Diagnosis, Prevention, Treatment and Medical Care for Gynecologic and Perinatal Diseases

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Women's Health Care".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 43747

Special Issue Editor


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Guest Editor
Department of Women’s Health, The University of Shiga Prefecture, Shiga 522-8533, Japan
Interests: gynecologic oncology; dietary therapy; edema; women’s health; medical equipment
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Special Issue Information

Dear Colleagues,

Regarding the forthcoming Special Issue which focuses on “Diagnosis, prevention, treatment and medical care for gynecologic and perinatal diseases”, we would like call for papers on a wide range of topics related to the diagnosis, prevention, treatment and nursing care for reproductive diseases (including maternal and child health, gynecologic cancers, genital diseases and breast diseases), endocrine (hormonal) diseases (including menstruation, birth-control and menopause), and general health topics (medical diseases) specific to women.

We warmly welcome your submissions, including novel and interesting original articles or reviews, for this Special Issue.

Prof. Dr. Masafumi Koshiyama
Guest Editor

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Keywords

  • women’s health
  • gynecologic disease
  • gynecologic cancer
  • perinatal disease
  • endocrine disease
  • medical disease
  • nursing care

Published Papers (16 papers)

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Research

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10 pages, 1623 KiB  
Article
The Effect of Sexual Intercourse during Pregnancy on Preterm Birth: Prospective Single-Center Cohort Study in Japan
by Yoshie Yo, Kaoru Kawasaki, Kaori Moriuchi, Reona Shiro, Masao Shimaoka and Noriomi Matsumura
Healthcare 2023, 11(11), 1657; https://doi.org/10.3390/healthcare11111657 - 5 Jun 2023
Viewed by 1796
Abstract
Several studies in Europe and the United States have shown that sexual intercourse (SI) during pregnancy is not associated with preterm birth. However, it is unclear whether these findings apply to pregnant Japanese women. The aim of this prospective cohort study was to [...] Read more.
Several studies in Europe and the United States have shown that sexual intercourse (SI) during pregnancy is not associated with preterm birth. However, it is unclear whether these findings apply to pregnant Japanese women. The aim of this prospective cohort study was to elucidate the influence of SI during pregnancy on preterm birth in Japan. A total of 182 women who underwent antenatal care and delivery were included in this study. The frequency of SI was assessed using a questionnaire, and its association with preterm birth was analyzed. The results showed that SI during pregnancy was associated with a significantly higher cumulative preterm birth rate (p = 0.018), which was more pronounced for SI more than once a week (p < 0.0001). Multivariate analysis showed that SI, bacterial vaginosis in the second trimester, previous preterm birth, and smoking during pregnancy were independent risk factors for preterm birth. The combination of SI and second trimester bacterial vaginosis was associated with a 60% preterm birth rate, whereas either factor alone was associated with a lower rate, suggesting a synergistic effect (p < 0.0001). Future studies are needed to investigate the effect of prohibiting SI in pregnant women with bacterial vaginosis on preterm birth. Full article
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10 pages, 12475 KiB  
Article
Diagnostic Utility of Hysteroscopic Biopsy in Cases of Suspected Lobular Endocervical Glandular Hyperplasia and Comparison with Cervical Conization
by Reona Shiro, Yasushi Kotani, Mamiko Ohta, Hanako Sato, Yoko Kashima, Kosuke Murakami, Kaoru Kawasaki, Hidekatsu Nakai and Noriomi Matsumura
Healthcare 2023, 11(11), 1619; https://doi.org/10.3390/healthcare11111619 - 1 Jun 2023
Viewed by 2267
Abstract
Background: Cervical cystic lesions encompass a range of benign and malignant pathologies. Magnetic resonance imaging or cytology alone cannot provide a definitive diagnosis, and conventional practice involves performing a cervical biopsy by conization to confirm the histology in cases exhibiting potential signs of [...] Read more.
Background: Cervical cystic lesions encompass a range of benign and malignant pathologies. Magnetic resonance imaging or cytology alone cannot provide a definitive diagnosis, and conventional practice involves performing a cervical biopsy by conization to confirm the histology in cases exhibiting potential signs of lobular endocervical glandular hyperplasia (LEGH) or malignancy. However, as postoperative complications resulting from conization can impact future fertility and pregnancy, alternative diagnostic methods are needed for reproductive-age patients. This study aimed to establish the efficacy of a hysteroscopic biopsy for diagnosing cervical cystic lesions and compare it with conization. Methods: Thirteen patients with cervical cystic lesions suspected of LEGH or malignancy underwent a hysteroscopic biopsy, while 23 underwent conization. Patient background information, preoperative evaluation, histology, and postoperative outcomes were collected and compared retrospectively. Results: No significant differences were found between the hysteroscopy and conization groups in terms of mean patient age (45 vs. 48 years), operating time (23 vs. 35 min), blood loss (small amount vs. 43 mL), and postoperative hospitalization (1.1 vs. 1.6 days). Conclusion: A hysteroscopic biopsy allows for targeted resection of the cervix while maintaining diagnostic accuracy. It may serve as an efficient method for diagnosing cervical cystic lesions. Full article
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11 pages, 271 KiB  
Article
Cervical Cancer Prevention Knowledge (Cckp-64) among Female Students in Novi Sad, Serbia during COVID-19 Pandemic
by Sanja D Tomić, Andrijana Ćorić, Slobodan Tomić, Ermina Mujičić, Jelena Malenković, Armin Šljivo and Goran Malenković
Healthcare 2023, 11(10), 1400; https://doi.org/10.3390/healthcare11101400 - 12 May 2023
Cited by 1 | Viewed by 1684
Abstract
Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic [...] Read more.
Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic using the Cervical Cancer Knowledge Prevention-64 (CCKP-64) tool. The study sample consisted of 402 predominantly 20–22-year-old female students from either social or technical science faculties in urban environments. Results revealed that out of the 402 female students involved in the study, most had a good general knowledge of primary prevention of cervical cancer, with a correct answer rate ranging from 29.9 to 80.6%. On the contrary, only 63.4% of female students have heard about the vaccine against cervical cancer; 52.0% know that the vaccine exists in Serbia; and 31.8% know where to get vaccinated. Only a small proportion of students (9.7%) have encountered cervical cancer among their relatives/friends and think that the disease could affect them in the future (25.4%). Older students (>26 years) generally (p < 0.05) had better knowledge regarding distressing symptoms of cervical cancer, cytological examination and secondary prevention; however, it was also noted that a significant percentage of this age group reported not having received vaccinations (53.0%, p = 0.001). This study underscores the need for increased awareness and education about the HPV vaccine and secondary prevention among young women in Serbia. Future research should investigate knowledge and attitudes toward cervical cancer prevention in diverse populations to develop effective interventions and strategies. These findings have implications for public health policies in Serbia to promote cervical cancer prevention among young women. Full article
14 pages, 285 KiB  
Article
Severity of Menstrual Pain Is Associated with Nutritional Intake and Lifestyle Habits
by Yuna Naraoka, Momo Hosokawa, Satomi Minato-Inokawa and Yuichi Sato
Healthcare 2023, 11(9), 1289; https://doi.org/10.3390/healthcare11091289 - 30 Apr 2023
Cited by 2 | Viewed by 5102
Abstract
Recently, the employment rate of women in Japan has steadily increased. Approximately 80% of women experience menstrual pain and premenstrual syndrome (PMS). These symptoms decrease a woman’s quality of life and her work productivity, leading to an economic loss. This cross-sectional study of [...] Read more.
Recently, the employment rate of women in Japan has steadily increased. Approximately 80% of women experience menstrual pain and premenstrual syndrome (PMS). These symptoms decrease a woman’s quality of life and her work productivity, leading to an economic loss. This cross-sectional study of 321 healthy Japanese women aged 20–39 years aimed to clarify the lifestyle-related factors or nutrient intake that might cause menstrual pain. The participants underwent body composition measurements and completed meal survey sheets and lifestyle questionnaires, including menstrual status, exercise, sleep and breakfast consumption. Based on the questionnaire results, participants were divided into two groups according to the severity of menstrual pain, namely, heavy and light. Chi-square and Wilcoxon signed-rank sum tests were used to compare the severity of menstrual pain in the two groups. In the heavy group, the intake of animal proteins, including fish, vitamin D and vitamin B12, was significantly lower (p < 0.05), as was the frequency of breakfast consumption and bathing (p < 0.05). The rate of PMS symptoms was significantly higher in the heavy group (p < 0.05). This study suggests that a lack of animal protein, the accompanying vitamins and fatty acids, and the frequency of breakfast or bathing are associated with the severity of menstrual pain. Full article
9 pages, 2347 KiB  
Article
Treatment for Locally Resectable Stage IIIC1 Cervical Cancer: A Retrospective, Single-Institution Study
by Yoko Kashima, Kosuke Murakami, Chiho Miyagawa, Hisamitsu Takaya, Yasushi Kotani, Hidekatsu Nakai and Noriomi Matsumura
Healthcare 2023, 11(5), 632; https://doi.org/10.3390/healthcare11050632 - 21 Feb 2023
Cited by 1 | Viewed by 2023
Abstract
According to the revision of the FIGO 2018 staging system, cervical cancer with pelvic lymph node metastases was changed to stage IIIC1. We retrospectively analyzed the prognosis and complications of locally resectable (classified as T1/T2 by TNM classification of the Union for International [...] Read more.
According to the revision of the FIGO 2018 staging system, cervical cancer with pelvic lymph node metastases was changed to stage IIIC1. We retrospectively analyzed the prognosis and complications of locally resectable (classified as T1/T2 by TNM classification of the Union for International Cancer Control) stage IIIC1 cervical cancer. A total of 43 patients were divided into three groups: surgery with chemotherapy (CT) (ope+CT group) (T1; n = 7, T2; n = 16), surgery followed by concurrent chemoradiotherapy (CCRT), or radiotherapy (RT) (ope+RT group) (T1; n = 5, T2; n = 9), and CCRT or RT alone (RT group) (T1; n = 0, T2; n = 6). In T1 patients, recurrence was observed in three patients, but there was no difference among the treatment groups, and no patients died. In contrast, in T2 patients, recurrence and death were observed in nine patients (8 in ope+CT; 1 in ope+RT), and recurrence-free survival and overall survival were lower in the ope+CT group (p = 0.02 and 0.04, respectively). Lymphedema and dysuria were more common in the ope+RT group. A randomized controlled trial comparing CT and CCRT as an adjuvant therapy after surgery in T1/T2 patients, including those with pelvic lymph node metastases, is currently underway. However, our data suggest that performing CT alone after surgery in T2N1 patients is likely to worsen the prognosis. Full article
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12 pages, 3649 KiB  
Article
Conservative Management for Retained Products of Conception in Late Pregnancy
by Risa Fujishima, Kaoru Kawasaki, Kaori Moriuchi, Reona Shiro, Yoshie Yo and Noriomi Matsumura
Healthcare 2023, 11(2), 168; https://doi.org/10.3390/healthcare11020168 - 5 Jan 2023
Cited by 1 | Viewed by 7159
Abstract
This retrospective study aims to compare the early manual removal of placenta (MROP) and conservative management of retained products of conception (RPOC) after 34 weeks of gestation. Nineteen cases underwent MROP within 24 h of delivery, of which nine patients had no symptoms [...] Read more.
This retrospective study aims to compare the early manual removal of placenta (MROP) and conservative management of retained products of conception (RPOC) after 34 weeks of gestation. Nineteen cases underwent MROP within 24 h of delivery, of which nine patients had no symptoms requiring emergent treatment. These 9 patients (group M) were compared with 22 patients who were treated conservatively (group C). Massive bleeding was observed in 5 (56%) patients in group M and 11 (50%) patients in group C, with no significant difference in frequency. However, the lowest hemoglobin level within 72 h after massive bleeding was lower in group M (median: 6.7 vs. 7.7 g/dL, p = 0.029), suggesting that massive bleeding occurred in a short period of time. On the other hand, a retained placenta was observed in four patients in group M after the MROP; however, the placenta disappeared more quickly than in group C (median; 1.0 vs. 99.0 days, p = 0.009). In group C, all bleeding and infection occurred within 60 days of delivery, including heavy bleeding in six cases during the placental-extraction trial. Human chorionic gonadotropin in group C fell below the measurable threshold at a median of 67 days postpartum. In conclusion, for RPOC without urgent symptoms, early MROP and conservative treatment have their advantages and disadvantages. Randomized controlled trials are needed to determine which of those treatments is superior. Full article
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10 pages, 1239 KiB  
Article
Role of CA-125 Level as a Marker in the Management of Severe Pre-Eclampsia
by Oana Balint, Cristina Secosan and Laurențiu Pirtea
Healthcare 2022, 10(12), 2474; https://doi.org/10.3390/healthcare10122474 - 7 Dec 2022
Cited by 1 | Viewed by 1516
Abstract
Background and Objectives: Hypertensive disorders of pregnancy remain one of the leading causes of morbidity and mortality in maternal–fetal medicine worldwide, particularly in low-resource settings. Despite extensive research in the last decades, pre-eclampsia prediction and, thus, effective prevention remains an unsolved problem. Current [...] Read more.
Background and Objectives: Hypertensive disorders of pregnancy remain one of the leading causes of morbidity and mortality in maternal–fetal medicine worldwide, particularly in low-resource settings. Despite extensive research in the last decades, pre-eclampsia prediction and, thus, effective prevention remains an unsolved problem. Current evidence suggests that CA-125, an already recognised tumoral marker and, lately, a valuable severity marker of heart failure, can be used to evaluate pre-eclampsia severity and thus improve the identification and management of high-risk patients; Materials and Methods: This is a case–control study involving 100 pregnant patients over 25 weeks of gestation, grouped based on the severity of hypertension in gestational hypertension (n = 22), non-severe pre-eclampsia (n = 11), severe pre-eclampsia (n = 17), and a control group (normotensive) (n = 50). Clinical and biochemical parameters recommended by the international guidelines for evaluating hypertensive pregnant patients were gathered from every patient in addition to CA-125 levels. The correlation was analysed. Results: Mean CA-125 levels increased with the severity of hypertension from a mean of 8.97 U/mL (±2.84) in the normotensive group to a mean of 21.23 U/mL (±11.18) in the severe pre-eclampsia group. Significant differences were observed between each group. The correlation of CA-125 levels with the assessed clinical and biochemical parameters showed positive correlations with MAP, 24 h proteinuria, and LDH values and negative correlations with platelet count, gestational age at birth, and birth weight Conclusions: The reported results support this marker’s promising role as a severity marker and its potential to improve pre-eclampsia management allowing a better selection of high-risk patients, aiding in decision making related to hospitalisation and/or timing of birth. Further studies are needed to improve the accuracy of the obtained results, identify an accurate cut-off and an optimal time of measurement, and achieve standardisation in measuring the marker. Full article
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11 pages, 962 KiB  
Article
HPV Vaccination among Polish Adolescents—Results from POLKA 18 Study
by Michalina Drejza, Katarzyna Rylewicz, Maria Lewandowska, Katarzyna Gross-Tyrkin, Grzegorz Łopiński, Joanna Barwińska, Ewa Majcherek, Klaudia Szymuś, Patrycja Klein, Katarzyna Plagens-Rotman, Magdalena Pisarska-Krawczyk, Witold Kędzia and Grażyna Jarząbek-Bielecka
Healthcare 2022, 10(12), 2385; https://doi.org/10.3390/healthcare10122385 - 28 Nov 2022
Cited by 4 | Viewed by 1974
Abstract
Human Papillomavirus (HPV) is the main cause of cervical cancer and genital warts and constitutes one of the most common sexually transmitted infections. Cervical cancer is the only reproductive cancer that has a primary prevention programme through the introduction of HPV vaccinations. Even [...] Read more.
Human Papillomavirus (HPV) is the main cause of cervical cancer and genital warts and constitutes one of the most common sexually transmitted infections. Cervical cancer is the only reproductive cancer that has a primary prevention programme through the introduction of HPV vaccinations. Even though the majority of European countries have nationally funded HPV vaccination programmes, in Poland these are exclusively local and scarcely funded. Moreover, the majority of local programmes are directed to females only. Meanwhile, Poland has one of the highest cervical cancer incidence rates among high income countries. The aim of this study was to measure HPV vaccination levels among final-year students in Poland and to establish the association between vaccination status and gender, region and level of sexual education received. This study is a part of the POLKA 18 Study, which used original self-reported paper-based questionnaires distributed in schools in six Polish regions. The study was conducted between April and December 2019. The obtained data were analysed in STATA 17. In total, 2701 fully completed questionnaires were collected. Over half of the respondents (58.2%) did not know their HPV vaccination status. Only 16.0% of the respondents replied that they have been vaccinated against HPV (18.2% of females and 14.5% of males). There was no direct association between vaccination status and access to ‘family life education’ classes. The vaccination level significantly differed among the different regions of Poland (p < 0.0001), with the Śląskie and Wielkopolskie regions achieving the highest rates. At least a quarter of adolescents after their sexual debut have not been vaccinated against HPV. Regions with immunization programmes introduced to their provincial capitals had higher vaccination rates. Our findings indicate the need for the introduction of state-funded vaccination programmes at the national level for the vaccination rate to increase, which will have the potential to decrease cervical cancer incidence in the country. Full article
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12 pages, 940 KiB  
Article
Kegel Exercise Training Program among Women with Urinary Incontinence
by Ahmad H. Abu Raddaha and Elsayeda H. Nasr
Healthcare 2022, 10(12), 2359; https://doi.org/10.3390/healthcare10122359 - 24 Nov 2022
Cited by 2 | Viewed by 3926
Abstract
A common condition with a large global prevalence and a persistent medical taboo for many people is urinary incontinence. Around one in three women globally are impacted by it. The most frequently suggested physical therapy treatment for women with stress incontinence or urge [...] Read more.
A common condition with a large global prevalence and a persistent medical taboo for many people is urinary incontinence. Around one in three women globally are impacted by it. The most frequently suggested physical therapy treatment for women with stress incontinence or urge incontinence is Kegel exercise (also called pelvic floor muscle training). This study aims to assess the effects of a Kegel exercise training program among women with urinary incontinence. The study was conducted at three government hospitals in Egypt’s Port Said city’s outpatient gynecological clinic. The intervention design was quasi-experimental. In total, 292 women with urine incontinence who visited the research sites made up the subjects. The necessary data were gathered using an interview questionnaire. Improvements in urinary incontinence and quality of life were positively correlated with daily Kegel exercise practice. Urinary incontinence has statistically significant positive correlations with age (p = 0.026), respiratory rate (p = 0.007), and body mass index (p = 0.026) as women grow older. Urinary incontinence, being single, and increasing pulse, however, had adversely significant negative correlations (p = 0.031 and 0.020, respectively). Urinary incontinence affects women’s overall wellbeing, particularly in the emotional and social spheres, as well as their quality of life and their ability to participate in normal everyday activities. Following the adoption of the Kegel exercise training program, there was a substantial improvement in both urine incontinence and quality of life. Full article
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9 pages, 1766 KiB  
Article
Plasma Antithrombin Activity during Long-Term Magnesium Sulfate Administration for Preeclampsia without Severe Hypertension
by Kaori Moriuchi, Kaoru Kawasaki, Maako Hayashi, Akihiko Ueda, Yukio Yamanishi, Haruta Mogami, Kohei Fujita, Reona Shiro, Yoshie Yo, Masaki Mandai and Noriomi Matsumura
Healthcare 2022, 10(8), 1581; https://doi.org/10.3390/healthcare10081581 - 19 Aug 2022
Cited by 1 | Viewed by 1642
Abstract
In preeclampsia, plasma antithrombin activity is decreased, which leads to exacerbation of the disorder. We previously showed that long-term magnesium sulfate (MgSO4) administration prolonged the pregnancy period and may be able to improve pregnancy outcomes for patients with severe preeclampsia. The [...] Read more.
In preeclampsia, plasma antithrombin activity is decreased, which leads to exacerbation of the disorder. We previously showed that long-term magnesium sulfate (MgSO4) administration prolonged the pregnancy period and may be able to improve pregnancy outcomes for patients with severe preeclampsia. The present study aimed to investigate the changes in plasma antithrombin activity during long-term MgSO4 administration for patients without severe hypertension. This multicenter retrospective study included patients with preeclampsia and superimposed preeclampsia without severe hypertension at diagnosis. The participants were divided into two groups: MgSO4 nontreatment group (three institutions) and MgSO4 treatment group (one institution). Antithrombin activity from time of diagnosis to delivery were compared between the two groups. In the MgSO4 nontreatment group (n = 16), antithrombin activity prior to delivery was significantly lower than at time of diagnosis (p = 0.015). In three cases, antithrombin activity was less than 60%. On the other hand, in the MgSO4 treatment group (n = 34), antithrombin activity did not change until just before delivery (p = 0.74). There were no cases in which antithrombin activity was decreased below 60%. Long-term MgSO4 administration for preeclampsia without severe hypertension may prevent a decrease in antithrombin activity and improve the disease state of preeclampsia. Full article
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9 pages, 253 KiB  
Article
Relationship between Edinburg Postnatal Depression Scale (EPDS) Scores in the Early Postpartum Period and Related Stress Coping Characteristics
by Shoichi Magawa, Sachiko Yanase, Tsutako Miyazaki, Kazumasa Igura, Shintaro Maki, Shota Nii, Masafumi Nii, Hiroaki Tanaka, Eiji Kondo, Tomoaki Ikeda and Takayuki Kageyama
Healthcare 2022, 10(7), 1350; https://doi.org/10.3390/healthcare10071350 - 21 Jul 2022
Cited by 2 | Viewed by 2181
Abstract
Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy [...] Read more.
Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy and EPDS scores. We recruited 353 women with normal pregnancies (160 primiparas, and 193 multiparas) and performed BSCP at 26 weeks of gestation. The EPDS was first performed within one week after delivery (T1), and then after one month (T2). Spearman’s correlation coefficients were calculated for the BSCP and EPDS for the whole and primi/multipara groups. Multiple regression analysis was performed with the EPDS T2 scores as the dependent variable. The EPDS scores were higher in the primipara group compared to the multipara (p < 0.001), and the EPDS T1 scores were higher than the overall T2 score (p < 0.001). In the multiple regression analysis, EPDS T1 and the “seeking help for solution” subscale were selected as significant explanatory variables when analyzed in the whole group; EPDS T1 and “active solution” for the primiparas; and EPDS T1, “changing mood”, and “seeking help for solution” for the multiparas. The BSCP can be used as a screening tool for postpartum depression during pregnancy. Full article
10 pages, 1287 KiB  
Article
Polycystic Ovary Syndrome (PCOS) and Non-Suicidal Self-Injury (NSSI): A Community-Based Study
by Sophie Williams, Dean Fido and David Sheffield
Healthcare 2022, 10(6), 1118; https://doi.org/10.3390/healthcare10061118 - 15 Jun 2022
Cited by 4 | Viewed by 2719
Abstract
Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still [...] Read more.
Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to no understanding of how non-suicidal self-injury and suicidal ideation and intention manifest in women with PCOS and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination and non-suicidal self-injury (NSSI), as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without, PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS. Full article
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Review

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9 pages, 250 KiB  
Review
Possible Interdisciplinar Standard for the Care of Pregnant Women Living with HIV-Polish Experience
by Katarzyna Plagens-Rotman, Piotr Merks, Magdalena Pisarska-Krawczyk, Witold Kędzia, Jaskulska Justyna, Magdalena Czarnecka-Operacz and Grażyna Jarząbek-Bielecka
Healthcare 2022, 10(10), 1949; https://doi.org/10.3390/healthcare10101949 - 5 Oct 2022
Viewed by 1473
Abstract
HIV data for 2020 show a decline in the number and rate of new HIV cases diagnosed in the EU during the last decade. The COVID-19 pandemic has paralyzed the functioning of healthcare facilities in Poland and worldwide, also impacting the detection of [...] Read more.
HIV data for 2020 show a decline in the number and rate of new HIV cases diagnosed in the EU during the last decade. The COVID-19 pandemic has paralyzed the functioning of healthcare facilities in Poland and worldwide, also impacting the detection of HIV infection. Early diagnosis of HIV and implementation of antiretroviral treatment limit HIV transmission. A woman with HIV diagnosed during pregnancy should be under the care of a specialist in infectious diseases experienced in antiretroviral treatment. In this way, she will be properly protected during the delivery, and relevant medications can be implemented for the newborn baby. Taking these aspects into account, the medical team should consist of: A specialist in infectious diseases, an obstetrician, a neonatologist and pediatrician, a midwife, and a dermato-venereologist. Every effort should be made to increase the scope and quality of monitoring of the spread of the epidemic in Poland, with special emphasis on diagnostics based on specific tests among populations particularly exposed to HIV infections cooperating with non-governmental organizations. Full article

Other

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9 pages, 2591 KiB  
Brief Report
A Histogram Analysis of the Pixel Grayscale (Luminous Intensity) of B-Mode Ultrasound Images of the Subcutaneous Layer Predicts the Grade of Leg Edema in Pregnant Women
by Eri Ikuta, Masafumi Koshiyama, Yumiko Watanabe, Airi Banba, Nami Yanagisawa, Miwa Nakagawa, Ayumi Ono, Keiko Seki, Haruki Kambe, Taiki Godo, Shin-ichi Sakamoto, Yoko Hara and Akira Nakajima
Healthcare 2023, 11(9), 1328; https://doi.org/10.3390/healthcare11091328 - 5 May 2023
Viewed by 1294
Abstract
The technique most widely used to quantitatively measure leg edema is only a pitting edema method. It has recently become possible to digitize B-mode ultrasound images and accurately quantify their brightness using an image-analysis software program. The purpose of this study was to [...] Read more.
The technique most widely used to quantitatively measure leg edema is only a pitting edema method. It has recently become possible to digitize B-mode ultrasound images and accurately quantify their brightness using an image-analysis software program. The purpose of this study was to find new indices of the grade of leg skin, to study whether or not analyses of the subcutaneous layer of leg skin on ultrasound images using image-editing software program can be used to evaluate it and to digitize it. Images of 282 subcutaneous layers of leg skin in 141 pregnant women were obtained using a B-scan portable ultrasound device. Rectangular photographs (vertical: skin thickness; horizontal: width of probe) were obtained using an image-editing program, and the luminous intensity (pixel grayscale: 0–255) and thickness of the skin were calculated using a histogram. We investigated the correlation between these parameters and the grade of pitting edema (0–3). There was a significant positive correlation between the grade of pitting edema and the average luminous intensity value, its standard deviation, and the skin thickness (ρ = 0.36, ρ = 0.22, ρ = 0.51, p < 0.0001, respectively). In particular, there was strong positive correlation between the grade of pitting edema and both the total number of pixels in a rectangle × (multiplied by) the average luminous intensity value and the total number of pixels in a rectangle × the standard deviation of the average luminous intensity value (ρ = 0.58 and ρ = 0.59, p < 0.0001, respectively). We could quantitatively evaluate the grade of leg edema by analyzing ultrasound photographs of the subcutaneous layer of the leg skin using an image-editing software program and found new indices to digitize it. Full article
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14 pages, 3864 KiB  
Case Report
Successful Implementation of Menstrual Cycle Biomarkers in the Treatment of Infertility in Polycystic Ovary Syndrome—Case Report
by Aleksandra M. Kicińska, Aneta Stachowska, Anna Kajdy, Tomasz H. Wierzba and Radosław B. Maksym
Healthcare 2023, 11(4), 616; https://doi.org/10.3390/healthcare11040616 - 18 Feb 2023
Cited by 3 | Viewed by 2624
Abstract
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Absent, impaired, or rare ovulation induces progesterone deficiency in the luteal phase, which is a critical problem in PCOS. A usual pattern of progesterone administration from a fixed and arbitrary pre-determined [...] Read more.
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Absent, impaired, or rare ovulation induces progesterone deficiency in the luteal phase, which is a critical problem in PCOS. A usual pattern of progesterone administration from a fixed and arbitrary pre-determined day of a menstrual cycle may preserve infertility but can easily be avoided. We present the case of a 29-year-old infertile woman who had been ineffectively treated for over two years. We introduced a line of therapy that was suited to her individual menstrual cycle by implementing biomarker recording. Supplementation based on a standardized observation of the basal body temperature (BBT) and cervical mucus stopped the vicious circle of absent ovulation and hyperandrogenism, restoring regular bleeding, ovulation cycles, and fertility. The implementation of a reliable fertility awareness method (FAM), accompanied by a standardized teaching methodology and periodic review of the observations recorded by the patient, validated through an ultrasound examination and plasma gonadotropins, estrogens, and progesterone concentrations, is key to achieving therapeutic success. The presented case is an example of a clinical vignette for many patients who have successfully managed to improve their fertility and pregnancy outcomes by applying the principles of a personalized treatment approach together with gestagens by recording their fertility biomarkers. Full article
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Case Report
A Case of Advanced Tubal Ectopic Pregnancy after Emergency Contraception
by Stefano Restaino, Matilde Degano, Diana Padovani, Anna Biasioli, Valentina Capodicasa, Giuseppe Vizzielli and Lorenza Driul
Healthcare 2022, 10(8), 1590; https://doi.org/10.3390/healthcare10081590 - 22 Aug 2022
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Abstract
Ectopic pregnancy is a relatively common condition and an important cause of morbidity in women of childbearing age. The most frequent implantation site is the fallopian tube. Most cases are diagnosed in an early gestational period. Patients come to the attention of clinicians [...] Read more.
Ectopic pregnancy is a relatively common condition and an important cause of morbidity in women of childbearing age. The most frequent implantation site is the fallopian tube. Most cases are diagnosed in an early gestational period. Patients come to the attention of clinicians for pelvic pain and vaginal blood loss, and consequent diagnosis is made through clinical presentation, laboratory tests, and ultrasound. Other rarer implantation sites such as the abdominal cavity give space for ectopic pregnancy to grow until later gestational ages, delaying diagnosis. This is a rare case of a healthy 41-year-old woman with an advanced ectopic pregnancy after emergency contraception with Ulipristal Acetate. The patient went to visit for amenorrhea after taking a contraceptive. Evaluation with ultrasound demonstrated a 10 + 4 weeks’ unruptured tubal pregnancy with fetal heart rate. The patient underwent laparoscopic salpingectomy without complication. This is the first case of such an advanced ectopic pregnancy in a woman who performed emergency contraception with Ulipristal Acetate. Full article
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