BMC Women's Health最新文献

Background: Endometriosis, affecting 10-15% of women, causes pain and infertility. Current treatments have limitations. This study aimed to investigate patients' knowledge, attitude, and practice (KAP) concerning endometriosis and its long-term management.

Methods: A cross-sectional study was conducted among patients diagnosed with endometriosis, using a self-designed questionnaire.

Results: A total of 301 valid questionnaires were included. The mean age of the participants was 32.3 ± 6.8 years, and 220 (73.1%) cases or participants. The participants scored a mean of 13.28 ± 5.98 (possible range: 0-24) for knowledge, 28.23 ± 2.38 (possible range: 8-40) for attitude, and 22.56 ± 4.76 (possible range: 7-35) for practice. They indicated a generally poor KAP. The structural equation model revealed that knowledge had a direct influence on attitude (β = 0.287, P = 0.014) and knowledge also directly influenced practice (β = 0.361, P = 0.005). Duration of endometriosis (β = 0.300, P = 0.006), having children (β = -0.127, P = 0.010), ethnicity (β = -0.127, P = 0.010), education (β = 0.217, P = 0.009), and having female relatives with endometriosis (β = -0.202, P = 0.004) had significant direct effects on knowledge. Having children (β = -0.037, P = 0.015), ethnicity (β = -0.037, P = 0.008), having female relatives with endometriosis (β = -0.058, P = 0.004), income (β = -0.176, P = 0.009), drinking (β = 0.318, P = 0.008), and health insurance (β = 0.169, P = 0.016) influenced attitude. Duration of endometriosis diagnosis (β = 0.103, P = 0.006), having children (β = -0.044, P = 0.010), ethnicity (β = -0.242, P = 0.015), education (β = 0.258, P = 0.013), having female relatives with endometriosis (β = -0.293, P = 0.007), and health insurance (β = -0.123, P = 0.030) influenced practice.

Conclusion: Patients demonstrated inadequate knowledge, moderate attitudes, and practices regarding endometriosis. These findings suggest a need for more targeted educational efforts. Healthcare providers should prioritize education, particularly for individuals from diverse backgrounds and those with limited resources, to enhance patient outcomes.

Background: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR), a new lipid marker, can comprehensively reflect the lipid metabolic status of an individual. This study aimed to investigate the association between the NHHR and endometriosis, as well as the potential mediating role of a novel immuno-nutritional score, the C-reactive protein-albumin-lymphocyte (CALLY) index, in this relationship.

Methods: The National Health and Nutrition Examination Survey (NHANES) 2001-2006 data were utilized for analysis. The link between NHHR values and EMS prevalence was examined via the multivariable logistic regression (MLR) models. The dose-response association was assessed through restricted cubic spline models. The stability of the findings was confirmed by subgroup analyses and interaction tests. A mediation analysis was conducted to investigate whether the CALLY index mediated the association between NHHR and endometriosis.

Results: A total of 3994 female individuals were included, with an overall EMS prevalence of 7.19% (n = 287 cases out of 3994). Weighted MLR analysis demonstrated that, in the fully controlled model, every unit rise in NHHR was linked to 14.3% greater odds of having EMS (OR = 1.143, 95% CI: 1.001-1.306, P = 0.049). The robustness of the results was verified by subgroup analyses. Mediation analysis indicated that the CALLY index partially mediated 13.95% of the association between NHHR and endometriosis.

Conclusion: This study revealed a positive linear association between NHHR levels and the odds of having endometriosis, with the CALLY index partially mediating this relationship. Therefore, active management of lipid levels may contribute to decreasing EMS prevalence.

Background: The interplay between menopause and domestic abuse (DA) presents a complex, under-researched nexus within women's health. Menopause, a significant physiological and psychosocial transition, may be affected by, or contribute to, women's experiences of abuse. This scoping review explores how DA during the perimenopausal and postmenopausal stages, referred to as midlife (ages 40-65) impacts symptom severity, abuse dynamics, and healthcare engagement.

Methods: A scoping review methodology following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines. MEDLINE, CINAHL, Web of Science, and EMBASE were searched for English-language peer-reviewed studies exploring the relationship between menopause and DA with no restriction on date range. Inclusion criteria were studies involving women who were perimenopausal or postmenopausal and had experienced DA.

Results: Of 189 unique records screened, 39 studies were included. Cross-sectional studies were most prevalent (n = 16, 41%), followed by cohort studies (n = 9, 23%) qualitative studies (n = 5, 15%) secondary data analysis (n = 3, 8%) and longitudinal studies (n = 2, 5%). There was also one each (n = 1, 2%) of clinical trial, retrospective analysis, case control study and systematic review. Three interconnected themes were identified:(1) a consistent link between experiences of DA and increased severity of menopausal symptoms (n = 34); (2) a tendency for DA to escalate or (re)emerge during midlife and menopause (n = 5); and (3) missed opportunities for DA disclosure within menopause-related healthcare encounters (n = 14). Studies spanned 14 countries, with the majority conducted in the United States (n = 16). No studies from the UK were identified.

Conclusion: For DA survivors there is an increase in menopausal symptoms, with profound effects on their mental, emotional, and physical health. Menopause represents both a potential risk period for DA and an opportunity for healthcare providers to identify abuse. This review highlights the urgent need for trauma-informed, menopause-sensitive healthcare practices, as well as further UK-based research.

Introduction: Spontaneous uterine rupture in a non-gravid, unscarred uterus is an exceedingly rare and life-threatening gynecological emergency. This report details a unique case of such a rupture in a postmenopausal woman, secondary to a fulminant pelvic infection.

Case presentation: A 55-year-old grand multipara postmenopausal woman, with a history of recurrent lower abdominal pain, presented with severe abdominal pain, malodorous vaginal discharge, and fever of six days duration. Physical examination revealed a diffusely tender abdomen with guarding, and laboratory investigations showed leukocytosis and anemia. Abdominal ultrasound revealed intra-abdominal collection with an echo complex mass in the paracolic gutter, suggestive of abscess collection in the abdominoplevic cavity. Due to hemodynamic instability, the patient was resuscitated with crystalloids and underwent emergent exploratory laparotomy involving both surgical and gynecologic teams. Intraoperatively, about 2000 ml of purulent material was sucked out, and the uterine fundus was found ruptured, necrotic, and eaten up for which a total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Microbiological analysis confirmed Escherichia coli infection, and histopathology ruled out malignancy, showing only inflammatory changes.

Conclusion: A spontaneous uterine rupture in a non-gravid, unscarred uterus resulted from fulminant pelvic infection, establishing chronic pelvic inflammatory disease as an etiology through direct tissue erosion. This case underscores the necessity of considering genital tract sepsis in postmenopausal women presenting with acute abdomen and highlights the critical importance of emergent surgical intervention, targeted antimicrobial therapy, and rigorous adherence to PID management guidelines for preventing this life-threatening complication.