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

Background: The prevalence of posttraumatic stress disorder (PTSD) among people living with HIV (PLWH) is higher than in the general population and can impact health behaviors. The influence of HIV on PTSD psychophysiology requires further investigation due to implications for the treatment of PTSD in PLWH.

Objective: Utilizing fear-potentiated startle (FPS), we aimed to interrogate the influence of PTSD and HIV on fear responses.

Materials and methods: Women (18-65 years of age) recruited from the Women's Interagency HIV Study in Atlanta, GA (n = 70, 26 without HIV and 44 with HIV), provided informed consent and completed a semistructured interview to assess trauma exposure and PTSD symptom severity. Participants also underwent an FPS paradigm to assess fear acquisition and extinction: Psychophysiological indices that measure how individuals learn new fear and then subsequently attempt to suppress this fear.

Results: Women with PTSD, who did not have HIV, exhibited a greater startle response compared to women without PTSD or HIV during late acquisition to both the danger cue, reinforced conditioned stimulus (CS+, p = 0.013)), and the safety cue, non-reinforced conditioned stimulus (CS-, p = 0.046)), whereas women living with HIV (WLH) and PTSD demonstrated blunted fear responses compared to women with PTSD only. During extinction, WLH comorbid with PTSD exhibited an increased fear response during the extinction period in comparison to all other groups (p = 0.023). Women without PTSD demonstrated a reduction in the fear response during extinction regardless of HIV status.

Conclusion: Our findings indicate that HIV further modifies fear psychophysiology in WLH with comorbid PTSD, highlighting the importance of considering HIV status in conjunction with PTSD treatment.

Background: Premenstrual syndrome (PMS) is experienced by many women who suffer from either its psychological or physical symptoms. Current treatment is limited to symptomatic therapy or oral contraceptives. On the other hand, l-theanine, which has a relaxant effect, has been reported to be useful for PMS, but its short half-life when administered orally makes it less effective. Permeability and properties of transdermal gel containing l-theanine were evaluated as a preclinical study of PMS symptoms relief formulation.

Materials and methods: Lyogel composed of stearic acid, stearyl alcohol, and propylene glycol was selected. The ratio of these components and the preparation method were investigated. Permeation of Strat-M membranes was evaluated by using Franz cells (in vitro). Moreover, lyogel was applied to institute of cancer research mice's backs for 10 days to examine the permeability of l-theanine.

Results: l-Theanine solution did not permeate the Strat-M membrane at all in the permeation study, but lyogel allowed l-theanine to permeate. When the composition of lyogel was 4.4:11.1:296 (mmol) for stearic acid, stearyl alcohol, and propylene glycol, l-theanine absorption through Strat-M membrane was better. In skin permeation study using mice, l-theanine was detected in the serum, that is, it was proven that l-theanine penetrated the skin.

Conclusion: The preparation of transdermal gels contained l-theanine was investigated as a preclinical study. The skin permeability of semisolid formulations of hydrophobic ointments, hydrophilic ointments, oily creams, creams, and lyogel containing theanine was compared and found that lyogel was the best. The composition of lyogel was also studied to obtain a formulation with good application comfort. Although it is suggested that this lyogel could be tested in clinical studies to determine whether it is effective for relief of PMS symptoms, lyogel may be suitable as an easy-to-use l-theanine-containing formulation for women that can relieve PMS symptoms.

Background: Performing accurate estimated fetal weights (EFWs) is a critical skill developed in obstetrics residency training. Resident physicians are often the first to perform EFWs on obstetric patients when they enter care. Evaluating residents' accuracy in performing EFWs is crucial for assessing their achievement in residency training milestones and providing patient care.

Methods: As part of an educational initiative program between 2014 and 2020, postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) residents performed EFW measurements on 10 term (>37w0d) patients using ultrasound and Leopold's maneuver and 10 preterm (>24w0d and <37w0d) patients using ultrasound. Clinical characteristics, mode of delivery, and actual birthweights (BWs) were recorded for each patient. The accuracy of these estimates was evaluated using mixed-effect regression models.

Results: Thirty-three residents, 1127 deliveries, and 1790 EFW measurements were evaluated. Overall, the percentage of residents with estimations within 10% of actual BW went up in PGY2 for Leopold's and ultrasound term births, but not for preterm ultrasound births. Maternal body mass index and actual BW were associated with absolute percentage estimation error. After adjusting for these variables, there was a statistically significant decrease in error between PGY1 and PGY2 for Leopold's method in term births; ultrasound (term and preterm) showed more modest reductions in error during PGY2.

Discussion: Resident physicians have accurate estimates of EFWs early in their training, beginning in their first year of residency by both Leopold's maneuver and ultrasound. Furthermore, PGY2 residents performed better than PGY1 residents for Leopold's method.

Introduction: Association of Southeast Asian Nations (ASEAN) countries have high Helicobacter pylori infections, and gastric cancer (GC) is a leading fatal cancer in this region, especially in female patients. This study aimed to compare clinical manifestations, histopathological subtypes, and prognostic factors associated with the overall survival rate of female GC patients in this important region.

Methods: This retrospective cohort study was conducted between 2007 and 2022 at a tertiary care center in Thailand. All clinical information, endoscopic findings, and histological types were extensively reviewed. Furthermore, all qualified studies in ASEAN published in PubMed and Scopus between 2000 and 2022 were extracted and thoroughly analyzed. Young female GC patients are defined as those ≤50 years of age.

Results: A total of 98 Thai female GC patients were included, with a mean age of 58.99 ± 14 years; 70.4% were elderly women. The common presenting symptoms were weight loss (69.4%) and dyspepsia (68.4%). Younger female GC patients had significantly more common diffuse-type GC than elderly female GC patients (82.8% vs. 53.6%, p-value = 0.007). Moreover, elderly female GC patients demonstrated significantly better survival than younger female GC patients (44.8% vs. 20.7%, odds ratio = 3.49; 95% confidence interval: 1.20-10.14, p-value = 0.022). Furthermore, a total of 1,491 female GC patients from ASEAN were reviewed and included in this study, aged 15 to 93 years. The top three countries with the highest proportion of female GC from ASEAN were Indonesia (66.7%), Thailand (44.9%), and Singapore (38.4%).

Conclusion: GC in women is not uncommon in ASEAN and presents at an advanced stage with a grave prognosis. This study showed that ASEAN countries with the highest disease burden were Indonesia, Thailand, and Singapore. Overall, survival rates for female GC patients in ASEAN countries were relatively low, highlighting the need for proactive measures such as intensive H. pylori eradication and the development of early detection methods for GC.

Background: Psychiatric interventions may be required during pregnancy. In the aspect of the management of psychiatric symptoms and the consideration of the need for pharmacotherapy, possibly to manage the effects on the fetus, pregnant women with mental disorders are considered high risk as other physical illnesses.

Objective: We investigated the characteristics of pregnant women with psychiatric disorders compared with high-risk pregnant women with physical illnesses at our university hospital and the effects of psychotropic drug use on pregnant women with mental disorders and their children.

Materials and methods: In a multivariate analysis of 1282 pregnant women, excluding those with multiple pregnancies who gave birth at our hospital between January 2017 and the end of December 2019, we evaluated the effects of mental disorders and the use of psychotropic drugs throughout at least the third trimester up to the day of delivery on obstetric complications and infants. All data were collected retrospectively.

Results: Ninety-nine pregnant women had mental disorders and 62 took psychotropic drugs. Among multiple factors, pregnant women with mental disorders were associated with significantly higher rates of smoking and gestational diabetes mellitus (GDM) and significantly lower child abnormalities. The cause or effect was difficult to determine; however, the use of antipsychotics or antidepressants was also significantly associated with GDM, while psychotropic use was not related to any of the other factors investigated in this study.

Conclusions: Attention to GDM might be important in the management of pregnant women with mental disorders.

Background: Cervical cancer is a malignant neoplasm that originates in the cervix, and it is a leading cause of mortality, with 270,000 deaths every year globally. Of these, 85% occur in developing countries, including Ethiopia. Routine cervical cancer screening and early treatment can prevent up to 80% of cervical cancers. Health professionals are expected to screen for and be screened for cervical cancer. However, there is limited information about the uptake of cervical cancer screening among health professionals in the study area.

Objective: This study aimed to determine the magnitude of cervical cancer screening uptake and identify its barriers among health professionals.

Methods: A multicenter cross-sectional study design was conducted among health professionals from December 01 to 30, 2022. A total of 164 respondents were included in the study, and simple random sampling was used to select the respondents. Variables with a p-value of <0.05 at 95% confidence interval (CI) were considered significantly associated with the outcome variable.

Results: Of the total respondents, 112 (68.3%) were younger than the age of 30 years, with a mean age of 29.4 years ranging from 21 to 45 years. Seventy-nine of the respondents (48.2%) have work experience of 6-10 years, and 103 (62.8%) are nurses in profession. In this study, the magnitude of cervical cancer screening uptake was 28.1% (95% CI: 27.7%-35.6%). Moreover, attitude (adjusted odds ratio [AOR] = 3.3, 95% CI: 2.1-5.1), age at first sexual intercourse (AOR = 2.1, 95% CI: 1.3-3.4), having history of sexually transmitted infections (STIs; AOR = 3.6, 95% CI: 1.5-11.6), knowing someone who had been screened (AOR = 2.9, 95% CI: 1.8-4.8), and cervical cancer screening training (AOR = 1.6, 95% CI: 1.1-2.9) were significantly associated with cervical cancer screening.

Conclusion: Generally, this study reported that the magnitude of cervical cancer screening uptake was low. The study also indicated that attitude, age at first sexual intercourse, history of STIs, knowing someone who had been screened, and training of cervical cancer screening were independent predictors of uptake of cervical cancer screening.

Introduction: Cigarette smoking is the most common cause of preventable cancers and other premature morbidity and mortality. Modifying hormonal patterns using hormonal contraceptives (HCs) may lead to improved smoking cessation outcomes in women, though the acceptability of this is unknown. Therefore, we explored the willingness of reproductive-age women who smoke to use HC for cessation.

Methods: A cross-sectional online survey was conducted with a convenience sample of reproductive-age women living in the United States who self-reported smoking combustible cigarettes. Questions covered smoking history, previous HC use, and willingness to use various HC methods (i.e., injectable, oral, patch, vaginal insert) for cessation. Chi-squared tests and logistic regression were conducted using StataBE 17.1.

Results: Of 358 eligible respondents, n = 312 (86.9%) reported previous HC use. Average age of those with HC use history was 32.1 ± 6.1 years compared with 27.8 ± 6.7 years for those without history of HC use (p = 0.001). Of respondents who reported previous HC use, 75.6% reported willingness to use HCs, compared with 60.9% of those without a history of HC use. Overall, willingness to use various types of HC ranged from 22.6% for the vaginal insert to 59.2% willing to use an oral contraceptive.

Discussion: These observations indicate that most women who smoke cigarettes are willing to use HC for a smoking cessation aid, especially if they have a history of HC use and with an oral form of HC. To improve the rate of smoking cessation for women of reproductive age, future interventions should explore how to incorporate HC for cessation.

Background: Sleep is important for health, but its relationship to cardiometabolic health in women of childbearing age remains unclear. Furthermore, stress, unmet basic needs, and lack of physical activity may be related to disrupted sleep and poor cardiometabolic health in women of childbearing age and these relationships may differ by ethnicity. The purposes of this study were to investigate the relationship between sleep, markers of cardiometabolic health, stress, unmet basic needs, and physical activity in women of childbearing age with overweight or obesity and identify if these relationships differed between women that identified as Latino/Hispanic and non-Latino/Hispanic ethnicity.

Methods: A secondary cross-sectional analysis was conducted using baseline data from a trial that embeds healthy eating and activity into a national home visiting program, Parents as Teachers. The sample was stratified based on self-reported ethnicity (Hispanic/Latino or non-Hispanic/Latino). Pearson's and Spearman's correlations were used to determine bivariate relationships among sleep, cardiometabolic variables, stress, unmet basic needs, and physical activity.

Results: Two hundred seventy-six women, 46% of whom identified as Hispanic/Latino, were included in the analysis. Body mass index (BMI) was significantly correlated with sleep disturbance (ρ = 0.23, p = 0.01) in women who identify as Hispanic/Latino. Stress was positively related to sleep disturbance, sleep duration, and unmet needs for both groups of women. BMI was correlated with unmet basic needs in women who identified as non-Hispanic/Latino (ρ = 0.25, p = 0.01).

Conclusions: Our results suggest that sleep, stress, and basic needs are important in understanding cardiometabolic health in women of childbearing age and these relationships differ depending on ethnicity. Clinical Trial Registration Number: NCT03758638.

Background: Colombia has a high teen pregnancy (TP) rate. In 2018, one in five pregnancies was from teen mothers between 10 and 19 years of age. While TP rates are declining globally, Colombia's TP rate decline has been particularly low, despite sexual education and contraception campaigns. Other factors must be studied to prevent TP. Colombia has a long history of violence. We aim to assess whether there is a relationship between TP and exposure to violence in Colombia.

Methods: Data from the Colombian Demographic and Health Survey 2015 and the Colombian National Department of Statistics were analyzed for association between TP and sexual violence, physical violence, physical punishment as a child, and community violence. Univariate, bivariate, multivariate, and multilevel binary logistic regression models were calculated using SPSS v.25 and HLM v.7.

Results: Fifteen percent of teens were pregnant. Emotional violence was reported by 47%, sexual harassment by 27%, physical violence by 17%, physical punishment as a child by 7%, and unwanted sex by 2%. Unwanted sex (odds ratio [OR]: 3.18, 95% confidence interval [95% CI]: 1.96-5.16), sexual harassment (OR: 2.43, 95% CI: 1.89-3.14), and physical punishment (OR: 20.30, 95% CI: 7.96-22.81) were associated with adolescent pregnancy. In unadjusted models, emotional violence was associated (OR: 1.22, 95% CI 1.06-1.40) and community violence showed a tendency (OR: 1.24, 95% CI: 0.99-1.55). Physical violence was not associated.

Conclusions: Violence exposure and particularly physical punishment, unwanted sex and sexual harassment were associated with TP incidence and should be considered risk factors for TP.

Background: Access to emergency contraception is an important consideration in preventing unintended pregnancies. Inconsistent information about emergency contraceptive given to patients at retail pharmacies may limit access.

Objective: In this study, we aimed to assess pharmacy students' knowledge of oral emergency contraception.

Methods: Students in a Doctor of Pharmacy program completed a confidential survey about their knowledge of and training on oral emergency contraception. Respondents self-reported demographics included age, race, ethnicity, gender, and year in pharmacy school. The survey questions assessed student knowledge of indications, availability, side effects, and mechanisms of action of oral emergency contraception, as well as their training on emergency contraception. Chi-squared and Fisher's exact tests were used to determine if demographics influenced knowledge outcomes. A multivariate logistic regression, including age, gender, ethnicity, religion, year of training, hours of education, and source of knowledge acquisition, was used to adjust for confounding variables.

Results: Among 296 pharmacy students, 31% (92/296) completed the survey. Among respondents, 34% (31/92) showed adequate knowledge of oral emergency contraception based on four critical knowledge questions. Third- and fourth-year students were more likely to have adequate knowledge than first- and second-year students (odds ratio [OR], 2.70; confidence interval [95% CI], 1.07-6.80). Students who reported learning about emergency contraception through reading assignments were more likely to have adequate knowledge than students who did not report learning from reading assignments (OR, 2.09; 95% CI, 1.30-3.35).

Conclusions: Most pharmacy students at a single academic center did not have adequate knowledge of oral emergency contraception. These findings highlight the need for trainings to improve pharmacy student knowledge of oral emergency contraception.