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

Uterine leiomyomas are noncancerous smooth muscle neoplasms that occur in up to 70% of women and the single most common cause of hysterectomy. There is a variety of treatments available for uterine leiomyomas, including medications, uterine artery embolization, myomectomy, and hysterectomy but surgical treatments predominate. Medical optimization of anemia is often required prior to surgical treatment secondary to heavy menstrual bleeding and resultant iron deficiency anemia from chronic blood loss. While iron and multivitamins are critical to increase hemoglobin, pharmacologic therapy to suppress menstrual bleeding is often needed. First line therapy is typically a trial of combined oral contraceptive pills (OCPs); however, this may not be effective in all patients. Parenteral administration of long-acting GnRH agonists is often used as a second line treatment; however, these agents can lead to an initial "flare" effect precipitating a heavy bleed during the agonist phase which can be problematic in such patients. An alternative course of action is the use of oral GnRH antagonist combination therapy (OGAC) with estradiol and norethindrone, an option approved in both the United States and the European Union for long-term treatment of leiomyoma-related heavy menstrual bleeding. To demonstrate the clinical utility of OGAC therapy in the preoperative setting, we report a successful patient outcome and review relevant literature.

Background: Short birth intervals (SBI), also known as suboptimal childbirth intervals, are frequent and have detrimental effects on both mother and child health. There is limited national data except for small-scale studies on the prevalence and contributing factors of SBI practices in Ethiopia. We did this review to find the pooled prevalence of suboptimal birth spacing and its contributing factors among Ethiopian women of reproductive age.

Methodology: This study followed the PRISMA guideline. Articles were found using MEDLINE/PubMed, Scopus, Hinari, Google Scholar, and Web of Science. Subgroup analysis was used to look for heterogeneity evidence. I ² statistics and funnel plots with the Egger test were used to assess the studies' heterogeneity and publication bias.

Results: In total, 19 studies were included in this meta-analysis with a sample size of 11,674. The pooled prevalence of SBI was 50.29% (95% confidence interval [CI], 43.18, 57.40). Rural residency (adjusted odds ratio [AOR] = 2.13; 95% CI: 1.19, 3.07), age at first marriage less than 18 (AOR = 1.94; 95% CI: 1.34, 2.54), women with no formal educational status (AOR = 3.39; 95% CI: 2.59, 4.19), no contraceptive use (AOR = 4.20; 95% CI: 2.84, 5.56), duration of breastfeeding less than 24 months (AOR = 3.44; 95% CI: 1.64, 5.25), female sex of the index child and survival (death) of the index child (AOR = 2.34; 95% CI: 1.53, 3.15), and (AOR = 2.17; 95% CI: 1.02, 3.31), respectively, were the main determinants of suboptimal child spacing.

Conclusion: The pooled prevalence of suboptimal child spacing practices in Ethiopia was found to be high almost half of the births were suboptimal.

Background: Psychological symptoms and sleep disturbance are common during pregnancy. Observational data suggest that being physically active during pregnancy is related to better mood and sleep, but whether sedentary behavior reduction interventions provide similar benefits is untested. We aimed to determine whether reducing sedentary behavior across pregnancy improved psychological and sleep parameters.

Methods: Pregnant participants (n = 51) were allocated 2:1 to a sedentary behavior reduction intervention or control in their first trimester. Depressive symptoms, perceived stress, mood disturbance, nausea/vomiting quality of life, and sleep parameters were assessed with validated questionnaires in each trimester. Linear mixed effects regression examined differences between groups across pregnancy. Spearman correlations tested whether changes in sedentary time and physical activity were associated with changes in psychological and sleep outcomes without regard to group.

Results: Despite significant reductions in sedentary behavior (-0.84 hour/day), the intervention had no effect on psychological health outcomes. Further, intervention participants demonstrated significant worsening of sleep efficiency factor scores compared with control (p = 0.038). Small but significant correlations were found between changes in sedentary time and nausea/vomiting quality of life, and between changes in physical activity and nausea/vomiting quality of life, sleep duration, and sleep efficiency.

Conclusions: Reducing sedentary behavior during pregnancy did not improve psychological symptoms and may worsen sleep efficiency. Recommendations for future sedentary behavior reduction research in pregnancy include a larger sample with poorer psychological health and sleep at baseline, targeting reductions in mentally passive sedentary behavior, and including device-based sleep assessments.

Introduction: Ovarian fibrothecoma is a rare benign sex cord-stromal ovarian tumor sorted under the thecoma-fibroma group. We present an analysis of clinical and laboratory findings and the radiological characteristic features of pathologically proven fibrothecomas in variable imaging modalities.

Methods: A retrospective analysis was done for 88 patients with 90 pathologically proven ovarian fibrothecoma between January 2011 and December 2023 from our center's prospectively maintained database. All the patients underwent preoperative ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) scans, clinical examinations, basic laboratory tests, and tumor markers.

Results: The results of Spearman's correlation revealed a statistically significant positive correlation between the largest tumor diameter and serum level. CA 125, the degree of ascites, and diffusion weighted imaging (DWI) signal intensity while the results of point biserial correlation revealed a statistically significant correlation of the largest tumor diameter with the presence of ascites, cystic changes, abdominal enlargement, surgery type, and border type. There were also statistically significantly higher hypoechoic lesions in the smaller tumor group (p = 0.001) but not for isoechoic (p = 0.099) and mixed (p = 0.052). Regarding the MRI, there was a statistically significantly larger tumor diameter in T2 mixed-hyperintense versus hypointense (p = 0.007) and intermediate (p = 0.010) signal intensities.

Conclusion: Fibrothecoma showed a statistically significant positive correlation between the largest tumor diameter with serum level CA 125 and the amount of ascites. On imaging, it shows mild enhancement in both CT and MRI, with a statistically significant positive correlation of the largest tumor diameter with T2 and DWI signal intensity.

Background: Depression is a significant mental disorder that affects >350 million individuals globally. It is noteworthy that females are approximately twice as likely as males to experience depression, with the incidence of depression in females rising during early adolescence. The fluctuation in levels of gonadal hormones contributes to the increased occurrence of depression in females. The use of hormonal contraceptives suppresses the natural production of these hormones, which, in turn, raises the risk of developing depressive symptoms in women. The complex relationship between fluctuating hormones and depression in women is multifaceted, with both natural hormonal changes and hormonal contraceptive use potentially impacting emotional well-being and susceptibility to affective disorders.

Methods: An institution-based cross-sectional study was conducted on a sample of 423 individuals. A simple random sampling technique was used for participant selection. The Beck Depression Inventory II screening tool, along with pretested structured interview questionnaires, was used to collect sociodemographic information as well as data on the use of hormonal contraceptives and menstrual history. Trained nurses administered the questionnaires and measured the body mass index (BMI) using standard measuring tools. The collected data were entered into Epi-Data Manager version 4.4.1 and then exported to Statistical Package for Social Sciences version 26 for statistical analysis. Bivariate and multivariate logistic regression analyses were performed to determine the association between dependent and independent variables. All explanatory variables with a p-value <0.25 in bivariate analysis were entered into the multivariable logistic regression model. A p-value <0.05 in the multivariate logistic regression analysis was used to determine statistically significant variables.

Results: The prevalence of depression among the study participants was 38.8%. The age category 18-25 years, poor social support, uncomfortable marital relationship, injectable hormonal contraceptives, and BMI status >25 kg/m² were variables that became significantly associated with depression in this study.

Conclusions: This study has shown that the prevalence of depression among contraceptive users was 38.8%. The age-group of 18-25 years, poor social support, an uncomfortable marital relationship, use of injectable hormonal contraceptives, and a BMI status >25 kg/m² have an impact on the prevalence of depression. Based on these findings, it is recommended that women's health initiatives prioritize mental health services. Providing adequate mental health support and counseling can help address the prevalence of depression among contraceptive users. It is also suggested that health care providers carefully evaluate the risks and benefits for women before initiating hormon

Sickle cell disease (SCD), a serious, chronic blood disorder is the most common genetic blood disease in the United States affecting 100,000 people and disproportionately affecting the African American population. Pregnancy is particularly risky for people with SCD due to higher risk of developing pregnancy-related complications compared with people without the disease. For African American pregnant women with SCD, the risk of maternal morbidity and mortality is up to 10 times higher. Physiological changes during pregnancy increase the risk of vaso-occlusive episodes (VOEs), acute chest syndrome, venous thromboembolic events, and infections. Dehydration increases risk as it triggers sickling of red blood cells, leading to painful VOEs and further increasing the risk of aforementioned complications. Climate change, observed since the mid-20th century, is evidenced by the increasing trend of global temperature, hurricanes, floods, and heat waves. Climate changes can profoundly impact people with SCD, as elevated temperatures result in increased core body temperatures, blood hyperosmolality, and dehydration. Assisted by a research librarian, a literature search was undertaken of major databases (PubMed, Embase, and Google Scholar), with delimiters of publication between 2019 and 2024 and human subjects, and 477 studies were retrieved. After meticulous screening, 20 relevant articles were analyzed. Evidence linking climate change impact to increased risk for pregnant people with SCD is lacking. Further research is needed to examine the phenomenon and mitigate this unique risk of climate change. SCD clinical guidelines stress the importance of preventing dehydration. Clinicians play a critical role in educating this vulnerable population about risks, including dehydration and exposure to extreme heat.

Background: Despite strong data indicating women leaders' proven efficacy as catalysts for organizational change, there is significant attrition for women across the advancement, promotion, and leadership pathways within academic medicine. To help early-career women faculty build a network of support, enhance leadership capacity and agility, and gain the skills necessary for career advancement and fulfillment, we created the Women's Leadership Development Program (WLDP) at our medical school in 2020.

Methods: From 2023 to 2024, we collected retrospective survey data from all interested prior participants to gauge the impact of the WLDP on faculty members' confidence, sense of belonging at Yale School of Medicine, and acquisition of leadership skills.

Results: Findings indicate the WLDP's positive impact on women faculty members' sense of leadership efficacy and skills, with participants reporting enhanced appreciation of their leadership potential, knowing how to lead with their strengths, improved leadership vision, and increased confidence in making an impact in academic medicine going forward.

Conclusion: The importance of leadership development programming for the professional development of early-career women faculty in academic medicine is explored. The article concludes with implications of these findings for our ongoing programming and leadership development initiatives for women in academic medicine more broadly.

Background: Physical behaviors (PBs), defined as physical activity (PA) and sedentary behavior (SB), are consistently less favorable in women than men. Extensive qualitative research has identified gender norms as a well-known barrier to women's PA, but they have yet to be clearly conceptualized and quantified. The purpose of this study was to (1) investigate the relationship between benevolent sexism endorsement (BSE) and PB, (2) explore women's experiences with sexism in PA settings, and (3) identify sexism constructs within focus group discussions.

Methods: Participants completed the Ambivalent Sexism Inventory (0-5 scale) and wore a hip-worn activity monitor for 7 days. Spearman correlations were calculated between BSE and PB. A 90-minute focus group (n = 4) was transcribed and coded to identify themes and sexism constructs.

Results: Participants (n = 20, 20.7 ± 1.3 years) exceeded PA guidelines and reported low BSE scores (1.8 ± 0.76). Weak associations were found between BSE and objectively measured PA (r = -0.19 to r = -0.37) and ST (r = 0.14). Focus group results yielded four themes: (1) Age-Related Decline in PA, (2) Parental Roles, (3) Peer Relationships/Friendships, and (4) Physical Education Teachers/Coaches.

Conclusion: As hypothesized, associations between BSE and PA outcomes and SB were negative and positive, respectively. Focus group themes were related to benevolent sexism constructs. Future research should be conducted in larger, more diverse samples and consider other factors that may impact one's endorsement of benevolent sexism.

Background: Women faculty face different obstacles in academic medical careers than their men counterparts. Women faculty report feeling like "outsiders" and experiencing multiple barriers to career advancement compared with men, especially if they hold a nonmedical degree (e.g., PhD). This study examined aspects of workplace culture that differentially impact women at a large regional academic medical center (AMC) in the Appalachian region of the United States-a geographic area that is largely understudied in this body of literature.

Materials and methods: Forty-seven women completed a survey that included the Culture Conducive to Women's Academic Success instrument, the Professional Fulfillment Index, the Work and Family Conflict scale, and items measuring burnout, childcare availability, and demographic factors.

Results: Our findings revealed that many women faculty felt that they were being treated differently than men faculty, that work infringed on their home and family life, and that while they were professionally fulfilled at work, childcare problems exacerbated feelings of wanting to leave that AMC. About 60% of our sample indicated some level of burnout.

Conclusions: These findings align with previous findings that women juggle multiple roles that are typically not expected of men, and this juggling may be one reason why women are not staying in academic medicine or being promoted at the same rate as men. We provide incremental validity for the measures used and delineate specific ideas for improvement, such as on-site childcare, standardized leave policies, and formal mentorship and curriculum programs.