Diagnosis and Treatment for Women's Health

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 December 2022) | Viewed by 96768

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Guest Editor
Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n° 15, 33100 Udine, Italy
Interests: gynecology; gynecology surgery; female healthcare; endometrial cancer; ovarian cancer
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Special Issue Information

Dear Colleagues, 

This Special Issue entitled “Diagnosis and Treatment for Women's Health” will focus on the latest technological innovations and procedures that allow for more accurate diagnosis and treatment of gynecological diseases. New diagnostic devices provide faster and more precise diagnoses. Technological innovations and the use of minimally invasive techniques, such as hysteroscopy, laparoscopy or robotic surgery, allow for early diagnosis and personalized treatment.

Dr. Stefano Restaino
Guest Editor

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Keywords

  • gynecology
  • gynecology surgery
  • female healthcare
  • endometrial cancer
  • ovarian cancer
  • mini-invasive surgery
  • laparoscopy
  • robotic surgery
  • hysteroscopy

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Published Papers (36 papers)

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14 pages, 895 KiB  
Article
Effects of Nonpharmacological Interventions on Sleep Quality and Insomnia in Perimenopausal and Postmenopausal Women: A Meta-Analysis
by Beomman Ha, Jisoon Kim, Wi-Young So and Seonho Kim
Healthcare 2023, 11(3), 327; https://doi.org/10.3390/healthcare11030327 - 22 Jan 2023
Cited by 1 | Viewed by 1692
Abstract
This study aimed to analyze the effects of nonpharmacological interventions on perimenopausal and postmenopausal women with sleep problems. Eight databases (MEDLINE/PubMed, Cochrane Library, EMBASE, CINAHL, and four Korean databases) were searched, from their inception through to 30 November 2021, for randomized controlled trials [...] Read more.
This study aimed to analyze the effects of nonpharmacological interventions on perimenopausal and postmenopausal women with sleep problems. Eight databases (MEDLINE/PubMed, Cochrane Library, EMBASE, CINAHL, and four Korean databases) were searched, from their inception through to 30 November 2021, for randomized controlled trials (RCTs) evaluating the effects of nonpharmacological interventions versus control conditions on sleep quality and insomnia in perimenopausal and postmenopausal women. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the severity of insomnia was assessed using the Insomnia Severity Index (ISI). In the meta-analysis, corrected standardized mean differences (SMDs; Hedges’ g) and 95% confidence intervals (CIs) were calculated as effect measures by applying the random effects model and inverse variant method. Fifteen trials met our inclusion criteria. Nonpharmacological interventions were found to have positive effects on sleep quality, measured with the PSQI (SMD = −1.32; 95% CI = −1.78 to −0.86; p < 0.001), and on the severity of insomnia, measured using the ISI (SMD = −1.11; 95% CI = −1.82 to –0.41; p = 0.002), compared with the control groups. Among perimenopausal and postmenopausal women with sleep problems, nonpharmacological interventions improved sleep quality and reduced the severity of insomnia. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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10 pages, 854 KiB  
Article
Strength and Bioelectrical Activity of the Pelvic Floor Muscles and Sexual Function in Women with and without Stress Urinary Incontinence: An Observational Cross-Sectional Study
by Clicia Raiane Galvão Ferreira, Wenderk Martins Soares, Caren Heloise da Costa Priante, Natália de Souza Duarte, Cleuma Oliveira Soares, Kayonne Campos Bittencourt, Giovana Salomão Melo, Erica Feio Carneiro Nunes, Fabiana de Campos Gomes, João Simão De Melo Neto and Cibele Nazaré Câmara Rodrigues
Healthcare 2023, 11(2), 181; https://doi.org/10.3390/healthcare11020181 - 06 Jan 2023
Viewed by 1114
Abstract
Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor [...] Read more.
Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor muscle (PFM) dysfunction. We aimed to verify the variation in strength and PFM bioelectrical activity and sexual function in women with SUI. Additionally, we analyzed the impact of this dysfunction on quality of life. This was an observational cross-sectional study. Women aged 25–55 years with frequent sexual intercourse were included. Women with SUI were included in a study group (G2, n = 17), and those without any type of incontinence were included in a control group (G1, n = 16). Primary outcomes were level of strength and PFM bioelectrical activity and sexual function as determinants of worse SUI in the control group. Secondary outcomes were associated between the primary outcomes and severity of urinary loss, impact on daily life, and quality of life in women with SUI. In the domains evaluated in the Female Sexual Function Index (FSFI), only sexual desire was lower in women with SUI (G2) than in the controls (p = 0.033). During analysis of G1 variables, a positive and moderate correlation was observed between power/myoeletric activation and maximum voluntary contraction (MVC) (p < 0.01), peak (p < 0.01), and mean amplitudes (p = 0.017). There was a high positive correlation between sexual arousal and other variables, including vaginal lubrication, sexual orgasm, and total FSFI value (p < 0.001 for all analyses). During evaluation of G2 variables, the MVC was positively correlated with the peak and mean amplitudes (p < 0.0001). Additionally, there was a high and positive correlation between the mean amplitudes (%MVC) and personal relationships (KHQ) (p = 0.001); the same was observed between the total (ICIQ) and activities of daily living (ICIQ) (p < 0.0001). Therefore, women with SUI presented with lower sexual desire and bioelectric activity but were not related to PFM strength. Additionally, the domains of sexual function and certain variables of quality of life are aggravated by SUI. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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11 pages, 264 KiB  
Article
Analysis of Fall Events, Physical Fitness, and Gait Speed According to Fall Risk in Older Korean Women
by Byung-Kun Lee, Wi-Young So and Hyun-Joo Kang
Healthcare 2022, 10(10), 1936; https://doi.org/10.3390/healthcare10101936 - 02 Oct 2022
Cited by 1 | Viewed by 1287
Abstract
The present study aimed to investigate the associations between fall risk and previous fall events, physical fitness, and gait speeds on flat ground and during obstacle avoidance in older adult women in Korea. Data were analyzed for 148 women over 65 years of [...] Read more.
The present study aimed to investigate the associations between fall risk and previous fall events, physical fitness, and gait speeds on flat ground and during obstacle avoidance in older adult women in Korea. Data were analyzed for 148 women over 65 years of age, divided into low (n = 52) and high Berg Balance Scale (BBS) score groups (n = 96). Physical fitness was assessed using arm curl, chair stand, 2 min step, chair sit-and-reach, timed up-and-go, and single-leg stance tests. Gait speed was measured on flat ground and during obstacle avoidance (5 cm, 10% of height, 30 cm). The incidence of falls was 18.2% lower among participants with BBS scores above the mean than in those with scores below the mean (p < 0.05). Furthermore, the two groups exhibited significant differences in the chair stand, chair sit-and-reach, timed up-and-go, and single-leg stance test results. The upper BBS group appeared faster at all four gait speeds, and participants in the upper BBS group were less likely to exhibit lower physical fitness in each test, with odds ratios (ORs) ranging from 0.227 to 0.447. The upper BBS group was also less likely to exhibit lower gait speed in most conditions, with ORs ranging from 0.327 to 0.516. Further studies should consider exercise programs that promote balance, muscular strength, and proprioception to lower the risk of falling in older adults. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
9 pages, 1975 KiB  
Article
Measurement of Skin Thickness Using Ultrasonography to Test the Usefulness of Elastic Compression Stockings for Leg Edema in Pregnant Women
by Airi Banba, Masafumi Koshiyama, Yumiko Watanabe, Koji Makino, Eri Ikuta, Nami Yanagisawa, Ayumi Ono, Miwa Nakagawa, Keiko Seki, Shin-ichi Sakamoto, Yoko Hara and Akira Nakajima
Healthcare 2022, 10(9), 1754; https://doi.org/10.3390/healthcare10091754 - 13 Sep 2022
Cited by 2 | Viewed by 1634
Abstract
Background: One of the most common treatments for leg edema during pregnancy is the use of compression stockings. The purpose of this study was to evaluate the objective effectiveness in pregnant women, by measuring the changes of skin thickness using ultrasonography. Methods: Pregnant [...] Read more.
Background: One of the most common treatments for leg edema during pregnancy is the use of compression stockings. The purpose of this study was to evaluate the objective effectiveness in pregnant women, by measuring the changes of skin thickness using ultrasonography. Methods: Pregnant women were diagnosed with leg edema using the pitting edema method at 36 weeks of gestation. Twenty-four pregnant women (48 legs) with leg edema spent time without wearing elastic stockings at 36–37 weeks of gestation. Then, they wore elastic stockings for one week at 37–38 weeks of gestation. We measured the grade of edema (from 0 to 3) and the skin thickness of the lower leg by portable ultrasonography at 36, 37, and 38 weeks of gestation (a before-and-after study). Results: In 24 pregnant women, thigh edema was not detected in any of the 48 legs before or after the use of elastic stockings. All 48 legs in 24 pregnant women had physiological lower leg edema, but not thigh edema. The average grade of pitting edema in each lower leg significantly decreased after using the stockings (36 weeks, 1.77 ± 0.85; 37 weeks, 1.79 ± 0.77; 38 weeks, 1.04 ± 0.74, p < 0.0001). In addition, the skin thickness of the lower legs was significantly decreased after the use of elastic stockings (36 weeks, 7.47 ± 2.45 mm; 37 weeks, 7.93 ± 2.83 mm; 38 weeks, 7.15 ± 2.35 mm, p < 0.0001). Conclusions: The wearing of elastic compression stockings on the lower legs is objectively effective for improving leg edema in pregnant women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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15 pages, 790 KiB  
Article
Assessing Barriers Encountered by Women in Cervical Cancer Screening and Follow-Up Care in Urban Bolivia, Cochabamba
by Sherihane Bensemmane, Katherine Loayza Villarroel, Kevin Montaño, Elyas Louati, Carla Ascarrunz, Patricia Rodriguez, Véronique Fontaine and Samia Laokri
Healthcare 2022, 10(9), 1604; https://doi.org/10.3390/healthcare10091604 - 24 Aug 2022
Cited by 1 | Viewed by 1882
Abstract
Background: Timely detection of cervical cells infected with high-risk human papillomavirus (HPV) improves cervical cancer prevention. In Bolivia, actual screening coverage only reaches 33.3% of the target population aged between 25 and 64 years despite free cytology screening. Furthermore, 50% to 80% screened [...] Read more.
Background: Timely detection of cervical cells infected with high-risk human papillomavirus (HPV) improves cervical cancer prevention. In Bolivia, actual screening coverage only reaches 33.3% of the target population aged between 25 and 64 years despite free cytology screening. Furthermore, 50% to 80% screened women are lost during follow-up. This study aimed at identifying factors explaining this lack of follow-up care. Method: During the first phase, face-to-face semi-structured interviews were conducted with HPV-positive women. Secondly, we explored the reasons for the non-adherence to the follow-up care: knowledge, perceptions and beliefs about HPV, as well as barriers to healthcare access, using a structured survey on Cochabamba women and healthcare professionals. Results: Barriers to effective follow-up of the targeted populations were associated with health system shortcomings, including poor service delivery at the front- and second-line, health providers shortage, inadequate training, waiting time, high direct and indirect costs of care seeking and care, complex procedures to obtain HPV screening results and poor patient–provider communication. The follow-up was perceived as extremely stressful by the participants. Conclusion: Improved communication on HPV and HPV-related cancers in terms of representation in the general population and among the health professional’s population is vital to improve access for HPV infection follow-up care. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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11 pages, 808 KiB  
Article
Breathing, (S)Training and the Pelvic Floor—A Basic Concept
by Helena Talasz, Christian Kremser, Heribert Johannes Talasz, Markus Kofler and Ansgar Rudisch
Healthcare 2022, 10(6), 1035; https://doi.org/10.3390/healthcare10061035 - 02 Jun 2022
Cited by 8 | Viewed by 4262
Abstract
Background: The current scientific literature is inconsistent regarding the potential beneficial or deleterious effects of high-intensity physical activities on the pelvic floor (PF) in women. So far, it has not been established with certainty whether disparate breathing mechanisms may exert short- or long-term [...] Read more.
Background: The current scientific literature is inconsistent regarding the potential beneficial or deleterious effects of high-intensity physical activities on the pelvic floor (PF) in women. So far, it has not been established with certainty whether disparate breathing mechanisms may exert short- or long-term influence on the PF function in this context, although based on the established physiological interrelationship of breathing with PF activation, this seems plausible. Objective: To propose a basic concept of the influence of different breathing patterns on the PF during strenuous physical efforts. Methodical approaches: Review of the recent literature, basic knowledge of classical western medicine regarding the principles of muscle physiology and the biomechanics of breathing, additional schematic illustrations, and magnetic resonance imaging (MRI) data corroborate the proposed concept and exemplify the consequences of strenuous efforts on the PF in relation to respective breathing phases. Conclusion: The pelvic floor muscles (PFMs) physiologically act as expiratory muscles in synergy with the anterolateral abdominal muscles, contracting during expiration and relaxing during inspiration. Obviously, a strenuous physical effort requires an expiratory motor synergy with the PFM and abdominal muscles in a co-contracted status to train the PFM and protect the PF against high intra-abdominal pressure (IAP). Holding breath in an inspiratory pattern during exertion stresses the PF because the high IAP impinges on the relaxed, hence insufficiently protected, PFMs. It seems conceivable that such disadvantageous breathing, if performed regularly and repeatedly, may ultimately cause PF dysfunction. At any rate, future research needs to take into account the respective breathing cycles during measurements and interventions addressing PFM function. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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11 pages, 2229 KiB  
Article
Provoked Vestibulodynia and Topical Treatment: A New Option
by Francesco De Seta, Guglielmo Stabile, Graziana Antoci, Gabriella Zito and Rossella E. Nappi
Healthcare 2022, 10(5), 830; https://doi.org/10.3390/healthcare10050830 - 30 Apr 2022
Cited by 6 | Viewed by 2042
Abstract
Background: Provoked vestibulodynia is commonly associated with dyspareunia and affects 7% to 15% of women. This pathology has major implications on sexual function and quality of life, and several types of treatments are available for its management. However, a consensus has not been [...] Read more.
Background: Provoked vestibulodynia is commonly associated with dyspareunia and affects 7% to 15% of women. This pathology has major implications on sexual function and quality of life, and several types of treatments are available for its management. However, a consensus has not been reached concerning the best treatment of vulvar pain. The aim of this study was to assess the efficacy and safety of a brand-new product, the vulvar emulgel Meclon® Lenex, for the management of provoked vestibulodynia and non-infective vulvitis. Methods: This was a monocentric, prospective, randomized, double-blind and placebo-controlled study. We enrolled 40 women with provoked vestibulodynia; 20 patients received Meclon® Lenex, whereas the remaining received a placebo. Each woman was assessed subjectively (through questionnaires) and objectively by evaluating vaginal and vulvar symptoms (Friedrichs criteria and Marinoff dyspareunia grade). We evaluated efficacy, safety, compliance and tolerability of the brand-new product vulvar gel Meclon® Lenex in provoked vestibulodynia. Results: After administration of Meclon® Lenex, we evaluated all parameters of the Friedrichs criteria (burning, dyspareunia, erythema, vulvar pain at the 5 o’clock position and 7 o’clock position), as well as the levels of Marinoff dyspareunia. The active treatment showed to be statistically significantly effective (p value ≤ 0.05) in reducing all symptoms of Friedrichs criteria, vulvar pain and Marinoff dyspareunia. Conclusion: This prospective study showed that Meclon® Lenex vulvar emulgel revealed an excellent tolerability and compliance, demonstrating to be a safe and effective option in the treatment of provoked vestibulodynia and non-infective vulvitis. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 251 KiB  
Article
Embryonic Development in Relation to Maternal Obesity Does Not Affect Pregnancy Outcomes in FET Cycles
by Adham Fawarseh, Yuval Atzmon, Nardin Aslih, Asaf Bilgory and Einat Shalom-Paz
Healthcare 2022, 10(4), 703; https://doi.org/10.3390/healthcare10040703 - 10 Apr 2022
Cited by 2 | Viewed by 1572
Abstract
This retrospective cohort study examined the effect of maternal BMI on embryo morphokinetics using a time-lapse incubator (TLI) and evaluated the effect on outcomes of frozen embryo transfer (FET) cycles. The study included 641 women who underwent FET of a total of 2553 [...] Read more.
This retrospective cohort study examined the effect of maternal BMI on embryo morphokinetics using a time-lapse incubator (TLI) and evaluated the effect on outcomes of frozen embryo transfer (FET) cycles. The study included 641 women who underwent FET of a total of 2553 embryos from January 2017 to August 2019. The women were divided into four groups according to BMI: underweight (<18.5 kg/m2), normal weight (18.5–24.99 kg/m2), overweight (25.0–29.99 kg/m2), and obese (≥30 kg/m2). Embryos were transferred on day 3 or 5, and their development was monitored using a TLI. We found that oocytes from obese patients were slower in the extraction of the second polar body (tPB2) after fertilization and the two pronucleus stage appeared later compared to normal-weight women. The time to fading of the pronucleus (tPNf), t2, and t4 were comparable between the four groups. Oocytes from underweight and overweight women had significantly faster cleavage at t3 and t5–t8 compared to normal weight. We did not find any significant difference in pregnancy rate, clinical pregnancy rate, or miscarriage rate among groups. In conclusion, embryos from normal-weight patients had slower cleavage rates compared to obese patients, while embryo quality was similar between BMI groups. The cycle outcomes demonstrated comparable pregnancy rates among the BMI groups. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
10 pages, 534 KiB  
Article
The Association between Menstrual Irregularities and the Risk of Diabetes in Premenopausal and Postmenopausal Women: A Cross-Sectional Study of a Nationally Representative Sample
by Byung-Soo Kwan, Seung-Chan Kim, Hyen-Chul Jo, Jong-Chul Baek and Ji-Eun Park
Healthcare 2022, 10(4), 649; https://doi.org/10.3390/healthcare10040649 - 30 Mar 2022
Cited by 2 | Viewed by 1584
Abstract
Background: Studies have assessed the effects of menstrual irregularities and menopause on diabetes, but no definitive conclusion has been reached. This study investigated for the first time the relationship between menstrual irregularity and diabetes before and after menopause. Methods: This population-based cross-sectional study [...] Read more.
Background: Studies have assessed the effects of menstrual irregularities and menopause on diabetes, but no definitive conclusion has been reached. This study investigated for the first time the relationship between menstrual irregularity and diabetes before and after menopause. Methods: This population-based cross-sectional study included 9043 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) V (2010–2012). Multivariate logistic regression was used to assess the effect of menstrual irregularities on impaired fasting glucose (IFG) and diabetes incidence in women before and after menopause. Results: After adjustment for age and other diabetes-related factors, both menopause (OR = 1.51, 95% CI = 1.101–2.27, p = 0.047) and menstrual irregularities (OR = 1.51, 95% CI = 1.1–2.07, p = 0.011) were found to increase the risk of diabetes. Menstrual irregularities were significantly related to diabetes in the postmenopausal group (OR = 1.65, 95% CI  =  1.12–2.42, p = 0.012) but not in the premenopausal group (OR = 1.22, 95% CI  =  0.64–2.32, p = 0.555). Conclusions: In this study, menopausal status appeared to independently affect diabetes risk; menstrual irregularities were found to be a risk factor for postmenopausal diabetes. This study emphasizes the need for monitoring and early prevention, along with medical advice on menstrual irregularities, to reduce the prevalence of diabetes and improve the quality of life of postmenopausal women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 296 KiB  
Article
Low-Pressure Laparoscopy Using the AirSeal System versus Standard Insufflation in Early-Stage Endometrial Cancer: A Multicenter, Retrospective Study (ARIEL Study)
by Alessandro Buda, Giampaolo Di Martino, Martina Borghese, Stefano Restaino, Alessandra Surace, Andrea Puppo, Sara Paracchini, Debora Ferrari, Stefania Perotto, Antonia Novelli, Elena De Ponti, Chiara Borghi, Francesco Fanfani and Robert Fruscio
Healthcare 2022, 10(3), 531; https://doi.org/10.3390/healthcare10030531 - 14 Mar 2022
Cited by 5 | Viewed by 2976
Abstract
The aim of our study was to evaluate the benefits of a low-pressure insufflation system (AirSeal) vs. a standard insufflation system in terms of anesthesiologists’ parameters and postoperative pain in patients undergoing laparoscopic surgery for early-stage endometrial cancer. This retrospective study involved five [...] Read more.
The aim of our study was to evaluate the benefits of a low-pressure insufflation system (AirSeal) vs. a standard insufflation system in terms of anesthesiologists’ parameters and postoperative pain in patients undergoing laparoscopic surgery for early-stage endometrial cancer. This retrospective study involved five tertiary centers and included 152 patients with apparent early-stage disease who underwent laparoscopic surgical staging with either the low-pressure AirSeal system (8–10 mmHg, n = 84) or standard laparoscopic insufflation (10–12 mmHg, n = 68). All the intraoperative anesthesia variables evaluated (systolic blood pressure, end-tidal CO2, peak airway pressure) were significantly lower in the AirSeal group. We recorded a statistically significant difference between the two groups in the median NRS scores for global pain recorded at 4, 8, and 24 h, and for overall shoulder pain after surgery. Significantly more women in the AirSeal group were also discharged on day one compared to the standard group. All such results were confirmed when analyzing the subgroup of women with a BMI >30 kg/m2. In conclusion, according to our preliminary study, low-pressure laparoscopy represents a valid alternative to standard laparoscopy and could facilitate the development of outpatient surgery. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 479 KiB  
Article
Cardiovascular Care of Turner Syndrome Women in Germany: Where Do We Stand?—Results from an Online Patient Survey
by Martina Bačová, Pengzhu Li, Leonie Arnold, Robert Dalla-Pozza, Nikolaus Alexander Haas and Felix Sebastian Oberhoffer
Healthcare 2022, 10(3), 504; https://doi.org/10.3390/healthcare10030504 - 09 Mar 2022
Cited by 1 | Viewed by 1718
Abstract
Background: This study aimed to investigate whether the cardiovascular care of Turner Syndrome (TS) women in Germany is in accordance with the latest clinical practice guidelines established by the 2016 Cincinnati international TS meeting. Methods: An anonymous online questionnaire was created to ask [...] Read more.
Background: This study aimed to investigate whether the cardiovascular care of Turner Syndrome (TS) women in Germany is in accordance with the latest clinical practice guidelines established by the 2016 Cincinnati international TS meeting. Methods: An anonymous online questionnaire was created to ask TS subjects about existing cardiovascular conditions and cardiovascular care received. Depending on cardiovascular morbidity and type of medical care received, the fulfillment of the latest clinical practice guidelines for the care of TS women was assessed. Results: 120 TS patients were included in this study. The mean age of TS subjects was 36.79 years. Only 80% of subjects received annual blood pressure measurements within the TS cohort, and only 60% received cardiac imaging according to international clinical practice guidelines. More than 55% of TS women did not feel well informed about TS-specific cardiovascular risk factors by their treating physician. Conclusions: A potential lack of cardiovascular care might be present in TS women in Germany as the results of this online patient survey suggest. The cardiovascular care of TS patients, particularly cardiac imaging and patient education, needs to receive more attention. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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11 pages, 1859 KiB  
Article
Comparison of Different Self-Sampling Devices for Molecular Detection of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs): A Pilot Study
by Illari Sechi, Clementina Elvezia Cocuzza, Marianna Martinelli, Narcisa Muresu, Santina Castriciano, Giovanni Sotgiu and Andrea Piana
Healthcare 2022, 10(3), 459; https://doi.org/10.3390/healthcare10030459 - 28 Feb 2022
Cited by 13 | Viewed by 2689
Abstract
Background: Cervical cancer is the fourth most common cancer in women, and it is well known that high-risk human papillomavirus (hrHPV) infections are the necessary carcinogenic factors for the development of cervical tumors. Moreover, the interaction between HPV and other sexually transmitted infections [...] Read more.
Background: Cervical cancer is the fourth most common cancer in women, and it is well known that high-risk human papillomavirus (hrHPV) infections are the necessary carcinogenic factors for the development of cervical tumors. Moreover, the interaction between HPV and other sexually transmitted infections (STIs) may increase the risk of cancer progression. Self-sampling has been demonstrated to represent a valid and well-accepted alternative, favoring women’s participation in screening programs. This study aimed to investigate the use of FLOQSwabs® (FS) as compared to two other vaginal self-collection devices for the detection of hrHPV and other sexually transmitted infections. Methods: Cervical and vaginal self-samples were collected, using two different combinations of vaginal self-sampling devices, from 40 women referred to colposcopy for a documented abnormal Pap smear. All samples were tested for hrHPV and seven STI pathogens using two commercial molecular assays. Results: Data on hrHPV detection from the first group of women showed an almost perfect agreement (kappa: 0.89) between cervical vs. FS vaginal self-samples, and a substantial agreement (kappa: 0.79) between cervical and HerSwab™ (HS) samples. In the second group of women, an almost perfect agreement (kappa: 0.90) was demonstrated in the detection of hrHPV between cervical samples vs. FS, and a moderate agreement (kappa: 0.60) for cervical vs. Evalyn®Brush (EB) self-collected samples. STI detections showed a very good agreement (kappa: 0.89 and kappa: 1.00) both among FS vs. HS and FS vs. EB, respectively. There was no statistically significant difference between the different devices used. The most frequently detected hrHPV genotypes in the studied population were HPV 16, 31, 35, 51, and 56; whilst the most frequently identified STI pathogens were Ureaplasma parvum and Mycoplasma hominis. Overall, investigated women did not report any discomfort in using the different vaginal self-collection devices. Conclusion: Evaluation of the three different vaginal self-collection devices confirmed their overall good acceptability by the studied population, as well as a similar agreement for hrHPV detection as compared to cervical samples. Our study indicated that the use of self-collected samples offers an alternative strategy to improve women’s participation in cervical cancer screening programs, but also underlined the importance of evaluating the concordance in hrHPV detection of collection devices in combination with the molecular hrHPV assay. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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12 pages, 808 KiB  
Article
Sexual Quality of Life-Female (SQoL-F): Cultural Adaptation and Validation of European Portuguese Version
by Margarida Sim-Sim, Vicki Aaberg, Sagrario Gómez-Cantarino, Hélia Dias, Ermelinda Caldeira, Irene Soto-Fernandez and Cinzia Gradellini
Healthcare 2022, 10(2), 255; https://doi.org/10.3390/healthcare10020255 - 28 Jan 2022
Cited by 1 | Viewed by 3333
Abstract
The Sexual Quality of Life-Female (SQoL-F) questionnaire was developed with qualitative data to assess the impact of sexual dysfunction in women. Objectives: the aim was to conduct a cross-cultural adaptation and psychometric analysis of a European Portuguese version of the Sexual Quality of [...] Read more.
The Sexual Quality of Life-Female (SQoL-F) questionnaire was developed with qualitative data to assess the impact of sexual dysfunction in women. Objectives: the aim was to conduct a cross-cultural adaptation and psychometric analysis of a European Portuguese version of the Sexual Quality of Life-Female questionnaire. Methods: Methodological study of the processes of translation and cultural adaptation. This is a retrospective study in which nursing students participated. Data collection: Lime Survey platform in a convenience sample was carried out in two stages, the latter being re-testing data. The instrument analysed, presented as a latent variable, consisted of 18 items on a Likert scale. The study was approved by the Ethics Committee. Participants: the sample was 113 women, mean age 21.99 years (±3.76), attending classes in the first 4 years of the first cycle of nursing. Results: Reliability was analysed and stability was found in the test–retest (rs = 0.658) and in the intraclass coefficient (rs = 0.821). The internal consistency analysis showed an alpha value of 0.846. Discriminant validity analysis using the Mann–Whitney test revealed a higher score of the quality of sexual life of students living with parents/surrogates. Factor validity analysis was conducted using Oblimin rotation with four-, three- and two-factor tests. Parallel analysis of the empirical matrix compared to the random matrix showed that the instrument was unidimensional. Conclusions: the assessment of the properties of the SQoL-F is valuable, as the provision of a valid and reliable instrument contributes to the quality of subsequent studies, including for local and multicentre research. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 933 KiB  
Article
Can Social Media Be Used as a Community-Building and Support Tool among Jewish Women Impacted by Breast and Ovarian Cancer? An Evidence-Based Observational Report
by Catherine Dunn, Sydney Campbell, Nikoleta Marku, Adina Fleischmann, Elana Silber, Melissa Rosen and Kenneth P. Tercyak
Healthcare 2022, 10(1), 51; https://doi.org/10.3390/healthcare10010051 - 28 Dec 2021
Cited by 2 | Viewed by 1517
Abstract
About 1 in 40 Ashkenazi Jewish women carry a deleterious mutation in BRCA1/2 genes, predisposing them to hereditary breast/ovarian cancer (HBOC). Thus, efforts to prevent and control HBOC in the US must include sufficient outreach and education campaigns within and across the Jewish [...] Read more.
About 1 in 40 Ashkenazi Jewish women carry a deleterious mutation in BRCA1/2 genes, predisposing them to hereditary breast/ovarian cancer (HBOC). Thus, efforts to prevent and control HBOC in the US must include sufficient outreach and education campaigns within and across the Jewish community. Social media (SM) is utilized in public health campaigns focused on cancer, but very little is known about the efficacy of those efforts when directed toward Jewish women at risk for (“previvors”) and affected by (“survivors”) HBOC. Here, we report on outcomes of a targeted SM campaign for this population, as led by a national not-for-profit HBOC advocacy organization. Mixed-methods data were obtained from n = 393 members of the community, including n = 20 key informants, and analyzed for engagement and satisfaction with its SM campaign and HBOC resources. Message recipients identified the SM campaign as helpful/meaningful (82%), of ‘newsworthy’ value (78%), and actionable/navigable (71%): interviews revealed that women were more likely to engage with SM if/when it featured stories relevant to their personal cancer experiences. SM is a valuable public health education tool to address the comprehensive cancer control and prevention needs of those previving and surviving with HBOC, including high-risk Jewish women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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12 pages, 771 KiB  
Article
Association between Teenage Pregnancy and Family Factors: An Analysis of the Philippine National Demographic and Health Survey 2017
by Kozue Tabei, Erlinda Susana S. Cuisia-Cruz, Chris Smith and Xerxes Seposo
Healthcare 2021, 9(12), 1720; https://doi.org/10.3390/healthcare9121720 - 13 Dec 2021
Cited by 4 | Viewed by 16132
Abstract
Adolescence is a key developmental period in one’s life course; health-related behaviors of adolescents can be linked to lifelong consequences, which affect their future health. Previous studies highlight the role of family and its significant association with adolescents’ health. In East Asia and [...] Read more.
Adolescence is a key developmental period in one’s life course; health-related behaviors of adolescents can be linked to lifelong consequences, which affect their future health. Previous studies highlight the role of family and its significant association with adolescents’ health. In East Asia and the Pacific, the Philippines is the only country that is showing an upward trend of teenage pregnancy while other countries in the region have declining teenage pregnancy rates. Against this backdrop, this study investigated the association between teenage pregnancy and family factors, specifically parent structure. Data for the study were extracted from the Philippine National Demographic and Health Survey 2017. All adolescent women aged 15–19 years old (n = 5120) were included in the analyses. The dependent variable was teenage pregnancy, while parent structure, defined as a presence or absence of parents in the domicile, was the exposure variable. Multivariable logistic regression was utilized in assessing the association of teenage pregnancy and family factors after adjusting for several potential confounders. Adolescent women were more likely to become pregnant as a teenager when they lived with neither parent (aOR = 4.57, 95% CI = 2.56–8.15), were closer to 19 years of age (aOR = 2.17, 95% CI = 1.91–2.46), had knowledge of contraception (aOR = 1.27, 95% CI = 1.22–1.32) and lived in a big family (aOR = 1.14, 95% CI = 1.09, 1.20). Furthermore, adolescent women who lived with neither parent and belonged to the poorest wealth quintile were more likely to become pregnant as a teenager (aOR = 3.55, 95% CI = 1.67–7.55). Conversely, educational attainment higher than secondary education (aOR = 0.08, 95% CI = 0.01–0.49) and those who belonged to the richest wealth quintile (aOR = 0.40, 95% CI = 0.18–0.92) exhibited a statistically inverse association with teenage pregnancy compared with those with no education and from the middle wealth quintile, respectively. Living with neither parent was found as a risk factor for teenage pregnancy. Furthermore, we found that several sociodemographic factors exhibited a non-uniform increment and reduction in the risk of teenage pregnancy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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12 pages, 256 KiB  
Article
Association between Serum Uric Acid Levels and Bone Mineral Density in Postmenopausal Women: A Cross-Sectional and Longitudinal Study
by Soyeon Kang, Dongjin Kwon, Jiwoo Lee, Youn-Jee Chung, Mee-Ran Kim, Jeong Namkung and In Cheul Jeung
Healthcare 2021, 9(12), 1681; https://doi.org/10.3390/healthcare9121681 - 04 Dec 2021
Cited by 9 | Viewed by 2260
Abstract
Background: Uric acid is one of natural antioxidants in human body. There have been several studies on the correlation between uric acid with oxidative stress and osteoporosis. However, the data are insufficient and results are controversial. In this regard, we determined the association [...] Read more.
Background: Uric acid is one of natural antioxidants in human body. There have been several studies on the correlation between uric acid with oxidative stress and osteoporosis. However, the data are insufficient and results are controversial. In this regard, we determined the association between uric acid levels and bone mineral density (BMD) during the postmenopausal period. Methods: We analyzed data from 328 postmenopausal women (mean age, 57.3 ± 6.5 years; mean serum uric acid level, 4.6 ± 1.0 mg/dL). The participants were divided into three groups based on tertiles of the serum uric acid level. The participants receiving hormone replacement therapy (HRT), bisphosphonates, or lipid-lowering agents were included. Results: Blood urea nitrogen, serum creatinine, and serum triglyceride levels were significantly higher in the upper tertiles of uric acid levels. No significant difference was found in the mean uric acid levels between medication users and non-users. Each HRT regimen had a different mean serum uric acid level. A cross-sectional analysis showed no significant correlation between the serum uric acid levels and BMD in the spine and femoral neck (spine BMD: 1.050 ± 0.131, 1.060 ± 0.160, 1.084 ± 0.140, p = 0.22; femoral neck BMD: 0.837 ± 0.110, 0.849 ± 0.096, 0.863 ± 0.115, p = 0.28 for each tertile of uric acid). Longitudinal analysis of data from 186 women with follow-up examinations at a mean interval of 14.6 months also revealed no difference in reduction in both spine and femoral neck BMD between tertile groups of serum uric acid (the median BMD reduction for spine: −0.02, 0.01, −0.04, p = 0.95; the median BMD reduction for femoral neck: 0.008, 0.005, −0.003, p = 0.34). Conclusions: Serum uric acid level is not associated with BMD in postmenopausal women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
10 pages, 269 KiB  
Article
Examination of in Factor V Leiden and Prothrombin II Thrombophilic Mutations in Czech Young Women Using ddPCR—Prevalence and Cost–Benefit Analysis
by Petra Riedlova, Dagmar Kramna, Silvie Ostrizkova, Hana Tomaskova and Vitezslav Jirik
Healthcare 2021, 9(12), 1656; https://doi.org/10.3390/healthcare9121656 - 29 Nov 2021
Cited by 3 | Viewed by 1626
Abstract
Background: Thrombophilic mutations in genes for factor V Leiden and factor II prothrombin are among the most important risk factors for developing the thromboembolic disease (TED), along with the use of oral contraceptives (OCs) or smoking. Aim: This study aimed to investigate the [...] Read more.
Background: Thrombophilic mutations in genes for factor V Leiden and factor II prothrombin are among the most important risk factors for developing the thromboembolic disease (TED), along with the use of oral contraceptives (OCs) or smoking. Aim: This study aimed to investigate the occurrence of risk factors in young women using droplet digital PCR (ddPCR) and, based on the results of this investigation, to perform a cost–benefit analysis of ddPCR-based screening in young women starting to take OCs compared to the treatment costs of patients who develop preventable TED in the Czech Republic. Methods: In this cross-sectional study, female university students filled in a questionnaire and provided a blood sample for DNA isolation and ddPCR analysis of both aforementioned genetic risk factors. The results, along with data from literature and web search, were used for cost–benefit analysis valid for the Czech Republic. Results: Out of 148 participants, 30 (20%) were smokers and 49 (33%) took OCs. A mutation was confirmed in 6 women (4.1%) in the factor V gene and in 3 women (2%) in the factor II gene, respectively. A model calculation on a cohort of 50,000 women starting to use contraceptives in the Czech Republic every year showed that at maximum compliance, (i.e., non-use of OC and smoking cessation), screening could prevent 68 cases of TED over the course of the mean period of OC use (5.7 years). Economically, the costs of testing in this cohort (2.25 mil. USD) would be significantly lower than prevented treatment costs (16 mil. USD at maximum compliance); the cost–benefit break-even point would be at 14.1% compliance. Conclusion: The cost–benefit analysis based on our results indicates that screening for factor V Leiden and factor II prothrombin in young women before starting to use OCs would, in the conditions of the Czech Republic, likely be highly economically effective. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
7 pages, 542 KiB  
Communication
A New Therapy for Uncomplicated Vulvovaginal Candidiasis and Its Impact on Vaginal Flora
by Guglielmo Stabile, Roberta Marie Gentile, Stefania Carlucci, Stefano Restaino and Francesco De Seta
Healthcare 2021, 9(11), 1555; https://doi.org/10.3390/healthcare9111555 - 16 Nov 2021
Cited by 4 | Viewed by 1925
Abstract
Background: An estimated 75% of women will have one episode of vulvovaginal candidiasis (VCC) during their lifetime, and 40–50% of these will experience further episodes. The high incidence of vulvovaginal candidiasis, combined with the problems of azole resistance and toxicity, highlights the necessity [...] Read more.
Background: An estimated 75% of women will have one episode of vulvovaginal candidiasis (VCC) during their lifetime, and 40–50% of these will experience further episodes. The high incidence of vulvovaginal candidiasis, combined with the problems of azole resistance and toxicity, highlights the necessity for new strategies for the treatment of this condition. In this context, natural compounds represent promising alternatives. Methods: We enrolled, between January 2020 and April 2021, forty women affected by uncomplicated vulvovaginal candidiasis. Women were divided into two groups. In the first group, we treated 20 women with clotrimazole daily administration for six days. In the second group, 20 women were treated with clotrimazole associated with Unilen® Microbio+, a new product containing Saccharomyces cerevisiae, melatonin, and GLA-14. Women underwent a check at days 15, 30, and 90. A clinical and cultural examination were performed to establish the effect of the treatments on vaginal flora. Results: In the group treated with Unilen® Microbio+, clinical and microbiological cure at 15 and 30 days was observed in 18 women (90%), compared with 16 women (80%) in the group treated only with clotrimazole. The efficacy of the association between clotrimazole and Unilen® Microbio+ in these uncomplicated forms was therefore not inferior to the azole treatment alone. Only four women (20%) in the Unilen® Microbio+ group presented symptomatic recurrences within the 3 months, compared with eight women (40%) in the clotrimazole-only group. Microscopic wet mount analysis at 1 and 3 months demonstrated a significant increase in lactobacillus count and a reduction in the polymorphonucleate cells in the Unilen® Microbio+ group. Conclusions: Unilen® Microbio+ supplementation was demonstrated to cure uncomplicated vulvovaginal candidiasis with clotrimazole, reducing recurrence and improving vaginal flora better than clotrimazole treatment alone. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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13 pages, 832 KiB  
Article
Effects of Sling-Based Thoracic Active Exercise on Pain and Function and Quality of Life in Female Patients with Neck Pain: A Randomized Controlled Trial
by Gun-Woo Park, Jungae An, Sang-Woo Kim and Byoung-Hee Lee
Healthcare 2021, 9(11), 1514; https://doi.org/10.3390/healthcare9111514 - 05 Nov 2021
Cited by 5 | Viewed by 2452
Abstract
This study aimed to investigate the effects of sling-based thoracic active exercise on pain, function, and quality of life in female patients with neck pain. A total of 27 female patients with neck pain were divided into the sling-based thoracic active exercise group [...] Read more.
This study aimed to investigate the effects of sling-based thoracic active exercise on pain, function, and quality of life in female patients with neck pain. A total of 27 female patients with neck pain were divided into the sling-based thoracic active exercise group (n = 14) and the control group (n = 13). The study group performed a sling-based thoracic active exercise with cervical manual therapy for 50 min a day, twice a week for 4 weeks, whereas the control group performed a placebo exercise with cervical manual therapy in the same manner as the study group. Evaluation of the degree of pain before and after treatment was based on the pressure pain threshold and numeric pain rating scale scores. The craniovertebral angle and neck disability index (NDI) were used to evaluate neck function, and quality of life was measured using the Short Form-36. Afterwards, the patients’ pressure pain thresholds were significantly increased, and the numeric pain rating scale score was significantly decreased in both groups (p < 0.05). In terms of function, the craniovertebral angle was significantly increased in both groups (p < 0.05), and neck dysfunction significantly decreased (p < 0.05). The quality of life significantly increased in both groups (p < 0.05). The pressure pain threshold, craniovertebral angle, neck dysfunction index, and quality of life scores (p < 0.05) were significantly different between groups, except the numeric pain scale score. Our results showed that sling-based thoracic active exercise is effective in reducing pain and improving function and quality of life in female patients with neck pain, thus emphasizing the need for thoracic treatment for such patients. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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8 pages, 237 KiB  
Article
ART Innovations: Fostering Women’s Psychophysical Health between Bioethics Precepts and Human Rights
by Simona Zaami, Lorenza Driul, Milena Sansone, Elisa Scatena, Karin Louise Andersson and Enrico Marinelli
Healthcare 2021, 9(11), 1486; https://doi.org/10.3390/healthcare9111486 - 01 Nov 2021
Cited by 3 | Viewed by 1784
Abstract
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, [...] Read more.
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
11 pages, 1006 KiB  
Article
Psycho-Emotional Impact of Anomaly Ultrasound Scan in Romanian Pregnant Women
by Liana Pleş, Bashar Haj Hamoud, Mihai Cornel Traian Dimitriu, Cătălin Cîrstoveanu, Bogdan Socea, Antoniu-Crîngu Ionescu, Dragoş Albu, Romina-Marina Sima and Mircea-Octavian Poenaru
Healthcare 2021, 9(11), 1415; https://doi.org/10.3390/healthcare9111415 - 21 Oct 2021
Cited by 2 | Viewed by 1631
Abstract
Objective: Second-trimester anomaly scan was introduced as a regulated practice in Romania in 2019, causing misperceptions and unrealistic expectations about this examination among pregnant women. This study aimed to assess whether second trimester anomaly scan is a reason “per se” for maternal anxiety. [...] Read more.
Objective: Second-trimester anomaly scan was introduced as a regulated practice in Romania in 2019, causing misperceptions and unrealistic expectations about this examination among pregnant women. This study aimed to assess whether second trimester anomaly scan is a reason “per se” for maternal anxiety. Design: A prospective type 1 cohort study was conducted in a tertiary prenatal diagnosis center with three locations in Bucharest, Romania, among pregnant women who underwent a second trimester anomaly scan between 1 December 2019 and 29 February 2020. Main outcome measure: Anxiety at the time of prenatal anomaly scan. Results: Out of the 138 participants, 32.6% believed that the anomaly scan could detect all fetus defects, 13.8% considered that the baby is bothered by the probe “light”, 8.7% believed that the scan could harm the fetus, 96.4% reported that it was a pleasant experience, and 95% felt that it strengthened their bond with the fetus. The State-Trait Anxiety Inventory (STAI) score revealed that women with high state anxiety were more anxious at pre-scan (p = 0.001). Conclusion: Ultrasound scan in the second trimester is correlated with a significant anxiety for women who are prone to this psychological trait. It is also a good opportunity to screen for highly anxious women who could benefit from prenatal psychological counseling to facilitate timely recognition and prevention of postpartum psychiatric disorders such as depression. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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13 pages, 484 KiB  
Article
Factors Affecting the Initiation of a Shared Decision Making Program in Obstetric Practices
by Deborah J. Bowen, Ann M. Nguyen, Cynthia LeRouge, Erin LePoire and Tao Sheng Kwan-Gett
Healthcare 2021, 9(9), 1217; https://doi.org/10.3390/healthcare9091217 - 16 Sep 2021
Cited by 2 | Viewed by 2055
Abstract
As healthcare systems progress toward initiatives that increase patient engagement, stakeholder hopes are that shared decision making (SDM) will become routine practice. Yet, there is limited empirical evidence to guide such SDM program implementations, particularly in obstetric practices. The first stage of any [...] Read more.
As healthcare systems progress toward initiatives that increase patient engagement, stakeholder hopes are that shared decision making (SDM) will become routine practice. Yet, there is limited empirical evidence to guide such SDM program implementations, particularly in obstetric practices. The first stage of any project implementation is the “initiation stage”, in which project leaders define a project’s purpose and stakeholders and structures are put in place to support the new initiative. Our study’s objective was to identify factors affecting the initiation stage of an SDM program implementation project for TOLAC, trial of labor after Cesarean. We conducted a multiple-case study of an SDM program implementation in three obstetric settings in Washington State. The research design and analysis were guided by implementation science frameworks and project management literature. Data sources included interviews with key informants from the State, SDM tool vendors, and three project sites, as well as implementation documents. The study results provide insight into how the identified project implementation factors provide an essential foundation for informing project planning, execution, and reflection/evaluation. In this study, the State’s decision aid certification program pressured the project sites to shape the project purpose and engage stakeholders that would meet immediate project requirements (specifically, state requirements). The study reveals that external demands may not be in perfect alignment with the internal necessities required for an SDM program’s long-term viability and sustainability. Findings may be used by implementers and researchers to model and strategize the early stages of SDM program implementation projects, particularly in the obstetric setting. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 245 KiB  
Article
The Effect of Physical and Mental Health and Health Behavior on the Self-Rated Health of Pregnant Women
by Eunwon Lee and Jiyoung Song
Healthcare 2021, 9(9), 1117; https://doi.org/10.3390/healthcare9091117 - 28 Aug 2021
Cited by 2 | Viewed by 1458
Abstract
Self-rated health (SRH) is an evaluation tool to assess an individual’s level of health, including both general health and personal experience. There have been existing studies on women’s SRH; however, few studies have been on pregnant women’s SRH and its associated factors. This [...] Read more.
Self-rated health (SRH) is an evaluation tool to assess an individual’s level of health, including both general health and personal experience. There have been existing studies on women’s SRH; however, few studies have been on pregnant women’s SRH and its associated factors. This study investigated the SRH of pregnant women and their factors using the Korea Community Health Survey. The chi-squared test and multivariable logistic regression were used to investigate the effects of demographic, physical, and mental health and health behaviors on the SRH of pregnant women. As a result of the study, 54.0% out of 1032 pregnant women had good SRH. Their SRH score was good when they were young, economically active, and living in cities. Poor SRH was observed with depression, hypertension, and after experiencing a fall. Good SRH was found when they exercised and slept for more than 8 h a day. This study is the first to observe the SRH of pregnant women and its related factors in South Korea. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
8 pages, 217 KiB  
Article
Factors Affecting Participation in Leisure Activities in Patients after Breast Cancer Surgery
by Yoshiteru Akezaki, Eiji Nakata, Masato Kikuuchi, Ritsuko Tominaga, Hideaki Kurokawa, Masaki Okamoto, Makiko Hamada, Kenjiro Aogi, Shozo Ohsumi and Shinsuke Sugihara
Healthcare 2021, 9(8), 1078; https://doi.org/10.3390/healthcare9081078 - 22 Aug 2021
Cited by 2 | Viewed by 2129
Abstract
Background: The purpose of this study was to investigate the factors related to patient’s participation in leisure activity in breast cancer patients with axillary lymph node dissection at 3 months after surgery. Methods: In total, 160 women who were employed before their surgery [...] Read more.
Background: The purpose of this study was to investigate the factors related to patient’s participation in leisure activity in breast cancer patients with axillary lymph node dissection at 3 months after surgery. Methods: In total, 160 women who were employed before their surgery were evaluated. Age, body mass index (BMI), employment, level of lymph node dissection, marital status, children, coresident household members, preoperative chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, shoulder range of motion test, upper limb function, quality of life, and patient’s participation in leisure activity were evaluated. Results: Patients who undertook leisure activities constituted the leisure activity group, and patients who did not constituted the non-leisure activity group. Global health status, emotional function, social function, and dyspnea were significantly different between the leisure activity group and the non-leisure activity group at 3 months after surgery (p < 0.05). Regarding factors that affected participation in leisure activities, logistic regression analysis showed that only participation in leisure activities before surgery was significantly associated with participation in leisure activities at 3 months after surgery (p < 0.05). Conclusion: Patients who did not participate in leisure activities prior to surgery were unlikely to participate 3 months after surgery and thus require intervention to encourage their involvement. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
10 pages, 245 KiB  
Article
Combined Effects of Metabolic Abnormalities and Obesity on Cardiovascular Diseases among Korean Postmenopausal Women
by Jin Suk Ra
Healthcare 2021, 9(8), 1064; https://doi.org/10.3390/healthcare9081064 - 19 Aug 2021
Cited by 1 | Viewed by 1565
Abstract
Combined effects of metabolic abnormalities, including metabolic syndrome and obesity, should be identified to screen postmenopausal women at risk of developing cardiovascular diseases. The purpose of this study was to identify the combined effects of metabolic abnormalities and obesity on cardiovascular diseases among [...] Read more.
Combined effects of metabolic abnormalities, including metabolic syndrome and obesity, should be identified to screen postmenopausal women at risk of developing cardiovascular diseases. The purpose of this study was to identify the combined effects of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women (aged 40–83 years). Data of 5959 postmenopausal women from the Korean National Health and Nutrition Examination Survey (2015–2018) were secondarily analyzed. Using complex simple analysis procedures, logistic regression analysis was performed to identify the combined effect of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women. In combination, metabolic syndrome (more than three metabolic abnormalities) and obesity (overweight [≥23 kg/m2 and <25 kg/m2 in body mass index] and obese [>25 kg/m2 in body mass index]) increased the likelihood of developing cardiovascular diseases but combining more than one metabolic abnormality and obesity did not. Combining metabolic syndrome and non-obesity (underweight and normal weight) increased the likelihood of the prevalence of cardiovascular diseases but combining more than one metabolic abnormality and non-obesity did not. Increased cardiovascular diseases in postmenopausal women may be more commonly associated with metabolic syndrome having multiple metabolic abnormalities, but not obesity. Thus, instead of simple weight control, early management of metabolic syndrome is recommended to prevent cardiovascular disease among postmenopausal Korean women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
9 pages, 846 KiB  
Article
Tumor Characteristic Variations between Symptomatic and Asymptomatic Endometrial Cancer
by Petra Vinklerová, Markéta Bednaříková, Luboš Minář, Michal Felsinger, Jitka Hausnerová, Petra Ovesná and Vít Weinberger
Healthcare 2021, 9(7), 902; https://doi.org/10.3390/healthcare9070902 - 16 Jul 2021
Cited by 1 | Viewed by 2221
Abstract
Endometrial cancer is the most common gynecologic malignancy in Europe and usually diagnosed in its initial stage owing to early symptoms of abnormal bleeding. There is no population screening for this disease, although it can sometimes be accidentally diagnosed in asymptomatic patients. Our [...] Read more.
Endometrial cancer is the most common gynecologic malignancy in Europe and usually diagnosed in its initial stage owing to early symptoms of abnormal bleeding. There is no population screening for this disease, although it can sometimes be accidentally diagnosed in asymptomatic patients. Our study aims to determine differences in clinical and tumor characteristics between an asymptomatic and symptomatic group of patients. This unicentric prospective observational study took place in University Hospital Brno between January 2016 and December 2019. A total of 264 patients met inclusion criteria (26% asymptomatic, 74% with reported symptoms). We did not find a statistically significant difference in clinical characteristics (menopausal status, parity, age, BMI, and serum level of CA 125) between groups. According to ultrasound examination, bleeding tumors were larger (19.5 vs. 12.7 mm, p ≤ 0.001). Definitive histology results indicated more frequent lymphovascular space invasion (p < 0.001), along with deep myometrial (p = 0.001) and cervical (p = 0.002) invasion. There was no difference in advanced stages of the tumor. We did not substantiate statistically significant difference in immunohistochemical profile (estrogen and progesterone receptors, L1 cell adhesion molecule, tumor protein p53), which is relevant for tumor recurrence risk and survival capacity. Our conclusions affirmed that bleeding occurs more often among patients with local tumor invasion into the myometrium and cervical stroma. Final International Federation of Gynecology and Obstetrics (FIGO) stage, histology, and immunohistochemical characteristics do not significantly affect symptom appearance. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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12 pages, 265 KiB  
Article
Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women
by Jin-Suk Ra and Hyesun Kim
Healthcare 2021, 9(7), 848; https://doi.org/10.3390/healthcare9070848 - 05 Jul 2021
Cited by 3 | Viewed by 1705
Abstract
This study aimed to identify the combined effects of unhealthy lifestyle behaviors, including diet, sedentary behavior, and physical activity on metabolic syndrome (MS) and components of MS among postmenopausal women. Secondary data analysis was conducted using the Korean National Health and Nutrition Examination [...] Read more.
This study aimed to identify the combined effects of unhealthy lifestyle behaviors, including diet, sedentary behavior, and physical activity on metabolic syndrome (MS) and components of MS among postmenopausal women. Secondary data analysis was conducted using the Korean National Health and Nutrition Examination Survey (2014–2018) with a cross-sectional study design. Logistic regression analysis was conducted with data from 6114 Korean postmenopausal women. While no significant effects of unhealthy lifestyle behaviors, either individually or as a combination, were found for MS, prolonged sedentary behavior without poor dietary behavior and insufficient physical activity was associated with increased likelihood of abdominal obesity (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.10–2.29) and impaired fasting glucose (AOR: 1.54, 95% CI: 1.13–2.10). The combination of poor dietary behavior and prolonged sedentary behaviors was also associated with increased likelihood of abdominal obesity (AOR: 1.48, 95% CI: 1.10–2.00) and impaired fasting glucose (AOR: 1.49, 95% CI: 1.14–1.96). In addition, prolonged sedentary behavior and insufficient physical activity together were associated with increased likelihood of abdominal obesity (AOR: 2.81, 95% CI: 1.90–4.20) and impaired fasting glucose (AOR: 1.59, 95% CI: 1.13–2.24). Finally, combining poor dietary behavior, prolonged sedentary behavior, and insufficient physical activity was also associated with increased likelihood of abdominal obesity (AOR: 2.05, 95% CI: 1.50–2.80) and impaired fasting glucose (AOR: 1.71, 95% CI: 1.32–2.23). Strategies for replacing sedentary behavior of postmenopausal women with activities are warranted for prevention of abdominal obesity and impaired fasting glucose. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
7 pages, 230 KiB  
Article
Gene Polymorphism in Five Target Genes of Immunosuppressive Therapy and Risk of Development of Preeclampsia
by Francesca Previtera, Stefano Restaino, Giulio Romano, Giuseppe Vizzielli, Andrea Neri, Elisa Scalzotto, Luigi Vetrugno, Beatrice Montessoro, Roberto Mioni and Lorenza Driul
Healthcare 2021, 9(7), 821; https://doi.org/10.3390/healthcare9070821 - 28 Jun 2021
Viewed by 1435
Abstract
Pregnancy can be considered as an allogeneic transplant and preeclampsia can be seen as a failure of the acceptance mechanisms of this transplant as occurs in acute organ transplant rejection. Some genetic polymorphisms may be involved in its pathogenesis. Since the kidney is [...] Read more.
Pregnancy can be considered as an allogeneic transplant and preeclampsia can be seen as a failure of the acceptance mechanisms of this transplant as occurs in acute organ transplant rejection. Some genetic polymorphisms may be involved in its pathogenesis. Since the kidney is one of the organs mainly involved in preeclampsia, our study attempted to determine the frequencies of single nucleotide polymorphisms of DNA (SNP) in 3 genes (adenosine triphosphate-binding cassette sub-family B member 1 (ABCB1)/multi drug reactivity 1 (MDR1) gene, interleukin 10 gene and tumor necrosis factor α gene) which are targets of immunosuppressive therapies and related to acute renal rejection. The study was an observational, monocentric, case-control study. We enrolled 20 women with severe preeclampsia and 10 women age-matched with regular pregnancy. Continuous variables were compared by the Student’s t-test for independent variables or using the Mann-Whitney test depending on their distribution. We used Fisher test to compare categorical variables between cases and controls, while we used logistic regression model to evaluate which risk factor was associated with preeclampsia. Although there was no statistically significant difference between the two groups, we found different percentages of two of the polymorphisms considered (rs1045642 and rs2032582 in the gene ABCB1). Despite these results, our work may be helpful for future research to better understand the pathogenesis of preeclampsia. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
9 pages, 1175 KiB  
Article
High Co-Infection Rate of Trichomonas vaginalis and Candidatus Mycoplasma Girerdii in Gansu Province, China
by Shuhui Xu, Zhixin Wang, Hang Zhou, Yongfeng Fu, Meng Feng and Xunjia Cheng
Healthcare 2021, 9(6), 706; https://doi.org/10.3390/healthcare9060706 - 10 Jun 2021
Cited by 4 | Viewed by 1787
Abstract
Trichomonas vaginalis (Tv) is a flagellated protist parasite that infects the human urogenital tract. The symbiotic relationship between Tv and Mycoplasma hominis has been reported. Recent studies have identified a new Mycoplasma strain, Candidatus Mycoplasma girerdii (Ca. M. girerdii), present [...] Read more.
Trichomonas vaginalis (Tv) is a flagellated protist parasite that infects the human urogenital tract. The symbiotic relationship between Tv and Mycoplasma hominis has been reported. Recent studies have identified a new Mycoplasma strain, Candidatus Mycoplasma girerdii (Ca. M. girerdii), present in the vaginal secretions of women and have shown that this strain may be related to trichomoniasis. Here, we evaluated the presence of Tv, M. hominis and Ca. M. girerdii in 312 clinical samples from adult women diagnosed with vaginitis in Zhangye, Gansu province, China. Among these samples, 94, 153, and 48 were Tv, M. hominis and Ca. M. girerdii positive, respectively. Moreover, Tv was highly frequent in 17–30-year-old women in this region. Forty samples (83.3%) positive for Ca. M. girerdii were also positive for Tv. Six Tv isolates were successfully cultured, including five isolates that showed symbiotic relationships with Mycoplasma. This is the first report to evaluate the genetic characteristics of Ca. M. girerdii in China and may therefore provide insights into the effects of Ca. M. girerdii on the reproductive health of women. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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13 pages, 1560 KiB  
Article
A Validation Study on the Frequency and Natural History of Miscarriages Using the Spanish Primary Care Database BIFAP
by Sara Sanchez Ortiz, Consuelo Huerta, Ana Llorente-García, Paloma Ortega, Paloma Astasio and Lucía Cea-Soriano
Healthcare 2021, 9(5), 596; https://doi.org/10.3390/healthcare9050596 - 18 May 2021
Cited by 3 | Viewed by 4414
Abstract
(1) Background: There is a major gap of knowledge towards the natural history of miscarriages in electronic medical records. We aimed to calculate the frequency of miscarriages using data from BIFAP database. (2) Methods: We identified all pregnancy losses and carried out a [...] Read more.
(1) Background: There is a major gap of knowledge towards the natural history of miscarriages in electronic medical records. We aimed to calculate the frequency of miscarriages using data from BIFAP database. (2) Methods: We identified all pregnancy losses and carried out a multistep validation exercise. Potential cases with positive predictive values (PPV) of miscarriage confirmation <85% or those confirming other pregnancy loss were excluded. Kaplan–Meier figures and incidence rates (IRs) of miscarriage with 95% confidence intervals (CIs) expressed by 1000 person-weeks were calculated. Stratifying analysis by age, specific high-risk groups, and drug exposure within the pre-pregnancy period were performed restricted to women with recording last menstrual period (LMP). (3) Results: Women with confirmed miscarriage (N = 18,070), tended to be older, with higher frequency of comorbidities and drug utilization. Restricting to women with LPM recorded, IR of miscarriage was 10.89 (CI 95% 10.68–11.10) per 1000 women-weeks, with a median follow-up of 10 weeks (IQR: 8–12). The IR according to age was: 2.71 (CI 95% 2.59–2.84) in those aged <30 years compared to 9.11 (CI 95% 8.55–9.70) in women aged ≥40 years. Advanced maternal age (Hazard Ratio (HR, 95% confidence interval) CI 95%: 3.34 (3.08–3.62)), use of antihypertensives (1.49 (1.21–1.84), and use of drugs classified as D or X during pregnancy (1.17 (1.07–1.29)) showed to be positive predictors associated with increased risk of miscarriages. (4) Conclusion: BIFAP database can be used to identify women suffering from miscarriages, which will serve to further study risk factors associated with miscarriages with special attention to drug utilization. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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Review

Jump to: Research, Other

12 pages, 430 KiB  
Review
Smartphone-Based Visual Inspection with Acetic Acid: An Innovative Tool to Improve Cervical Cancer Screening in Low-Resource Setting
by Jana Sami, Sophie Lemoupa Makajio, Emilien Jeannot, Bruno Kenfack, Roser Viñals, Pierre Vassilakos and Patrick Petignat
Healthcare 2022, 10(2), 391; https://doi.org/10.3390/healthcare10020391 - 18 Feb 2022
Cited by 4 | Viewed by 3746
Abstract
Visual inspection with acetic acid (VIA) is recommended by the World Health Organization for primary cervical cancer screening or triage of human papillomavirus-positive women living in low-resource settings. Nonetheless, traditional VIA with the naked-eye is associated with large variabilities in the detection of [...] Read more.
Visual inspection with acetic acid (VIA) is recommended by the World Health Organization for primary cervical cancer screening or triage of human papillomavirus-positive women living in low-resource settings. Nonetheless, traditional VIA with the naked-eye is associated with large variabilities in the detection of pre-cancer and with a lack of quality control. Digital-VIA (D-VIA), using high definition cameras, allows magnification and zooming on transformation zones and suspicious cervical regions, as well as simultaneously compare native and post-VIA images in real-time. We searched MEDLINE and LILACS between January 2015 and November 2021 for relevant studies conducted in low-resource settings using a smartphone device for D-VIA. The aim of this review was to provide an evaluation on available data for smartphone use in low-resource settings in the context of D-VIA-based cervical cancer screenings. The available results to date show that the quality of D-VIA images is satisfactory and enables CIN1/CIN2+ diagnosis, and that a smartphone is a promising tool for cervical cancer screening monitoring and for on- and off-site supervision, and training. The use of artificial intelligence algorithms could soon allow automated and accurate cervical lesion detection. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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9 pages, 1242 KiB  
Review
Adult Granulosa Cell Tumor in Pregnancy: A New Case and a Review of the Literature
by Sofia Guidi, Vincenzo Berghella, Giovanni Scambia, Anna Fagotti, Annalisa Vidiri, Stefano Restaino, Giuseppe Vizzielli, Frediano Inzani and Anna Franca Cavaliere
Healthcare 2021, 9(11), 1455; https://doi.org/10.3390/healthcare9111455 - 27 Oct 2021
Cited by 5 | Viewed by 2307
Abstract
Granulosa cell tumors are rare ovarian tumors that can arise during pregnancy. We present a new case of recurrent adult granulosa cell tumor (AGCT) in pregnancy and a systematic review of the literature. The new case described is a 41-year-old woman G5P1122 with [...] Read more.
Granulosa cell tumors are rare ovarian tumors that can arise during pregnancy. We present a new case of recurrent adult granulosa cell tumor (AGCT) in pregnancy and a systematic review of the literature. The new case described is a 41-year-old woman G5P1122 with a prior history of AGCT that was referred to our center at 29 weeks because of a symptomatic abdominal mass, compatible with a possible recurrence of AGCT. At 36 + 3 weeks, she underwent a cesarean delivery for preterm labor and a total hysterectomy with a radical surgical staging. A healthy female infant was delivered. The patient received a platinum-based chemotherapy, with a 26-month follow-up negative for recurrence. Analyzing our case with the four identified by the literature review, three were recurrent and two were primary AGCT. Only one required surgery for AGCT at 15 weeks, while another underwent chemotherapy in pregnancy. In the other three cases, surgery for AGCT was done at the time of cesarean delivery. There were three cases of preterm delivery. All five pregnancies resulted in the birth of live babies with weight adequate for gestational age. In conclusion, AGCT diagnosed in pregnancy is rare, reported in only five cases. All gave birth to live babies in the third trimester, and maternal outcome at up to 18 months showed no recurrence. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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23 pages, 3770 KiB  
Review
Safety Assessment of Endocrine Disruption by Menopausal Health Functional Ingredients
by Soyeon Kang, Hagyeong Jo and Mee-Ran Kim
Healthcare 2021, 9(10), 1376; https://doi.org/10.3390/healthcare9101376 - 15 Oct 2021
Cited by 1 | Viewed by 3753
Abstract
During menopause, women experience various symptoms including hot flashes, mood changes, insomnia, and sweating. Hormone replacement therapy (HRT) has been used as the main treatment for menopausal symptoms; however, other options are required for women with medical contraindications or without preference for HRT. [...] Read more.
During menopause, women experience various symptoms including hot flashes, mood changes, insomnia, and sweating. Hormone replacement therapy (HRT) has been used as the main treatment for menopausal symptoms; however, other options are required for women with medical contraindications or without preference for HRT. Functional health foods are easily available options for relieving menopausal symptoms. There are growing concerns regarding menopausal functional health foods because the majority of them include phytoestrogens which have the effect of endocrine disruption. Phytoestrogens may cause not only hormonal imbalance or disruption of the normal biological function of the organ systems, but also uterine cancer or breast cancer if absorbed and accumulated in the body for a long period of time, depending on the estrogen receptor binding capacity. Therefore, we aimed to determine the effects and safety of menopausal functional health ingredients and medicines on the human body as endocrine disruptors under review in the literature and the OECD guidelines. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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12 pages, 453 KiB  
Review
Readability Assessment of HPV Vaccination and Cervical Cancer Information: A Systematic Scoping Review
by Tsuyoshi Okuhara, Hiroko Okada, Eiko Goto and Takahiro Kiuchi
Healthcare 2021, 9(10), 1246; https://doi.org/10.3390/healthcare9101246 - 22 Sep 2021
Cited by 5 | Viewed by 2007
Abstract
It is important to provide information on HPV vaccination and on early detection and early treatment for cervical cancer. Readability is a key aspect in the success of cancer communication using written health information. We reviewed studies assessing the readability of information on [...] Read more.
It is important to provide information on HPV vaccination and on early detection and early treatment for cervical cancer. Readability is a key aspect in the success of cancer communication using written health information. We reviewed studies assessing the readability of information on HPV vaccination and cervical cancer. We conducted a systematic literature search in June 2021 using four online databases (Medline, CINAHL, PsycArticles, and PsycINFO). Studies that assessed the readability level of online and offline information regarding HPV vaccination and cervical cancer were included in the review. Twelve articles were deemed fit for study inclusion. Our results showed that most of the materials assessed were difficult to read and higher than eighth-grade reading level. Few of the materials assessed were at the recommended grade 5–6 level or below. Readability assessments of HPV vaccination and cervical cancer information are scarce. Additional studies on the readability of information regarding HPV vaccination and cervical cancer are recommended. Health professionals should develop health information on HPV vaccination and cervical cancer that is easy to read. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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17 pages, 636 KiB  
Review
Towards Personalized Medicine: Non-Coding RNAs and Endometrial Cancer
by Anna Franca Cavaliere, Federica Perelli, Simona Zaami, Roberto Piergentili, Alberto Mattei, Giuseppe Vizzielli, Giovanni Scambia, Gianluca Straface, Stefano Restaino and Fabrizio Signore
Healthcare 2021, 9(8), 965; https://doi.org/10.3390/healthcare9080965 - 30 Jul 2021
Cited by 35 | Viewed by 2694
Abstract
Endometrial cancer (EC) is the most frequent female cancer associated with excellent prognosis if diagnosed at an early stage. The risk factors on which clinical staging is based are constantly updated and genetic and epigenetic characteristics have recently been emerging as prognostic markers. [...] Read more.
Endometrial cancer (EC) is the most frequent female cancer associated with excellent prognosis if diagnosed at an early stage. The risk factors on which clinical staging is based are constantly updated and genetic and epigenetic characteristics have recently been emerging as prognostic markers. The evidence shows that non-coding RNAs (ncRNAs) play a fundamental role in various biological processes associated with the pathogenesis of EC and many of them also have a prognosis prediction function, of remarkable importance in defining the therapeutic and surveillance path of EC patients. Personalized medicine focuses on the continuous updating of risk factors that are identifiable early during the EC staging to tailor treatments to patients. This review aims to show a summary of the current classification systems and to encourage the integration of various risk factors, introducing the prognostic role of non-coding RNAs, to avoid aggressive therapies where not necessary and to treat and strictly monitor subjects at greater risk of relapse. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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Other

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5 pages, 680 KiB  
Case Report
Ectopic Intrauterine Device Revealed by Ureteral Colic in a 37-Week Pregnant Woman: Case Report
by Alexandra Matei, Mihai Cornel Traian Dimitriu, Irina Pacu and Crîngu Ionescu
Healthcare 2022, 10(6), 1060; https://doi.org/10.3390/healthcare10061060 - 08 Jun 2022
Viewed by 3683
Abstract
Copper T intrauterine devices (IUDs) are a popular long-acting reversible contraceptive method. The most common reasons for contraceptive failure are expulsion and extrauterine migration. We report a case of a 28-year-old female, G13P3, 37 weeks pregnant, who presented to the hospital for left [...] Read more.
Copper T intrauterine devices (IUDs) are a popular long-acting reversible contraceptive method. The most common reasons for contraceptive failure are expulsion and extrauterine migration. We report a case of a 28-year-old female, G13P3, 37 weeks pregnant, who presented to the hospital for left abdominal flank pain. The patient was admitted for treatment of left ureteral colic. The woman went into labour, and Caesarean Section was performed due to foetal distress. During the surgery, an inspection of the peritoneal cavity revealed a copper IUD embedded in the granulous tissue located in the left lateral abdominal region, which was extracted. No uterine scar tissue could be identified macroscopically. The migration of an IUD in the abdominal cavity is a rare finding, and coexistence with third-trimester pregnancy is an infrequent but serious event due to potential visceral complications. Higher gravidity can be associated with an increased risk of IUD migration in women with a non-scarred uterus. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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