Austin Journal of Women's Health最新文献

{"title":"Home Deliveries in Rwinkwavu District Hospital, Rwanda: Factor Associated with Recurrence of the Practice","authors":"A. Muhire, B. Mukarwego, I. Muhimba, Bizimana Ge, T. Bagwaneza, E. Rutayisire","doi":"10.26420/austinjwomenshealth.2021.1054","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2021.1054","url":null,"abstract":"Home delivery is persisting in developing countries. In Rwanda, 9% of mothers derived at home as reported in 2015 Demographic Health Survey. Delivering at home is associated with higher risk of maternal deaths. This study aims to investigate the rates of home delivery and associated factors. This study was a cross sectional study design with both qualitative and quantitative approaches. A convenience sampling was used to select 160 mothers for quantitative data. For qualitative data, 16 FGDs were conducted. Data were collected by using a structured questionnaire and interview guide. Quantitative data was analyzed using SPSS while qualitative data were thematically analyzed. A total of 160 mothers from 8 sectors of Kayonza district participated in the study. Of them 61.3% were aged less than 35 years, 70% were married, and 93.8% had attended primary education. The rate of delivering at home was 36.9% (deliver at home for two times or more). We found that mothers aged over 35 years were 3.5 times more likely to recurrently deliver at home than mothers aged between 15-35 years (OR=3.5; 95% CI: [1.80-6.96]; p<0.001). The odds of having a recurrence of home delivery was found to be 4 times higher among mothers with limited transport facilitation (OR=4.0; 95% CI: [1.01- 16.1]; p=0.047). Poverty, family conflicts, increase of teenage pregnancies, lack of health insurance, a lack of money to pay for a hospital services were mentioned as factors influencing recurrence of home delivery. There is a need to increase the support received by poor families in Rwanda.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129454909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploration of the Reproductive Health Concerns in Women with Systemic Lupus Erythematosus","authors":"Shim Jb","doi":"10.26420/austinjwomenshealth.2021.1053","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2021.1053","url":null,"abstract":"Systemic Lupus Erythematosus (SLE) is more frequent in women, with a female-to-male ratio ranging from 2-6:1 prior to puberty and 3-8:1 following menopause up to 8-15:1 during their fertile years [1]. SLE commonly begins when women are in their 20s, during the prime of their child-bearing years when they are often beginning to plan their families [2], and may have enormous impact on their childrearing. Although rates of infertility are not felt to be elevated among women with SLE, secondary amenorrhea has been identified in 13-17% of women with SLE who are naïve to cyclophosphamide, compared with a prevalence 1-5% in a healthy population [3]. One reason may be related lower levels of anti-Mullerian hormone [4] and higher levels of elevated anti-corpus luteum antibody levels in female patients with SLE [5]. According to one study, 64% women with SLE had fewer children than originally planned. This is likely a result of many factors including disease and medication impact on fertility and fear of disease flare-up with pregnancy. Moreover, many socioeconomic challenges accompany the disease, particularly concerns about the impact of SLE on child welfare and family life, a feature shared by many other chronic illnesses. One study reported that patients with SLE who chose to have less children than they had previously desired described concerns about inability to care for a child, damage from medications, and genetic transmission of their disease leading to the decision to pursue fewer pregnancies [6,7]. Anxieties regarding transmission and impaired ability to take care of children are among the primary worries of patients with lupus [8]. Nevertheless, this generally does not reflect a major concern of medical practitioners, leading to gaps in communication and discordant goals of care [9]. Despite intact fertility among SLE patients, there is morbidity associated with pregnancy. One study of 13,555 participants illustrated a maternal mortality 20-fold higher among women with SLE compared with healthy age-matched controls [10]. The rate of miscarriage is reported as 21.2% compared with 14% in a normal population. While the percentage of live births ranges from 85 to 90, pregnancy is considered a high-risk situation for female SLE patients [11]. Rate of stillbirth is 5 to 10 fold higher in patients with SLE than in the general population [12]. Preeclampsia is more common in SLE and may occur in up to 20% of lupus related pregnancies [13]. There is also increased risk for fetal morbidity, particularly preterm birth (12%) among SLE pregnancies compared with 4% in controls), intrauterine growth restriction, and neonatal lupus [11,14]. One third of pregnancies end in caesarian section [15]. Pregnancy morbidity is most strongly associated with increased disease activity in the six to 12 months prior to and during pregnancy, especially in cases with renal involvement [16,17]. Other risk factors in pregnancy include presence of hypocomplementemia, elevated le","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127734945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetric Dense Breast is an Independent Breast Cancer Risk Factor","authors":"A. Alikhassi, R. Shariatalavi, B. Moradi","doi":"10.26420/austinjwomenshealth.2021.1051","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2021.1051","url":null,"abstract":"Objectives: There are multiple known breast cancer risk factors, but most women with breast cancer do not have any of them, so there should be some other unknown risk factors. We hypothesized that asymmetric breast densities could be another breast cancer risk factor. Method: In this study, we defined two case and control groups with 136 women with breast cancer and 136 who did not have breast cancer, respectively. Any different type of asymmetry in either breast was recorded in both groups. Result: The frequency of focal asymmetry in cases was 47 (34.6%), which was statistically more significant than in the control group (28 (20.6%)) (p=0.010). There were three (2.9%) and five (3.7%) global asymmetries in the case and control groups, respectively (p=0.735). The frequency of one view asymmetry in the case and control groups was not significant (16 (11.8%) and 9 (6.6%) respectively) (p=0.142). In the case group, 59 (43.4%) women had at least one type of asymmetry, compared to 41 (30.1%) in the control group (p=0.02). We identify focal asymmetries (likelihood ratio, 1.215; p=0.027) is risk factors for breast cancer. Conclusion: Breast density asymmetry is a breast cancer risk factor that could be scored, thus enhancing risk stratification for screening and prevention.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114871034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest Exposure to X-Rays of Female Interventional Electrophysiologist","authors":"M. Giaccardi, F. Turreni, F. Rossi, T. Chechi, S. Mazzocchi","doi":"10.26420/AUSTINJWOMENSHEALTH.2021.1048","DOIUrl":"https://doi.org/10.26420/AUSTINJWOMENSHEALTH.2021.1048","url":null,"abstract":"Interventional Female Cardiologists (WIC) operating in high case mix laboratories are exposed to a significant chest X-Ray scattered dose from the patient. In this setting stochastic effect may be highly detrimental because of breast radiation sensitivity. Aim of this study is to measure and optimize WICs’ chest radiation exposure in a high case mix electrophysiology laboratory, in order to validate and implement the use of personal protective equipment and lead equivalent glass viewing window, and to evaluate chest X-Ray exposure behind the protective equipment.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"342 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123125887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar Diagnostic Accuracy and Reproducibility of BIRADS 4 and 5 Lesions in Radial and Meander-Like Breast Ultrasound","authors":"P. Brasier-Lutz, C. Jäggi-Wickes, R. Burian, S. Schaedelin, C. Schoenenberger, R. Zanetti-Dällenbach","doi":"10.26420/AUSTINJWOMENSHEALTH.2021.1046","DOIUrl":"https://doi.org/10.26420/AUSTINJWOMENSHEALTH.2021.1046","url":null,"abstract":"Breast ultrasound is crucial in the diagnostics of breast cancer. While meander-like Ultrasound (m-US) is most commonly used, radial Ultrasound (r- US) is emerging as suitable alternative. Breast lesions category BI-RADS 4 and 5 are suspicious and highly suggestive of malignancy, respectively, and mandate breast biopsy. We compare m-US and r-US in real-time with regard to diagnostic accuracy, examination time and the agreement in location, size and final BIRADS classification of BI-RADS 4 and 5 lesions. Out of 1948 dual examinations (m-US and r-US), 57 lesions were classified as BI-RADS 4 or 5 either by r-US or m-US or by both scanning methods. For breast lesions category BI-RADS 4 or 5, sensitivity (both scan methods 94.1%), specificity (m-US 21.7%, r-US 39.1%), cancers missed rate (both 5.9%), accuracy (m-US 64.9%, r-US 71.9%), positive predictive value (m-US 64.0%, r-US 69.6%) and negative predictive value (both 100%) were similar. In m-US, the malignancy rate for category BI-RADS 5 was 93.8% versus for 50.0% for BI-RADS 4 whereas in r-US, malignancy rates were 88.2% and 58.6% for category BI-RADS 5 and 4, respectively. The examination was significantly shorter (p<0.01) for r-US (13.6 minutes) compared to m-US (27.8 minutes). Our results support radial ultrasound as an alternative to meander-like ultrasound in breast lesions category BI-RADS 4 and 5 where patients benefit from a significantly shorter examination time.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123481098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin Aging and Modern Age Anti-Aging Strategies","authors":"Abdul Kader Mohiuddin","doi":"10.26420/austinjwomenshealth.2019.1034","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2019.1034","url":null,"abstract":"As the most voluminous organ of the body that is exposed to the outer environment, the skin suffers from both intrinsic and extrinsic aging factors. Skin aging is characterized by features such as wrinkling, loss of elasticity, laxity, and rough-textured appearance. This aging process is accompanied with phenotypic changes in cutaneous cells as well as structural and functional changes in extracellular matrix components such as collagens and elastin. With intrinsic aging, structural changes occur in the skin as a natural consequence of the biological changes over time and produce a certain number of histological, physiological, and biochemical modifications. Intrinsic aging is determined genetically (influence of gender and ethnic group), variable in function of skin site, and also influenced by hormonal changes. Visually it is characterized by fine wrinkles. By comparison, “photoaging” is the term used to describe the changes occurring in the skin, resulting from repetitive exposure to sunlight. The histological, physiological, and biochemical changes in the different layers of the skin are much more drastic. From a mechanical point of view, human skin appears as a layered composite containing the stiff thin cover layer presented by the stratum corneum, below which are the more compliant layers of viable epidermis and dermis and further below the much more compliant adjacent layer of subcutaneous white adipose tissue. Upon exposure to a strain, such a multilayer system demonstrates structural instabilities in its stiffer layers, which in its simplest form is the wrinkling. These instabilities appear hierarchically when the mechanical strain in the skin exceeds some critical values. Their appearance is mainly dependent on the mismatch in mechanical properties between adjacent skin layers or between the skin and subcutaneous white adipose tissue, on the adhesive strength and thickness ratios between the layers, on their bending and tensile stiffness as well as on the value of the stress existing in single layers. Gradual reduction of elastic fibers in aging significantly reduces the skin’s ability to bend, prompting an up to 4-fold reduction of its stability against wrinkling, thereby explaining the role of these fibers in skin aging. Anti-aging medicine is practiced by physicians, scientists, and researchers dedicated to the belief that the process of physical aging in humans can be slowed, stopped, or even reversed through existing medical and scientific interventions. This specialty of medicine is based on the very early detection and prevention of age-related diseases. Physicians practicing anti-aging medicine seek to enhance the quality of life as well as its length, limiting the period of illness and disability toward the end of one’s life. Anti-aging medicine encompasses lifestyle changes (diet and exercise); hormone replacement therapies, as needed, determined by a physician through blood testing (DHEA, melatonin, thyroid, human growth hor","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133773176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Mind-Body Therapies for the Treatment of Urinary Incontinence in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"K. P., Sylvan Sl, B. S","doi":"10.26420/austinjwomenshealth.2021.1050","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2021.1050","url":null,"abstract":"Introduction: The efficacy of mind-body therapies to manage urinary incontinence in women is outdated and inconclusive. This review aims to determine the efficacy of mind - body therapies for Stress Urinary Incontinence (SUI) in women. Methods: The databases AMED, CINAHL, EMBASE, Medline, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, and Web of Science, were searched from database inception until May 2020. Randomized controlled trials comparing mind-body therapies to control were included. The methodological quality and the quality of the evidence were evaluated using the Physiotherapy Evidence Database (PEDro) scale and the Grading of Recommendations, Assessment, Development, and Evaluation tool, respectively. The risk of bias was assessed using the Cochrane risk of bias tool. Results: Six studies were included in the review. Pooled analysis of data from two studies of low to high methodological quality, low-grade evidence revealed a statistically significant decrease in the number of SUI episodes in the yoga group than in the control group (MD 0.83 [95% CI-1.64 to 0.02]; p=0.04). Pooled analysis of three methodologically low-quality, very low-grade studies revealed no significant difference between groups receiving Paula exercise and pelvic floor muscle training on grams of urine lost in the 1h pad test (MD 0.15 [95% CI-1.15 to 1.46] p=0.82). Conclusions: This review found hatha yoga poses intended to address the pelvic floor as beneficial for managing SUI in women. Yoga is a low-risk intervention and therefore it may be considered for clinical use. The effect of Paula exercise on SUI remains inconclusive.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117148663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hystoroscopy Assisted Non-Suture Cold-Knife Conization and Cold-Knife Conization in Patients with CINIII: A Comparative Study","authors":"Xiong J, Deng Y, Z. H","doi":"10.26420/austinjwomenshealth.2021.1052","DOIUrl":"https://doi.org/10.26420/austinjwomenshealth.2021.1052","url":null,"abstract":"167 patients of cervical conization were performed for CINIII in a 34-month study. Conization include Cold-Knife Conization (CKC) (n=120) and hystoroscopy assisted non-suture cold-knife conization (HCKC) (n=47). Both groups were similar in terms of age, indications for conization, and size of cervical cone specimens. Comparing with CKC group, HCKC group was done in a significantly shorter time (28.52±9.80 minutes vs. 52.19±18.09 minutes) (P<0.05), with less intraoperative bleeding of HCKC group (44.89±10.81 ml vs. 51.50±19.94 ml) (P<0.05), shorter hospitalization time (6.89±2.11 days vs. 7.63±1.40 days) (P<0.05, and higher HPV clearance rate (100% vs. 87.13%) (P<0.05) than CKC group. While, the difference in the cure rate (95% vs. 91%) (P>0.05) , the recurrence rate (0% vs. 1%) (P>0.05) and the postoperative complication (P>0.05) between HCKC group and CKC group were not significant. The margins of the excision were checked by rapid histologic examination, showing the incidence of residual CIN was lower in HCKC group (8.51%) than in CKC group (9.17%) (P>0.05). Our study indicates that HCKC is a better treatment than CKC in the management of patients with CINIII.","PeriodicalId":360290,"journal":{"name":"Austin Journal of Women's Health","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124437362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}