Women's health reports (New Rochelle, N.Y.)最新文献

Background: Prior studies have suggested gender differences in COVID-related outcomes that have the potential to impact cardiovascular risk. We aimed to investigate gender differences on short- and long-term effects of COVID-19 infection.

Methods: Patients hospitalized with COVID-19 infection were enrolled in an ongoing prospective registry across NY-Presbyterian networks, which encompassed same-day echocardiogram, cardiac magnetic resonance (CMR), 6-minute walk test, and quality of life assessment 1 year following acute COVID hospitalization.

Results: In this prospective cohort of 213 hospitalized patients with COVID-19 infection, males were more likely to require intensive care unit (ICU) stay (13.6 vs. 3.6%; p = 0.009) and oxygen supplementation (40.8 vs. 26.4%; p = 0.026), paralleling higher rates of elevated troponin, C-reactive protein, ferritin, and D-dimer (p < 0.05 for all). In contrast, 1 year following COVID hospitalization, females reported worse physical function and fatigue on Patient-Reported Outcomes Measurement Information System (PROMIS) scale (p < 0.05 for all). Additionally, 6-minute walk distance was less in females than males (383.0 ± 98.0 vs. 428.6 ± 78.6 m; p = 0.006), and Borg dyspnea score was nearly twofold higher in females vs. males (2.0 ± 2.3 vs. 1.0 ± 1.5; p < 0.001). With respect to imaging parameters, females had higher left ventricle and right ventricle ejection fraction (p < 0.05 for all) with smaller infarct size (p = 0.042) on CMR.

Conclusion: Whereas males have greater morbidity during acute COVID hospitalization, females are disproportionately impacted by post-COVID impaired functional status despite higher biventricular ejection fraction and smaller infarct size.

Objective: Determine if diagnosis of gestational diabetes mellitus (GDM) increases the incidence of postpartum depression (PPD) in rural Appalachian Ohio.

Methods: A retrospective chart review was conducted to review pregnancies between February 2020 and March 2023 to look for diagnoses of gestational diabetes and PPD.

Results: The population studied showed that 5.41% of pregnancies were affected by gestational diabetes, 7.76% of pregnancies had associated PPD, and 1.26% had both. Hypertension incidence that was a secondary data point in this study showed that 20.4% of pregnancies were affected by a form of hypertension.

Conclusions: Incidence of gestational diabetes and PPD were similar in this population to the rest of the United States and occurred together at low rates. Hypertension was a more common condition that affected pregnancies in this population.

Background: Across the reproductive life course, women receive information about contraception that may influence their contraceptive behaviors. This study examines the information sources that adolescents and older women combine to acquire information about contraception.

Methods: A state-representative survey of women aged 18-44 residing in Delaware, US, in 2017 asked from what sources respondents recently learned about contraception and the type of information obtained. The 2017 Delaware Youth Risk Behavior Survey, representative of public high school students aged 14-18, included analogous questions. Latent class analysis was applied to classify respondents in both samples of adolescents (n = 1253) and adult women (n = 1008) according to the information sources they combined. We estimated multinomial logistic regressions to assess the demographic and reproductive history predictors of using each of the information source repertoires and binomial logistic regressions to analyze their relationship to the information acquired.

Results: Adolescents are more likely than adults to report having recently acquired any information about contraception (76% vs. 64%), but they are more likely to rely primarily on a single source. In contrast, adult women are more likely to combine multiple sources. Age, education, and sexual activity emerged as important predictors of information source repertoires. Adults who combine information sources and adolescents who learn mainly from health care providers or school personnel report the greatest breadth in the contraception-related information acquired.

Conclusion: Interventions to provide or improve contraceptive knowledge may be more effective if they account for how women use and combine information sources, particularly at different stages of their reproductive lives.

Purpose: Globally, there is a lack of access to health care providers who offer gynecological procedures. Understanding the practice patterns of academic family physicians (AFPs) and whether additional training impacts the provision of care is critical. This study surveys the practice patterns of AFPs regarding gynecological procedures offered, identifies barriers, and explores the impact of additional training.

Methods: We circulated an anonymous, cross-sectional survey to all 17 family medicine programs across Canada, receiving responses from 71 AFPs. We computed descriptive statistics and bivariate associations.

Results: A total of 71 respondents from five universities participated. Most participants (97.2%) performed Papanicolaou (Pap) smears; 67.6% provided intrauterine device (IUD) insertion, and only 54.9% offered endometrial biopsy. Numbers decreased significantly for routine pessary care (29.5%), punch biopsy of the vulva (15.5%), and pessary fitting (5.6%). Eighteen participants (26.9%) had received enhanced skills training with a certificate of added competence (CAC), of which 55.6% were in women's health. CAC holders in women's health provided IUD insertions (100% vs. 67.3%; p = 0.049, V = 0.28) and endometrial biopsies (90.0% vs. 53.1%; p = 0.036, V = 0.28) at higher rates than general AFPs. Frequently cited barriers to offering gynecological procedures included lack of knowledge, procedural skills, and insufficient patient volumes to maintain competence. During the COVID-19 pandemic, 44% of respondents reported reducing or ceasing to provide Pap smears.

Conclusions: Many AFPs in Canada do not provide essential gynecological procedures. This impacts patient access and the training of the next generation of family physicians and thus requires innovative strategies to address the persistent procedural skills educational gap for trainees.

Objective: There is an increasing interest in human papillomavirus (HPV) self-collection as a strategy for women not up-to-date with cervical cancer screening. We report the findings of an HPV self-collection educational intervention for health care providers and staff.

Materials and methods: As part of the Health Outcomes through Motivation and Education (HOME) Initiative, health care providers from 10 health care systems in Appalachian regions of four states attended online sessions during 2021-2023. Participants (n = 167) completed pre- and postintervention surveys focused on knowledge and attitudes about HPV self-collection and cervical cancer screening. The postintervention survey also addressed satisfaction with the educational intervention.

Results: Participants correctly answered an average of 4.6 out of 7 knowledge items on preintervention surveys and an average of 6.0 items on postintervention surveys (p < 0.001). Attitudes were more positive on postintervention surveys and included that participants reported that they were better informed about HPV self-collection and more confident they could talk to patients about HPV self-collection (both p < 0.05). Nearly all (>97%) participants reported being satisfied with the educational intervention and being pleased their health center was included in the HOME Initiative.

Conclusions: An online educational intervention for health care providers and staff about HPV self-collection as a cervical cancer screening strategy was efficacious in improving knowledge and attitudes and was well-received by participants. Given its online delivery and that it can be completed individually or in a group setting, this educational intervention with minor adaptations has potential for wide dissemination to educate health care providers and staff about HPV self-collection.

Background: Ovarian cancer is one of the top seven causes of cancer deaths. Incidence of ovarian cancer varies by ethnicity, where Asian women demonstrate lower incidence rates than non-Hispanic Blacks and Whites. Survival prediction models for ovarian cancer have been developed for Caucasians and Black populations using national databases; however, whether these models work for Asians is unclear. Therefore, a retrospective cohort study was conducted to develop survival prediction models for patients with epithelial ovarian cancer from a Taiwan Cancer Registry (TCR) who underwent de-bulking and chemotherapy, with the aim to identify variables that can predict prognosis accurately. Patients diagnosed with OC from TCR were included.

Method: Two prognostic models (M1 and M2) were developed: M1 utilized clinical variables only, M2 additionally included cancer-specific variables with the aim to improve the accuracy. All methods were repeated independently for patients with only serous ovarian cancer. All findings for model M1 were validated among Black, White, and Asian populations from Surveillance, Epidemiology, and End Results (SEER) database and 10-fold internal cross-validations. Due to absence of cancer-specific site variables in SEER, model M2 was only internally validated. Cox-proportional hazards regression analysis was performed and a stepwise strategy with Akaike-information criterion was used to select appropriate variables as predictors to develop both M1 and M2.

Results: The c-index values of both models were >0.7 in both TCR and SEER populations for epithelial ovarian cancer. Calibration analysis demonstrated good prediction performance with the proportional difference between predicted and observed survival to be <5%. The performance was similar for the subset of patients with serous epithelial ovarian cancer. Notably, no significant racial differences were observed.

Conclusion: The prognostic models proposed in this study can potentially be used for identifying patients, especially from Taiwan, at higher risk of ovarian cancer mortality early on, leading to improved prognosis, through shared decision-making between physicians and patients.

Objective: Patients with polycythemia have a high risk of thrombo-atherosclerotic diseases. However, it remains to be clarified whether a high blood hemoglobin level is related to cardiometabolic risk in women.

Methods: The overall subjects were 18,410 middle-aged women who had received health checkup examinations at their workplaces. The subjects were divided into four groups of quartiles for hemoglobin levels. Cardiometabolic risk factors were compared in the four quartile groups. Individuals showing abnormally low hemoglobin levels (less than 11.0 g/dL) and/or having a history of therapy for anemia (n = 3,690) were excluded from the study.

Results: The prevalence of polycythemia (hemoglobin: higher than 16.0 g/dL) was 0.14%. Body mass index, waist-to-height ratio, blood pressure, triglycerides, LDL cholesterol, and hemoglobin A_1c were significantly higher in the highest quartile group of hemoglobin than in the lowest quartile group and tended to be higher with an increase of the quartile. Odds ratios of the highest versus lowest quartile groups of hemoglobin were 2.64 (2.25-3.10) for high LDL cholesterol/HDL cholesterol ratio, 3.05 (2.69-3.46) for high lipid accumulation product, 2.26 (2.05-2.50) for high cardiometabolic index, and 3.71 (3.07-4.47) for metabolic syndrome.

Conclusions: Although the prevalence of polycythemia was very low, cardiometabolic risk was higher in those showing relatively high hemoglobin levels than in those with lower levels. Therefore, normal high blood hemoglobin is suggestive of increased cardiovascular risk in middle-aged women.

Background: Our study aimed to perform Hungarian cross-cultural adaptation and assess the reliability and validity of the Pain Self-Efficacy Questionnaire (PSEQ) in women diagnosed with endometriosis and chronic pelvic pain.

Methods: The current study was conducted in Hungary among women aged 18-50 (34.39 ± 6.68 years). We examined the reliability of the Hungarian version of PSEQ (PSEQ-HU) by applying internal consistency and test-retest evaluations. Confirmatory factor analysis was used to determine the construct validity of the PSEQ-HU, while Spearman's rank correlation coefficient established the convergent validity using the 36-Item Short-Form Health Survey, numeric rating scale (NRS), Pain Catastrophizing Scale, and Perceived Stress Scale. To determine discriminant validity, two groups were created based on NRS (0-4 no or mild pain, 5-10 moderate or strong pain). The results were analyzed using IBM SPSS version 28.0 software with a significance level of p ≤0.05.

Results: A total of 262 women participated in this study. The Cronbach's α was 0.97, and the intraclass correlation coefficient (ICC) values showed adequate reliability (ICC = 0.94. 95% confidence interval 0.88-0.97) for the PSEQ-HU. Based on the Spearman's correlation coefficients the convergent validity showed significant results (r = 0.22-0.63; p ≤0.001).

Conclusion: We concluded that the PSEQ is a reliable and valid measurement among Hungarian women with endometriosis-related pelvic pain.

Background: Competing at a high level is challenging for athletes, both mentally and physically. Intense sport engagement is not always beneficial for health. This study investigates and compares self-esteem, wellbeing, and health status among athletes at different levels. In addition, it examines whether the type of sport (individual versus team) affects the self-esteem and wellbeing.

Methods: A quantitative, observational survey was conducted, involving 296 female participants aged 18-35 years divided into three groups based on their sport performance: high-performance athletes (41%), recreational athletes (27%), and individuals with no or lower levels of physical activity (32%). The Rosenberg Self-Esteem Scale, WHO-5 Well-Being Index, and the EuroQol Visual Analogue Scale were used to measure self-esteem, wellbeing, and health status, respectively.

Results: High-performance athletes exhibited significantly higher self-esteem, wellbeing, and health status compared with individuals with no or lower levels of physical activity. Recreational athletes showed better wellbeing than individuals with no or lower levels of physical activity and had no significant differences from high-performance athletes in any parameter. Results were not affected by whether the sport was individual or team-based.

Conclusions: These findings highlight that regular sport participation, whether at a recreational or high-performance level, provides substantial mental and physical health benefits, while individuals with no or lower levels of physical activity experience significantly lower levels of self-esteem, subjective wellbeing, and health. The findings of this study suggest that regular sport activity, regardless of competitive level, provides substantial benefits, underscoring the importance of maintaining a physically active lifestyle.