Medical Specialties Commons^™

Ethnic Disparities In Cervical Cancer Survival Among Medicare Eligible Women In A Multiethnic Population, Ann L. Coker, Katherine S. Eggleston, Xianglin L. Du, Lois Ramondetta

CRVAW Faculty Journal Articles

To determine predictors of cervical cancer survival by socioeconomic status (SES), urbanization, race/ethnicity, comorbid conditions, and treatment among elderly Medicare-eligible women whose conditions were diagnosed with cervical cancer in a multiethnic population.

Methods: A total of 538 women with cervical cancer aged 65 years or older were identified from 1999 to 2001 from the Texas Cancer Registry and were linked with the state Medicare data and Texas Vital Records to determine survival times. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of SES was created using census tract-level data as was urbanization. Treatment and …

Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

Obesity And Contraception, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Ritonavir Blocks Akt Signaling, Activates Apoptosis And Inhibits Migration And Invasion In Ovarian Cancer Cells, Sanjeev Kumar, Christopher S. Bryant, Sreedhar Chamala, Aamer Qazi, Shelly Seward, Jagannath Pal, Christopher P. Steffes, Donald W. Weaver, Robert Morris, John M. Malone, Masood A. Shammas, Madhu Prasad, Ramesh B. Batchu

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Ovarian cancer is the leading cause of mortality from gynecological malignancies, often undetectable in early stages. The difficulty of detecting the disease in its early stages and the propensity of ovarian cancer cells to develop resistance to known chemotherapeutic treatments dramatically decreases the 5-year survival rate. Chemotherapy with paclitaxel after surgery increases median survival only by 2 to 3 years in stage IV disease highlights the need for more effective drugs. The human immunodeficiency virus (HIV) infection is characterized by increased risk of several solid tumors due to its inherent nature of weakening of immune system. Recent observations …

The Role Of Abortion In The Last Stage Of Fertility Decline In Vietnam, Bussarawan Teerawichitchainan, Sajeda Amin

Poverty, Gender, and Youth

Vietnam’s rapid fertility decline can be explained by very high rates of contraceptive use and induced abortion, but despite the overall decline, fertility rates vary considerably across the country’s 54 ethnic groups. To explore the prospects for further fertility decline through use of abortion among high-fertility minority populations, this study analyzes unique data from the Vietnam National Health Survey to examine ethnic differentials in prevalence and determinants of abortion and contraception, using a new classification system for ethnicity. The report concludes that providing improved abortion services alone is unlikely to reduce fertility among high-fertility minority groups. Service provision needs to …

Increased Strength And Physical Performance With Eccentric Training In Women With Impaired Glucose Tolerance: A Pilot Study, Robin L. Marcus, Paul C. Lastayo, Leland E. Dibble, Laura Hill, Donald A. Mcclain

Human Movement Studies & Special Education Faculty Publications

Background: Menopause is associated with both a loss of muscle mass and a worsening of insulin sensitivity (IS). Although eccentric resistance exercise (ECC) can effectively improve muscle mass over time, a single bout of ECC can worsen IS. This study assessed the effect of repeated ECC on IS, muscle mass, and function in postmenopausal women with impaired glucose tolerance (IGT).

Methods: Sixteen PM women (aged 56 years +/- 6.4) with IGT were randomly assigned to a 12-week, knee extensor ECC program (n = 10) or a nonexercise control group (CON) (n = 6). Participants underwent hyperinsulinemic-euglycemic clamps, dual-energy …

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Elevated Corticotropin-Releasing Hormone In Human Pregnancy Increases The Risk Of Postpartum Depressive Symptoms, Ilona S. Yim, Laura M. Glynn, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Curt A. Sandman

Psychology Faculty Articles and Research

Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence.

Maturation Of The Human Fetal Startle Response: Evidence For Sex-Specific Maturation Of The Human Fetus, Claudia Buss, Elyssia Poggi Davis, Quetzal A. Class, Matt Gierczak, Carol Pattillo, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

Despite the evidence for early fetal experience exerting programming influences on later neurological development and health risk, very few prospective studies of human fetal behavior have been reported. In a prospective longitudinal study, fetal nervous system maturation was serially assessed by monitoring fetal heart rate (FHR) responses to vibroacoustic stimulation (VAS) in 191 maternal/fetal dyads. Responses were not detected at 26 weeks gestational age (GA). Sex-specific, age-characteristic changes in the FHR response to VAS were observed by 31 weeks' GA. Males showed larger responses and continued to exhibit maturational changes until 37 weeks'GA, females however, presented with a mature FHR …

Fmic Annual Report 2009​ | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Prolonged Monitoring After Decelerations On Outpatient Non-Stress Tests: How Long Is Enough?, P. Koduri, Md, M. Giraldo, Md, V. Berghella, Md, S. P. Chauhan, Md

Department of Obstetrics and Gynecology Faculty Papers

Objective: To determine the appropriate duration of prolonged monitoring following decelerations noted on outpatient non-stress test (NST).

Conclusion: Prolonged monitoring beyond 120 min is not associated with increased rate of delivery secondary to NRFS or worse neonatal outcome measured by the 5 minute Apgar score. Monitoring after a deceleration on outpatient NST may be limited to less than 120 minutes. Larger studies are needed to confirm this finding.

Does 17 Alpha-Hydroxyprogesterone Caproate Decrease The Rate Of Preterm Birth In Women With An Ultrasound-Indicated Cerclage?, T. J. Rafael, D. Mackeen, V. Berghella

Department of Obstetrics and Gynecology Faculty Papers

Objective: To estimate whether the use of 17 alpha-hydroxyprogesterone caproate (17P) in women with an ultrasound-indicated cerclage (UIC) reduces the rate of preterm birth (PTB).

Conclusions: Among women with a prior spontaneous PTB and current UIC for CL<25mm, 17P did not reduce the rate of PTB <35 weeks.

Effectiveness Of 17-Alpha-Hydroxyprogesterone Caproate On The Prevention Of Preterm Birth In Women With A History-Indicated Cerclage, D. Mackeen, Md, T. J. Rafael, Md, J. Zavodnick, Ba, V. Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Objective: To determine whether 17-alpha-hydroxyprogesterone caproate (17P) reduces the incidence of preterm birth (PTB) in women with a history-indicated cerclage.

Conclusions: 17P does not appear to have an effect on preterm birth <35 weeks in women with a history-indicated cerclage.

Cervical Cancer Prevention In Pregnant Women: Is Biopsy Useful?, N. S. Seligman, Md, J. Zavodnick, Ba, K. Mccullen, Md

Department of Obstetrics and Gynecology Faculty Papers

Objective: To estimate if cervical biopsy at the time of colposcopy changes the management or outcome of abnormal cervical cytology during pregnancy.

Conclusion: Biopsy of suspected cervical lesions can be safely deferred until after pregnancy because there were no significant changes between antepartum and postpartum CC and no missed cases of cervical cancer were detected.

Genomic Rna Profiling And The Programme Controlling Preimplantation Mammalian Development., Christine E Bell, Michele D Calder, Andrew J Watson

Obstetrics & Gynaecology Publications

Preimplantation development shifts from a maternal to embryonic programme rapidly after fertilization. Although the majority of oogenetic products are lost during the maternal to embryonic transition (MET), several do survive this interval to contribute directly to supporting preimplantation development. Embryonic genome activation (EGA) is characterized by the transient expression of several genes that are necessary for MET, and while EGA represents the first major wave of gene expression, a second mid-preimplantation wave of transcription that supports development to the blastocyst stage has been discovered. The application of genomic approaches has greatly assisted in the discovery of stage specific gene expression …

Torsion Of Fallopian Tube, Fimbrial Cyst, Imrana Masroor, Nadir Khan

Department of Radiology

A case of fallopian tube fimbrial cyst torsion with haemorrhage is presented, occurring in a 37-year-old female who had tubal ligation 6 years back. She presented in emergency with acute abdomen. Initial assessment of ovarian cyst haemorrhage or torsion was made. Ultrasound showed cystic structures in left adnexa and complex cyst in right adnexa with suspicion of torsion. Laparoscopy was performed and bilateral fimbrial cysts in fallopian tubes were identified with torsion on right side, and a left ovarian haemorrhagic cyst, which was subsequently confirmed on histopathology. Although fallopian tube torsion of fimbrial cyst is rare, it should be considered …

Predicting Length Of Treatment For Neonatal Abstinence Syndrome In Methadone-Exposed Neonates., Neil S. Seligman, Nicole Salva, Edward J. Hayes, Kevin C. Dysart, Edward C. Pequignot, Jason K. Baxter

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The objective of the study was to identify maternal variables predicting length of treatment for neonatal abstinence syndrome (NAS).

STUDY DESIGN: This was a retrospective cohort study of infants treated for NAS during 2000-2006 whose mothers were on methadone maintenance at delivery. Mixed-effects linear regression was used to examine the interaction of maternal and neonatal variables with length of treatment.

RESULTS: Of 204 neonates born to methadone exposed mothers, the average dose at delivery was 127 mg daily (25-340 mg) with median length of treatment 32 days (1-122 days). Trimester of initial exposure (P = .33), methadone dose at …

Icpd To Mdgs: Missing Links And Common Grounds., Farina G Abrejo, Babar Shaikh, Sarah Saleem

Community Health Sciences

The ICPD agenda of reproductive health was declared as the most comprehensive one, which had actually broadened the spectrum of reproductive health and drove the states to embark upon initiatives to improve reproductive health status of their populations. However, like all other countries, Pakistan also seems to have shifted focus of its policies and programs towards achieving MDGs. As a result, concepts highlighted in the ICPD got dropped eventually. In spite of specific goals on maternal and child mortalities in MDGs and all the investment and policy shift, Pakistan has still one of the highest maternal mortality ratios among developing …

Perinatal Outcomes In Pregnancy With Asthma., Rashid Jooma, Rashid Zaheer Syed, Ali Bin Sarwar Zubairi, Muhammad Ahsan Zafar, Rahat Qureshi

Department of Medicine

Objective: To examine the relationship between asthmatic pregnancies and selected maternal and neonatal outcomes in a representative cohort.

Methods: A retrospective cohort study was conducted at the Aga Khan University Hospital during the year 2004. A random selection was made of 65 asthmatic and 63 non-asthmatic singleton births. The neonatal outcomes studied were birth weight, premature birth and Apgar scores at 1 and 5 minutes. The maternal outcomes studied were number of hospital admissions, and number of documented UTI during the studied pregnancy and past history of abortions and stillbirths.

Results: The mean age of asthmatics and nonasthmatics were 28.0±4.9 …

Perinatal Outcomes In Pregnancy With Asthma, Rashid Zaheer Syed, Ali Bin Sarwar Zubairi, Muhammad Ahsan Zafar, Rahat Qureshi

Department of Obstetrics & Gynaecology

Objective: To examine the relationship between asthmatic pregnancies and selected maternal and neonatal outcomes in a representative cohort.

Methods: A retrospective cohort study was conducted at the Aga Khan University Hospital during the year 2004. A random selection was made of 65 asthmatic and 63 non-asthmatic singleton births. The neonatal outcomes studied were birth weight, premature birth and Apgar scores at 1 and 5 minutes. The maternal outcomes studied were number of hospital admissions, and number of documented UTI during the studied pregnancy and past history of abortions and stillbirths.

Resluts: The mean age of asthmatics and nonasthmatics were 28.0 …

Misoprostol In Addition To Routine Treatment Of Postpartum Hemorrhage: A Hospital-Based Randomized-Controlled Trial In Karachi, Pakistan., N. F. Zuberi, Jill Durocher, Rozina Sikander, Neelofur Baber, Jennifer Blum, Gijs Walraven

Department of Obstetrics & Gynaecology

Background:Postpartum hemorrhage (PPH) remains a major killer of women worldwide. Standard uterotonic treatments used to control postpartum bleeding do not always work and are not always available. Misoprostol's potential as a treatment option for PPH is increasingly known, but its use remains ad hoc and available evidence does not support the safety or efficacy of one particular regimen. This study aimed to determine the adjunct benefit of misoprostol when combined with standard oxytocics for PPH treatment.

Methods: A randomized controlled trial was conducted in four Karachi hospitals from December 2005 - April 2007 to assess the benefit of a …

Reducing The Rate Of Primary Caesarean Sections--An Audit, Lumaan Sheikh, Sara Tehseen, Saqib Ali Gowani, Hadi Bhurgri, Javed Rizvi, S Kagazwala

Department of Obstetrics & Gynaecology

Objective: To evaluate how the implementation of universally acceptable standards affects rates for primary caesarean sections, without compromising maternal or foetal safety.

Method: A complete audit cycle of all the primary caesarean sections performed in the maternity unit of Aga Khan University was conducted from 1st January to 31st March during years 2003 and 2004. New labour management guidelines were implemented after the first audit (appendix). The rates of caesarean section, induction of labour, failed induction, and maternal and foetal outcomes were compared before and after the implementation of the guidelines.

Results: Primary emergency caesarean section rate decreased from 16% …

Drug-Prescribing Patterns During Pregnancy In The Tertiary Care Hospitals Of Pakistan: A Cross Sectional Study., Dileep K Rohra, Nirmal Das, Syed I Azam, Nazir A Solangi, Zahida Memon, Abdul M Shaikh, Nusrat H Khan

Department of Biological & Biomedical Sciences

Background: The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan. Methods: This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outPatient medicinal prescriptions given to pregnant Patients attending the antenatal clinics were collected. The drugs were classified according …

Neuronal Connections From The Cervix To The Spinal Cord Before Parturition, Mary Medina Groves

Loma Linda University Electronic Theses, Dissertations & Projects

By the day before birth, the density of nerve fibers in the cervix has increased compared to earlier in pregnancy or in nonpregnant mice. Similar findings are reported in parturient women. To test the hypothesis that connections between the cervix and spinal cord are enhanced by term, the cervix of nonpregnant and time-dated pregnant mice (day 15 or 18 post-breeding) was injected with pseudorabies virus (PRV), a trans-synaptic retrograde neural tract tracer. Mice were euthanized and perfused 5 days later. The spinal cord and cervix were removed and postfixed overnight, immersed in sucrose, and cryostat sections through the thoracic to …

Connexin Expression And Gap Junctional Coupling In Human Cumulus Cells: Contribution To Embryo Quality, Hong-Xing Wang, Dan Tong, Faraj El-Gehani, Francis R. Tekpetey, Gerald M. Kidder

Physiology and Pharmacology Publications

Gap junctional coupling among cumulus cells is important for oogenesis since its deficiency in mice leads to impaired folliculogenesis. Multiple connexins (Cx), the subunits of gap junction channels, have been found within ovarian follicles in several species but little is known about the connexins in human follicles. The aim of this study was to determine which connexins contribute to gap junctions in human cumulus cells and to explore the possible relationship between connexin expression and pregnancy outcome from in vitro fertilization (IVF). Cumulus cells were obtained from IVF patients undergoing intracytoplasmic sperm injection (ICSI). Connexin expression was examined by RT-PCR …

Bovine Oocytes And Early Embryos Express Staufen And Elavl Rna-Binding Proteins., M D Calder, P Madan, A J Watson

Obstetrics & Gynaecology Publications

RNA-binding proteins (RBP) influence RNA editing, localization, stability and translation and may contribute to oocyte developmental competence by regulating the stability and turnover of oogenetic mRNAs. The expression of Staufen 1 and 2 and ELAVL1, ELAVL2 RNA-binding proteins during cow early development was characterized. Cumulus-oocyte complexes were collected from slaughterhouse ovaries, matured, inseminated and subjected to embryo culture in vitro. Oocyte or preimplantation embryo pools were processed for RT-PCR and whole-mount immunofluorescence analysis of mRNA expression and protein distribution. STAU1 and STAU2 and ELAVL1 mRNAs and proteins were detected throughout cow preimplantation development from the germinal vesicle (GV) oocyte to …

A Study To Determine Factors That Inhibit Compliance With Engaging In Recommended Papanicoaou Smear Screenings In African American Women, Valecia Gail Carter-Vaughn

Dissertations

Papanicolaou (Pap) smear screenings help to detect abnormal cervical cells in the cervix. African American women are usually diagnosed in the later stages of cervical cancer. The purpose of this study was to determine factors that inhibit compliance with Pap smear screening in African American women.

Ninety-three African American women ages 18 or older, attending an urban health clinic participated in this descriptive design study to answer three research questions: 1) What factors inhibit compliance with recommended Pap smear screening in African American women age 18 or older? 2) Is there a difference between participants who attended the mobile clinic …

Practices Regarding Diagnosis And Management Of Third And Fourth Degree Perineal Tears, Raheela Mohsin Rizvi, Nasreen Chaudhury

Department of Obstetrics & Gynaecology

Objective: To review our practice of diagnosing and managing third and fourth degree perineal tears.

Method: Retrospective case series conducted by reviewing medical records of all women having singleton, full term vaginal delivery at Aga Khan University Hospital, Karachi from November 1990 to October 2005.

Results: The frequency of obstetric anal sphincter injury (OASI) in our department was 0.5% (135) out of a total of 26,844 vaginal deliveries. Seventy five percent were nulliparous (102). Forceps delivery was performed in 86 patients out of 135 (63.7%). In only 28 patients (20.7%), the diagnostic criterion for classification of third degree tears was …

Como Mujer…Yo Decido: El Derecho De Salud Sexual Y Reproductiva En Mujeres Aymara De Putre, Chile, Alice Manos

Independent Study Project (ISP) Collection

The human right to sexual and reproductive health, as defined at the International United Nations Conference on Population and Development (Cairo, 1994), continues to be a pending issue in Chile. The sexual and reproductive health of indigenous women emerges as a crucial issue within this field due to Chile’s history of cultural ignorance and a dictatorial healthcare system. Studies of women’s sexual and reproductive healthcare within indigenous communities in Chile have focused on the Cosmo vision and traditional medicine of the Aymara due to their distinct concepts of reproduction, gender roles, and family planning. Studies conducted by Maria Soledad Pérez …

Cervical Screening And General Physical Examination Behaviors Of Women Exposed In Utero To Diethylstilbestrol, Elizabeth A. Camp, Ann L. Coker, Rebecca Troisi, Stanley J. Robboy, Kenneth L. Noeller, Karen J. Goodman, Linda T. Titus-Ernstoff, Elizabeth E. Hatch, Arthur L. Herbst, Raymond H. Kaufman, Ervin Adam

CRVAW Faculty Journal Articles

Objective. To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women.

Materials and Methods. 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations.

Results. Diethylstilbestrol-exposed women exceeded the recommended frequency of Papanicolaou smear …