BMC Women's Health最新文献

Background: Incarcerated women face significantly elevated cervical cancer risks compared to the general population due to higher human papillomavirus (HPV) prevalence, limited healthcare access, and socio-demographic vulnerabilities. Despite elevated risk, female inmates are substantially less likely to receive cervical screening. No studies examining cervical screening among incarcerated populations in Nordic countries have been identified.

Objective: To examine risk factors for cervical abnormalities, screening experiences, HPV vaccination status, barriers to screening participation, and symptoms among incarcerated women in Norway before and after a cervical screening campaign.

Methods: A repeated cross-sectional study was conducted in all three Norwegian prisons with women's wards using a researcher-developed questionnaire. Data were collected at baseline (January/February 2025, n = 77) and post-campaign (May/June 2025, n = 97). The campaign included informational materials, prison visits, and educational sessions. The questionnaire assessed demographics, risk factors, screening history, vaccination status, participation barriers, and symptoms. Data were analyzed using descriptive statistics and chi-square tests.

Results: Most respondents were aged 25-44 years, serving sentences under six months. High prevalence of risk factors was observed: tobacco/snus use (61.0%/53.9% at baseline) and multiple sexual partners (38.2% reported ≥ 5 partners). While 68.8% had prior cervical screening, only 19.6% received screening during incarceration. HPV vaccination rates were low (16.9%). Primary barriers included insufficient information (22.7% baseline, 33.8% post-campaign), fear of pain, previous trauma, and healthcare mistrust. Approximately one-third reported symptoms potentially indicating cervical abnormalities, most commonly persistent lower back pain (52% baseline, 65.6% post-campaign) and pelvic pain (36% baseline, 40.6% post-campaign). No statistically significant differences were observed between baseline and post-campaign responses.

Conclusions: Incarcerated Norwegian women exhibit multiple cervical cancer risk factors yet face substantial screening barriers during imprisonment. The campaign demonstrated limited impact on screening uptake, suggesting comprehensive sustained interventions are needed. Future strategies should address structural barriers, ensure adequate follow-up care, and explore self-sampling approaches to reduce health disparities in this vulnerable population.

Aim: In the our study, we examined the relationship between galectin-3 levels and global longitudinal strain (GLS) and aortic intima-media thickness (A-IMT) in patients with polycystic ovary syndrome (PCOS). We evaluated the potential of this molecule as a biomarker in the early stages of atherosclerosis and heart failure.

Material and method: A total of 80 participants, 40 newly diagnosed PCOS patients and 40 healthy controls, were included in the Health Sciences University Adana City Training and Research Hospital between 01.06.2021 and 31.03.2022. Galectin-3 level was measured by using Human galectin-3 kits and Enzyme-Linked Immuno Sorbent Assay method. A-IMT and GLS measurements were performed by using ultrasonography and echocardiography.

Results: When both study groups were evaluated, a statistically significant difference was found between the PCOS patient and the control groups in terms of blood glucose (93.6 ± 9.82 mg/dL to 87.7 ± 8.42 mg/dL; p = 0.006) HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) Index (2.55 ± 0.49 to 2.05 ± 0.61; p < 0.001), galectin-3 (13.7 ± 0.98 ng/mL to 12.2 ± 2.08 ng/mL; p < 0.001), A-IMT (1.41 ± 0.008 mm to 1.25 ± 0.16 mm; p < 0.001), and GLS (-16.7 ± 1.75% to -18.8 ± 1.37%; p < 0.001) values A correlation analysis was conducted, resulting in the identification of a robust association between galectin-3 levels and GLS (r = 0.747, p < 0.001). Additionally, weaker yet statistically significant correlations were observed between galectin-3 levels and A-IMT (r = 0.327, p = 0.006) and HOMA-IR (r = 0.446, p < 0.001). Multivariate analysis revealed that GLS was the only independent predictor of galectin-3 levels (B = 0.395; p < 0.001). Conversely, A-IMT and HOMA-IR were not significant predictors (p = 0.340 and p = 0.887, respectively).

Conclusion: Galectin-3 levels were significantly associated with markers of subclinical atherosclerosis and early cardiac dysfunction in patients with PCOS. Galectin-3 demonstrated potential utility as a biomarker for the early identification of subclinical atherosclerosis and heart failure risk in this population. Notably, this study is the first to evaluate the association of galectin-3 with both A-IMT and GLS in patients with PCOS, providing novel insights into their cardiovascular risk profile.

Background: Endometriosis is a prevalent chronic condition that causes persistent pelvic pain, significantly impairing quality of life and contributing to psychological distress. This study aimed to assess the prevalence of clinically significant symptoms of depression and anxiety among women with endometriosis and to identify factors associated with these mental health outcomes.

Methods: This cross-sectional study was conducted between 2023 and 2024 at Shahid Kamali Hospital, Karaj, Iran. Women with a confirmed diagnosis of endometriosis by a gynecologist were recruited using convenience sampling. Participants completed the Hospital Anxiety and Depression Scale (HADS), a validated self-report screening tool, and clinical data were extracted from medical records. Univariate and multivariate logistic regression analyses were performed to identify demographic and clinical factors associated with clinically significant symptoms of depression and anxiety.

Results: A total of 112 women participated (mean age: 31.6 ± 4.9 years; mean BMI: 26.3 ± 3.7 kg/m²). The prevalence of clinically significant symptoms of depression and anxiety was 59.8% (95% CI: 50.4-68.6) and 54.5% (95% CI: 45.1-63.6), respectively. Univariate analyses showed that longer disease duration and higher pain intensity were significantly associated with depression, while education level was associated with anxiety. No significant association was found between endometriosis severity and either outcome. In the multivariate model, age, disease duration, and pain intensity remained significant correlates of depression, while education level and age were associated with anxiety.

Conclusions: Clinically significant symptoms of depression and anxiety were highly prevalent among women with endometriosis. Disease duration and pain intensity were the main factors associated with depressive symptoms, while education level was linked to anxiety. These findings emphasize the need for integrated physical and psychological care for women with endometriosis, particularly those experiencing prolonged disease and chronic pain.

Background: Postmenopausal women undergo physiological changes in the vaginal and cervical transformation zones, which influence the accuracy of cervical cancer screening and colposcopy results. This study aims to evaluate the immediate risk of cervical intraepithelial neoplasia (CIN) in postmenopausal women who are positive non-16/18 high-risk human papillomavirus (HPV) and Thinprep Cytologic Test (TCT) results classified as either no intraepithelial lesion or malignancy (NILM) or atypical squamous cells of undetermined significance (ASC-US), examine the clinical implications of cervical cancer screening and colposcopy in this population and identify potential approaches to enhance current diagnostic protocols.

Methods: This study collected and analyzed clinical data from postmenopausal women who tested positive for either abnormal cytology or HPV between January 2023 to December 2024 at a single center hospital. The incidence of CIN was compared between the HPV16/18-positive group and the non-HPV16/18-positive group among patients with TCT results categorized as NILM or ASC-US. Additionally, a detailed analysis of the colposcopic results was performed for non-HPV16/18-positive women presenting with NILM or ASC-US on TCT.

Results: Among the 392 patients who were non-HPV16/18-positive and had TCT results indicating either NILM or ASC-US, there were 50 cases (12.76%) of CIN 1, 18 cases (4.59%) of CIN 2/3, and 1 case (0.26%) of cervical cancer. Of these patients, 312 had TCT results classified as NILM and 80 as ASC-US. Within these subgroups, 15 cases (4.81%) in the NILM group and 4 cases (5.00%) in the ASC-US group developed CIN 2 + lesions. The difference between the two groups was not statistically significant (p = 0.94). Among the 104 patients diagnosed with CIN 2 + lesions, 27 cases (25.96%) exhibited symptoms such as postmenopausal vaginal bleeding or abnormal discharge symptoms of varying degrees.

Conclusions: Vaginal bleeding and abnormal discharge in postmenopausal women warrant immediate evaluation. For postmenopausal patients who are HPV 16/18‑negative and have NILM or ASC‑US cytology, routine surveillance is appropriate. Adjunctive testing with E6/E7 mRNA assays or p16/Ki‑67 dual‑staining may be employed; any abnormal result should prompt diagnostic work‑up.