Pub Date : 2021-01-01DOI: 10.26502/fjwhd.2644-28840069
Jeffrey D Miller, A. Vilalta, Kathleen A Troeger
Objectives: Consensus U.S. cervical cancer screening guidelines recommend women aged 30–65 years should be screened: (1) every 5 years with high-risk HPV testing alone; or (2) every 5 years with Pap and highrisk HPV co-testing; or (3) every 3 years with Pap alone. However, nearly 1-in-5 cancers (18.6%) are missed by HPV testing alone and 12.2% of cancers are missed by Pap testing alone. Hence, co-testing is the preferred screening method, but the cost implications are not fully known. For deeper understanding, we performed updated clinical-economic comparisons of cervical cancer screening with co-testing versus primary HPV from a U.S. perspective. Methods: A health state transition (Markov) model with one-year cycling was previously developed using epidemiologic, clinical, and economic data from healthcare databases and published literature. After updating the model, it was used to perform simulations of women receiving either 3-year or 5-year interval cervical cancer screening with either co-testing or HPV primary, starting from age 30 years and running up through age 64 years. Outcomes included total and incremental differences in costs, number of referral colposcopies (true and false positive), invasive cervical cancer (ICC) cases, ICC deaths, and quality-adjusted life years (QALYs) for cost-effectiveness calculations. J Women’s Health Dev 2021; 4 (4): 151-162 DOI: 10.26502/fjwhd.2644-28840069 Journal of Women’s Health and Development Volume 4 No 4 – December 2021 152 Results: In the 3-year and 5-year screening interval scenarios, per-patient cumulative costs of screening and management over 35 years with co-testing versus HPV primary led to cost savings of $15 and $217, respectively. These cost saving resulted from fewer referral colposcopies, fewer ICC cases, and fewer ICC deaths. Co-testing also conferred more QALYs. Costeffectiveness calculations showed co-testing as the economically dominant screening strategy by simultaneously confers greater effectiveness (i.e., more QALYs) at lower cost compared with HPV primary. National average annual cost savings of $154 to $655 million could be realized if every woman in the U.S. was routinely screened with co-testing instead of HPV primary. Conclusions: Model results demonstrate that cervical cancer screening with co-testing provides valuable clinical and economic outcomes when compared to primary HPV testing alone. These findings are relevant to healthcare payers and women’s health policy advocates seeking cost-effective cervical cancer screening options.
{"title":"Revisiting the Cost-Effectiveness of HPV Co-Testing Versus Primary HPV Testing for Cervical Cancer Screening","authors":"Jeffrey D Miller, A. Vilalta, Kathleen A Troeger","doi":"10.26502/fjwhd.2644-28840069","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-28840069","url":null,"abstract":"Objectives: Consensus U.S. cervical cancer screening guidelines recommend women aged 30–65 years should be screened: (1) every 5 years with high-risk HPV testing alone; or (2) every 5 years with Pap and highrisk HPV co-testing; or (3) every 3 years with Pap alone. However, nearly 1-in-5 cancers (18.6%) are missed by HPV testing alone and 12.2% of cancers are missed by Pap testing alone. Hence, co-testing is the preferred screening method, but the cost implications are not fully known. For deeper understanding, we performed updated clinical-economic comparisons of cervical cancer screening with co-testing versus primary HPV from a U.S. perspective. Methods: A health state transition (Markov) model with one-year cycling was previously developed using epidemiologic, clinical, and economic data from healthcare databases and published literature. After updating the model, it was used to perform simulations of women receiving either 3-year or 5-year interval cervical cancer screening with either co-testing or HPV primary, starting from age 30 years and running up through age 64 years. Outcomes included total and incremental differences in costs, number of referral colposcopies (true and false positive), invasive cervical cancer (ICC) cases, ICC deaths, and quality-adjusted life years (QALYs) for cost-effectiveness calculations. J Women’s Health Dev 2021; 4 (4): 151-162 DOI: 10.26502/fjwhd.2644-28840069 Journal of Women’s Health and Development Volume 4 No 4 – December 2021 152 Results: In the 3-year and 5-year screening interval scenarios, per-patient cumulative costs of screening and management over 35 years with co-testing versus HPV primary led to cost savings of $15 and $217, respectively. These cost saving resulted from fewer referral colposcopies, fewer ICC cases, and fewer ICC deaths. Co-testing also conferred more QALYs. Costeffectiveness calculations showed co-testing as the economically dominant screening strategy by simultaneously confers greater effectiveness (i.e., more QALYs) at lower cost compared with HPV primary. National average annual cost savings of $154 to $655 million could be realized if every woman in the U.S. was routinely screened with co-testing instead of HPV primary. Conclusions: Model results demonstrate that cervical cancer screening with co-testing provides valuable clinical and economic outcomes when compared to primary HPV testing alone. These findings are relevant to healthcare payers and women’s health policy advocates seeking cost-effective cervical cancer screening options.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91275092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.21203/rs.3.rs-83574/v1
Jian-fa Wang, Zhi Zhu, Lei Sun, Shimeng Shao, Baoyu Ma, Yaofeng Wang, R. Jin, Hongbo Hao, Han Yue
Objective: We aimed to determine the significance of MSC-derived exosomes (MSC-Exos) in chondrocyte autophagy under normal and inflammatory conditions.Design: Human umbilical cord-derived MSCs (hMSCs) were cultured in vitro. hMSC-Exos( EX） were isolated by an ultracentrifugation method. Transmission electron microscopy and western analysis were used to identify exosomes. Human chondrocytes were extracted from five adult males with OA undergoing total knee arthroplasty. Primary cultures of chondrocytes from OA patients were stimulated with 50 ng/ml tumor necrosis factor-α (TNF-α) in the presence or absence of hMSC-Exos. Autophagy levels were determined based on expression of autophagic marker LC3, StubRFP-SensGFP-LC3 analysis, and electron microscopy. Catabolic gene and chemokine expression were evaluated using quantitative PCR. The NF-κB inhibitor NS398 was used to analyze the role of the NF-κB pathway in autophagic activation.Results: hMSC-Exos increased LC3-II levels as well as autophagosome number in chondrocytes. hMSC-Exos inhibited TNF-α–induced expression of MMP-3, -9, and -13; ADAMTS5; CCL-2 and -5; and CXCL1. NF-κB inhibition activated autophagy in TNF-α–treated chondrocytes. These results indicate that hMSC-Exos might suppress the levels of catabolic and inflammatory factors in chondrocytes by promoting autophagy via NF-κB pathway inhibition.Conclusions: Our data support the interest in hMSC-Exos to develop new therapeutic approaches for joint conditions.
{"title":"Exosomes derived from mesenchymal stem cells inhibit catabolism in human chondrocytes by activating autophagy via inhibition of the NF-κB pathway","authors":"Jian-fa Wang, Zhi Zhu, Lei Sun, Shimeng Shao, Baoyu Ma, Yaofeng Wang, R. Jin, Hongbo Hao, Han Yue","doi":"10.21203/rs.3.rs-83574/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-83574/v1","url":null,"abstract":"\u0000 Objective: We aimed to determine the significance of MSC-derived exosomes (MSC-Exos) in chondrocyte autophagy under normal and inflammatory conditions.Design: Human umbilical cord-derived MSCs (hMSCs) were cultured in vitro. hMSC-Exos( EX） were isolated by an ultracentrifugation method. Transmission electron microscopy and western analysis were used to identify exosomes. Human chondrocytes were extracted from five adult males with OA undergoing total knee arthroplasty. Primary cultures of chondrocytes from OA patients were stimulated with 50 ng/ml tumor necrosis factor-α (TNF-α) in the presence or absence of hMSC-Exos. Autophagy levels were determined based on expression of autophagic marker LC3, StubRFP-SensGFP-LC3 analysis, and electron microscopy. Catabolic gene and chemokine expression were evaluated using quantitative PCR. The NF-κB inhibitor NS398 was used to analyze the role of the NF-κB pathway in autophagic activation.Results: hMSC-Exos increased LC3-II levels as well as autophagosome number in chondrocytes. hMSC-Exos inhibited TNF-α–induced expression of MMP-3, -9, and -13; ADAMTS5; CCL-2 and -5; and CXCL1. NF-κB inhibition activated autophagy in TNF-α–treated chondrocytes. These results indicate that hMSC-Exos might suppress the levels of catabolic and inflammatory factors in chondrocytes by promoting autophagy via NF-κB pathway inhibition.Conclusions: Our data support the interest in hMSC-Exos to develop new therapeutic approaches for joint conditions.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85718318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-04DOI: 10.21203/rs.3.rs-30088/v1
E. Antoniou, Eirini Orovou, Maria Iliadou, Angeliki Sarella, E. Palaska, A. Sarantaki, G. Iatrakis, M. Dagla
Background Cesarean Section was historically performed to save the lives of mothers and infants. Ηowever, in the past decades, a significant increase in Cesarean Section rates have been observed in Greece and worldwide. The purpose of this research was to investigate the contributing factors to the increase in the Cesarean Section rate (emergency and elective) and postoperative complications.Methods A total of births in 6 months (August 2019- February 2020) at the University Hospital of Larisa in Greece was collected. The performed analysis included the available socio-demographic and medical information in the medical records and a socio-demographic and medical questionnaire for women with cesarean deliveries. We also analyzed the importance of the variables in cesarean deliveries compared to vaginal deliveries and postoperative complications.Results Out of the total number of the included 633 births, the vaginal delivery rate was 42% (n = 268), and the cesarean delivery rate was 58% (n = 365); Elective Cesarean Section was performed in 36% (n = 230) of the Cesarean Section cases and Emergency Cesarean Section in 22% (n = 135). Women with a previous Cesarean Section and women with in vitro fertilization showed higher percentages for Elective Cesarean Section (46%) compared to women who underwent an Emergency Cesarean Section for the same reasons (42.2%). Besides, a higher percentage of Emergency Cesarean Sections was observed in women living in urban centers (OR = 4.044, p = 0.002) and those diagnosed with stress disorders (OR = 7.048, p = 0.004). Furthermore, Cesarean Section complications were more common among women having undergone Emergency Cesarean Section (OR = 10.357, p < 0.001).Conclusion The overall high rates of Cesarean Section in Greece demonstrate the lack of national strategies and prevention mechanisms from iatrogenic interventions and lack of promoting good midwifery practices. More specifically, a decrease in iatrogenic factors leading to the primary Cesarean Section will decrease Cesarean Section rates in Greece.
历史上，剖宫产术是为了挽救母亲和婴儿的生命。Ηowever，在过去的几十年里，在希腊和世界范围内，剖宫产率显著增加。本研究的目的是探讨剖宫产率(急诊和择期)和术后并发症增加的影响因素。方法收集2019年8月至2020年2月在希腊拉里萨大学医院出生的6个月的新生儿。所进行的分析包括医疗记录中现有的社会人口和医学信息，以及剖宫产妇女的社会人口和医学问卷。我们还分析了剖宫产与阴道分娩和术后并发症的变量的重要性。结果633例分娩中，经阴道分娩率为42% (n = 268)，剖宫产率为58% (n = 365);择期剖宫产占剖宫产病例的36% (n = 230)，急诊剖宫产占22% (n = 135)。与因同样原因接受紧急剖宫产的妇女(42.2%)相比，以前接受过剖宫产手术和体外受精的妇女选择选择性剖宫产的比例(46%)更高。此外，生活在城市中心的妇女(OR = 4.044, p = 0.002)和被诊断为应激障碍的妇女(OR = 7.048, p = 0.004)的紧急剖宫产率更高。剖宫产并发症在急诊剖宫产患者中更为常见(OR = 10.357, p < 0.001)。结论希腊剖宫产率总体较高，表明缺乏国家战略和预防机制，缺乏从医源性干预措施和促进良好的助产实践。更具体地说，减少导致首次剖宫产的医源性因素将降低希腊的剖宫产率。
{"title":"Factors Associated with the Type of Cesarean Section and the Risk of Postoperative Complications in Greek Women","authors":"E. Antoniou, Eirini Orovou, Maria Iliadou, Angeliki Sarella, E. Palaska, A. Sarantaki, G. Iatrakis, M. Dagla","doi":"10.21203/rs.3.rs-30088/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-30088/v1","url":null,"abstract":"\u0000 Background Cesarean Section was historically performed to save the lives of mothers and infants. Ηowever, in the past decades, a significant increase in Cesarean Section rates have been observed in Greece and worldwide. The purpose of this research was to investigate the contributing factors to the increase in the Cesarean Section rate (emergency and elective) and postoperative complications.Methods A total of births in 6 months (August 2019- February 2020) at the University Hospital of Larisa in Greece was collected. The performed analysis included the available socio-demographic and medical information in the medical records and a socio-demographic and medical questionnaire for women with cesarean deliveries. We also analyzed the importance of the variables in cesarean deliveries compared to vaginal deliveries and postoperative complications.Results Out of the total number of the included 633 births, the vaginal delivery rate was 42% (n = 268), and the cesarean delivery rate was 58% (n = 365); Elective Cesarean Section was performed in 36% (n = 230) of the Cesarean Section cases and Emergency Cesarean Section in 22% (n = 135). Women with a previous Cesarean Section and women with in vitro fertilization showed higher percentages for Elective Cesarean Section (46%) compared to women who underwent an Emergency Cesarean Section for the same reasons (42.2%). Besides, a higher percentage of Emergency Cesarean Sections was observed in women living in urban centers (OR = 4.044, p = 0.002) and those diagnosed with stress disorders (OR = 7.048, p = 0.004). Furthermore, Cesarean Section complications were more common among women having undergone Emergency Cesarean Section (OR = 10.357, p < 0.001).Conclusion The overall high rates of Cesarean Section in Greece demonstrate the lack of national strategies and prevention mechanisms from iatrogenic interventions and lack of promoting good midwifery practices. More specifically, a decrease in iatrogenic factors leading to the primary Cesarean Section will decrease Cesarean Section rates in Greece.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84319473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01Epub Date: 2020-05-25DOI: 10.26502/fjwhd.2644-28840022
James P McHale, Jean A Talbot, Steven Reisler
During late adolescence, interpersonal acuity and decisiveness are facilitative of transitions to emerging adulthood. Disruptions in these capacities may be traceable to phenomena evoked by origin family coparental conflict - paralysis of initiative and hypersensitivity to conflict. Documenting such connections can lead to more beneficial interventions for adolescents transitioning into adulthood. The aims of this study were to examine relationships between college freshmen's reports of coparenting conflict in their origin families and (a) their immobility and indecision when faced with calls to action and (b) their hypersensitivity to signs of inter-adult conflict. Thirty-four freshmen (25 women and 9 men) rated their own coparents' conflict dynamics and completed (a) a timed perceptual-motor challenge in which quick and deft action was essential to avoid failure; (b) the Rorschach inkblot test; and (c) a judgement task requiring ratings of and predictions about the interpersonal dynamics between unfamiliar adults portrayed in videos coparenting small children. Even controlling for the effects of self-reported depressive symptoms, significant links emerged between greater recalled coparenting conflict in the origin family and longer delays in initiating action in the perceptual-motor challenge; lower active-to-passive responses on the Rorschach; and attributions of more dissonant coparenting behavior in the videotaped family interactions. Results suggest that origin family coparental conflict may show ties to hypersensitivity to conflict and to indecisiveness in the face of calls to action. Implications for theory, research and practice are discussed.
{"title":"Recalled Coparenting Conflict, Paralysis of Initiative, and Sensitivity to Conflict during Late Adolescence.","authors":"James P McHale, Jean A Talbot, Steven Reisler","doi":"10.26502/fjwhd.2644-28840022","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-28840022","url":null,"abstract":"<p><p>During late adolescence, interpersonal acuity and decisiveness are facilitative of transitions to emerging adulthood. Disruptions in these capacities may be traceable to phenomena evoked by origin family coparental conflict - paralysis of initiative and hypersensitivity to conflict. Documenting such connections can lead to more beneficial interventions for adolescents transitioning into adulthood. The aims of this study were to examine relationships between college freshmen's reports of coparenting conflict in their origin families and (a) their immobility and indecision when faced with calls to action and (b) their hypersensitivity to signs of inter-adult conflict. Thirty-four freshmen (25 women and 9 men) rated their own coparents' conflict dynamics and completed (a) a timed perceptual-motor challenge in which quick and deft action was essential to avoid failure; (b) the Rorschach inkblot test; and (c) a judgement task requiring ratings of and predictions about the interpersonal dynamics between unfamiliar adults portrayed in videos coparenting small children. Even controlling for the effects of self-reported depressive symptoms, significant links emerged between greater recalled coparenting conflict in the origin family and longer delays in initiating action in the perceptual-motor challenge; lower active-to-passive responses on the Rorschach; and attributions of more dissonant coparenting behavior in the videotaped family interactions. Results suggest that origin family coparental conflict may show ties to hypersensitivity to conflict and to indecisiveness in the face of calls to action. Implications for theory, research and practice are discussed.</p>","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"3 2","pages":"114-124"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38736902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-27DOI: 10.21203/rs.3.rs-24260/v1
Y. Qiu, L. Mao, Shi-ping Chen, Hao Li, Hairong Wang, Li Guan, Jin Huang, Xuan Wu, Yu Liu, Jie Xiao, Yuan Fang
Background: To evaluate the prevalence of alpha- and beta-thalassemia in Ji'an City, Jiangxi Province, 28,941 people in the region were genetically screened to identify various thalassemia genotypes. Methods: High-throughput amplicon sequencing and gap-PCR was used to screen 301 thalassemia alleles in 28,941 people in the region. Pregnant women were the focus of this screening, and if a pregnant woman harbored mutations in a thalassemia-inducing gene, her spouse was also genetically tested. Results: Of the participants, 2,380 people were carriers of thalassemia, with at least one thalassemia allele, including 1,742 alpha-thalassemia carriers, 686 beta-thalassemia carriers and 48 composite alpha- and beta-thalassemia carriers. The total carrying rate of thalassemia in Ji'an was 8.22%, and the carrying rates of alpha- and beta-thalassemia were 6% and 2.37%, respectively. In addition, the first measured carrier rate of composite alpha- and beta-thalassemia in Ji'an was 0.17%. According to the geographical distribution of the 1,742 alpha -thalassemia carriers, the city with the highest carrier rate was Suichuan, followed by Wan’an and Taihe. According to the geographical distribution of the 686 beta-thalassemia carriers, the top three cities with high carrier rates were Suichuan, Wan'an and Xiajiang, sequentially. Conclusions: This research emphasizes the importance of large-scale population screening and that comprehensive molecular epidemiology data are necessary for the proper prevention and treatment of thalassemia. The epidemiological data updated in this research may enable the local government to focus on the severity of this disease and determine a method for effective resource allocation under limited resource conditions.
{"title":"Large-scale screening of thalassemia in Ji’an, P.R. China","authors":"Y. Qiu, L. Mao, Shi-ping Chen, Hao Li, Hairong Wang, Li Guan, Jin Huang, Xuan Wu, Yu Liu, Jie Xiao, Yuan Fang","doi":"10.21203/rs.3.rs-24260/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-24260/v1","url":null,"abstract":"\u0000 Background: To evaluate the prevalence of alpha- and beta-thalassemia in Ji'an City, Jiangxi Province, 28,941 people in the region were genetically screened to identify various thalassemia genotypes. \u0000\u0000Methods: High-throughput amplicon sequencing and gap-PCR was used to screen 301 thalassemia alleles in 28,941 people in the region. Pregnant women were the focus of this screening, and if a pregnant woman harbored mutations in a thalassemia-inducing gene, her spouse was also genetically tested. \u0000\u0000Results: Of the participants, 2,380 people were carriers of thalassemia, with at least one thalassemia allele, including 1,742 alpha-thalassemia carriers, 686 beta-thalassemia carriers and 48 composite alpha- and beta-thalassemia carriers. The total carrying rate of thalassemia in Ji'an was 8.22%, and the carrying rates of alpha- and beta-thalassemia were 6% and 2.37%, respectively. In addition, the first measured carrier rate of composite alpha- and beta-thalassemia in Ji'an was 0.17%. According to the geographical distribution of the 1,742 alpha -thalassemia carriers, the city with the highest carrier rate was Suichuan, followed by Wan’an and Taihe. According to the geographical distribution of the 686 beta-thalassemia carriers, the top three cities with high carrier rates were Suichuan, Wan'an and Xiajiang, sequentially. \u0000\u0000Conclusions: This research emphasizes the importance of large-scale population screening and that comprehensive molecular epidemiology data are necessary for the proper prevention and treatment of thalassemia. The epidemiological data updated in this research may enable the local government to focus on the severity of this disease and determine a method for effective resource allocation under limited resource conditions.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81200655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Osteoporosis is a skeletal disorder characterized by low bone mass with consequent increase in bone fragility and fracture. The interplay between genetics and environment has a crucial role in determining the bone mineral density. Many studies showed that the genetic polymorphisms of MTHFR gene and its impact in the development of numerous human diseases. Normal MTHFR activity may help maintain the pool of circulating folate and methionine and possibly prevent of homocysteine. It has been shown that high serum homocysteine concentration may weaken bone by interfering with collagen cross-linking, thereby increasing the risk of osteoporosis. Therefore, the present study was aimed to investigate the role of MTHFR C677T gene polymorphism and its influence on BMD in pre and postmenopausal osteoporotic women of Indian ethnicity. Methods: In this study 427 osteoporotic women and 460 age matched controls were included. MTHFR C677T gene polymorphism was assessed by PCR-RFLP method. Total ALP, Bone specific ALP Total acid phosphatase, TRAP, Calcium and Phosphorus was measured by Bergmeyer et al method. Results: The frequency of TT genotype and T allele was more in pre- and postmenopausal osteoporotic women in comparison with controls. The logistic regression analysis to understand the risk assessment showed that the TT genotypes were 2.7 times (95% CI 1.1-1.6) and CT 1.7 times (95% CI 1.3-2.2 ) were at higher risk of osteoporosis in comparison to CC genotypes .This was found true even after adjustment for menopausal status. Conclusions: This study showed that increased bone turnover is not only restricted to postmenopausal women indicating the role of MTHFR gene variations in determining osteoporosis in both pre and post-menopausal South Indian women from Telangana.
背景:骨质疏松症是一种以低骨量为特征的骨骼疾病，随之而来的是骨脆性和骨折的增加。遗传和环境的相互作用在决定骨矿物质密度方面起着至关重要的作用。许多研究表明，MTHFR基因的遗传多态性及其在许多人类疾病发展中的影响。正常的MTHFR活性可能有助于维持叶酸和蛋氨酸的循环，并可能预防同型半胱氨酸。研究表明，高血清同型半胱氨酸浓度可能通过干扰胶原交联而削弱骨骼，从而增加骨质疏松症的风险。因此，本研究旨在探讨MTHFR C677T基因多态性在印度族绝经前和绝经后骨质疏松妇女中的作用及其对骨密度的影响。方法:本研究纳入427名骨质疏松症妇女和460名年龄匹配的对照组。采用PCR-RFLP法检测MTHFR C677T基因多态性。测定总ALP、骨特异性ALP、总酸性磷酸酶、TRAP、钙、磷含量，采用Bergmeyer等法。结果:绝经前和绝经后骨质疏松妇女TT基因型和T等位基因频率高于对照组。通过logistic回归分析了解风险评估结果，TT基因型的2.7倍(95% CI 1.1-1.6)和CT基因型的1.7倍(95% CI 1.3-2.2)与CC基因型相比，骨质疏松的风险更高，即使在调整绝经状态后也是如此。结论:本研究表明，骨转换增加不仅局限于绝经后妇女，这表明MTHFR基因变异在决定泰伦加纳邦绝经前和绝经后南印度妇女骨质疏松症中的作用。
{"title":"Menopausal Status and MTHFR Gene Polymorphism in the Etiopathogenesis of Osteoporosis","authors":"Yasovanthi Jeedigunta, Shehnaz Sultana, B. Nagalla, Raghunath Manchala, Rajender Rao Kalashikam","doi":"10.26502/fjwhd.2644-28840032","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-28840032","url":null,"abstract":"Background: Osteoporosis is a skeletal disorder characterized by low bone mass with consequent increase in bone fragility and fracture. The interplay between genetics and environment has a crucial role in determining the bone mineral density. Many studies showed that the genetic polymorphisms of MTHFR gene and its impact in the development of numerous human diseases. Normal MTHFR activity may help maintain the pool of circulating folate and methionine and possibly prevent of homocysteine. It has been shown that high serum homocysteine concentration may weaken bone by interfering with collagen cross-linking, thereby increasing the risk of osteoporosis. Therefore, the present study was aimed to investigate the role of MTHFR C677T gene polymorphism and its influence on BMD in pre and postmenopausal osteoporotic women of Indian ethnicity. Methods: In this study 427 osteoporotic women and 460 age matched controls were included. MTHFR C677T gene polymorphism was assessed by PCR-RFLP method. Total ALP, Bone specific ALP Total acid phosphatase, TRAP, Calcium and Phosphorus was measured by Bergmeyer et al method. Results: The frequency of TT genotype and T allele was more in pre- and postmenopausal osteoporotic women in comparison with controls. The logistic regression analysis to understand the risk assessment showed that the TT genotypes were 2.7 times (95% CI 1.1-1.6) and CT 1.7 times (95% CI 1.3-2.2 ) were at higher risk of osteoporosis in comparison to CC genotypes .This was found true even after adjustment for menopausal status. Conclusions: This study showed that increased bone turnover is not only restricted to postmenopausal women indicating the role of MTHFR gene variations in determining osteoporosis in both pre and post-menopausal South Indian women from Telangana.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83314815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.26502/fjwhd.2644-28840031
Neha R. Malhotra, N. Taneja, R. Shankar, Akanksha Pal, Bhavika Chawla, A. Awasthi, R. Janardhanan
Background: Cervical Cancer is the fourth most frequent cancer among women worldwide. Around 500,000 new cases of cervical cancer are diagnosed every year out of which 270,000 women die in developing countries. It is an issue of significant public health concern. Objective: To review the knowledge, attitude & practice towards cervical cancer screening among women globally. Methodology: Literature search was done on electronic databases including PubMed and Google scholar for articles published between 2013 to March 2020. Keywords used for the search were (cervical cancer screening) (knowledge) (attitude) (practice). A total of 17 studies were included in the review based on eligibility criteria. The articles included were specific to English language. Result: A total of 17 studies were included in the review with a total of 6158 women aged between 15-70 years having varied levels of knowledge, attitude & practice towards cervical cancer screening. 42.22% women had knowledge about the screening process. The source of information was friends & family (26.70%), media (15.92%), health professionals (12.35%). More than half of the participants showed positive attitude towards the cervical cancer screening (59.97%). Only 13.26% had undergone the cervical cancer screening. Most common reason for not undergoing screening was no signs & symptoms (32.78%) followed by no knowledge (28.21%). Conclusion: There is a dire need to generate awareness and formulate plans for implementation of screening programs in the most cost effective and feasible way, ensuring maximum community participation.
{"title":"Knowledge, Attitude & Practice towards Cervical Cancer Screening among Women Globally - A Systematic Review","authors":"Neha R. Malhotra, N. Taneja, R. Shankar, Akanksha Pal, Bhavika Chawla, A. Awasthi, R. Janardhanan","doi":"10.26502/fjwhd.2644-28840031","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-28840031","url":null,"abstract":"Background: Cervical Cancer is the fourth most frequent cancer among women worldwide. Around 500,000 new cases of cervical cancer are diagnosed every year out of which 270,000 women die in developing countries. It is an issue of significant public health concern. Objective: To review the knowledge, attitude & practice towards cervical cancer screening among women globally. Methodology: Literature search was done on electronic databases including PubMed and Google scholar for articles published between 2013 to March 2020. Keywords used for the search were (cervical cancer screening) (knowledge) (attitude) (practice). A total of 17 studies were included in the review based on eligibility criteria. The articles included were specific to English language. Result: A total of 17 studies were included in the review with a total of 6158 women aged between 15-70 years having varied levels of knowledge, attitude & practice towards cervical cancer screening. 42.22% women had knowledge about the screening process. The source of information was friends & family (26.70%), media (15.92%), health professionals (12.35%). More than half of the participants showed positive attitude towards the cervical cancer screening (59.97%). Only 13.26% had undergone the cervical cancer screening. Most common reason for not undergoing screening was no signs & symptoms (32.78%) followed by no knowledge (28.21%). Conclusion: There is a dire need to generate awareness and formulate plans for implementation of screening programs in the most cost effective and feasible way, ensuring maximum community participation.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86375127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/FJWHD.2644-28840010
F. Wirsiy, Denis Ebot Ako-Arrey, P. Njukeng
Background and aim: The health systems of Cameroon are still facing considerable challenges in achieving better women’s health outcomes among its diverse population. mHealth (Mobile technologies application in health care) represent a feasible approach to aid the alleviation of some of Cameroon’s disease burden and generate improvements in women’s health care outcomes. Although some studies have shown the potentials of mHealth in Cameroon, there is a huge gap of data establishing clear outcomes of mHealth interventions in Cameroon. This review was carried out to evaluate the evidence on the empirical impact of mHealth interventions on women’s health outcomes in Cameroon. Methods: A search on PubMed, ScienceDirect, Cochrane Library, African Journals Online, MEDLINE, Scopus and Google Scholar with the following Keywords: “mobile health”, “Mobile phone”, “health care”, “interventions”, “Cameroon”, “Women’s Health Outcomes” was conducted, with the Medical Subject Headings (MeSH), on empirical studies relating to mHealth interventions on health outcomes in Cameroon. Our search was limited to, articles published from the year 2009 to 2019 (A 10 year review) in English and French. The search identified a total of 111 articles amongst which only 5 original articles met the inclusion criteria. Results: This review revealed that, using SMS text messages and mobile phones (mHealth interventions) in Cameroon had been targeted at eliciting behavioral actions as well as improving treatment adherence in women patients/individuals. However, while mHealth augurs the potential to improve women’s health outcomes and probably transform the Cameroon health systems, there was insufficient evidence to assert the effect of the mHealth interventions on improved women’s health outcomes. Conclusion: This review showed that despite the opportunity presented by rapidly expanding mobile technologies in Cameroon, evidence of their impact in improving women’s health outcomes and revolutionizing healthcare solutions is limited. Thus, there is a need for more intervention studies to ascertain the effect of mHealth interventions on women’s health outcomes and health care delivery processes in Cameroon and the Central African region at large.
{"title":"Mobile Health Interventions in Cameroon: A Review of their Effect on Women’s Health Outcomes","authors":"F. Wirsiy, Denis Ebot Ako-Arrey, P. Njukeng","doi":"10.26502/FJWHD.2644-28840010","DOIUrl":"https://doi.org/10.26502/FJWHD.2644-28840010","url":null,"abstract":"Background and aim: The health systems of Cameroon are still facing considerable challenges in achieving better women’s health outcomes among its diverse population. mHealth (Mobile technologies application in health care) represent a feasible approach to aid the alleviation of some of Cameroon’s disease burden and generate improvements in women’s health care outcomes. Although some studies have shown the potentials of mHealth in Cameroon, there is a huge gap of data establishing clear outcomes of mHealth interventions in Cameroon. This review was carried out to evaluate the evidence on the empirical impact of mHealth interventions on women’s health outcomes in Cameroon. Methods: A search on PubMed, ScienceDirect, Cochrane Library, African Journals Online, MEDLINE, Scopus and Google Scholar with the following Keywords: “mobile health”, “Mobile phone”, “health care”, “interventions”, “Cameroon”, “Women’s Health Outcomes” was conducted, with the Medical Subject Headings (MeSH), on empirical studies relating to mHealth interventions on health outcomes in Cameroon. Our search was limited to, articles published from the year 2009 to 2019 (A 10 year review) in English and French. The search identified a total of 111 articles amongst which only 5 original articles met the inclusion criteria. Results: This review revealed that, using SMS text messages and mobile phones (mHealth interventions) in Cameroon had been targeted at eliciting behavioral actions as well as improving treatment adherence in women patients/individuals. However, while mHealth augurs the potential to improve women’s health outcomes and probably transform the Cameroon health systems, there was insufficient evidence to assert the effect of the mHealth interventions on improved women’s health outcomes. Conclusion: This review showed that despite the opportunity presented by rapidly expanding mobile technologies in Cameroon, evidence of their impact in improving women’s health outcomes and revolutionizing healthcare solutions is limited. Thus, there is a need for more intervention studies to ascertain the effect of mHealth interventions on women’s health outcomes and health care delivery processes in Cameroon and the Central African region at large.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72816468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjwhd.2644-28840011
Mustafizur Rahman Km
As a developing country, insecure pregnancy related health status remains one of the major health concerns in Bangladesh. Although the condition of pregnancy and the production of child birth are natural processes, these are never risk free. In spite of several steps are taken to improve the service of maternal child health (MCH), the incidence of weak pregnancy related health status still remain high due to multifaceted web of causal factors especially socio-economic factors. The study is developed with the main purpose that is to establish the vital interaction between the different socio-economic variables and pregnancy related health care services among the study population. The results of this study should contribute to the creation of effective policies and programs that can improve the women’s pregnancy related health status in Bangladesh.
{"title":"Factors Associated with Pregnancy Related Health Status among Rural Women in Bangladesh: A Micro-Survey Study","authors":"Mustafizur Rahman Km","doi":"10.26502/fjwhd.2644-28840011","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-28840011","url":null,"abstract":"As a developing country, insecure pregnancy related health status remains one of the major health concerns in Bangladesh. Although the condition of pregnancy and the production of child birth are natural processes, these are never risk free. In spite of several steps are taken to improve the service of maternal child health (MCH), the incidence of weak pregnancy related health status still remain high due to multifaceted web of causal factors especially socio-economic factors. The study is developed with the main purpose that is to establish the vital interaction between the different socio-economic variables and pregnancy related health care services among the study population. The results of this study should contribute to the creation of effective policies and programs that can improve the women’s pregnancy related health status in Bangladesh.","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78433535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjwhd.2644-2884009
Frankline Sevidzem Wirsiy
{"title":"Adolescent Pregnancy in Cameroon: A Five Year Retrospective Chart Review to Determine its Prevalence","authors":"Frankline Sevidzem Wirsiy","doi":"10.26502/fjwhd.2644-2884009","DOIUrl":"https://doi.org/10.26502/fjwhd.2644-2884009","url":null,"abstract":"","PeriodicalId":74017,"journal":{"name":"Journal of women's health and development","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72782372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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