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Commentary: Women’s Sexual and Reproductive Health and Public Health Crisis 评论:妇女性健康和生殖健康与公共卫生危机

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021432

R. Coutinho

ARCH Women Health Care, Volume 4(3): 1–2, 2021 Soon after the Zika virus hit Brazil, in 2015, cases of Congenital Zika Syndrome (CZS), for which the most known consequence is microcephaly, exploded. One unique feature of this virus is its capability of being transmitted by both the Aedes aegypti mosquito, a long known vector for Brazilians, and by unprotected sexual intercourse. The epidemic was soon declared a Public health Emergency of International Concern and amidst informal recommendations for pregnancy delays, little was known about how women were navigating the crisis. Knowing that half of the pregnancies are unplanned in Brazil, it was difficult to imagine that most women would be able to comply with the recommendation.

2015年，寨卡病毒袭击巴西后不久，先天性寨卡综合征(CZS)病例激增，其最著名的后果是小头畸形。这种病毒的一个独特特征是，它能够通过埃及伊蚊(巴西人早就知道的病媒)和无保护的性交传播。这一流行病很快被宣布为国际关注的突发公共卫生事件，在关于推迟怀孕的非正式建议中，人们对妇女如何应对这场危机知之甚少。知道巴西一半的怀孕是计划外的，很难想象大多数妇女能够遵守这一建议。

引用次数: 0

BMK Blood Test Result as Evaluation of Bisphosphonates Used for the Treatment of Osteoporosis BMK血液试验结果评价双膦酸盐治疗骨质疏松症的疗效

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021414

Emeritus Sek Aksaranugraha

ARCH Women Health Care, Volume 4(1): 1–3, 2021 There has been long use of Bisphosphonates for bone antiresorption; for example, Alendronate 10 mg: 1 tablet/day Alendronate 70 mg: 1 tablet/week Risedronate 5 mg: 1 tablet/day Risedronate 35 mg: 1 tablet/week Risedronate 150 mg: 1 tablet/month Ibandronate 150 mg: 1 tablet/month However, effectiveness of the recommended dosage and appropriate length of time have never been evaluated. After blood test for Biological Bone Marker, studies have been gathered for more than 10 years or since 2005-2017, and surprisingly, remarkable results have been found out. First of all, BMK blood test must be correct throughout its process, for reliable and accurate results [1]. 1. No food is allowed for patients from 8 pm to 8 am (12 hrs) 2. Blood sample is taken between 8 am to 9 am only (normal values specified by Prof. Dr. Narong B) 3. Blood Test by the Laboratory needs to be done immediately as result value varies by time. 4. Solution used for running the BMK blood test must be calibrated every morning. This report covers evaluation on bone resorting value which is CTx or Beta Cross Laps only. Normal value specified by Prof. Dr. Narong B. is 0.31 for female [2]. If CTx or Beta Cross laps as measured = 0.31 for female, there will be 100% bone resorption, as normal, for female. If CTx is more than 100% bone resorption is faster or higher than normal. If CTx is less than 100%, bone resorption is slower or lesser than normal. Example CTx value of a patient = 0.45 CTx 0.31 = 100% Review Article BMK Blood Test Result as Evaluation of Bisphosphonates Used for the Treatment of Osteoporosis Emeritus Sek Aksaranugraha* Director, Thai Red Cross Rehabilitation Center, Samut Prakarn, Thailand *Corresponding author: Emeritus Sek Aksaranugraha, Director, Thai Red Cross Rehabilitation Center, Samut Prakarn, Thailand

ARCH妇女保健，卷4(1):1 - 3,2021双膦酸盐长期用于骨抗吸收;例如，阿仑膦酸10mg: 1片/天阿仑膦酸70mg: 1片/周利塞膦酸5mg: 1片/天利塞膦酸35mg: 1片/周利塞膦酸150mg: 1片/月伊班膦酸150mg: 1片/月然而，推荐剂量的有效性和适当的时间长度从未被评估过。经过对生物骨标志物的血液检测，从2005年到2017年，收集了10多年的研究，令人惊讶的是，发现了显着的结果。首先，BMK血液检测在整个过程中必须是正确的，才能得到可靠准确的结果[1]。1. 从晚上8点到早上8点(12小时)，病人不允许进食。仅在上午8点至9点之间采集血液样本(正常值由Narong B教授指定)。由于化验结果随时间而异，故须立即进行化验。4. 用于BMK血液测试的溶液必须每天早上校准。本报告涵盖骨诉诸价值的评估，这是CTx或β交叉圈仅。Narong B.教授指定的正常值为女性[2]的0.31。如果女性的CTx或Beta Cross = 0.31，则女性的骨吸收正常为100%。如果CTx大于100%骨吸收比正常更快或更高。如果CTx低于100%，骨吸收较慢或低于正常水平。例患者的CTx值= 0.45 CTx 0.31 = 100%综述文章BMK血液测试结果评价用于治疗骨质疏松症的双磷酸盐*名誉Sek Aksaranugraha*主任，泰国，萨穆特，泰国红十字会康复中心*通讯作者:名誉Sek Aksaranugraha，主任，泰国，萨穆特，泰国红十字会康复中心

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引用次数: 0

Reaching the Roof of the World: Assessing the SRHR Beliefs of Communities Residing in the Highest Mountain Ranges in the World for Integration of Lifeskills Based Education in School Curricula 到达世界屋脊:评估居住在世界最高山脉的社区的SRHR信仰，将生活技能教育纳入学校课程

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021424

Junaid-ur-Rehman Siddiqui, Hira Mustafa Khan, M. Islam, S. Tajuddin, A. Ijaz

The Gilgit-Baltistan (GB) region of Pakistan is home to the highest mountains in the world, and the communities residing here are largely disconnected from development efforts dedicated to Sexual and Reproductive Health and Rights (SRHR) in Pakistan. In Gilgit-Baltistan, the unique topography and isolated nature of communities residing at high altitudes makes it challenging for SRHR programmers to firstly access these communities and, secondly, understand their prevalent beliefs and practices. Aahung is a Karachi-based NGO which is planning to pilot a curriculum for Life-Skills Based Education (LSBE) in schools in GB; however, with limited information available, we conducted formative research to inform curriculum design. The aim of this study is to understand the prevalent SRHR beliefs and practices with adolescence and gender as the crosscutting themes. 25 Focus Group Discussions (FGDs) were conducted with 148 total participants in different districts of GB to assess the SRHR-related needs of adolescents in the region. Approximately 34 teachers, 36 parents, and 78 students between grades 6-10 participated in the study. All FGDs were separated by gender and the students were further divided into 2 groups: Grades 6-8 and Grades 9-10. FGD guides and consent forms were developed in English and translated into Urdu. Data were transcribed and thematically analyzed by researchers to identify the SRHR and health-related needs of adolescents in the studied region. Apart from the general prevalence of poor SRHR information among young people, findings showed a significant gender difference in SRHR knowledge and practices. Boys stated several sources of SRHR information, madrasah being the key one, whereas, girls shared that although they could receive some guidance regarding puberty from madrasah, friends and female family members, even their mothers were reluctant in discussing SRHR with them in greater detail. Findings from the study will be used to inform the design of a Life-Skills Based Education (LSBE) curriculum which will be piloted with schools in GB.

巴基斯坦吉尔吉特-巴尔蒂斯坦地区拥有世界上最高的山脉，居住在这里的社区在很大程度上与巴基斯坦致力于性健康和生殖健康及权利的发展努力脱节。在吉尔吉特-巴尔蒂斯坦，居住在高海拔地区的社区的独特地形和孤立性使得SRHR程序员首先要进入这些社区，其次要了解他们普遍的信仰和习俗，这对他们来说是一个挑战。Aahung是一家总部位于卡拉奇的非政府组织，它计划在巴基斯坦的学校试行一门以生活技能为基础的教育课程;然而，由于信息有限，我们进行了形成性研究，为课程设计提供信息。本研究的目的是了解以青少年和性别为横切主题的普遍的性别和性别歧视的信念和做法。在英国不同地区共进行了25次焦点小组讨论(fgd)，共有148名参与者，以评估该地区青少年的性别与生殖健康相关需求。大约34名教师，36名家长和78名6-10年级的学生参与了这项研究。所有fdd按性别分开，学生进一步分为2组:6-8年级和9-10年级。用英文编写了FGD指南和同意表格，并翻译成乌尔都语。研究人员对数据进行转录和主题分析，以确定研究地区青少年的SRHR和健康相关需求。除了年轻人普遍缺乏SRHR信息外，研究结果还显示，在SRHR知识和实践方面存在显著的性别差异。男孩们陈述了几个关于性和性别问题的信息来源，其中伊斯兰学校是主要来源，而女孩们则说，虽然她们可以从伊斯兰学校、朋友和女性家庭成员那里得到一些关于青春期的指导，但甚至她们的母亲也不愿与她们更详细地讨论性和性别问题。研究结果将用于指导生活技能教育(LSBE)课程的设计，该课程将在英国的学校进行试点。

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引用次数: 0

Women and Venous Disease of the Lower Limbs 女性与下肢静脉疾病

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021421

Musil

ARCH Women Health Care, Volume 4(2): 1–2, 2021 The most common occasions for phlebological examination in women are edema of the lower limbs and varicose veins. These are closely related. One study investigating the cause of leg edema of unknown origin found lymphatic insufficiency, Chronic Venous Disease (CVD) or both in 70% of patients [1]. There is also a close relationship between the two diseases. Long lasting CVD causes tissue damage, lymphatic dysfunction and phlebolymphedema. On the other hand, progressive lymphedema causes leg imobility, failure of the calf-muscle venous pump and venostasis.

ARCH妇女保健，第4卷(2):1-2,2021女性最常见的血液学检查是下肢水肿和静脉曲张。这些是密切相关的。一项调查不明原因腿部水肿原因的研究发现，70%的患者存在淋巴功能不全、慢性静脉疾病(CVD)或两者兼有[1]。这两种疾病之间也有密切的关系。长期的心血管疾病会导致组织损伤、淋巴功能障碍和淋巴水肿。另一方面，进行性淋巴水肿导致腿部活动不便，小腿肌静脉泵功能衰竭和静脉停滞。

引用次数: 0

Infant Oral Health: Focus on Caries Prevention during Pregnancy 婴儿口腔健康:孕期预防龋齿为重点

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021434

Marcelle M. Nascimento

highly preventable through a combination of oral hygiene, the use of fluoride and dietary measures. Prevention of caries should start in the prenatal period because the maternal caries status is strongly associated with the caries status of their children. This short review will address the importance of early risk assessment for identification of parent-infant groups who are at high risk for Early Childhood Caries (ECC) and would benefit significantly from early preventive intervention.

通过口腔卫生、使用氟化物和饮食措施相结合，可以高度预防。预防龋齿应从产前开始，因为母亲的龋齿状况与其子女的龋齿状况密切相关。这篇简短的综述将阐述早期风险评估对识别儿童早期龋齿(ECC)高危父母-婴儿群体的重要性，并将从早期预防干预中获益。

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The Role of Atezolizumab in the Treatment of Triple- Negative Breast Cancer 阿特唑单抗在治疗三阴性乳腺癌中的作用

Archives of women health and care

Pub Date : 2021-01-01 DOI: 10.31038/awhc.2021422

P. Luz, L. Bretes, A. Arede

versus placebo were 36% and 22%). These results have been widely debated since the study design did not allow drawing these conclusions in PDL1 positive patients and it was only planned to verify the OS in PDL-1 positive patients if the data were positive in the intention to treat population. The Impassion131 trial also contradicts the findings of the IMpassion130 trial which corroborates the need for further investigations in terms of the use of atezolizumab in the treatment of TNBC this trial patients were assigned to PFS the PD-L1-positive Abstract Triple-Negative Breast Cancer (TNBC) is commonly treated with chemotherapy. However, immunotherapy has been widely suggested as a treatment option for patients with TNBC, including atezolizumab. The present narrative article aims to fully understand the evidence of atezolizumab in the treatment of TNBC. Newer and better biomarkers are needed to select patients with TNBC that are more likely to benefit from immunotherapy.

分别为36%和22%)。这些结果引起了广泛的争论，因为研究设计不允许在PDL1阳性患者中得出这些结论，并且只有在意图治疗人群的数据为阳性时才计划验证PDL-1阳性患者的OS。Impassion131试验也与IMpassion130试验的结果相矛盾，IMpassion130试验证实了在使用atezolizumab治疗TNBC方面需要进一步调查。该试验患者被分配到PFS, pd - l1阳性的Abstract三阴性乳腺癌(TNBC)通常用化疗治疗。然而，免疫疗法已被广泛建议作为TNBC患者的治疗选择，包括atezolizumab。本文旨在充分了解atezolizumab治疗TNBC的证据。需要更新和更好的生物标志物来选择更有可能从免疫治疗中获益的TNBC患者。

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Mapping Contextual Drivers of HIV Vulnerability: A Qualitative Study of African, Caribbean, Black Youth in Windsor, Canada 绘制艾滋病毒脆弱性的背景驱动因素:对加拿大温莎的非洲、加勒比、黑人青年的定性研究

Archives of women health and care

Pub Date : 2020-12-29 DOI: 10.31038/awhc.2020353

F. Omorodion, E. Maticka-Tyndale, N. W. Jangu

Background: Based on POWER study: Promoting and owning empowerment and resilience among African, Caribbean, and Black Canadian (ACB) youth, this paper explored the contextual factors that expose ACB youth to HIV infection. Method: We conducted six focused community-mapping sessions with 43 purposively drawn ACB youth living in Windsor, Canada. Based on socio-environmental approach, we investigated a number of issues including, where to find ACB people, places afraid to go, places to find casual partners, where they spend leisure time, healthy and unhealthy places. Results: The findings showed that ACB population mainly resides in poor areas, with close proximity to bars, strip shops, recreational/sports places. And, multifaceted factors, such as economic deprivation, marginalization, discrimination, and substance use provided an enabling environment for ACB youth exposure to HIV/AIDS. Conclusion: Future HIV/AIDS prevention must be locality specific and culturally sensitive, by taking into account individual, structural, environmental and socio-cultural factors in future HIV prevention strategies.

背景:基于POWER研究:促进和拥有非洲、加勒比和加拿大黑人(ACB)青年的赋权和复原力，本文探讨了使ACB青年暴露于艾滋病毒感染的环境因素。方法:我们对居住在加拿大温莎的43名ACB青年进行了6次重点社区测绘会议。基于社会环境方法，我们调查了许多问题，包括在哪里可以找到ACB人，害怕去的地方，找到临时伴侣的地方，他们在哪里度过闲暇时间，健康和不健康的地方。结果:ACB人群主要分布在贫困地区，靠近酒吧、脱衣舞店、文体娱乐场所;此外，经济贫困、边缘化、歧视和药物使用等多方面因素为ACB青年接触艾滋病毒/艾滋病提供了有利的环境。结论:未来的艾滋病毒/艾滋病预防必须考虑到个人、结构、环境和社会文化因素，具有地方特异性和文化敏感性。

引用次数: 0

Sources of Information and Health Care Experiences Related to COVID-19 among Women Involved in Criminal Legal System in Three U.S. Cities. 美国三个城市刑事司法系统女性与COVID-19相关的信息来源和医疗保健经历

Archives of women health and care

Pub Date : 2020-12-01 Epub Date: 2020-10-08 DOI: 10.31038/awhc.2020351

J Lorvick, J Hemberg, K Cropsey, J Wickliffe, A Faust, M Comfort, M Ramswamy

Women in the United States criminal legal (CL) system are at the nexus of several drivers of the COVID-19 pandemic, including incarceration, poverty, chronic illness and racism. There are 1.25 million women incarcerated or on community supervision (probation or parole) in the U.S. We present findings regarding the impact of COVID-19 on women in the CL system (N=344) during the early days of the pandemic. Participants were drawn from community settings in an ongoing study of cervical cancer risk in three U.S. cities: Birmingham, Alabama, Oakland, California and Kansas City, which straddles the states of Kansas and Missouri. Regional differences were found in COVID-19 testing and perceived susceptibility to the virus, but not in COVID-related disruptions to health care. We found differences by race/ethnicity in trusted sources of information about COVID. Black women had higher odds of choosing TV as their most trusted source of information, while White women were more likely to cite government or social service agencies as their most trusted source. Notably, 15% of women said they did not trust any source of information regarding COVID-19. COVID-19 disproportionately impacts populations with high levels of mistrust towards medical and government institutions, a result of the twin legacies of medical mistreatment and structural racism. Our findings underscore the need for innovative strategies to reach these groups with accurate and timely information.

美国刑事法律体系中的妇女是COVID-19大流行的几个驱动因素的核心，包括监禁、贫困、慢性病和种族主义。在美国，有125万女性被监禁或接受社区监督(缓刑或假释)。我们提出了关于COVID-19在大流行早期对CL系统中女性(N=344)的影响的研究结果。参与者是从美国三个城市的社区环境中抽取的，这三个城市是:伯明翰、阿拉巴马、奥克兰、加利福尼亚和堪萨斯城，横跨堪萨斯州和密苏里州。在COVID-19检测和对该病毒的易感性方面发现了地区差异，但在与COVID-19相关的卫生保健中断方面没有发现地区差异。我们发现关于COVID的可信信息来源存在种族/民族差异。黑人女性更倾向于选择电视作为她们最信任的信息来源，而白人女性更倾向于将政府或社会服务机构作为她们最信任的信息来源。值得注意的是，15%的女性表示，她们不相信任何有关COVID-19的信息来源。由于医疗虐待和结构性种族主义的双重影响，COVID-19对医疗和政府机构高度不信任的人群产生了不成比例的影响。我们的研究结果强调了创新策略的必要性，以便向这些群体提供准确和及时的信息。

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引用次数: 2

Severe Spinal Column Deformity from Scoliosis with Harrington Rods Implant 重度脊柱侧凸伴哈林顿棒植入

Archives of women health and care

Pub Date : 2020-08-20 DOI: 10.31038/awhc.2020344

Hina Faisal, SN Johnson, AO Gaber

ARCH Women Health Care, Volume 3(4): 1–1, 2020 Severe scoliotic deformity of the thoracolumbar spine imposes a significant anesthesia challenge for non-spine surgery. Patients with severe scoliosis are at increased risk for perioperative morbidity and mortality due to underlying pulmonary and cardiac dysfunctions [1-3]. Stress, pain, mechanical ventilation, and surgery-induced inflammation can further increase the risk of postoperative cardiopulmonary failure. We present a preoperative chest radiograph demonstrating extensive thoracolumbar scoliosis with Harrington rods implant, anatomic distortion, and bony dysmorphism (Panel A, white arrow). The patient underwent a living donor kidney transplant under general anesthesia. Preoperative anesthesia and surgical planning is crucial and should focus on airway difficulty, ventilation management, positioning, new kidney location, and postoperative pain management.

严重的胸腰椎侧凸畸形对非脊柱手术的麻醉提出了重大挑战。重度脊柱侧凸患者由于潜在的肺和心脏功能障碍，围手术期发病率和死亡率的风险增加[1-3]。压力、疼痛、机械通气和手术引起的炎症可进一步增加术后心肺衰竭的风险。我们的术前胸片显示广泛的胸腰椎侧凸伴哈林顿棒植入，解剖扭曲和骨畸形(图a，白色箭头)。病人在全身麻醉下接受了活体肾移植手术。术前麻醉和手术计划至关重要，应关注气道困难、通气管理、体位、新肾定位和术后疼痛管理。

引用次数: 0

The Urgent Need to Optimize Gestational Weight in Overweight/Obese Women to Lower Maternal- Fetal Morbidities: A Retrospective Analysis on 59,000 Singleton Term Pregnancies 超重/肥胖妇女迫切需要优化妊娠体重以降低母胎发病率:对59000例单胎足月妊娠的回顾性分析

Archives of women health and care

Pub Date : 2020-06-24 DOI: 10.31038/awhc.2020342

P. Robillard, G. Dekker, M. Boukerrou, B. Boumahni, T. Hulsey, M. Scioscia

Objective : We retrospectively did a simulation applying the optimal gestational weight gain (optGWG) equation (that we have proposed in 2018) on our population, and observed if its effect on maternal/fetal morbidities in singleton term pregnancies (≥37 weeks). Design: Retrospective observational study. sample All singleton births maternity. database. Methods Mathematical simulation on a 19-year historical cohort (2001-2019). Main outcome measures : Five Maternal/fetal morbidities. Results : Beginning with overweight women, and enlarging the effect with the rise of different obesities (class I to III) and considering maternal pre- pregnancy BMI (ppBMI), individualized counselling women on their GWG (optimal gestational weight gain, optGWG) lowers significantly maternal/ fetal morbidities: in a logistic regression model among overweight/obese women, with the outcome optGWG, several morbidities have a negative coefficient as independent factors: cesarean-section, birthweight ≥ 4000 g, term preeclampsia, lowering the effect of rising maternal ppBMI per increment of 5 kg/m² (coefficient -0.13), all p < 0.001. We propose as a prediction to be verified in future prospective studies that a follow-up and counselling since the first prenatal visit should also lower gestational diabetes mellitus rates. Conclusion : We may have significant health (and cost) benefits by lowering c-section rates, term preeclampsia, macrosomic babies and LGA babies in overweight/obese women and low-birthweights babies in lean women. We may have much to win from reducing weight gain during pregnancy in overweight/obese women. It is urgent to verify and establish in all continents the specific linear-curve of optGWG for each geographic/ethnic area.

目的:我们回顾性地对我们的人群进行了一次模拟，应用我们在2018年提出的最佳妊娠体重增加(optGWG)方程，并观察其对单胎足月妊娠(≥37周)中母体/胎儿发病率的影响。设计:回顾性观察性研究。所有的单胎分娩。数据库。方法对2001-2019年19年的历史队列进行数学模拟。主要结局指标:5例孕产妇/胎儿发病率。结果:从超重妇女开始，随着不同肥胖程度(I至III级)的增加，并考虑到产妇孕前体重指数(ppBMI)，个体化咨询妇女的GWG(最佳妊娠体重增加，optGWG)显著降低了产妇/胎儿的发病率;在超重/肥胖妇女的logistic回归模型中，以optGWG为结局，一些发病率作为独立因素具有负系数:剖宫产，出生体重≥4000 g，足月子痫前期，每增加5 kg/m²产妇ppBMI降低效果(系数-0.13)，均p < 0.001。我们建议在未来的前瞻性研究中验证，自首次产前检查以来的随访和咨询也应降低妊娠期糖尿病的发病率。结论:通过降低超重/肥胖妇女的剖腹产率、足月先兆子痫、巨大婴儿和LGA婴儿以及瘦妇女的低出生体重婴儿，我们可能会有显著的健康(和成本)效益。我们可以从减少超重/肥胖妇女孕期体重增加中获益良多。迫切需要在各大洲验证和建立每个地理/民族区域的特定光热工作曲线。

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引用次数: 11

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