    Science.gov (United States)

    Castillo, Marta; Astudillo, Aurora; Clavero, Omar; Velasco, Julio; Ibáñez, Raquel; de Sanjosé, Silvia

    2017-06-16

    To assess the impact of screening history on the incidence of cervical cancer from 2000 to 2010 in Asturias. Retrospective study. All public hospitals in Asturias. From 374 women diagnosed with cervical cancer were retrieved. Clinical information, FIGO stage and all previous cytological data were extracted from clinical and histopathological records. Proportional differences were assessed using chi-square tests. Logistic regression analysis was used to estimate odds ratios and 95% confidence intervals. Women between 25 and 70years had no records of a previous cytology within 5.5years of cancer diagnosis in 65.6%. This proportion was related with older age, presence of symptoms and an advance tumor stage at diagnosis. Women over 70years old had no records of a previous cytology in 83.3%. An organized cervical cancer screening program and optimal quality of the system, monitored through audits, could help to reduce cervical cancer incidence and mortality in Asturias. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  6. Development of an mHealth Application for Women Newly Diagnosed with Osteoporosis without Preceding Fractures: A Participatory Design Approach.

    Science.gov (United States)

    Ravn Jakobsen, Pernille; Hermann, Anne Pernille; Søndergaard, Jens; Wiil, Uffe Kock; Clemensen, Jane

    2018-02-13

    mHealth is a useful tool to improve health outcome within chronic disease management. However, mHealth is not implemented in the field of postmenopausal osteoporosis even though it is a major worldwide health challenge. Therefore, this study aims to design and develop an mHealth app to support women in self-management of osteoporosis when they are diagnosed without preceding fractures. Participatory design is conducted in three phases. Based on identified needs in the first phase, a prototype is designed and developed in an iterative process in the second phase before the mHealth app is tested in the third phase. This paper focuses on the user activities in phase two and describes how a team of researchers, women, physicians, healthcare professionals, and app designers are involved in the participatory design process. The study shows that participatory design is a viable approach when developing an mHealth app for women with asymptomatic osteoporosis. Results obtained from the workshops and laboratory tests demonstrate the importance of feedback from users in the iterative process, as well as the participation of users and app designers in workshops and laboratory tests to enable mutual learning when developing new mHealth solutions. The regular member-checks and involvement of users helped to identify challenges associated with providing healthcare services through an app.

  7. Women's experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study.

    Science.gov (United States)

    Macey, Kat; Gregory, Angela; Nunns, David; das Nair, Roshan

    2015-06-20

    Recent research has highlighted controversies in the conceptualisation, diagnosis and treatment of vaginismus. Vaginal trainers are currently the most widely used treatment. Critiques have highlighted concerns that the evidence-base of its effectiveness is limited, with controlled trials reporting disappointing results, and its prescription promotes 'performance-based' sexuality which may be detrimental. Despite this, little has been done to seek women's views about their treatment. This study set out to explore women's experiences of vaginismus treatment with vaginal trainers, and to use their voices to propose guidelines for improving treatment. 13 women who had used vaginal trainers for vaginal penetration difficulties diagnosed as vaginismus were recruited through a specialist clinic, university campuses, and online forums. The women took part in semi-structured individual interviews (face-to-face/telephone/Skype), which were audio-recorded, transcribed verbatim and analysed using Thematic Analysis. Four superordinate themes were elicited and used to draft 'better treatment' guidelines. Themes were: (1) Lack of knowledge, (2) Invalidation of suffering by professionals, (3) Difficult journey, and (4) Making the journey easier. This paper describes themes (3) and (4). Difficult Journey describes the long and arduous 'Journey into treatment', including difficulties asking for help, undergoing physical investigations and negotiating 'the system' of medical referrals. It also describes the sometimes demoralising process of 'being in treatment', which includes emotional and practical demands of treatment. Making the journey easier highlights the importance of and limits to 'partner support'. 'Professional support' comprises personal qualities of professionals/therapeutic relationship, the value of specialist skills and knowledge and the need for facilitating couple communication about vaginismus. 'Peer support/helping each other' describes the importance of

  8. Age at first intercourse and subsequent sexual partnering among adult women in the United States, a cross-sectional study.

    Science.gov (United States)

    Magnusson, Brianna M; Nield, Jennifer A; Lapane, Kate L

    2015-02-07

    Concurrency and serial monogamy may increase risk for STIs when gaps fall within the infectious period. This study examined the association between early sexual debut and concurrent or serial sexual partnering among heterosexual adult women. We identified 6,791 heterosexually active women, ages 21-44, from the 2006-2010 National Survey of Family Growth, a multi-stage probability sample of women in the United States. Self-reported age at first intercourse was categorized as partnering was defined as concurrency (within the same month), serial monogamy with either a 1-3 month, or ≥4 month gap between partners, or monogamy (referent) in the year prior to interview. Polytomous logistic models provided adjusted odds ratios (aOR) and 95% confidence intervals (CI). Concurrent partnerships in the year prior to interview were reported by 5.2% of women. Serial monogamy with a 1-3 month gap was reported by 2.5% of women. Compared with women whose sexual debut was ≥18 years, those partners (aOR1-3 months: 2.13; 95% CI 1.15-3.94) as compared to women ≥18 years at sexual debut. Sexual debut at partners in U.S. women aged 21-44.

  9. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7)

    DEFF Research Database (Denmark)

    Oza, Amit M; Cook, Adrian D; Pfisterer, Jacobus

    2015-01-01

    by a minimisation algorithm stratified by FIGO stage, residual disease, interval between surgery and chemotherapy, and Gynecologic Cancer InterGroup group. The primary endpoint was progression-free survival; the study was also powered to detect a difference in overall survival. Analysis was by intention to treat......BACKGROUND: The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results...... chemotherapy group vs 48·4 months [47·0-49·9] in the bevacizumab group; p=0·20). An updated analysis of progression-free survival showed no difference between treatment groups. During extended follow-up, one further treatment-related grade 3 event (gastrointestinal fistula in a bevacizumab-treated patient...

  10. Metabolic syndrome and subsequent risk of type 2 diabetes and cardiovascular disease in elderly women Challenging the current definition

    DEFF Research Database (Denmark)

    Møller, Katrine Dragsbæk; Neergaard, Jesper; Laursen, Janne Marie

    2016-01-01

    ) and cardiovascular disease (CVD) in elderly Caucasian women. We further investigated if stratification of individuals not defined with MetS would add predictive power in defining future disease prevalence of individuals with MetS. The Prospective Epidemiological Risk Factor Study, a community-based cohort study......, followed 3905 Danish women since 2000 (age: 70.1±6.5) with no previous diagnosis of T2DM or CVD, holding all measurements used for MetS definition; central obesity, hypertension, hyperlipidemia, and hyperglycemia combined with register-based follow-up information. Elderly women with defined MetS presented...

  11. Antimicrobial susceptibility and vaginolysin in Gardnerella vaginalis from healthy and bacterial vaginosis diagnosed women.

    Science.gov (United States)

    Knupp de Souza, Daniele Maria; Diniz, Claudio Galuppo; Filho, Didier Silveira Castellano; Andrade de Oliveira, Laura Maria; Coelho, Débora Martins; Talha, Luciana De Souza; Nascimento, Thiago César do; Ferreira-Machado, Alessandra Barbosa; Silva, Vânia Lúcia da

    2016-09-30

    Bacterial vaginosis (BV) is a syndrome related to Gardnerella vaginalis and is characterized by an imbalance in the vaginal microbiota. This work focused on the evaluation of antimicrobial susceptibility patterns and the occurrence of the vaginolysin (vly) gene in G. vaginalis isolated from BV and non-BV patients. The vaginal secretions were collected randomly and processed for G. vaginalis isolation. The isolates were presumptively identified by β-hemolysis and oxidase and catalase tests. Polymerase chain reaction (PCR) was performed to confirm bacterial identity and to detect the vly gene. Antimicrobial susceptibility patterns were determined. Of 89 patients, G. vaginalis was isolated from 42 (37 BV and 5 non-BV), and 204 isolates were selected (179 from BV and 25 non-BV). The vly gene was detected in all G. vaginalis isolated from non-BV women and in 98.3% of the bacteria from BV patients. High resistance was observed for ampicillin (54.4%), metronidazole (59.8%), tinidazole (60.3%) and secnidazole (71.6%). Further studies are needed to better address the role of G. vaginalis and the vly gene in BV pathogenesis.

  12. Left in limbo – Experiences and needs among postmenopausal women newly diagnosed with osteoporosis without preceding osteoporotic fractures: A qualitative study

    DEFF Research Database (Denmark)

    Jakobsen, Pernille Ravn; Søndergaard, Jens; Hermann, Anne Pernille

    2018-01-01

    Introduction Despite the fact that the first osteoporotic fracture is preventable, osteoporosis is still a major health challenge. The disease is highly prevalent among postmenopausal women. However little is known about how to meet and support women, when they are diagnosed with osteoporosis...... without preceding fractures. Therefore this study aims at gaining a deeper understanding of how women experience being diagnosed. Furthermore to describe and identify their needs, which should be met in future healthcare services. Methods We conducted a phenomenological qualitative study. We included 17...... women aged 52–65 and collected data through semi-structured interviews. We analysed data following Giorgi's methodology. Findings Needs among the women were classified into three main themes: (1) needs of targeted and tailored information about osteoporosis, (2) needs of being prepared for GP visit...

  13. Histories of Childhood Victimization and Subsequent Mental Health Problems, Substance Use, and Sexual Victimization for a Sample of Incarcerated Women in the US

    Science.gov (United States)

    Tripodi, Stephen J.; Pettus-Davis, Carrie

    2012-01-01

    Women are entering US prisons at nearly double the rate of men and are the fastest growing prison population. Current extant literature focuses on the prevalence of the incarceration of women, but few studies exist that emphasize the different trajectories to prison. For example, women prisoners have greater experiences of prior victimization, more reports of mental illness, and higher rates of illicit substance use. The purpose of this study was to understand the prevalence of childhood victimization and its association with adult mental health problems, substance abuse disorders, and further sexual victimization. The research team interviewed a random sample of 125 women prisoners soon to release from prison to gather information on their childhood physical and sexual victimization, mental health and substance abuse problems as an adult, and sexual victimization in the year preceding incarceration. Results indicate that women prisoners in this sample who were both physically and sexually victimized as a child were more likely to be hospitalized as an adult for a psychological or emotional problem. Women who were sexually victimized or both physically and sexually victimized were more likely to attempt suicide. Women who experienced physical victimization as children and women who were both physically and sexually victimized were more likely to have a substance use disorder and women who were sexually abused as children or both physically and sexually victimized were more likely to be sexually abused in the year preceding prison. This article ends with a discussion about prisons’ role in providing treatment for women prisoners and basing this treatment on women’s trajectories to prison, which disproportionately includes childhood victimization and subsequent mental health and substance use problems. PMID:23196054

  14. Use of azathioprine and corticosteroids during pregnancy and birth outcome in women diagnosed with inflammatory bowel disease.

    Science.gov (United States)

    Plauborg, Anne Veie; Hansen, Anne Vinkel; Garne, Ester

    2016-06-01

    The aim of this study was to describe prescription patterns for azathioprine and corticosteroids for pregnant women with inflammatory bowel diseases (IBD) before, during, and after pregnancy and to describe pregnancy outcomes. A cohort composed of all singleton pregnancies in Danish registries from 1996 to 2009 was divided by maternal IBD status: Crohn's disease (CD, n = 827), ulcerative colitis (UC, N = 1361), or no IBD diagnosis (background population, n = 814,231). The number of women with a prescription for azathioprine, local and systemic steroids within a 3-month period was computed for each of the pregnancy trimesters and the year before and after pregnancy. Outcomes of interest were stillbirth, perinatal mortality, low birth weight (LBW), preterm birth, and small for gestational age (SGA). Number of prescriptions for azathioprine decreased just before and during pregnancy and increased after birth. Number of prescriptions for local and systemic corticosteroids decreased approximately 30% compared with before pregnancy and increased in the second trimester. There was an increased risk among mothers with IBD of LBW (adjusted odds ratio [adjOR]: CD: 2.25 [95% confidence interval {CI}, 1.74-2.91], UC: 1.81 [95% CI, 1.42-2.30]), preterm birth (adjOR: CD: 2.54 [95% CI, 2.04-3.15], UC: 1.86 [95% CI, 1.52-2.27]), and SGA (adjOR: CD: 1.99 [95% CI, 1.26-3.15], UC: 1.80 [95% CI, 1.18-2.75]). Use of azathioprine and corticosteroids was often reduced or discontinued before or during early pregnancy followed by an increased use of corticosteroids later in pregnancy. Women diagnosed with IBD and with prescriptions for azathioprine and/or corticosteroids, have an increased risk of LBW, pre-term birth, and SGA. Birth Defects Research (Part A) 106:494-499, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in nordic women

    DEFF Research Database (Denmark)

    Klingberg, Sofia; Mehlig, Kirsten; Lanfer, Anne

    2015-01-01

    OBJECTIVE: Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC), measured once, was protective against total and ca...... and ever-smokers. This implies the importance of developing strategies to prevent central fat deposition.......OBJECTIVE: Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC), measured once, was protective against total...

  16. PP046. A unique urinary proteome profile at 15 weeks' gestation in low-risk women with subsequent pre-eclampsia.

    Science.gov (United States)

    Bramham, Kate; Mistry, Hiten; Lynham, Steven; Ward, Malcolm; Fiseha, Dima; Poston, Lucilla; Chappell, Lucy

    2013-04-01

    Pre-eclampsia remains one of the leading causing of maternal and perinatal morbidity and mortality. Recent plasma biomarker discovery has improved the diagnosis of pre-eclampsia; however no factors which are quantitatively different remote from disease onset have been identified. Urine represents an ideal non-invasive fluid for analysis and potentially rich source of biomarker detection. Proteomics is a rapidly developing technique which allows the detection and identification of individual proteins. We propose that early glomerular changes will result in significant differences in the urinary proteome of women destined to develop pre-eclampsia, prior to detection of the clinical syndrome. To define a urinary profile at 15 weeks' gestation, predictive of subsequent pre-eclampsia, in low risk nulliparous women. Urine samples from twelve women at 15 weeks' gestation who subsequently developed pre-eclampsia (cases) and twelve gestation-, BMI- and age-matched controls were selected from the SCreening Of Pregnancy Endpoints (SCOPE) cohort. A proteome profile was established using a validated workflow, involving selective immunodepletion, 1D SDS-PAGE gel fractionation, in-gel digestion of gel sections, LC-MS/MS analysis and normalised spectral analysis. More than 900 proteins were identified using minimal stringency in Scaffold. Spectral counts revealed 24 proteins were significantly upregulated in cases and absent in controls and 3 proteins were absent in cases but present in controls. For protection of intellectual property protein identities are omitted. A urinary proteomic signature can be identified in the urine of women at 15 weeks' gestation who subsequently develop pre-eclampsia. Formal quantitative analysis will be performed with selective reactive-monitoring analysis, followed by subsequent validation of this differential proteomic profile using a larger number samples per groups. Copyright © 2013. Published by Elsevier B.V.

  17. Metabolic syndrome and subsequent risk of type 2 diabetes and cardiovascular disease in elderly women Challenging the current definition

    DEFF Research Database (Denmark)

    Møller, Katrine Dragsbæk; Neergaard, Jesper; Laursen, Janne Marie

    2016-01-01

    , followed 3905 Danish women since 2000 (age: 70.1±6.5) with no previous diagnosis of T2DM or CVD, holding all measurements used for MetS definition; central obesity, hypertension, hyperlipidemia, and hyperglycemia combined with register-based follow-up information. Elderly women with defined MetS presented...... a 6.3-fold increased risk of T2DM (95% confidence interval: [3.74-10.50]) and 1.7-fold increased risk of CVD (1.44-2.05) compared to women with no MetS risk factors. Subdividing the control group without defined MetS revealed that both centrally obese controls and controls holding other MetS risk...

  18. Do energy density and dietary fiber influence subsequent 5-year weight changes in adult men and women?

    DEFF Research Database (Denmark)

    Iqbal, Sofia I; Helge, Jørn W; Heitmann, Berit L

    2006-01-01

    the associations between ED and subsequent changes in BW, and despite a general belief that ED is a major determinant of obesity, the present study did not generally lend support for an association. However, among certain subgroups, an energy-dense diet may be a risk factor for weight development....

  19. No difference in the frequency of locus-specific methylation in the peripheral blood DNA of women diagnosed with breast cancer and age-matched controls

    DEFF Research Database (Denmark)

    Wojdacz, Tomasz K; Thestrup, Britta Boserup; Cold, Søren

    2011-01-01

    might predispose for cancer development. Here, we have used the methlyation-sensitive high-resolution melting approach to examine the methylation status of the BRCA1, BRCA2, APC, RASSF1A and RARβ2 genes in PBLs of a group of women diagnosed with breast cancer, and an age-matched control group...... with no signs of breast cancer. No significant differences in the frequency of methylation of the above genes were found between cases and controls in our study. Hence, testing for the presence of methylation of cancer-related genes in PBL DNA from women diagnosed with sporadic breast cancer and classified...

  20. Influence of high-carbohydrate mixed meals with different glycemic indexes on substrate utilization during subsequent exercise in women.

    Science.gov (United States)

    Stevenson, Emma J; Williams, Clyde; Mash, Laura E; Phillips, Beth; Nute, Maria L

    2006-08-01

    Few data exist on the metabolic responses to mixed meals with different glycemic indexes and their effects on substrate metabolism during exercise in women. We examined the effects of preexercise mixed meals providing carbohydrates with high (HGI) or low glycemic index (LGI) on substrate utilization during rest and exercise in women. Eight healthy, active, eumenorrheic women [aged 18.6 +/- 0.9 y; body mass: 59.9 +/- 7.1 kg; maximal oxygen uptake (VO(2)max): 48.7 +/- 1.1 mL . kg(-1) . min(-1)] completed 2 trials. On each occasion, subjects were provided with a test breakfast 3 h before performing a 60-min run at 65% VO(2)max on a motorized treadmill. Both breakfasts provided 2 g carbohydrate/kg body mass and were isoenergetic. The calculated GIs of the meals were 78 (HGI) and 44 (LGI). Peak plasma glucose and serum insulin concentrations were greater after the HGI breakfast than after the LGI breakfast (P fat oxidation was greater in the LGI trial than in the HGI trial (P glucose or serum insulin were observed during exercise. Altering the GI of the carbohydrate within a meal significantly changes the postprandial hyperglycemic and hyperinsulinemic responses in women. A LGI preexercise meal resulted in a higher rate of fat oxidation during exercise than did an HGI meal.

  1. Stress reactivity and its effects on subsequent food intake in depressed and healthy women with and without adverse childhood experiences.

    Science.gov (United States)

    Wingenfeld, Katja; Kuehl, Linn K; Boeker, Anita; Schultebraucks, Katharina; Ritter, Kristin; Hellmann-Regen, Julian; Otte, Christian; Spitzer, Carsten

    2017-06-01

    Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems. We systematically examined the stress response and consecutive food intake in 32 women with MDD and ACE as determined by a clinical interview (Early Trauma Inventory), 52 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE. All participants underwent a psychosocial stress test (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST) before they were offered a buffet of snacks. Participants were not aware that the primary outcome variable was the amount of consumed kilocalories (kcal). The four groups did not differ in demographic variables. Stress resulted in higher cortisol release and higher blood pressure compared to the control condition. Patients with MDD without ACE had a significantly lower cortisol response to stress compared to controls. Across groups, we found higher kcal intake after stress compared to the control condition. Comparing high and low cortisol responders to stress, higher kcal intake after stress was only seen in those with low cortisol release. This study provides evidence that blunted rather than enhanced cortisol release to stress might lead to increased food intake, independent from MDD and ACE. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Risk of second primary cancers in women diagnosed with endometrial cancer in German and Swedish cancer registries.

    Science.gov (United States)

    Chen, Tianhui; Brenner, Hermann; Fallah, Mahdi; Jansen, Lina; Castro, Felipe A; Geiss, Karla; Holleczek, Bernd; Katalinic, Alexander; Luttmann, Sabine; Sundquist, Kristina; Ressing, Meike; Xu, Leiting; Hemminki, Kari

    2017-12-01

    Along with the increasing incidence and favorable prognosis, more women diagnosed with endometrial cancer may develop second primary cancers (SPCs). We aimed at investigating risk of SPCs after endometrial cancer in Germany and Sweden to provide insight into prevention strategies for SPCs. Endometrial cancer patients diagnosed at age ≥15 years in Germany during 1997-2011 and in Sweden nationwide during 1997-2012 were selected. Standardized incidence ratios (SIRs), calculated as the ratio of observed to expected numbers of cases, were used to assess the risk of a specific second cancer after endometrial cancer for both German and Swedish datasets. Among 46,929 endometrial cancer survivors in Germany and 18,646 in Sweden, overall 2,897 and 1,706 SPCs were recorded, respectively. Significantly elevated SIRs were observed in Germany for ovarian (SIR = 1.3; 95%CI:1.1-1.5) and kidney cancers [1.6 (1.3-1.8)], while in Sweden the SIRs were 5.4 (4.6-6.3) and1.4 (1.0-1.9), respectively. Elevated risk for second ovarian endometrioid carcinoma was pronounced after early (endometrial cancer in Germany [9.0 (4.8-15)] and Sweden [7.7 (5.1-11)]. In Germany elevated risks were found for second ovarian endometrioid carcinoma after endometrioid histology of first endometrial cancer [6.3 (4.0-9.4)] and for second kidney cancer after clear cell histology of endometrial cancer [4.9 (1.6-11)]. We found exceptionally elevated risk of second ovarian endometrioid carcinoma after endometrial cancer of the same histology or of early onset. Risk for second kidney cancer was also increased, particularly after endometrial cancer of clear cell histology. Cancer prevention strategies should focus on these cancers after endometrial cancer diagnosis. © 2017 UICC.

  3. Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey.

    Science.gov (United States)

    Khan, M S; Khine, T M; Hutchison, C; Coker, R J; Hane, K M; Innes, A L; Aung, S

    2016-03-03

    Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34% of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health systems barriers that may be driving lower tuberculosis case finding among women. From October 2014 to March 2015, we systematically collected data on all new adult smear positive tuberculosis cases in ten township health centres across Yangon, the largest city in Myanmar, to produce an electronic tuberculosis database. We conducted a descriptive cross-sectional analysis of sex differences in tuberculosis diagnoses at the township health centres. We also analysed national prevalence survey data to calculate additional case finding in men and women by using sputum culture when smear microscopy was negative, and estimated the sex-specific impact of using a more sensitive diagnostic tool at township health centres. Overall, only 514 (30%) out of 1371 new smear positive tuberculosis patients diagnosed at the township health centres were female. The proportion of female patients varied by township (from 21% to 37%, p = 0.0172), month of diagnosis (37% in February 2015 and 23% in March 2015 p = 0.0004) and age group (26% in 25-64 years and 49% in 18-25 years, p prevalence survey analysis indicated that the use of a more sensitive diagnostic tool could result in the proportion of females diagnosed at township health centres increasing to 36% from 30%. Our study, which is the first to systematically compile and analyse routine operational data from tuberculosis diagnostic centres in Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township of diagnosis. Low sensitivity of tuberculosis diagnosis may lead to a potential under-diagnosis of

  4. Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation

    DEFF Research Database (Denmark)

    Lauritzen, J B; Schwarz, Peter; McNair, P

    1993-01-01

    or the humerus. Women suffering an upper extremity fracture (radius or humerus) in snowy or icy weather had a marginally increased risk (RR = 1.3, 0.4-2.3, 95% CL and RR = 1.8, 0.3-3.4, 95% CL) for a later hip fracture. A woman 50 years old with a radial or a humeral fracture had an estimated residual lifetime...

  5. Development and pilot testing of a communication aid to assist clinicians to communicate with women diagnosed with ductal carcinoma in situ (DCIS).

    Science.gov (United States)

    De Morgan, Simone E; Butow, Phyllis N; Lobb, Elizabeth A; Price, Melanie A; Nehill, Caroline

    2011-05-01

    The literature highlights the confusion amongst women diagnosed with ductal carcinoma in situ (DCIS) about aspects of their disease and treatment and the wide variation in how doctors communicate about DCIS. The DCIS communication aid (CA) was developed to assist clinicians to communicate with women diagnosed with DCIS and to improve women's understanding about their disease, prognosis and treatment options. This study aimed to assess patient and clinician perceptions of the CA. The CA included information and diagrams about key aspects of the diagnosis, prognosis, treatment and support. It was designed to be used in clinical consultations and taken home after the consultation. Australian women with DCIS (n = 18) participated in structured interviews and clinicians (n = 7), including surgeons and radiation oncologists, completed surveys to assess their perceptions of the CA. Main outcome measures included satisfaction with the content, design and diagrams in the CA, and perceptions of the benefits of the CA and its impact on doctor-patient communication. All clinicians and women with DCIS reported that the CA would assist communication and help women understand their diagnosis. This is the first intervention designed to decrease the confusion amongst women with DCIS and improve doctor-patient communication in this area. This study highlights that interventions such as the DCIS communication aid may be a valuable resource for clinicians and women with DCIS. This study also highlights key communication challenges relating to DCIS.

  6. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks׳ gestation in nulliparous women who subsequently develop preeclampsia.

    Science.gov (United States)

    Mistry, Hiten D; Gill, Carolyn A; Kurlak, Lesia O; Seed, Paul T; Hesketh, John E; Méplan, Catherine; Schomburg, Lutz; Chappell, Lucy C; Morgan, Linda; Poston, Lucilla

    2015-01-01

    Preeclampsia is a pregnancy-specific condition affecting 2-7% of women and a leading cause of perinatal and maternal morbidity and mortality. Deficiencies of specific micronutrient antioxidant activities associated with copper, selenium, zinc, and manganese have previously been linked to preeclampsia at the time of disease. Our aims were to investigate whether maternal plasma micronutrient concentrations and related antioxidant enzyme activities are altered before preeclampsia onset and to examine the dependence on genetic variations in these antioxidant enzymes. Predisease plasma samples (15±1 weeks׳ gestation) were obtained from women enrolled in the international Screening for Pregnancy Endpoints (SCOPE) study who subsequently developed preeclampsia (n=244) and from age- and BMI-matched normotensive controls (n=472). Micronutrient concentrations were measured by inductively coupled plasma mass spectrometry; associated antioxidant enzyme activities, selenoprotein-P, ceruloplasmin concentration and activity, antioxidant capacity, and markers of oxidative stress were measured by colorimetric assays. Sixty-four tag-single-nucleotide polymorphisms (SNPs) within genes encoding the antioxidant enzymes and selenoprotein-P were genotyped using allele-specific competitive PCR. Plasma copper and ceruloplasmin concentrations were modestly but significantly elevated in women who subsequently developed preeclampsia (both Ppreeclampsia. The modest elevation in copper may contribute to oxidative stress, later in pregnancy, in those women that go on to develop preeclampsia. The lack of evidence to support the hypothesis that functional SNPs influence antioxidant enzyme activity in pregnant women argues against a role for these genes in the etiology of preeclampsia. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Use of azathioprine and corticosteroids during pregnancy and birth outcome in women diagnosed with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Veie Plauborg, Anne; Hansen, Anne Vinkel; Garne, Ester

    2016-01-01

    was computed for each of the pregnancy trimesters and the year before and after pregnancy. Outcomes of interest were stillbirth, perinatal mortality, low birth weight (LBW), preterm birth, and small for gestational age (SGA). RESULTS: Number of prescriptions for azathioprine decreased just before and during......% confidence interval {CI}, 1.74-2.91], UC: 1.81 [95% CI, 1.42-2.30]), preterm birth (adjOR: CD: 2.54 [95% CI, 2.04-3.15], UC: 1.86 [95% CI, 1.52-2.27]), and SGA (adjOR: CD: 1.99 [95% CI, 1.26-3.15], UC: 1.80 [95% CI, 1.18-2.75]). CONCLUSION: Use of azathioprine and corticosteroids was often reduced...... or discontinued before or during early pregnancy followed by an increased use of corticosteroids later in pregnancy. Women diagnosed with IBD and with prescriptions for azathioprine and/or corticosteroids, have an increased risk of LBW, pre-term birth, and SGA. Birth Defects Research (Part A) 106:494-499, 2016...

  8. Potential impact and acceptability of Internet partner notification for men who have sex with men and transgender women recently diagnosed as having sexually transmitted disease in Lima, Peru.

    Science.gov (United States)

    Clark, Jesse L; Segura, Eddy R; Perez-Brumer, Amaya G; Reisner, Sari L; Peinado, Jesus; Salvatierra, Hector J; Sanchez, Jorge; Lama, Javier R

    2014-01-01

    We assessed the potential impact of Internet partner notification among men who have sex with men and transgender women in Peru recently diagnosed as having sexually transmitted disease. Use of Internet partner notification was anticipated for 55.9% of recent partners, including 43.0% of partners not currently expected to be notified, a 20.6% increase in anticipated notification outcomes.

  9. Potential Impact and Acceptability of Internet Partner Notification for Men Who Have Sex with Men and Transgender Women Recently Diagnosed with STD in Lima, Peru

    Science.gov (United States)

    Clark, Jesse L; Segura, Eddy R; Perez-Brumer, Amaya G; Reisner, Sari L; Peinado, Jesus; Salvatierra, Hector J; Sanchez, Jorge; Lama, Javier R

    2014-01-01

    We assessed the potential impact of internet partner notification (PN) among MSM and transgender women in Peru recently diagnosed with STD. Use of internet PN was anticipated for 55.9% of recent partners, including 43.0% of partners not currently expected to be notified, a 20.6% increase in anticipated notification outcomes. PMID:24326581

  10. Socio-demographic factors, comorbidity and diagnostic delay among women diagnosed with cervical, endometrial or ovarian cancer: a nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Robinson, Kirstine Magtengaard; Christensen, Karl Bang; Ottesen, Bent Smedegaard

    2011-01-01

    This study investigates the association between socio-demographic factors, comorbidity and diagnostic delay among gynaecological cancer patients. A questionnaire was sent to 1052 women diagnosed with cervical, endometrial or ovarian cancer between October 2006 and December 2007 in Denmark. Long...... patient delays were associated with diagnosis with a greater risk of experiencing long delays among women diagnosed with cervical and endometrial cancer as opposed to ovarian cancer. The risk of experiencing long GP referral delays was associated with residential area, with a greater risk of long delays...... diagnosed with cervical and endometrial cancer as opposed to ovarian cancer, and with working as opposed to being retired. In conclusion, this study found that socio-demographic factors and comorbidity play a role in the probability of experiencing long delays. If delays in diagnosis are to be reduced...

  11. Antenatal Iron Supplementation Regimens for Pregnant Women in Rural Vietnam and Subsequent Haemoglobin Concentration and Anaemia among Their Infants.

    Directory of Open Access Journals (Sweden)

    Thach Duc Tran

    Full Text Available Little evidence about the effects of antenatal iron supplementation on infant anaemia is available. The aim was to compare effects on six-month-old infants' Haemoglobin (Hb concentration and anaemia of daily iron-folic acid (IFA, twice-weekly IFA with or without other micronutrients (MMN and usual antenatal care in rural Vietnam.Secondary data analysis from: a prospective population-based observational study (OS which examined effects of antenatal psychosocial factors, anaemia and iron deficiency on infant development and health; and a three-arm cluster randomised trial (CRT of different antenatal iron supplementation regimens. In the OS 497 women (<20 weeks gestation from 50 randomly-selected communes participated, and in the CRT 1,258 pregnant women (<16 weeks gestation in 104 communes were allocated randomly to trial arms. The main outcome was six-month-old infant Hb concentration. Baseline data included women's socio-demographic characteristics, reproductive health, Hb and serum ferritin. Mean differences in infant Hb and odds ratios of infant anaemia between CRT arms and OS were calculated by multivariable regression models, controlling for baseline differences and clustering, using robust standard errors. Infant anaemia prevalence was 68.6% in the OS, 47.2% daily IFA, 53.5% weekly IFA, and 50.3% MMN conditions. After adjustment, mean infant haemoglobin levels in daily IFA (mean difference = 0.95 g/dL; 95%CI 0.7-11.18; weekly IFA (0.91; 95%CI 0.69-1.12 and MMN (1.04; 95%CI 0.8-1.27 were higher than in the OS. After adjustment there were lower odds ratios of anaemia among infants in the daily IFA (OR = 0.31; 95% CI 0.22-0.43, weekly IFA (0.38; 95%CI 0.26-0.54 and MMN (0.33; 95%CI 0.23-0.48 groups than in the OS.Infant anaemia is a public health problem in Vietnam and other resource-constrained countries. All supplementation regimens could have clinically significant benefits for Hb and reduce anaemia risk among six-month-old infants

  12. Effect of having a subsequent child on the mental health of women who lost a child in the 2008 Sichuan earthquake: a cross-sectional study.

    Science.gov (United States)

    Xu, Yao; Herrman, Helen; Bentley, Rebecca; Tsutsumi, Atsuro; Fisher, Jane

    2014-05-01

    To assess whether having a subsequent child had an effect on the mental health of Chinese mothers who lost a child during an earthquake. A cross-sectional survey of bereaved mothers was conducted 30 to 34 months after the 2008 Sichuan earthquake using individual structured interviews to assess sociodemographic characteristics, post-disaster experiences and mental health. The interviews incorporated standardized psychometric measures of anxiety, depression, post-traumatic stress disorder (PTSD) and complicated grief (CG). Social support was also assessed. An adjusted model taking potential confounders into account was used to explore any association between psychological symptoms and the birth of a subsequent child. The prevalence of psychological symptoms was higher in mothers who did not have a child after losing the first one. In an adjusted model, symptoms of anxiety (odds ratio, OR: 3.37; 95% confidence interval, CI: 1.51-7.50), depression (OR: 9.47; 95% CI: 2.58-34.80), PTSD (OR: 5.11; 95% CI: 2.31-11.34) and CG (OR: 10.73; 95% CI: 1.88-61.39) were significantly higher among the 116 women without a subsequent child than among the 110 mothers who had another child after bereavement. More than two thirds of the mothers with new infants had clinically important psychological symptoms. Women who have lost an only child in a natural disaster are especially vulnerable to long-term psychological problems, especially if they have reached an age when conception is difficult. Research should focus on developing and evaluating interventions designed to provide women with psychosocial support and reproductive services.

  13. Does Employer-Provided Health Insurance Constrain Labor Supply Adjustments to Health Shocks? New Evidence on Women Diagnosed with Breast Cancer

    Science.gov (United States)

    Neumark, David; Barkowski, Scott

    2013-01-01

    Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse’s employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11 percent smaller. Women’s subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior. PMID:23891911

  14. Adverse trajectories of mental health problems predict subsequent burnout and work-family conflict - a longitudinal study of employed women with children followed over 18 years.

    Science.gov (United States)

    Nilsen, Wendy; Skipstein, Anni; Demerouti, Evangelia

    2016-11-08

    The long-term consequence of experiencing mental health problems may lead to several adverse outcomes. The current study aims to validate previous identified trajectories of mental health problems from 1993 to 2006 in women by examining their implications on subsequent work and family-related outcomes in 2011. Employed women (n = 439) with children were drawn from the Tracking Opportunities and Problems-Study (TOPP), a community-based longitudinal study following Norwegian families across 18 years. Previous identified latent profiles of mental health trajectories (i.e., High; Moderate; Low-rising and Low levels of mental health problems over time) measured at six time points between 1993 and 2006 were examined as predictors of burnout (e.g., exhaustion and disengagement from work) and work-family conflict in 2011 in univariate and multivariate analyses of variance adjusted for potential confounders (age, job demands, and negative emotionality). We found that having consistently High and Moderate symptoms as well as Low-Rising symptoms from 1993 to 2006 predicted higher levels of exhaustion, disengagement from work and work-family conflict in 2011. Findings remained unchanged when adjusting for several potential confounders, but when adjusting for current mental health problems only levels of exhaustion were predicted by the mental health trajectories. The study expands upon previous studies on the field by using a longer time span and by focusing on employed women with children who experience different patterns of mental health trajectories. The long-term effect of these trajectories highlight and validate the importance of early identification and prevention in women experiencing adverse patterns of mental health problems with regards to subsequent work and family-related outcomes.

  15. Prenatal Exposure to the Pesticide DDT and Hypertension Diagnosed in Women before Age 50: A Longitudinal Birth Cohort Study

    Science.gov (United States)

    Cirillo, Piera M.; Terry, Mary Beth; Krigbaum, Nickilou Y.; Flom, Julie D.; Cohn, Barbara A.

    2013-01-01

    Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39–47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development. PMID:23591545

  16. Women more vulnerable than men when facing risk for treatment-induced infertility: a qualitative study of young adults newly diagnosed with cancer.

    Science.gov (United States)

    Armuand, Gabriela M; Wettergren, Lena; Rodriguez-Wallberg, Kenny A; Lampic, Claudia

    2015-02-01

    Being diagnosed with cancer constitutes not only an immediate threat to health, but cancer treatments may also have a negative impact on fertility. Retrospective studies show that many survivors regret not having received fertility-related information and being offered fertility preservation at time of diagnosis. This qualitative study investigates newly diagnosed cancer patients' experiences of fertility-related communication and how they reason about the risk of future infertility. Informants were recruited at three cancer wards at a university hospital. Eleven women and 10 men newly diagnosed with cancer participated in individual semi-structured interviews focusing on three domains: experiences of fertility-related communication, decision-making concerning fertility preservation, and thoughts and feelings about the risk of possible infertility. Data was analyzed through qualitative content analysis. The analysis resulted in three sub-themes, 'Getting to know', 'Reacting to the risk' and 'Handling uncertainty', and one main theme 'Women more vulnerable when facing risk for infertility', indicating that women reported more negative experiences related to patient-provider communication regarding fertility-related aspects of cancer treatment, as well as negative emotional reactions to the risk of infertility and challenges related to handling uncertainty regarding future fertility. The informants described distress when receiving treatment with possible impact on fertility and used different strategies to handle the risk for infertility, such as relying on fertility preservation or thinking of alternative ways to achieve parenthood. The negative experiences reported by the female informants may be related to the fact that none of the women, but almost all men, had received information about and used fertility preservation. Women newly diagnosed with cancer seem to be especially vulnerable when facing risk for treatment-induced infertility. Lack of shared decision

  17. Monosodium L-glutamate in soup reduces subsequent energy intake from high-fat savoury food in overweight and obese women.

    Science.gov (United States)

    Miyaki, Takashi; Imada, Toshifumi; Hao, Susan Shuzhen; Kimura, Eiichiro

    2016-01-14

    The umami seasoning, monosodium L-glutamate (MSG), has been shown to increase satiety in normal body weight adults, although the results have not been consistent. The satiety effect of MSG in overweight and obese adults has not been examined yet. The objective of the present study was to investigate the effect of MSG in a vegetable soup on subsequent energy intakes as well as food selection in overweight and obese adult women without eating disorders. A total of sixty-eight overweight and obese women (BMI range: 25·0-39·9 kg/m²), otherwise healthy, were recruited to our study. A fixed portion (200 ml) of control vegetable soup or the same soup with added MSG (0·5 g/100 ml) was provided 10 min before an ad libitum lunch and an ad libitum snack in the mid-afternoon. The control soup had equivalent amount of Na to the soup with added MSG. Energy intakes at the ad libitum lunch and ad libitum snack time after the soup preload were assessed using a randomised, double-blind, two-way cross-over design. The soup with MSG in comparison with the control soup resulted in significantly lower consumption of energy at lunch. The addition of MSG in the soup also reduced energy intake from high-fat savoury foods. The soup with MSG showed lower but no significant difference in energy intake at mid-afternoon. The addition of umami seasoning MSG in a vegetable soup may decrease subsequent energy intake in overweight and obese women who do not have eating disorders.

  18. Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women.

    Science.gov (United States)

    Schousboe, John T; Ensrud, Kristine E; Nyman, John A; Melton, L Joseph; Kane, Robert L

    2005-10-01

    To investigate the cost-effectiveness of universal bone densitometry in women aged 65 and older combined with alendronate treatment for those diagnosed with osteoporosis (femoral neck T-score fracture, distal forearm fracture, radiographic (but clinically inapparent) vertebral fracture, clinical vertebral fracture, hip fracture, hip and vertebral fracture, and other fractures), using the societal perspective. Women living independently and those in nursing homes. Caucasian women aged 65, 75, 85, or 95. Bone densitometry of the hip, with 5 years of alendronate therapy for those found to have osteoporosis versus no intervention (densitometry or drug therapy). Lifetime accumulated quality adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios. The cost per QALY gained for the screen-and-treat strategy was 43,000 dollars per QALY gained for 65-year-old women and 5,600 dollars per QALY gained for 75-year-old women. For 85- and 95-year-old women, the screen-and-treat strategy was cost saving. Sensitivity analyses showed that the screen-and-treat strategy was cost-effective even under assumptions of reduced adherence to drug therapy, reduced fracture reduction benefit from alendronate therapy, or reduced QALYs saved by preventing fracture. Universal bone densitometry combined with alendronate therapy for those found to have osteoporosis is highly cost-effective for women aged 65 and older and may be cost saving for ambulatory women aged 85 and older (whether independently living or residing in nursing homes).

  19. Women Are Diagnosed with Type 2 Diabetes at Higher Body Mass Indices and Older Ages than Men: Korea National Health and Nutrition Examination Survey 2007-2010

    Directory of Open Access Journals (Sweden)

    Su Kyoung Kwon

    2014-02-01

    Full Text Available BackgroundMany epidemiologic studies have shown that women with type 2 diabetes have an increased risk of developing cardiovascular disease compared with men with diabetes. The aim of this study is to elucidate whether disparities of adiposity, age and insulin resistance (IR at the time of diabetes diagnosis exist between women and men in the adult Korean population.MethodsData from The Korea National Health and Nutrition Examination Survey, performed in Korea from 2007 to 2010, were used. In the survey, anthropometric data and blood samples were obtained during a fasting state. IR and β-cell function were calculated using the homeostasis model assessment (HOMA-IR and HOMA-β, respectvely.ResultsThe mean age of diabetes diagnosis was 58.5 years in women and was 55.1 years in men (P=0.015. The mean body mass index (BMI of newly diagnosed diabetes subjects was 26.1 kg/m2 in women and 25.0 kg/m2 in men (P=0.001. The BMI was inversely related to age in both genders, and the higher BMI in women than men was consistent throughout all age groups divided by decade. The HOMA-IR in women with diabetes is higher than in men with diabetes (7.25±0.77 vs. 5.20±0.32; P=0.012.ConclusionKorean adult women are diagnosed with type 2 diabetes at higher BMI and older age than men and are more insulin-resistant at the time of diabetes diagnosis. This may help explain why women with diabetes have an increased risk of developing cardiovascular disease after the diagnosis of diabetes, compared to men.

  20. The impact of exposure to images of ideally thin models in TV commercials on eating behavior: an experimental study with women diagnosed with bulimia nervosa.

    Science.gov (United States)

    Rühl, Ilka; Legenbauer, Tanja; Hiller, Wolfgang

    2011-09-01

    This study investigates whether eating behavior in women with diagnosed bulimia nervosa is influenced by prior exposure to images of ideally thin models. Twenty-six participants diagnosed with bulimia nervosa (BN) and 30 normal controls (NC) were exposed to body-related and neutral TV commercials; then food that typically triggers binge eating was provided, and the amount of food eaten was measured. No significant difference for food intake between NC and BN could be found, but food intake for BN was predicted by the degree of thoughts related to eating behaviors during exposure to the thin ideal. No impact of general body image or eating pathology on food intake could be found. The results emphasize the importance of action-relevance of dysfunctional cognitions for the maintenance of eating-disordered behaviors in women with bulimia nervosa, when exposed to eating-disorder-specific triggers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Effect of Mindfulness Based Stress Reduction on Immune Function, Quality of Life and Coping In Women Newly Diagnosed with Early Stage Breast Cancer

    OpenAIRE

    Witek-Janusek, Linda; Albuquerque, Kevin; Chroniak, Karen Rambo; Chroniak, Christopher; Durazo, Ramon; Mathews, Herbert L

    2008-01-01

    This investigation used a non-randomized controlled design to evaluate the effect and feasibility of a mindfulness based stress reduction (MBSR) program on immune function, quality of life (QOL), and coping in women recently diagnosed with breast cancer. Early stage breast cancer patients, who did not receive chemotherapy, self-selected into an 8-week MBSR program or into an assessment only, control group. Outcomes were evaluated over time. The first assessment was at least 10 days after surg...

  2. Study protocol for Young & Strong: a cluster randomized design to increase attention to unique issues faced by young women with newly diagnosed breast cancer.

    Science.gov (United States)

    Greaney, Mary L; Sprunck-Harrild, Kim; Ruddy, Kathryn J; Ligibel, Jennifer; Barry, William T; Baker, Emily; Meyer, Meghan; Emmons, Karen M; Partridge, Ann H

    2015-01-31

    Each year, approximately 11% of women diagnosed with breast cancer in the United States are 45 years of age or younger. These women have concerns specific to or accentuated by their age, including fertility-related concerns, and have higher rates of psychosocial distress than women diagnosed at older ages. Current guidelines recommend that fertility risks be considered early in all treatment plans; however, the extant research indicates that attention to fertility by the healthcare team is limited. Importantly, attention to fertility may be a proxy for whether or not other important issues warranting attention in younger women with breast cancer are addressed, including genetic risks, psychosocial distress, sexual functioning, and body image concerns. The Young & Strong study tests the efficacy of an intervention designed for young women recently diagnosed with breast cancer and their oncologists with the intention to: 1) increase attention to fertility as an important surrogate for other issues facing young women, 2) educate and support young women and their providers, and 3) reduce psychosocial distress among young women with breast cancer. The study employs a cluster randomized design including 14 academic institutions and 40 community sites across the U.S. assigned to either the study intervention arm or contact-time comparison intervention arm. Academic institutions enroll up to 15 patients per site while community sites enroll up to 10 patients. Patient eligibility requirements include: an initial diagnosis of stage I-III invasive breast cancer within three months prior, without a known recurrence or metastatic breast cancer; 18-45 years of age at diagnosis; ability to read and write in English. The primary outcome is oncologists' attention to fertility concerns as determined by medical record review. Secondary outcomes include differences in patient satisfaction with care and psychosocial distress between the two study arms. Study findings will provide

  3. Incremental Cancer Detection of Locoregional Restaging with Diagnostic Mammography Combined with Whole-Breast and Regional Nodal Ultrasound in Women with Newly Diagnosed Breast Cancer.

    Science.gov (United States)

    Candelaria, Rosalind P; Huang, Monica L; Adrada, Beatriz E; Bassett, Roland; Hunt, Kelly K; Kuerer, Henry M; Smith, Benjamin D; Chavez-MacGregor, Mariana; Yang, Wei Tse

    2017-02-01

    This study aims to determine if locoregional restaging with diagnostic mammography and ultrasound (US) of the whole breast and regional nodes performed for quality assurance in women with newly diagnosed breast cancer who were referred to a tertiary care center yields incremental cancer detection. An institutional review board-approved retrospective, single-institution database review was performed on the first 1000 women referred to our center in 2010 with a provisional breast cancer diagnosis. Locoregional restaging consisted of diagnostic full-field digital mammography combined with US of the whole breast and regional nodal basins. Bilateral whole-breast US was performed in women with contralateral mammographic abnormality or had heterogeneously or extremely dense parenchyma. Demographic, clinical, and pathologic factors were analyzed. Final analyses included 401 women. Of the 401 women, 138 (34%) did not have their outside images available for review upon referral. The median age was 54 years (range 21-92); the median tumor size was 2.9 cm (range 0.6-18.0) for women whose disease was upstaged and 2.2 cm (range 0.4-15.0) for women whose disease was not upstaged. Incremental cancer detection rates were 15.5% (62 of 401) in the ipsilateral breast and 3.9% (6 of 154) in the contralateral breast (P < 0.0001). The total upstage rate was 25% (100 of 401). Surgical management changed from segmentectomy to mastectomy in 12% (50 of 401). The re-excision rate after segmentectomy was 19% (35 of 189). Locoregional restaging with diagnostic mammography combined with whole-breast and regional nodal US that is performed for standardization of the imaging workup for newly diagnosed breast cancer patients can reduce underestimation of disease burden and impact therapeutic planning. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. [Characteristics of adolescent and adult young women diagnosed with human papilloma virus infection at the Center for Research on Human Reproduction (CIRH)].

    Science.gov (United States)

    Grajales, B; Flores, H; Mendoza, A; Martínez, L; De León, A; Andino, N; Ronner, Z; De León, R G; Guerra, A; Austin, K L

    1997-01-01

    We reviewed 239 charts of adolescents and young adults, who visited our clinic. The purpose was to know the incidence of the Human Papiloma Virus infection (HPVI), diagnosed by Pap's smears, and the relationship to a population with some gynecological and sociodemographic characteristics. The women age population was between 14-24 years old with a mean age of 19.9 years. Seventy (29.3%) were PIV positive and 169 (70.7%) negatives. About 75% among both groups (PIV + and -) began active sexual life between 15-19 years old. Among the women with 4 or more sexual partners, 55.6% were HPVI positive. About 60% of all women had never used any method before being admitted to the clinic. In this study there is no correlation between IVSA and HPVI. We do demonstrate that the greater the number of sexual partners, the highest the risk of a sexual acquired disease.

  5. Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer.

    Science.gov (United States)

    Bradley, Cathy J; Neumark, David; Barkowski, Scott

    2013-09-01

    Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse's employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11% smaller. Women's subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States: a report from the Breast Cancer Surveillance Consortium.

    Science.gov (United States)

    Allison, Kimberly H; Abraham, Linn A; Weaver, Donald L; Tosteson, Anna N A; Nelson, Heidi D; Onega, Tracy; Geller, Berta M; Kerlikowske, Karla; Carney, Patricia A; Ichikawa, Laura E; Buist, Diana S M; Elmore, Joann G

    2015-05-01

    Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends. Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up). Of the total mammograms, 88.5% were screening and 11.5% diagnostic; 1.2% of screening and 6.8% of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer. Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices. © 2015 American Cancer Society.

  7. Increased rates of complications in singleton pregnancies of women previously diagnosed with polycystic ovary syndrome predominantly in the hyperandrogenic phenotype

    NARCIS (Netherlands)

    de Wilde, Marlieke A.|info:eu-repo/dai/nl/413993809; Lamain-de Ruiter, Marije; Veltman-Verhulst, Susanne M.; Kwee, Anneke|info:eu-repo/dai/nl/290465648; Laven, Joop S.; Lambalk, Cornelis B.; Eijkemans, Marinus J.C.|info:eu-repo/dai/nl/156353253; Franx, Arie|info:eu-repo/dai/nl/157009939; Fauser, Bart C.J.M.|info:eu-repo/dai/nl/071281932; Koster, Maria P.H.

    2017-01-01

    Objective To study the presence of several maternal and neonatal complications in a cohort of women with hyperandrogenic as well as normoandrogenic polycystic ovary syndrome (PCOS) and women with PCOS who received different fertility treatments. Design Prospective multicenter cohort study. Setting

  8. Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Breijer, M. C.; Peeters, J. A. H.; Opmeer, B. C.; Clark, T. J.; Verheijen, R. H. M.; Mol, B. W. J.; Timmermans, A.

    2012-01-01

    Objectives Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial

  9. Markers of Breast Cancer Risk in Women with Benign Breast Disease

    National Research Council Canada - National Science Library

    Mandelson, Margaret

    2004-01-01

    ... not go on to develop breast cancer. In contrast, many women with "low risk" benign lesions are subsequently diagnosed with breast cancer and for these women, the histopathology of their BBD is not a useful predictor of risk...

  10. The Accuracy of p16/Ki-67 and HPV Test in the Detection of CIN2/3 in Women Diagnosed with ASC-US or LSIL.

    Directory of Open Access Journals (Sweden)

    Júlio C Possati-Resende

    Full Text Available The objective of this study was to compare the accuracies of double staining for p16/Ki-67 and the molecular test for high-risk HPV (hr-HPV to identify high-grade cervical intraepithelial neoplasia (CIN2/CIN3 in women with cervical cytology of atypical squamous cells of undetermined significance (ASC-US and low-grade squamous intraepithelial lesion (LSIL. Data were collected from 201 women who underwent cervical cytology screening in the Barretos Cancer Hospital and their results were categorized as ASC-US (n=96 or LSIL (n=105. All patients underwent colposcopy with or without cervical biopsy for diagnosis of CIN2/CIN3. The hr-HPV test (Cobas 4800 test and immunocytochemistry were performed to detect biomarkers p16/Ki-67 (CINtec PLUS test. Two samples (1 ASC-US/1 LSIL were excluded from the analysis due to inconclusive results of the histologic examination. There were 8 cases of CIN2/CIN3 among 95 women with ASC-US (8.4%, and 23 cases of CIN2/CIN3 among 104 women with LSIL (22.1%. In the group of women with ASC-US, the sensitivity and specificity in diagnosing CIN2/CIN3 were 87.5% and 79.5% for the HPV test and 62.5% and 93.1% for p16/Ki-67. Among women with LSIL, the sensitivity and specificity in the diagnosis of CIN2/CIN3 were 87% and 34.7% for the HPV test and 69.6% and 75.3% for immunocytochemistry. Superior performance was observed for p16/Ki-67 double staining, especially among women under 30 for whom the test had an area under the ROC curve of 0.762 (p30 years. In younger women (≤30 years with LSIL, p16/Ki-67 had greater accuracy in identifying precursor lesions. Among women >30 years diagnosed with LSIL, the two methods showed similar performance.

  11. Age at first childbirth and newly diagnosed diabetes among postmenopausal women: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Yarmolinsky, James; Duncan, Bruce Bartholow; Barreto, Sandhi Maria; Diniz, Maria de Fátima Sander; Chor, Dora; Schmidt, Maria Inês

    2017-01-01

    It has been reported that earlier age at first childbirth may increase the risk of adult-onset diabetes among postmenopausal women, a novel finding with important public health implications. To date, however, no known studies have attempted to replicate this finding. We aimed to test the hypothesis that age at first childbirth is associated with the risk of adult-onset diabetes among postmenopausal women. Cross-sectional analysis using baseline data from 2919 middle-aged and elderly postmenopausal women in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Age at first childbirth was determined from self-reporting and newly diagnosed diabetes through a 2-hour 75-g oral glucose tolerance test and/or glycated hemoglobin. Logistic regression was performed to examine associations between age at first childbirth and newly diagnosed diabetes among postmenopausal women. We did not find any association between age at first childbirth and diabetes, either when minimally adjusted for age, race and study center (odds ratio, OR [95% confidence interval, CI]: ≤ 19 years: 1.15 [0.82-1.59], 20-24 years: 0.90 [0.66-1.23] and ≥ 30 years: 0.86 [0.63-1.17] versus 25-29 years; P = 0.36) or when fully adjusted for childhood and adult factors (OR [95% CI]: ≤ 19 years: 0.95 [0.67-1.34], 20-24 years: 0.78 [0.56-1.07] and ≥ 30 years: 0.84 [0.61-1.16] versus 25-29 years; P = 0.40). Our current analysis does not support the existence of an association between age at first childbirth and adult-onset diabetes among postmenopausal women, which had been reported previously.

  12. Role of continuing supportive cares in increasing social support and reducing perceived uncertainty among women with newly diagnosed breast cancer in Taiwan.

    Science.gov (United States)

    Liu, Li-Ni; Li, Chung-Yi; Tang, Siew Tzuh; Huang, Chiun-Shen; Chiou, Ai-Fu

    2006-01-01

    The purpose of this study was to explore the roles of continuing supportive care in increasing the social support and reducing the perceived uncertainty among women newly diagnosed with breast cancer in Taiwan. A longitudinal, quasi-experimental design was used in this study. Sixty-one women younger than 60 years, newly diagnosed with breast cancer and undergoing surgery, were recruited from 2 urban teaching hospitals in northern Taiwan. The experimental group was provided with additional continuing supportive care for 3 months. Two instruments, including the Social Support Questionnaire and an uncertainty questionnaire, were administered to participants at 3 time points: presurgery within 2 weeks after diagnosis, 1 month after surgery, and 3 months after diagnosis. The experimental group reported significantly higher social support and lower disease uncertainty compared with the control group at 1 month after surgery and 3 months after diagnosis. With knowledge of the role that continuing-care intervention plays in social support and disease uncertainty, nurses and other healthcare professionals can continue to explore and strengthen strategies to enhance the coping ability of women with breast cancer in Taiwan.

  13. Survey on Addressing the Information and Support Needs of Jewish Women at Increased Risk for or Diagnosed with Breast Cancer: The Sharsheret Experience

    Directory of Open Access Journals (Sweden)

    Kenneth P. Tercyak

    2015-05-01

    Full Text Available Approximately 12% of women living in the United States will be diagnosed with breast cancer during their lifetimes. While all women face formidable challenges posed by the threat of living with or at increased risk for breast cancer, those of Ashkenazi Jewish descent face additional challenges owing to higher BRCA1/2 mutation prevalence in this population. Amidst calls for population-based screening for hereditary breast cancer risk, much can be learned from the experiences of Jewish women about their needs. The present study is a secondary analysis of psychoeducational program satisfaction and evaluation data previously collected by a community organization dedicated to serving women of all Jewish backgrounds facing, or at risk for, breast cancer. Among respondents (n = 347, over one-third were referred to the organization by family or friends, most often after a cancer crisis. Of the information and support resources offered, the greatest level of engagement occurred with the one-on-one peer support and health care symposia resources. Respondents endorsed high levels of satisfaction with the programs and services, and a strong desire to give back to the community. These data suggest that culturally-relevant information and support services for Jewish women could be scaled-up for larger dissemination to meet the anticipated needs in this special population.

  14. Evaluation of internal alpha radiation exposure and subsequent infertility among a cohort of women formerly employed in the radium dial industry.

    Energy Technology Data Exchange (ETDEWEB)

    Schieve, L. A.; Davis, F.; Roeske, J.; Handler, A.; Freels, S.; Stinchcomb, T.; Keane, A.; Environmental Research; Univ. of Illinois at Chicago; Univ. of Chicago; DePaul Univ.

    1997-02-01

    This study examined the effect of internal exposure to {alpha}-particle radiation on subsequent fertility among women employed in the radium dial industry prior to 1930, when appreciable amounts of radium were often ingested through the practice of pointing the paint brush with the lips. The analysis was limited to women for whom a radium body burden measurement had been obtained and who were married prior to age 45 (n=603). Internal radiation dose to the ovary was calculated based on initial intakes of radium-226 and radium-228, average ovarian mass, number and energy of {alpha} particles emitted, fraction of energy absorbed with in the ovary, effective retention integrals and estimated photon irradiation. Time between marriage and pregnancy, number of pregnancies and number of live births served as surrogates for fertility. Radiation appeared to have no effect on fertility at estimated cumulative ovarian dose equivalents below 5 Sv; above this dose, however, statistically significant declines in both number of pregnancies and live births were observed. These trends persisted after multivariable adjustment for potential confounding variables and after exclusion of subjects contributing a potential classification or selection bias to the study. Additionally, the high-dose group experienced fewer live births than would have been expected based on population rates. There were no differences in time to first pregnancy between high- and low-dose groups. These results are consistent with earlier studies of {gamma}-ray exposures and suggest that exposure to high doses of radiation from internally deposited radium reduces fertility rather than inducing sterility.

  15. Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors.

    Science.gov (United States)

    Micali, Nadia; Martini, Maria G; Thomas, Jennifer J; Eddy, Kamryn T; Kothari, Radha; Russell, Ellie; Bulik, Cynthia M; Treasure, Janet

    2017-01-17

    Eating disorders (EDs) are common amongst women; however, no research has specifically investigated the lifetime/12-month prevalence of eating disorders amongst women in mid-life (i.e., fourth and fifth decade of life) and the relevant longitudinal risk factors. We aimed to investigate the lifetime and 12-month prevalence of EDs and lifetime health service use and to identify childhood, parenting, and personality risk factors. This is a two-phase prevalence study, nested within an existing longitudinal community-based sample of women in mid-life. A total of 5658 women from the UK Avon Longitudinal Study of Parents and Children (ALSPAC; enrolled 20 years earlier) participated. ED diagnoses were obtained using validated structured interviews. Weighted analyses were carried out accounting for the two-phase methodology to obtain prevalence figures and to carry out risk factor regression analyses. By mid-life, 15.3% (95% confidence intervals, 13.5-17.4%) of women had met criteria for a lifetime ED. The 12-month prevalence of EDs was 3.6%. Childhood sexual abuse was prospectively associated with all binge/purge type disorders and an external locus of control was associated with binge-eating disorder. Better maternal care was protective for bulimia nervosa. Childhood life events and interpersonal sensitivity were associated with all EDs. By mid-life a significant proportion of women will experience an ED, and few women accessed healthcare. Active EDs are common in mid-life, both due to new onset and chronic disorders. Increased awareness of the full spectrum of EDs in this stage of life and adequate service provision is important. This is the first study to investigate childhood and personality risk factors for full threshold and sub-threshold EDs and to identify common predictors for full and sub-threshold EDs. Further research should clarify the role of preventable risk factors on both full and sub-threshold EDs.

  16. Validity of preeclampsia-related diagnoses recorded in a national hospital registry and in a postpartum interview of the women

    DEFF Research Database (Denmark)

    Klemmensen, Ase K; Olsen, Sjurdur F; Osterdal, Marie Louise

    2007-01-01

    defined in accordance with the guidelines from the American College of Obstetricians and Gynecologists, the authors reviewed hospital charts of 3,039 women and found that 61 of 88 preeclampsia cases (69.3%) and 24 of 55 cases of serious subtypes of preeclampsia (43.6%) were recorded...... as such by the registry. A total of 21 of 2,951 women without preeclampsia (0.71%) had a preeclampsia diagnosis in the registry. All registrations of serious subtypes of preeclampsia reflected true cases. The positive predictive value of a preeclampsia diagnosis in the registry was 74.4%. Including interview data reduced...

  17. The clinical profile of young and adolescent women with laparoscopically diagnosed endometriosis in a Singapore tertiary hospital

    Directory of Open Access Journals (Sweden)

    Yoke-Fai Fong

    2017-04-01

    Conclusion: Endometriosis can cause severe disease even in adolescents and young females. Increased awareness among patients and healthcare providers would raise a higher index of suspicion for endometriosis in these women, with consequent early treatment which may result in better functional and fertility outcomes.

  18. Indicators for metabolic disturbances in anovulatory women with polycystic ovary syndrome diagnosed according to the Rotterdam consensus criteria

    NARCIS (Netherlands)

    Goverde, A. J.; van Koert, A. J. B.; Eijkemans, M. J.; Knauff, E. A. H.; Westerveld, H. E.; Fauser, B. C. J. M.; Broekmans, F. J.

    Polycystic ovary syndrome (PCOS) is associated with metabolic abnormalities. It is debated whether all women with PCOS should be screened for metabolic abnormalities as these may vary with PCOS phenotype, age and ethnicity. The aims of this study were to assess the prevalence of metabolic

  19. Therapist and Patient Perceptions of Alliance and Progress in Psychological Therapy for Women Diagnosed with Gynecological Cancers

    Science.gov (United States)

    Manne, Sharon L.; Kashy, Deborah A.; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2012-01-01

    Objective: The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also…

  20. The challenge of diagnosing pulmonary embolism in children, pregnant women, and elderly patients: a descriptive review of the literature.

    Science.gov (United States)

    Tufano, Antonella; Di Capua, Mirko; Coppola, Antonio; Arturo, Claudia; Ieranò, Paola; Cerbone, Anna Maria; Di Minno, Giovanni

    2011-11-01

    The prompt and accurate diagnosis of pulmonary embolism (PE) greatly influences patient outcomes. However, diagnosing PE is one of the most difficult challenges confronting physicians, even more so when the clinical suspicion is addressed in children, during pregnancy, or in elderly patients. In these patient groups, symptoms and signs from concomitant conditions or diseases may mimic PE and make difficult defining clinical probability categories for PE as usually applied to general adult patients. Moreover, the diagnostic techniques show wider, specific limitations in these settings. PE is considered rare in children. The diagnostic management of a child with suspected PE is largely extrapolated from the knowledge achieved in adult patients. An increased risk of venous thromboembolism is reported in all trimesters of pregnancy and in the puerperium. An accurate diagnosis of PE in pregnancy has important implications, including the need for prolonged anticoagulation, delivery planning, and prophylaxis during future pregnancies, as well as concerns about future oral contraceptive use and estrogen therapy. Although incidence, morbidity, and mortality increase steadily with age, PE remains an underdiagnosed disease in elderly patients. About 40% of PE found at necropsy were not suspected antemortem. In the present article, challenges in diagnosing PE in children, during pregnancy, and in the elderly will be discussed, reviewing the available clinical, laboratory, and instrumental diagnostic strategies. © Thieme Medical Publishers.

  1. Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial.

    Science.gov (United States)

    Sklempe Kokic, Iva; Ivanisevic, Marina; Biolo, Gianni; Simunic, Bostjan; Kokic, Tomislav; Pisot, Rado

    2017-10-18

    Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child. To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus. Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50-55min. The experimental group had lower postprandial glucose levels at the end of pregnancy (P<0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P=0.035). The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  2. Illness-associated productivity costs among women with employer-sponsored insurance and newly diagnosed breast cancer.

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    Meadows, Eric S; Johnston, Stephen S; Cao, Zhun; Foley, Kathleen A; Pohl, Gerhardt M; Johnston, Joseph A; Ramsey, Scott D

    2010-04-01

    Determine lost work time and job attrition for incident breast cancer (BC). The cases were employed women, aged 18 to 64, with BC identified by a validated algorithm between 1999 and 2005, from claims (MarketScan) and attendance databases. Controls without cancer were matched 3:1 on age, comorbidity, and index year. First-year mean disability days were 60 (cases, N = 880) versus 5 (controls, N = 2640) (P Employee retention is much higher for BC cases versus controls.

  3. Pregnancy intent among a sample of recently diagnosed HIV-positive women and men practicing unprotected sex in Cape Town, South Africa.

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    Mantell, Joanne E; Exner, Theresa M; Cooper, Diane; Bai, Dan; Leu, Cheng-Shiun; Hoffman, Susie; Myer, Landon; Moodley, Jennifer; Kelvin, Elizabeth A; Constant, Debbie; Jennings, Karen; Zweigenthal, Virginia; Stein, Zena A

    2014-12-01

    Sexual and reproductive health (SRH) services for HIV-positive women and men often neglect their fertility desires. We examined factors associated with pregnancy intent among recently diagnosed HIV-positive women (N = 106) and men (N = 91) who reported inconsistent condom use and were enrolled in an SRH intervention conducted in public sector HIV care clinics in Cape Town. Participants were recruited when receiving their first CD4 results at the clinic. All reported unprotected sex in the previous 3 months. Logistic regression identified predictors of pregnancy intent for the total sample and by gender. About three fifths of men and one fifth of women reported intent to conceive in the next 6 months. In the full-sample multiple regression analysis, men [adjusted odds ratio (AOR = 6.62)] and those whose main partner shared intent to conceive (AOR = 3.80) had significantly higher odds of pregnancy intent; those with more years of education (AOR = 0.81) and more biological children (AOR = 0.62) had lower odds of intending pregnancy. In gender-specific analyses, partner sharing pregnancy intent was positively associated with intent among both men (AOR = 3.53) and women (AOR = 13.24). Among men, odds were lower among those having more biological children (AOR = 0.71) and those unemployed (AOR = 0.30). Among women, relying on hormonal contraception was negatively associated with intent (AOR = 0.08), and main partner knowing her HIV status (AOR = 5.80) was positively associated with intent to conceive. Findings underscore the importance of providing integrated SRH services, and we discuss implications for clinical practice and care.

  4. Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer.

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    Boone, Stephanie D; Baumgartner, Kathy B; Baumgartner, Richard N; Connor, Avonne E; John, Esther M; Giuliano, Anna R; Hines, Lisa M; Rai, Shesh N; Riley, Elizabeth C; Pinkston, Christina M; Wolff, Roger K; Slattery, Martha L

    2015-11-01

    Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than nonsmokers; however, differences by ethnicity or prognostic factors and risk for noncancer mortality have not been evaluated. We examined associations of active and passive smoke exposure with mortality among Hispanic (n = 1020) and non-Hispanic white (n = 1198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years). Risk of breast cancer-specific (HR = 1.55, 95% CI = 1.11-2.16) and all-cause (HR = 1.68, 95% CI = 1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of noncancer mortality (HR = 1.68, 95% CI = 1.12-2.51). Associations were strongest for current smokers who smoked for 20 years or more were postmenopausal, overweight and/or obese, or reported moderate and/or high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased two fold for moderate and/or high recent passive smoke exposure among never smokers (HR = 2.12, 95% CI = 1.24-3.63). Findings support associations of active-smoking and passive-smoking diagnosis with risk of breast cancer-specific and all-cause mortality and ever smoking with noncancer mortality, regardless of ethnicity, and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation, and maintenance programs should be routinely recommended for women with breast cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Human papillomavirus genotype prevalence in cervical biopsies from women diagnosed with cervical intraepithelial neoplasia or cervical cancer in Fiji.

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    Tabrizi, Sepehr N; Law, Irwin; Buadromo, Eka; Stevens, Matthew P; Fong, James; Samuela, Josaia; Patel, Mahomed; Mulholland, E Kim; Russell, Fiona M; Garland, Suzanne M

    2011-09-01

    There is currently limited information about human papillomavirus (HPV) genotype distribution in women in the South Pacific region. This study's objective was to determine HPV genotypes present in cervical cancer (CC) and precancers (cervical intraepithelial lesion (CIN) 3) in Fiji. Cross-sectional analysis evaluated archival CC and CIN3 biopsy samples from 296 women of Melanesian Fijian ethnicity (n=182, 61.5%) and Indo-Fijian ethnicity (n=114, 38.5%). HPV genotypes were evaluated using the INNO-LiPA assay in archival samples from CC (n=174) and CIN3 (n=122) among women in Fiji over a 5-year period from 2003 to 2007. Overall, 99% of the specimens tested were HPV DNA-positive for high-risk genotypes, with detection rates of 100%, 97.4% and 100% in CIN3, squamous cell carcinoma (SCC) and adenosquamous carcinoma biopsies, respectively. Genotypes 16 and 18 were the most common (77%), followed by HPV 31 (4.3%). Genotype HPV 16 was the most common identified (59%) in CIN3 specimens, followed by HPV 31 (9%) and HPV 52 (6.6%). Multiple genotypes were detected in 12.5-33.3% of specimens, depending on the pathology. These results indicated that the two most prevalent CC-associated HPV genotypes in Fiji parallel those described in other regions worldwide, with genotype variations thereafter. These data suggest that the currently available bivalent and quadrivalent HPV vaccines could potentially reduce cervical cancers in Fiji by over 80% and reduce precancers by at least 60%.

  6. The impact of miscarriage on women's pregnancy-specific anxiety and feelings of prenatal maternal-fetal attachment during the course of a subsequent pregnancy: an exploratory follow-up study.

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    Tsartsara, Eirini; Johnson, Martin P

    2006-09-01

    This study assesses the implications a miscarriage history has on women's pregnancy-specific anxiety and feelings of prenatal maternal-fetal attachment during the 1st and 3rd trimesters of a subsequent pregnancy. Thirty-five pregnant women (N = 10 with a history of miscarriage) volunteered participation completing the Pregnancy Outcome Questionnaire (POQ), the Maternal Antenatal Attachment Scale (MAAS and a demographic/reproductive history questionnaire during the first trimester of pregnancy. Of these, 24 participants completed the measures again during the third trimester of pregnancy. Women with a miscarriage history reported significantly higher pregnancy-specific anxiety at trimester 1 than women with no miscarriage history; even when the effects of parity were controlled. All expectant mothers, irrespective of miscarriage history, scored similarly at trimester 1 on the MAAS scales. By the 3rd trimester, pregnancy-specific anxiety had significantly decreased for women with a miscarriage history whose mean scores on the POQ were now similar to women with no history of miscarriage. Maternal-fetal attachment had significantly risen by the 3rd trimester for all women. These findings suggest that having a miscarriage history may not have a long-lasting adverse effect on woman's psychological adaptation during the course of a subsequent pregnancy.

  7. Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries.

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    Melanie M Taylor

    Full Text Available Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis.Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis.Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases.Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment of maternal syphilis

  8. Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries

    Science.gov (United States)

    Taylor, Melanie M.; Nurse-Findlay, Stephen; Zhang, Xiulei; Hedman, Lisa; Kamb, Mary L.; Broutet, Nathalie; Kiarie, James

    2016-01-01

    Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Methods Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Results Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases. Conclusion Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment

  9. Functional Fitness and Self-Reported Quality of Life of Older Women Diagnosed with Knee Osteoarthrosis: A Cross-Sectional Case Control Study

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    Paula Andréa Malveira Cavalcante

    2015-01-01

    Full Text Available Aim. Utilizing a cross-sectional case control design, the aim of this study was to evaluate the functional fitness and self-reported quality of life differences in older people diagnosed with knee osteoarthrosis (O who participated in health promotion groups. Methods. Ninety older women were distributed into two groups: control without O of the knee (C, n=40 and a group diagnosed with primary and secondary knee O with grade II or higher, with definite osteophytes (OA, n=50. Functional fitness was evaluated by specific tests, and the time spent in physical activity and quality of life was evaluated by the IPAQ and WHOQOL (distributed in four domains: physical: P, psychological: PS, social: S, and environmental: E domain questionnaires. Results. No differences were found between ages of groups (C: 66±7; OA: 67±9; years. The values of the chair stand test (rep in the OA (13±5 group were different when compared to C group (22±5. For the 6-minute walk test (meters, the values obtained for the C (635±142 were higher (P<0.01 than the OA (297±143 group. The time spent in physical activity (min was greater (P<0.001 in the control (220±12 group compared to OA (100±10 group. Higher values (P<0.001 in all domains were found in the C (P: 69±16, PS: 72±17, S: 67±15, E: 70±15 group compared to OA (P: 48±7, PS: 43±8, S: 53±13, E: 47±14 group. Conclusion. Our data suggests that knee O, in older women, can promote a decline in time spent performing physical activity and functional fitness with decline in quality of life with an increase in sitting time.

  10. Intrapartum cervical lacerations: characteristics, risk factors, and effects on subsequent pregnancies.

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    Melamed, Nir; Ben-Haroush, Avi; Chen, Rony; Kaplan, Boris; Yogev, Yariv

    2009-04-01

    The purpose of this study was to assess the clinical characteristics, risk factors, and effects on subsequent pregnancies of intrapartum cervical lacerations. A retrospective study of all women who were diagnosed with clinically significant cervical lacerations from 1994-2006. Data were compared with a control group. The outcome of subsequent pregnancies for women in the study and control groups was analyzed. Of 81,047 deliveries, 131 (0.16%) were complicated by cervical lacerations. With multivariate logistic regression analysis, the cervical cerclage, precipitous labor, vacuum extraction, nulliparity, and use of episiotomy were associated independently with cervical lacerations. The outcomes of subsequent pregnancies for women in the cervical-laceration (n = 42) and control (n = 518) groups were similar. There were no cases of recurrent cervical lacerations. Careful inspection of the cervix should be considered in cases of precipitous labor, operative vaginal delivery, or cervical cerclage during pregnancy. Intrapartum cervical lacerations do not appear to affect the outcome of subsequent pregnancies.

  11. Impact of selective use of breast MRI on surgical decision-making in women with newly diagnosed operable breast cancer.

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    Brennan, Meagan E; McKessar, Merran; Snook, Kylie; Burgess, Ian; Spillane, Andrew J

    2017-04-01

    This study evaluated the impact of breast MRI on surgical planning in selected cases of breast malignancy (invasive cancer or DCIS). MRI was used when there was ambiguity on clinical and/or conventional imaging assessment. Consecutive women with breast malignancy undergoing breast MRI were included. Clinical, mammogram and ultrasound findings and surgical plan before and after MRI were recorded. MRI findings and histopathology results were documented and the impact of MRI on treatment planning was evaluated. MRI was performed in 181/1416 (12.8%) cases (invasive cancer 155/1219 (12.7%), DCIS 26/197 (13.2%)). Indications for MRI were: clinically dense breast tissue difficult to assess (n = 66; 36.5%), discordant clinical/conventional imaging assessment (n = 61; 33.7%), invasive lobular carcinoma in clinically dense breast tissue (n = 22; 12.2%), palpable/mass-forming DCIS (n = 11; 6.1%); other (n = 19; 10.5%). The recall rate for assessment of additional lesions was 35% (63/181). Additional biopsy-proven malignancy was found in 11/29 (37.9%) ipsilateral breast recalls and 8/34 (23.5%) contralateral breast recalls. MRI detected contralateral malignancy (unsuspected on conventional imaging) in 5/179 (2.8%). The additional information from MRI changed management in 69/181 (38.1%), with more unilateral surgery (wider excision or mastectomy) in 53/181 (29.3%), change to bilateral surgery in 12/181 (6.6%), less surgery in 4/181 (2.2%). Clinical examination estimated histological size within 20 mm in 57%, conventional imaging in 55% and MRI in 71%. MRI was most likely to show concordance with histopathology in the 'discordant assessment' and 'invasive lobular' groups and less likely for 'challenging clinically dense breast tissue.' MRI changed management in 69/181 (38.1%). Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Prospective evaluation of the molecular effects of metformin on the endometrium in women with newly diagnosed endometrial cancer: A window of opportunity study.

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    Soliman, Pamela T; Zhang, Qian; Broaddus, Russell R; Westin, Shannon N; Iglesias, David; Munsell, Mark F; Schmandt, Rosemarie; Yates, Melinda; Ramondetta, Lois; Lu, Karen H

    2016-12-01

    Metformin reduces cancer incidence and improves overall survival in diabetic patients. In preclinical studies, metformin decreases endometrial cancer (EC) cell growth by activation of AMPK/mTOR inhibition. We sought to determine the effects of metformin on serum/tumor biomarkers in women with EC. In this prospective trial, newly diagnosed EC patients underwent pre-treatment blood draw/endometrial biopsy, were administered oral metformin 850mg daily for ≥7days, and underwent post-treatment blood draw/definitive surgery. Pre- and post- serum analyses were performed. Tumor samples were evaluated for changes in AMPK, PI3K/AKT pathway, proliferation, and apoptosis by immunohistochemistry. Twenty patients completed the trial. Median age and BMI were 57years (range: 27-67) and 34.5kg/m2 (range: 21.9-50.0). Median duration of metformin was 9.5days (range: 7-24). A majority of women had endometrioid adenocarcinomas (90%) and were early stage (85%). After metformin, there were significant decreases in serum IGF-1 (p=0.046), omentin (p=0.007), insulin (p=0.012), C-peptide (p=0.018), and leptin (p=0.0035). Compared to baseline, post-treatment tissue showed decreased phospho-AKT in 18/20 patients (90%, p=0.0002), decreased phospho-S6rp in 14/20 patients (70%, p=0.057), and decreased phospho-p44/42MAPK in 15/18 patients (83.3%, p=0.0038). There was no difference in Ki67, phospho-ACC, or caspase 3. Changes did not correlate with BMI, grade, or KRAS mutation. In this prospective window of opportunity study, we demonstrated that relevant serum and molecular changes occur in patients with newly diagnosed EC after a short course of metformin. Ongoing clinical trials will help determine the appropriate role for metformin in the treatment of women with EC. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Impact of an educational DVD on anxiety and glycaemic control in women diagnosed with gestational diabetes mellitus (GDM): A randomised controlled trial.

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    Draffin, Claire R; Alderdice, Fiona A; McCance, David R; Maresh, Michael; Harper, Roy; Patterson, Christopher C; Bernatavicius, Giovanna; Brennan, Sarah F; Gough, Aisling; McSorley, Oonagh; Holmes, Valerie A

    2017-04-01

    The diagnosis of gestational diabetes mellitus (GDM) during pregnancy can lead to anxiety. This study evaluated the impact of an innovative patient-centred educational DVD on anxiety and glycaemic control in women newly diagnosed with GDM. 150 multi-ethnic women, aged 19-44years, from three UK hospitals were randomised to either usual care plus DVD (DVD group, n=77) or usual care alone (control group, n=73) at GDM diagnosis. Primary outcomes were anxiety (State-Trait Anxiety Inventory) and mean 1-h postprandial capillary self-monitored blood glucose for all meals, on day prior to follow-up. No significant difference between the DVD and control group were reported, for anxiety (37.7±11.7 vs 36.2±10.9; mean difference after adjustment for covariates (95% CI) 2.5 (-0.8, 5.9) or for mean 1-h postprandial glucose for all meals (6.9±0.9 vs 7.0±1.2mmol/L; -0.2 (-0.5, 0.2). However, the DVD group had significantly lower postprandial breakfast glucose compared to the control group (6.8±1.2 vs 7.4±1.9mmol/L; -0.5 (-1.1, -<0.1; p=0.04). The results in this trial did not highlight any differences between those who received the intervention and those who received usual care. It is possible that women already felt supported by their frequent attendance at specialist clinics for monitoring and advice. Healthcare professional and family support are key elements to empowering women with GDM and require further consideration in future interventions. Nonetheless, educational resources such as this will be beneficial to help support women given the current resource and time implications of the year on year rises in the incidence of gestational diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Prevalence of hospitalized live births affected by alcohol and drugs and parturient women diagnosed with substance abuse at liveborn delivery: United States, 1999-2008.

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    Pan, I-Jen; Yi, Hsiao-ye

    2013-05-01

    To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.

  15. The risk of stable partnerships: associations between partnership characteristics and unprotected anal intercourse among men who have sex with men and transgender women recently diagnosed with HIV and/or STI in Lima, Peru.

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    Mary C Cambou

    Full Text Available Partnership type is an important factor associated with unprotected anal intercourse (UAI and subsequent risk for HIV and sexually transmitted infections (STI. We examined the association of partnership type with UAI among men who have sex with men (MSM and male-to-female transgender women (TGW in Lima, Peru, recently diagnosed with HIV and/or STI.We report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE models with Poisson distribution were used to estimate prevalence ratios (PR for UAI according to partner type.Among 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0, 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous, and 14.7% transactional partners (i.e. transactional sex client or sex worker. Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59-0.91], transactional partner APR 0.53 [0.36-0.78], p10 encounters APR 1.43 [1.06-1.92], p10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW.

  16. The risk of stable partnerships: associations between partnership characteristics and unprotected anal intercourse among men who have sex with men and transgender women recently diagnosed with HIV and/or STI in Lima, Peru.

    Science.gov (United States)

    Cambou, Mary C; Perez-Brumer, Amaya G; Segura, Eddy R; Salvatierra, H Javier; Lama, Javier R; Sanchez, Jorge; Clark, Jesse L

    2014-01-01

    Partnership type is an important factor associated with unprotected anal intercourse (UAI) and subsequent risk for HIV and sexually transmitted infections (STI). We examined the association of partnership type with UAI among men who have sex with men (MSM) and male-to-female transgender women (TGW) in Lima, Peru, recently diagnosed with HIV and/or STI. We report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE) models with Poisson distribution were used to estimate prevalence ratios (PR) for UAI according to partner type. Among 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0), 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous), and 14.7% transactional partners (i.e. transactional sex client or sex worker). Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59-0.91], transactional partner APR 0.53 [0.36-0.78], p10 encounters APR 1.43 [1.06-1.92], p10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW.

  17. The Risk of Stable Partnerships: Associations between Partnership Characteristics and Unprotected Anal Intercourse among Men Who Have Sex with Men and Transgender Women Recently Diagnosed with HIV and/or STI in Lima, Peru

    Science.gov (United States)

    Cambou, Mary C.; Perez-Brumer, Amaya G.; Segura, Eddy R.; Salvatierra, H. Javier; Lama, Javier R.; Sanchez, Jorge; Clark, Jesse L.

    2014-01-01

    Background Partnership type is an important factor associated with unprotected anal intercourse (UAI) and subsequent risk for HIV and sexually transmitted infections (STI). We examined the association of partnership type with UAI among men who have sex with men (MSM) and male-to-female transgender women (TGW) in Lima, Peru, recently diagnosed with HIV and/or STI. Methods We report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE) models with Poisson distribution were used to estimate prevalence ratios (PR) for UAI according to partner type. Results Among 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0), 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous), and 14.7% transactional partners (i.e. transactional sex client or sex worker). Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59–0.91], transactional partner APR 0.53 [0.36–0.78], psexual encounters with the partner (>10 encounters APR 1.43 [1.06–1.92], p10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW. PMID:25029514

  18. Screening of pregnant women for hepatitis B virus surface antigen (HBsAg) and subsequent management, Qiandongnan prefecture, Guizhou, China, 2010.

    Science.gov (United States)

    Huang, Yan; Li, Leilei; Sun, Xiaohong; Lu, Mei; Liu, Huihui; Tang, Guangpeng; Wang, Dingming; Hutin, Yvan J

    2013-12-27

    In China, in 2010, a high proportion of pregnant women were tested for hepatitis B surface antigen (HBsAg). However, the preventive actions taken following screening were unclear. We followed up infants who were born to HBsAg positive mothers to describe the management that took place after screening. We selected eight counties with a probability proportional to population size in the Qiandongnan prefecture, Guizhou province. In each county, we selected a hospital at random. In each hospital, we (a) reviewed records to estimate the proportion of pregnant women who had been screened for HBsAg in 2010 and (b) sampled 10 screened women at random to assess management after one year in 2011. We calculated proportions and confidence intervals (CI) using standard formulae. Among the 7232 women who delivered in 2010 in the 8 hospitals, 98% (95% CI: 97%-99%) had been tested for HBsAg. Among 82 HBsAg women sampled for follow-up, 45 (55%; 95% CI: 44%-65%) knew they had been tested during pregnancy and 60 (73%; 95% CI: 63%-82%) knew they were HBsAg positive. The 82 infants had received three doses of hepatitis B vaccines and 79 (96%; 95% CI: 90%-99%) had received the first dose within 24h. However, only 11 infants (13%; 95% CI: 9%-25%) had received HBIG in addition to hepatitis B vaccine and 16 (20%; 95% CI: 12%-29%) had been tested for HBsAg upon completion of the vaccine series as part of their routine management. HBsAg testing of pregnant women was common in Qiandongnan, Guizhou, but post-screening management was limited. There is a need to ensure continuity of care through engaging women in HBsAg testing and following up infants with comprehensive management, including immunoprophylaxis and serological testing. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Measurement of unmet need for family planning: longitudinal analysis of the impact of fertility desires on subsequent childbearing behaviors among urban women from Uttar Pradesh, India.

    Science.gov (United States)

    Speizer, Ilene S; Calhoun, Lisa M; Hoke, Theresa; Sengupta, Ranajit

    2013-10-01

    The measure of unmet need relies on women's reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. Our study uses recently collected longitudinal data from four cities in Uttar Pradesh, India, to examine whether women's fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the 2-year follow-up period. Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the 2-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP, did not distinguish pregnancy/birth experience. Ninety-two percent of pregnancies/births over the follow-up period were considered "wanted then" suggesting post-hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing 2 years earlier. More nuanced assessments of fertility intentions may be needed to adequately gauge latent FP needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. EXPERIENCE OF FORCED SEX AND SUBSEQUENT SEXUAL, DRUG, AND MENTAL HEALTH OUTCOMES: AFRICAN AMERICAN AND HISPANIC WOMEN IN THE SOUTHEASTERN UNITED STATES.

    Science.gov (United States)

    Jones, Deborah; Marks, Gary; Villar-Loubet, Olga; Weiss, Stephen M; O'Daniels, Christine; Borkowf, Craig B; Simpson, Cathy; Adimora, Ada A; McLellan-Lemal, Eleanor

    2015-10-23

    This cross-sectional study examined African American and Hispanic women's (N = 1,509) self-reports of unwanted forced sex and its association with behavioral and mental health outcomes after the event. Twenty percent of the women had experienced forced sex (1st occurrence at age 15 years or younger for 10%, 1st occurrence at older than 15 years of age for 10%). Regardless of when forced sex 1st occurred, women were more likely to have engaged in unprotected vaginal and anal sex, to have had multiple unprotected sex partners, to have sexually transmitted infections, to have reported binge drinking and illicit drug use, and to exhibit distress and have received mental health counseling. Forced sex may have wide-ranging behavioral and mental health consequences years later.

  1. Formula supplementation in hospital and subsequent feeding at discharge among women who intended to exclusively breastfeed: An administrative data retrospective cohort study.

    Science.gov (United States)

    Bentley, Jason P; Nassar, Natasha; Porter, Maree; de Vroome, Michelle; Yip, Elizabeth; Ampt, Amanda J

    2017-12-01

    Among women who intend to exclusively breastfeed, it is important to identify mothers and their infants who have a greater risk of formula supplementation in hospital, and are unlikely to recover exclusive breastfeeding at discharge. We investigated factors associated with in-hospital formula feeding among healthy term infants born to women who intended to exclusively breastfeed, and among this group, predictors of infant feeding at discharge. Retrospective cohort study utilizing routinely collected clinical data for women who intended to exclusively breastfeed and gave birth to healthy term infants in five hospitals in New South Wales, Australia, 2010-2013. Robust Poisson regression was used to obtain adjusted relative risks (aRR) for the associations between formula feeding in hospital, feeding at discharge, and associated factors. Of 24 713 mother-infant dyads in the study population, 16.5% received formula in hospital. After adjustment, the strongest predictors of formula supplementation were breastfeeding difficulties (aRR 2.90 [95% confidence interval {CI} 2.74-3.07]), Asian born mother (aRR 2.07 [95% CI 1.92-2.23]), and neonatal conditions (aRR 2.00 [95% CI 1.89-2.13]). Among infants who received formula (n=3998), 49.3% were fully breastfeeding at discharge, 33.1% partially breastfeeding, and 17.5% formula-only feeding. Compared with formula-only feeding, special care nursery admission (aRR 1.23 [95% CI 1.17-1.30]) and ≥1 neonatal conditions (compared with none) were most strongly associated with fully breastfeeding at discharge (aRR 1.21 [95% CI 1.16-2.16]). Women and their infants who receive formula in hospital need additional support to attain exclusive breastfeeding by hospital discharge. Such support is especially needed for younger women, smokers, and women with breastfeeding difficulties. © 2017 Wiley Periodicals, Inc.

  2. Exposure to tobacco smoke in utero and subsequent plasma lipids, ApoB, and CRP among adult women in the MoBa cohort.

    Science.gov (United States)

    Cupul-Uicab, Lea A; Skjaerven, Rolv; Haug, Kjell; Travlos, Gregory S; Wilson, Ralph E; Eggesbø, Merete; Hoppin, Jane A; Whitworth, Kristina W; Longnecker, Matthew P

    2012-11-01

    Recent findings suggest that maternal smoking during pregnancy may play a role in the development of metabolic alterations in offspring during childhood. However, whether such exposure increases the risk of developing similar metabolic alterations during adulthood is uncertain. We evaluated the association of in utero exposure to maternal tobacco smoke with plasma lipids, apolipoprotein B (apoB), and C-reactive protein (CRP) in adulthood. The study was based on a subsample of the Norwegian Mother and Child Cohort Study (MoBa) and included 479 pregnant women with plasma lipids, apoB, and CRP measurements. Information on in utero exposure to tobacco smoke, personal smoking, and other factors were obtained from the women by a self-completed questionnaire at enrollment, at approximately 17 weeks of gestation. Women exposed to tobacco smoke in utero had higher triglycerides [10.7% higher; 95% confidence interval (CI): 3.9, 17.9] and lower high-density lipoprotein cholesterol (HDL) (-1.9 mg/dL; 95% CI: -4.3, 0.5) compared with unexposed women, after adjusting for age, physical activity, education, personal smoking, and current body mass index (BMI). Exposed women were also more likely to have triglycerides ≥ 200 mg/dL [adjusted odds ratio (aOR) = 2.5; 95% CI: 1.3, 5.1] and HDL < 50 mg/dL (aOR = 2.3; 95% CI: 1.1, 5.0). Low-density lipoprotein cholesterol, total cholesterol, and apoB were not associated with the exposure. CRP was increased among exposed women; however, after adjustment for BMI, the association was completely attenuated. In this population, in utero exposure to tobacco smoke was associated with high triglycerides and low HDL in adulthood, 18-44 years after exposure.

  3. Psychosocial and Clinical Factors Associated with Family Communication of Cancer Genetic Test Results among Women Diagnosed with Breast Cancer at a Young Age.

    Science.gov (United States)

    Elrick, Ashley; Ashida, Sato; Ivanovich, Jennifer; Lyons, Sarah; Biesecker, Barbara B; Goodman, Melody S; Kaphingst, Kimberly A

    2017-02-01

    Genetic test results have medical implications beyond the patient that extend to biological family members. We examined psychosocial and clinical factors associated with communication of genetic test results within families. Women (N = 1080) diagnosed with breast cancer at age 40 or younger completed an online survey; 920 women that reported prior cancer genetic testing were included in analysis. We examined the proportion of immediate family members to whom they communicated genetic test results, and built multivariable regression models to examine clinical and psychosocial variables associated with the proportion score. Participants were most likely to communicate test results to their mother (83 %) and least likely to their son (45 %). Participants who carried a BRCA mutation (OR = 1.34; 95 % CI = 1.06, 1.70), had higher interest in genomic information (OR = 1.55; 95 % CI = 1.26, 1.91) and lower genetic worry (OR = 0.91; 95 % CI = 0.86, 0.96) communicated genetic test results to a greater proportion of their immediate family members. Participants with a BRCA1/2 mutation shared their genetic test results with more male family members (OR = 1.72; 95 % CI = 1.02, 2.89). Our findings suggest that patients with high worry about genetic risks, low interest in genomic information, or receive a negative genetic test result will likely need additional support to encourage family communication.

  4. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to estim......INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy...

  5. Outcome of the subsequent pregnancy after a first loss in women with the factor V Leiden or prothrombin 20210A mutations

    NARCIS (Netherlands)

    Coppens, M.; Folkeringa, N.; Teune, M. J.; Hamulyak, K.; van der Meer, J.; Prins, M. H.; Buller, H. R.; Middeldorp, S.

    Background: The factor V Leiden (FVL) and prothrombin 20210A (PTm) mutations are associated with single late pregnancy loss and recurrent early pregnancy loss. The prognosis after an initial loss in women with thrombophilia is uncertain. Objective: To assess the pregnancy outcome of the second

  6. How and for whom are decision aids effective? Long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer.

    Science.gov (United States)

    Vodermaier, Andrea; Caspari, Cornelia; Wang, Lisa; Koehm, Janna; Ditsch, Nina; Untch, Michael

    2011-01-01

    The current study evaluates the long-term psychological impact of a decision aid intervention for surgical and systemic treatment in women with newly diagnosed breast cancer from a previous reported randomized, controlled trial (Vodermaier et al., 2009). Patients (n = 111) were randomized into usual care, or a 20-min decision aid intervention plus an information brochure prior to consultation planning with the senior physician. The retention rate at 1 year was 88%. Linear mixed model analyses demonstrated that the intervention group experienced less decisional conflict (p = .047; d = .19), which was driven by perceptions of a more effective choice (p = .029; d = .20) over time. Subgroup analyses revealed that patients in the intervention group who participated in chemotherapy decision making showed better long-term body image outcomes (p = .009; d = .44), which were mediated by reduced depressive coping (p = .049). No effects emerged for anxiety and depressive symptoms, or for quality of life. Internal health locus of control moderated group effects on 'uncertainty with the decision' (p = .003). The study results provide novel evidence on the role of individual differences and the mechanisms behind decision aid effectiveness, and demonstrate the long-term impact of decision aid interventions on some indices of well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  7. In utero exposure to maternal tobacco smoke and subsequent obesity, hypertension, and gestational diabetes among women in the MoBa cohort.

    Science.gov (United States)

    Cupul-Uicab, Lea A; Skjaerven, Rolv; Haug, Kjell; Melve, Kari K; Engel, Stephanie M; Longnecker, Matthew P

    2012-03-01

    Environmental factors influencing the developmental origins of health and disease need to be identified and investigated. In utero exposure to tobacco smoke has been associated with obesity and a small increase in blood pressure in children; however, whether there is a corresponding increased risk of conditions such as diabetes and hypertension during adulthood remains unclear. Our goal was to assess the association of self-reported in utero exposure to tobacco smoke with the prevalence of obesity, hypertension, type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM) in women 14-47 years of age. We conducted a cross-sectional analysis of the Norwegian Mother and Child Cohort Study, which enrolled pregnant women in Norway from 1999 thorough 2008. Exposure to tobacco smoke in utero (yes vs. no) was ascertained on the baseline questionnaire (obtained at ~ 17 weeks' gestation); the outcomes were ascertained from the Medical Birth Registry of Norway and the questionnaire. Our analysis included 74,023 women. Women exposed to tobacco smoke in utero had 1.53 times the odds of obesity [95% confidence interval (CI): 1.45, 1.61] relative to those unexposed, after adjusting for age, education, and personal smoking. After further adjustment for body mass index, the odds ratio for hypertension was 1.68 (95% CI: 1.19, 2.39); for T2DM 1.14 (95% CI: 0.79, 1.65); and for GDM 1.32 (95% CI: 1.10, 1.58) among exposed compared with unexposed. Exposure to tobacco smoke in utero was associated with obesity, hypertension, and GDM in adult women. The possibility that the associations were attributable to unmeasured confounding cannot be excluded.

  8. Association between surgically diagnosed endometriosis and adverse pregnancy outcomes.

    Science.gov (United States)

    Chen, Innie; Lalani, Shifana; Xie, Ri-Hua; Shen, Minxue; Singh, Sukhbir S; Wen, Shi-Wu

    2017-11-29

    To examine the association between surgically diagnosed endometriosis and pregnancy outcomes in subsequent pregnancies. Retrospective cohort study of women who delivered a singleton live birth from 2003 to 2013 in Ottawa, Ontario, Canada. Tertiary level academic center. Pregnant women with surgically diagnosed endometriosis were identified using International Classification of Diseases-10 codes from previous hospital admissions and were compared with pregnant women with no prior admission for endometriosis for the occurrences of adverse pregnancy outcomes. Observational study. Gestational hypertension, preeclampsia, placenta previa, placental abruption, postpartum hemorrhage, preterm birth, low birth weight, small for gestational age, and neonatal intensive care unit admission. Among the 52,202 eligible mother-infant pairs, we identified 469 mothers with surgically diagnosed endometriosis from a previous hospital encounter. Compared with women without endometriosis, women with endometriosis were on average older and were more likely to be primiparous, have lower gravidity, have a history spontaneous abortion, conceive with assisted reproductive technology, and reside in areas with higher neighborhood income and lower proportion of immigrants. Women with endometriosis were found to have an elevated risk of placenta previa (relative risk [RR], 3.30; 95% confidence interval [CI], 1.65-5.40) and cesarean delivery (RR, 1.24; 95% CI, 1.10-1.40). After adjustment for potential confounding factors, women with endometriosis were found to have a significantly elevated risk of placenta previa compared with women without endometriosis (adjusted RR, 2.54; 95% CI, 1.39-4.64). This study identifies baseline demographic differences between women with and without endometriosis and suggests that women affected by endometriosis have an independently elevated risk of placenta previa in pregnancy. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc

  9. Work-Home Interference, Perceived Total Workload, and the Risk of Future Sickness Absence Due to Stress-Related Mental Diagnoses Among Women and Men: a Prospective Twin Study.

    Science.gov (United States)

    Svedberg, Pia; Mather, Lisa; Bergström, Gunnar; Lindfors, Petra; Blom, Victoria

    2018-02-01

    Work-home interference has been proposed as an important explanation for sickness absence (SA). Previous studies show mixed results, have not accounted for familial factors (genetics and shared everyday environment), or investigated diagnosis specific SA. The aim was to study whether work-home interference and perceived total workload predict SA due to stress-related mental diagnoses, or SA due to other mental diagnoses, among women and men, when adjusting for various confounders and familial factors. This study included 11,916 twins, 19-47 years (49% women). Data on work-to-home and home-to-work conflicts, perceived total workload, and relevant confounders were derived from a 2005 survey, and national register data on SA spells until 2013 were obtained. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Discordant twin pair design was applied to adjust for familial factors. Each one unit increase in work-to-home and home-to-work conflicts, and perceived total workload was associated with higher odds for SA due to stress-related mental diagnoses and to SA due to other mental diagnoses among women, when adjusting for sociodemographic factors (ORs 1.15-1.31). Including health or familial factors, no associations remained. For men, each one unit increase in work-to-home conflicts was associated with higher odds for SA due to stress-related diagnoses (ORs 1.23-1.35), independently of confounders. Work-to-home conflict was independently associated with future SA due to stress-related diagnoses among men only. Health- and work-related factors seem to be important confounders when researching work-home interference, perceived total workload, and SA. Not including such confounders involves risking drawing incorrect conclusions. Further studies are needed to confirm sex differences and whether genetic factors are important for the associations studied.

  10. EFFECT OF LAMIVUDINE TREATMENT IN THE THIRD TRIMESTER IN HEPATITIS B POSITIVE PREGNANT WOMEN IN DECREASING THE VIRAL LOAD AND SUBSEQUENT FOETAL TRANSMISSION

    Directory of Open Access Journals (Sweden)

    Beena Guhan

    2017-03-01

    Full Text Available BACKGROUND Hepatitis B infection is most commonly acquired through perinatal or horizontal transmission. The combined immunity of hepatitis B vaccine and high-titre hepatitis B immunoglobulin HBIG has excellent efficacies in blocking the maternal-foetal transmission of hepatitis B virus. This study was aimed to stop such transmission from mothers with high hepatitis B virus DNA viral loads by giving them lamivudine antenatally. The aim of the study is to study the effect of lamivudine treatment to decrease hepatitis B virus DNA viral load in the third trimester in hepatitis B surface antigen pregnant positive women and its effect on vertical transmission of hepatitis B. MATERIALS AND METHODS The hepatitis B surface antigen positive pregnant women attending the department who satisfied the inclusion criteria were selected for this prospective case-control study of 30 in each group. Hepatitis B viral DNA load was seen at 28 weeks in both groups and lamivudine started at 32 weeks in the case group. Both groups were followed up antenatally, intrapartum and postpartum till 1 month and babies till 6 months. DNA viral load 1 month postpartum for the mother and hepatitis B surface antigen positivity observed in the babies till the age of 6months. RESULTS The prevalence of hepatitis B infection was more in the age group of 25-30 years. A high transmission rate of 36.1% was observed in hepatitis B envelope antigen positive mothers. There was a significant fall in the DNA viral load in the range of 10 log 4 to 10 log 6 in the case group, p value 0.000. 48.3% hepatitis B envelope antigen positive mothers in the case group became hepatitis B envelope antigen negative at the end of the study. 46.7% babies in the control group versus only 16.7% in the case group were hepatitis B surface antigen positive at the end. CONCLUSION Lamivudine treatment of highly viraemic hepatitis B surface antigen positive women during the final months of pregnancy has reduced the

  11. Diagnosing "dayans" and "demons".

    Science.gov (United States)

    Shiva, M

    1999-01-01

    The new ¿Witch Craft Prevention Bill¿ prohibiting witch hunting was passed in Bihar, India, in reaction to the branding and subsequent killing of more than 500 helpless women as "dayans" (witches) in the past 7 years. Most of them were single, widows, or deserted women victimized by the pathological greed of some of the male members of their families or by some powerful persons in the village community interested in claiming their property. Even with the passage of the bill, though, most of these crimes will remain unpunished because the community is an accomplice in them, and they tend not to be reported. What is needed overall is socioeconomic and political development that will lead to the empowerment of women to ensure that there will be an end to the cruel and inhuman activities (such as witch hunting) instigated by traditional healers or "Ojhas".

  12. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.

    Science.gov (United States)

    Cramer, Holger; Lauche, Romy; Klose, Petra; Lange, Silke; Langhorst, Jost; Dobos, Gustav J

    2017-01-03

    Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs

  13. 'I was just so different': The experiences of women diagnosed with an autism spectrum disorder in adulthood in relation to gender and social relationships.

    Science.gov (United States)

    Kanfiszer, Lucie; Davies, Fran; Collins, Suzanne

    2017-08-01

    Existing literature exploring autism spectrum disorders within female populations predominantly utilises quantitative methodology. A limited number of small-scale, qualitative studies have explored the experiences of adolescent girls with autism spectrum disorder, but adult women have remained largely unheard. This study aims to broaden the stories told within autobiographical literature and empower those within the wider community of women with autism spectrum disorder. In doing so, it seeks to extend existing conceptualisations of experience to include socially and culturally located factors. A qualitative methodology was adopted, utilising multi-stage narrative analysis. Seven semi-structured interviews with women who received a diagnosis in adulthood were conducted. Recruitment spanned community mental health services, an inpatient service and a community support group. From the women's diverse experiences and stories emerged two broad categories related to gender identity and social relationships. The findings are discussed in relation to existing constructs of autism in women.

  14. Insulin Resistance Is Associated with Prevalence of Physician-Diagnosed Urinary Incontinence in Postmenopausal Non-Diabetic Adult Women: Data from the Fourth Korea National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Byung Il Yoon

    Full Text Available To investigate the association between insulin resistance (IR and urinary incontinence in Korean adult women by analyzing the data from the Korea National Health and Nutrition Examination Survey IV (KNHANES 2007-2009.A nationally representative sample of 5318 non-diabetic Korean women ≥19-years-of-age (3043 premenopausal and 2275 postmenopausal women was included from KNHANES 2008-2010. IR was measured using the homeostasis model assessment of IR (HOMA-IR. Participants in the highest and lowest quartile of HOMA-IR were defined as insulin-resistant and insulin-sensitive respectively. Women who have current physician-diagnosed urinary incontinence were classified as having urinary incontinence.Incontinence was found in 9.18% of the total population, 8.51% of the premenopausal population, and 10.86% of the postmenopausal population. The prevalence of incontinence increased with age, reaching a peak at 60-69-years-of-age. The prevalence of urinary incontinence increased significantly with higher HOMA-IR quartiles in pre- and post-menopausal women (p for linear association = 0.0458 and 0.0009 respectively. Among post-menopausal women, those in the highest quartile of HOMA-IR were significantly more likely to have urinary incontinence compared to those in the lowest quartile [adjusted odds ratio, 1.72; 95% confidence interval, 1.07-2.77]. However premenopausal population exhibited no association between incontinence and HOMA-IR quartiles.Our results suggest that the prevalence of incontinence increased across HOMA-IR in non-diabetic adult women, and especially, IR might be a risk factor for incontinence in postmenopausal non-diabetic women.

  15. Morbidity and risk of subsequent diagnosis of HIV

    DEFF Research Database (Denmark)

    Søgaard, Ole S; Lohse, Nicolai; Østergaard, Lars Jørgen

    2012-01-01

    Early identification of persons with undiagnosed HIV infection is an important health care issue. We examined associations between diseases diagnosed in hospitals and risk of subsequent HIV diagnosis.......Early identification of persons with undiagnosed HIV infection is an important health care issue. We examined associations between diseases diagnosed in hospitals and risk of subsequent HIV diagnosis....

  16. Preeclampsia, gestational hypertension and subsequent hypothyroidism

    Science.gov (United States)

    Männistö, Tuija; Karumanchi, S. Ananth; Pouta, Anneli; Vääräsmäki, Marja; Mendola, Pauline; Miettola, Satu; Surcel, Heljä-Marja; Bloigu, Aini; Ruokonen, Aimo; Järvelin, Marjo-Riitta; Hartikainen, Anna-Liisa; Suvanto, Eila

    2012-01-01

    Objectives To evaluate the effect of preeclampsia (PE) and gestational hypertension (GH) on subsequent hypothyroidism. Recent studies suggest that women with PE have increased risk for reduced thyroid function, but the association between PE and GH with overt hypothyroidism has not been examined. Study design Two prospective population-based cohort studies, the Northern Finland Birth Cohorts 1966 and 1986, followed women who had PE (N=955), GH (N=1449) or were normotensive (N=13531) during pregnancy. Finnish national registers were used to confirm subsequent hypothyroidism. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) estimated hypothyroidism risk when comparing women with PE or GH with normotensive women. Main outcome measures Primary hypothyroidism during follow-up of 20–40 years. Results The subsequent prevalence of hypothyroidism was higher among women with PE (4.0%) and GH (4.5%) compared with normotensive women (3.5%), but the risk increase was not significant (aHR for PE 1.13, 95%CI 0.80–1.59 and aHR for GH 1.11, 95%CI 0.85–1.45). Subgroup analysis among nulliparous women revealed a significant association between late PE and subsequent hypothyroidism (aHR 1.82, 95%CI 1.04–3.19). Early or recurrent PE were not associated with hypothyroidism (aHR 0.93, 95%CI 0.46–1.81 and aHR 1.35, 95%CI 0.63–2.88, respectively). Conclusions Overall, PE or GH during pregnancy was not significantly associated with subsequent hypothyroidism in Finnish women after 20–40 years of follow-up. However, late PE in nulliparous women was associated with a 1.8-fold increased risk of subsequent hypothyroidism, a finding that merits further study in other populations. PMID:23439671

  17. Relationship between Polycystic Ovarian Syndrome and Subsequent Gestational Diabetes Mellitus: A Nationwide Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Mei-Lien Pan

    Full Text Available This nationwide population-based study aims to explore the relationship between polycystic ovarian syndrome (PCOS and subsequent gestational diabetes mellitus (GDM.Data from 1998-2012 Taiwan National Health Insurance Research Database were used for this study. ICD9-CM codes 256.4X and 648.X were used separately for the diagnoses of PCOS and GDM, which were further confirmed by records of blood tests or ultrasonography to ensure the accuracy of the diagnoses. Women diagnosed at 45 years of age, and those diagnosed with overt diabetes mellitus or GDM prior to PCOS were excluded. During pregnancy, each woman with a previous diagnosis of PCOS was age-matched to 10 women without PCOS. Odds ratios (ORs for risk of GDM were calculated by logistic regression analysis with adjustment for economic status and co-morbidities.Among 7,629 eligible women with a valid PCOS diagnosis, 3,109 (42.87% had subsequent pregnancies. GDM occurred frequently among women with a history of PCOS as compared to those without PCOS (20.46% vs. 10.54%, p0.05. If not used after conception, OHAs did not reduce the risk of GDM (adjusted OR = 1.20; 95% CI:0.88-1.62.A history of PCOS is a significant and independent risk factor for development of GDM. Medication for PCOS or pre-pregnancy use of OHAs does not reduce the risk of GDM. When at-risk women become pregnant, they require closer surveillance for maternal and fetal well-being, and should follow a strict diet and adhere to weight gain control to avoid obstetric complications due to GDM.

  18. Matching Subsequences in Trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li

    2009-01-01

    Given two rooted, labeled trees P and T the tree path subsequence problem is to determine which paths in P are subsequences of which paths in T. Here a path begins at the root and ends at a leaf. In this paper we propose this problem as a useful query primitive for XML data, and provide new...

  19. A binary histologic grading system for ovarian serous carcinoma is an independent prognostic factor: a population-based study of 4317 women diagnosed in Denmark 1978-2006.

    Science.gov (United States)

    Hannibal, Charlotte Gerd; Vang, Russell; Junge, Jette; Kjaerbye-Thygesen, Anette; Kurman, Robert J; Kjaer, Susanne K

    2012-06-01

    To evaluate the prognostic significance of histologic grade on survival of ovarian serous cancer in Denmark during nearly 30 years. Using the nationwide Danish Pathology Data Bank, we evaluated 4317 women with ovarian serous carcinoma in 1978-2006. All pathology reports were scrutinized and tumors classified as either low-grade serous carcinomas (LGSC) or high-grade serous carcinomas (HGSC). Tumors in which the original pathology reports were described as well-differentiated were classified as LGSC, and those that were described as moderately or poorly differentiated were classified as HGSC. We obtained histologic slides from the pathology departments for women with a diagnosis of well-differentiated serous carcinoma during 1997-2006, which were then reviewed by expert gynecologic pathologists. Data were analyzed using Kaplan-Meier methods and Cox proportional hazards regression analysis with follow-up through June 2009. Women with HGSC had a significantly increased risk of dying (HR=1.9; 95% CI: 1.6-2.3) compared with women with LGSC while adjusting for age and stage. Expert review of 171 women originally classified as well-differentiated in 1997-2006 were interpreted as LGSC in 30% of cases, whereas 12% were interpreted as HGSC and 50% as serous borderline ovarian tumors (SBT). Compared with women with confirmed LGSC, women with SBT at review had a significantly lower risk of dying (HR=0.5; 95% CI: 0.22-0.99), and women with HGSC at review had a non-significantly increased risk of dying (HR=1.6; 95% CI: 0.7-3.4). A binary grading system is a significant predictor of survival for ovarian serous carcinoma. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Education and psychological support meet the supportive care needs of Taiwanese women three months after surgery for newly diagnosed breast cancer: a non-randomised quasi-experimental study.

    Science.gov (United States)

    Liao, Mei-Nan; Chen, Shin-Cheh; Lin, Yung-Chang; Chen, Miin-Fu; Wang, Chao-Hui; Jane, Sui-Whi

    2014-03-01

    Few studies have comprehensively examined the effectiveness of information and psychosocial support on all dimensions of cancer patients' supportive care needs. To investigate the effects of education and psychological support on anxiety, symptom distress, social support, and unmet supportive care needs of Taiwanese women newly diagnosed with breast cancer over 3 months after surgery. Two-group, non-randomised quasi-experimental design. The general surgical outpatient department of the largest teaching medical centre in northern Taiwan. Women newly diagnosed with breast cancer (N=80) were divided into experimental (n=40) and control (n=40) groups. The experimental group received education and psychological support in the form of individual face-to-face and telephone follow-up sessions; the control group received routine care. Data were collected during the patients' first postoperative visit (baseline), 1 month after surgery, and 3 months after surgery. After adjusting for covariates, the levels of symptom distress and unmet needs for participants in the experimental group were lower at 1 and 3 months after surgery than for those in the control group, with the results at 3 months achieving significance. However, the sexuality needs for both groups were not significantly different at 1 and 3 months. Furthermore, levels of state anxiety were significantly lower for the experimental group at 1 and 3 months than for the control group. The education and psychological support components of our intervention programme effectively improved the unmet supportive care needs of patients newly diagnosed with breast cancer 3 months after surgery. Following prolonged treatment, women with breast cancer still have physical, psychological, and information care needs. Thus, clinical healthcare personnel should continually and actively provide culturally sensitive, individualised, and accessible information and psychological support to these patients. Crown Copyright © 2013

  1. Changes in health-related quality of life by occupational status among women diagnosed with breast cancer--a population-based cohort study.

    Science.gov (United States)

    Lundh, Marie Høyer; Lampic, Claudia; Nordin, Karin; Ahlgren, Johan; Bergkvist, Leif; Lambe, Mats; Berglund, Anders; Johansson, Birgitta

    2013-10-01

    To investigate whether longitudinal changes in health-related quality of life (HRQoL) among breast cancer patients vary by prediagnosis occupational status or postdiagnosis changes in working time. We identified 1573 patients in the Breast Cancer Quality Register of Central Sweden and asked them to participate in a longitudinal questionnaire study. A total of n = 841 women completed three questionnaires within a mean time of 4, 16, and 38 months postdiagnosis. Generalized estimating equation models were used to examine changes in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Cancer-Specific Quality of Life Questionnaire subscales stratified by prediagnosis occupational status and postdiagnosis changes in working time. Over time, the proportion of employed women reporting good functioning increased more, and the proportion reporting a high level of symptoms decreased more compared with women on sick leave/disability pension and retirement pensioners (p women, more consistent improvements in role and social functioning were observed among those with an increase/no change in working time than among those who had decreased it or stopped working (p women with an increase/no change in working time compared with women with decreased working time, among whom the proportion reporting pain increased (p = 0.008). Being employed prediagnosis and resuming work to the same extent as prior to the breast cancer diagnosis are associated with consistent improvements in HRQoL. These results highlight the importance of interventions to improve HRQoL and policies to support return to work following diagnosis. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Influence of socioeconomic factors on survival after breast cancer--a nationwide cohort study of women diagnosed with breast cancer in Denmark 1983-1999.

    Science.gov (United States)

    Dalton, Susanne Oksbjerg; Ross, Lone; Düring, Maria; Carlsen, Kathrine; Mortensen, Preben Bo; Lynch, John; Johansen, Christoffer

    2007-12-01

    The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25,897 Danish women who underwent protocol-based treatment for breast cancer in 1983-1999 were identified in a clinical database and information on socioeconomic variables and both somatic and psychiatric comorbid disorders was obtained from population-based registries. We used Cox proportional hazards models to estimate the association between socioeconomic position and overall survival and further to analyse breast cancer specific deaths in a competing risk set-up regarding all other causes of death as competing risks. The adjusted hazard ratio (HR) for death was reduced in women with higher education (HR, 0.91; 95% confidence interval (CI), 0.85-0.98), with higher income (HR, 0.93; 95% CI, 0.87-0.98) and with larger dwellings (HR, 0.90; 95% CI, 0.85-0.96 for women living in houses larger than 150 m(2)). Presence of comorbid disorders increased the HR. An interaction between income and comorbid disorders resulting in a 15% lower survival 10 year after primary surgery in poor women with low-risk breast cancer having comorbid conditions ( approximately 65%) compared to rich women with similar breast cancer prognosis and comorbid conditions ( approximately 80%) suggests that part of the explanation for the social inequality in survival after breast cancer surgery in Denmark lies in the access to and/or compliance with management of comorbid conditions in poorer women. (c) 2007 Wiley-Liss, Inc.

  3. "I Was Just so Different": The Experiences of Women Diagnosed with an Autism Spectrum Disorder in Adulthood in Relation to Gender and Social Relationships

    Science.gov (United States)

    Kanfiszer, Lucie; Davies, Fran; Collins, Suzanne

    2017-01-01

    Existing literature exploring autism spectrum disorders within female populations predominantly utilises quantitative methodology. A limited number of small-scale, qualitative studies have explored the experiences of adolescent girls with autism spectrum disorder, but adult women have remained largely unheard. This study aims to broaden the…

  4. Effectiveness of Cognitive Behavioral and Supportive-Expressive Group Therapy for Women Diagnosed with Breast Cancer: A Review of the Literature

    Science.gov (United States)

    Boutin, Daniel L.

    2007-01-01

    A review of the literature revealed 20 studies that examined the extent to which cognitive behavioral therapy (CBT), supportive-expressive group therapy (SEGT), and a combination of these two treatments impact women with breast cancer. Based on this review, it is determined that CBT and SEGT have repeated experimental support for positively…

  5. TH1 and TH2 cytokine data in insulin secretagogues users newly diagnosed with breast cancer

    Directory of Open Access Journals (Sweden)

    Zachary A.P. Wintrob

    2017-04-01

    Full Text Available Stimulation of insulin production by insulin secretagogue use may impact T helper cells’ cytokine production. This dataset presents the relationship between baseline insulin secretagogues use in women diagnosed with breast cancer and type 2 diabetes mellitus, the T-helper 1 and 2 produced cytokine profiles at the time of breast cancer diagnosis, and subsequent cancer outcomes. A Pearson correlation analysis evaluating the relationship between T-helper cytokines stratified by of insulin secretagogues use and controls is also provided.

  6. Influence of socioeconomic factors on survival after breast cancer-A nationwide cohort study of women diagnosed with breast cancer in Denmark 1983-1999

    DEFF Research Database (Denmark)

    Dalton, Susanne Oksbjerg; Ross, Lone; During, M.

    2007-01-01

    The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25......,897 Danish women who underwent protocol-based treatment for breast cancer in 1983-1999 were identified in a clinical database and information on socioeconomic variables and both somatic and psychiatric comorbid disorders was obtained from population-based registries. We used Cox proportional hazards models...... to estimate the association between socioeconomic position and overall survival and further to analyse breast cancer specific deaths in a competing risk set-up regarding all other causes of death as competing risks. The adjusted hazard ratio (HR) for death was reduced in women with higher education (HR, 0...

  7. Pathophysiological characteristics and effects of obesity in women with early and late manifestation of gestational diabetes diagnosed by the International Association of Diabetes and Pregnancy Study Groups criteria.

    Science.gov (United States)

    Bozkurt, Latife; Göbl, Christian S; Pfligl, Lisa; Leitner, Karoline; Bancher-Todesca, Dagmar; Luger, Anton; Baumgartner-Parzer, Sabina; Pacini, Giovanni; Kautzky-Willer, Alexandra

    2015-03-01

    Appropriate risk stratification is essential in gestational diabetes (GDM) diagnosis to optimize therapeutic strategies during pregnancy. However, there are sparse data related to the newly recommended International Association of Diabetes and Pregnancy Study Groups criteria and their use in early pregnancy. This study sought to evaluate clinical and pathophysiological characteristics less up to gestational week (GW) 21 in women with early and late GDM onset. This was a prospective study conducted at the Medical University of Vienna. Pregnant women (n = 211) underwent an oral glucose tolerance test at 16 GW (interquartile range, 14-18 wk) with multiple measurements of glucose, insulin, and C-peptide for evaluation of insulin sensitivity and ß-cell function in addition to detailed obstetrical risk assessment. Clinical followups were performed until end of pregnancy. We performed a metabolic characterization of early-onset GDM. Of 81 women, 49 (23%) showed early (GDMEarly ≤ 21 GW) and 32 (15%) later manifestation (GDMLate ≥ 24 GW) whereas 130 (62%) remained normal-glucose-tolerant (NGT). In contrast with GDMLate, GDMEarly were affected by decreased insulin sensitivity (GDMEarly vs NGT, P obesity. However, ß-cell dysfunction was also detectable in GDMLate, indicating defective compensatory mechanisms emerging already in early pregnancy.

  8. Elevated blood pressure in pregnancy and subsequent chronic disease risk.

    Science.gov (United States)

    Männistö, Tuija; Mendola, Pauline; Vääräsmäki, Marja; Järvelin, Marjo-Riitta; Hartikainen, Anna-Liisa; Pouta, Anneli; Suvanto, Eila

    2013-02-12

    Preeclampsia, a new-onset hypertensive disorder of pregnancy, is associated with lifetime cardiovascular disease risk, but less is known about risk after other pregnancy-related hypertension. The Northern Finland Birth Cohort 1966 included all expected births from 1 year (N=12 055 women). Blood pressure measurements and other prospective data were determined from prenatal care records and questionnaires for 10 314 women. Subsequent diagnoses were ascertained from Finnish registries (average follow-up, 39.4 years). Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) estimate risks in hypertensive women compared with normotensive women. Hypertension during pregnancy was associated with increased risk of subsequent cardiovascular disease and arterial hypertension. Women with chronic hypertension and superimposed preeclampsia/eclampsia had high risk for future diseases. Gestational hypertension was associated with increased risk of ischemic heart disease (HR, 1.44 [95% CI, 1.24-1.68]), myocardial infarcts (HR, 1.75 [95% CI, 1.40-2.19]), myocardial infarct death (HR, 3.00 [95% CI, 1.98-4.55]), heart failure (HR, 1.78 [95% CI, 1.43-2.21]), ischemic stroke (HR, 1.59 [95% CI, 1.24-2.04]), kidney disease (HR, 1.91 [95% CI, 1.18-3.09]), and diabetes mellitus (HR, 1.52 [95% CI, 1.21-1.89]). Isolated systolic hypertension was associated with increased risk of myocardial infarct death (HR, 2.15 [95% CI, 1.35-3.41]), heart failure (HR, 1.43 [95% CI, 1.13-1.82]), and diabetes mellitus (HR, 1.42 [95% CI, 1.13-1.78]), whereas isolated diastolic hypertension was associated with increased risk of ischemic heart disease (HR, 1.26 [95% CI, 1.05-1.50]). Results were similar in nonsmoking women aged pregnancy. Elevated blood pressure during pregnancy, regardless of type and even without known risk factors, signals high risk of later cardiovascular disease, chronic kidney disease, and diabetes mellitus. Clinical monitoring, risk factor evaluation, and early intervention could

  9. Pregnancy scares and subsequent unintended pregnancy

    Directory of Open Access Journals (Sweden)

    Heather Gatny

    2014-11-01

    Full Text Available Background: A substantial number of young women experience pregnancy scares - thinking they might be pregnant, and later discovering that they are not. Although pregnancy scares are distressing events, little is known about who experiences them and whether they are important to our understanding of unintended pregnancy. Objective: We describe the young women who experience pregnancy scares, and examine the link between pregnancy scares and subsequent unintended pregnancy. Methods: We used data from the Relationship Dynamics and Social Life Study. T-tests and regression analyses were conducted using baseline and weekly data to estimate relationships between respondent characteristics and subsequent pregnancy scares. Event history methods were used to assess pregnancy scares as a predictor of unintended pregnancy. Results: Nine percent of the young women experienced a pregnancy scare during the study. African-American race, lack of two-parent family structure, lower GPA, cohabitation, and sex without birth control prior to the study are associated with experiencing a pregnancy scare and with experiencing a greater number of pregnancy scares. Further, experiencing a pregnancy scare is strongly associated with subsequent unintended pregnancy, independent of background factors. Forty percent of the women who experienced a pregnancy scare subsequently had an unintended pregnancy during the study period, relative to only 11Š of those who did not experience a pregnancy scare. Conclusions: Young women from less advantaged backgrounds are more likely to experience a pregnancy scare, and pregnancy scares are often followed by an unintended pregnancy.

  10. Pathophysiological Characteristics and Effects of Obesity in Women With Early and Late Manifestation of Gestational Diabetes Diagnosed by the International Association of Diabetes and Pregnancy Study Groups Criteria

    Science.gov (United States)

    Bozkurt, Latife; Göbl, Christian S.; Pfligl, Lisa; Leitner, Karoline; Bancher-Todesca, Dagmar; Luger, Anton; Baumgartner-Parzer, Sabina; Pacini, Giovanni

    2015-01-01

    Context: Appropriate risk stratification is essential in gestational diabetes (GDM) diagnosis to optimize therapeutic strategies during pregnancy. However, there are sparse data related to the newly recommended International Association of Diabetes and Pregnancy Study Groups criteria and their use in early pregnancy. Objective: This study sought to evaluate clinical and pathophysiological characteristics less up to gestational week (GW) 21 in women with early and late GDM onset. Design and Setting: This was a prospective study conducted at the Medical University of Vienna. Patients and Interventions: Pregnant women (n = 211) underwent an oral glucose tolerance test at 16 GW (interquartile range, 14–18 wk) with multiple measurements of glucose, insulin, and C-peptide for evaluation of insulin sensitivity and ß-cell function in addition to detailed obstetrical risk assessment. Clinical followups were performed until end of pregnancy. Main outcome measure: We performed a metabolic characterization of early-onset GDM. Results: Of 81 women, 49 (23%) showed early (GDMEarly ≤ 21 GW) and 32 (15%) later manifestation (GDMLate ≥ 24 GW) whereas 130 (62%) remained normal-glucose-tolerant (NGT). In contrast with GDMLate, GDMEarly were affected by decreased insulin sensitivity (GDMEarly vs NGT, P manifested subjects showed impairments in ß-cell function. GDMEarly showed highest levels of preconceptional and actual body mass index (BMI), which was related to fasting glucose (r = 0.42, P manifestation of GDM is affected by insulin resistance that is partly explained by higher degree in obesity. However, ß-cell dysfunction was also detectable in GDMLate, indicating defective compensatory mechanisms emerging already in early pregnancy. PMID:25574889

  11. Induced abortion and subsequent pregnancy duration

    DEFF Research Database (Denmark)

    Zhou, Wei Jin; Sørensen, Henrik Toft; Olsen, Jørn

    1999-01-01

    OBJECTIVE: To examine whether induced abortion influences subsequent pregnancy duration. METHODS: Women who had their first pregnancies during 1980, 1981, and 1982 were identified in three Danish national registries. A total of 15,727 women whose pregnancies were terminated by first-trimester ind......OBJECTIVE: To examine whether induced abortion influences subsequent pregnancy duration. METHODS: Women who had their first pregnancies during 1980, 1981, and 1982 were identified in three Danish national registries. A total of 15,727 women whose pregnancies were terminated by first......-trimester induced abortions were compared with 46,026 whose pregnancies were not terminated by induced abortions. All subsequent pregnancies until 1994 were identified by register linkage. RESULTS: Preterm and post-term singleton live births were more frequent in women with one, two, or more previous induced...... abortions. After adjusting for potential confounders and stratifying by gravidity, the odds ratios of preterm singleton live births in women with one, two, or more previous induced abortions were 1.89 (95% confidence interval [CI] 1.70, 2.11), 2.66 (95% CI 2.09, 3.37), and 2.03 (95% CI 1.29, 3...

  12. Prevalence and concordance of high-risk papillomavirus infection in male sexual partners of women diagnosed with high grade cervical lesions.

    Science.gov (United States)

    López Diez, Elena; Pérez, Sonia; Iñarrea, Amparo; de la Orden, Angel; Castro, Máximo; Almuster, Sheila; Tortolero, Leonardo; Rodríguez, Moises; Montero, Ruben; Ojea, Antonio

    2017-05-01

    Little is known about the characteristics of high-risk papillomavirus (HR-HPV) infection in men. The aims of this cross-sectional study were: (a) to investigate HR-HPV prevalence and genotype distribution in men, sexual partners of women presenting with high-grade cervical intraepithelial neoplasia (HG-CIN), according to epidemiological characteristics, and (b) to assess type-specific concordance between partners. A total of 125 men were recruited within the first 6 months after HG-CIN diagnosis of their partner. Samples from the coronal sulcus, glans penis shaft, and scrotum were tested with linear array HPV genotyping assay (Roche Diagnostics, Mannheim, Germany). Type-specific concordance within 120 couples was studied. Epidemiological factors were evaluated by multivariate logistic regression analysis. SPSS 19 (IBM, Chicago, USA). The prevalence of HR-HPV infection in males was 50.4% (63/125). HPV16/53/52/51/66/31 were the most frequent genotypes (24/10.4/9.6/8.8/8/7.2%, respectively). Current smoking was associated with an increased risk for HR-HPV infection in men (38.2% (21/55) vs 60% (42/70), OR 2.4, p=0.025). Among 60 infected couples, 62% shared at least one genotype: 41.7% couples were concordantly HPV16 positive and 18.3% were HPV16 negative (kappa value: 0.21). The proportion of women with the same genotype as their male partner was higher than the proportion of men sharing the same genotype as their female partner: 58.7% (37/63) vs 30.8% (37/120), p<0.0001. Sexual partners of women with HG-CIN are a significant reservoir and vector of HPV infection, a fact that could contribute to making viral clearance more difficult to achieve in their partners after treatment of their HG-CIN lesions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. Temporal trend, clinicopathologic and sociodemographic characterization of age at diagnosis of breast cancer among US women diagnosed from 1990 to 2009.

    Science.gov (United States)

    Escarela, Gabriel; Pérez-Ruiz, Luis Carlos; Núñez-Antonio, Gabriel

    2014-01-01

    This paper investigates the distribution of age at diagnosis of female breast cancer and its association with temporal trend, clinicopathologic and sociodemographic variables in the presence of two latent clusters that are directly unobservable. Such clusters help to identify two subpopulations of either young or old patients whose etiologies are thought to be different. A large sample drawn from registry data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program from 1990 to 2009 was analyzed using a two-component Gaussian mixture model. Evidence of a steady delay of age at diagnosis and an increasing proportion of young patients being diagnosed during the 20-year period was found. Histopathologic effects indicate that duct and lobular carcinomas differ significantly in regard to subpopulation membership, which confirms that they represent different etiologies. While the presence of estrogen receptor status in the model overlaps the effects of other important variables it is highly correlated with, it is found that the grade, extension and size of the tumor along with lymph node involvement status, race and marital status are important predictors of age at diagnosis. The results highlight the significant impacts that such features can have on breast cancer control efforts, and point to the importance of ensuring that medical decision making should use them along with an indicator of the age subpopulation a patient may belong to.

  14. Recurrent miscarriage and antiphospholipid antibodies: prognosis of subsequent pregnancy.

    NARCIS (Netherlands)

    Cohn, D.M.; Goddijn, M.; Middeldorp, S.; Korevaar, J.C.; Dawood, F.; Farquharson, R.G.

    2010-01-01

    Background: Although women with antiphospholipid antibodies (APLAs) are at increased risk of recurrent miscarriage, the outcome of a subsequent pregnancy is not clearly elucidated. Objectives: To assess the pregnancy outcome of a subsequent pregnancy in women with APLAs and compare this outcome with

  15. Prevalence of High-Risk Genotypes of Human Papillomavirus: Women Diagnosed with Premalignant and Malignant Pap Smear Tests in Southern Ecuador

    Directory of Open Access Journals (Sweden)

    Paola Dalgo Aguilar

    2017-01-01

    Full Text Available Human papillomavirus (HPV is the primary infectious agent for the development of cervical cancer, although the presence of the virus alone is insufficient for viral development and proliferation; this can be attributed to the increase in potential oncogenic risk, along with other risk factors. In the present investigation, the prevalence of high-risk HPV was determined from samples of premalignant or malignant cervical cytology in women from the southern region of Ecuador. The kit we used was able to detect genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. In addition, 64.5% of the analyzed samples were positive for HPV, with genotypes 16 and 18 being the most prevalent (16 was detected in 148 samples and 18 in 108. Genotypes 58 and 51 were the third most frequent simple and multiple infections, respectively. The data are very similar to those obtained worldwide, suggesting that the strategy of sex education, and the use of vaccines as primary prevention agents, could significantly decrease the incidence and mortality rate of cervical cancer in the southern region of Ecuador.

  16. Prevalence of High-Risk Genotypes of Human Papillomavirus: Women Diagnosed with Premalignant and Malignant Pap Smear Tests in Southern Ecuador

    Science.gov (United States)

    Loján González, Cisne; Córdova Rodríguez, Ana; Acurio Páez, Katherine; Arévalo, Ana Paulina; Bobokova, Jana

    2017-01-01

    Human papillomavirus (HPV) is the primary infectious agent for the development of cervical cancer, although the presence of the virus alone is insufficient for viral development and proliferation; this can be attributed to the increase in potential oncogenic risk, along with other risk factors. In the present investigation, the prevalence of high-risk HPV was determined from samples of premalignant or malignant cervical cytology in women from the southern region of Ecuador. The kit we used was able to detect genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. In addition, 64.5% of the analyzed samples were positive for HPV, with genotypes 16 and 18 being the most prevalent (16 was detected in 148 samples and 18 in 108). Genotypes 58 and 51 were the third most frequent simple and multiple infections, respectively. The data are very similar to those obtained worldwide, suggesting that the strategy of sex education, and the use of vaccines as primary prevention agents, could significantly decrease the incidence and mortality rate of cervical cancer in the southern region of Ecuador. PMID:28717342

  17. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients.

    Science.gov (United States)

    de Haan, Jorine; Verheecke, Magali; Van Calsteren, Kristel; Van Calster, Ben; Shmakov, Roman G; Mhallem Gziri, Mina; Halaska, Michael J; Fruscio, Robert; Lok, Christianne A R; Boere, Ingrid A; Zola, Paolo; Ottevanger, Petronella B; de Groot, Christianne J M; Peccatori, Fedro A; Dahl Steffensen, Karina; Cardonick, Elyce H; Polushkina, Evgeniya; Rob, Lukas; Ceppi, Lorenzo; Sukhikh, Gennady T; Han, Sileny N; Amant, Frédéric

    2018-03-01

    Awareness is growing that cancer can be treated during pregnancy, but the effect of this change on maternal and neonatal outcomes is unknown. The International Network on Cancer, Infertility and Pregnancy (INCIP) registers the incidence and maternal, obstetric, oncological, and neonatal outcomes of cancer occurring during pregnancy. We aimed to describe the oncological management and obstetric and neonatal outcomes of patients registered in INCIP and treated in the past 20 years, and assess associations between cancer type or treatment modality and obstetric and neonatal outcomes. This descriptive cohort study included pregnant patients with cancer registered from all 37 centres (from 16 countries) participating in the INCIP registry. Oncological, obstetric, and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between Jan 1, 1996, and Nov 1, 2016, were retrospectively and prospectively collected. We analysed changes over time in categorical patient characteristics, outcomes, and treatment methods with log-binomial regression. We used multiple logistic regression to analyse preterm, prelabour rupture of membranes (PPROM) or preterm contractions, small for gestational age, and admission to the neonatal intensive care unit (NICU). The INCIP registry study is registered with ClinicalTrials.gov, number NCT00330447, and is ongoing. 1170 patients were included in the analysis and 779 (67%) received treatment during pregnancy. Breast cancer was the most common malignant disease (462 [39%]). Every 5 years, the likelihood of receiving treatment during pregnancy increased (relative risk [RR] 1·10, 95% CI 1·05-1·15), mainly related to an increase of chemotherapeutic treatment (1·31, 1·20-1·43). Overall, 955 (88%) of 1089 singleton pregnancies ended in a livebirth, of which 430 (48%) of 887 pregnancies ended preterm. Each 5 years, we observed more livebirths (RR 1·04, 95% CI 1·01-1·06) and fewer iatrogenic preterm

  18. Risk Factors for Gestatıonal Diabetes in Women with Polycystic Ovarian Syndrome

    OpenAIRE

    Arda Duz, Senem; Turkcuoglu, Ilgın

    2016-01-01

    We aimed to compare the pre-gestational metabolic states of the women who were previously diagnosed with policystic ovarian syndrome and had gestational diabetes mellitus in the subsequent pregnancy and who did not have gestational diabetes mellitus in subsequent pregnancy and to determine the independent variables that predict the gestational diabetes mellitus risk for policystic ovarian syndrome patients in the subsequent pregnancy. Between the dates 2007 and 2012, the patients who were dia...

  19. Perceived Stress Levels, Chemotherapy, Radiation Treatment and Tumor Characteristics Are Associated with a Persistent Increased Frequency of Somatic Chromosomal Instability in Women Diagnosed with Breast Cancer: A One Year Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Noran Aboalela

    Full Text Available While advances in therapeutic approaches have resulted in improved survival rates for women diagnosed with breast cancer, subsets of these survivors develop persistent psychoneurological symptoms (fatigue, depression/anxiety, cognitive dysfunction that compromise their quality of life. The biological basis for these persistent symptoms is unclear, but could reflect the acquisition of soma-wide chromosomal instability following the multiple biological/psychological exposures associated with the diagnosis/treatment of breast cancer. An essential first step toward testing this hypothesis is to determine if these cancer-related exposures are indeed associated with somatic chromosomal instability frequencies. Towards this end, we longitudinally studied 71 women (ages 23-71 with early-stage breast cancer and quantified their somatic chromosomal instability levels using a cytokinesis-blocked micronuclear/cytome assay at 4 timepoints: before chemotherapy (baseline; four weeks after chemotherapy initiation; six months after chemotherapy (at which time some women received radiotherapy; and one year following chemotherapy initiation. Overall, a significant change in instability frequencies was observed over time, with this change differing based on whether the women received radiotherapy (p=0.0052. Also, significantly higher instability values were observed one year after treatment initiation compared to baseline for the women who received: sequential taxotere/doxorubicin/cyclophosphamide (p<0.001 or taxotere/cyclophosphamide (p=0.014. Significant predictive associations for acquired micronuclear/cytome abnormality frequencies were also observed for race (p=0.0052, tumor type [luminal B tumors] (p=0.0053, and perceived stress levels (p=0.0129. The impact of perceived stress on micronuclear/cytome frequencies was detected across all visits, with the highest levels of stress being reported at baseline (p =0.0024. These findings suggest that the cancer

  20. Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol.

    Science.gov (United States)

    Jones, G L; Hughes, J; Mahmoodi, N; Greenfield, D; Brauten-Smith, G; Skull, J; Gath, J; Yeomanson, D; Baskind, E; Snowden, J A; Jacques, R M; Velikova, G; Collins, K; Stark, D; Phillips, R; Lane, S; Bekker, H L

    2017-03-13

    Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the 'Cancer, Fertility and Me' study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need. This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis. Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval

  1. Diagnosing Acoustic Neuroma

    Science.gov (United States)

    ... Values Leadership & Staff Annual Reports Shop ANA Home Learn Diagnosing English English Arabic Catalan Chinese (Simplified) Chinese (Traditional) Danish French German Greek Haitian Creole Hebrew Hindi Italian Japanese Korean Portuguese Romanian Spanish Diagnosing The diagnosis of an acoustic ...

  2. TH1 and TH2 cytokines dataset in insulin users with diabetes mellitus and newly diagnosed breast cancer

    Directory of Open Access Journals (Sweden)

    Zachary A.P. Wintrob

    2017-04-01

    Full Text Available Exogenous insulin use may interfere with the T helper cells’ cytokine production. This dataset presents the relationship between pre-existing use of injectable insulin in women diagnosed with breast cancer and type 2 diabetes mellitus, the T-helper 1 and 2 produced cytokine profiles at the time of breast cancer diagnosis, and subsequent cancer outcomes. A Pearson correlation analysis evaluating the relationship between T-helper cytokines stratified by of insulin use and controls is also provided.

  3. Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols.

    Science.gov (United States)

    Toftager, M; Bogstad, J; Løssl, K; Prætorius, L; Zedeler, A; Bryndorf, T; Nilas, L; Pinborg, A

    2017-03-01

    Are cumulative live birth rates (CLBRs) similar in GnRH-antagonist and GnRH-agonist protocols for the first ART cycle including all subsequent frozen-thaw cycles from the same oocyte retrieval? The chances of at least one live birth following utilization of all fresh and frozen embryos after the first ART cycle are similar in GnRH-antagonist and GnRH-agonist protocols. Reproductive outcomes of ART treatment are traditionally reported as pregnancies per cycle or per embryo transfer. However, the primary concern is the overall chance of a live birth. After the first ART cycle with fresh embryo transfer, we found live birth rates (LBRs) of 22.8% and 23.8% (P = 0.70) for the GnRH-antagonist and GnRH-agonist protocols, respectively. But with CLBRs including both fresh and frozen embryos from the first oocyte retrieval, chances of at least one live birth increases. There are no previous randomized controlled trials (RCTs) comparing CLBRs in GnRH-antagonist versus GnRH-agonist protocols. Previous studies on CLBR are either retrospective cohort studies including multiple fresh cycles or RCTs comparing single embryo transfer (SET) with double embryo transfer (DET). CLBR was a secondary outcome in a Phase IV, dual-center, open-label, RCT including 1050 women allocated to a short GnRH-antagonist or a long GnRH-agonist protocol in a 1:1 ratio over a 5-year period using a web-based concealed randomization code. The minimum follow-up time from the first IVF cycle was 2 years. The aim was to compare CLBR between the two groups following utilization of all fresh and frozen embryos from the first ART cycle. All women referred for their first ART cycle at two public fertility clinics, live birth was irrespective of the duration of gestation. CLBR was defined as at least one live birth per allocated woman after fresh and frozen cycles. Subjects were censored out after the first live birth. Cox proportional hazard model was used to evaluate the relative prognostic significance of

  4. Women with celiac disease present with fertility problems no more often than women in the general population.

    Science.gov (United States)

    Dhalwani, Nafeesa N; West, Joe; Sultan, Alyshah Abdul; Ban, Lu; Tata, Laila J

    2014-12-01

    Studies have associated infertility with celiac disease. However, these included small numbers of women attending infertility specialist services and subsequently screened for celiac disease, and therefore may not have been representative of the general population. We performed a large population-based study of infertility and celiac disease in women from the United Kingdom. We identified 2,426,225 women with prospective UK primary care records between 1990 and 2013 during their child-bearing years from The Health Improvement Network database. We estimated age-specific rates of new clinically recorded fertility problems among women with and without diagnosed celiac disease. Rates were stratified by whether celiac disease was diagnosed before the fertility problem or afterward and compared with rates in women without celiac disease using Poisson regression, adjusting for sociodemographics, comorbidities, and calendar time. Age-specific rates of new clinically recorded fertility problems in 6506 women with celiac disease were similar to the rates in women without celiac disease (incidence rate ratio, 1.12; 95% confidence interval, 0.88-1.42 among women age 25-29 years). Rates of infertility among women without celiac disease were similar to those of women with celiac disease before and after diagnosis. However, rates were 41% higher among women diagnosed with celiac disease when they were 25-29 years old, compared with women in the same age group without celiac disease (incidence rate ratio, 1.41; 95% confidence interval, 1.03-1.92). Women with celiac disease do not have a greater likelihood of clinically recorded fertility problems than women without celiac disease, either before or after diagnosis, except for higher reports of fertility problems between 25-39 years if diagnosed with CD. These findings should assure most women with celiac disease that they do not have an increased risk for fertility problems. Copyright © 2014 AGA Institute. Published by Elsevier

  5. Cesarean Delivery and Risk for Subsequent Ectopic Pregnancy.

    Science.gov (United States)

    Bowman, Zachary S; Smith, Ken R; Silver, Robert M

    2015-07-01

    This study aims to examine the risk for subsequent ectopic pregnancy in women with prior cesarean delivery. Women with a history of at least one cesarean delivery in the state of Utah during 1996 to 2011 were identified and compared with women with vaginal delivery only. The primary outcome was subsequent ectopic pregnancy. Data were analyzed by multivariate logistic regression and stratified by first, second, or third live births. Model covariates included maternal age, ethnicity, marital status, education level, gravidity, and prior ectopic pregnancy. Overall, 260,249 women with at least one live birth were identified. After exclusions, 255,082, 154,930, and 70,228 women had at least one, two, and three prior live births that lead to 531, 199, and 62 subsequent ectopic pregnancies, respectively. Women who had one prior cesarean delivery were not at increased risk for subsequent ectopic pregnancy in relation to women with no prior cesarean delivery. However, women with two of two, two of three, or three of three prior cesareans had increased risk for subsequent ectopic pregnancy with odds ratios (95% confidence interval) of 1.54 (1.06-2.22), 3.50 (1.49-8.24), and 1.99 (1.00-3.98), respectively. History of two or three cesarean deliveries is associated with increased risk for subsequent ectopic pregnancy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Korean women's breast cancer experience.

    Science.gov (United States)

    Im, Eun-Ok; Lee, Eun Ok; Park, Young Sook

    2002-11-01

    The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) "I did wrong," (b) "I cannot ask male physicians." (c) "I don't want to show the operation site to my husband." and (d) "I do household tasks by myself." The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women's health/illness experience.

  7. Autoimmune disease and subsequent urological cancer.

    Science.gov (United States)

    Liu, Xiangdong; Ji, Jianguang; Forsti, Asta; Sundquist, Kristina; Sundquist, Jan; Hemminki, Kari

    2013-06-01

    We examined the subsequent risk and prognosis of urological cancer in individuals diagnosed with autoimmune disease. We systematically analyzed the risk and prognosis of prostate, kidney and bladder cancers in individuals diagnosed with any of 33 autoimmune diseases based on a national Swedish database for 1964 through 2008. The SIR and HR were calculated for subsequent urological cancers between 1964 and 2008 in individuals hospitalized for autoimmune disease. An increased SIR for urological cancer was recorded after 26 autoimmune diseases. An increased HR for cancer specific survival was noted after 4 autoimmune diseases and for overall survival after 18. The highest SIRs were seen for kidney cancer after polyarteritis nodosa (2.85) and polymyositis/dermatomyositis (2.68), and for bladder cancer after polymyositis/dermatomyositis (2.45). The highest risk of prostate cancer (1.70) was observed after polyarteritis nodosa. SIRs were lower during followup from 1990 to 2008 compared to the previous period. Individuals diagnosed with prostate and kidney cancers showed an improved cancer specific prognosis, in contrast to the poorer overall prognosis for all 3 urological cancers. The risk of urological cancer was increased after all autoimmune diseases. The most significant changes after individual autoimmune diseases were toward higher risk. Survival data were reassuring since autoimmune disease only marginally influences the prognosis of cancer specific mortality. However, overall survival was decreased for the 3 types of cancer. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. The impact of expectant management, systemic methotrexate and surgery on subsequent pregnancy outcomes in tubal ectopic pregnancy.

    Science.gov (United States)

    Demirdag, E; Guler, I; Abay, S; Oguz, Y; Erdem, M; Erdem, A

    2017-05-01

    The most common treatment modalities of ectopic pregnancy may influence long-term subsequent fertility outcomes in women who previously treated for ectopic pregnancy. Our objective was to compare long-term subsequent fertility outcomes after treatment with expectant management, systemic methotrexate (MTX) and surgery in tubal ectopic pregnancy. We searched our database for all women diagnosed with tubal ectopic pregnancy between January 2007 and January 2011 who were managed expectantly, with systemic MTX and with surgery. Treatment success and spontaneous pregnancy rates were compared in patients who desire to conceive following a tubal pregnancy. One hundred twelve of 151 women desired to conceive following tubal ectopic pregnancy. Twenty-seven of 112 (24.1 %) patients were managed expectantly. Fifty-three (47.3 %) and 32 (28.5 %) patients were managed with systemic MTX or surgery, respectively. All patients in expectant and surgery groups were managed successfully. Two (3.7 %) patients had surgery after failed treatment with systemic MTX. Spontaneous intrauterine pregnancy rates were 62.9 % in expectantly managed women, 58.4 % in women with systemic MTX and 68.7 % in women with surgery (p > 0.05). Treatment of ectopic pregnancy with either expectant management or systemic MTX is equally effective as compared to surgery. Spontaneous intrauterine pregnancy rates were comparable in expectant management, systemic methotrexate and surgery.

  9. Association of Periodontitis and Subsequent Depression

    Science.gov (United States)

    Hsu, Chih-Chao; Hsu, Yi-Chao; Chen, Hsuan-Ju; Lin, Che-Chen; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Kao, Chia-Hung

    2015-01-01

    Abstract Periodontitis is a systemic and chronic inflammatory disease associated with multiple physical conditions. Distress and depression are other problems affecting the progression of periodontitis. However, the causal relationship between depression and periodontitis has not been adequately investigated. This aim of this study was to determine the association between periodontitis and the subsequent development of depression. We identified 12,708 patients with newly diagnosed periodontitis from 2000 to 2005 and 50,832 frequency-matched individuals without periodontitis. Both groups were followed until diagnosed with depression, withdrawal from the National Health Insurance program, or the end of 2011. The association between periodontitis and depressio was analyzed using Cox proportional hazard regression models. The incidence density rate of depression was higher in the periodontitis group than in the nonperiodontitis group, with an adjusted hazard ratio of 1.73 (95% confidence interval 1.58–1.89) when adjusting for sex, age, and comorbidity. Cox models revealed that periodontitis was an independent risk factor for depression in patients, except for comorbidities of diabetes mellitus (DM), alcohol abuse, and cancer. Periodontitis may increase the risk of subsequent depression and was suggested an independent risk factor regardless of sex, age, and most comorbidities. However, DM, alcohol abuse, and cancer may prevent the development of subsequent depression because of DM treatment, the paradoxical effect of alcohol, and emotional distress to cancer, respectively. Prospective studies on the relationship between periodontitis and depression are warranted. PMID:26705230

  10. Stability of psychiatric diagnoses in clinical practice.

    Science.gov (United States)

    Daradkeh, T K

    1996-01-01

    This is a retrospective study that aimed at studying the diagnostic stability of psychiatric diagnoses over a 4-year period. Three-hundred and twelve patients (n = 312) admitted more than once to Al Ain in-patient unit from January 1, 1990 to December 31, 1993, were the subjects for this study. The sample included patients with the following index diagnoses: acute psychoses (n = 37), alcohol abuse (n = 15), bipolar disorder (n = 27), depressive disorders (n = 63), drug abuse (n = 21), hysteria (n = 23), neurotic disorders (n = 50) and schizophrenia (n = 76). Diagnoses on discharge for first admissions were considered the index diagnoses. The shift from index diagnoses to subsequent diagnoses was counted. Diagnostic stability was calculated as the percentages of index diagnoses that did not change over time. In nearly half of the patients the index diagnoses changed over the 4-year period. Highest diagnostic stability was found in patients with index diagnoses of alcohol abuse, schizophrenia and drug abuse (92%, 74% and 71% respectively), while the lowest stability was found in patients with neurotic, hysterical, depressive disorders, acute psychoses and bipolar disorders (38%, 48% and 45%, 42%, 52% respectively). Two distinct patterns of shifts were noted. First shift occurred between functional psychoses and second shift between depressive and neurotic disorders. This study provides further support to the notion that diagnostic stability in clinical practice is still far from being satisfactory.

  11. Chronic myeloproliferative neoplasms and subsequent cancer risk

    DEFF Research Database (Denmark)

    Frederiksen, H.; Farkas, Dora Kormendine; Christiansen, C.F.

    2011-01-01

    Patients with chronic myeloproliferative neoplasms, including essential thrombocythemia (ET), polycythemia vera (PV), and chronic myeloid leukemia (CML), are at increased risk of new hematologic malignancies, but their risk of nonhematologic malignancies remains unknown. In the present study, we...... diagnosed with a chronic myeloproliferative neoplasm during 1977-2008. We compared the incidence of subsequent cancer in this cohort with that expected on the basis of cancer incidence in the general population (standardized incidence ratio). Overall, ET, PV, and CML patients were at increased risk...... conclude that patients with chronic myeloproliferative neoplasms are at increased risk of developing a new malignant disease....

  12. Divorce and risk of hospital-diagnosed infectious diseases.

    Science.gov (United States)

    Nielsen, Nete Munk; Davidsen, Rie B; Hviid, Anders; Wohlfahrt, Jan

    2014-11-01

    Although, divorce is considered to have a negative impact on morbidity, very little is known concerning exposure to divorce and risk of infectious diseases. We aimed to investigate the association between divorce and subsequent hospital contacts with infectious diseases. We performed a nation-wide cohort study, including all Danish men and women (n≈5.6 million) alive on the 1 January 1982 or later, and followed them for infectious disease diagnosed in hospital settings from 1982 to 2010. The association between divorce and risk of infectious diseases was evaluated through rate ratios (RRs) comparing incidence rates of infectious diseases between divorced and married pesons. Compared with married persons, divorced persons were overall at a 1.48 fold (RR=1.48 (95% CI: 1.47-1.50)) increased risk of hospital-diagnosed infectious diseases (RR adjusted for sex, age, period, income and education). The risk of infectious diseases was slightly more pronounced for divorced women (RR=1.54 (1.52-1.56)) than divorced men ((RR=1.42 (1.41-1.44)). The increased risk remained almost unchanged even more than 15 years after the divorce. Young age at divorce, short duration of marriage and number of divorces further increased the risk of infectious diseases, whereas number of children at time of divorce had no impact on risk of hospital-diagnosed infectious diseases following the divorce. Divorce appears to have a moderate but long lasting impact on the risk of infectious diseases the underlying mechanism is unknown but shared risk factors predicting divorce and infectious diseases could contribute to our findings. © 2014 the Nordic Societies of Public Health.

  13. Placental histomorphometry in gestational diabetes mellitus: the relationship between subsequent type 2 diabetes mellitus and race/ethnicity.

    Science.gov (United States)

    Bentley-Lewis, Rhonda; Dawson, Deanna L; Wenger, Julia B; Thadhani, Ravi I; Roberts, Drucilla J

    2014-04-01

    We examined placental histomorphometry in gestational diabetes mellitus (GDM) for factors associated with race/ethnicity and subsequent type 2 diabetes mellitus (T2DM). We identified 124 placentas from singleton, full-term live births whose mothers had clinically defined GDM and self-reported race/ethnicity. Clinical and placental diagnoses were abstracted from medical records. Forty-eight white and 76 nonwhite women were followed for 4.1 years (median, range 0.0-8.9 years). White women developed less T2DM (12.5% vs 35.5%; P = .005) but had higher systolic (mean ± SD, 116 ± 13 vs 109 ± 11 mm Hg; P < .001) and diastolic (71 ± 9 vs 68 ± 7 mm Hg; P = .02) blood pressure, more smoking (35.4% vs 10.5%; P = .004), and more chorangiosis (52.1% vs 30.3%; P = .02) than nonwhite women. Although more nonwhite women developed T2DM, more white women had chorangiosis, possibly secondary to the higher percentage of smokers among them. Further study is necessary to elucidate the relationship among chorangiosis, subsequent maternal T2DM, and race.

  14. Cause-specific or relative survival setting to estimate population-based net survival from cancer? An empirical evaluation using women diagnosed with breast cancer in Geneva between 1981 and 1991 and followed for 20 years after diagnosis.

    Science.gov (United States)

    Schaffar, Robin; Rachet, Bernard; Belot, Aurélien; Woods, Laura

    2015-06-01

    Both cause-specific and relative survival settings can be used to estimate net survival, the survival that would be observed if the only possible underlying cause of death was the disease under study. Both resulting net survival estimators are biased by informative censoring and prone to biases related to the data settings within which each is derived. We took into account informative censoring to derive theoretically unbiased estimators and examine which of the two data settings was the most robust against incorrect assumptions in the data. We identified 2489 women in the Geneva Cancer Registry, diagnosed with breast cancer between 1981 and 1991, and estimated net survival up to 20-years using both cause-specific and relative survival settings, by tackling the informative censoring with weights. To understand the possible origins of differences between the survival estimates, we performed sensitivity analyses within each setting. We evaluated the impact of misclassification of cause of death and of using inappropriate life tables on survival estimates. Net survival was highest using the cause-specific setting, by 1% at one year and by up to around 11% twenty years after diagnosis. Differences between both sets of net survival estimates were eliminated after recoding between 15% and 20% of the non-specific deaths as breast cancer deaths. By contrast, a dramatic increase in the general population mortality rates was needed to see the survival estimates based on relative survival setting become closer to those derived from cause-specific setting. Net survival estimates derived using the cause-specific setting are very sensitive to misclassification of cause of death. Net survival estimates derived using the relative-survival setting were robust to large changes in expected mortality. The relative survival setting is recommended for estimation of long-term net survival among patients with breast cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Maternal Obesity in Early Pregnancy and Subsequent Pregnancy ...

    African Journals Online (AJOL)

    Despite a rising prevalence worldwide, there is limited data on pregnancy outcome among African women with prepregnancy or early pregnancy obesity. This was a case-control study to determine the prevalence of maternal obesity in early pregnancy and compare the subsequent pregnancy outcome between 201 women ...

  16. Reactions to abortion and subsequent mental health.

    Science.gov (United States)

    Fergusson, David M; Horwood, L John; Boden, Joseph M

    2009-11-01

    There has been continued interest in the extent to which women have positive and negative reactions to abortion. To document emotional reactions to abortion, and to examine the links between reactions to abortion and subsequent mental health outcomes. Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30. Abortion was associated with high rates of both positive and negative emotional reactions; however, nearly 90% of respondents believed that the abortion was the right decision. Analyses showed that the number of negative responses to the abortion was associated with increased levels of subsequent mental health disorders (Pabortion and reporting negative reactions had rates of mental health disorders that were approximately 1.4-1.8 times higher than those not having an abortion. Abortion was associated with both positive and negative emotional reactions. The extent of negative emotional reactions appeared to modify the links between abortion and subsequent mental health problems.

  17. How Is Atherosclerosis Diagnosed?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  18. How Is Cardiomyopathy Diagnosed?

    Science.gov (United States)

    ... extra or unusual sounds heard during a heartbeat.) Diagnosis Your doctor will diagnose cardiomyopathy based on your medical and family histories, a ... 03, 2013 | News Release Risk factors identified at diagnosis help predict outcomes for ... Cardiomyopathy ...

  19. Two cases of keratoconus diagnosed after pregnancy.

    Science.gov (United States)

    Soeters, Nienke; Tahzib, Nayyirih G; Bakker, Laura; Van der Lelij, Allegonda

    2012-01-01

    This case report aims to demonstrate that pregnancy-induced biomechanical corneal changes in combination with risk factors for ectasia can develop into (the exacerbation of) keratoconus. We describe two women who were clinically diagnosed with keratoconus after their second pregnancy. Both women were myopic and had a history of allergies and contact lens wear. It is unclear whether these two women had a newly diagnosed keratoconus that developed during pregnancy or had experienced an exacerbation of an unrecognized, subclinical keratoconus. Nowadays, documented progression of keratoconus can be treated by corneal crosslinking to stabilize the weakened cornea. Therefore, it is important to understand the effects of hormonal changes in (keratoconic) eyes during pregnancy and to include topographic imaging in unexplained visual deterioration in young individuals, especially during or after a pregnancy.

  20. PHACE syndrome in antenatally diagnosed posterior fossa anomaly

    Directory of Open Access Journals (Sweden)

    Seema Pavaman Sindgikar

    2014-01-01

    Full Text Available PHACE is a neurocutaneous syndrome, an acronym to describe patients with facial segmental hemangiomas and other malformations. We describe a newborn antenatally diagnosed to have posterior fossa anomaly and subsequently as PHACE syndrome.

  1. Subsequence Automata with Default Transitions

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye

    2016-01-01

    of states and transitions) of the subsequence automaton is O(nσ) and that this bound is asymptotically optimal. In this paper, we consider subsequence automata with default transitions, that is, special transitions to be taken only if none of the regular transitions match the current character, and which do...... not consume the current character. We show that with default transitions, much smaller subsequence automata are possible, and provide a full trade-off between the size of the automaton and the delay, i.e., the maximum number of consecutive default transitions followed before consuming a character......(nσ) and delay O(1), thus matching the bound for the standard subsequence automaton construction. The key component of our result is a novel hierarchical automata construction of independent interest....

  2. Subsequence automata with default transitions

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Skjoldjensen, Frederik Rye

    2017-01-01

    of states and transitions) of the subsequence automaton is O(nσ) and that this bound is asymptotically optimal. In this paper, we consider subsequence automata with default transitions, that is, special transitions to be taken only if none of the regular transitions match the current character, and which do...... not consume the current character. We show that with default transitions, much smaller subsequence automata are possible, and provide a full trade-off between the size of the automaton and the delay, i.e., the maximum number of consecutive default transitions followed before consuming a character......(1), thus matching the bound for the standard subsequence automaton construction. Finally, we generalize the result to multiple strings. The key component of our result is a novel hierarchical automata construction of independent interest....

  3. A case study of high genetic loading and subsequent development ...

    African Journals Online (AJOL)

    became depressed and her school functioning declined even more. A child psychiatrist diagnosed a major depressive disorder and ADHD. She was prescribed citalopram 10 mg daily and methylphenidate. She became hyperactive on the antidepressant, which was subsequently discontinued. The methylphenidate was ...

  4. Caesarean section and subsequent fertility in sub-Saharan Africa.

    Science.gov (United States)

    Collin, S M; Marshall, T; Filippi, V

    2006-03-01

    To determine the impact of caesarean section on fertility among women in sub-Saharan Africa. Analysis of standardised cross-sectional surveys (Demographic and Health Surveys). Twenty-two countries in sub-Saharan Africa, 1993-2003. A total of 35 398 women of childbearing age (15-49 years). Time to subsequent pregnancy was compared by mode of delivery using Cox proportional hazards regression models. Natural fertility rates subsequent to delivery by caesarean section compared with natural fertility rates subsequent to vaginal delivery. The natural fertility rate subsequent to delivery by caesarean section was 17% lower than the natural fertility rate subsequent to vaginal delivery (hazard ratio = 0.83, 95% CI 0.73-0.96, P Caesarean section was also associated with prior fertility and desire for further children: among multiparous women, an interval > or =3 versus caesarean section at the index birth (OR = 1.4, 95% CI 1.1-1.7, P= 0.005); among all women, the odds of desiring further children were lower among women who had previously delivered by caesarean section (OR = 0.67, 95% CI 0.54-0.84, P Caesarean section did not appear to increase the risk of a subsequent pregnancy ending in miscarriage, abortion or stillbirth. Among women in sub-Saharan Africa, caesarean section is associated with lower subsequent natural fertility. Although this reflects findings from developed countries, the roles of pathological and psychological factors may be quite different because a much higher proportion of caesarean sections in sub-Saharan Africa are emergency procedures for maternal indication.

  5. Psychopathology and coping in recently diagnosed HIV/AIDS patients

    African Journals Online (AJOL)

    Psychopathology and coping in recently diagnosed HIV/AIDS patients- the role of gender. ... Women were more likely to suffer from post-traumatic stress disorder, and to use coping strategies of planning and ... a description of the source 29

  6. How a Stroke Is Diagnosed

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  7. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis Questions to Ask Your Doctor about Acute Bronchitis ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  8. How Are Genetic Conditions Diagnosed?

    Science.gov (United States)

    ... Consultation How are genetic conditions diagnosed? How are genetic conditions diagnosed? A doctor may suspect a diagnosis ... and advocacy resources. For more information about diagnosing genetic conditions: Genetics Home Reference provides information about genetic ...

  9. Diagnosing ADHD in Adolescence

    Science.gov (United States)

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  10. Diagnosing plant problems

    Science.gov (United States)

    Cheryl A. Smith

    2008-01-01

    Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...

  11. Being publicly diagnosed

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

    2014-01-01

    . METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...

  12. Association between previously unknown connective tissue disease and subclinical hypothyroidism diagnosed during first trimester of pregnancy.

    Science.gov (United States)

    Beneventi, Fausta; Locatelli, Elena; Alpini, Claudia; Lovati, Elisabetta; Ramoni, Véronique; Simonetta, Margherita; Cavagnoli, Chiara; Spinillo, Arsenio

    2015-11-01

    To investigate the presence of autoimmune rheumatic disorders among women with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy and subsequent pregnancy outcomes. Case-control study. Tertiary obstetric and gynecologic center. Pregnant women in the first trimester of pregnancy. Clinical, laboratory, ultrasonographic evaluations. Thyroid-stimulating hormone (TSH) level; antibodies against thyroperoxidase, thyroid globulin and TSH receptor detection; screening for rheumatic symptoms and antinuclear antibodies (ANA); uterine artery pulsatility index evaluation; pregnancy complication onset. Out of 3,450 women enrolled, 106 (3%) were diagnosed with autoimmune thyroid disorders. ANA were present in 18 (16.9%) of 106 cases and 26 (12.6%) of 206 controls. Of the cases, 28 (26.4%) of 106 reported rheumatic symptoms, 5 of these were diagnosed with Sjögren syndrome or with undefined connective tissue disease. Autoimmune thyroid diseases are statistically significantly associated with a higher risk of preeclampsia, fetal growth restriction, and overall pregnancy complications compared with controls, with a higher uterine artery pulsatility index, suggesting a defective placentation in thyroid disorders. The effect of ANA-positivity on moderate/severe adverse pregnancy outcomes was statistically significant among the patients with thyroid disorders (9 of 18 as compared to 8 of 88, odds ratio 9.65; 95% confidence interval, 2.613-7.81). Connective tissue diseases are frequently associated with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy. Thyroid autoimmunity and ANA positivity independently increased the risk of adverse pregnancy outcomes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Liability for Diagnosing Malingering.

    Science.gov (United States)

    Weiss, Kenneth J; Van Dell, Landon

    2017-09-01

    Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis. © 2017 American Academy of Psychiatry and the Law.

  14. pregnant women

    Directory of Open Access Journals (Sweden)

    Ewelina Buraczewska

    2016-09-01

    Full Text Available Background . Diabetes in pregnancy is a condition which includes pre-pregnancy diabetes in women already suffering from diabetes who become pregnant, and hyperglycaemia first diagnosed during pregnancy, defined as a disorder of carbohydrate tolerance resulting in increased blood glucose concentrations, which were first diagnosed in pregnant healthy women. Women’s knowledge about the disease and the practical use of this knowledge play an important role in the healing process. Objectives. The assessment of the state of knowledge about diabetes in pregnant women diagnosed with hyperglycaemia during pregnancy. Material and methods. The study involved 127 pregnant women with hyperglycemia which was first diagnosed during pregnancy. The median age of the subjects was 32.1 (19–45. A diagnostic survey was a research method. A self-prepared survey questionnaire was the research tool. The results were statistically analyzed. Results. The surveyed women assessed their knowledge about gestational diabetes as good and very good. The study showed, however, very poor knowledge about the clinical signs of diabetes among the subjects. The most frequently cited risk factors for gestational diabetes include: the presence of diabetes in one’s family, overweight states or obesity, and diabetes in previous pregnancy. The Internet was the main source of knowledge about diabetes among the subjects. Conclusions . 1. The level of knowledge in women about gestational diabetes is insufficient. 2. There is a need to extend educational activities related to the symptoms of diabetes and the principles of its prevention among pregnant women. 3. The participation of general practitioners in the education of women about diabetes in pregnancy is insufficient.

  15. Medical abortion and the risk of subsequent adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Virk, Jasveer; Zhang, Jun; Olsen, Jørn

    2007-01-01

    BACKGROUND: The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies. METHODS: We...... identified all women living in Denmark who had undergone an abortion for nonmedical reasons between 1999 and 2004 and obtained information regarding subsequent pregnancies from national registries. Risks of ectopic pregnancy, spontaneous abortion, preterm birth (at ... weight (abortion were compared with risks in women who had had a first-trimester surgical abortion. RESULTS: Among 11,814 pregnancies in women who had had a previous first-trimester medical abortion (2710 women...

  16. Subsequent pregnancy outcomes after obstetric anal sphincter injuries (OASIS).

    Science.gov (United States)

    Basham, Elizabeth; Stock, Laura; Lewicky-Gaupp, Christina; Mitchell, Christopher; Gossett, Dana R

    2013-01-01

    To describe obstetric outcomes in women with a prior obstetric anal sphincter injury (OASIS) and to identify risk factors for recurrence. A retrospective chart review of women who sustained an OASIS between November 2005 and March 2010 at a tertiary care hospital was performed to identify risk factors for recurrence. One thousand six hundred twenty-nine patients had an OASIS. Of these, 758 patients (90%) subsequently delivered during the aforementioned timeframe; 685 patients had a subsequent vaginal delivery. Of the women, 3.2% had a recurrent OASIS. Recurrence was associated with larger birth weight (27% ≥4000 g vs 11.6% <4000 g; P = 0.04) and delivery mode (25.0%, 12.5%, and 2.7% for forceps-assisted, vacuum-assisted, and spontaneous deliveries, respectively (P = 0.0001)), whereas a history of fourth-degree laceration, prior wound complication, or episiotomy at subsequent delivery were not (P = 0.5, P = 0.5, and P = 0.4, respectively). Recurrent OASIS occurred in a small percentage of women (3.2%) who subsequently delivered vaginally. Recurrent OASIS was associated with operative vaginal delivery and birth weight 4000 g or greater. Neither episiotomy at first delivery nor at subsequent delivery conferred an increased recurrence risk.

  17. Failure of fertility therapy and subsequent adverse cardiovascular events

    Science.gov (United States)

    Udell, Jacob A.; Lu, Hong; Redelmeier, Donald A.

    2017-01-01

    BACKGROUND: Infertility may indicate an underlying predisposition toward premature cardiovascular disease, yet little is known about potential long-term cardiovascular events following fertility therapy. We investigated whether failure of fertility therapy is associated with subsequent adverse cardiovascular events. METHODS: We performed a population-based cohort analysis of women who received gonadotropin-based fertility therapy between Apr. 1, 1993, and Mar. 31, 2011, distinguishing those who subsequently gave birth and those who did not. Using multivariable Poisson regression models, we estimated the relative rate ratio of adverse cardiovascular events associated with fertility therapy failure, accounting for age, year, baseline risk factors, health care history and number of fertility cycles. The primary outcome was subsequent treatment for nonfatal coronary ischemia, stroke, transient ischemic attack, heart failure or thromboembolism. RESULTS: Of 28 442 women who received fertility therapy, 9349 (32.9%) subsequently gave birth and 19 093 (67.1%) did not. The median number of fertility treatments was 3 (interquartile range 1–5). We identified 2686 cardiovascular events over a median 8.4 years of follow-up. The annual rate of cardiovascular events was 19% higher among women who did not give birth after fertility therapy than among those who did (1.08 v. 0.91 per 100 patient-years, p treatment cycles. INTERPRETATION: Fertility therapy failure was associated with an increased risk of long-term adverse cardiovascular events. These women merit surveillance for subsequent cardiovascular events. PMID:28385819

  18. Irregularidades menstruales y de hormonas sexuales en mujeres que se les diagnosticó la diabetes tipo 1 antes de la menarquia o después de esta Menstruation disorders and sexual hormones in women diagnosed with type 1 diabetes before menarche or after it

    Directory of Open Access Journals (Sweden)

    Yaquelín González Ricardo

    2010-04-01

    determine the sexual hormones levels and to establish the influence of this entity on the menarche age. METHODS: a cross-sectional descriptive study was conducted in 74 women aged 15 and 35, all seen in the Diabetes Care Center of Ciudad de La Habana, Cuba, which were distributed in two groups: A and B, both with n= 37; A: diagnosed with diabetes before the menarche appearance and B; after it. We designed a questionnaire of general data and puberal and menstrual medical records; we determined the presence of fasting glycemia, glycosylated hemoglobin and sexual hormones; both groups were compared using the t Student and chi² tests. RESULTS: we achieved a high frequency of dysmenorrhea, menorrhhea and premenstrual tension, as well the loss of a correlation among some sexual hormones. Earlier presence of type 1 diabetes mellitus determined a greater age of menarche, lower levels of gonadotropins (LH and FSH and oligomenorrhea. CONCLUSIONS: type 1 diabetes mellitus diagnosed before menarche seems to interfere with maturation and subsequent function of female gonadal axis, which conditioned a greater frequency of dysmenorrhea and menstrual irregularities.

  19. Receiving versus being denied an abortion and subsequent drug use.

    Science.gov (United States)

    Roberts, Sarah C M; Rocca, Corinne H; Foster, Diana Greene

    2014-01-01

    Some research finds that women receiving abortions are at increased risk of subsequent drug use and drug use disorders. This literature is rife with methodological problems, particularly inappropriate comparison groups. This study used data from the Turnaway Study, a prospective, longitudinal study of women who sought abortions at 30 sites across the U.S. Participants included women presenting just prior to an abortion facility's gestational age limit who received abortions (Near Limit Abortion Group, n=452), just beyond the gestational limit who were denied abortions (Turnaways, n=231), and who received first trimester abortions (First Trimester Abortion Group, n=273). This study examined the relationship between receiving versus being denied an abortion and subsequent drug use over two years. Trajectories of drug use were compared using multivariate mixed effects regression. Any drug use, frequency of drug use, and marijuana use did not change over time among women in any group. There were no differential changes over time in any drug use, frequency of drug use, or marijuana use between groups. However, Turnaways who ultimately gave birth increased use of drugs other than marijuana compared to women in the Near Limit Abortion Group (p=.041), who did not increase use. Women receiving abortions did not increase drug use over two years or have higher levels of drug use than women denied abortions. Assertions that abortion leads women to use drugs to cope with the stress of abortion are not supported. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Receiving versus being denied an abortion and subsequent tobacco use.

    Science.gov (United States)

    Roberts, Sarah C M; Foster, Diana Greene

    2015-03-01

    The negative health consequences of tobacco use are well documented. Some research finds women receiving abortions are at increased risk of subsequent tobacco use. This literature has methodological problems, most importantly, inappropriate comparison groups. This study uses data from the Turnaway Study, a longitudinal study of women who all sought, but did not all receive, abortions at 30 facilities across the United States. Participants included women presenting just before an abortion facility's gestational age limit who received abortions (Near Limit Abortion Group, n = 452), just after the gestational limit who were denied abortions (Turnaways, n = 231), and who received first trimester abortions (First Trimester Abortion Group, n = 273). This study examined the association between receiving versus being denied an abortion and subsequent tobacco use over 2-years. Trajectories of tobacco use over 2 years were compared using multivariate mixed effects regression. Women receiving abortion maintained their level of tobacco use over 2 years. Women denied abortion initially had lower levels of tobacco use than women receiving abortion, but increased their tobacco use from 1 week through 12-18 months post-abortion seeking and then decreased their use by 2 years post-abortion seeking. Baseline parity modified these associations. Receiving an abortion was not associated with an increase in tobacco use over time. Overall, women who carry unwanted pregnancies to term appear to demonstrate similar cessation and resumption patterns to other pregnant women.

  1. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

    Science.gov (United States)

    Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

    2018-02-06

    Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

  2. Risks associated with subsequent pregnancy after one caesarean ...

    African Journals Online (AJOL)

    The absolute risk of failed trial of vaginal birth after a cesarean was 45% (95% CI: 38.5, 51.5). Conclusion: Women who have one previous C.section face a markedly increased risk of repeat caesarean sections and feto.maternal complications in subsequent pregnancies. There is a need for doctors in Nigeria to be mindful of ...

  3. Incidence of pelvic organ prolapse repair subsequent to hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy. METHODS: From the Danish National Patient Registry, we collected data on all radical...

  4. Diagnosing Musculoskeletal Tumours

    Directory of Open Access Journals (Sweden)

    Robert J. Grimer

    2001-01-01

    Full Text Available In 1993 we became aware of a worrying increase in apparent errors in the histopathological diagnosis of musculoskeletal tumours in our Unit. As a result all cases seen over the past 8 years were reviewed by an independent panel. Of the 1996 cases reviewed there was an error in 87. In 54 cases (2.7% this had led to some significant change in the active management of the patient. The main areas where errors arose were in those very cases where clinical and radiological features were not helpful in confirming or refuting the diagnosis. The incidence of errors rose with the passage of time, possibly related to a deterioration in the pathologist’s health. The error rate in diagnosing bone tumours in previously published series ranges from 9 to 40%. To ensure as accurate a rate of diagnosis as possible multidisciplinary working and regular audit are essential.

  5. Psychiatric symptoms and pregnancy distress in subsequent pregnancy after spontaneous abortion history

    OpenAIRE

    Haghparast, Elahe; Faramarzi, Mahbobeh; Hassanzadeh, Ramezan

    2016-01-01

    Objectives: Spontaneous abortion is one of the most important complications of pregnancy with short and long adverse psychological effects on women. This study assesses the implications of a spontaneous abortion history has on women?s psychiatric symptoms and pregnancy distress in subsequent pregnancy less than one years after spontaneous abortion. Methods: A case-control study was conducted on pregnant women of Babol city from September 2014 to May 2015. In this study, 100 pregnant women wit...

  6. Diagnosing Dementia—Positive Signs

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

  7. How Is Lactose Intolerance Diagnosed?

    Science.gov (United States)

    ... Find a Study Resources and Publications How is lactose intolerance diagnosed? Skip sharing on social media links Share this: Page Content Many people think that they or their children are lactose intolerant without being tested or diagnosed. ...

  8. Supporting Women Planning a Vaginal Breech Birth: An International Survey.

    Science.gov (United States)

    Petrovska, Karolina; Watts, Nicole P; Catling, Christine; Bisits, Andrew; Homer, Caroline S E

    2016-12-01

    The aim of this study was to explore the experiences of women who planned a vaginal breech birth. An online survey was developed consisting of questions regarding women's experiences surrounding planned vaginal breech birth. The survey was distributed between April 2014 and January 2015 to closed membership Facebook groups that had a consumer focus on vaginal breech birth. In total, 204 unique responses to the survey were obtained from women who had sought the option of a vaginal breech birth in a previous pregnancy. Most women (80.8%) stated that they were happy with the birth choices they made, and a significant proportion (89.4%) would attempt a vaginal breech birth in subsequent pregnancies. Less than half of women were formally referred to a clinician skilled in vaginal breech birth when their baby was diagnosed breech (41.8%), while the remainder sourced a clinician themselves. Half of the women felt supported by their care provider (56.7%) and less than half (42.3%) felt supported by family and friends. The women who responded to this international survey sought the option of a vaginal breech birth, were subsequently happy with this decision, and would attempt a vaginal breech birth in their next pregnancy. Access to vaginal breech birth is important for some women; however, this choice may be challenging to achieve. Consistent information and support from clinicians is important to assist decision-making. © 2016 Wiley Periodicals, Inc.

  9. Diagnoses and interventions in podiatry.

    OpenAIRE

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical diagnoses, the podiatry diagnoses (impairments and disabilities), treatment goals derived from these diagnoses, and interventions. Impairments were recorded in nearly all patients. The interrelationship ...

  10. Diagnosing Lynch Syndrome

    LENUS (Irish Health Repository)

    Gleeson, J

    2016-11-01

    Lynch Syndrome, also known as Hereditary Non-Polyposis Colorectal Cancer (HNPCC), is a hereditary condition that increases an individual’s risk of developing a constellation of cancers. These most commonly arise in the colon, but also involve other solid organs such as the endometrium and ovaries in women, the stomach, brain and the skin. Ireland’s small population offers an opportunity to identify all those with Lynch Syndrome (LS) in the country, which would represent a powerful preventive opportunity to meaningfully impact on the incidence of cancer in Ireland.

  11. Circulating carotenoids and subsequent risk of rheumatoid arthritis in women.

    Science.gov (United States)

    Hu, Yang; Cui, Jing; Sparks, Jeffrey A; Malspeis, Susan; Costenbader, Karen H; Karlson, Elizabeth W; Lu, Bing

    2017-01-01

    The aim of the present study was to examine the associations between circulating carotenoids and future risk of rheumatoid arthritis (RA). We conducted a nested case-control study consisting of 227 incident RA cases and 671 matched controls with prospectively measured plasma carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin) levels in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II). Each incident RA case was matched with 3 healthy controls. Serologic phenotype of RA was determined by rheumatoid factor or anti-citrullinated peptide antibody (ACPA) obtained by chart review. Multivariable logistic regressions were used to estimate odds ratios (OR) and 95% confident intervals (95% CI) for RA risk associated with each circulating carotenoid after adjusting for matching factors and other covariates. The median time from blood draw until RA diagnosis was 8.6 years. In the multivariable models, no significant associations were found between any plasma carotenoids and risk of RA. We further examined the associations for two subtypes of RA, and found associations of circulating α-carotene and β-carotene with reduced risk of seronegative RA. After correction for multiple comparisons using the Bonferroni method, the findings did not reach statistical significance. Circulating carotenoids levels are not associated with reduced risk of RA. Further investigations using large prospective cohorts are needed to confirm our findings.

  12. Abortion in Young Women and Subsequent Mental Health

    Science.gov (United States)

    Fergusson, David M.; Horwood, L. John; Ridder, Elizabeth M.

    2006-01-01

    Background: The extent to which abortion has harmful consequences for mental health remains controversial. We aimed to examine the linkages between having an abortion and mental health outcomes over the interval from age 15-25 years. Methods: Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study…

  13. The role of fear in diagnosing cancer in time.

    Science.gov (United States)

    Machácek, J

    1996-01-01

    The causes of the relatively frequent late discovery of the breast cancer (40-60%) in Czech republic are numerous. One of them is the attitude of the patient herself to the disease. Fear and anxiety play are important role in seeing her doctor too late. Beliefs feelings and attitudes to treatment have been formed in potential patients mostly by negative experience and information. It is necessary to impress to the female population the idea that breast cancer can be curable and that the degree of successful treatment depends on early diagnosis and that fear and anxiety delaying the therapy are dangerous. The sources of fear are as follows: false image of incurable disease an idea of subsequent loss of an organs--the symbols of womanhood and sex-appeal physical and psychical degradation subsequent fears of losing a partner loss of social prestige and position at work considerable change in hitherto lifestyle. Own knowledge that these negative ideas are not quite true must be accepted not only by these who have been treated but first of all by those who could find themselves in such a difficult situation. Many other potential sources of fear and worries concern health care. Apart from the lack of interest reluctance and rudeness of hospital staff it is a chronic shortcoming of positive information and intensive health education. In authors group of 120 patients has been proved that mental feelings, fear and anxiety significantly influence the timeliness of diagnosing an illness and its whole course. It is the physicians foremost task to look for any possible ways of overcoming the sources of fear and anxiety and thus to help women to see a doctor as soon as possible. It would be a significant contribution to decreasing the number of advanced stages of breast cancer.

  14. Language experience changes subsequent learning.

    Science.gov (United States)

    Onnis, Luca; Thiessen, Erik

    2013-02-01

    What are the effects of experience on subsequent learning? We explored the effects of language-specific word order knowledge on the acquisition of sequential conditional information. Korean and English adults were engaged in a sequence learning task involving three different sets of stimuli: auditory linguistic (nonsense syllables), visual non-linguistic (nonsense shapes), and auditory non-linguistic (pure tones). The forward and backward probabilities between adjacent elements generated two equally probable and orthogonal perceptual parses of the elements, such that any significant preference at test must be due to either general cognitive biases, or prior language-induced biases. We found that language modulated parsing preferences with the linguistic stimuli only. Intriguingly, these preferences are congruent with the dominant word order patterns of each language, as corroborated by corpus analyses, and are driven by probabilistic preferences. Furthermore, although the Korean individuals had received extensive formal explicit training in English and lived in an English-speaking environment, they exhibited statistical learning biases congruent with their native language. Our findings suggest that mechanisms of statistical sequential learning are implicated in language across the lifespan, and experience with language may affect cognitive processes and later learning. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Language experience changes subsequent learning

    Science.gov (United States)

    Onnis, Luca; Thiessen, Erik

    2013-01-01

    What are the effects of experience on subsequent learning? We explored the effects of language-specific word order knowledge on the acquisition of sequential conditional information. Korean and English adults were engaged in a sequence learning task involving three different sets of stimuli: auditory linguistic (nonsense syllables), visual non-linguistic (nonsense shapes), and auditory non-linguistic (pure tones). The forward and backward probabilities between adjacent elements generated two equally probable and orthogonal perceptual parses of the elements, such that any significant preference at test must be due to either general cognitive biases, or prior language-induced biases. We found that language modulated parsing preferences with the linguistic stimuli only. Intriguingly, these preferences are congruent with the dominant word order patterns of each language, as corroborated by corpus analyses, and are driven by probabilistic preferences. Furthermore, although the Korean individuals had received extensive formal explicit training in English and lived in an English-speaking environment, they exhibited statistical learning biases congruent with their native language. Our findings suggest that mechanisms of statistical sequential learning are implicated in language across the lifespan, and experience with language may affect cognitive processes and later learning. PMID:23200510

  16. Pregnancy-associated breast cancer and pregnancy following treatment for breast cancer, in a cohort of women from Victoria, Australia, with a first diagnosis of invasive breast cancer.

    Science.gov (United States)

    Bell, Robin J; Fradkin, Pamela; Parathithasan, Nishanthinie; Robinson, Penelope J; Schwarz, Max; Davis, Susan R

    2013-10-01

    This study examined pregnancy-associated breast cancer (PABC) and pregnancy following treatment for breast cancer. We analysed data from a questionnaire-based, prospective study of women diagnosed with breast cancer. Timing of diagnosis in relation to pregnancy was self-reported in the enrolment questionnaire. Women reported subsequent pregnancies in annual follow-up questionnaires, up to at least 5 years from diagnosis. Women with PABC made up 3.3% of women pregnancies following treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Obstructive sleep apnea and the subsequent risk of depressive disorder: a population-based follow-up study.

    Science.gov (United States)

    Chen, Yi-Hua; Keller, Joseph K; Kang, Jiunn-Horng; Hsieh, Heng-Ju; Lin, Herng-Ching

    2013-05-15

    Empirical findings on the prospective link between obstructive sleep apnea (OSA) and subsequent depression are mixed. This nationwide, population-based study thus aimed at assessing the risk of depressive disorder within the first year following a diagnosis with OSA. Gender effects were further examined. Cohort study. Taiwan. This study used data from the Longitudinal Health Insurance Database 2000. A total of 2,818 patients diagnosed with OSA between 2002 and 2008 were evaluated, and 14,090 matched non-OSA enrollees used as a comparison cohort. Each patient was followed for one year to identify subsequent depressive disorder. We found that during the one-year follow-up, the incidence of depressive disorder per thousand person-years was about twice as high among patients with OSA (18.10, 95% CI = 13.62-23.61) as those without OSA (8.23, 95% CI = 6.83-9.84). The Cox proportional hazards model revealed that patients with OSA were independently associated with a 2.18 times (95% CI = 1.55-3.08) increased risk of subsequent depressive disorder within a year, compared to those without OSA. As epidemiological studies have consistently documented an increased risk for depression in women, we hypothesized and confirmed higher risks of depressive disorder among female patients with OSA (2.72, 95% CI = 1.68-4.40) than their male counterparts (1.81, 95% CI = 1.09-3.01). A prospective link between OSA and subsequent depressive disorder within one year was confirmed by the current study. The risk was particularly evident among women. Regular psychiatric screening among patients with OSA is suggested to prompt the timely detection of depression. A commentary on this article appears in this issue on page 425.

  18. The usefulness of CYFRA 21-1 to diagnose and predict preeclampsia: a nested case-control study.

    Science.gov (United States)

    Kuessel, Lorenz; Zeisler, Harald; Ristl, Robin; Binder, Julia; Pateisky, Petra; Schmid, Maximilian; Marschalek, Julian; Perkmann, Thomas; Haslacher, Helmuth; Husslein, Heinrich

    2016-11-03

    The ability to identify patients at risk for developing preeclampsia is important for preventing morbidity and mortality in both the mother and child. Although CYFRA 21-1 (a fragment of Cytokeratin 19) is considered a promising biomarker for diagnosing preeclampsia, little is known regarding the levels of CYFRA 21-1 during pregnancy. Here, we measured serum CYFRA 21-1 levels in women with an uneventful pregnancy and in women whose pregnancy was complicated by preeclampsia. Furthermore we evaluated whether maternal CYFRA 21-1 levels can be used to predict and/or diagnose preeclampsia. Longitudinal, sequential blood samples were collected prospectively at seven predetermined visits during pregnancy. Maternal CYFRA 21-1 levels were measured in 50 women with an uneventful pregnancy (control group) and in 10 asymptomatic women whose pregnancy was later complicated by preeclampsia (PE_long group). In addition, CYFRA 21-1 levels were measured from a single sample collected from a separate group of 50 pregnant women with symptomatic preeclampsia (PE_state group). The CYFRA 21-1 levels were significantly higher in the PE_state group compared to the control group (p preeclampsia, the ROC curve for diagnosing preeclampsia in gestational week 28-32 showed the largest AUC of 0.92, at a cut-off point of 3.1 ng/ml, leading to sensitivity of 92 % and specificity of 80 %. The elevated serum levels of CYFRA 21-1 observed in both groups of women with preeclampsia may reflect endothelial damage and/or dysfunction. Our results suggest that maternal serum CYFRA 21-1 is a promising biomarker for diagnosing preeclampsia. Although its value for predicting the long-term occurrence of subsequent preeclampsia may be limited, our findings indicate a trend towards elevated maternal CYFRA 21-1 levels preceding the short-term occurrence of preeclampsia in asymptomatic women. Additional prospective longitudinal studies are needed in order to determine the value of measuring maternal serum

  19. Alcohol consumption and breast cancer-specific and all-cause mortality in women diagnosed with breast cancer at the New York site of the Breast Cancer Family Registry.

    Directory of Open Access Journals (Sweden)

    Nur Zeinomar

    Full Text Available Alcohol consumption is an established and important risk factor for breast cancer incidence in the general population. However, the relationship between alcohol and mortality among women with breast cancer is less clear. This study examines the effect of alcohol consumption on mortality in women affected with breast cancer at baseline from a high-risk family breast and ovarian cancer registry.We studied 1116 women affected with breast cancer at baseline from the Metropolitan New York Registry. The examined reported alcohol consumption (total of beer, wine, liquor was defined as the average number of drinks per week reported from age 12 to age at baseline. We assessed vital status of each participant using participant or family reported data and we used the National Death Index to supplement deaths reported through family updates. We used Cox proportional hazards models to estimate the association between alcohol intake and overall mortality (HRO, breast cancer-specific mortality (HRBC, and non-breast cancer mortality (HRNBC, adjusted for confounders.After a mean follow-up of 9.1 years, we observed 211 total deaths and 58 breast cancer deaths. Compared to non-drinkers, we found that both low and moderate to heavy levels of alcohol intake were not associated with greater overall mortality (≤3 drinks/week: HRO: 0.66, 95% CI: 0.38-1.14; > 3 drinks/week: HRO: 1.16, 95% CI: 0.85-1.58, breast cancer-specific mortality (≤ 3 drinks/week: HRBC:0.62, 95% CI: 0.19-2.03; >3 drinks/week: HR BC: 0.96, 95% CI: 0.49-1.89, or non-breast cancer-specific mortality (≤3 drinks/week: HR NBC: 0.73, 95% CI: 0.32-1.6; >3 drinks/week: HRNBC: 1.18, 95% CI: 0.75-1.86.Alcohol intake reported from age 12 to age at baseline was not associated with overall or breast cancer-specific mortality in this cohort of affected women with a family history of breast cancer.

  20. Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: A systematic review and meta-analysis of randomized trials.

    Science.gov (United States)

    Bgeginski, Roberta; Ribeiro, Paula A B; Mottola, Michelle F; Ramos, José Geraldo L

    2017-11-01

    Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, no meta-analysis has analyzed the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effects of weekly supervised exercise (EXE) or physical activity counseling (PA) in women with GDM compared with usual prenatal care (UPN) on glycemic control. Eligible trials were identified from Medline, EMBASE, Web of Science, Scopus and SportDiscus up to December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly supervised (at least once a week) prenatal exercise or PA counseling for which FBG values before and after intervention were available. Random-effects meta-analysis was performed for mean difference in FBG after exercise intervention. The search yielded 781 publications, of which 82 were assessed for eligibility and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P = 0.11) compared with UPN. However, PA versus UPN showed a significant reduction in absolute FBG concentrations (weighted mean difference -3.88 mg/dL; 95% confidence interval -7.33, -0.42 mg/dL; I 2 48%; P heterogeneity  importance of an early intervention that lasts to delivery for best practice of GDM management. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  1. Información recibida por las mujeres diagnosticadas de cáncer de mama Informação recebida pelas mulheres diagnosticadas com câncer de mama Information received from women diagnosed with breast cancer

    Directory of Open Access Journals (Sweden)

    RAFAELA BLANCO SÁNCHEZ

    2011-07-01

    ços Específicos do Hospital Vall d'Hebron, e na unidade de ginecologia do “Centro de Atención Primaria de Salud La Mina de Barcelona”, de 2004 a 2006. A faixa etária é de 20 a 69 anos. Resultados: As mulheres são agrupadas segundo seu nível de instrução, reunidas em cinco grupos: mulheres capazes de explicar os erros médicos; profissionais da saúde doentes; donas de casa com um ensino primário incompleto; mulheres com ensino médio; mulheres com estudos universitários e com diversas profissões. Mulheres e profissionais explicam a dificuldade de dar e receber informação. Discussão: A conclusão atingida foi a mesma de outros autores: dizer a verdade é um processo individualizado e sempre difícil; no qual o doente tem a iniciativa, põe limites e faz as perguntas e controla o fluxo da conversação. A informação profissional tem que fornecer a maior quantidade de benefícios ao doente. Conclusões: As mulheres têm medo às recidivas. Este medo aumenta quando desconfiam da informação que recebem da equipe que as trata. As universidades desejam receber a informação sem nenhum paternalismo. As mulheres que cursaram o ensino primário desejam verificar a compreensão da informação.Purpose: To analyze information received by women with breast cancer. To explain what they understand from said explanations. To analyze difficulties experienced by professionals to convey process information. Methods: qualitative phenomenological. 34 interviews were carried out in depth (to 29 women, 1 man and 4 physicians in the specific services of Vall d'Hebron Hospital, and in the gynecology service of the Primary Health Care Center La Mina in Barcelona, between 2004 and 2006. Age range was between 20 and 69 years. Results: Women were grouped as per instruction level. There were 5 groups of women: who explain medical errors; sick health professionals; housewives, with incomplete primary education; with high school education; with university education and different

  2. Risk of myeloid neoplasms after radiotherapy among older women with localized breast cancer: A population-based study

    Science.gov (United States)

    Long, Jessica B.; Wang, Rong; Hu, Xin; Yu, James B.; Huntington, Scott F.; Abel, Gregory A.; Mougalian, Sarah S.; Podoltsev, Nikolai A.; Gore, Steven D.; Gross, Cary P.; Ma, Xiaomei; Davidoff, Amy J.

    2017-01-01

    Background There are inconsistent and limited data regarding the risk of myeloid neoplasms (MN) among breast cancer survivors who received radiotherapy (RT) in the absence of chemotherapy. Concern about subsequent MN might influence the decision to use adjuvant RT for women with localized disease. As patients with therapy-related MN have generally poor outcomes, the presumption of subsequent MN being therapy-related could affect treatment recommendations. Methods We used the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database to study older women with in-situ or stage 1–3 breast cancer diagnosed 2001–2009 who received surgery. Chemotherapy and RT were ascertained using Medicare claims, and new MN diagnoses were captured using both SEER registry and Medicare claims. We excluded women who received chemotherapy for initial treatment, and censored at receipt of subsequent chemotherapy. Competing-risk survival analysis was used to assess the association between RT and risk of subsequent MN adjusting for relevant characteristics. Results Median follow-up for 60,426 eligible patients was 68 months (interquartile range, 46 to 92 months), with 47.6% receiving RT. In total, 316 patients (0.52%) were diagnosed with MN; the cumulative incidence per 10,000 person-years was 10.6 vs 9.0 among RT-treated vs non-RT-treated women, respectively (p = .004); the increased risk of subsequent MN persisted in the adjusted analysis (hazard ratio = 1.36, 95% confidence interval: 1.03–1.80). The results were consistent in multiple sensitivity analyses. Conclusions Our data suggest that RT is associated with a significant risk of subsequent MN among older breast cancer survivors, though the absolute risk increase is very small. These findings suggest the benefits of RT outweigh the risks of development of subsequent MN. PMID:28902882

  3. How Is Heart Disease Diagnosed?

    Science.gov (United States)

    ... Back To Health Topics / Heart Disease in Women Heart Disease in Women Leer en español How Does Heart ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque (plak) ...

  4. Mifepristone-induced abortion and vaginal bleeding in subsequent pregnancy.

    Science.gov (United States)

    Liang, Hong; Gao, Er-sheng; Chen, Ai-min; Luo, Lin; Cheng, Yi-min; Yuan, Wei

    2011-12-01

    The aim of this study is to explore the effect of first-trimester mifepristone-induced abortion on vaginal bleeding in subsequent pregnancy. This observational cohort study was conducted during 1998-2001 at antenatal clinics in Beijing, Chengdu, and Shanghai, China. The study enrolled 4,931 women with one previous mifepristone-induced abortion, 4,925 women with no history of induced abortion, and 4,800 women with one previous surgical abortion and followed them through pregnancy and childbirth. The rates of vaginal bleeding in pregnant women with a history of medical abortion, no abortion, and surgical abortion were 16.5%, 13.9%, and 17.3%, respectively. The women with medical abortion had a higher risk (adjusted relative risk (aRR)=1.17, 95% confidence interval (CI): 1.07, 1.29) of vaginal bleeding compared with those with no abortion but similar risk to prior surgical abortion. When the correlation between medical abortion and vaginal bleeding was examined by period, increased risk was observed only in the early period (abortion and no abortion showed that the observed risks increased particularly in those with abortion at gestational age ≤ 7 weeks (aRR=1.33, 95% CI: 1.18, 1.49), those followed by a postabortion curettage (aRR=1.58, 95% CI: 1.37, 1.84) or complications (aRR=1.99, 95% CI: 1.67, 2.37). There was no difference between women with medical abortion and women with surgical abortion in the occurrence of vaginal bleeding for either period. One previous mifepristone-induced abortion increased the risk of vaginal bleeding in early gestation period of subsequent pregnancy compared with no abortion, especially if abortion occurred before 7 weeks of gestation and was followed by a curettage or complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Challenges of diagnosing acute HIV-1 subtype C infection in African women: performance of a clinical algorithm and the need for point-of-care nucleic-acid based testing.

    Science.gov (United States)

    Mlisana, Koleka; Sobieszczyk, Magdalena; Werner, Lise; Feinstein, Addi; van Loggerenberg, Francois; Naicker, Nivashnee; Williamson, Carolyn; Garrett, Nigel

    2013-01-01

    Prompt diagnosis of acute HIV infection (AHI) benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symptoms at first HIV-positive visit were compared to HIV-negative visits. Logistic regression identified clinical predictors of AHI. A model-based score was assigned to each predictor to create a risk score for every woman. Twenty-eight women seroconverted after a total of 390 person-years of follow-up with an HIV incidence of 7.2/100 person-years (95%CI 4.5-9.8). Fifty-seven percent reported ≥1 sign or symptom at the AHI visit. Factors predictive of AHI included age signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; psigns and symptoms of AHI is critical for early diagnosis of HIV infection. Our algorithm may assist in risk-stratifying individuals for AHI, especially in resource-limited settings where there is no routine testing for AHI. Independent validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care antigen or viral load technology is required, however, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission.

  6. Vulvar Carcinoma in Pregnant Women Aged Less than 40 Years: Case Report

    OpenAIRE

    Hasanzadeh, Malihe; Zamiri-Akhlaghi, Amir; Hassanpoor-Moghaddam, Maryam; Shahidsales, Soodabeh

    2014-01-01

    Background Invasive squamous cell carcinoma of the vulva is primarily a disease of postmenopausal women and thus is rarely associated with pregnancy. Case We have reported on a young woman under 40 years old with vulvar carcinoma, which occurred during the pregnancy but optimal treatment was delayed to the postpartum period. This 37-year-old woman was diagnosed with 3x3 cm vulvar lesion, 2 weeks after cesarean section, subsequent biopsy revealed squamous cell carcinoma. She had a history of a...

  7. Missed Diagnosis of Twin Pregnancy and Mis-Diagnosed Fetal ...

    African Journals Online (AJOL)

    We present a 41 year old booked grandmultipara with twin gestation erroneously diagnosed as singleton pregnancy with fetal hydrocephalous and scheduled for elective caesarean delivery at term but subsequently went into spontaneous labour at 35weeks of gestation and had vaginal delivery of two live male babies ...

  8. Nephrotic syndrome in pregnancy wrongly diagnosed and managed ...

    African Journals Online (AJOL)

    The index case which is being presented is a 27 year old multigravid multiparous trader that was eventually diagnosed asnephrotic syndrome in pregnancy which was being managed as preeclampsia. The patient subsequently had a renal biopsy done which showed minimal change nephropathy. However, the patient was ...

  9. Los diagnósticos y las historias clínicas de mujeres en los hospicios de Buenos Aires entre 1900-1930 The diagnoses and clinical histories of women in the psychiatric hospital of Buenos Aires between 1900-1930

    Directory of Open Access Journals (Sweden)

    Vanesa Eva Navarlaz

    2010-12-01

    Full Text Available Este trabajo analiza la singularidad de los aspectos ligados a los diagnósticos psiquiátricos en las mujeres alienadas entre los años 1900 y 1930 en Argentina; que permiten ubicar diferencias en los supuestos etiológicos que explican la enfermedad mental entre hombres y mujeres. Se analizan los diseños de las historias clínicas de mujeres del Hospital Nacional de Alienadas (actual Hospital Moyano y del Asilo de Lomas de Zamora (actual Hospital Interzonal Esteves de Temperley. Se cruzan los datos obtenidos con fuentes primarias del campo de la medicina y la psiquiatría que trabajan sobre la particularidad de la alienación en la mujer. Se indagan las causas y explicaciones singulares que se han sostenido en éste contexto histórico y su diferencia con las de los enfermos varones para la misma época.This paper analyzes the uniqueness of the associated issues with psychiatric diagnoses in alienated women between 1900 and 1930 in Argentina that allow locating differences in the etiological assumptions that explain the mental illness between men and women. Designs of clinical records of women in the Hospital Nacional de Alienadas (now Hospital Moyano and the Asilo de Lomas de Zamora (now Hospital Interzonal Esteves de Temperley are analyzed. Data obtained with primary sources of medicine and psychiatry is intersected, which work on the particularity of alienation in women. It is inquired the causes and singular explanations that have been held in this historical context and their difference in those male patients for the same period.

  10. Challenges of diagnosing acute HIV-1 subtype C infection in African women: performance of a clinical algorithm and the need for point-of-care nucleic-acid based testing.

    Directory of Open Access Journals (Sweden)

    Koleka Mlisana

    Full Text Available Prompt diagnosis of acute HIV infection (AHI benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting.245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symptoms at first HIV-positive visit were compared to HIV-negative visits. Logistic regression identified clinical predictors of AHI. A model-based score was assigned to each predictor to create a risk score for every woman.Twenty-eight women seroconverted after a total of 390 person-years of follow-up with an HIV incidence of 7.2/100 person-years (95%CI 4.5-9.8. Fifty-seven percent reported ≥1 sign or symptom at the AHI visit. Factors predictive of AHI included age <25 years (OR = 3.2; 1.4-7.1, rash (OR = 6.1; 2.4-15.4, sore throat (OR = 2.7; 1.0-7.6, weight loss (OR = 4.4; 1.5-13.4, genital ulcers (OR = 8.0; 1.6-39.5 and vaginal discharge (OR = 5.4; 1.6-18.4. A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p<0.001.Accurate recognition of signs and symptoms of AHI is critical for early diagnosis of HIV infection. Our algorithm may assist in risk-stratifying individuals for AHI, especially in resource-limited settings where there is no routine testing for AHI. Independent validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care antigen or viral load technology is required, however, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission.

  11. Subsequent pregnancy and prognosis in breast cancer survivors.

    Science.gov (United States)

    Kasum, Miro; Beketić-Orešković, Lidija; Orešković, Slavko

    2014-09-01

    An increase in the incidence of breast cancer in women aged breast cancer in women of childbearing age has significantly improved, they are often concerned whether subsequent pregnancy will alter their risk of disease recurrence. In the modern era, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer and women can bear children after breast cancer treatment without compromising their survival. Therefore, they should not be discouraged from becoming pregnant, and currently the usual waiting time of at least 2 years after the diagnosis of breast cancer is recommended. However, a small, nonsignificant adverse effect of pregnancy on breast carcinoma prognosis among women who conceive within 12 months of breast cancer diagnosis and a higher risk of relapse in women younger than 35 up to 5 years of the diagnosis may be found. Fortunately, for women with localized disease, earlier conception up to six months after completing their treatment seems unlikely to reduce their survival. Ongoing and future prospective studies evaluating the risks associated with pregnancy in young breast cancer survivors are required.

  12. Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis.

    Science.gov (United States)

    Dukas, L; Schacht, E; Runge, M

    2010-07-01

    We assessed in a cross-sectional study in elderly men and women with osteoporosis, the association between the creatinine clearance (CrCl) and the performance in different balance and muscle power and function tests and found that a decreasing creatinine clearance was significantly associated with lower balance and muscle power. To determine if a creatinine clearance of power and balance and an increased risk for falls and fractures. We assessed in a cross-sectional-study in 1781 German osteoporotic patients, the association between the CrCl, the physical performance, and the number of falls and fractures. Controlling for age, gender, BMI, and osteoporosis treatment (fracture analysis only), a decreasing CrCl was associated with lower physical performance in the timed-up-and-go test (corr -0.2337, P or=65 ml/min. In this study, we found a significant gender-independent correlation between decreasing CrCl and lower performance in balance and muscle power tests. Reduced muscle power and balance may therefore be involved in the low creatinine clearance associated increased risk for falls and fall-related fractures. Furthermore, we found that a CrCl power, muscle function, and balance tests, is a significant risk factor for falls and fractures.

  13. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.

    LENUS (Irish Health Repository)

    Dempsey, Mark Anthony

    2015-05-01

    This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.

  14. Early-onset preeclampsia appears to discourage subsequent pregnancy but the risks may be overestimated.

    Science.gov (United States)

    Seeho, Sean K; Algert, Charles S; Roberts, Christine L; Ford, Jane B

    2016-12-01

    Early-onset preeclampsia is associated with adverse maternal and perinatal outcomes. For women who consider another pregnancy after one complicated by early-onset preeclampsia, the likelihood of recurrence and the subsequent pregnancy outcome for themselves and their babies are pertinent considerations. The purpose of this study was to determine the subsequent pregnancy rate after a nulliparous pregnancy that was complicated by early-onset preeclampsia and among those who have a subsequent pregnancy, the risk of recurrence by gestational week, and adverse pregnancy outcomes. This was a population-based record linkage cohort study. The study population included nulliparous women with a singleton pregnancy and early-onset preeclampsia (Early-onset in the index birth was further categorized as pregnancy outcomes that were assessed included the pregnancy rate, preeclampsia recurrence, and maternal and perinatal morbidity and mortality rates. The risk of preeclampsia necessitating delivery at each gestational week for women who were at risk was plotted, and the net gain or loss of gestational age when comparing the index with the subsequent pregnancy was calculated. Among 361,031 nulliparous women with singleton pregnancies, 1473 (0.4%) had early-onset preeclampsia. Women with early-onset preeclampsia in their first pregnancy had a lower subsequent pregnancy rate (59.7%) than women without preeclampsia (67.7%). Of the 758 women with a subsequent singleton birth, 256 (33.8%) experienced preeclampsia in the next pregnancy; 57 women (7.5%) with recurrent early-onset preeclampsia were included. Cumulative rates of preeclampsia in the subsequent pregnancy were higher at every gestation from 23 weeks gestation when the index birth was age in their subsequent pregnancy. The median overall increase in gestational age at delivery was 6 weeks (interquartile range, 4-8); among women with recurrent preeclampsia, the median increase was 5 weeks (interquartile range, 2-7). Women with

  15. Transcultural Nursing and Nursing Diagnoses.

    Science.gov (United States)

    Geissler, Elaine M.

    1991-01-01

    Points out the inadequacies of the nursing diagnoses officially sanctioned by the North American Nursing Diagnosis Association for use with culturally diverse patients. Looks at the changes needed to make the defining characteristics more congruent with transcultural nursing. (JOW)

  16. How Is Polycythemia Vera Diagnosed?

    Science.gov (United States)

    ... PV. These tests include a complete blood count (CBC) and other tests, if necessary. Complete Blood Count ... first test used to diagnose PV is a CBC. The CBC measures many parts of your blood. ...

  17. How to diagnose cardiac tamponade

    NARCIS (Netherlands)

    van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P

    Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of

  18. Incidence of repeat testing and diagnoses ofChlamydia trachomatisandNeisseria gonorrhoeain swingers, homosexual and heterosexual men and women at two large Dutch STI clinics, 2006-2013.

    Science.gov (United States)

    Dukers-Muijrers, Nicole H T M; van Rooijen, Martijn S; Hogewoning, Arjan; van Liere, Genevieve A F S; Steenbakkers, Mieke; Hoebe, Christian J P A

    2017-09-01

    Swingers, that is, heterosexuals who as a couple have sex with others, including group sex and bisexual behaviour, are an older-aged risk group for STIs. Here, we report on their repeat testing (reattendance) and STI yield compared with other heterosexuals and men who have sex with men (MSM, homosexual men) at two Dutch STI clinics. Swingers are routinely (since 2006, South Limburg, registration-completeness: 99%) or partially (since 2010, Amsterdam, registration-completeness: 20%) included in the clinic patient registries. Data (retrospective cohort) are analysed to assess incidence (per 100 person-years (PY)) of reattendance and STI ( Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG)) and associated factors calculating HRs. In South Limburg 7714 and in Amsterdam 2070 swinger consultations were identified. Since 2010, swingers' incidence of reattendance was 48-57/100 PY. Incidence was lower in MSM (30-39/100 PY, HR 0.56; 95% CI 0.51 to 0.61, South Limburg; HR 0.88; 95% CI 0.80 to 0.96, Amsterdam), heterosexual men (8-14/100 PY, HR 0.16; 95% CI 0.15 to 0.17, South Limburg; HR 0.33; 95% CI 0.30 to 0.36, Amsterdam) and women (13-20/100 PY, HR 0.56; 95% CI 0.51 to 0.61, South Limburg; HR 0.46; 95% CI 0.42 to 0.51, Amsterdam). Swingers' STI incidence at reattendance was 11-12/100 PY. Incidence was similar in heterosexual men (14-15/100 PY; HR 1.19; 95% CI 0.90 to 1.57, South Limburg; HR 1.20; 95% CI 0.91 to 1.59, Amsterdam) and women (12-14/100 PY; HR 1.14; 95% CI 0.88 to 1.49, South Limburg; HR 0.98; 95% CI 0.74 to 1.29, Amsterdam) and higher in MSM (18-22/100 PY; HR 1.59; 95% CI 1.19 to 2.12, South Limburg; HR 1.80; 95% CI 1.36 to 2.37, Amsterdam). Risk factors for STI incidence were partner-notified (contact-tracing), symptoms and previous STI. Swingers' positivity at any clinic attendance was 3-4% for NG (ie, higher than other heterosexuals) and 6-8% for CT (ie, lower than heterosexuals overall but higher than older heterosexuals

  19. Exame simples de urina no diagnóstico de infecção urinária em gestantes de alto risco Urine test to diagnose urinary tract infection in highh-risk pregant women

    Directory of Open Access Journals (Sweden)

    Gláucia Virgínia de Queiroz Lins Guerra

    2012-11-01

    Full Text Available OBJETIVO: Identificar a acurácia do exame simples de urina para diagnóstico de infecção urinária em gestantes de alto risco. MÉTODOS: Realizou-se um estudo transversal, prospectivo, em 164 gestantes admitidas na enfermaria de alto risco do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP, no período de janeiro a junho de 2011. Foram excluídas as pacientes em uso de antibiótico nos últimos dez dias. Todas as pacientes foram submetidas aos exames de urina simples e urocultura no início de sua admissão. A concordância entre os resultados dos exames foi avaliada pelo índice Kappa (K, sendo, ainda, determinados a acurácia, sensibilidade, especificidade e valor preditivo positivo (VPP e negativo (VPN. RESULTADOS: Utilizando como critério de diagnóstico apenas a presença de piócitos no exame simples de urina para sugerir bacteriúria, observou-se uma fraca concordância quando comparado à urocultura (K=0,16. A acurácia foi de 61%, com sensibilidade de 62,5% e especificidade de 60,6%. O VPP foi de 27,78% e o VPN, de 87%. CONCLUSÃO: Na presença de alteração do exame simples de urina não necessariamente está em curso uma infecção urinária, sendo necessária a realização da urocultura. Porém, quando o exame simples de urina for normal, a urocultura pode ser dispensada.PURPOSE: To identify the accuracy of urinalysis in the diagnosis of urinary tract infection in pregnant women at high risk. METHODS: a prospective, cross-sectional study was conducted on 164 pregnant women admitted to the high-risk the ward of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP during the period from January to June 2011. Patients who had been taking antibiotics in the last ten days were excluded. All patients were subjected to simple urine tests and urine culture at the beginning of their admission. The agreement between the results of the examinations was evaluated by Kappa indices (K, and accuracy, sensitivity

  20. Müllerian duct anomalies diagnosed by saline contrast sonohysterography

    DEFF Research Database (Denmark)

    Dreisler, Eva; Stampe Sørensen, Søren

    2014-01-01

    (S): The shape of the uterus was dynamically evaluated in the transversal and longitudinal planes during SCSH and classified in accordance with American Fertility Society as normal, arcuate, septate (partial, complete), bicorn (partial, complete), or unicorn. History of previous miscarriage and menstrual cycle.......7%), 1 complete septate (1.6%), and 1 unicorn uterus (1.6%). Müllerian anomalies were significantly more frequently diagnosed in nulliparous (20% [26 of 128]) compared with parous women (7% [35 of 494]). Müllerian anomalies were more frequent in women with oligomenorrhea compared with women with normal...

  1. Gestational Diabetes and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-12

    This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

  2. Mode of delivery in a subsequent pregnancy following previous instrumental delivery.

    Science.gov (United States)

    Lurie, Samuel; Steinberg, Netanel; Tannus, Samer; Golan, Abraham; Sadan, Oscar

    2013-05-01

    To assess mode of subsequent delivery in women with previous instrumental vaginal delivery. In this retrospective longitudinal study we followed women who underwent instrumental delivery. The study group included all consecutive parturient women who underwent an instrumental vaginal delivery during a 24-month period (1996-1999). We then identified women who had a subsequent delivery in our center until the end of the year 2010. The control group included women who had a spontaneous vaginal delivery from the same time. During the index period we had 349 consecutive successful instrumental vaginal deliveries. Of those, 125 women had a subsequent delivery in our center (35.8%). In subsequent pregnancies, the spontaneous vaginal delivery rate was 76.8% and 90.4%; the instrumental delivery rate was 8.8% and 1.6%; and the cesarean rate was 14.4% and 8.0%, in the instrumental delivery, and spontaneous vaginal delivery groups, respectively (Pinstrumental delivery or a cesarean after having an instrumental delivery in a previous pregnancy was 2.8 (95% confidence interval 1.4-5.9, Pinstrumental delivery are at an increased risk of requiring either an instrumental delivery or a cesarean section in a subsequent pregnancy compared with women with a previous spontaneous vaginal delivery.

  3. Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery

    NARCIS (Netherlands)

    Schaaf, Jelle M.; Hof, Michel H. P.; Mol, Ben Willem J.; Abu-Hanna, Ameen; Ravelli, Anita C. J.

    2012-01-01

    OBJECTIVE: The purpose of this study was to investigate the recurrence risk of preterm birth ( <37 weeks' gestation) in a subsequent singleton pregnancy after a previous nulliparous preterm twin delivery. STUDY DESIGN: We included 1957 women who delivered a twin gestation and a subsequent singleton

  4. Subsequent Type 2 Diabetes in Patients with Autoimmune Disease.

    Science.gov (United States)

    Hemminki, Kari; Liu, Xiangdong; Försti, Asta; Sundquist, Jan; Sundquist, Kristina; Ji, Jianguang

    2015-09-09

    Immunological data show that type 2 diabetes (T2D) manifests autoimmune features. We wanted to test the association epidemiologically by assessing subsequent diagnosis of T2D following diagnosis of autoimmune disease (AId) and subsequent AId after T2D in the same individuals. Patients were identified from three Swedish health databases. A total of 32 different AId were included. Standardized incidence ratios (SIRs) were calculated for T2D diagnosis in patients with previously diagnosed AId and compared to those without a previous AId. Among a total of 757,368 AId patients, 15,103 were diagnosed with T2D, giving an overall SIR for T2D of 1.66. T2D risks were increased after 27 AIds; the highest SIRs were noted for chorea minor (8.00), lupoid hepatitis (5.75), and Addison disease (2.63). T2D was increased after 27 of 32 AIds but we were unable to control for factors such as obesity and smoking. However, the clearly increased risks for T2D in most types of AId patients, and in reverse order increased risks for AId after T2D, do not support an overall confounding by life-style factors. Mechanistic links shared by T2D, AId and life-style factors such as obesity, perhaps through chronic inflammation, may drive autoimmune activation of T2D and many AIds.

  5. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate whether the indication for hysterectomy was itself a risk factor for subsequent pelvic organ prolapse (POP) in Danish women who underwent hysterectomy from 1977 to 2009. METHODS: Data from 154,882 women who underwent hysterectomy...

  6. Stress fractures of the ankle malleoli diagnosed by ultrasound: a report of 6 cases

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, Stefano [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); Luong, Dien Hung [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); University of Montreal, Department of Physical Medicine and Rehabilitation, Montreal (Canada)

    2014-06-15

    To present the ultrasound appearance of stress fractures (SF) of the ankle malleoli. We present a retrospective review of 6 patients (4 women and 2 men, with an age range of 24-52 years, mean age of 39 years) in which ultrasound diagnosed, together with the clinical findings, an SF of the ankle malleoli. For all of these patients ultrasound was the first imaging technique applied because of a clinical suspicion of soft tissue injuries following excessive exertion. Patients were subsequently examined using standard radiographs and/or MRI. At ultrasound patients showed thickening of the periosteum in all patients, calcified bone callus was evident in 3 out of 6 patients. Cortical irregularities and subcutaneous oedema were found in all but one patient. Colour Doppler showed local hypervascular changes in all patients. Local compression with the transducers during real-time scanning increased pain in all cases. Ultrasound, together with the clinical findings, can diagnose an SF of the ankle malleoli. We suggest that sonologists should include malleolar SF in their differential diagnosis, particularly in the case of perimalleolar pain from over-solicitation. They must also include, as part of every ultrasound examination of the ankle, the evaluation of both malleoli and should be aware of the ultrasound appearance of malleolar SF. If the diagnosis remains uncertain, an MRI should be prescribed. (orig.)

  7. The effect of abortion on outcome of subsequent pregnancy

    Directory of Open Access Journals (Sweden)

    Abortion

    1999-08-01

    Full Text Available In a historical cohort study we evaluated the effects of spontaneous abortion on subsequent pregnancy outcome. 1693 pregnant women were classifield in three groups: 1100: without any prior pregnancy, group 1; 550: with history of one spontaneous abortion (G2A1, group 2; 43: with two or more prior spontaneous abortions and no other prior pregnancies, group 3. We collected data through interview, patient's records and physical examination. We matched the patients according to their age subgroups, history of chronic disease, drug administration and radiation during current pregnancy and familial marriage. Then we compared adverse outcome of present pregnancy in group 1 and 2 with the women without prior pregnancy. We analysed the data with Chi-square and Fisher's exact methods. In this study we concluded that history of one spontaneous abortion had no effect on subsequent pregnancy except on prolonged ROM (P<0.000, but history of two or more abortions significantly affects occurrence of stillbirth (RR=29, P=0.003 and placenta previa (RR=8.5, P=0.03. These findings suggest that pregnant women with history of two or more spontaneous abortion need special prenatal care.

  8. Diagnosing ectopic pregnancy in the emergency setting.

    Science.gov (United States)

    Lee, Robert; Dupuis, Carolyn; Chen, Byron; Smith, Andrew; Kim, Young H

    2017-08-19

    Ectopic pregnancy is the implantation of a fertilized egg outside the uterine endometrial cavity. For women presenting to the emergency department with abdominal pain and/or vaginal bleeding, ectopic pregnancy is an important diagnostic consideration. The diagnosis is made based on laboratory values and ultrasound imaging findings. The ultrasound appearance of both normal early pregnancy and ectopic pregnancy are variable and often subtle, presenting diagnostic challenges for radiologists. This pictorial essay describes and illustrates the sonographic findings of ectopic pregnancy and reviews the differential diagnoses that can mimic ectopic pregnancy on ultrasound. With the possibility of medical management, the value of early detection and prompt initiation of treatment has increased in improving clinical outcomes and preventing the complications of ectopic pregnancy.

  9. Nursing diagnoses in overweight adolescents

    Directory of Open Access Journals (Sweden)

    Raphaela Santos do Nascimento Rodrigues

    2013-05-01

    Full Text Available This study aimed to identify nursing diagnoses in overweight adolescents from public schools, according to the International Classification for Nursing Practice. A population-based cross-sectional study that investigated the socio-demographic, behavioural and psychological characteristics of adolescents aged from 10 to 14 years. 11 nursing diagnoses were identified: "Risk of overweight", "Risk of impaired adolescent development", "Risk of insecurity in parental role performance", "Risk of the family impaired ability to manage diet regime", "Risk of impaired ability to manage diet regime", "Risk of lack of knowledge of dietary regime", "Risk of excess food intake", "Risk of negative self-image", "Risk of low self-esteem", "Risk of impaired social well-being" and "Impaired exercise pattern". These diagnoses reflect the multifactorial nature of obesity, highlighting the need for interdisciplinary and intersectoral articulation of nursing interventions for prevention and control of overweight.

  10. Sex of prior children and risk of stillbirth in subsequent pregnancies

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Mortensen, Laust Hvas; Nygaard, Ulrikka

    2010-01-01

    BACKGROUND: Delivery of a boy has been reported to increase a woman's risk of recurrent miscarriage in subsequent pregnancies. We explored whether delivery of boys similarly increases the risk of a subsequent stillbirth. METHODS: We identified all Danish women delivering their first child...... (singleton) between 1980 and 1998 (n = 499,731) using the Danish Birth Registry. These women had subsequent singleton births through 2004 (n = 558,314). We assessed the risk of stillbirth conditional on sex of prior children. RESULTS: The risk of stillbirth was increased by 12% after deliver of boys compared...

  11. Insulin use, hormone receptor status and hematopoietic cytokines׳ circulation in women with diabetes mellitus and breast cancer

    Directory of Open Access Journals (Sweden)

    Zachary A.P. Wintrob

    2017-04-01

    The data presented here is among the first to show a relationship between pre-existing use of injectable insulin in women diagnosed with breast cancer and type 2 diabetes mellitus, hematopoietic cytokine profiles at time of breast cancer diagnosis, and subsequent cancer outcomes. A Pearson correlation analysis evaluating the relationship between G-CSF, GM-CSF, and IL-7 stratified by insulin use, controls, as well as by estrogen and progesterone receptor status is also provided.

  12. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, R.E.; Estrada, J.J.; Grogl, M.

    1989-01-31

    A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.

  13. Wildland fire limits subsequent fire occurrence

    Science.gov (United States)

    Sean A. Parks; Carol Miller; Lisa M. Holsinger; Scott Baggett; Benjamin J. Bird

    2016-01-01

    Several aspects of wildland fire are moderated by site- and landscape-level vegetation changes caused by previous fire, thereby creating a dynamic where one fire exerts a regulatory control on subsequent fire. For example, wildland fire has been shown to regulate the size and severity of subsequent fire. However, wildland fire has the potential to influence...

  14. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  15. A review of subsequence time series clustering.

    Science.gov (United States)

    Zolhavarieh, Seyedjamal; Aghabozorgi, Saeed; Teh, Ying Wah

    2014-01-01

    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies.

  16. A Review of Subsequence Time Series Clustering

    Science.gov (United States)

    Teh, Ying Wah

    2014-01-01

    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies. PMID:25140332

  17. Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

    Science.gov (United States)

    Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

    2013-01-01

    To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back

  18. Nursing diagnoses related to psychiatric adult inpatient care.

    Science.gov (United States)

    Frauenfelder, Fritz; van Achterberg, Theo; Müller Staub, Maria

    2018-02-01

    To detect the prevalence of NANDA-I diagnoses and possible relationships between those and patient characteristics such as gender, age, medical diagnoses and psychiatric specialty/setting. There is a lack on studies about psychiatric inpatient characteristics and possible relationships among these characteristics with nursing diagnoses. A quantitative-descriptive, cross-sectional, completed data sampling study was performed. The data were collected from the electronic patient record system. Frequencies for the social-demographic data, the prevalence of the NANDA-I diagnoses and the explanatory variables were calculated. In total, 410 nursing phenomena were found representing 85 different NANDA-I diagnoses in 312 patients. The NANDA-I diagnosis "Ineffective Coping" was the most frequently stated diagnosis followed by "Ineffective Health Maintenance," "Hopelessness" and "Risk for Other-Directed Violence". Men were more frequently affected by the diagnoses "Ineffective Coping," "Hopelessness," "Risk for Self-Directed Violence," "Defensive Coping" and "Risk for Suicide," whereas the diagnoses "Insomnia," "Chronic Confusion," "Chronic Low Self-Esteem" and "Anxiety" were more common in women. Patients under the age of 45 years were more frequently affected by "Chronic Low Self-Esteem" and "Anxiety" than older patients. "Ineffective Coping" was the most prevalent diagnosis by patients with mental disorders due to psychoactive substance use. Patients with schizophrenia were primarily affected by the diagnoses "Ineffective Coping," "Impaired Social Interaction" and "Chronic Low Self-Esteem." This study demonstrates the complexity and diversity of nursing care in inpatient psychiatric settings. Patients' gender, age and psychiatric diagnoses and settings are a key factor for specific nursing diagnosis. There are tendencies for relationships between certain nursing diagnosis and patient characteristics in psychiatric adult inpatients. This enhances the specific, extended

  19. How Is Pulmonary Hypertension Diagnosed?

    Science.gov (United States)

    ... ankles A bluish color on your lips and skin Diagnosis Your doctor will diagnose pulmonary hypertension (PH) based ... and legs for swelling and your lips and skin for a bluish color. These are signs of ... and procedures to confirm a diagnosis of PH and to look for its underlying ...

  20. Diagnoses and interventions in podiatry.

    Science.gov (United States)

    Zuijderduin, W M; Dekker, J

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical diagnoses, the podiatry diagnoses (impairments and disabilities), treatment goals derived from these diagnoses, and interventions. Impairments were recorded in nearly all patients. The interrelationship among impairments was analysed. Four dimensions of highly interrelated impairments were found. Disabilities were recorded in about one-third of the patients. Only one dimension of interrelated disabilities was identified. Podiatric soles were applied in the treatment of two-thirds of the patients, silicone devices in one-fifth of the patients and nail braces in only a few patients. Advice, instruction and exercise was given in one-third of the patients, while basic foot care was given in a quarter of the patients. Significant relationships between treatment goals and the application of interventions were found. The main conclusions from this study are: (1) the podiatry diagnosis is primarily at the level of impairments; (2) treatment goals derived from impairments determine which interventions are applied. The implications of these findings with regard to the further development of the podiatry diagnosis and the design of studies on the outcome of podiatric interventions are discussed.

  1. Diagnoses and interventions in podiatry.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical

  2. Nutrient intake and nutritional status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia.

    Science.gov (United States)

    Menon, Kavitha; Razak, Shariza Abdul; Ismail, Karami A; Krishna, Bhavaraju Venkata Murali

    2014-09-30

    Cancer therapy in Malaysia primarily focuses on the clinical management of patients with cancer and malnutrition continues to be one of the major causes of death in these patients. There is a dearth of information on the nutrient intake and status of newly diagnosed patients with cancer prior to the initiation of treatment. The present study aims to assess the nutrient intake and status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia. A cross-sectional study was conducted using a convenient sample of newly diagnosed adult patients with cancer (n = 70) attending the Oncology clinic, Hospital Universiti Sains Malaysia in the East Coast of Peninsular Malaysia. Information on socio-demographic characteristics, clinical status, anthropometry, dietary intake and biochemical data including blood samples was obtained. The mean (SD) age, triceps skin fold (TSF), mid upper arm circumference (MUAC) and body mass index (BMI) of participants was 21.1(3.9) years, 17.6(7.9) mm, 24.1(5.5) cm, and 21.1(3.9) Kg/m(2), respectively; 39% participants had BMI Malaysia were underweight and undernourished. The majority of patients with cancer had poor micronutrient intakes; the older women had a poor macro and micronutrient intakes. Before the initiation of rigorous clinical management of patients with cancer, screening for nutritional status, subsequent nutrition counseling, and interventions are essential to improve their nutritional status; consequently, response to cancer therapy, survival and quality of life.

  3. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek

    2016-01-01

    We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first....... In the second case, an elective Caesarean section was scheduled at 38 + 3 weeks of gestation, and the delivery and postpartum period were uncomplicated. Albeit a rare condition, a uterine artery aneurysm should be among the differential diagnosis considered in pregnant women who present with pelvic and vaginal...

  4. Diagnósticos de enfermagem numa gestante de alto risco baseados na teoria do autocuidado de Orem: estudo de caso Diagnósticos de enfermería en una gestante de alto riesgo basados en la teoria del autocuidado de Orem Nursing diagnoses in high-risk pregnant women based on Orem's self-care theory: a case study

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Andrade Duarte de Farias

    2000-12-01

    Full Text Available Trata-se de uma pesquisa descritiva com uma abordagem qualitativa, realizada objetivando identificar diagnósticos de enfermagem numa gestante de alto risco, baseados na teoria do autocuidado, de Orem. Foram identificados os seguintes diagnósticos de enfermagem: déficit de volume de líquidos, ansiedade, processo familiar alterado, comunicação prejudicada, mobilidade física prejudicada, entre outros. Os resultados mostraram a importância da execução do processo de enfermagem, apoiado num modelo de assistência, para a identificação de diagnóstico de enfermagem, bem como a viabilidade da paciente engajar-se no autocuidado.Investigación descriptiva con un abordaje cualitativo, realizada con el objetivo de identificar diagnósticos de enfermería en una gestante de alto riesgo, basados en la teoría del autocuidado de Orem. Fueron identificados los siguientes diagnósticos de enfermería: déficit de volumen de líquidos, ansiedad, proceso familiar alterado, comunicación perjudicada, movilidad física perjudicada, entre otros. Los resultados mostraran la importancia de la ejecución del proceso de enfermería, apoyado en un modelo de atención, para la identificación del diagnóstico de enfermería, así como también la viabilidad del paciente adaptarse al proceso de autocuidado.This work concerns a descriptive research with a qualitative approach which aimed to identify nursing diagnoses in high-risk pregnant women based on Orem's self-care theory. The following nursing diagnoses were identified: deficit of liquid volume, anxiety, altered family process, handicapped communication, handicapped physical mobility, among others. The results showed the importance of the nursing process execution supported on an assistance pattern, for the identification of nursing diagnoses as well as the feasibility of the patient's engagement in self-care.

  5. Measurement of Fertility Benefits with Low Dose Thyroxine in Sub-fertile women

    Directory of Open Access Journals (Sweden)

    Upendra Pandit

    2016-12-01

    Full Text Available Introduction: High prevalence rate of thyroid dysfunction associated infertility is identified by a number of studies in Nepal. Thyroid dysfunction not only affects fertility but is also associated with miscarriage and fetal death. The objective of this study was to measure the fertility rate after low dose Thyroxine, 12.5 microgram, in women with subfertility. Methods: This was a descriptive and observational study done among women visiting infertility and in-vitro fertilization (IVF center at Nepalgunj Medical College, Nepal. After undergoing baseline investigations for infertility, all women diagnosed with primary or secondary infertility were enrolled in the study. Male factor and tubal factor infertility was excluded. All 136 women who were enrolled in the study received 12.5 microgram of thyroxine supplementation for a period of three months and subsequently followed up until the same time period. Results: Out of 136 women, 83 (61.02% women achieved pregnancy within three months of supplementation with low dose thyroxine. Among them, 34 (40.9% women with primary infertility achieved pregnancy within three months. Similarly 14 (16.8% women with previous miscarriage, 20 (24.09% women with previous caesarean section within past five years back, and 15 (18.07% with previous IUFD achieved pregnancy within three months. Conclusion: Low dose thyroxine supplementation would be beneficial and recommended to subfertile women of reproductive age group in the endemic regions of hypothyroidism. Dose adjustment would give extended benefits as soon as pregnancy is achieved.

  6. The impact of postpartum cervical tear on the occurrence of preterm birth in subsequent pregnancy.

    Science.gov (United States)

    Zafran, Noah; Gerszman, Eden; Garmi, Gali; Zuarez-Easton, Sivan; Salim, Raed

    2017-08-01

    To examine the occurrence of subsequent preterm birth (PTB) among women who experienced a cervical tear during prior delivery. A retrospective study conducted at a single teaching hospital on data from January 1994 to March 2014. The study group included all women who had a cervical tear detected at uterine and cervical examination, performed due to early postpartum hemorrhage. The control group consisted of women who delivered vaginally, experienced an early postpartum hemorrhage, and had an intact cervix at uterine and cervical examination. The control group was matched for maternal age and ethnicity at a ratio of 1:2. Women who had a cervical tear but then did not have a subsequent delivery, or had multiple fetal gestations or cervical cerclage at subsequent pregnancies were excluded. Primary outcome was spontaneous PTB rate (<37 weeks) in the subsequent pregnancy. Secondary outcomes included any PTBs in other subsequent pregnancies. Overall, 389 women were included. Of all cases of cervical tear, 129 were identified eligible and included in the final analysis. The control group included 260 women with an intact cervix. No significant differences were found between the study and control groups in the incidence of spontaneous PTB in the immediate subsequent pregnancy [1.6% (2/129) vs. 3.8% (10/260), respectively, p = 0.35]. The incidence of any spontaneous PTBs in all subsequent pregnancies did not differ also [4.7% (6/129) vs. 7.3% (19/260), respectively, p = 0.31]. Cervical tear detected after delivery does not increase the risk of spontaneous PTB in subsequent pregnancies.

  7. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...

  8. Mifepristone-induced abortion and placental complications in subsequent pregnancy.

    Science.gov (United States)

    Zhu, Qian-Xi; Gao, Er-Sheng; Chen, Ai-Min; Luo, Lin; Cheng, Yi-Min; Yuan, Wei

    2009-02-01

    The aim of the study was to explore the effect of first-trimester mifepristone-induced abortion (MA) on placental complications in subsequent pregnancy. Two cohorts of nulliparous pregnant women were recruited in China during early pregnancy, one with a history of one MA and the other with no abortion (NA). Women were followed up until delivery. The incidence proportions of abruptio placenta, placenta previa, placenta accreta and retained placenta in the MA group (4673) and NA group (4690) were, respectively, 0.5 and 0.3, 0.8 and 0.9, 0.5 and 0.5, and 0.7 and 0.8% (all differences non-significant). After adjustment for center, age, education, occupation, residence, income, BMI and type of delivery, the incidence rates of placenta previa, accreta and retained placenta in the MA and NA groups showed no significant differences. The risk of abruptio placenta in women with a MA was nearly double that of women with no abortion, although this apparent increased risk was not statistically significant. Furthermore, this increased risk of abruptio placenta was found only in those with a gestational age >6 weeks at abortion (aOR: 2.46; 95% CI: 1.00-6.04), a curettage after abortion (aOR: 3.00; 95% CI: 1.25-7.20) or a longer inter-pregnancy interval (P-value for trend: 0.022). Mifepristone-induced abortion itself is not associated with placental complications in subsequent pregnancy, but other factors related to medical abortion-such as a gestational age >6 weeks at abortion, a curettage after abortion, and a longer interpregnancy interval-may increase the risk of abruptio placenta.

  9. Four Cases of Parkinson Disease Diagnosed During the Postpartum Period.

    Science.gov (United States)

    Maltête, David; Grangeon, Lou; Le Goff, Floriane; Ozel, Gulden; Fetter, Damien; Ahtoy, Patrick; Temgoua, Olivier; Rouillé, Audrey; Lefaucheur, Romain

    2017-07-01

    There is little experience with the effect of pregnancy on Parkinson disease because the number of women with Parkinson disease who are of childbearing age is small. We report four cases beginning during the postpartum period and discuss the potential contribution of different factors that may influence the occurrence of Parkinson disease in this time period. Four women aged 29-35 years developed arm tremor, shoulder pain, dizziness, or decreased dexterity of the hand in the first few days or months after childbirth. They were initially diagnosed with postpartum depression or psychogenic parkinsonism. Finally, dopamine transporter imaging confirmed the diagnosis of young-onset Parkinson disease. Early-onset Parkinson disease may present in postpartum women. In women with atypical motor symptoms in addition to depression, this diagnosis should be considered.

  10. Abortions: Does It Affect Subsequent Pregnancies?

    Science.gov (United States)

    Healthy Lifestyle Getting pregnant Could an abortion increase the risk of problems in a subsequent pregnancy? Answers from Yvonne Butler Tobah, M.D. Generally, elective abortion isn't thought to cause fertility issues or ...

  11. Maternal and fetal Doppler velocimetry in women diagnosed with ...

    African Journals Online (AJOL)

    2016-03-16

    Mar 16, 2016 ... the pulsatility index (PI) and resistance index (RI) values for uterine, umbilical, and mid cerebral arteries were recorded. Results: Both groups had similar PI and RI values for umbilical and mid cerebral arteries (P > 0.05). However, PI and. RI values for both right and left uterine arteries were higher in FOC ...

  12. Cervical cancer in women diagnosed at the National Health ...

    African Journals Online (AJOL)

    Conclusion: To determine the incidence of cervical cancer in the Sudan a national populationbased registry is necessary. The mean age of patients presenting with cervical cancer to NHL is 53.25 years. This is in keeping with the natural history of the human papilloma virus (HPV). The late presentation of patients with ...

  13. Crohn’s Disease: The Subsequent Visit

    OpenAIRE

    Manolakis, Catherine S.; Farraye, Francis A.; Di Palma, Jack A.

    2013-01-01

    The diagnosis and subsequent management of Crohn’s disease are challenging for both the patient and the gastroenterologist. After the initial assessment, subsequent visits should assess the patient’s readiness to begin therapy, monitor progress if therapy has been initiated, assess for complications of the disease or therapy, and ensure that all appropriate health maintenance measures are current. This article is intended to be a companion to our earlier paper “Crohn’s Disease: The First Visi...

  14. Diagnósticos e intervenções de enfermagem frequentes em mulheres internadas em uma unidade de terapia intensiva Diagnósticos y intervenciones de enfermería frecuentes en mujeres en una unidad de terapía intensiva Frequent nursing diagnoses and interventions for women under critical care

    Directory of Open Access Journals (Sweden)

    Mirna Fontenele de Oliveira

    2009-06-01

    Full Text Available Objetivou-se identificar os Diagnósticos de Enfermagem mais freqüentes e propor intervenções para mulheres internadas em uma unidade de terapia intensiva materna de um hospital público de Fortaleza-CE. Estudo retrospectivo, realizado em prontuários de mulheres internadas. Foram elaborados dez Diagnósticos de Enfermagem. Destes, quatro de risco: risco para infecção, risco para desequilíbrio no volume de líquidos, risco para aspiração, risco para integridade da pele prejudicada e seis reais: maternidade alterada, mobilidade física prejudicada, ansiedade e comunicação verbal prejudicada. Para os referidos Diagnósticos de Enfermagem, propõem-se intervenções, segundo a ligação entre NANDA, NIC e NOC. Conclui-se que o uso dos Diagnósticos de Enfermagem é tecnologia necessária ao cotidiano de enfermagem, pois possibilita o cuidado integral.El objetivo del estudio fue identificar los Diagnósticos de Enfermería más frecuentes y proponer intervenciones para mujeres internadas en una unidad de terapia intensiva maternal de un hospital público en Fortaleza, CE, Brasil. Estudio retrospectivo realizado con los prontuarios de mujeres internadas. Se elaboró diez Diagnósticos de Enfermería, cuatro de riesgo: riesgo para infección, riesgo para desequilibrio en el volumen de líquidos, riesgo para aspiración, riesgo para integridad de la piel perjudicada y seis reales: maternidad alterada, mobilidad física perjudicada, ansiedad y comunicación verbal perjudicada. Para los referidos DE, se propone intervenciones, según la ligación entre NANDA, NIC y NOC. Se concluye que el uso de los DE es una tecnología necesaria a la rutina de la enfermería, ya que posibilita la atención integral.This study aimed at identifying the most frequent Nursing Diagnoses and propose interventions for women under critical care into a maternal intensive care unit in a public hospital in Fortaleza, CE, Brazil. Retrospective study conducted with women

  15. Changes in alcohol consumption and subsequent risk of type 2 diabetes in men

    NARCIS (Netherlands)

    Joosten, M.M.; Chiuve, S.E.; Mukamal, K.J.; Hu, F.B.; Hendriks, H.F.; Rimm, E.B.

    2011-01-01

    OBJECTIVE: The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed

  16. Changes in Alcohol Consumption and Subsequent Risk of Type 2 Diabetes in Men

    NARCIS (Netherlands)

    Joosten, M.M.; Chiuve, S.E.; Mukamal, K.J.; Hu, F.B.; Hendriks, H.F.J.; Rimm, E.B.

    2011-01-01

    Objective -The objective of this study was to investigate the association of four-year changes in alcohol consumption with subsequent risk of type 2 diabetes. Research Design and Methods - We prospectively examined 38,031 men from the Health Professionals Follow-up Study free of diagnosed diabetes

  17. Diagnosing GORD in respiratory medicine

    Directory of Open Access Journals (Sweden)

    Chris James Timms

    2011-07-01

    Full Text Available Gastroesophageal reflux disease is increasing in prevalence and is associated with several lung diseases such as asthma and COPD. Current diagnostic methods are imperfect, being insensitive, nonspecific, expensive or invasive. An accurate diagnosis of GORD can aid effective treatment with a significant clinical impact. Novel methods such as exhaled breath condensate analysis and electronic nose technology have the potential to improve the accuracy of diagnosing GORD.

  18. Non Melanoma Skin Cancer and Subsequent Cancer Risk

    Science.gov (United States)

    Rees, Judy R.; Zens, M. Scot; Gui, Jiang; Celaya, Maria O.; Riddle, Bruce L.; Karagas, Margaret R.

    2014-01-01

    Introduction Several studies have shown an increased risk of cancer after non melanoma skin cancers (NMSC) but the individual risk factors underlying this risk have not been elucidated, especially in relation to sun exposure and skin sensitivity to sunlight. Purpose The aim of this study was to examine the individual risk factors associated with the development of subsequent cancers after non melanoma skin cancer. Methods Participants in the population-based New Hampshire Skin Cancer Study provided detailed risk factor data, and subsequent cancers were identified via linkage with the state cancer registry. Deaths were identified via state and national death records. A Cox proportional hazard model was used to estimate risk of subsequent malignancies in NMSC patients versus controls and to assess the potential confounding effects of multiple risk factors on this risk. Results Among 3584 participants, risk of a subsequent cancer (other than NMSC) was higher after basal cell carcinoma (BCC) (adjusted HR 1.40 [95% CI 1.15, 1.71]) than squamous cell carcinoma (SCC) (adjusted HR 1.18 [95% CI 0.95, 1.46]) compared to controls (adjusted for age, sex and current cigarette smoking). After SCC, risk was higher among those diagnosed before age 60 (HR 1.96 [95% CI 1.24, 3.12]). An over 3-fold risk of melanoma after SCC (HR 3.62; 95% CI 1.85, 7.11) and BCC (HR 3.28; 95% CI 1.66, 6.51) was observed, even after further adjustment for sun exposure-related factors and family history of skin cancer. In men, prostate cancer incidence was higher after BCC compared to controls (HR 1.64; 95% CI 1.10, 2.46). Conclusions Our population-based study indicates an increased cancer risk after NMSC that cannot be fully explained by known cancer risk factors. PMID:24937304

  19. Non melanoma skin cancer and subsequent cancer risk.

    Directory of Open Access Journals (Sweden)

    Judy R Rees

    Full Text Available Several studies have shown an increased risk of cancer after non melanoma skin cancers (NMSC but the individual risk factors underlying this risk have not been elucidated, especially in relation to sun exposure and skin sensitivity to sunlight.The aim of this study was to examine the individual risk factors associated with the development of subsequent cancers after non melanoma skin cancer.Participants in the population-based New Hampshire Skin Cancer Study provided detailed risk factor data, and subsequent cancers were identified via linkage with the state cancer registry. Deaths were identified via state and national death records. A Cox proportional hazard model was used to estimate risk of subsequent malignancies in NMSC patients versus controls and to assess the potential confounding effects of multiple risk factors on this risk.Among 3584 participants, risk of a subsequent cancer (other than NMSC was higher after basal cell carcinoma (BCC (adjusted HR 1.40 [95% CI 1.15, 1.71] than squamous cell carcinoma (SCC (adjusted HR 1.18 [95% CI 0.95, 1.46] compared to controls (adjusted for age, sex and current cigarette smoking. After SCC, risk was higher among those diagnosed before age 60 (HR 1.96 [95% CI 1.24, 3.12]. An over 3-fold risk of melanoma after SCC (HR 3.62; 95% CI 1.85, 7.11 and BCC (HR 3.28; 95% CI 1.66, 6.51 was observed, even after further adjustment for sun exposure-related factors and family history of skin cancer. In men, prostate cancer incidence was higher after BCC compared to controls (HR 1.64; 95% CI 1.10, 2.46.Our population-based study indicates an increased cancer risk after NMSC that cannot be fully explained by known cancer risk factors.

  20. Term induction of labor and subsequent preterm birth.

    Science.gov (United States)

    Levine, Lisa D; Bogner, Hillary R; Hirshberg, Adi; Elovitz, Michal A; Sammel, Mary D; Srinivas, Sindhu K

    2014-04-01

    Although the rate of inductions continues to rise, there is a paucity of data investigating subsequent pregnancy outcomes after induction. Our objective was to compare term inductions with term spontaneous labor and evaluate the rate of subsequent spontaneous preterm birth (sPTB). A retrospective cohort study of women with 2 consecutive deliveries from 2005 through 2010 was performed. Term inductions or term spontaneous labor in the index pregnancy was included, and those with a prior sPTB were excluded. Data were obtained through chart abstraction. The primary outcome was sPTB (Term inductions were less likely to have a subsequent sPTB compared with term spontaneous labor (6% vs 11%; odds ratio [OR], 0.49; 95% confidence interval, 0.29-0.81; P = .005). This remained after adjusting for confounders (adjusted OR, 0.55; P = .04). The sPTB risk depended on gestational age of index delivery. At 37-38.9 weeks, the sPTB rate after spontaneous labor was 24% vs 9% after induction (OR, 3.0; 95% confidence interval, 1.44-6.16; P = .003). This was not significant for 39-39.9 weeks (P = .2) or 40 weeks or longer (P = .8). Induction is not a risk factor for subsequent sPTB. Spontaneous labor, however, in the early term period is associated with subsequent sPTB. Further investigation among early term deliveries is warranted to evaluate the risk of sPTB and target interventions in this cohort. Copyright © 2014 Mosby, Inc. All rights reserved.

  1. Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV Association between CD4+ T-cell count and intraepithelial cervical neoplasia diagnosed by histopathology in HIV-infected women

    Directory of Open Access Journals (Sweden)

    Juliana Barroso Zimmermmann

    2006-06-01

    Full Text Available OBJETIVO: avaliar a associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical em pacientes HIV positivas. MÉTODOS: estudo transversal no qual foram incluídas 87 pacientes infectadas pelo HIV, confirmado por testes sorológicos prévios. Todas eram portadoras do HPV cervical, diagnosticado por meio da reação em cadeia da polimerase. Foram realizados anamnese, exame físico e colposcopia de todas em pacientes. A biópsia do colo uterino foi realizada quando indicada pelo exame colposcópico. Os resultados histopatológicos foram classificados com neoplasia intra-epitelial de baixo grau (NIC I ou de alto grau (NIC II e II. A associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão foi verificada por meio da comparação de médias utilizando a análise da variância (ANOVA. RESULTADOS: entre as 60 pacientes biopsiadas foram encontrados 24 casos (40,0% com NIC I, oito (13,3% NIC II, três (5% NIC III, 14 (23,3% pacientes somente com cervicite crônica e 11 (18,3% apresentando efeito citopático produzido pelo HPV, mas sem perda da polaridade celular. Isso equivale a 35 mulheres com lesão intra-epitelial de baixo grau (NIC I + HPV (58,3% e 11 (18,3% com lesão intra-epitelial de alto grau (NIC II + NIC III. A associação entre a média da contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial cervical não foi significativa (p=0,901. CONCLUSÕES: não houve associação entre a contagem de linfócitos T CD4+ e a gravidade da lesão intra-epitelial do colo uterino, diagnosticada pelo exame histopatológico.PURPOSE: to evaluate association between CD4+ cell count and cervical intraepithelial lesion severity in HIV-infected women. METHODS: cross-sectional study of 87 HIV-infected patients which were confirmed by previous serologic examinations. All had cervical HPV diagnosed by polymerase chain reaction (PCR. All patients underwent anamnesis, physical examinations and

  2. Splenectomy increases the subsequent risk of systemic lupus erythematosus.

    Science.gov (United States)

    Hsu, Chao-Yu; Chen, Hsuan-Ju; Hsu, Chung Y; Kao, Chia-Hung

    2016-02-01

    Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55-20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.

  3. Three Generations of Lancashire Women

    Science.gov (United States)

    Biscomb, Kay

    2012-01-01

    In 1914 opportunities for working-class women's sports participation were limited and peripheral, but the 1980s, policy reforms resulted in the then Sports Council identifying women as a "target group". Subsequently the notion that barriers to women's participation are issues to be identified and resolved has become commonplace in…

  4. Causes and outcome of prenatally diagnosed hydronephrosis

    Directory of Open Access Journals (Sweden)

    Ahmadzadeh Ali

    2009-01-01

    Full Text Available Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S. Hydronephrosis may be obstructive or non-obstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD in transverse plane: mild (6-9.9 mm, moderate (10-14.9 mm and severe (> 15 mm hydronephrosis. Voiding cystourethrography (VCUG was obtained in all of the patients to rule out vesicoureteral reflux (VUR. In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO. Twenty two cases (32.8% had mild, 20 (29.9% had moderate, and 25 (37.3% had severe hydronephrosis. The causes of hydroneph-rosis were VUR (40.2%, UPJO (32.8%, posterior urethral valves (PUVs (13.4 %, and transient hydronephrosis (13.4 %. The lesion was obstructive in 37 (55.2% infants. Totally, 33 (49.2% patients with hydronephrosis (9 mild, 9 moderate, and 15 severe subsequently developed com-plications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4% patients. We conclude that every newborn with any degree of hydro-nephrosis should be assessed postnatally for specific diagnosis and treatment.

  5. Predictors of type 2 diabetes among Taiwanese women with prior gestational diabetes mellitus.

    Science.gov (United States)

    Lin, Pei-Chao; Hung, Chich-Hsiu; Huang, Ruei-Dian; Chan, Te-Fu

    2016-01-01

    The aims of this study were to determine the blood glucose screening rate of Taiwanese post-partum women with gestational diabetes (GDM) and to identify the predictors of type 2 diabetes among Taiwanese women with GDM. The medical records of 130 women with GDM, who were delivered at a hospital in southern Taiwan between 1997 and 2010, were retrospectively reviewed. The GDM diagnosis was performed according to the National Diabetes Data Group and Expert Committee Criteria. The 2010 American Diabetes Association diabetes diagnosis criteria were used to determine whether post-partum women subsequently developed type 2 diabetes. In total, 71 records (54.6%) included blood glucose testing after childbirth between the first month and the ninth year, and 29 records (22.3%) documented subsequent type 2 diabetes. In a multiple logistic regression analysis, the patients' pre-pregnancy body mass indices and insulin use during pregnancy were independently associated with subsequent type 2 diabetes. In this study, documentation during pregnancy, which could have provided beneficial insights, was limited. Healthcare professionals should develop a program to improve the post-partum follow-up of women diagnosed with GDM. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  6. Infant developmental milestones and subsequent cognitive function.

    Science.gov (United States)

    Murray, Graham K; Jones, Peter B; Kuh, Diana; Richards, Marcus

    2007-08-01

    Developmental delay is associated with a subsequent diagnosis of learning disability. However, the relationship between the age of reaching infant developmental milestones and later intellectual function within the general population remains unresolved. We hypothesized that earlier attainment of developmental milestones would be associated with better subsequent intellectual performance throughout the range of abilities, rather than confined to extremes. Developmental data were obtained at age 2 years in the National Survey of Health and Development, a representative sample of 5,362 children born in the United Kingdom in 1946. Data on intellectual function and educational attainment at ages 8, 26, and 53 years were also obtained. Multiple linear regression and logistic regression were used to analyze the effect of age of reaching developmental milestones on subsequent cognition and educational attainment. The age of reaching developmental milestones was associated with intellectual performance at ages 8, 26, and 53 years; for every month earlier a child learned to stand, there was, on average, a gain of one half of one intelligence quotient point at age 8. Speech development had a small but statistically significant effect on subsequent educational attainment (later developers were less likely to progress beyond basic education); this effect was not apparent for motor development. Effect sizes were reduced when the slowest developers were excluded, but many effects remained significant. The association between later development and poorer subsequent intellectual function is small, but it does have theoretical implications; we suggest it is secondary to suboptimal cortical-subcortical connectivity.

  7. Physical activity before and during pregnancy and risk of abnormal glucose tolerance among Hispanic women.

    Science.gov (United States)

    Chasan-Taber, L; Silveira, M; Lynch, K E; Pekow, P; Braun, B; Manson, J E; Solomon, C G; Markenson, G

    2014-02-01

    Women diagnosed with abnormal glucose tolerance and gestational diabetes mellitus are at increased risk for subsequent type 2 diabetes, with higher risks in Hispanic women. Studies suggest that physical activity may be associated with a reduced risk of these disorders; however, studies in Hispanic women are sparse. We prospectively evaluated this association among 1241 Hispanic participants in Proyecto Buena Salud. The Pregnancy Physical Activity Questionnaire was used to assess pre, early, and mid pregnancy physical activity. Medical records were abstracted for pregnancy outcomes. A total of 175 women (14.1%) were diagnosed with abnormal glucose tolerance and 57 women (4.6%) were diagnosed with gestational diabetes. Increasing age and body mass index were strongly and positively associated with risk of gestational diabetes. We did not observe statistically significant associations between total physical activity or meeting exercise guidelines and risk. However, after adjusting for age, BMI, gestational weight gain, and other important risk factors, women in the top quartile of moderate-intensity activity in early pregnancy had a decreased risk of abnormal glucose tolerance (odds ratio=0.48, 95% Confidence Interval 0.27-0.88, Ptrend=0.03) as compared to those in the lowest quartile. Similarly, women with the highest levels of occupational activity in early pregnancy had a decreased risk of abnormal glucose tolerance (odds ratio=0.48, 95% Confidence Interval 0.28-0.85, Ptrend=0.02) as compared to women who were unemployed. In this Hispanic population, total physical activity and meeting exercise guidelines were not associated with risk. However, high levels of moderate-intensity and occupational activity were associated with risk reduction. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Abortion and subsequent mental health: Review of the literature.

    Science.gov (United States)

    Bellieni, Carlo V; Buonocore, Giuseppe

    2013-07-01

    The risk that abortion may be correlated with subsequent mental disorders needs a careful assessment, in order to offer women full information when facing a difficult pregnancy. All research papers published between 1995 and 2011, were examined, to retrieve those assessing any correlation between abortion and subsequent mental problems. A total of 36 studies were retrieved, and six of them were excluded for methodological bias. Depression, anxiety disorders (e.g. post-traumatic stress disorder) and substance abuse disorders were the most studied outcome. Abortion versus childbirth: 13 studies showed a clear risk for at least one of the reported mental problems in the abortion group versus childbirth, five papers showed no difference, in particular if women do not consider their experience of fetal loss to be difficult, or if after a fetal reduction the desired fetus survives. Only one paper reported a worse mental outcome for childbearing. Abortion versus unplanned pregnancies ending with childbirth: four studies found a higher risk in the abortion groups and three, no difference. Abortion versus miscarriage: three studies showed a greater risk of mental disorders due to abortion, four found no difference and two found that short-term anxiety and depression were higher in the miscarriage group, while long-term anxiety and depression were present only in the abortion group. In conclusion, fetal loss seems to expose women to a higher risk for mental disorders than childbirth; some studies show that abortion can be considered a more relevant risk factor than miscarriage; more research is needed in this field. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

  9. Vagotomy and subsequent development of diabetes

    DEFF Research Database (Denmark)

    Starup-Linde, Jakob; Gejl, Michael; Borghammer, Per

    2016-01-01

    registration of vagotomy and/or upper gastrointestinal disease in the period 1977-2011. Controls had no subsequent diagnosis of diabetes and were matched by incidence density sampling, age and gender. Logistic regression analyses were conducted. RESULTS: 501,724 diabetes patients and 1,375,567 matched controls......BACKGROUND: Vagal signaling is involved in gastric emptying and the secretion and effect of a number of hormones regulating gluco-metabolic processes and, thus, crucial for metabolic homeostasis. PURPOSE: We hypothesized that vagotomy would increase the risk of developing type 2 diabetes...... and examined the association between vagotomy and subsequent development of diabetes. METHODS: A nested case-control study was conducted with information on cases and controls from the Danish National Patient Registry. Cases included individuals with a diabetes diagnosis subsequent (>12months) to the first...

  10. How to diagnose acute appendicitis

    DEFF Research Database (Denmark)

    Mostbeck, Gerhard; Adam, E Jane; Nielsen, Michael Bachmann

    2016-01-01

    Acute appendicitis (AA) is a common abdominal emergency with a lifetime prevalence of about 7 %. As the clinical diagnosis of AA remains a challenge to emergency physicians and surgeons, imaging modalities have gained major importance in the diagnostic work-up of patients with suspected AA in order...... appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear....

  11. Double-Edged Sword: Women with Breast Cancer Caring for a Spouse with Cancer.

    Science.gov (United States)

    Rottenberg, Yakir; Baider, Lea; Jacobs, Jeremy M; Peretz, Tamar; Goldzweig, Gil

    2016-12-01

    Experiences in caregiving may affect further coping with illness. The aim of this study was to assess mortality risk among women diagnosed with breast cancer while caring for a male spouse who had been diagnosed with cancer before or at the time of their own diagnosis. We used a historical prospective study of a nationally representative cohort that was assessed by the Israeli Central Bureau of Statistics 1995 census and followed until 2011. The study population was divided into 2 × 2 groups (according to a positive/negative cancer history of the male spouse before the time of breast cancer diagnosis of the women X spouse alive/dead). The analyses were adjusted for age, ethnicity, breast cancer staging, and time of diagnosis. A total of 14,429 cases of breast cancer and 3,400 deaths were reported during the study period. Mortality was not mediated by the spouse's survival at the time of breast cancer diagnosis of the women. However, decreased risk of death was seen in women with a positive spouse history of cancer when the spouse was alive at the time of diagnosis in women who were diagnosed with breast cancer stages II and III (hazard ratio = 0.76, 95% CI: 0.59-0.98). Among a subset of women diagnosed with breast cancer, there is evidence of a significant protective association between a history of caregiving for cancer of a spouse who is alive at the time of self-diagnosis and subsequent survival. Our findings support hypotheses concerning a positive experience of caregiving and emphasize the need to define the patient and the caregiver as an integrative "unit of care."

  12. Is induced abortion a risk factor in subsequent pregnancy?

    Science.gov (United States)

    Voigt, Manfred; Henrich, Wolfgang; Zygmunt, Marek; Friese, Klaus; Straube, Sebastian; Briese, Volker

    2009-01-01

    To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. The control group consisted of primiparous women without previous induced abortions. Maternal age was adjusted for. There was an overall trend towards an increased rate of preterm delivery at or=2 previous induced abortions were 7.8% and 8.5%, respectively, compared to 6.5% in the control population (P=0.015). Preceding terminations of pregnancy did not alter the rate of small-for-gestational-age newborns. Psychosocial stress and symptoms associated with prematurity such as cervical incompetence and vaginal bleeding before and after 28 weeks of gestation occurred more frequently in women with previous induced abortion compared to the control group (Pabortions. Similarly, symptoms associated with prematurity are more common. The rate of small-for-gestational-age newborns was not affected by preceding terminations of pregnancy.

  13. Induced abortion and the risk of subsequent ectopic pregnancy.

    Science.gov (United States)

    Holt, V L; Daling, J R; Voigt, L F; McKnight, B; Stergachis, A; Chu, J; Weiss, N S

    1989-01-01

    This study assessed the effect of legal induced abortion on ectopic pregnancy risk by using a comparison group of reproductive-age women who were at risk of becoming pregnant during the same time period the women with ectopic pregnancy conceived. Cases were members of Group Health Cooperative of Puget Sound who were hospitalized for ectopic pregnancy from October 1981 through September 1986 (N = 211). Controls were randomly selected members matched to cases on age and county of residence (N = 457). All subjects in this analysis had had one or more prior pregnancies. Eighty-eight cases (41.7 per cent) and 177 controls (38.7 per cent) had a history of one or more induced abortions. The relative risk of ectopic pregnancy associated with one abortion was 0.9 (95 per cent confidence interval 0.6, 1.3), adjusted for age, county, reference date, religion, gravidity, age at first pregnancy, lifetime number of sexual partners, and miscarriage history. Among women with two or more prior pregnancies, the risk associated with two or more abortions was 1.2 (0.6, 2.4). Controlling for pelvic inflammatory disease and use of intrauterine devices did not alter these risks. We conclude that legal abortion as performed in the US since 1970 has little or no influence on a woman's risk of ectopic pregnancy in subsequent pregnancies. PMID:2764199

  14. Family cancer history affecting risk of colorectal cancer in a prospective cohort of Chinese women.

    Science.gov (United States)

    Murphy, Gwen; Shu, Xiao-Ou; Gao, Yu-Tang; Ji, Bu-Tian; Cook, Michael Blaise; Yang, Gong; Li, Hong Lan; Rothman, Nathaniel; Zheng, Wei; Chow, Wong-Ho

    2009-10-01

    An elevated risk of colorectal cancer has been associated with sporadic colorectal cancer in first-degree relatives, mostly in Western populations. Limited data exist from traditionally low-risk areas, such as Asia, where the prevalence of risk factors may differ. We examined the association of family history of cancer and subsequent colorectal cancer risk in a cohort of traditionally low-risk Chinese women. We followed 73,358 women in the Shanghai Women's Health Study for cancer incidence until December 2005. After an average of 7 years of follow-up, 391 women were diagnosed with colorectal cancer. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards models adjusted for age, smoking, family income, education, body mass index, physical activity, and history of diabetes. We observed a significant association between colorectal cancer risk and history of a parent being diagnosed with colorectal cancer (hazard ratio: 3.34; 95% confidence interval: 1.58, 7.06). No association was observed for colorectal cancer diagnosed among siblings. Colorectal cancer risk was not influenced by a positive family history of cancer generally or any of the other cancers investigated (lung, breast, prostate, gastric, esophageal, endometrial, ovarian, urinary tract, central nervous system, and small bowel). Our cohort results suggest that consistent with findings from Western populations, having a family history of colorectal cancer may influence colorectal cancer risk to a similar extent in a low-risk population.

  15. 75 FR 82005 - Proposed Subsequent Arrangement

    Science.gov (United States)

    2010-12-29

    ... Nonproliferation and International Security, Department of Energy. ACTION: Proposed subsequent arrangement. SUMMARY..., Canada, to Korea Nuclear Fuel Co. Ltd. in Yuson-Gu, Taejon, South Korea. The material, which is currently... Energy. Thomas P. D'Agostino, Administrator, National Nuclear Security Administration. [FR Doc. 2010...

  16. Compressed Subsequence Matching and Packed Tree Coloring

    DEFF Research Database (Denmark)

    Bille, Philip; Cording, Patrick Hagge; Gørtz, Inge Li

    2017-01-01

    We present a new algorithm for subsequence matching in grammar compressed strings. Given a grammar of size n compressing a string of size N and a pattern string of size m over an alphabet of size \\(\\sigma \\), our algorithm uses \\(O(n+\\frac{n\\sigma }{w})\\) space and \\(O(n+\\frac{n\\sigma }{w}+m\\log N...

  17. 7 CFR 1781.22 - Subsequent loans.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Subsequent loans. 1781.22 Section 1781.22 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) RESOURCE CONSERVATION AND DEVELOPMENT (RCD) LOANS AND WATERSHED (WS) LOANS AND ADVANCES § 1781.22...

  18. Subsequent Reproductive Performance in Survivors of Complicated ...

    African Journals Online (AJOL)

    There were 2 cases of postpartum hemorrhage. 103 (44%) of the subjects who still desired pregnancy were yet unable to conceive. Conclusions The subsequent reproductive performance in survivors of complicated abortion appears to be largely characterized by a high rate of sub-fertility, fetal wastage and preterm ...

  19. Weight at birth and subsequent fecundability

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Riis, Anders H; Ehrenstein, Vera

    2014-01-01

    OBJECTIVE: To examine the association between a woman's birth weight and her subsequent fecundability. METHOD: In this prospective cohort study, we included 2,773 Danish pregnancy planners enrolled in the internet-based cohort study "Snart-Gravid", conducted during 2007-2012. Participants were 18...

  20. 7 CFR 3560.73 - Subsequent loans.

    Science.gov (United States)

    2010-01-01

    ... accordance with 7 CFR part 1940, subpart G. (f) Design requirements. All improvements, repairs, and... applicant must obtain architectural services when any of the following conditions exist: (1) Enclosed space... being proposed requires architectural services. (h) Restrictive-use requirements. Subsequent loans are...

  1. Screen-detected malignant breast lesions diagnosed following benign (B2) or normal (B1) needle core biopsy diagnoses.

    Science.gov (United States)

    Rakha, Emad A; Lee, Andrew H S; Reed, Jacquie; Murphy, Alison; El-Sayed, Maysa; Burrell, Helen; Evans, Andrew J; Ellis, Ian O

    2010-07-01

    Breast needle core biopsy (NCB) is now a standard diagnostic procedure in the triple assessment of screen detected breast lesions. However, unlike fine needle aspiration (FNA) cytology, information on the miss rate including false-negative diagnoses (FN) of malignancy (benign 'B2' or normal 'B1' NCB with a malignant outcome) is limited. A large series of NCBs (121,742) performed over an 8-year period has been studied to assess the frequency and causes of missing a malignant diagnosis on NCB and to evaluate their impact on patients' management in the screening service. During the period of this study, 50,691 were diagnosed as B2 and 9599 were diagnosed as B1. Of those, 779 B2 and 919 B1 were diagnosed as malignant on the subsequent surgical specimens, respectively, giving a FN rate of 3.0%. However when year of diagnosis was taken into consideration, we found that during the period 1999-2001, the FN rate for B2 was 2.7% while the miss rate for B1 was 4.0%. This showed marked improvement over time to reach a figure of 0.5% and 0.5% for B2 and B1, respectively, during the period 2005-2007. On detailed review of cases from a single screening region diagnosed during the last 3 years (2005-2008), 14 cases (0.17% of all NCBs) with malignant surgery were diagnosed as B2 (seven cases; FN rate 0.19%) and B1 (seven cases; B1 biopsy rate from cancer 0.19%). In these cases, NCB was unsatisfactory, there was a discrepancy between radiological abnormalities and histological findings with recommendation for excision or suspicious/malignant cytological diagnosis on concurrent FNA material. Therefore, our results indicate that the malignancy miss rate on NCB is rare and FN NCB diagnoses had no impact on patient management. Copyright 2010 Elsevier Ltd. All rights reserved.

  2. Cervical dilation at the time of cesarean section for dystocia - effect on subsequent trial of labor

    DEFF Research Database (Denmark)

    Abildgaard, Helle; Diness, Marie; Nickelsen, Carsten

    2012-01-01

    Objective. To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery. Design. Retrospective study. Setting. University hospital in Copenhagen capital area. Population. All women with a prior...... anesthesia and mode of birth was collected. Results. A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully...... or almost fully dilated cervix (9-10 cm) (p women with a previous vaginal delivery prior to their cesarean section, the success rate for vaginal birth was 76.2%, in contrast to 48.9% in the group without a previous vaginal delivery (p Women who had a trial of labor...

  3. Implementing an evidence-based breast cancer support and communication tool to newly diagnosed patients as standard care in two institutions

    National Research Council Canada - National Science Library

    Rahm, Alanna Kulchak; Hawkins, Robert P; Dearing, James W; Pingree, Suzanne; Lomax, Jana Bolduan; McDowell, Helen; Morse, Erica Ferro; Barela, BreAnne

    2015-01-01

    While many women turn to the Internet to obtain health information, it is unlikely that unstructured Internet use provides optimal benefit to women newly diagnosed with breast cancer, due to uneven...

  4. Ethical Dilemmas when Diagnosing Hypertension

    Directory of Open Access Journals (Sweden)

    Sandra Santana López

    2012-12-01

    Full Text Available A review on the ethical dilemmas in the diagnosis of hypertension and some elements in the emergence of the bioethics concept was performed. Ethical conflicts that appear at each stage of diagnosis of hypertension: at the time of providing the information, at the point of indication and performance of diagnostic tests, when communicating the diagnosis and during subsequent decision making were identified. We conclude that technological development will introduce new ethical decisions in the diagnosis of hypertension that will increasingly involve the interests of society and create, in one way or another, ethical and moral conflict in the decision making process.

  5. Paraphilic diagnoses in DSM-5.

    Science.gov (United States)

    Krueger, Richard B; Kaplan, Meg S

    2012-01-01

    The DSM-5 has been under revision since 1999 and is scheduled for publication in 2013. This article will review the major proposed modifications of the Paraphilias. The information reviewed was obtained from PubMed, PsychInfo, the DSM-5.org website and other sources and reviewed. Pedohebephilia, Hypersexual Disorder and Paraphilic Coercive Disorder are new proposed diagnoses. Paraphilias have been assigned their own chapter in DSM- 5 and a distinction has been made between Paraphilias and Paraphilic Disorders. Victim numbers have been included in diagnosis of paraphilias that involve victims and remission and severity measures have been added to all paraphilias. Transvestic Disorder can apply to males or females, Fetishistic Disorder now includes partialism, and Sexual Masochism Disorder has Asphyxiophilia as a specifier. This study is based on a literature review and influenced by the knowledge and biases of the authors. The Paraphilic Disorders Section of the DSM-5 represents a significant departure from DSMIV-TR.

  6. Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

    Science.gov (United States)

    Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

    2017-08-01

    Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

  7. [Munchausen disease diagnosed ten years after debut].

    Science.gov (United States)

    Mrgan, Monija; Taasti, Lena Merete

    2013-09-02

    Munchausen disease is difficult to diagnose especially because it is often an exclusion diagnosis. We present a case of skin ulcers in a young woman, who was eventually diagnosed with Munchausen disease.

  8. Fertility Preservation for Children Diagnosed with Cancer

    Science.gov (United States)

    ... website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open ... Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation ...

  9. Outcomes of conception subsequent to methotrexate treatment for an unruptured ectopic pregnancy.

    Science.gov (United States)

    Svirsky, Ran; Ben-Ami, Ido; Berkovitch, Matitiahu; Halperin, Reuvit; Rozovski, Uri

    2017-11-01

    To assess the risk of adverse pregnancy outcomes in subsequent pregnancies among women treated with methotrexate for ectopic pregnancy. In a retrospective single-center study, data were assessed for women treated with methotrexate for ectopic pregnancy at Asaf Harofe Medical Center, Zerifin, Israel, between May 2004 and May 2014. Overall, 226 women were treated with methotrexate for ectopic pregnancy and subsequently conceived. The median time from treatment to conception was 10 months (range 1-120 months), and 127 women conceived within 12 months of treatment. Except for early missed abortion-which affected 23 (10.2%) pregnancies-adverse pregnancy outcomes such as fetal malformations were rare. The frequency of early abortion was lowest for women who conceived within 6 months of treatment with methotrexate (3/93, 3.2%), increased between 6 and 23 months (15/83, 18.1%), and remained high thereafter (7/50, 14.0%; P=0.006). The frequency of fetal malformation in a subsequent pregnancy was low among women treated with methotrexate for ectopic pregnancy. The frequency of early missed abortion was lowest during the first 6 months after treatment with methotrexate. © 2017 International Federation of Gynecology and Obstetrics.

  10. A Case of Bilateral Testicular Tumors Subsequently Diagnosed as Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

    Directory of Open Access Journals (Sweden)

    Yan-Kun Sha

    2016-12-01

    Full Text Available 21-hydroxylase deficiency (21-OHD caused congenital adrenal hyperplasia (CAH is a group of autosomal recessive genetic disorders resulting from mutations in genes involved with cortisol (CO synthesis in the adrenal glands. Testicular adrenal rest tumors (TARTs are rarely the presenting symptoms of CAH. Here, we describe a case of simple virilizing CAH with TARTs, in a 15-year-old boy. The patient showed physical signs of precocious puberty. The levels of blood adrenocorticotropic hormone (ACTH, urinary 17-ketone steroids (17-KS, dehydroepiandrosterone sulfate (DHEA-S, and serum progesterone (PRGE were elevated, whereas those of follicle-stimulating hormone (FSH, luteinizing hormone (LH, and CO were reduced. Computed tomography (CT of the adrenal glands and magnetic resonance imaging (MRI of the testes showed a soft tissue density (more pronounced on the right side and an irregularly swollen mass (more pronounced on the left side, respectively. Pathological examination of a specimen of the mass indicated polygonal/circular eosinophilic cytoplasm, cord-like arrangement of interstitial cells, and lipid pigment in the cytoplasm. Immunohistochemistry results precluded a diagnosis of Leydig cell tumors. DNA sequencing revealed a hackneyed homozygous mutation, I2g, on intron 2 of the CYP21A2 gene. The patient’s symptoms improved after a three-month of dexamethasone therapy. Recent radiographic data showed reduced hyperplastic adrenal nodules and testicular tumors. A diagnosis of TART should be considered and prioritized in CAH patients with testicular tumors. Replacement therapy using a sufficient amount of dexamethasone in this case helps combat TART.

  11. A Case of Bilateral Testicular Tumors Subsequently Diagnosed as Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

    Science.gov (United States)

    Sha, Yan-Kun; Sha, Yan-Wei; Ding, Lu; Liu, Wei-Wu; Song, Yue-Qiang; Lin, Jin; He, Xue-Mei; Qiu, Ping-Ping; Zhang, Ling; Li, Ping

    2016-01-01

    21-hydroxylase deficiency (21-OHD) caused congenital adrenal hyperplasia (CAH) is a group of autosomal recessive genetic disorders resulting from mutations in genes involved with cortisol (CO) synthesis in the adrenal glands. Testicular adrenal rest tumors (TARTs) are rarely the presenting symptoms of CAH. Here, we describe a case of simple virilizing CAH with TARTs, in a 15-year-old boy. The patient showed physical signs of precocious puberty. The levels of blood adrenocorticotropic hormone (ACTH), urinary 17-ketone steroids (17-KS), dehydroepiandrosterone sulfate (DHEA-S), and serum progesterone (PRGE) were elevated, whereas those of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and CO were reduced. Computed tomography (CT) of the adrenal glands and magnetic resonance imaging (MRI) of the testes showed a soft tissue density (more pronounced on the right side) and an irregularly swollen mass (more pronounced on the left side), respectively. Pathological examination of a specimen of the mass indicated polygonal/circular eosinophilic cytoplasm, cord-like arrangement of interstitial cells, and lipid pigment in the cytoplasm. Immunohistochemistry results precluded a diagnosis of Leydig cell tumors. DNA sequencing revealed a hackneyed homozygous mutation, I2g, on intron 2 of the CYP21A2 gene. The patient’s symptoms improved after a three-month of dexamethasone therapy. Recent radiographic data showed reduced hyperplastic adrenal nodules and testicular tumors. A diagnosis of TART should be considered and prioritized in CAH patients with testicular tumors. Replacement therapy using a sufficient amount of dexamethasone in this case helps combat TART. PMID:26985347

  12. Accumulation and subsequent utilization of waste heat

    Science.gov (United States)

    Koloničný, Jan; Richter, Aleš; Pavloková, Petra

    2016-06-01

    This article aims to introduce a special way of heat accumulation and primary operating characteristics. It is the unique way in which the waste heat from flue gas of biogas cogeneration station is stored in the system of storage tanks, into the heat transfer oil. Heat is subsequently transformed into water, from which is generated the low-pressure steam. Steam, at the time of peak electricity needs, spins the special designed turbine generator and produces electrical energy.

  13. National screening guidelines and developments in prenatal diagnoses and live births of Down syndrome in the period 1973-2016 in Denmark.

    Science.gov (United States)

    Lou, Stina; Petersen, Olav Bjørn; Jørgensen, Finn Stener; Lund, Ida Charlotte Bay; Kjaergaard, Susanne; Vogel, Ida

    2017-12-01

    Denmark was the first country in the world to implement a national, free-for-all offer of prenatal screening for Down syndrome to all pregnant women. It has a high uptake (> 90%) compared to other countries. Thus, Denmark offers an interesting case for investigating the consequences of implementing a comprehensive, national prenatal screening guideline. The aim of this study was to describe the historical developments in invasive procedures, pre-/postnatal diagnoses of Down syndrome and Down syndrome live births in the period 1973-2016 in Denmark MATERIAL AND METHODS: Data on invasive procedures, pre- and postnatal Down syndrome diagnoses were retrieved from the Danish Cytogenetic Central Registry RESULTS: From 1973-1993 screening based on maternal age and high-risk indications resulted in a constant increase in invasive procedures. After the introduction of the triple test in 1994, invasive procedures decreased for the first time in 20 years. Following the introduction of an offer of combined screening to all pregnant women in 2004, the number of invasive procedures decreased markedly while there was a concurrent increase in prenatal diagnoses of Down syndrome. Additionally, the number of Down syndrome live births decreased suddenly and significantly, but subsequently stabilized at 23-35 annual live births. Of these, the majority was diagnosed postnatally CONCLUSIONS: Though prenatal screening technologies constantly improve, it is the introduction of and adherence to national guidelines that resulted in marked shifts in screening procedures and outcome in Denmark. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. The role of physical examination in diagnosing common causes of vaginitis: a prospective study.

    Science.gov (United States)

    Singh, Rameet H; Zenilman, Jonathan M; Brown, Kathryn M; Madden, Tessa; Gaydos, Charlotte; Ghanem, Khalil G

    2013-05-01

    We evaluated agreement in diagnoses for bacterial vaginosis (BV), Trichomonas vaginalis (TV) and vulvovaginal candidiasis (VVC) between clinicians examining the patient and performing diagnostic tests versus a clinician with access only to the patient's history and diagnostic findings from self-obtained vaginal swabs (SOVS). Women presenting with vaginal discharge to a sexually transmitted infections clinic provided SOVS for evaluation and completed the study and qualitative questionnaires. A clinician then obtained a history and performed speculum and bimanual examinations. Participants' history and diagnostic test results from SOVS were provided to a masked non-examining clinician who rendered independent diagnoses. Overall agreement in diagnoses and κ statistics was calculated. The prevalence of infections among the 197 participants was 63.4% (BV), 19% (TV) and 14% (VVC). The per cent agreement between the examining and non-examining clinician for the diagnoses of BV was 68.5%, 90.9% for TV and 91.9% for VVC. Of the 105 women diagnosed with BV by the examining clinician, 34 (32%) were missed by the non-examining clinician. The non-examining clinician missed 13 (48%) of 27 women and 12 (34%) of 35 women treated for VVC and TV, respectively. Four women who all presented with abdominal pain were diagnosed with pelvic inflammatory disease. Tests from SOVS and history alone cannot be used to adequately diagnose BV, TV and VVC in women presenting with symptomatic vaginal discharge. Cost benefits from eliminating the speculum examination and using only tests from SOVS may be negated by long-term costs of mistreatment.

  15. Religious Service Attendance and Lower Depression Among Women-a Prospective Cohort Study.

    Science.gov (United States)

    Li, Shanshan; Okereke, Olivia I; Chang, Shun-Chiao; Kawachi, Ichiro; VanderWeele, Tyler J

    2016-12-01

    Previous studies on the association between religious service attendance and depression have been mostly cross-sectional, subject to reverse causation, and did not account for the potential feedback between religious service attendance and depression. We prospectively evaluated evidence whether religious service attendance decreased risk of subsequent risk of depression and whether depression increased subsequent cessation of service attendance, while explicitly accounting for feedback with potential effects in both directions. We included a total of 48,984 US nurses who were participants of the Nurses' Health Study with mean age 58 years and who were followed up from 1996 to 2008. Religious service attendance was self-reported in 1992, 1996, 2000, and 2004. Depression was defined as self-reported physician-diagnosed clinical depression, regular anti-depressant use, or severe depressive symptoms. Multivariate logistic regression and marginal structural models were used to estimate the odds ratio of developing incident depression, adjusted for baseline religious service attendance, baseline depression, and time-varying covariates. Compared with women who never attended services, women who had most frequent and recent religious service attendance had the lowest risk of developing depression (odds ratio [OR] = 0.71, 95 % confidence interval [CI] 0.62-0.82). Compared with women who were not depressed, women with depression were less likely to subsequently attend religious services once or more per week (OR = 0.74, 95 % CI 0.68-0.80). In this study of US women, there is evidence that higher frequency of religious service attendance decreased the risk of incident depression and women with depression were less likely to subsequently attend services.

  16. Spontaneous antenatal resolution of canine hydrops fetalis diagnosed by ultrasound.

    Science.gov (United States)

    Hopper, B J; Richardson, J L; Lester, N V

    2004-01-01

    A previously unreported syndrome of transient mid-gestational hydrops fetalis identified by ultrasound was diagnosed in 16 litters of 16 different dogs between November 1999 and May 2002. During this study period, a total of 161 canine pregnancies were diagnosed by ultrasound. A 17th litter of eight fetuses developed similar ultrasonographic changes concurrently with maternal systemic mastocytosis and subsequently spontaneously aborted. No pups were born with clinical signs of hydrops fetalis. Fetal resorption in the affected litters was 7/95 (7.4 per cent) and 8/95 (8.4 per cent) aborted. Of the fetuses that survived to term, there were 7/88 (8 per cent) stillbirths. Neonatal mortality rate in the affected litters was 15 per cent (11/73) and the incidence of congenital abnormalities was 7/73 (9.6 per cent). Pugs were significantly (22.8 times) more likely to be affected than other breeds.

  17. Pregnancy in women with hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Pieper, P. G.; Walker, F.

    Hypertrophic cardiomyopathy (HCM) is increasingly being diagnosed in pregnant women. Women with HCM generally tolerate pregnancy well. The risk is however higher in women who are symptomatic before pregnancy or in those with severe left ventricular outflow tract obstruction. The incidence of

  18. [Noninfectious differential diagnoses of pneumonia].

    Science.gov (United States)

    Wielandner, A; Agarwal, P; Toelly, A; Bardach, C

    2017-01-01

    In patients with a clinical suspicion of pneumonia, typical clinical and laboratory features along with the detection of infiltrates on chest X‑ray are as a rule considered diagnostic and therapy is immediately initiated; however, studies have shown that in up to 5% of patients with an initial suspicion of pneumonia, another noninfectious pulmonary disease was the underlying cause. Early recognition and differentiation of diseases mimicking pneumonia are prerequisites for an adequate therapy. The aim of this review is to present the important noninfectious differential diagnoses of pneumonia and to provide the reader with tools for a systematic diagnostic approach. A literature search was carried out. As alterations in the lungs often result in similar imaging appearances and a differentiation between transudates, exsudates, blood and cells is not feasible by chest X‑ray or CT, a systematic approach is essential to make an appropriate diagnosis. Hence, consideration of the temporal course, predominant pattern, distribution of findings, additional findings and clinical presentation are indispensable.

  19. Challenges in diagnosing mesenteric ischemia.

    Science.gov (United States)

    van den Heijkant, Teun C; Aerts, Bart A C; Teijink, Joep A; Buurman, Wim A; Luyer, Misha D P

    2013-03-07

    Early identification of acute mesenteric ischemia (AMI) is challenging. The wide variability in clinical presentation challenges providers to make an early accurate diagnosis. Despite major diagnostic and treatment advances over the past decades, mortality remains high. Arterial embolus and superior mesenteric artery thrombosis are common causes of AMI. Non-occlusive causes are less common, but vasculitis may be important, especially in younger people. Because of the unclear clinical presentation and non-specific laboratory findings, low clinical suspicion may lead to loss of valuable time. During this diagnostic delay, progression of ischemia to transmural bowel infarction with peritonitis and septicemia may further worsen patient outcomes. Several diagnostic modalities are used to assess possible AMI. Multi-detector row computed tomographic angiography is the current gold standard. Although computed tomographic angiography leads to an accurate diagnosis in many cases, early detection is a persistent problem. Because early diagnosis is vital to commence treatment, new diagnostic strategies are needed. A non-invasive simple biochemical test would be ideal to increase clinical suspicion of AMI and would improve patient selection for radiographic evaluation. Thus, AMI could be diagnosed earlier with follow-up computed tomographic angiography or high spatial magnetic resonance imaging. Experimental in vitro and in vivo studies show promise for alpha glutathione S transferase and intestinal fatty acid binding protein as markers for AMI. Future research must confirm the clinical utility of these biochemical markers in the diagnosis of mesenteric ischemia.

  20. Recurrence of small-for-gestational-age pregnancy: analysis of first and subsequent singleton pregnancies in The Netherlands

    NARCIS (Netherlands)

    Voskamp, Bart Jan; Kazemier, Brenda M.; Ravelli, Anita C. J.; Schaaf, Jelle; Mol, Ben Willem J.; Pajkrt, Eva

    2013-01-01

    OBJECTIVE: Small-for-gestational-age (SGA) neonates are at increased risk of adverse pregnancy outcome. Our objective was to study the recurrence rate of SGA in subsequent pregnancies. STUDY DESIGN: A prospective national cohort study of all women with a structurally normal first and subsequent

  1. Risk of borderline ovarian tumors among women with benign ovarian tumors

    DEFF Research Database (Denmark)

    Guleria, Sonia; Jensen, Allan; Kjær, Susanne K

    2018-01-01

    OBJECTIVE: A growing number of studies suggest that some ovarian cancers can arise from benign and borderline ovarian tumors. However, studies on the association between benign and borderline ovarian tumors are lacking. We studied the overall- and histotype-specific risk of borderline ovarian...... tumors among women with a benign ovarian tumor. METHODS: This nationwide cohort study included all Danish women diagnosed with a benign ovarian tumor (n=139,466) during 1978-2012. The cohort was linked to the Danish Pathology Data Bank and standardized incidence ratios (SIR) with 95% confidence intervals...... (CI) were calculated. RESULTS: Women with benign ovarian tumors had increased risks for subsequent borderline ovarian tumors (SIR 1.62, 95% CI 1.43-1.82), and this applied to both serous (SIR 1.69, 95% CI 1.39-2.03) and mucinous (SIR 1.75, 95% CI 1.45-2.10) histotypes of borderline ovarian tumors...

  2. Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour.

    Science.gov (United States)

    Sivell, Stephanie; Elwyn, Glyn; Edwards, Adrian; Manstead, Antony S R

    2013-08-20

    Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided research on this issue highlight the need for further research into the factors influencing women's choices. An extended Theory of Planned Behaviour (TPB) could provide a basis to understand and predict women's surgery choices. The aims of this study were to understand and predict the surgery intentions and choices of women newly diagnosed with early breast cancer, examining the predictive utility of an extended TPB. Sixty-two women recruited from three UK breast clinics participated in the study; 48 women, newly diagnosed with early breast cancer, completed online questionnaires both before their surgery and after accessing an online decision support intervention (BresDex). Questionnaires assessed views about breast cancer and the available treatment options using items designed to measure constructs of an extended TPB (i.e., attitudes, subjective norms, perceived behavioural control, and anticipated regret), and women's intentions to choose mastectomy or BCS. Objective data were collected on women's choice of surgery via the clinical breast teams. Multiple and logistic regression analyses examined predictors of surgery intentions and subsequent choice of surgery. The extended TPB accounted for 69.9% of the variance in intentions (p subjective norms were significant predictors. Including additional variables revealed anticipated regret to be a more important predictor than subjective norms. Surgery intentions significantly predicted surgery choices (p TPB in predicting and understanding women's surgery intentions and choices for early breast cancer. Understanding these factors should help to identify key components of interventions to support women while considering their surgery

  3. Do Cervical Cancer Patients Diagnosed with Opportunistic Screening Live Longer? An Arkhangelsk Cancer Registry Study

    Directory of Open Access Journals (Sweden)

    Elena E. Roik

    2017-11-01

    Full Text Available The aim of the current study was to compare cervical cancer (СС patients diagnosed with and without screening in terms of: (i sociodemographic and clinical characteristics; (ii factors associated with survival; and (iii, and levels of risk. A registry-based study was conducted using data from the Arkhangelsk Cancer Registry. It included women with newly diagnosed malignant neoplasm of the uterine cervix during the period of 1 January 2005 to 11 November 2016 (N = 1548. The Kaplan-Meier method, the log-rank test, and Cox regression were applied. Most participants who were diagnosed by screening were at stage I and died less frequently from CC than those diagnosed without screening. The latter group was also diagnosed with СС at a younger age and died younger. Younger individuals and urban residents diagnosed with stage I and II, squamous cell carcinoma had longer survival times. Cox regression modeling indicated that the hazard ratio for death among women with CC diagnosed without screening was 1.61 (unadjusted and 1.37 (adjusted. CC diagnosed by screening, cancer stage, patient residence, histological tumor type, and age at diagnosis were independent prognostic variables of longer survival time with CC. Diagnosis of CC made within a screening program improved survival.

  4. Female infertility, infertility-associated diagnoses, and comorbidities: a review.

    Science.gov (United States)

    Hanson, Brent; Johnstone, Erica; Dorais, Jessie; Silver, Bob; Peterson, C Matthew; Hotaling, James

    2017-02-01

    The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1-10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7, 8, 10-20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardiovascular disease and metabolic disorders such as diabetes than the general population [16, 21-26]. Female infertility and associated diagnoses have overall health implications. Beyond treatment of patients' immediate reproductive needs, healthcare professionals must be aware of the broader health impact of specific causes of infertility in order to provide accurate counseling regarding long-term risk.

  5. Caesarean section and subsequent ectopic pregnancy: a systematic review and meta-analysis

    NARCIS (Netherlands)

    O'Neill, S.M.; Khashan, A.S.; Kenny, L.C.; Greene, R.A.; Henriksen, T.B.; Lutomski, J.E.; Kearney, P.M.

    2013-01-01

    BACKGROUND: Caesarean section rates are increasing worldwide, and the long-term effects are unknown. OBJECTIVE: To evaluate the risk of subsequent ectopic pregnancy in women with a previous caesarean section, compared with vaginal delivery. SEARCH STRATEGY: Systematic review of the literature using

  6. Inter- and intra-observer agreement of non-reassuring cardiotocography analysis and subsequent clinical management

    NARCIS (Netherlands)

    Rhose, S.; Heinis, A.M.; Vandenbussche, F.P.; Drongelen, J. van; Dillen, J. van

    2014-01-01

    OBJECTIVE: To quantify inter- and intra-observer agreement of non-reassuring intrapartum cardiotocography (CTG) patterns and subsequent clinical management. DESIGN: Methodological study. SETTING: University Medical Center. POPULATION: CTG patterns of 79 women beyond 37 weeks of gestation with a

  7. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS: We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women...

  8. Weight at birth and subsequent fecundability: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Cathrine Wildenschild

    Full Text Available To examine the association between a woman's birth weight and her subsequent fecundability.In this prospective cohort study, we included 2,773 Danish pregnancy planners enrolled in the internet-based cohort study "Snart-Gravid", conducted during 2007-2012. Participants were 18-40 years old at study entry, attempting to conceive, and were not receiving fertility treatment. Data on weight at birth were obtained from the Danish Medical Birth Registry and categorized as <2,500 grams, 2,500-2,999 grams, 3,000-3,999 grams, and ≥ 4,000 grams. In additional analyses, birth weight was categorized according to z-scores for each gestational week at birth. Time-to-pregnancy measured in cycles was used to compute fecundability ratios (FR and 95% confidence intervals (CI, using a proportional probabilities regression model.Relative to women with a birth weight of 3,000-3,999 grams, FRs adjusted for gestational age, year of birth, and maternal socio-demographic and medical factors were 0.99 (95% CI: 0.73;1.34, 0.99 (95% CI: 0.87;1.12, and 1.08 (95% CI: 0.94;1.24 for birth weight <2,500 grams, 2,500-2,999 grams, and ≥ 4,000 grams, respectively. Estimates remained unchanged after further adjustment for markers of the participant's mother's fecundability. We obtained similar results when we restricted to women who were born at term, and to women who had attempted to conceive for a maximum of 6 cycles before study entry. Results remained similar when we estimated FRs according to z-scores of birth weight.Our results indicate that birth weight appears not to be an important determinant of fecundability.

  9. Workplace bullying and subsequent health problems.

    Science.gov (United States)

    Nielsen, Morten Birkeland; Magerøy, Nils; Gjerstad, Johannes; Einarsen, Ståle

    2014-07-01

    Cross-sectional studies demonstrate that exposure to bullying in the workplace is positively correlated with self-reported health problems. However, these studies do not provide a basis to draw conclusions on the extent to which bullying leads to increased health problems or whether health problems increase the risk of being bullied. To provide better indications of a causal relationship, knowledge from prospective studies on the association between bullying in the workplace and health outcomes is therefore summarised. We conducted a systematic literature review of original articles from central literature databases on longitudinal associations between bullying in the workplace and health. Average associations between bullying and health outcomes are calculated using meta-analysis. A consistent finding across the studies is that exposure to bullying is significantly positively related to mental health problems (OR =1.68; 95% KI 1.35-2.09) and somatic symptoms (OR = 1.77; 95% KI 1.41-2.22) over time. Mental health problems are also associated with subsequent exposure to bullying (OR = 1.74; 95% KI 1.44-2.12). Bullying is positively related to mental health problems and somatic symptoms. The association between mental health problems and subsequent bullying indicates a self-reinforcing process between mental health and bullying. The methodological quality of the studies that were conducted is relatively sound. However, based on the existing knowledge base there are no grounds for conclusions regarding an unambiguous causal relationship between bullying and health.

  10. Validation of hospital discharge diagnoses for hypertensive disorders of pregnancy

    DEFF Research Database (Denmark)

    Møller Luef, Birgitte; Andersen, Louise B; Renault, Kristina Martha

    2016-01-01

    INTRODUCTION: A correct diagnosis of preeclampsia and gestational hypertension is important for treatment and epidemiological studies. Changes in diagnostic criteria and underreporting in certain subsets of patients may hamper validity of the diagnoses. MATERIALS AND METHODS: We validated...... the discharge diagnoses of preeclampsia and gestational hypertension, which are reported to the Danish National Patient Registry, in a cohort of 2163 pregnant women by retrospective evaluation of electronic hospital data. RESULTS: A preeclampsia discharge diagnosis was found in 113 (5.2%) of the participants....... After validation, significantly more patients fulfilled criteria for diagnosis of preeclampsia (n = 163, 7.5%, p = 0.002); more had severe preeclampsia, 14 (0.6%) vs. 70 (3.2%), p preeclampsia...

  11. Social support and subsequent disability: it is not the size of your network that counts.

    Science.gov (United States)

    McLaughlin, Deirdre; Leung, Janni; Pachana, Nancy; Flicker, Leon; Hankey, Graeme; Dobson, Annette

    2012-09-01

    high levels of social support and engagement may help sustain good health and functional ability. However, the definition of social support in previous research has been inconsistent and findings are mixed. The aim of this analysis was to explore the effect of two aspects of social support on subsequent disability in a group of community dwelling older women and men. data were drawn from two concurrent prospective observational cohort studies of community-based older Australian women (N = 2,013) and men (N = 680). Baseline and follow-up data were drawn from the second (1999) and fifth (2008) surveys of the women and the second (2001) and third (2008) surveys of the men. At baseline, social support was measured by the two subscales (social network and subjective support) of the Duke Social Support Index (DSSI). The outcome measure was Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). overall, social network size was not associated with subsequent disability in either women or men. After adjusting for health status at baseline, lack of satisfaction with social support was associated with greater difficulties in ADLs and IADLs for both women and men. our results suggest that the provision of social support is insufficient to limit subsequent disability: support provided must be subjectively perceived to be relevant and adequate.

  12. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    Directory of Open Access Journals (Sweden)

    Schultz Jennifer F

    2010-06-01

    Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar

  13. Investigating vaginal bleeding in postmenopausal women found to have an endometrial thickness of equal to or greater than 10 mm on ultrasonography.

    Science.gov (United States)

    Turnbull, Hilary L; Akrivos, Nikolaos; Simpson, Paul; Duncan, Timothy J; Nieto, Joaquin J; Burbos, Nikolaos

    2017-02-01

    This aim of this study is to determine the risk of endometrial cancer in symptomatic postmenopausal women, when endometrial thickness on transvaginal ultrasonography is equal to or greater than 10 mm, and subsequent office-based endometrial sampling histology is negative. This is a prospective cross-sectional study, performed in a gynaecological oncology centre in the United Kingdom between February 2008 and July 2012. All postmenopausal women presenting with vaginal bleeding were investigated using transvaginal ultrasonography. Women with endometrial thickness measurements equal to or greater than 10 mm and negative office-based endometrial biopsy underwent hysteroscopy and endometrial biopsies. Over a 52-month period, 4148 women were investigated for postmenopausal vaginal bleeding. 588 (14.2%) women were found to have endometrial thickness measurements of equal to or greater than 10 mm on transvaginal ultrasonography. 170 (28.9%) cases of endometrial cancer were diagnosed in this group: 149 (87.6%) of the cancer cases were diagnosed in the outpatient setting with a Pipelle® endometrial sampler, whilst 21 (12.4%) had a negative Pipelle® sample and were diagnosed with hysteroscopy. The group diagnosed with hysteroscopy had lower BMI (32.7 kg/m2 versus 39.7 kg/m2, p < 0.001) whilst the group diagnosed with Pipelle was more likely to have a history of hypertension and diabetes mellitus (p = 0.019 for both). The sensitivity of Pipelle was 87.65%. For women presenting with postmenopausal bleeding and where the endometrial thickness is equal to or greater than 10 mm and Pipelle sampling is negative, hysteroscopic evaluation with directed biopsy is strongly recommended.

  14. Depressive symptomatology at age 75 and subsequent use of health and social services

    DEFF Research Database (Denmark)

    Larsen, Käte; Schroll, Marianne; Avlund, Kirsten

    2005-01-01

    It is well documented that elderly persons are the largest consumers of many health and social services. Consequently it is of interest to identify characteristics of users of those services. The purpose of this study is to examine whether depressive symptoms among men and women at age 75...... (CES-D Scale). Use of health and social services was measured by asking the participants whether they had been hospitalized or used home help during the year before follow-up. Among women, depressive symptoms at age 75 were associated with subsequent use of home help at age 80 (odds ratio (OR) = 2.......5; 95% confidence interval (CI): 1.2-5.0) and marginally associated with subsequent hospitalization (OR = 1.8; 95% CI: 0.96-3.5). None of these results were seen in men. Preventive services should take into account depressive symptoms among elderly women....

  15. Activity recognition from minimal distinguishing subsequence mining

    Science.gov (United States)

    Iqbal, Mohammad; Pao, Hsing-Kuo

    2017-08-01

    Human activity recognition is one of the most important research topics in the era of Internet of Things. To separate different activities given sensory data, we utilize a Minimal Distinguishing Subsequence (MDS) mining approach to efficiently find distinguishing patterns among different activities. We first transform the sensory data into a series of sensor triggering events and operate the MDS mining procedure afterwards. The gap constraints are also considered in the MDS mining. Given the multi-class nature of most activity recognition tasks, we modify the MDS mining approach from a binary case to a multi-class one to fit the need for multiple activity recognition. We also study how to select the best parameter set including the minimal and the maximal support thresholds in finding the MDSs for effective activity recognition. Overall, the prediction accuracy is 86.59% on the van Kasteren dataset which consists of four different activities for recognition.

  16. Excisional treatments of the cervix and effect on subsequent fertility: a retrospective cohort study.

    Science.gov (United States)

    Martyn, Fiona M; McAuliffe, Fionnuala M; Beggan, Caitlin; Downey, Paul; Flannelly, Grainne; Wingfield, Mary B

    2015-02-01

    Concerns exist regarding the impact of excisional treatments for cervical intraepithelial neoplasia (CIN) on subsequent pregnancy outcome yet few studies have addressed fertility following surgery. Retrospective cohort study. Set in the colposcopy service of National Maternity Hospital. A postal questionnaire was sent to 3590 women of reproductive age who attended colposcopy from 2001 to 2007; 1795 of these had at least one excisional treatment (surgical group) and 1795 had no treatment (non-surgical group). Records were reviewed to confirm the clinical details and volume of tissue excised. The main outcome measures were pregnancy and fertility rates as well as time to conception correlated with volume of tissue excised. Students' t-test, Mann-Whitney U-test, spearman correlation and Kruskal-Wallis tests were used during the analysis. 1355 Women (37.7%) responded. 537 Women had no treatment and 818 had at least one excision. A subsequent pregnancy was reported in 730 women (434 surgical and 296 non-surgical groups). No difference was detected between the groups in the reported pregnancy rates (p=0.56), the time to conception (p=0.37) or fertility problems (p=0.89). The volume of the excision did not affect fertility rates or time to conception. There were fewer pregnancies in women following a cold knife cone or more than one LLETZ treatment-significant surgery, (p=0.004) but no difference in their reported time to conception (p=0.54). One excisional treatment for CIN does not appear to affect subsequent fertility. Our study showed no delay in conception and no increased risk of problems conceiving in this group, even when controlling for the volume and depth of tissue removed. Women should be reassured by these results. Further work is required to evaluate the effect of cold knife cone biopsy and repeated LLETZ procedures on subsequent fertility. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Frequency of the HFE C282Y and H63D mutations in Danish patients with clinical haemochromatosis initially diagnosed by phenotypic methods

    DEFF Research Database (Denmark)

    Milman, Nils; Koefoed, Pernille; Pedersen, Palle

    2003-01-01

    diagnosis of clinical idiopathic haemochromatosis was made before blood samples were taken for HFE genotyping. The total series consisted of 58 patients (40 men and 18 women) with a median age of 60 yrs (range 18-74). HFE genotyping was performed by the polymerase chain reaction (PCR) technique. RESULTS...... idiopathic haemochromatosis diagnosed by phenotypic methods (serum transferrin saturation, serum ferritin, liver biopsy and mobilisable body iron stores). In 32 unrelated patients, frozen blood samples were available for genetic analysis. In a subsequent series of 26 unrelated Danish patients, a phenotypic...... appears to be the prevailing cause of clinically overt genetic haemochromatosis. This finding has implications both for the evaluation of patients with iron overload disorders and for the strategy in future population screening surveys....

  18. 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. ...

  19. Subsequent leukaemia in autoimmune disease patients.

    Science.gov (United States)

    Hemminki, Kari; Liu, Xiangdong; Försti, Asta; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

    2013-06-01

    Previous studies have shown that patients diagnosed with some autoimmune (AI) diseases are at an increased risk of leukaemia but limited data are available on survival. We systematically analysed the risks (standardized incidence ratio, SIR) and survival (hazard ratio, HR) in nine types of leukaemia among 402 462 patients hospitalized for any of 33 AI diseases and compared to persons not hospitalized for AI diseases. Risk for all leukaemia was increased after 13 AI diseases and survival was decreased after six AI diseases. SIRs were increased after all AI diseases for seven types of leukaemia, including SIR 1·69 (95% confidence interval (CI): 1·29-2·19) for acute lymphoblastic leukaemia (ALL), 1·85 (95% CI: 1·65-2·07) for acute myeloid leukaemia, 1·68 (95% CI: 1·37-2·04) for chronic myeloid leukaemia, 2·20 (95% CI: 1·69-2·81) for 'other myeloid leukaemia', 2·45 (95% 1·99-2·98) for 'other and unspecified leukaemia', 1·81 (95% CI: 1·11-2·81) for monocytic leukaemia, and 1·36 (95% CI: 1·08-1·69) for myelofibrosis. The HRs were increased for four types of leukaemia, most for myelofibrosis (1·74, 95% CI: 1·33-2·29) and ALL (1·42, 95% CI: 1·03-1·95). Some AI diseases, including rheumatoid arthritis, were associated with increased SIRs and HRs in many types of leukaemia. The present data showed increases in risk and decreases in survival for many types of leukaemia after various AI diseases. Leukaemia is a rare complication in AI disease but findings about this comorbidity at the time of leukaemia diagnosis may help to optimize the treatment and improve survival. © 2013 John Wiley & Sons Ltd.

  20. [Incidence of refractive errors with corrective aids subsequent selection].

    Science.gov (United States)

    Benes, P; Synek, S; Petrová, S; Sokolová, Sidlová J; Forýtková, L; Holoubková, Z

    2012-02-01

    This study follows the occurrence of refractive errors in population and the possible selection of the appropriate type of corrective aids. Objective measurement and subsequent determination of the subjective refraction of the eye is on essential act in opotmetric practice. The file represented by 615 patients (1230 eyes) is divided according to the refractive error of myopia, hyperopia and as a control group are listed emetropic clients. The results of objective and subjective values of refraction are compared and statistically processed. The study included 615 respondents. To determine the objective refraction the autorefraktokeratometer with Placido disc was used and the values of spherical and astigmatic correction components, including the axis were recorded. These measurements were subsequently verified and tested subjectively using the trial lenses and the projection optotype to the normal investigative distance of 5 meters. After this the appropriate corrective aids were then recommended. Group I consists of 123 men and 195 women with myopia (n = 635) of clients with an average age 39 +/- 18,9 years. Objective refraction - sphere: -2,57 +/- 2,46 D, cylinder: -1,1 +/- 1,01 D, axis of: 100 degrees +/- 53,16 degrees. Subjective results are as follows--the value of sphere: -2,28 +/- 2,33 D, cylinder -0,63 +/- 0,80 D, axis of: 99,8 degrees +/- 56,64 degrees. Group II is represented hyperopic clients and consists of 67 men and 107 women (n = 348). The average age is 58,84 +/- 16,73 years. Objective refraction has values - sphere: +2,81 +/- 2,21 D, cylinder: -1,0 +/- 0,94 D; axis 95 degree +/- 45,4 degrees. Subsequent determination of subjective refraction has the following results - sphere: +2,28 +/- 2,06 D; cylinder: -0,49 +/- 0,85 D, axis of: 95,9 degrees +/- 46,4 degrees. Group III consists from emetropes whose final minimum viasual acuity was Vmin = 1,0 (5/5) or better. Overall, this control group is represented 52 males and 71 females (n = 247). The average

  1. Early postpartum discharge and subsequent breastfeeding.

    Science.gov (United States)

    Janson, S; Rydberg, B

    1998-12-01

    Early postpartum discharge of babies was gradually introduced in Sweden in the 1980s on ideological grounds, based on the premise that maternity wards were unnatural settings for mothers and babies and hampered breastfeeding. From about 1990, early discharge was used as a means to reduce costs. The purpose of this study was to examine if mandated early discharge at Central Hospital of Karlstad, Sweden, influenced subsequent breastfeeding. Breastfeeding outcomes of infants up to six months of age of all births in 1993 (n = 3231) were compared with the outcome of newborns in 1990 (n = 1462). Breastfeeding at six months postpartum continued to increase during the early 1990s for both healthy and sick infants, irrespective of whether or not they were discharged early. In infants born in 1995 the breastfeeding rate at six months was 64 percent for healthy newborns and 53 percent for sick newborns. Factors other than the time of discharge, most likely a positive change of attitude in society and vigorous introduction of the Baby Friendly Hospital Initiative, seem to have been more important for successful breastfeeding.

  2. Mental imagery affects subsequent automatic defense responses

    Directory of Open Access Journals (Sweden)

    Muriel A Hagenaars

    2015-06-01

    Full Text Available Automatic defense responses promote survival and appropriate action under threat. They have also been associated with the development of threat-related psychiatric syndromes. Targeting such automatic responses during threat may be useful in populations with frequent threat exposure. Here, two experiments explored whether mental imagery as a pre-trauma manipulation could influence fear bradycardia (a core characteristic of freezing during subsequent analogue trauma (affective picture viewing. Image-based interventions have proven successful in the treatment of threat-related disorders, and are easily applicable. In Experiment 1 43 healthy participants were randomly assigned to an imagery script condition. Participants executed a passive viewing task with blocks of neutral, pleasant and unpleasant pictures after listening to an auditory script that was either related (with a positive or a negative outcome or unrelated to the unpleasant pictures from the passive viewing task. Heart rate was assessed during script listening and during passive viewing. Imagining negative related scripts resulted in greater bradycardia (neutral-unpleasant contrast than imagining positive scripts, especially unrelated. This effect was replicated in Experiment 2 (N = 51, again in the neutral-unpleasant contrast. An extra no-script condition showed that bradycardia was not induced by the negative related script, but rather that a positive script attenuated bradycardia. These preliminary results might indicate reduced vigilance after unrelated positive events. Future research should replicate these findings using a larger sample. Either way, the findings show that highly automatic defense behavior can be influenced by relatively simple mental imagery manipulations.

  3. General anaesthesia-induced anaphylaxis: impact of allergy testing on subsequent anaesthesia.

    Science.gov (United States)

    Trautmann, A; Seidl, C; Stoevesandt, J; Seitz, C S

    2016-01-01

    Immunoglobulin E-mediated allergy to drugs and substances used during general anaesthesia as well as non-allergic drug hypersensitivity reactions may account for anaesthesia-induced anaphylaxis. As IgE-mediated anaphylaxis is a potentially life-threatening reaction, identification of the culprit allergen is essential to avoid anaphylaxis recurrence during subsequent general anaesthesia. To study whether preventive recommendations derived from allergy testing after intraoperative anaphylaxis were followed in subsequent general anaesthesia. Results of standardized allergy testing after anaesthesia-induced anaphylaxis and outcome of subsequent general anaesthesia were analysed retrospectively. Fifty-three of 107 patients were diagnosed with IgE-mediated allergy to a drug or substance used during general anaesthesia, and 54 patients were test negative. Twenty-eight of 29 allergy patients tolerated subsequent general anaesthesia uneventfully. One patient with cefazolin allergy suffered from anaphylaxis recurrence due to accidental reapplication of cefazolin. Twenty-two of 24 test-negative patients tolerated subsequent general anaesthesia, whereas two patients again developed anaphylaxis despite pre-medication regimens. Our results confirm the practical impact of allergy testing in general anaesthesia-induced anaphylaxis. By identification of the allergen, it is possible to avoid allergic anaphylaxis during subsequent anaesthesia. In most cases, recommended pre-medication seems to prevent the recurrence of non-allergic drug hypersensitivity reactions. © 2015 John Wiley & Sons Ltd.

  4. Prevalence and associated factors of incidentally diagnosed ...

    African Journals Online (AJOL)

    Background: Prostatic carcinoma carries a high morbidity and mortality if it is not diagnosed early. In resource limited countries, patients are at increased risk of being diagnosed late as they are operated for presumed benign prostatic hyperplasia. The information on the magnitude and risk factors of this problem in

  5. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open ... Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation ...

  6. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... are pelvic floor disorders diagnosed? Skip sharing on social media links Share this: Page Content A physical exam may be all that is needed to diagnose a PFD. In some cases, a woman’s health care provider will see or feel a bulge ...

  7. De dokter en de diagnose-verzamelaar

    NARCIS (Netherlands)

    Geersing, Geert-Jan

    2015-01-01

    In the course of the medical curriculum, medical students are trained to recognise diagnoses. They classify these in their minds, together with detailed information on laboratory and imaging tests, as collections of diagnoses. The downside of this could be overdiagnosis. This paper describes some of

  8. FLOW (finding lasting options for women)

    Science.gov (United States)

    Howard, Courtney; Rose, Caren Lee; Trouton, Konia; Stamm, Holly; Marentette, Danielle; Kirkpatrick, Nicole; Karalic, Sanja; Fernandez, Renee; Paget, Julie

    2011-01-01

    Abstract Objective To determine whether menstrual cups are a viable alternative to tampons. Design Randomized controlled trial. Setting Prince George, Victoria, and Vancouver, BC. Participants A total of 110 women aged 19 to 40 years who had previously used tampons as their main method of menstrual management. Intervention Participants were randomized into 2 groups, a tampon group and a menstrual cup group. Using online diaries, participants tracked 1 menstrual cycle using their regular method and 3 menstrual cycles using the method of their allocated group. Main outcome measures Overall satisfaction; secondary outcomes included discomfort, urovaginal infection, cost, and waste. Results Forty-seven women in each group completed the final survey, 5 of whom were subsequently excluded from analysis (3 from the tampon group and 2 from the menstrual cup group). Overall satisfaction on a 7-point Likert scale was higher for the menstrual cup group than for the tampon group (mean [standard deviation] score 5.4 [1.5] vs 5.0 [1.0], respectively; P = .04). Approximately 91% of women in the menstrual cup group said they would continue to use the cup and recommend it to others. Women used a median of 13 menstrual products per cycle, or 169 products per year, which corresponds to approximately 771 248 400 products used annually in Canada. Estimated cost for tampon use was $37.44 a year (similar to the retail cost of 1 menstrual cup). Subjective vaginal discomfort was initially higher in the menstrual cup group, but the discomfort decreased with continued use. There was no significant difference in physician-diagnosed urovaginal symptoms between the 2 groups. Conclusion Both of the menstrual management methods evaluated were well tolerated by subjects. Menstrual cups are a satisfactory alternative to tampons and have the potential to be a sustainable solution to menstrual management, with moderate cost savings and much-reduced environmental effects compared with tampons. Trial

  9. Signs and symptoms of temporomandibular disorders in women and men.

    Science.gov (United States)

    Ferreira, Claudia Lúcia Pimenta; Silva, Marco Antônio Moreira Rodrigues da; Felício, Cláudia Maria de

    2016-01-01

    Women are more likely to present temporomandibular disorders (TMD); however, studies comparing genders in Brazilian samples are rare. To analyze the proportion of men and women, as well as the association between gender and age, problem duration, and TMD symptoms in patients admitted to an university clinic for treatment. Interview and assessment data of protocols from 1,000 patients diagnosed with TMD were collected and analyzed and then divided into two groups, male (n = 177) and female (n = 823). The exploratory analysis was based on contingency tables and χ2 test was carried out. Subsequently, the logistic regression model was used and the odds ratios (OR) concerning the evaluated comparisons were calculated. Females were more prevalent in the sample, and mean ages and TMD duration were similar between the groups, with higher occurrence in young adults (19 to 40 years old). The OR values showed an association between the female gender and the signs/symptoms of pain in the temporomandibular joint, pain in the facial muscles, neck and shoulders, headache, fatigue in the muscles of mastication, otologic symptoms, and dysphonia. Women had two times higher chances of presenting these symptoms than men. In the sample of Brazilian patients with TMD, the number of women who presented a higher prevalence of painful symptoms was greater, followed by otologic symptoms and complaints of dysphonia. The prevalence of joint noise was similar in both studied groups.

  10. Pregnancy complications in women with polycystic ovary syndrome.

    Science.gov (United States)

    Palomba, Stefano; de Wilde, Marlieke A; Falbo, Angela; Koster, Maria P H; La Sala, Giovanni Battista; Fauser, Bart C J M

    2015-01-01

    The great majority of studies performed so far concerning women diagnosed with polycystic ovary syndrome (PCOS) have focused on diagnosis, menstrual cycle abnormalities, hirsutism and infertility. Although progress has been made in developing methods for achieving a pregnancy and reducing multiple gestations in women with PCOS, little attention has been paid to pregnancy complications and subsequent child outcomes. This review aims to summarize current knowledge regarding the clinical and pathophysiological features of pregnancy and children in women with PCOS. A literature search up to April 2015 was performed in PubMed, Medline, the Cochrane Library and Web of Science without language restriction. All articles were initially screened for title and abstract and full texts of eligible articles were subsequently selected. Systematic reviews with meta-analysis were initially included for each specific subject. Recent randomised controlled trials (RCTs), which were not included in the systematic reviews, were also included. In addition to evidence from meta-analyses or RCTs, we used non-randomized prospective, uncontrolled prospective, retrospective and experimental studies. When specific data for patients with PCOS were lacking, results from general population studies were reported. Women with PCOS exhibit a clinically significant increased risk of pregnancy complications compared with controls. Data which were not adjusted for BMI or other confounders demonstrated in PCOS a 3-4-fold increased risk of pregnancy-induced hypertension and pre-eclampsia, a 3-fold increased risk of gestational diabetes and 2-fold higher chance for premature delivery. Features characteristic of PCOS, such as hyperandrogenism, obesity, insulin resistance and metabolic abnormalities, may contribute to the increased risk of obstetric and neonatal complications. Limited available data suggest that offspring of women with PCOS have an increased risk for future metabolic and reproductive

  11. Breast Cancer Surgery Decision-Making and African-American Women.

    Science.gov (United States)

    Schubart, Jane R; Farnan, Michelle A; Kass, Rena B

    2015-09-01

    Prior research has used focus group methodology to investigate cultural factors impacting the breast cancer experience of women of various ethnicities including African-Americans; however, this work has not specifically addressed treatment decision-making. This study identifies key issues faced by African-American women diagnosed with breast cancer regarding treatment decisions. We used an interpretive-descriptive study design based on qualitative data from three focus groups (n = 14) representing a population of African-American women in central Pennsylvania. Participants were asked to think back to when they were diagnosed with breast cancer and their visit with the breast surgeon. Questions were asked about the actual visit, treatment choices offered, sources of information, and whether the women felt prepared for the surgery and subsequent treatments. The prompts triggered memories and encouraged open discussion. The most important themes identified were fear across the breast cancer disease trajectory, a preference for visual information for understanding the diagnosis and surgical treatment, and support systems relying on family and friends, rather than the formal health-care system. Our results have implications for practice strategies and development of educational interventions that will help breast cancer patients better understand their diagnosis and treatment options, encourage their participation in treatment decision-making, and provide psychosocial support for those at high risk for emotional distress.

  12. Sexual Dysfunction in Primary Care: An Exploratory Descriptive Analysis of Medical Record Diagnoses.

    Science.gov (United States)

    Heiden-Rootes, Katie M; Salas, Joanne; Gebauer, Sarah; Witthaus, Matthew; Scherrer, Jeffrey; McDaniel, Kristin; Carver, Dasha

    2017-11-01

    The prevalence of sexual dysfunction (SDx) diagnoses in primary care settings is not well known, which is a concern because of the high prevalence of comorbid chronic health conditions in patients diagnosed with SDx. To explore the relation of SDx diagnosis, chronic health conditions, and prescription medications commonly associated with SDx for men and women in primary care using medical records diagnoses. Exploratory descriptive analyses were used to interpret secondary data from a primary care patient database. The database included patient data from 3 family and internal medicine clinics in the St Louis metropolitan area from July 1, 2008 to June 30, 2015. Analysis included key demographic variables, chronic illness, and health conditions of hypertension, pain, prostate disorder, menopause, substance abuse, depression, anxiety, and associated medications. Analysis of the database yielded 30,627 adult patients (men: n = 12,097, mean age = 46.8 years, 65.6% white race; women: n = 18,530, mean age = 46.6 years, 59.2% white race) with significant comorbid associations between SDx and other chronic illness, health conditions, and medication prescription. Depression, anxiety, pain, hypertension, diabetes, and psychotropic medication use were significantly associated with SDx for men and women. Examination of specific SDx diagnoses showed erectile dysfunction to be significantly associated with all tested variables for men. For women, pain-related SDx diagnoses were associated more with chronic illness, health conditions, and medication use than were psychosexual SDx diagnoses (eg, orgasm), except for menopause. Prevalence varied by sex, with a higher prevalence rate of any SDx for men (13.5%) than for women (1.0%), although sex comparisons were not part of the analytics. This study suggests the diagnosis of SDx is closely associated with other common chronic illness and health conditions and could go underdiagnosed in women in primary care. The cross

  13. A phase 2a multicenter, double-blind, placebo-controlled, crossover trial to investigate the efficacy, safety, and toleration of CP-866,087 (a high-affinity mu-opioid receptor antagonist) in premenopausal women diagnosed with female sexual arousal disorder (FSAD)

    DEFF Research Database (Denmark)

    Orri, Miguel; Abraham, Lucy; Giraldi, Annamaria

    2013-01-01

    Female sexual arousal disorder (FSAD) is a condition that can affect women of all ages and have a significant negative impact on emotional well-being.......Female sexual arousal disorder (FSAD) is a condition that can affect women of all ages and have a significant negative impact on emotional well-being....

  14. Subclinical atherosclerosis and subsequent cognitive function.

    Science.gov (United States)

    Rossetti, Heidi C; Weiner, Myron; Hynan, Linda S; Cullum, C Munro; Khera, Amit; Lacritz, Laura H

    2015-07-01

    To examine the relationship between measures of subclinical atherosclerosis and subsequent cognitive function. Participants from the Dallas Heart Study (DHS), a population-based multiethnic study of cardiovascular disease pathogenesis, were re-examined 8 years later (DHS-2) with the Montreal Cognitive Assessment (MoCA); N = 1904, mean age = 42.9, range 8-65. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status. A significant linear trend of successively lower MoCA scores with increasing numbers of atherosclerotic indicators was observed (F(3, 1150) = 5.918, p = .001). CAC was weakly correlated with MoCA scores (p = .047) and MoCA scores were significantly different between participants with and without CAC (M = 22.35 vs 23.69, p = 0.038). With the exception of a small association between abdominal AWT and MoCA in subjects over age 50, abdominal AWT and abdominal aortic plaque did not correlate with MoCA total score (p ≥ .052). Cognitive scores and atherosclerosis measures were not impacted by ApoE4 status (p ≥ .455). In this ethnically diverse population-based sample, subclinical atherosclerosis was minimally associated with later cognitive function in middle-aged adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Concoradance of clinical and neurophysiologic diagnoses of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Martić Vesna

    2015-01-01

    Full Text Available Introduction/Aim. Clinical presentation and neurophysiological examination are crucial in diagnosing carpal tunnel syndrome (CTS. The aim of this study was to determine sensitivity and specificity of clinical examination for diagnosing of CTS in relation to neurophysiological evaluation. Methods. The sample included 181 patients referred to the neurologist for further diagnosis of pain and parestesias in the arm (81 women and 100 men mean age 42 ± 14 years and 52 ± 16 years, respectively. All the patients were neurophysiologicly tested. Results. Out of 181 patients, clinical findings were considered positive for CTS in 37 patients. The neurophysiological findings for CTS were positive in 60 patients. Both clinical and neurophysiological findings were positive in 31 patients and both findings were negative in 115 patients (sensitivity 0,51; specificity 0,95. Conclusion. Low sensitivity and high specificity suggest that it is easier to exclude rather than to accurately diagnose CTS based on clinical examination alone. Thus, there is the need for neurophysiological evaluation of patients with complains in the arm.

  16. [Subsequent pregnancy outcomes after first pregnancy with severe preeclampsia and delivery before 34 weeks of gestation].

    Science.gov (United States)

    Lemonnier, M; Beucher, G; Morello, R; Herlicoviez, M; Dreyfus, M; Benoist, G

    2013-04-01

    Women who had severe preeclampsia are at high risk of gestational vascular complications (preeclampsia, gestational hypertension, fetal death, small for gestational age, placenta abruptio) in subsequent pregnancies. The aim of this study was to describe outcomes of subsequent pregnancy after severe preeclampsia with delivery before 34 weeks of gestation during the first pregnancy. One hundred and thirty-four primiparous women delivered before 34 weeks of gestation resulting in severe preeclampsia between January 2002 and December 2009. The data of the index pregnancy were identified from the medical record of our maternity, those of the subsequent pregnancy from paper or computerized medical records of the hospitals where deliveries took place. Our study ended on December 31 2011 for a decrease of at least 2 years after the index pregnancy. Of the 75 subsequent pregnancies, 59 have been studied. Twenty patients (34%) had gestational vascular complications, in type of gestational hypertension alone (10%), preeclampsia (65%), isolated small for gestational age (20%) or fetal death (5%). Thirty-nine patients (66%) showed no recurrence of gestational vascular complications but only 33 patients (56%) had a pregnancy of course totally physiological. The only risk factor for recurrent gestational vascular complications in subsequent pregnancy was a long time interval between two pregnancies, with an increased risk in case of delay beyond 26 months. Women with a history of severe preeclampsia with delivery before 34 weeks of gestation during first pregnancy are at increased risk for gestational vascular complications during the next pregnancy. A close obstetrical monitoring is recommended during a subsequent pregnancy. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  17. Fear of Success in Gay Women.

    Science.gov (United States)

    Itzkowitz, Stuart; Petrie, Donna

    1982-01-01

    Compared gay women (N=11) with heterosexual women (N=12) for frequency of high and low fear of success responses. Probability analysis determined the two groups differed significantly, with gay women evidencing less fear of success than expected. Devised a continuum of kinds of responses with subsequent analysis. (Author)

  18. Hair loss in women.

    Science.gov (United States)

    Harfmann, Katya L; Bechtel, Mark A

    2015-03-01

    Hair loss is a common cause of morbidity for many women. As a key member of the woman's health care team, the obstetrician/gynecologist may be the first person to evaluate the complaint of hair loss. Common types of nonscarring hair loss, including female pattern hair loss and telogen effluvium, may be diagnosed and managed by the obstetrician/gynecologist. A systematic approach to diagnosis and management of these common forms of hair loss is presented.

  19. Misdiagnosed HIV infection in pregnant women initiating universal ART in South Africa.

    Science.gov (United States)

    Hsiao, Nei-Yuan; Zerbe, Allison; Phillips, Tamsin K; Myer, Landon; Abrams, Elaine J

    2017-08-29

    Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few. We examined the accuracy of RDT diagnosis among HIV-infected pregnant women attending public sector antenatal services in Cape Town, South Africa. We describe the proportion of women found to have started on ART erroneously due to FP RDT results based on pre-ART viral load (VL) testing and enzyme-linked immunosorbent assay (ELISA). We analysed 952 consecutively enrolled pregnant women diagnosed as HIV infected based on two RDTs per local guideline and found 4.5% (43/952) of pre-ART VL results to be women who had detectable virus on subsequent VL measurements, ELISA was performed on the 37 remaining women. Of these, 3/952 (0.3%) HIV RDT diagnoses were found to be FP. We estimate that using ELISA to confirm all positive RDTs would cost $1110 (uncertainty interval $381-$5382) to identify one patient erroneously initiated on ART, while it costs $3912 for a lifetime of antiretrovirals with VL monitoring for one person. Compared to the cost of confirming the RDT-based diagnoses, the cost of HIV misdiagnosis is high. While testing programmes based on RDT should strive for constant quality improvement, where resources permit, laboratory confirmation algorithms can play an important role in strengthening the quality of HIV diagnosis in the era of universal ART.

  20. Mode of delivery and the probability of subsequent childbearing: a population-based register study.

    Science.gov (United States)

    Elvander, C; Dahlberg, J; Andersson, G; Cnattingius, S

    2015-11-01

    To investigate the relationship between mode of first delivery and probability of subsequent childbearing. Population-based study. Nationwide study in Sweden. A cohort of 771 690 women who delivered their first singleton infant in Sweden between 1992 and 2010. Using Cox's proportional-hazards regression models, risks of subsequent childbearing were compared across four modes of delivery. Hazard ratios (HRs) were calculated, using 95% confidence intervals (95% CIs). Probability of having a second and third child; interpregnancy interval. Compared with women who had a spontaneous vaginal first delivery, women who delivered by vacuum extraction were less likely to have a second pregnancy (HR 0.96, 95% CI 0.95-0.97), and the probabilities of a second childbirth were substantially lower among women with a previous emergency caesarean section (HR 0.85, 95% CI 0.84-0.86) or an elective caesarean section (HR 0.82, 95% CI 0.80-0.83). There were no clinically important differences in the median time between first and second pregnancy by mode of first delivery. Compared with women younger than 30 years of age, older women were more negatively affected by a vacuum extraction with respect to the probability of having a second child. A primary vacuum extraction decreased the probability of having a third child by 4%, but having two consecutive vacuum extraction deliveries did not further alter the probability. A first delivery by vacuum extraction does not reduce the probability of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section. © 2014 Royal College of Obstetricians and Gynaecologists.

  1. Preeclampsia: A risk factor for gestational diabetes mellitus in subsequent pregnancy.

    Directory of Open Access Journals (Sweden)

    Joohyun Lee

    Full Text Available Preeclampsia and gestational diabetes (GDM have several mechanisms in common. The aim of this study was to determine whether women with preeclampsia have an increased risk of GDM in a subsequent pregnancy. Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2007-2012. Patients who had their first delivery in 2007 and a subsequent delivery between 2008 and 2012 in Korea were enrolled. A model of multivariate logistic regression analysis was performed with GDM as the final outcome to evaluate the risk of GDM in the second pregnancy. Among the 252,276 women who had their first delivery in 2007, 150,794 women had their second delivery between 2008 and 2012. On the multivariate regression analysis, women with preeclampsia alone in the first pregnancy had an increased risk of GDM in the second pregnancy when compared with women who had neither of these conditions in their first pregnancy (OR 1.2, 95% CI, 1.1-1.3. Women with GDM alone in the first pregnancy were at an increased risk for GDM in the second pregnancy (OR 3.3, 95% CI 3.1-3.4. The co-presence of preeclampsia and GDM in the first pregnancy further increased the risk of GDM in the second pregnancy (OR 5.9, 95% CI, 4.0-8.6. Our study showed that a history of preeclampsia may serve as an additional risk factor for GDM in a subsequent pregnancy.

  2. Diagnoses and visit length in complementary and mainstream medicine

    Directory of Open Access Journals (Sweden)

    de Groot Judith

    2010-01-01

    Full Text Available Abstract Background The demand for complementary medicine (CM is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. Methods Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs participating in the second Dutch national study in general practice (DNSGP-2. Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. Results The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. Conclusions CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to

  3. A prospective cohort study of endometriosis and subsequent risk of infertility

    Science.gov (United States)

    Prescott, J.; Farland, L.V.; Tobias, D.K.; Gaskins, A.J.; Spiegelman, D.; Chavarro, J.E.; Rich-Edwards, J.W.; Barbieri, R.L.; Missmer, S.A.

    2016-01-01

    STUDY QUESTION Is there a temporal relationship between endometriosis and infertility? SUMMARY ANSWER Endometriosis is associated with a higher risk of subsequent infertility, but only among women age infertile women undergoing laparoscopic examination. Whether endometriosis is a cause of infertility or an incidental discovery during the infertility examination is unknown. STUDY DESIGN, SIZE, DURATION This study included data collected from 58 427 married premenopausal female nurses infertility risk (defined as attempting to conceive for >12 months) among women with and without endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE We identified 4612 incident cases of infertility due to any cause over 362 219 person-years of follow-up. Compared with women without a history of endometriosis, women with endometriosis had an age-adjusted 2-fold increased risk of incident infertility (HR = 2.12, 95% CI = 1.76–2.56) that attenuated slightly after accounting for parity. The relationship with endometriosis was only observed among women infertility was similar subsequent to endometriosis diagnosis. Among women with primary infertility, 50% became parous after the endometriosis diagnosis, and among all women with endometriosis, 83% were parous by age 40 years. LIMITATIONS, REASONS FOR CAUTION We did not have information on participants' intentions to conceive, but by restricting the analytic population to married women we increased the likelihood that pregnancies were planned (and therefore infertility would be recognized). Women in our cohort with undiagnosed asymptomatic endometriosis will be misclassified as unexposed. However, the small proportion of these women are diluted among the >50 000 women accurately classified as endometriosis-free, minimizing the impact of exposure misclassification on the effect estimates. WIDER IMPLICATIONS OF THE FINDINGS This study supports a temporal association between endometriosis and infertility risk. Our prospective analysis indicates

  4. Increase in depression diagnoses and prescribed antidepressants among young girls. A national cohort study 2000-2013

    DEFF Research Database (Denmark)

    Skovlund, Charlotte Wessel; Kessing, Lars Vedel; Mørch, Lina Steinrud

    2017-01-01

    AIMS: To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS: Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression...... diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS: The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses...... and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression...

  5. Pregnancy in women with a history of Kawasaki disease: management and outcomes.

    Science.gov (United States)

    Gordon, C T; Jimenez-Fernandez, S; Daniels, L B; Kahn, A M; Tarsa, M; Matsubara, T; Shimizu, C; Burns, J C; Gordon, J B

    2014-10-01

    To characterise the obstetrical management and outcomes in a series of women with a history of Kawasaki disease (KD) in childhood. Retrospective case series. Tertiary healthcare setting in the USA. Women with a history of KD in childhood. Women completed a detailed health questionnaire and participated in research imaging studies as part of the San Diego Adult KD Collaborative Study. Obstetrical management, complications during pregnancy and delivery, and infant outcomes. Ten women with a history of KD in childhood carried a total of 21 pregnancies to term. There were no cardiovascular complications during labour and delivery despite important cardiovascular abnormalities in four of the ten subjects. Pregnancy was complicated by pre-eclampsia and the post-partum course was complicated by haemorrhage in one subject each. Two of the 21 progeny subsequently developed KD. Women with important cardiovascular sequelae from KD in childhood should be managed by a team that includes both a maternal-fetal medicine specialist and a cardiologist. Pre-pregnancy counselling should include delineation of the woman's current functional and structural cardiovascular status and appropriate adjustment of medications, but excellent outcomes are possible with appropriate care. Review of the English and Japanese literature on KD and pregnancy revealed the occurrence of myocardial infarction during pregnancy in women with missed KD and aneurysms that were not diagnosed until their acute event. Our study highlights the need for counselling with regard to the increased genetic risk of KD in offspring born to these mothers. © 2014 Royal College of Obstetricians and Gynaecologists.

  6. Human Papilloma Virus and Cervical Cancer Education Needs among HIV-Positive Haitian Women in Miami.

    Science.gov (United States)

    Kenya, Sonjia; Carrasquillo, Olveen; Fatil, Marie; Jones, Jamal; Jean, Chrystelle; Huff, India; Kobetz, Erin

    2015-01-01

    Haitian immigrant women, the largest growing Black ethnic group in Miami, experience the highest rates of cervical cancer and account for one of the largest populations diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in South Florida. Using community-based participatory research methods, we conducted a pilot study to examine human papilloma virus (HPV)/cervical cancer knowledge and identify intervention preferences among HIV positive Haitian women. Community health workers conducted three focus groups with 21 HIV-positive Haitian women. All sessions were conducted in Haitian Kreyol, digitally recorded, and subsequently interpreted and transcribed into English. The first focus group assessed HPV/cervical cancer knowledge, the second session explored HPV/cervical cancer considerations specific to HIV-positive women, and the third focus group discussed HPV/cervical cancer screening and intervention preferences. Data analysis was guided by a grounded theory approach. Our sample had limited HPV/cervical cancer knowledge. Misconceptions about screening, transmission, and treatment were common. Participants felt that stigma by providers impacted negatively the care they received and that stigma by the community diminished social support. Strong support for culturally tailored interventions to improve HPV/cervical cancer knowledge was expressed. Although no participants had participated in research previously, all were willing to participate in future trials. There is critical need for culturally relevant interventions to improve HPV/cervical cancer knowledge among HIV-positive Haitian women. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. Prevalence of glucose intolerance at 6 weeks postpartum in Indian women with gestational diabetes mellitus.

    Science.gov (United States)

    Jindal, Radhika; Siddiqui, Mohammad A; Gupta, Nitin; Wangnoo, Subhash K

    2015-01-01

    Women with a history of gestational diabetes mellitus (GDM) have an increased risk for future glucose intolerance, and should be followed up with subsequent screening for the development of diabetes or pre-diabetes at 6-12 weeks postpartum. We studied the prevalence of glucose intolerance at 6 weeks postpartum in Indian women with GDM diagnosed according to ADA criteria. This longitudinal study, conducted at a tertiary care centre, included 75 Asian-Indian women aged ≥18 years, with a diagnosis of GDM (as per ADA criteria), who were referred to the Endocrine Department at Indraprastha Apollo Hospital, Delhi. A 2-h 75 g oral glucose tolerance test (OGTT) was performed at 6 weeks postpartum. Out of the 75 women who had GDM and were recommended an OGTT at 6 weeks postpartum, 17.3% did not return for the test. Out of 62 women, one-third (33.8%) developed an abnormal OGTT at 6 weeks postpartum, while 66.1% had reverted to normal glucose tolerance. Impaired fasting glucose (IFG) was seen in 14.5%, 4.8% had impaired glucose tolerance (IGT), 8% had both IFG and IGT, and 6.4% had overt type 2 diabetes. Our study emphasizes the need for compulsory follow up OGTT for women with GDM in our part of the world in view of ethnicity and prevailing socio-cultural factors. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  8. Sickness absence due to specific mental diagnoses and all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants of Sweden.

    Directory of Open Access Journals (Sweden)

    Ellenor Mittendorfer-Rutz

    Full Text Available BACKGROUND: Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality. METHODS: A cohort of all 4 857 943 individuals living in Sweden on 31.12.2004 (aged 16-64 years, not sickness absent, or on retirement or disability pension, was followed from 01.01.2005 through 31.12.2008 for all-cause and cause-specific mortality (suicide, cancer, circulatory disease through linkage of individual register data. Individuals with at least one new sick-leave spell with a mental