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Sample records for 17-year-old female patient

  1. A rare cause of right upper quadrant pain in a 17-year-old female.

    PubMed

    Nwankwo, Nwabundo; Barbaryan, Aram; Ali, Alaa M; Mirrakhimov, Aibek E

    2013-01-01

    A 17-year-old Hispanic female presented to our hospital with complaints of right upper quadrant abdominal pain, vomiting, and fever. Physical exam was positive for hepatomegaly. Abdominal computed tomography showed multiple hypoechoic liver masses. Liver biopsy was done, which was diagnostic for hepatic epithelioid hemangioendothelioma.

  2. Myocardial infarction in a 17-year-old patient due to neurofibromatosis-associated coronary aneurysm.

    PubMed

    Evrengul, Harun; Kilic, Dogu I; Zungur, Mustafa; Alihanoglu, Yusuf I; Tanriverdi, Halil

    2013-06-01

    Neurofibromatosis is an autosomal dominant multi-system genetic disorder. Extra-cardiac vascular manifestations of neurofibromatosis have been previously described in many reports. However, coronary arterial involvements have been rarely described. A 17-year-old girl with neurofibromatosis presented to our institute with subacute myocardial infarction. Coronary angiogram revealed an aneurysm with thrombus in the left anterior descending artery.

  3. Impact of Louisiana's HPV Vaccine Awareness Policy on HPV Vaccination Among 13- to 17-Year-Old Females.

    PubMed

    Pierre-Victor, Dudith; Trepka, Mary Jo; Page, Timothy F; Li, Tan; Stephens, Dionne P; Madhivanan, Purnima

    2017-01-01

    The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana's policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.

  4. A Case Report of Probable Paliperidone ER-Induced Serotonin Syndrome in a 17-Year-Old Taiwanese Female With New Onset Psychosis

    PubMed Central

    Yang, Chung-Hao; Juang, Kai-Dih; Chou, Po-Han; Chan, Chin-Hong

    2016-01-01

    Abstract A 17-year-old female with new-onset psychosis was treated with paliperidone. After increasing the paliperidone dose to 12 mg per day the patient developed a series of side effects; Tachycardia (140 bpm), severe drooling, restlessness, diaphoresis, whole-body tremor, inducible foot clonus, predominant lower limbs rigidity, bilateral pupil dilation, increased bowel sounds with watery diarrhea, and muscle hypertonicity. The symptoms subsided after stopping the paliperidone, and recurred after resuming paliperidone 9 mg per day. To our knowledge, this is the first case of a very clear and close relationship between the symptoms of serotonin syndrome and the use of paliperidone. We have to cautiously consider the diagnosis of serotonin syndrome in potential cases. PMID:26945397

  5. Regional variations in HPV vaccination among 9–17 year old adolescent females from the BRFSS, 2008–2010

    PubMed Central

    Hirth, Jacqueline M; Rahman, Mahbubur; Smith, Jennifer S; Berenson, Abbey B

    2015-01-01

    Human papillomavirus (HPV) vaccine uptake among 18–26 y old women varies by geographic region in the US. However, little is known about regional variations in vaccination among girls who are in the vaccine's targeted age groups. Regional variation in HPV vaccination among female adolescents (9–17 y old) was examined using cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2008 and 2010. Multivariable logistic regression estimated the association of region of residence (10 states included questions about adolescent HPV vaccination) with uptake and completion of the 3-shot HPV vaccine series. Among 7,849 adolescents, 26.9% initiated, and 55.2% of initiators completed the series. Adolescents from Northeast/Midwest/West states were 1.74 (95% CI: 1.45-2.10) times more likely to have initiated HPV vaccination compared to the South/Southwestern states. Among initiators, vaccine series completion did not vary significantly between the South/Southwestern and Northeast/Midwest/West states. Flu vaccination was associated with increased odds of initiation in both regions and completion of the HPV vaccine series in the South/Southwestern states only. Girls 9–10 and 11–12 y old were less likely to have initiated and 11–12 y olds were less likely to have completed the HPV vaccine series compared to 13–17 y olds. The observed regional variations in vaccination could cause rates of cervical cancer to remain higher in the South/Southwest and widen currently observed regional disparities in cervical cancer rates. PMID:25668660

  6. An acute in-patient psychiatric service for 16- to 17-year-old adolescents in the UK: a descriptive evaluation

    PubMed Central

    Duddu, Venu; Rhouma, Abdulhakim; Qureshi, Masood; Chaudhry, Imran Bashir; Drake, Terry; Sumra, Altaf; Husain, Nusrat

    2016-01-01

    Aims and method The need for an age-appropriate in-patient service for 16- to 17-year-olds led to the development of a 6-bed acute admissions unit in a non-metropolitan county in the UK. We provide a descriptive evaluation of the first 2 years of its operation. All admissions from April 2010 to March 2012 were reviewed, clinical details systematically recorded and descriptively analysed. Results Ninety-seven young people were admitted during this period (a third were compulsorily detained under the Mental Health Act 1983). The average length of stay was 3–4 weeks. The most common presenting complaints were self-harm and low mood, usually in the context of life events and childhood adversity. Nearly half had substance misuse and other risk-taking behaviours. A third presented with psychotic symptoms. Adjustment and anxiety disorders were most common, followed by alcohol/substance use disorders, depressive illnesses and psychotic illnesses. Comorbidity was the rule rather than the exception. Most patients improved by the time of discharge. Clinical implications The unit provides an accessible and effective age-appropriate service and is likely to constitute an important component of the comprehensive child and adolescent mental health service strategy in the county. PMID:27752345

  7. Thoracoscopic resection of a bronchogenic cyst in a 17-year-old girl

    PubMed Central

    Pułtorak, Roksana; Pasierbek, Michał; Grabowski, Andrzej

    2016-01-01

    Bronchogenic cysts comprise approximately 6% of mediastinal tumors in children. The treatment consists in surgical resection of the cyst. The authors present the case of a 17-year-old girl who was accidentally diagnosed with a mediastinal cyst. The patient was successfully treated with thoracoscopic surgery with good early and late clinical outcomes. PMID:28096839

  8. Hirayama disease in a 17-year-old Chinese man

    PubMed Central

    Sitt, Jacqueline Ching Man; Fung, Eva Lai Wah; Yuen, Edmund Hok-Yuen; Ahuja, Anil Tejbhan

    2014-01-01

    Hirayama disease is an uncommon cervical myelopathy associated with neck flexion. It has been postulated to be related to the anterior shifting of the posterior dura of the lower cervical dural canal during neck flexion, resulting in lower cervical cord atrophy with asymmetric flattening. We report a case of Hirayama disease in a 17-year-old Chinese man and demonstrate the use of dynamic flexion magnetic resonance imaging of the cervical spine in the diagnosis of the disease. PMID:24379115

  9. School and the 17-Year-Old: A Comparison of Career Development Skills of 17-Year-Olds Attending School and Those Not Attending.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    National performance for 17-year-olds in school, 17-year-olds not in school and young adults aged 26-35 in the area of career and occupational development (COD) was assessed to determine whether or not education status and career development skills are related. Within each of the groups, performance of various subgroups was examined, defined by…

  10. Appendiceal Hemangioma, Mimicking Acute Appendicitis in a 17-Year-Old Girl

    PubMed Central

    Geramizadeh, Bita; Niakan, Amin; Zolmadjdi, Nadjmeh; Marzban, Mahsa

    2016-01-01

    Epithelial tumors of appendix are not so common, and mesenchymal tumors of the appendix are even less common. Capillary hemangioma of the appendix is an extremely rare event and to the best of our knowledge only 4 cases have been reported in the English literature so far. In this case report we want to explain our experience with an extremely rare occurrence of capillary hemangioma of appendix in a 17-year-old girl presented with right lower quadrant pain that was operated with the clinical impression of acute appendicitis. The patient has been operated as a routine appendectomy with a completely uneventful postoperative period. PMID:27441077

  11. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Limited driving of automobiles and trucks by 17-year-olds... Amended Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. Section 13(c)(6... employment, perform the occasional and incidental driving of automobiles and trucks on public highways...

  12. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Limited driving of automobiles and trucks by 17-year-olds... Amended Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. Section 13(c)(6... employment, perform the occasional and incidental driving of automobiles and trucks on public highways...

  13. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Limited driving of automobiles and trucks by 17-year-olds... Amended Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. Section 13(c)(6... employment, perform the occasional and incidental driving of automobiles and trucks on public highways...

  14. 29 CFR 570.129 - Limited driving of automobiles and trucks by 17-year-olds.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Limited driving of automobiles and trucks by 17-year-olds... Amended Exemptions § 570.129 Limited driving of automobiles and trucks by 17-year-olds. Section 13(c)(6... employment, perform the occasional and incidental driving of automobiles and trucks on public highways...

  15. Lyme disease: a case report of a 17-year-old male with fatal Lyme carditis.

    PubMed

    Yoon, Esther C; Vail, Eric; Kleinman, George; Lento, Patrick A; Li, Simon; Wang, Guiqing; Limberger, Ronald; Fallon, John T

    2015-01-01

    Lyme disease is a systemic infection commonly found in the northeastern, mid-Atlantic, and north-central regions of the United States. Of the many systemic manifestations of Lyme disease, cardiac involvement is uncommon and rarely causes mortality. We describe a case of a 17-year-old adolescent who died unexpectedly after a 3-week viral-like syndrome. Postmortem examination was remarkable for diffuse pancarditis characterized by extensive infiltrates of lymphocytes and focal interstitial fibrosis. In the cardiac tissue, Borrelia burgdorferi was identified via special stains, immunohistochemistry, and polymerase chain reaction. The findings support B. burgdorferi as the causative agent for his fulminant carditis and that the patient suffered fatal Lyme carditis. Usually, Lyme carditis is associated with conduction disturbances and is a treatable condition. Nevertheless, few cases of mortality have been reported in the literature. Here, we report a rare example of fatal Lyme carditis in an unsuspected patient.

  16. Variceal bleeding caused by oesophageal varices: A manifestation of hepatocellular carcinoma in a 17-year-old girl

    PubMed Central

    Ali, Saadia Sasha; Sanmuganathan, Samuel N

    2015-01-01

    The authors present the rare case of a 17-year-old girl referred to the medical assessment unit following a large upper gastrointestinal haemorrhage. On further evaluation, she was found to have a primary hepatocellular carcinoma with extensive metastases. In our patient, the tumour was deemed incurable by resection, liver transplantation or percutaneous treatment. She underwent palliative chemotherapy and passed away 11 months following presentation. PMID:27489703

  17. Paroxysmal hemicrania with visual aura in a 17-year-old boy.

    PubMed

    Seidel, Stefan; Wöber, Christian

    2009-04-01

    We report the case of a 17-year-old boy presenting with a history of recurrent episodes of isolated visual aura later followed infrequently by indomethacin-responsive headache attacks resembling paroxysmal hemicrania.

  18. Sexual behaviour and early coitarche in a national sample of 17 year old Swedish girls

    PubMed Central

    Edgardh, K.

    2000-01-01

    Objective: To evaluate sexual behaviour in 17 year old girls, using data from a national survey on adolescent sexuality. Method: The study was based on two samples of 17 year olds, comprising 2% of the population born in 1973 and carried out in 1990. A school sample and a sample of school non-attenders were recruited in a two step procedure. Data were collected by anonymous self administered questionnaires. 2583 questionnaires were distributed. Response rates from students was 92%, for school non-attenders 44%. 1121 female students and 118 female school dropouts responded. Results: 64% of the student girls had experienced their first intercourse; 16% were "early starters" with coitarche before age 15. STD and pregnancy were reported by 15% of early starters and pregnancy by 14%, p<0.001 and 0.002 respectively when compared with later starters. The number of coital partners, experience of first date intercourse, and of oral and anal sex was higher in the early starters, p<0.001. Early starters reported menarche at age 11 or earlier more often than the later starters (OR 2.30, 95% CI 1.48–3.56), as well as a perceived social age exceeding the chronological by 2 years (OR 1.94, 95% CI 1.34–2.80). Sexual abuse was reported by 20% of the early and 11% of the later starters, p=0.002. Among school non-attenders no significant differences were found with regard to age for coitarche. A majority of 83% of the girls had experienced voluntary intercourse, and 49% were early starters. Five girls were mothers. STD was reported by 19% and induced abortion by 14%. Sexual abuse was alleged by 28%. Conclusion: Coitarche before age 15 is related to early menarche and high perceived social age. High number of partners and first date intercourse make early starters at increased risk for STD and unintended pregnancy. Sexual abuse is alleged more often by early starters. Key Words: adolescent sexuality; sex; coitarche; sexual behaviour; sexual abuse PMID:10858710

  19. Malignant pleural mesothelioma in a 17-year old boy: A case report and literature review

    PubMed Central

    Pérez-Guzmán, C.; Barrera-Rodríguez, R.; Portilla-Segura, J.

    2016-01-01

    Background Malignant pleural mesothelioma is a rare, invasive and often fatal neoplasm that develops in the thin layer of tissue surrounding the lungs known as the pleura. Although rare, mesotheliomas do occur in the young; their characteristics are distinct from those of older patients. Case presentation This is a case report of a 17-year-old boy who had moderate dyspnea, cough, right-sided pleuritic chest pain, fever, headache and no weight loss. Physical examination showed a right pleural effusion and chest roentgenograms revealed a homogenous opacity on lower right hemithorax. Biochemical analysis of pleural fluid showed hemorrhagic/turbid effusion compatible with exudate. It was initially treated as an empyema. The pleural fluid culture was negative. Adenosine deaminase level was 34.3 U/L (admission) and 19.02 U/L (two weeks after). Pleural fluid smear and culture for Mtb were negative. During the open pleural biopsy, thickened pleura and multiple pale yellow nodules in the lung were observed. The histopathological report was compatible with malignant pleural mesothelioma. With this diagnosis, a chemotherapy regimen with cisplatin was initiated. After two cycles, the patient had no clinical and radiological improvement. The patient is currently under regular follow up. Conclusion MPM is rare in young adults and its clinical presentation makes it different from mesothelioma in elderly patients, so it will be necessary to identify the new risk factors that can identify these patients. PMID:27222787

  20. Absence of exertional hyperthermia in a 17-year-old boy with severe burns.

    PubMed

    McEntire, Serina J; Lee, Jong O; Herndon, David N; Suman, Oscar E

    2009-01-01

    An important safety concern when exercising burned patients is the potential for an excessive increase in core body temperature (hyperthermia=body core temperature>39 degrees C) during exercise. We examined the thermoregulatory response to exercise in the heat (31 degrees C, relative humidity 40%) in a 17-year-old boy with a 99% TBSA burn. A 30-minute exercise test was performed at an intensity of 75% of his peak aerobic capacity. Intestinal temperature was assessed via telemetry with an ingestible capsule. Intestinal temperature was measured before, during, and postexercise. The patient completed 12 minutes of the 30-minute exercise test. Starting core temperature was 36.98 degrees C and increased 0.69 degrees C during exercise. After exercise, intestinal temperature continued to increase, but no hyperthermia was noted. It has been reported that burned children can safely exercise at room temperature; however, the response in the heat is unknown. This patient did not develop exertional hyperthermia, which we propose is due to his low-fitness level and heat intolerance. However, the potential for hyperthermia would be increased if he was forced to maintain a high relative workload in the heat. We propose that severely burned individuals should be able to safely participate in physical activities. However, the decision to stop exercising should be accepted to avoid development of exertional hyperthermia.

  1. A 17-Year-Old With Steroid-Resistant Nephrotic Syndrome.

    PubMed

    Band, Molly E; Sheldon, Candice; Brancato, John; Parikh, Nehal S; D'Alessandri-Silva, Cynthia

    2016-05-01

    A 17-year-old girl presented with facial swelling and shortness of breath to an outside emergency department. She was treated for an allergic reaction with steroids and antihistamines, and discharged from the hospital. Subsequently, she was referred as an outpatient to pediatric nephrology for recurrent edema and proteinuria. Initial laboratory workup by nephrology was significant for a normal complete blood count and reassuring electrolyte panel. Pertinent laboratories were a creatinine of 0.5 mg/dL (0.4-1.1 mg/dL) and an albumin 2.3 g/dL (3.5-5.0 g/dL). The urine protein-to-creatinine ratio was >7 (<0.2). A renal ultrasound showed symmetrically sized kidneys with normal echotexture. The patient's renal biopsy results were consistent with minimal change disease. Based on the biopsy results, prednisone was started. Due to a poor response to prednisone, an alternate immunomodulator therapy was selected. Her subsequent complete blood counts showed a downward trend of all cell lines and an elevated serum uric acid. Concurrently, she reported worsening fatigue, low back pain, nausea, vomiting, night sweats, and pruritus. More details of her case and the outcome are presented.

  2. Frontal Lobe Morphometry with MRI in a Normal Age Group of 6-17 Year-Olds

    PubMed Central

    İlkay Koşar, M; Otağ, İlhan; Sabancıoğulları, Vedat; Atalar, Mehmet; Tetiker, Hasan; Otağ, Aynur; Çimen, Mehmet

    2012-01-01

    Background Morphometric data of the frontal lobe are important for surgical planning of lesions in the frontal lobe and its surroundings. Magnetic resonance imaging (MRI) techniques provide suitable data for this purpose. Objectives In our study, the morphometric data of mid-sagittal MRI of the frontal lobe in certain age and gender groups of children have been presented. Patients and Methods In a normal age group of 6-17-year-old participants, the length of the line passing through predetermined different points, including the frontal pole (FP), commissura anterior (AC), commissura posterior (PC), the outermost point of corpus callosum genu (AGCC), the innermost point of corpus callosum genu (IGCC), tuberculum sella (TS), AGCC and IGCC points parallel to AC-PC line and the point such line crosses at the frontal lobe surface (FCS) were measured in three age groups (6-9, 10-13 and 14-17 years) for each gender. Results The frontal lobe morphometric data were higher in males than females. Frontal lobe measurements peak at the age group of 10-13 in the male and at the age group of 6-13 in the female. In boys, the length of FP-AC increases 4.1% in the 10-13 age group compared with the 6-9-year-old group, while this increase is 2.3% in girls. Conclusion Differences in age and gender groups were determined. While the length of AGCC-IGCC increases 10.4% in adults, in children aged 6-17, the length of AC-PC is 11.5% greater than adults. These data will contribute to the preliminary assessment for developing a surgical plan in fine interventions in the frontal lobe and its surroundings in children. PMID:23599707

  3. Employment of Minors. A Guide for 14- through 17-year-olds, Their Parents and Employers.

    ERIC Educational Resources Information Center

    Oregon State Bureau of Labor and Industry, Portland.

    This guide on the employment of minors is intended for 14- through 17-year olds, their parents, and employers. It first lists requirements for employers who hire minors. Then it lists the jobs that 14- and 15-year-old workers can do, both the types of businesses that would hire them and examples of the kinds of jobs that 14- and 15-year-olds may…

  4. Acute torsion of wandering spleen in a 17-year-old girl.

    PubMed

    Jiang, Maoqing; Chen, Ping; Ruan, Xinzhong; Ye, Xianwang; Huang, Qiuli

    2015-01-01

    The acute torsion of wandering spleen is a very rare disease characterized by acute abdominal pain. Without early surgical intervention, wandering spleen can lead to splenic infarction or rupture. However, early clinical diagnosis is very difficult, so imaging modalities play an important role. We present a case of acute abdominal pain due to torsion of the wandering spleen in a 17-year-old girl, diagnosed by computed tomography and effectively managed by splenectomy for splenic infarction.

  5. Acute torsion of wandering spleen in a 17-year-old girl

    PubMed Central

    Jiang, Maoqing; Chen, Ping; Ruan, Xinzhong; Ye, Xianwang; Huang, Qiuli

    2015-01-01

    The acute torsion of wandering spleen is a very rare disease characterized by acute abdominal pain. Without early surgical intervention, wandering spleen can lead to splenic infarction or rupture. However, early clinical diagnosis is very difficult, so imaging modalities play an important role. We present a case of acute abdominal pain due to torsion of the wandering spleen in a 17-year-old girl, diagnosed by computed tomography and effectively managed by splenectomy for splenic infarction. PMID:26379994

  6. Relationship between general and specific coordination in 8- to 17-year-old male basketball players.

    PubMed

    Kamandulis, Sigitas; Venckūnas, Tomas; Masiulis, Nerijus; Matulaitis, Kestutis; Balciūnas, Mindaugas; Peters, Derek; Skurvydas, Albertas

    2013-12-01

    The purpose of the present study was to investigate the relationships between general coordination, sport-specific coordination, and sport-specific fitness of 8- to 17-year-old male basketball players. 312 males with training experience ranging from one year in the 8-year-old cohort up to 10 years for the 17-year-olds performed basketball-specific fitness (20 m sprint, Illinois, countermovement jump), general coordination (20 m run with three obstacles), semi-basketball-specific coordination (20 m sprint dribbling two balls, countermovement jump with arm swing) and basketball-specific coordination (Illinois ball dribbling) tests. There were moderate to large correlations between the results of both general and basketball-specific coordination with the results of most basketball-specific coordination tests in all age groups. Correlations between general and basketball-specific coordination were large in four age groups (11-14 yr., r = .52 to r = .76), moderate in five groups (8-10, 15 & 16 yr., r = .37 to r = .46), while not significant in the 17-year-olds. These results suggest that the importance of general coordination for sport-specific skills improvements during a sports-specific skill acquisition phase, remains high at the skill refinement phase, and decreases when sport-specific skills have been mastered to near-perfection.

  7. Social jet lag, chronotype and body mass index in 14-17-year-old adolescents.

    PubMed

    Malone, Susan Kohl; Zemel, Babette; Compher, Charlene; Souders, Margaret; Chittams, Jesse; Thompson, Aleda Leis; Pack, Allan; Lipman, Terri H

    2016-08-11

    The relationship between sleep duration and obesity in adolescents is inconclusive. This may stem from a more complex relationship between sleep and obesity than previously considered. Shifts toward evening preferences, later sleep-wake times and irregular sleep-wake patterns are typical during adolescence but their relationship to body mass index (BMI) has been relatively unexplored. This cross-sectional study examined associations between sleep duration, midpoint of sleep and social jet lag (estimated from 7 days of continuous actigraphy monitoring), and morningness/eveningness with BMIs (BMI z-scores) and waist-to-height ratios in 14-17-year-old adolescents. Seventy participants were recruited from ninth and tenth grades at a public high school. Participants' characteristics were as follows: 74% female, 75% post-pubertal, 36% Hispanic, 38% White, 22% Black, 4% Asian and 64% free/reduced lunch participants with a mean age of 15.5 (SD, 0.7). Forty-one percent of the participants were obese (BMI ≥ 95th percentile); 54% were abdominally obese (waist-to-height ratio ≥ 0.5). Multivariable general linear models were used to estimate the association between the independent variables (school night sleep duration, free night sleep duration, midpoint of sleep (corrected), social jet lag and morningness/eveningness) and the dependent variables (BMI z-scores and waist-to-height ratios). Social jet lag is positively associated with BMI z-scores (p < 0.01) and waist-to-height ratios (p = 0.01). Midpoint of sleep (corrected) is positively associated with waist-to-height ratios (p = 0.01). After adjusting for social jet lag, school night sleep duration was not associated with waist-to-height ratios or BMI z-scores. Morningness/eveningness did not moderate the association between sleep duration and BMI z-scores. Findings from this study suggest that chronobiological approaches to preventing and treating obesity may be important for accelerating progress in reducing obesity

  8. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain

    PubMed Central

    Ruivo, Rodrigo M.; Pezarat-Correia, Pedro; Carita, Ana I.

    2014-01-01

    Background: There is sparse literature that provides evidence of cervical and shoulder postural alignment of 15 to 17-year-old adolescents and that analyzes sex differences. Objectives: To characterize the postural alignment of the head and shoulder in the sagittal plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and explore the relationships between three postural angles and presence of neck and shoulder pain. Method: This cross-sectional study was conducted in two secondary schools in Portugal. 275 adolescent students (153 females and 122 males) aged 15 to 17 were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) was used to assess shoulder pain, whereas neck pain was self-reported with a single question. Results: Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7, 47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed protraction of the head, whereas 58% of them had protraction of the shoulder. The boys showed a significantly higher mean cervical angle, and adolescents with neck pain revealed lower mean cervical angle than adolescents without neck pain. 53% of the girls self-reported regular neck pain, contrasting with 19% of the boys. Conclusions: This data shows that forward head and protracted shoulder are common postural disorders in adolescents, especially in girls. Neck pain is prevalent in adolescents, especially girls, and it is associated with forward head posture. PMID:25054381

  9. Benign cystic mediastinal teratoma presenting as a massive pleural effusion in a 17-year-old boy.

    PubMed

    Montebello, Annalisa; Mizzi, Adrian; Cassar, Paul John; Cassar, Karen

    2017-01-10

    Mediastinal teratomas are a rare, albeit an important differential diagnosis of anterior/middle mediastinal masses in young adults and various atypical presentations have been reported. The authors report a case of a 17-year-old boy who presented with a 2-month history of worsening shortness of breath and pleuritic chest pain. A massive left-sided pleural fluid collection was seen on a chest radiograph (CXR). The pleural fluid was drained and a CT Thorax confirmed the presence of a cystic mass. Following re-accumulation of the fluid, thoracotomy was performed and a benign mediastinal teratoma excised. The patient remained well with no evidence of recurrence on follow-up CXRs a year post operatively.

  10. Primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old woman: a case report

    PubMed Central

    2010-01-01

    Introduction Primary Ewing's sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis. Case presentation We present an extremely rare case of Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t(11; 22) (q24; q12) (EWSR1-FLI1), thus confirming the diagnosis of a Ewing's sarcoma/primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001. Conclusion This is a rare case of primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing's sarcoma or primitive neuroectodermal tumor at uncommon sites. PMID:20233457

  11. Video games use patterns and parenteral supervision in a clinical sample of Hispanic adolescents 13-17 years old.

    PubMed

    Colón-de Martí, Luz N; Rodríguez-Figueroa, Linnette; Nazario, Lelis L; Gutiérrez, Roberto; González, Alexis

    2012-01-01

    Video games have become a popular entertainment among adolescents. Although some video games are educational, there are others with high content of violence and the potential for other harmful effects. Lack of appropriate supervision of video games use during adolescence, a crucial stage of development, may lead to serious behavioral consequences in some adolescents. There is also concern about time spent playing video games and the subsequent neglect of more developmentally appropriate activities, such as completing academic tasks. Self-administered questionnaires were used to assess video game use patterns and parental supervision among 55 adolescent patients 13-17 years old (mean age 14.4 years; 56.4% males) and their parents. Parental supervision /monitoring of the adolescents video games use was not consistent and gender related differences were found regarding their video game use. Close to one third (32%) of the participants reported video game playing had interfered with their academic performance. Parents who understood video games rating system were more likely to prohibit their use due to rating. These findings underscore the need for clear and consistently enforced rules and monitoring of video games use by adolescents. Parents need to be educated about the relevance of their supervision, video games content and rating system; so they will decrease time playing and exposure to potentially harmful video games. It also supports the relevance of addressing supervision, gender-based parental supervisory styles, and patterns of video games use in the evaluation and treatment of adolescents.

  12. Multi-district coronary tree involvement in a 17-year-old girl with Williams-Beuren syndrome.

    PubMed

    Serena, Tiziana; Valerio, Enrico; Castaldi, Biagio; Reffo, Elena; Milanesi, Ornella

    2015-01-01

    We describe a case of 17-year-old Chinese girl referred to our Pediatric Cardiology Unit for asthenia, reduced exercise tolerance, and dyspnea. Past medical history was relevant for multiple chest pain episodes in childhood and several syncopal episodes, for which the patient had been never evaluated. Clinical examination, electrocardiogram, and echocardiography were compatible with Williams-Beuren syndrome; such condition was later confirmed by genetic analysis. Cardiac magnetic resonance imaging showed transmural fibrosis of the apex with impaired left ventricular ejection fraction (29 %), severe stenosis of aortic sinotubular junction with left and right coronary ostia involvement; more importantly, the whole coronary artery tree beyond ostia was affected by multiple stenosis and aneurysmatic tracts. Ascending aorta proved hypoplastic, with post-stenotic dilation and multiple aneurysms. At the end of the diagnostic process, surgical risk was considered too high to proceed with the correction. The presented case is of educational value since it provides good iconographical illustration of diffuse, multiple-site coronary artery tree involvement, a rather rare co-morbidity in Williams-Beuren syndrome.

  13. Revascularization in a 17-Year-Old Girl with Neurofibromatosis and Severe Hypertension Caused by Renal Artery Stenosis

    PubMed Central

    Geavlete, Oliviana D.; Botezatu, Simona; Postu, Marin; Popescu, Bogdan A.; Ginghina, Carmen; Coman, Ioan M.

    2017-01-01

    Renal artery stenosis caused by neurofibromatosis is a rare cause of renovascular hypertension. This hypertension can develop during childhood and is one of the leading causes of poor outcome. We report the case of a 17-year-old girl who was incidentally diagnosed with severe hypertension. During her examination for secondary hypertension, we reached a diagnosis of neurofibromatosis type 1 on the basis of a cluster of typical findings: optic nerve glioma, café au lait spots, nodular neurofibromas, and axillary freckling. Renal angiograms revealed a hemodynamically significant left renal artery stenosis (70%). Renal angioplasty with a self-expanding stent was performed one month later for rapidly progressive renal artery stenosis (90%) and uncontrolled blood pressure. Excellent blood pressure control resulted immediately and was maintained as of the 2-year follow-up evaluation. We think that percutaneous transluminal renal angioplasty can be effective in select patients who have neurofibromatosis type 1 and refractory hypertension caused by renal artery stenosis. PMID:28265213

  14. Checkup: A National Assessment of Health Awareness Among 17-Year-Olds and Young Adults. Report No. 08-H-01.

    ERIC Educational Resources Information Center

    1978

    Questions relating to knowledge of basic health concerns were the foundation of a survey of two groups of individuals: 17-year-old school students and adults between the ages of 26 and 35. The questions were grouped into two general categories--accident prevention and emergency care skills, and good health practices. Each of these topics contained…

  15. The Relation between 8- to 17-Year-Olds' Judgments of Other's Honesty and Their Own Past Honest Behaviors

    ERIC Educational Resources Information Center

    Evans, Angela D.; Lee, Kang

    2014-01-01

    The present investigation examined whether school-aged children and adolescents' own deceptive behavior of cheating and lying influenced their honesty judgments of their same-aged peers. Eighty 8- to 17-year-olds who had previously participated in a study examining cheating and lie-telling behaviors were invited to make honesty judgments of their…

  16. Functional Literacy: Basic Reading Performance. An Assessment of In-School 17-Year-Olds in 1974. Technical Summary.

    ERIC Educational Resources Information Center

    Gadway, Charles; Wilson, H. A.

    The functional literacy of various groups of 17-year-old students was assessed to discover whether the reading skills which are usually taught in the schools are adequate for functioning in everyday life. Eighty-six test exercises were classified according to the various formats of reading materials they represent and according to the types of…

  17. Football-related injuries among 6- to 17-year-olds treated in US emergency departments, 1990-2007.

    PubMed

    Nation, Adam D; Nelson, Nicolas G; Yard, Ellen E; Comstock, R Dawn; McKenzie, Lara B

    2011-03-01

    Football is one of the most popular youth sports in the United States despite the high rate of injuries. Previously published studies have investigated football-related injuries that occurred in organized play but have excluded those that occurred during unorganized play. Through use of the National Electronic Injury Surveillance System database, cases of football-related injuries were identified for analysis. Sample weights were used to calculate national estimates. An estimated 5 252 721 children and adolescents 6 to 17 years old were treated in US emergency departments for football-related injuries. The annual number of cases increased by 26.5% over the 18-year study period. The 12- to 17-year-old age group accounted for 77.8% of all injuries and had nearly twice the odds of sustaining a concussion. The findings suggest the need for increased prevention efforts to lower the risk of football-related injury in children and adolescents.

  18. ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: report of a case in a 17-year-old woman.

    PubMed

    Wagner, David G; Weisensel, Joseph; Mentrikoski, Mark J; Leo, Sharon D; Bonfiglio, Thomas A; Hoda, Rana S

    2010-09-01

    Endocervical adenocarcinoma is an uncommon malignancy that is composed of multiple subtypes and accounts for approximately 15% of all cervical cancers. In this article, we describe the cytomorphology and differential diagnosis of an AJCC clinical stage IIIb, FIGO IB2 endocervical adenocarcinoma in a 17-year-old woman in a ThinPrep Pap test.The patient was a 17-year-old G0P0 white woman with no significant past medical history and no prior history of cervical dysplasia. She presented to her physician with a putrid vaginal discharge. A sample was sent to cytology that was interpreted as atypical endocervical cells, favor neoplasia. A subsequent cervical biopsy was diagnosed as endocervical adenocarcinoma with villoglandular features and ultimately, a hysterectomy with lymph node dissection was performed. The final diagnosis was endocervical adenocarcinoma with metastasis to three pelvic lymph nodes.The cytomorphology of endocervical adenocarcinoma on ThinPrep Pap test is similar to that described for conventionally-processed Pap smears. This difficult diagnosis should be considered on a ThinPrep Pap test, regardless of age when the characteristic cytomorphology is observed. On a cytology sample, it is advisable to state atypical endocervical cells, adenocarcinoma in situ, or endocervical adenocarcinoma without providing a specific subtype even if there is a predominance of features for a particular subtype.

  19. Occupational injury deaths of 16 and 17 year olds in the US: trends and comparisons with older workers.

    PubMed Central

    Castillo, D. N.; Malit, B. D.

    1997-01-01

    OBJECTIVE: To examine patterns of occupational injury deaths of 16 and 17 year olds in the United States for the three year period 1990-2, examine trends since the 1980s, and compare fatality rates with those of older workers. METHODS: Occupational injury deaths were analyzed using the death certificate based National Traumatic Occupational Fatalities (NTOF) surveillance system. Fatality rates were calculated using estimates of full time equivalent (FTE) workers based on data from the Current Population Survey, a monthly household survey. RESULTS: There were 111 deaths of 16 and 17 year olds for the years 1990-2. The average yearly rate was 3.5 deaths/100,000 FTE. The leading causes of death were motor vehicle related, homicide, and machinery related. All causes occupational injury fatality rates for 16 and 17 year olds were lower than for adults for 1990-2. Rates for the leading causes of death (motor vehicle related, homicide, and machinery related) were comparable or slightly higher than the rates for young and middle aged adult workers. Although rates decreased dramatically from 1980 to 1983, the decreasing trend attenuated in later years. CONCLUSIONS: Comparisons of youth fatality rates to those of adult workers should address differences in patterns of employment, most importantly hours of work. Comparisons to narrow age groupings of adults is preferable to a single category of all workers 18 years and older. Increasing compliance with federal child labor regulations could help reduce work related deaths of youth. Other measures are needed, however, as there are many work hazards, including those associated with homicides, that are not addressed by United States federal child labor law regulations. PMID:9493624

  20. Multihormonal hypopituitarism, hypothyroidism and hypoparathyroidism in a 17-years-old girl with Diamond-Blackfan anemia and secondary hemochromatosis.

    PubMed

    Głąb, Ewa; Barg, Ewa; Wikiera, Beata; Bieniasz, Jolanta

    2013-01-01

    Congenital hypoplastic anemia (Diamond-Blakcfan syndrom) is a genetically determined disorder which is manifested in early childhood with selective deficiency of erythrocyte line in bone marrow. Severe anemia usually appears in the first six months of life. Survival depends on blood transfusions, which in consequence lead to hemochromatosis. The most common complications of transfusional hemochromatosis are hepatic cirrhosis, hypopituitarism, hypogonadism, diabetes mellitus, other endocrinopathies, and cardiomyopathy. We present the case of 17 years old girl with congenital hypoplastic anemia and multihormonal insufficiency due to secondary hemochromatosis.

  1. A 17-year-old male with pseudotumor cerebri secondary to performance-enhancing steroids triggering venous thrombosis in the brain.

    PubMed

    DeSena, Allen D; Weimer, Stephen

    2009-03-01

    This article is a case report of a 17-year-old male who presented with a headache and blurry vision. He subsequently was noted to have papilledema on a fundoscopic examination and an initial normal magnetic resonance imaging and computed tomography of his head; his condition was, therefore, diagnosed as pseudotumor cerebri. A subsequent magnetic resonance venography of his head revealed venous thrombosis, and other investigations revealed an elevated factor VIII level as well as a mutation at the MTHFR locus, consistent with an elevated risk for hypercoagulability. In addition, he admitted to steroid usage for purposes of performance enhancement in baseball. The patient's condition eventually improved with acetazolamide and serial lumbar punctures. Steroids have been linked to predisposition to hypercoagulable states, but there are no reports identified by these authors that link performance-enhancing steroids with pseudotumor cerebri as a result of a coagulation dyscrasia.

  2. Vaccination coverage in French 17-year-old young adults: an assessment of mandatory and recommended vaccination statuses.

    PubMed

    Roblot, F; Robin, S; Chubilleau, C; Giraud, J; Bouffard, B; Ingrand, P

    2016-02-01

    We aimed to assess vaccination coverage (VC) in 17-year-old French young adults (YAs) participating in one mandatory Day of Defence and Citizenship (DDC). Between June 2010 and May 2011, YAs participating in 43 randomly selected mandatory sessions of the DDC programme in Poitou-Charentes (France) were asked to provide their personal vaccination record. Tetanus, diphtheria, polio, hepatitis B, Haemophilus influenzae b, pertussis, measles, mumps and rubella vaccination status were assessed at ages 2, 6, 13 and 17 years. Of 2610 participants, 2111 (81%) supplied documents for evaluation. Of these, 1838 (87%, M:F sex ratio 0·96) were aged 17 years (9% of the global population of this age in the area). The assessment of the 17-year-olds demonstrated the following rates of complete vaccination: diphtheria-tetanus-polio 83%; measles, mumps and rubella 83%; pertussis 69%; H. influenzae b 61%; human papillomavirus 47%; and hepatitis B 40%. At age 6 years, only 46% had received two doses of the vaccine against measles. The YAs were not aware of their status but were in favour of vaccination. VC in YAs is insufficient, particularly for hepatitis B, pertussis and measles. Combined vaccines and the simplification of vaccination schedules should improve VC. Preventive messages should focus on YAs.

  3. Geographic variation in human papillomavirus vaccination uptake among 13-17 year old adolescent girls in the United States.

    PubMed

    Rahman, Mahbubur; McGrath, Christine J; Berenson, Abbey B

    2014-05-01

    Geographic variation in provider-verified human papillomavirus (HPV) vaccine uptake among adolescent girls in the US has not been examined. To investigate this, we analyzed 2011 National Immunization Survey-Teen data. Among 13-17 year old girls (n=11,236), weighted vaccine initiation (48.4%) and completion rates (30.6%) were the lowest in the South when compared to the Northeast (53.4% and 39.9%), Midwest (51.1% and 33.5%) and West (61.6% and 38.7%) (P<.001, both for initiation and completion). Multivariable log-binomial regression analysis indicated that 13-17 year old girls living in the South were less likely to initiate [adjusted prevalence ratio (aPR)=0.86, 95% confidence interval (CI) 0.75-0.97] and complete (aPR=0.83, 95% CI, 0.74-0.93) the HPV vaccine series compared to girls living in the Northeast. Similar differences were observed when the uptake rates in the South were compared to other regions in the US. Intervention programs to increase HPV vaccine uptake and reduce regional disparities are warranted.

  4. Juvenile Cobalamin Deficiency in a 17 Year Old Child with Autonomic Dysfunction and Skin Changes

    PubMed Central

    Siddiqui, Abdul Hafeez; Ansari, Aamir; Beech, Cameron M.; Shah, Nidhi P.; Tanner, Stephan M.; Sarnaik, Sharada A.

    2011-01-01

    We report a rare case of juvenile cobalamin deficiency who presented at the age of seventeen years. He was underweight and had skin changes, normocytic anemia and autonomic dysfunction which lead to adynamic ileus and acute post-renal failure. The expected macrocytosis was masked by an underlying alpha thalassemia trait. The patient had an excellent response to parenteral cobalamin treatment. PMID:22082743

  5. Auditory Brainstem Implant Candidacy in the United States in Children 0-17 Years Old

    PubMed Central

    Puram, Sidharth V.; Owoc, Maryanna S.; Shah, Parth V.; Hight, A. E.; Sethi, Rosh K.V.; Remenschneider, Aaron K.; Lee, Daniel J.

    2015-01-01

    Introduction Advances in neuroprosthetic technology have ushered in a new era for children with hearing loss. The auditory brainstem implant (ABI) is an option for hearing rehabilitation in profoundly deaf patients ineligible for cochlear implantation. No study has examined the potential population-level demand for ABIs in the United States (US). Herein, we aim to quantify the potential need for pediatric ABIs. Methods A systematic literature review was conducted to identify studies detailing the rates of congenital cochlear and/or cochlear nerve (CN) anomalies. Absolute indications for ABI include bilateral cochlea or CN aplasia (Group A), and relative indications for ABI include bilateral cochlea or CN hypoplasia (Group B). Data was subsequently correlated to the US Census Bureau, the National Health Interview Survey, and the Gallaudet Research Institute to provide an estimation of pediatric ABI candidates. Results Eleven studies documented rates of bilateral findings. Bilateral cochlea aplasia was identified in 0-8.7% of patients and bilateral CN aplasia in 0-4.8% of patients (Group A). Bilateral cochlea hypoplasia was identified in 0-8.7% of patients and bilateral CN hypoplasia in 0-5.4% of patients (Group B). Using population-level sensorineural hearing loss data, we roughly estimate 2.1% of children with severe to profound sensorineural hearing loss meet absolute indications for an ABI in the United States. Conclusion Congenital cochlear and cochlear nerve anomalies are exceedingly rare. This study provides the first preliminary estimate of cochlea and CN aplasia/hypoplasia at the population level albeit with limitations based on available data. These data suggest the need for dedicated ABI centers to focus expertise and management. PMID:25577282

  6. Cerebral salt wasting treated with fludrocortisone in a 17-year-old boy.

    PubMed

    Choi, Min Jeong; Oh, Yoon Su; Park, Se Jin; Kim, Ji Hong; Shin, Jae Il

    2012-07-01

    Cerebral salt wasting is characterized by inappropriate natriuresis and volume contraction with associated cerebral pathology. It is distinct from the syndrome of inappropriate antidiuretic hormone secretion, which is characterized by inappropriate retention of free water. We report a patient with a porencephalic cyst who developed cerebral salt wasting. His initial treatment was supplementation of water and salt, which did not improve natriuresis or volume contraction. Fludrocortisone administration effectively managed the cerebral salt wasting.

  7. Leptomeningeal dissemination of pilocytic astrocytoma in a 17-year-old boy.

    PubMed

    Jandaghi, Ali BabaeI; Bidabadi, Elham; Saadat, Seyed; Alijani, Babak; Daliri, Saeid; Reyhanian, Zoheir; Mashouf, Mehryar

    2014-01-01

    Pilocytic astrocytoma with leptomeningeal dissemination is a rare phenomenon and can be associated with obstructive hydrocephalus and an unfavorable prognosis. Herein, we report a seventeen-year-old boy with a history of ventriculo-peritoneal shunt insertion due to severe hydrocephalus who presented with progressive headache and vomiting together with ocular and cerebellar signs and symptoms. Neuroimaging confirmed the presence of multiple intracranial masses in the cerebellum and thalamus. Intracranial dissemination of tumor to the the leptomeninges was seen during neuroendoscopy. Simultaneous biopsy and endoscopic third ventriculostomy were performed and the diagnosis of low-grade pilocytic astrocytoma with leptomeningeal dissemination was made by histological examination. The patient underwent chemotherapy in combination with radiotherapy to reduce the risk of reoccurrence of the primary tumor and was followed for one year.

  8. From Benign to Malign in a Case of Cervical Adenopathy in a 17-Year-Old Adolescent: Diagnostic Traps

    PubMed Central

    Trailescu, Maria; Burlea, Amelia; Covaci, Claudia; Balan, Ozana; Pavel, Adrian; Crișan, Carmen

    2016-01-01

    Distinguishing between benign and malign adenopathies remains a challenge and could represent a source of error in a diagnosis. We report a case of right laterocervical adenopathy in a 17-year-old teenager admitted to hospital with an episode of fever associated with dysphagia, congested pharynx, and pultaceous deposits. Initially the adenopathy was considered to be secondary to a coinfection with Streptococcus B-hemolytic and Epstein-Barr virus, as suggested by the positive bacteriological and serological tests. The onset of the adenopathy before the episode and the ultrasound modifications raised the suspicion of a malignancy, later confirmed by the histopathologic examination of the lymph node excision. The final diagnosis was nodal metastasis of an undifferentiated lymphoepithelial carcinoma with an ENT starting point. Currently, the adolescent is hospitalised in the ENT ward, where the pharynx carcinoma with nodal metastasis was confirmed. Sometimes the infectious context can mask or unmask a malign chronic disease with insidious evolution. PMID:28018695

  9. Academic well-being and smoking among 14- to 17-year-old schoolchildren in six European cities.

    PubMed

    Kinnunen, Jaana M; Lindfors, Pirjo; Rimpelä, Arja; Salmela-Aro, Katariina; Rathmann, Katharina; Perelman, Julian; Federico, Bruno; Richter, Matthias; Kunst, Anton E; Lorant, Vincent

    2016-07-01

    It is well established that poor academic performance is related to smoking, but the association between academic well-being and smoking is less known. We measured academic well-being by school burnout and schoolwork engagement and studied their associations with smoking among 14- to 17-year-old schoolchildren in Belgium, Germany, Finland, Italy, the Netherlands, and Portugal. A classroom survey (2013 SILNE survey, N = 11,015) was conducted using the Short School Burnout Inventory and the Schoolwork Engagement Inventory. Logistic regression, generalized linear mixed models, and ANOVA were used. Low schoolwork engagement and high school burnout increased the odds for daily smoking in all countries. Academic performance was correlated with school burnout and schoolwork engagement, and adjusting for it slightly decreased the odds for smoking. Adjusting for socioeconomic factors and school level had little effect. Although high school burnout and low schoolwork engagement correlate with low academic performance, they are mutually independent risk factors for smoking.

  10. Unusual presentation of squamous cell carcinoma in young female patient: A case report and review of literature

    PubMed Central

    Kaur, Jasbir; Singh, Anantpreet; Chopra, Rohit

    2016-01-01

    Oral squamous cell carcinoma is the most common “malignant neoplasm” of epithelial origin usually affecting individuals over 50 years of age. It is rare in patients aged <40 years old. This report describes a case of squamous cell carcinoma involving anterior mandibular alveolar region in a 17-year-old female patient, with no history of deleterious habits. This report focuses on etiological factors, diagnosis and prognosis related to the case. PMID:27194884

  11. Family-Based Treatment of a 17-Year-Old Twin Presenting with Emerging Anorexia Nervosa: A Case Study Using the "Maudsley Method"

    ERIC Educational Resources Information Center

    Loeb, Katharine L.; Hirsch, Alicia M.; Greif, Rebecca; Hildebrandt, Thomas B.

    2009-01-01

    This article describes the successful application of family-based treatment (FBT) for a 17-year-old identical twin presenting with a 4-month history of clinically significant symptoms of anorexia nervosa (AN). FBT is a manualized treatment that has been studied in randomized controlled trials for adolescents with AN. This case study illustrates…

  12. Brachial artery injury following opened elbow dislocation associated with accessory brachial artery: two rare entities in a 17-year -old girl: case report.

    PubMed

    Hajji, Rita; Zrihni, Youssef; Naouli, Hamza; Bouarhroum, Abdellatif

    2015-01-01

    Elbow dislocations are the most frequently encountered after shoulder dislocations. In their vast majority, these injuries carry a good prognosis. Although, concomitant arterial injury is rare and make them more serious. In this paper, we report a case of a 17 year old woman with opened elbow dislocation with arterial injury associated to an artery variation: "accessory brachial artery".

  13. [Severe hypercalcemia as a complication of intensive treatment for osteoporosis due to steroid therpay in 17-year-old girl with the nephrotic syndrome].

    PubMed

    Ksiazek, Ewelina; Majewski, Marek; Borzecka, Halina; Sikora, Przemysław; Bieniaś, Beata; Zajaczkowska, Małgorzata

    2008-01-01

    In the article, 17-year-old girl with iatrogenic severe hipercalcemia was presented. The girl was treated since the age of 12 years for steroid-sensitive minimal change disease. Due to steroid therapy osteoporosis developed and intensive treatment with active form of vitamin D and high doses of calcium was started. She was admitted to our clinic in severe general state with abdominal pain, vomiting, dehydration, muscle weakness, hypertension and mental confusion. Severe hipercalcemia with nephrocalcinosis was diagnosed. The history revealed that the girl had increased the doses of drugs intentionally. The authors emphasized the need for careful monitoring of prophylaxis and treatment for osteoporosis due to steroid therapy.

  14. [Study on vitamin A nutritional status of 6- to 17-year-old urban children and adolescents between 2010 and 2012 in China].

    PubMed

    Zhang, Y; Liu, X B; Yang, L C; Chen, J; Wang, R; Yang, X G; Piao, J H; Mao, D Q

    2017-02-06

    Objective: To investigate the vitamin A nutritional status of 6- to 17-year-old urban children and adolescents by analyzing serum retinol level, between 2010 and 2012 in China. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and the population proportional stratified random sampling method, 6 617 children aged 6-17 years from 32 metropolis and 41 middle-sized and small cities of China were selected. The questionnaire survey was used to collect demographic information. Blood samples were analyzed using high-performance liquid chromatography to determine serum retinol concentration, and the World Health Organization guidelines were used to evaluate the nutritional status of vitamin A. Vitamin A levels, vitamin A deficiency, and marginal vitamin A deficiency in children with different characteristics were compared. Results: A total of 3 785 cases with valid samples were obtained. The overall mean serum retinol concentration level was (1.49±0.71) μmol/L; the mean serum retinol concentration was (1.55±0.69) μmol/L for metropolis and (1.49±0.75) μmol/L for middle-sized and small cities (P>0.05). The mean serum retinol concentration was (1.52±0.78) μmol/L for boys and (1.47±0.68) μmol/L for girls (P>0.05). The mean serum retinol concentration level was (1.46±0.70) μmol/L for 6- to 11-year-old children and (1.54±0.65) μmol/L for 12- to 17-year-old children (P<0.05). The total vitamin A deficiency rate and marginal vitamin A deficiency rate was 7.69% (291/3 785) and 18.57% (703/3 785), respectively. The vitamin A deficiency rate was 8.00% (36/450) for metropolis and 7.64% (65/3 335) for middle-sized and small cities; 8.12% (155/1 908) for boys and 7.25% (136/1 877) for girls; and 8.04% (171/2 115) for 6- to 11-year-old children and 7.18% (120/1 670) for 12- to 17-year-old children. No significant differences were observed for region, sex, or age (P>0.05). The marginal vitamin A

  15. Comparison of Updated Weight and Height Percentiles with Previous References in 6-17-Year-Old Children in Kayseri, Turkey

    PubMed Central

    Zararsız, Gökmen; Çiçek, Betül; Kondolot, Meda; Mazıcıoğlu, M. Mümtaz; Öztürk, Ahmet; Kurtoğlu, Selim

    2017-01-01

    Objective: To compare updated weight and height percentiles of 6-17-year-old children from all socio-economic levels in Kayseri with previous local references and other national/international data. Methods: The second study “Determination of Anthropometric Measurements of Turkish Children and Adolescents study (DAMTCA II)” was conducted in Kayseri, between October 2007 and April 2008. Weight and height measurements from 4321 (1926 boys, 2395 girls) school children aged between 6 to 17 years were included in this cross-sectional study. Using these data, weight and height percentile curves were produced with generalized additive models for location, scale and shape (GAMLSS) and compared with the most recent references. Results: Smoothed percentile curves including the 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th percentiles were obtained for boys and girls. These results were compared with DAMTCA I study and with two national (İstanbul and Ankara) and international data from Asia and from Europe. Conclusion: This study provides updated weight and height references for Turkish school children aged between 6 and 17 years residing in Kayseri. PMID:27507256

  16. Coverage of the English national human papillomavirus (HPV) immunisation programme among 12 to 17 year-old females by area-level deprivation score, England, 2008 to 2011.

    PubMed

    Hughes, A; Mesher, D; White, J; Soldan, K

    2014-01-16

    The English national human papillomavirus (HPV) immunisation programme has offered vaccination to girls aged 12 years at the start of each school year since September 2008. A catch-up programme has offered vaccination to girls up to 18 years. Delivery is predominantly school-based, with some general practitioner (GP)-based immunisation. The relationship between HPV immunisation coverage and deprivation (index of multiple deprivation, IMD) was assessed by geographical area (N=151) for each school year offered the HPV vaccine between 2008 to 2011 using the Spearman’s rank correlation coefficient, and compared to that for adequate cervical screening of women aged 25 to 49 years. Coverage at age 12 showed no significant association with IMD at the area-level (p=0.12). Within the catch-up years, there was some suggestion of higher deprivation being associated with lower coverage. This was not significant for girls offered immunisation under 16 years (in compulsory education) (p=0.09), but was more marked and statistically significant for older girls (p<0.0001). The proportion of women aged 25 to 49 years with an adequate cervical screen was negatively associated with deprivation (p<0.0001). School-based HPV immunisation delivery appears to be successfully reducing inequalities in cervical cancer control at area-level. However, the catch-up cohorts above the age of compulsory education may face increased inequality. Further investigation is needed into individual-level factors associated with coverage.

  17. Müllerian Remnant Cyst as a Cause of Acute Abdomen in a Female Patient with Müllerian Agenesis: Radiologic and Pathologic Findings

    PubMed Central

    2016-01-01

    We report a case of a 17-year-old female with Müllerian agenesis who presented with right sided abdominal pain clinically suspicious for acute appendicitis. Multimodality imaging workup revealed a heterogeneous cystic right upper quadrant mass with surrounding fluid and inflammatory changes. Surgical resection of this mass was performed and a histopathologic diagnosis of a hemorrhagic Müllerian remnant cyst was made, which to the best of our knowledge has never been described in a patient with Müllerian agenesis. PMID:27446624

  18. The effects of the Malaysian Department of Wildlife and National Parks' environmental education program on the environmental knowledge and attitudes of 13--17 year old students

    NASA Astrophysics Data System (ADS)

    Yusof, Ebil

    The study focused on the effects of the Malaysian Department of Wildlife and National Park's (DWNP) environmental education program on the environmental knowledge and attitudes of the secondary school students. Conducted between May 11, 1998 and August 11, 1998, this study was designed to reflect three objectives: (1) to determine the effect of participation in the DWNP's environmental education program on environmental knowledge and attitudes of 13--17 year old Malaysian students, (2) to identify demographic factors that contribute to the change of environmental knowledge and attitudes, and (3) to establish base line data for future evaluation of the effectiveness of DWNP's environmental education program. The sample was comprised of 806 randomly selected students from 10 different schools, with 402 randomly assigned to the experimental grouped and 404 to the control group. Pretest and post-tests were administered at the schools. The experimental group was exposed to the Environmental Education Program (EEP) at the Environmental Education Center (EEC) at Bukit Rengit, Lanchang, Pahang, Malaysia sometime between May 14, 1998 and August 8, 1998. At the EEC, the experimental group was again divided, with half receiving the pretest and post-test, while the other half were given only the post-test. The instrument used in this study was a modification of the Children's Environmental Attitudes and Knowledge Scale (CHEAKS) developed by Leeming, et al. (1995). This instrument had sound psychometric properties suitable for this research setting, and allowed comparisons of results with previous studies. T-tests, ANOVA, and ANCOVA were used to determine group differences. Overall, secondary school students in the experimental group showed a significantly greater change in environmental knowledge than did students in the control group. Significant differences were also found on the Attitude sub-scale, with the control group exhibiting negative change in attitude, and slightly

  19. Effect of oral health education in the form of Braille and oral health talk on oral hygiene knowledge, practices, and status of 12–17 years old visually impaired school girls in Pune city: A comparative study

    PubMed Central

    Bhor, K.; Shetty, V.; Garcha, V.; Nimbulkar, G. C.

    2016-01-01

    Aim: To assess the effect of oral health education (OHE) in the form of Braille and combination with Oral health talk (OHT) on oral hygiene knowledge, practices, and status of 12–17 years old visually impaired school girls in Pune city. Materials and Methods: A 6-week comparative study was conducted among 74 residential visually impaired school girls aged 12–17 years, who were trained to read Braille. The participants were divided into two groups, namely, Group A (n = 37) receiving OHE only in the form of Braille and Group B (n = 37) receiving OHE in form of Braille and OHT at baseline, 2, and 4-week interval. Oral health knowledge was assessed using a self-administered, pre-validated, pre-tested questionnaire typed in Marathi Braille. Assessment of oral hygiene practices and status was done using standardized proforma and simplified oral hygiene index (OHI-S), respectively, at baseline and at the end of 6 weeks. Data was analyzed using paired and unpaired Student's t-test. Results: The results showed a statistically significant increase in oral health knowledge levels in Group B (4.95 ± 1.66) as compared to Group A (2.97 ± 1.28). There was a significant increase in the frequency of mouth-rinsing in Group B (97.3%) as compared to Group A (86.5%) as well as in the tongue cleaning practice in Group B (100%) as compared to Group A (81.1%) at the end of 6 weeks. Conclusion: OHE in the form of Braille and OHT was more effective than OHE using only Braille. PMID:27891313

  20. Malignant syphilis in an immunocompetent female patient*

    PubMed Central

    Requena, Camila Bueno; Orasmo, Cínthia Rosane; Ocanha, Juliana Polizel; Barraviera, Silvia Regina Catharino Sartore; Marques, Mariangela Esther Alencar; Marques, Silvio Alencar

    2014-01-01

    Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient. PMID:25387504

  1. Urethral hemangioma in a prepubertal female patient

    PubMed Central

    Li, Chiao-Ching; Li, Chiao-Zhu; Yen, Ching-Heng; Tsai, Wen-Chuan; Wu, Sheng-Tang; Cha, Tai-Lung; Meng, En

    2017-01-01

    Abstract Rationale: Urethral hemangiomas commonly occur in men or elderly women. We presented a rare case of urethral hemangioma in a prepubertal female patient. Patients concerns: An 8-year-old girl had the complaints of bloody staining of clothing, a foul perineal odor, and urethral pain. She was brought to our genitourinary outpatient department for survey and a single, 1-cm compressible reddish nodule at the 10-2 o’clock position in the distal urethra was found. Diagnoses: Urethral hemangioma in a prepubertal girl was diagnosed after excision of the urethral nodule. Interventions: Excision with 8 “stay” sutures in the protruding urethral mucosa was performed. Outcomes: Normal micturition without symptom recurrence was noted at the 3-month follow-up. Lessons: Urethral hemangioma is also found in prepubertal female patient. Increased physician awareness and early recognition of a urethral hemangioma can avoid unnecessary examinations and patient anxiety. The procedure of excision with 8 “stay” sutures in the protruding urethral mucosa facilitates mobilization from the distal urethra and provides a good surgical view of abnormal proliferative blood vessels. Therefore, the lesion can be removed as clean as possible. PMID:28353601

  2. Managing the female patient with hereditary angioedema.

    PubMed

    Banerji, Aleena; Riedl, Marc

    2016-06-01

    Hereditary angioedema (HAE) is a rare disorder resulting from decreased functional levels of C1-inhibitor (C1-INH), which manifests as periodic episodes of localized edema which can be extremely painful, debilitating and even fatal if the swelling affects the larynx. HAE can complicate many aspects of obstetric/gynecologic care, and an awareness of the disease is critical for clinicians involved in the care of women because of potential HAE-related complications pertaining to pregnancy, labor and delivery, and other women's health issues. This article provides a review of published literature specific to HAE and its management in female patients, including important concerns regarding obstetric/gynecologic care. A growing body of relevant experience is presented to help guide the care of women with HAE.

  3. Fertility preservation in female classic galactosemia patients.

    PubMed

    van Erven, Britt; Gubbels, Cynthia S; van Golde, Ron J; Dunselman, Gerard A; Derhaag, Josien G; de Wert, Guido; Geraedts, Joep P; Bosch, Annet M; Treacy, Eileen P; Welt, Corrine K; Berry, Gerard T; Rubio-Gozalbo, M Estela

    2013-07-16

    Almost every female classic galactosemia patient develops primary ovarian insufficiency (POI) as a diet-independent complication of the disease. This is a major concern for patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The unique pathophysiology of classic galactosemia with a severely reduced follicle pool at an early age requires an adjusted approach. In this article recommendations for physicians based on current knowledge concerning galactosemia and fertility preservation are made. Fertility preservation is only likely to be successful in very young prepubertal patients. In this group, cryopreservation of ovarian tissue is currently the only available technique. However, this technique is not ready for clinical application, it is considered experimental and reduces the ovarian reserve. Fertility preservation at an early age also raises ethical questions that should be taken into account. In addition, spontaneous conception despite POI is well described in classic galactosemia. The uncertainty surrounding fertility preservation and the significant chance of spontaneous pregnancy warrant counseling towards conservative application of these techniques. We propose that fertility preservation should only be offered with appropriate institutional research ethics approval to classic galactosemia girls at a young prepubertal age.

  4. Choroidoretinal granuloma in a young female patient.

    PubMed

    Massa, Horace F; Gatzioufas, Zisis; Mangioris, Georgios; Panos, Georgios D

    2014-04-17

    A 16-year-old Brazilian female patient presented with blurring of vision in the right eye. Corrected visual acuity was OD 2/20, OS 20/20. Afferent pupillary defect was absent and anterior segment examination revealed anterior uveitis. Fundus examination showed light vitritis and a raised grey-white granuloma located at posterior pole with focal serous retinal detachment on optical coherence. Indocyacnine green angiography disclosed a complete mask effect in granuloma's area. Differential diagnoses were infectious (bacterial, viral, fungal and parasites) diseases, systemic inflammatory diseases, tumours. Blood serologies (HIV, toxoplasma, Borrelia, cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), rubeola) showed positive results for IgM and IgG for toxoplasma, and anterior chamber tap (PCR for toxoplasma, CMV, HSV, VZV) revealed toxoplasma DNA. Anti-toxoplasma therapy, pyrimethamine, sulfadiazine and calcium folinate, was administered immediately. On follow-up granuloma regression was observed, with complete visual restoration. This case demonstrates a clinically challenging posterior pole granuloma.

  5. How patient-centered do female physicians need to be? Analogue patients' satisfaction with male and female physicians' identical behaviors.

    PubMed

    Hall, Judith A; Roter, Debra L; Blanch-Hartigan, Danielle; Mast, Marianne Schmid; Pitegoff, Curtis A

    2015-01-01

    Previous research suggests that female physicians may not receive appropriate credit in patients' eyes for their patient-centered skills compared to their male counterparts. An experiment was conducted to determine whether a performance of higher (versus lower) verbal patient-centeredness would result in a greater difference in analogue patient satisfaction for male than female physicians. Two male and two female actors portrayed physicians speaking to a patient using high or low patient-centered scripts while not varying their nonverbal cues. One hundred ninety-two students served as analogue patients by assuming the patient role while watching one of the videos and rating their satisfaction and other evaluative responses to the physician. Greater verbal patient-centeredness had a stronger positive effect on satisfaction and evaluations for male than for female physicians. This pattern is consistent with the hypothesis that the different associations between patient-centeredness and patients' satisfaction for male versus female physicians occur because of the overlap between stereotypical female behavior and behaviors that comprise patient-centered medical care. If this is the case, high verbal patient-centered behavior by female physicians is not recognized as a marker of clinical competence, as it is for male physicians, but is rather seen as expected female behavior.

  6. Rehabilitation of a Female Dancer with Patellofemoral Pain Syndrome: Applying Concepts of Regional Interdependence in Practice

    PubMed Central

    Welsh, Caitlyn; Podschun, Laura; Kolber, Morey J.

    2010-01-01

    Due to complex movements and high physical demands, dance is often associated with a multitude of impairments including pain of the low back, pelvis, leg, knee, and foot. This case report provides an exercise progression, emphasizing enhancement of strength and neuromuscular performance using the concept of regional interdependence in a 17 year old female dancer with patellofemoral pain syndrome. PMID:21589665

  7. Randomized Trial Outcomes of a TTM-Tailored Condom Use and Smoking Intervention in Urban Adolescent Females

    ERIC Educational Resources Information Center

    Redding, Colleen A.; Prochaska, James O.; Armstrong, Kay; Rossi, Joseph S.; Hoeppner, Bettina B.; Sun, Xiaowu; Kobayashi, Hisanori; Yin, Hui-Qing; Coviello, Donna; Evers, Kerry; Velicer, Wayne F.

    2015-01-01

    Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females…

  8. Superior mentalizing abilities of female patients with schizophrenia.

    PubMed

    Abu-Akel, Ahmad; Bo, Sune

    2013-12-30

    Mentalizing abilities are severely disrupted in patients with schizophrenia, but gender-related differences in this domain are virtually unexplored. Given the importance of these abilities in understanding psychopathology, social functioning and outcome, this study aimed to examine the mentalizing abilities of male and female patients with schizophrenia. The cognitive and affective mentalizing abilities of self and other of clinically stable male and female patients with schizophrenia were analyzed using the abbreviated version of the Metacognitive Assessment Scale (MAS-A). Compared to their male counterparts, the female patients demonstrated superior overall mentalizing abilities. This advantage was also evident when mentalizing about the Self or the Other. When examining cognitive versus affective mentalizing, women were significantly better in their ability to attribute and understand the affective mental states of others. These differences were unrelated to intelligence or psychopathology. The superior mentalizing abilities of female patients extend gender-related differences in schizophrenia to include social cognition. This suggests that our current knowledge of socio-cognitive abilities in schizophrenia is generalizable to male but not to female patients. The findings also provide important insights to understanding how etiological differences affect social cognition. Awareness to such differences has important implications for diagnosis and clinical treatment.

  9. Revision Stapedectomy in a Female Patient with Inner Ear Malformation

    PubMed Central

    Patel, Tirth R.; Moberly, Aaron C.

    2016-01-01

    Objectives. We describe an unusual case of surgical management of congenital mixed hearing loss in a female patient with inner ear malformation. This report outlines the role of temporal bone imaging and previous surgical history in evaluating a patient's risk of perilymph gusher during stapes surgery. Methods. A 68-year-old female patient with a history of profound bilateral mixed hearing loss due to ossicular and cochlear malformation presented to our otology clinic. She had undergone multiple unsuccessful previous ear surgeries. Computed tomography revealed bilateral inner ear malformations. She elected to proceed with revision stapedectomy. Results. The patient received modest benefit to hearing, and no operative complications occurred. Conclusions. Although stapedectomy has been shown to improve hearing in patients with stapes fixation, there is risk of perilymph gusher in patients with inner ear abnormalities. Evaluation and counseling of the risk of gusher during stapes surgery should be done on a case-by-case basis. PMID:27144044

  10. Dental management of patient with Williams Syndrome - A case report

    PubMed Central

    Wong, Daniel; Ramachandra, Srinivas Sulugodu; Singh, Ashish Kumar

    2015-01-01

    Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26–28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed. PMID:26321847

  11. Acne in the adult female patient: a practical approach.

    PubMed

    Kamangar, Faranak; Shinkai, Kanade

    2012-10-01

    Acne vulgaris is a common reason why adult women present to dermatologists and can be a clinical challenge to treat. It may also be an important sign of an underlying endocrine disease such as Polycystic Ovary Syndrome (PCOS). Although standard acne therapies can be successfully used to treat acne in adult female patients, hormonal treatment is a safe and effective therapeutic option that may provide an opportunity to better target acne in this population, even when other systemic therapies have failed. In this article, a practical approach to the adult female patient with acne will be reviewed to enhance the dermatologist's ability to use hormonal acne therapies and to better identify and evaluate patients with acne in the setting of a possible endocrine disorder.

  12. Autograft Choice in Young Female Patients: Patella Tendon versus Hamstring.

    PubMed

    Shakked, Rachel; Weinberg, Maxwell; Capo, Jason; Jazrawi, Laith; Strauss, Eric

    2017-03-01

    With the increasing incidence of anterior cruciate ligament (ACL) reconstruction in women and younger patients, the optimal graft choice in the young female patient has become the subject of much debate. This study aimed to evaluate patient-reported outcomes, objective knee stability, complication rates, and the incidence of failure after ACL reconstruction using bone-patellar tendon-bone (BPTB) autograft compared with hamstring (HS) autograft in young female patients. Female patients who underwent primary ACL reconstruction with BPTB or HS autograft between ages 15 and 25 years were identified. Medical records were reviewed for postoperative complications and subsequent procedures on the operative knee. Patients were evaluated with functional surveys, physical examination including Lachman and pivot-shift tests, and arthrometric testing with a KT-1000 arthrometer. There were 37 patients in the BPTB group and 28 patients in the HS group. For patients who did not undergo revision, significant differences were not found in visual analog score (p = 0.94), Lysholm score (p = 0.81), Kujala score (p = 0.85), or Tegner level (p = 0.81). No difference was detected in the rate of return to a level of activity at or above the same level prior to injury (p = 0.31). Significantly more patients in the BPTB group were graded 1a Lachman and negative pivot shift compared with the HS group (p < 0.001). There was a significant difference in mean side-to-side manual maximum arthrometric testing (p < 0.001). There were significantly fewer subsequent procedures and a lower rate of graft failures in the BPTB group. We detected no difference in subjective functional outcomes following ACL reconstruction. However, a higher failure rate in the HS reconstructions and greater laxity by arthrometric testing may indicate increased objective stability with the use of BPTB autograft in the young female patient population. The level of evidence for this article is

  13. Female sexual dysfunction in patients with endometriosis: Indian scenario

    PubMed Central

    Mishra, Vineet V.; Nanda, Sakshi; Gandhi, Khushali; Aggarwal, Rohina; Choudhary, Sumesh; Gondhali, Raveendra

    2016-01-01

    BACKGROUND: Female sexual dysfunction (FSD) in Indian women is often overlooked due to cultural beliefs and considered as social taboos. Sexuality is an important and integral part of life. There are many causes of sexual dysfunction, but the prevalence of FSD in endometriotic patients is still underdiagnosed. MATERIALS AND METHODS: Study design - Cross-sectional observational study conducted at tertiary care center, from June 2015 to March 2016. Sample size - Fifty-one patients in reproductive age group (18–47 years) who were diagnosed with endometriosis on diagnostic laparoscopy were included. Methods - FSD was assessed with a detailed 19-item female sexual function index questionnaire. All six domains of sexual dysfunction, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain were studied. Exclusion - Patients with other gynecological, medical or surgical history were excluded. RESULTS: Out of 51 patients with endometriosis, 47.06% of patients had sexual dysfunction. With the increase in staging of endometriosis, sexual dysfunction prevalence is also rising. FSD was 100% in patients with severe endometriosis as compared to 33.33% in minimal endometriosis. CONCLUSION: Every individual deserves good sexual life. The sexual dysfunction associated with endometriosis should also be taken into consideration while managing these patients. PMID:28216913

  14. X-chromosome inactivation in female patients with Fabry disease.

    PubMed

    Echevarria, L; Benistan, K; Toussaint, A; Dubourg, O; Hagege, A A; Eladari, D; Jabbour, F; Beldjord, C; De Mazancourt, P; Germain, D P

    2016-01-01

    Fabry disease (FD) is an X-linked genetic disorder caused by the deficient activity of lysosomal α-galactosidase (α-Gal). While males are usually severely affected, clinical presentation in female patients may be more variable ranging from asymptomatic to, occasionally, as severely affected as male patients. The aim of this study was to evaluate the existence of skewed X-chromosome inactivation (XCI) in females with FD, its concordance between tissues, and its contribution to the phenotype. Fifty-six females with FD were enrolled. Clinical and biological work-up included two global scores [Mainz Severity Score Index (MSSI) and DS3], cardiac magnetic resonance imaging, measured glomerular filtration rate, and measurement of α-Gal activity. XCI was analyzed in four tissues using DNA methylation studies. Skewed XCI was found in 29% of the study population. A correlation was found in XCI patterns between blood and the other analyzed tissues although some punctual variability was detected. Significant differences in residual α-Gal levels, severity scores, progression of cardiomyopathy and deterioration of kidney function, depending on the direction and degree of skewing of XCI were evidenced. XCI significantly impacts the phenotype and natural history of FD in females.

  15. Body Image and the Female Adolescent Oncology Patient.

    PubMed

    Burg, Alison Joy

    2016-01-01

    Female adolescent oncology patients undergo many physical changes throughout treatment that have challenging psychological, emotional, and social implications. Body image for this population is a subject that tends to be overlooked in the midst of the cancer experience. This article will examine the complex concept of body image and discuss why female adolescent patients are at such high risk for negative body image. Assessment and care strategies are needed to foster a positive body image, resiliency, and overall well-being. Although survivorship studies may offer insightful information about the effects of the cancer journey on long-term body image, focus should be on prevention and holistic care as part of the treatment itself. The health care team, especially nursing professionals, should acknowledge, recognize, and address this vital issue as a critical part of oncology care.

  16. Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis in moyamoya patient.

    PubMed

    Chung, Moon Young; Park, Young Seok; Kim, Dong-Seok; Choi, Joong-Uhn

    2009-09-01

    Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis (EDAS) is very rare. The effect of revascularization surgery for preventing hemorrhagic event of moyamoya disease remains controversial. We report a 17-year-old female with intracerebral hemorrhage and intraventricular hemorrahge 10 years after successful EDAS. Even though cerebral vessels angiography showed good collateral circulations without specific weak points, a cerebral hemorrhage could occur in patient with ischemic type of moyamoya disease long after successful indirect bypass operations. Good collateralization of cerebral angiography or magnetic resonance perfusion image after indirect bypass surgery would ensure against ischemic symptoms, not a hemorrhage. And, thus a life-time follow-up strategy might be necessary even if a good collateral circulation has been established.

  17. Hypovitaminosis D in female patients with chronic low back pain.

    PubMed

    Lotfi, Ahmed; Abdel-Nasser, Ahmed M; Hamdy, Ahmed; Omran, Ahmed A; El-Rehany, Mahmoud A

    2007-11-01

    Chronic low back pain (LBP) is an extremely common problem in practice, where it is often labeled idiopathic. No sufficient studies have been conducted to analyze the contribution of hypovitaminosis D to the etiology of chronic LBP in populations wherein vitamin D deficiency is endemic. The present study was, therefore, carried out to examine hypovitaminosis D and its determinants in female patients with chronic LBP during the childbearing period. Sixty female patients complaining of LBP lasting more than 3 months were clinically studied rheumatologically and neurologically. Questionnaires and indices quantifying risk factors associated with vitamin D deficiency were utilized. Biochemical assays of serum calcium, phosphorus, alkaline phosphatase (ALP), parathormone (PTH), and 25-hydroxyvitamin D (25 OHD) were performed and compared to those of 20 matched healthy controls. The determinants of vitamin D levels in patients were examined by stepwise regression. Patients with LBP had significantly lower 25 OHD levels (p < 0.05) and significantly higher PTH (p < 0.05) and ALP (p < 0.001) than controls, although there were no significant group differences in calcium and phosphorus. Hypovitaminosis D (25 OHD < 40 ng/ml) was found in 49/60 patients (81%) and 12/20 (60%) of controls, with an odds ratio of 2.97. Although many risk factors related to sun exposure, clothing, diet, and pregnancy were significantly correlated with vitamin D levels in patients, only limited duration of sun exposure, contributing 55% to the variance of 25 OHD, limited areas of skin exposed (13%), and increased number of pregnancies (2%), were significant determinants of vitamin D levels in patients. Despite the sunny climate, hypovitaminosis D is prevalent among Egyptian women in the childbearing period, especially those presenting with chronic LBP, where it is associated with hyperphosphatasia and hyperparathyroidism, without alterations in serum calcium. The major determinant of hypovitaminosis D

  18. Female sexual dysfunction in patients with substance-related disorders

    PubMed Central

    Diehl, Alessandra; da Silva, Rosiane Lopes; Laranjeira, Ronaldo

    2013-01-01

    OBJECTIVE: To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. METHODS: This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerström Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. RESULTS: The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerström Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. CONCLUSIONS: Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use. PMID:23525317

  19. Height velocity curves in female patients with idiopathic scoliosis.

    PubMed

    Chazono, Masaaki; Soshi, Sigeru; Kida, Yoshikuni; Hashimoto, Kurando; Inoue, Takeshi; Nakamura, Yousuke; Shinohara, Akira; Marumo, Keishi; Kono, Katsuki; Suzuki, Nobumasa

    2012-01-01

    Following identification of peak height velocity (PHV) by a recent study as a possible prognostic factor for curve progression in patients with idiopathic scoliosis (IS), the aim of this study was to investigate PHV curves in Japanese female patients with IS. The study subjects were 20 skeletally immature IS patients who were followed until maturity. The mean age and the mean pubertal status at the initial visit were 9.8 years and 24 months before menarche, respectively, with a follow-up period of 5.2 years. Height measurements were recorded at each visit, and HV was calculated as the change in height (cm) divided by the time interval (yr.) between visits of 6 to 12 months. The PHV, age at PHV (APHV), height at PHV (HPHV), and final height (FH) were determined. Patient HV curves were plotted using their HV data, and growth periods (GPs) were calculated from the curves. PHVs and GPs of study patients were compared to standard data from unaffected girls. The median values and interquartile ranges in PHV, APHV, HPHV, and FH were 8.5 cm/yr. (7.9-9.7), 11.8 yr. (11.2-12.1), 153.2 cm (150.1-155.8), and 160.1 cm (157.4-162.4), respectively. The median GP was 27 months. The PHV and GP values in IS female patients were higher and shorter than those in unaffected girls. These findings indicate that the patterns of height velocity curves in IS patients are different from those in unaffected girls, suggesting that curve progression in IS patients is associated with the magnitude of PHV and duration of GP. Recently, we have developed an HV reader to easily and quickly identify the present HV in patients with scoliosis, applicable for the clinical setting or school screening. We conclude that risk assessments of curve progression in patients with IS should include HV along with measures of skeletal maturity such as the Risser sign and/or digital skeletal age using hand X-rays.

  20. Cognitive functioning in female patients with 21-hydroxylase deficiency.

    PubMed

    Dittmann, R W; Kappes, M H; Kappes, M E

    1993-01-01

    The cognitive functioning of 27 female patients with congenital adrenal hyperplasia (CAH) (aged 11-41 yrs) and 13 of their healthy sisters (13-31 yrs) was compared using short versions of age-appropriate Wechsler scales. In contrast to other studies, neither a higher than average IQ level for CAH patients (mean: 99.0) nor for their sisters (97.7) was found. Unexpectedly, and in contrast to other reports, the subgroup of salt-wasting (SW) patients>16 yrs (N=6; mean score: 111.5) differed from their sisters as well as from simple-virilizing (SV) patients in "full IQ" (p<0.05) and subtest scorings for "Information", "Similarities", and "Picture Completion" (p<0.05-<0.10). SW patients displayed "more masculine" behaviour (vs. SV patients and sisters) which, in turn, was related to differential prenatal hormonal influences. No clear-cut relationships between IQ/cognitive (subtest) findings and gender-role behaviour were found.

  1. Inhaled corticosteroids can reduce osteoporosis in female patients with COPD

    PubMed Central

    Liu, Shih-Feng; Kuo, Ho-Chang; Liu, Guan-Heng; Ho, Shu-Chen; Chang, Huang-Chih; Huang, Hung-Tu; Chen, Yu-Mu; Huang, Kuo-Tung; Chen, Kuan-Yi; Fang, Wen-Feng; Lin, Meng-Chih

    2016-01-01

    Background Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. Patients and methods This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan’s National Health Insurance (TNHI) database between 1996 and 2011 (International Classification of Diseases, Ninth Revision – Clinical Modification [ICD-9-CM] 491, 492, 496). The patients with COPD were defined by the presence of two or more diagnostic codes for COPD within 12 months on either inpatient or outpatient service claims submitted to TNHI. Patients were excluded if they were younger than 40 years or if osteoporosis had been diagnosed prior to the diagnosis of COPD and cases of asthma (ICD-9 CM code 493.X) before the index date. These enrolled patients were followed up till 2011, and the incidence of osteoporosis was determined. The Cox proportional hazards regression model was also used to estimate hazard ratios (HRs) for incidences of lung cancer. Results Totally, 10,723 patients with COPD, including ICS users (n=812) and nonusers (n=9,911), were enrolled. The incidence rate of osteoporosis per 100,000 person years is 4,395 in nonusers and 2,709 in ICS users (HR: 0.73, 95% confidence interval [CI]: 0.63–084). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69–1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59–1.04; and >60 mg, HR: 0.72, 95% CI: 0.55–0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001). Conclusion Female patients with COPD using ICS have a dose–response protective effect for osteoporosis. PMID:27478374

  2. Caring for female patients: The experiences of male nurses.

    PubMed

    Keogh, Brian; Gleeson, Madeline

    This article presents the results of two small qualitative studies, which examined the experiences of six male registered psychiatric nurses (RPN) and five male registered general nurses (RGN) when caring for patients of the opposite sex. Semi-structured interviews were used to collect the data. The focus of the interviews was an attempt to describe the male nurses' experiences of caring for women with a particular emphasis on interventions that involved physical touch. Themes were generated from both studies and the common themes are presented here. Male nurses in this study were often apprehensive about using physical touch and they used coping strategies in response to their fears of being accused of using touch inappropriately. Several factors also influenced the male nurses when using physical touch as an intervention. These findings suggest that learning about caring for female patients needs to be included in the undergraduate curriculum and that further research on the experience of men as nurses is required.

  3. Treatment of Osteitis Pubis in Non-Athlete Female Patients

    PubMed Central

    Kavroudakis, E; Karampinas, P.K; Evangelopoulos, D.S; Vlamis, J

    2011-01-01

    Background: Osteitis pubis represents a non-infectious inflammation of the pubic symphysis causing varying degrees of lower abdominal and pelvic pain. Although, the disease is believed to affect mainly young athletic patients, it is also encountered in other specific patient groups. Both conservative and surgical treatment options are available. While for elite athletes surgical treatment is indicated, leading to fast pain relief and mobilization, for non-athletic patients no clear indication can be established. Methods: Eight non-athletic women with osteitis pubis, referred to our Department for treatment, were evaluated. All were initially treated conservatively with bed rest, per os non steroidal anti-inflammatory drugs and physical therapy. Results: Seven patients improved significantly with conservative treatment while one displayed no improvement and was treated surgically with arthrodesis. Conclusion: We conclude that, for non-athletic female patients suffering from osteitis pubis, surgery is rarely required and that conservative treatment by means of non steroidal anti inflammatory drugs and physical modalities represents a fair option regarding pain and limitation of everyday activity. PMID:21966337

  4. Cluster Headache: Special Considerations for Treatment of Female Patients of Reproductive Age and Pediatric Patients.

    PubMed

    VanderPluym, Juliana

    2016-01-01

    Cluster headache is a rare disorder that is more common in adult male patients. It has a unique phenotype of unilateral, severe, to very severe headaches lasting 15 to 180 min with ipsilateral autonomic symptoms. Time to correct diagnosis can be protracted. A number of treatment options exist for the standard cluster headache patient, but special considerations must be made for female patients of reproductive age and pediatric patients. The objective of this article is to explore the current literature pertaining to special considerations in cluster headache management, including treatment of pregnant or breastfeeding patients and pediatric patients.

  5. A Nutrition Screening Form for Female Infertility Patients.

    PubMed

    Langley, Susie

    2014-12-01

    A Nutrition Screening Form (NSF) was designed to identify lifestyle risk factors that negatively impact fertility and to provide a descriptive profile of 300 female infertility patients in a private urban infertility clinic. The NSF was mailed to all new patients prior to the initial physician's visit and self-reported data were assessed using specific criteria to determine if a nutrition referral was warranted. This observational study revealed that 43% of the women had a body mass index (BMI) <20 or ≥25 kg/m(2), known risks for infertility. Almost half reported a history of "dieting" and unrealistic weight goals potentially limiting energy and essential nutrients. A high number reported eating disorders, vegetarianism, low fat or low cholesterol diets, and dietary supplement use. Fourteen percent appeared not to supplement with folic acid, 13% rated exercise as "extremely" or "very active", and 28% reported a "high" perceived level of stress. This preliminary research demonstrated that a NSF can be a useful tool to identify nutrition-related lifestyle factors that may negatively impact fertility and identified weight, BMI, diet, exercise, and stress as modifiable risk factors deserving future research. NSF information can help increase awareness among health professionals and patients about the important link between nutrition, fertility, and successful reproductive outcomes.

  6. Phenotypic differences of patients with fibrodysplasia ossificans progressive due to p.Arg258Ser variants of ACVR1

    PubMed Central

    Nakahara, Yasuo; Suzuki, Ryuyo; Katagiri, Takenobu; Toguchida, Junya; Haga, Nobuhiko

    2015-01-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare, congenital disorder caused by heterozygous mutation of the bone morphogenetic protein type I receptor ACVR1. Various forms of atypical FOP have recently been identified, and a recurrent mutation, ACVR1 (p.Arg258Ser) was reported. We encountered a 17-year-old Japanese female patient with sporadic occurrence of FOP. At the age of 7 years, radiological examination revealed progressive heterotopic ossification and cervical spine malformations. Although great toe malformation was not observed, we diagnosed her as having FOP. Then, ACVR1 was analyzed and a recurrent mutation of p.Arg258Ser was identified. We noticed that there may be phenotypic differences between c.774G>T and c.774G>C, which lead to the same amino-acid change, p.Arg258Ser. Genotype–phenotype correlation was discussed with the review of the previous reports. PMID:27081558

  7. Autoantibody studies of female patients with reproductive failure.

    PubMed

    Reimand, K; Talja, I; Metsküla, K; Kadastik, U; Matt, K; Uibo, R

    2001-08-01

    The aim of this study was to investigate the prevalence and character of autoimmune derangements in women with reproductive failure. A total of 108 females (age range 17-43, mean 27.5 years), including 16 with primary menstrual cycle disturbances and polycystic ovaries (PCO), 20 with polycystic ovary syndrome (PCOS), 38 with endometriosis (E), and 34 with chronic anovulation, luteal phase insufficiency, subfertility or unexplained infertility (INF) were investigated. A control group of 392 women was formed from an unselected population sample (age range 17-43, mean 31.0 years). All sera were tested by indirect immunofluorescence method to assess common autoantibodies: nuclear (ANA), smooth muscle (SMA), parietal cell (PCA), thyroid microsomal (TMA), reticulin (ARA), mitochondrial (AMA) and liver/kidney microsomal autoantibodies (LKMA). Enzyme-linked immunosorbent assay was used to detect antibodies against beta2-glycoprotein I (anti-beta 2GPI) and carbonic anhydrase (anti-CA). Our results showed that 40.7% of patients' sera and 14.8% of control sera contained one or more common autoantibodies, ANA and SMA were most frequently detected (difference between two groups P<0.005). Anti-beta 2GPI were found in eight cases (7.4%), including two patients with INF but without other autoantibodies. Anti-CA were revealed in nine cases (8.3%) including patients' PCOS, E and INF. A comparison of patients' clinical data with antibody assay results did not reveal any significant associations. Our results indicate a high prevalence of autoimmune reactions in women with reproductive failure due to the most common causes PCO, PCOS and E as well as in unexplained infertility. This might reflect the propensity to develop autoimmune reactions in such patients, including pathogenic autoimmune reactions to specific target antigens.

  8. Gynaecological Prolapse Surgery in Very Old Female Patients

    PubMed Central

    Mothes, A. R.; Lehmann, T.; Kwetkat, A.; Radosa, M. P.; Runnebaum, I. B.

    2016-01-01

    Background: The aim of this study is to compare very elderly female patients with a younger control group after prolapse surgery with regard to co-morbidity and complications. Method: In a case-control design, the consecutive data of patients after prolapse surgery at the age of over 80 years and those of a control group were analysed by means of the Clavien-Dindo (CD) classification of surgical complications, the Charlson Comorbidity Index and the Cumulative Illness Rating Scale Geriatrics (CIRS-G). Statistics: Studentʼs t, Fisherʼs exact and Mann-Whitney U tests. Results: The analysis comprised n = 57 vs. n = 60 operations. In the very elderly patients there was often a grade IV prolapse (p < 0.001), apical fixations were more frequent (p < 0.001), but the operating times were not different. In the very elderly patients 21 % CD II+III complications were observed, in the control group 6.6 % (p = 0.031). No CD IV and V complications occurred in either group, the duration of inpatient stay amounted to 5 (± 1) vs. 4.1 (± 0.8; p < 0.001) days, the very elderly patients needed an inpatient follow-up more frequently (p < 0.001). The co-morbidities of the very elderly patients differed from those of the control group in number (median 2.0 vs. 1.5; p < 0.001), in CIRS-G (4.1 ± 2.2 vs. 2.4 ± 1.7; p < 0.01) and in Charlson Index (1.6 ± 1.6 vs. 0.5 ± 0.7; p < 0.001). Conclusions: A prolapse in very elderly women can be safely managed by surgery. In no case did the complications require intensive care treatment nor were they life-threatening, but they did lead to a longer duration of hospital stay and more frequently to further treatment geriatric or inpatient internal medicine facilities. PMID:27582580

  9. Patient-Centered Mental Health Care for Female Veterans

    PubMed Central

    Kimerling, Rachel; Bastian, Lori A.; Bean-Mayberry, Bevanne A.; Bucossi, Meggan M.; Carney, Diane V.; Goldstein, Karen M.; Phibbs, Ciaran S.; Pomernacki, Alyssa; Sadler, Anne G.; Yano, Elizabeth M.; Frayne, Susan M.

    2016-01-01

    Objective Mental health services for women vary widely across the Veterans Health Administration (VHA) system, without consensus on the need for, or organization of, specialized services for women. Understanding women’s needs and priorities is essential to guide the implementation of patient-centered behavioral health services. Methods In a cross-sectional, multisite survey of female veterans using primary care, potential stakeholders were identified for VHA mental health services by assessing perceived or observed need for mental health services. These stakeholders (N=484) ranked priorities for mental health care among a wide range of possible services. The investigators then quantified the importance of having designated women’s mental health services for each of the mental health services that emerged as key priorities. Results Treatment for depression, pain management, coping with chronic general medical conditions, sleep problems, weight management, and posttraumatic stress disorder (PTSD) emerged as women’s key priorities. Having mental health services specialized for women was rated as extremely important to substantial proportions of women for each of the six prioritized services. Preference for primary care colocation was strongly associated with higher importance ratings for designated women’s mental health services. For specific types of services, race, ethnicity, sexual orientation, PTSD symptoms, and psychiatric comorbidity were also associated with higher importance ratings for designated women’s services. Conclusions Female veterans are a diverse population whose needs and preferences for mental health services vary along demographic and clinical factors. These stakeholder perspectives can help prioritize structural and clinical aspects of designated women’s mental health care in the VHA. PMID:25642611

  10. Anaesthesia for a patient with Leigh's syndrome undergoing surgery for scoliosis.

    PubMed

    Jacobs, T F; Plasschaert, F S; Bossuyt, G P; Szegedi, L L; Herregods, L L

    2004-01-01

    Anaesthesia for patients with Leigh's syndrome has rarely been reported. Leigh's syndrome or subacute necrotizing encephalomyelopathy is a neurodegenerative disorder of infancy or childhood. Acute exacerbation with respiratory failure may accompany surgery and general anaesthesia. In this case report we describe the anaesthetic management of a 17 year old patient scheduled for spine surgery.

  11. Comparison of acute non-haemolytic transfusion reactions in female and male patients receiving female or male blood components

    PubMed Central

    Imoto, S; Araki, N; Shimada, E; Saigo, K; Nishimura, K; Nose, Y; Bouike, Y; Hashimoto, M; Mito, H; Okazaki, H

    2007-01-01

    To study the relationship between antibodies detected in patients’ and/or donors’ sera and the clinical features of acute non-haemolytic transfusion reactions (ANHTRs), and to determine any gender-related difference. ANHTRs range from urticaria to transfusion-related acute lung injury (TRALI). Antibodies to human leukocyte antigen (HLA), granulocytes, platelets, and/or plasma proteins are implicated in some of the ANHTRs. A higher antibody positivity is expected for females than for males. A comparative study of ANHTRs for antibody positivity and their clinical features between females and males for both patients and donors is helpful for characterizing ANHTRs including TRALI more clearly, but such studies are few and outdated. Two hundred and twenty-three ANHTR cases reported by 45 hospitals between October 2000 and July 2005 were analysed. The patients and 196 donors of suspect blood products were screened for antibodies to HLA Class I, HLA Class II, granulocytes, and platelets. The patients were also screened for anti-plasma protein antibodies. The types and severity of ANHTR did not differ significantly between female and male patients. The frequency of the anti-HLA antibodies, but not that of the non-HLA antibodies, was significantly higher in females. Non-HLA antibodies were significantly associated with severe reactions in females. All the TRALI cases had predisposing risk factors for acute lung injury, and 60% of the cases showed anti-leucocyte antibodies. Although the anti-HLA antibodies were detected more frequently in females than males, no significant association of ANHTRs including TRALI with gender, not only for patients, but also for donors, could be shown in this study. PMID:18067650

  12. Effect of juggling therapy on anxiety disorders in female patients

    PubMed Central

    Nakahara, Toshihiro; Nakahara, Kazuhiko; Uehara, Miho; Koyama, Ken-ichiro; Li, Kouha; Harada, Toshiro; Yasuhara, Daisuke; Taguchi, Hikaru; Kojima, Sinya; Sagiyama, Ken-ichiro; Inui, Akio

    2007-01-01

    Aims The aim of this study was to investigate the effect of juggling therapy for anxiety disorder patients. Design and Method Subjects were 17 female outpatients who met the DSM-IV diagnostic criteria for anxiety disorders. Subjects were treated with standard psychotherapy, medication and counseling for 6 months. For the last 3 months of treatment, subjects were randomized into either a non-juggling group (n = 9) or a juggling therapy group (juggling group: n = 8). The juggling group gradually acquired juggling skills by practicing juggling beanbags (otedama in Japan) with both hands. The therapeutic effect was evaluated using scores of psychological testing (STAI: State and Trate Anxiety Inventry, POMS: Profile of Mood Status) and of ADL (FAI: Franchay Activity Index) collected before treatment, 3 months after treatment (before juggling therapy), and at the end of both treatments. Results After 6 months, an analysis of variance revealed that scores on the state anxiety, trait anxiety subscales of STAI and tension-anxiety (T-A) score of POMS were significantly lower in the juggling group than in the non-juggling group (p < 0.01). Depression, anger-hostility scores of POMS were improved more than non-jugglers. In the juggling group, activity scores on the vigor subscale of POMS and FAI score were significantly higher than those in the non juggling group (p < 0.01). Other mood scores of POMS did not differ between the two groups. Conclusion These findings suggest that juggling therapy may be effective for the treatment of anxiety disorders. PMID:17470298

  13. Victimizations of Mexican youth (12-17 years old): A 2014 national survey.

    PubMed

    Frías, Sonia M; Finkelhor, David

    2017-02-24

    Victimization of Mexican youth (aged 12-17) has received little attention compared to that of adults. Using the 2014 Social Survey on Social Cohesion for the Prevention of Violence and Delinquency, we examine prevalence and types of victimization; describe the characteristics of incidents in terms of relationship with perpetrator(s) and places where took place; and study significant correlates of forms of victimization and poly-victimization. During 2014 alone, more than 2.8 million minors were victims of bullying, cyberbullying, theft, sexual abuse, physical assault, threats, robbery, or extortion. About 10% of these were poly-victims-experienced at least four different types of victimization by at least four types of perpetrators. Youth tended to be victimized by people in their inner circle. The factors associated with victimization tended to vary by victimization type, but proximity to crime and peer delinquency increased the risk of experiencing all types of victimization. Implications for future research and practice are discussed.

  14. Malnutrition and its risk factors among children 1-7 years old in rural Malaysian communities.

    PubMed

    Norhayati, M; Noorhayati, M I; Mohammod, C G; Oothuman, P; Azizi, O; Fatimah, A; Fatmah, M S

    1997-12-01

    The aims of this study were to investigate the nutritional status of children aged 1-7 years in Malaysian rural communities and to identify its risk factors. In all, 221 children were assessed using anthropometric measurements, dietary questionnaires and other tools. Weight-for-age, height-for-age, weight-for-height were analysed. Based on the NCHS standards, the overall prevalence of underweight, stunting and wasting was 46.2%, 18.1% and 30.3% respectively. Almost one-third of the 1-2 years old groups were malnourished. Univariate analysis identified household income £ MR750.00 as a significant risk factor of stunting and wasting.

  15. MP3 player listening sound pressure levels among 10 to 17 year old students.

    PubMed

    Keith, Stephen E; Michaud, David S; Feder, Katya; Haider, Ifaz; Marro, Leonora; Thompson, Emma; Marcoux, Andre M

    2011-11-01

    Using a manikin, equivalent free-field sound pressure level measurements were made from the portable digital audio players of 219 subjects, aged 10 to 17 years (93 males) at their typical and "worst-case" volume levels. Measurements were made in different classrooms with background sound pressure levels between 40 and 52 dBA. After correction for the transfer function of the ear, the median equivalent free field sound pressure levels and interquartile ranges (IQR) at typical and worst-case volume settings were 68 dBA (IQR = 15) and 76 dBA (IQR = 19), respectively. Self-reported mean daily use ranged from 0.014 to 12 h. When typical sound pressure levels were considered in combination with the average daily duration of use, the median noise exposure level, Lex, was 56 dBA (IQR = 18) and 3.2% of subjects were estimated to exceed the most protective occupational noise exposure level limit in Canada, i.e., 85 dBA Lex. Under worst-case listening conditions, 77.6% of the sample was estimated to listen to their device at combinations of sound pressure levels and average daily durations for which there is no known risk of permanent noise-induced hearing loss, i.e., ≤  75 dBA Lex. Sources and magnitudes of measurement uncertainties are also discussed.

  16. Clonidine Extended-Release Tablets for Pediatric Patients with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Jain, Rakesh; Segal, Scott; Kollins, Scott H.; Khayrallah, Moise

    2011-01-01

    Objective: This study examined the efficacy and safety of clonidine hydrochloride extended-release tablets (CLON-XR) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: This 8-week, placebo-controlled, fixed-dose trial, including 3 weeks of dose escalation, of patients 6 to 17 years old with ADHD evaluated the…

  17. Cardiac transplantation in a patient with a single ventricle and transposition of the great vessels.

    PubMed

    Richenbacher, W E; Karwande, S V; Shaddy, R E; Renlund, D G; Bristow, M R; O'Connell, J B; Gay, W A

    1991-10-01

    The technical details of orthotopic cardiac transplantation in a 17-year-old man with a single ventricle and transposition of the great vessels are described. Special considerations in the evaluation and management of patients with complex congenital heart disease who are to undergo cardiac transplantation are delineated.

  18. Becker's Nevus Syndrome in a Pediatric Female Patient

    PubMed Central

    Hernandez-Quiceno, Sara; Ramírez-Jiménez, Juan Jose; Lopera-Cañaveral, Maria Victoria; Toro-Ramos, Martin; Usuga-Arcila, Yuri; Correa-Londoño, Luis; Martinez, Juan Camilo; Monroy, Jennifer; Alfaro, Juan Manuel

    2016-01-01

    Becker's nevus syndrome is part of the epidermal nevus syndromes and has been described with a phenotype that includes Becker's nevus, ipsilateral breast hypoplasia, and variable skeletal malformations. It is more frequent in males than in females (5 : 1) but is more relevant in females. The diagnosis is clinically based and the skin lesion must be present and no other numbered criteria have been established, but with more criteria being present the possibility of the diagnosis is higher. Regarding the treatment of breast hypoplasia, the use of antiandrogen medication has demonstrated adequate clinical response in a dose of 50 mg/day of spironolactone. PMID:27891278

  19. Hyperammonemia crisis following parturition in a female patient with ornithine transcarbamylase deficiency

    PubMed Central

    Kido, Jun; Kawasaki, Tatsuya; Mitsubuchi, Hiroshi; Kamohara, Hidenobu; Ohba, Takashi; Matsumoto, Shirou; Endo, Fumio; Nakamura, Kimitoshi

    2017-01-01

    Ornithine transcarbamylase deficiency (OTCD) is an X-linked disorder, with an estimated prevalence of 1 per 80000 live births. Female patients with OTCD develop metabolic crises that are easily provoked by non-predictable common disorders, such as genetic (private mutations and lyonization) and external factors; however, the outcomes of these conditions may differ. We resuscitated a female patient with OTCD from hyperammonemic crisis after she gave birth. Hyperammonemia after parturition in a female patient with OTCD can be fatal, and this type of hyperammonemia persists for an extended period of time. Here, we describe the cause and treatment of hyperammonemia in a female patient with OTCD after parturition. Once hyperammonemia crisis occurs after giving birth, it is difficult to improve the metabolic state. Therefore, it is important to perform an early intervention before hyperammonemia occurs in patients with OTCD or in carriers after parturition. PMID:28293384

  20. Hyperammonemia crisis following parturition in a female patient with ornithine transcarbamylase deficiency.

    PubMed

    Kido, Jun; Kawasaki, Tatsuya; Mitsubuchi, Hiroshi; Kamohara, Hidenobu; Ohba, Takashi; Matsumoto, Shirou; Endo, Fumio; Nakamura, Kimitoshi

    2017-02-28

    Ornithine transcarbamylase deficiency (OTCD) is an X-linked disorder, with an estimated prevalence of 1 per 80000 live births. Female patients with OTCD develop metabolic crises that are easily provoked by non-predictable common disorders, such as genetic (private mutations and lyonization) and external factors; however, the outcomes of these conditions may differ. We resuscitated a female patient with OTCD from hyperammonemic crisis after she gave birth. Hyperammonemia after parturition in a female patient with OTCD can be fatal, and this type of hyperammonemia persists for an extended period of time. Here, we describe the cause and treatment of hyperammonemia in a female patient with OTCD after parturition. Once hyperammonemia crisis occurs after giving birth, it is difficult to improve the metabolic state. Therefore, it is important to perform an early intervention before hyperammonemia occurs in patients with OTCD or in carriers after parturition.

  1. 47,XYY karyotype and normal SRY in a patient with a female phenotype.

    PubMed

    Benasayag, S; Rittler, M; Nieto, F; Torres de Aguirre, N; Reyes, M; Copelli, S

    2001-06-01

    A rare case of a female patient with a 47,XYY karyotype is described. She had normal female external genitalia, bilateral testes, rudimentary Fallopian tubes and no uterus. Molecular analysis revealed a normal SRY encoding sequence. The possible events in the etiology of this sex reversal entity are discussed.

  2. 46,XX patients with congenital adrenal hyperplasia: initial assignment as male, reassigned female.

    PubMed

    Lee, Peter A; Witchel, Selma F

    2005-02-01

    Six 46,XX patients with congenital adrenal hyperplasia (CAH) presented with genital ambiguity, five so severe that initial gender assignment was male. Once diagnosis was realized, parents were involved in evaluation and chose sex re-assignment as female. To date, these girls and their parents all indicate satisfaction with their decision for a female sex of rearing. The girls have a female gender identity with behavior characteristics known for females with CAH. Thus, while outcome is satisfactory, it is realized that for most, expression of sexual orientation and adult life adjustments have not yet occurred.

  3. Assessment of the female patient with urinary incontinence.

    PubMed

    Bates, Frankie

    2002-10-01

    Understanding the pelvic floor anatomy and all of its components is crucial when performing pelvic floor examination and assessing patients suffering from urinary incontinence. It is important for urology nurses to understand the pelvic floor, including the muscle, nerve, and fascia involved; external and internal examination of the vulva; and global assessment of the patient.

  4. Skewed X-inactivation in a tumor tissue from a female patient with leiomyomatosis

    SciTech Connect

    Kishino, T.; Jinno, Y.; Niikawa, N.

    1995-07-17

    Leiomyomatosis (multiple leiomyomas) is characterized by benign smooth muscle cell proliferations in the esophagus, tracheobronchial tree, and female genital tract. At least 3 genetically different hereditary leiomyomatoses have been identified. Among them, an X-linked leiomyomatosis is often associated with an Alport syndrome-like nephropathy. It has remained obscure whether the leiomyomata occur monoclonally or polyclonally. The clonality of various malignancies has been examined by analysis of X-inactivation patterns in female patients heterozygous for polymorphic alleles of X-linked genes. We examined the clonality of a leiomyoma in a female patient by a polymerase chain reaction (PCR)-based X-inactivation assay. 6 refs., 1 fig.

  5. The effect of office based flexible and rigid cystoscopy on pain experience in female patients

    PubMed Central

    Vriesema, Jessica L.; Stomps, Saskia P.; van Balen, Olav L.W.B.; Cornel, Erik B.

    2017-01-01

    Purpose Rigid and flexible cystoscopies are both routinely used in female patients. Literature is conflicting whether flexible cystoscopy is less painful compared to rigid cystoscopy. The aim of this study was therefore to investigate whether using flexible cystoscopy leads to less discomfort and pain compared to rigid cystoscopy in female patients who underwent first time cystoscopy. Materials and Methods One hundred eighty-nine female patients, who never had undergone cystoscopy, were randomized into 2 groups: 92 patients underwent rigid cystoscopy and 97 patients flexible cystoscopy. Directly after the cystoscopy procedure all patients were asked to fill out their pain experience on a 100-mm visual analogue pain scale (VAS). Results Median VAS score was significantly lower for women undergoing flexible cystoscopy (0 [0–20]) compared to rigid cystoscopy (15 [0–38], p<0.001). In addition, age was inversely associated with VAS score, indicating that younger females experienced more pain (R=−0.30, p=0.001). The use of flexible cystoscopy was associated with a decrease in VAS score and remained significant after adjustment for age, sex of urologist, performing urologist and indication (standardized β=−0.17, p=0.048). Conclusions The use of flexible cystoscopy resulted in a significantly lower pain experience compared to rigid cystoscopy. Based on patient's pain experience during cystoscopy, this study implicates to use flexible cystoscopy in female patients who undergo first time cystoscopy. PMID:28097268

  6. Survival Outcomes and Predictive Factors for Female Urethral Cancer: Long-term Experience with Korean Patients.

    PubMed

    Kang, Minyong; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe; Ku, Ja Hyeon

    2015-08-01

    The aim of this study was to evaluate female urethral cancer (UCa) patients treated and followed-up during a time period spanning more than 20 yr at single institution in Korea. We reviewed medical records of 21 consecutive patients diagnosed with female UCa at our institution between 1991 and 2012. After exclusion of two patients due to undefined histology, we examined clinicopathological variables, as well as survival outcomes of 19 patients with female UCa. A Cox proportional hazards ratio model was used to identify significant predictors of prognosis according to variables. The median age at diagnosis was 59 yr, and the median follow-up duration was 87.0 months. The most common initial symptoms were voiding symptoms and blood spotting. The median tumor size was 3.4 cm, and 55% of patients had lesions involving the entire urethra. The most common histologic type was adenocarcinoma, and the second most common type was urothelial carcinoma. Fourteen patients underwent surgery, and 7 of these patients received adjuvant radiation or systemic chemotherapy. Eleven patients experienced tumor recurrence after primary therapy. Patients with high stage disease, advanced T stage (≥T3), and positive lymph nodes had worse survival outcomes compared to their counterparts. Particularly, lymph node positivity and advanced T stage were significant predictive factors for all survival outcomes. Tumor location was the only significant predictor for recurrence-free survival. Although our study included a small number of patients, it conveys valuable information about this rare female urologic malignancy in a Korean population.

  7. Sexual Concerns of Male Spouses of Female Alzheimer's Disease Patients.

    ERIC Educational Resources Information Center

    Litz, Brett T.; And Others

    1990-01-01

    Presents case study which highlights attendant cognitive changes that occur in Alzheimer's patient, presenting caregiver with challenges to couple's sexual functioning. Describes man who reported erectile dysfunction directly stemming from stressful changes that had occurred in his relationship to his wife who had Alzheimer's disease. General…

  8. Bulbocavernosus Reflex Test for Diagnosis of Pudendal Nerve Injury in Female Patients with Diabetic Neurogenic Bladder

    PubMed Central

    Niu, Xiaoting; Wang, Xun; Huang, Huanjie; Ni, Peiqi; Lin, Yuanshao; Shao, Bei

    2016-01-01

    The study was designed to investigate the clinical application and significance of the bulbocavernosus reflex (BCR) test for diagnosing diabetic neurogenic bladder (DNB) in female subjects. In this study, 68 female patients with DNB and 40 female normal controls were subjected to a nerve conduction study (NCS) of all four limbs and the BCR test. The data were analyzed and compared, and the corresponding diagnostic sensitivities were discussed. Mean BCR latency for female DNB patients was significantly prolonged, compared to that of the control group, suggesting pudendal nerve injuries in female DNB patients. Moreover, DNB patients were categorized according to the diabetes course. Compared to that of Group A (diabetes course < 5 y), the mean BCR latency was significantly prolonged in Group B (diabetes course between 5 and 10 y) and then further prolonged in Group C (diabetes course > 10 y), which were all longer than the control group. Furthermore, compared with that of the controls, the mean BCR latency was prolonged in DNB patients with or without NCS abnormalities in limbs. Nevertheless, no significant difference was observed in BCR latency between DNB patients with and without NCS abnormalities. Significantly increasing trends were also observed in the NCS and BCR abnormality rates along with increased diabetes course. Most importantly, compared with the NCS of limbs, the BCR test was more sensitive in diagnosing DNB in the female subjects. Overall, our findings suggest that the BCR test would help to assess the pudendal nerve injury in female DNB patients, which might be a potential diagnostic tool in the clinic. PMID:28053822

  9. Female gender lost protective effect against disease progression in elderly patients with chronic hepatitis B

    PubMed Central

    You, Hong; Kong, Yuanyuan; Hou, Jinlin; Wei, Lai; Zhang, Yuexin; Niu, Junqi; Han, Tao; Ou, Xiaojuan; Dou, Xiaoguang; Shang, Jia; Tang, Hong; Xie, Qing; Ding, Huiguo; Ren, Hong; Xu, Xiaoyuan; Xie, Wen; Liu, Xiaoqing; Xu, Youqing; Li, Yujie; Li, Jie; Chow, Shein-Chung; Zhuang, Hui; Jia, Jidong

    2016-01-01

    Female gender and younger age are protective factors against disease progression in chronic hepatitis B (CHB). However, it is not clear whether the disease progression still remains slow in elderly females. This study investigated the interaction of female gender and older age on the development of cirrhosis in patients recorded in China Registry of Hepatitis B. A total of 17,809 CHB patients were enrolled in this multi-center cross-sectional study. The prevalence of cirrhosis in female CHB patients increased faster than that in male CHB patients over 50 years old. Multivariate analysis showed that the increase of adjusted ORs for developing cirrhosis in females started to accelerate after 50 years old: 11.19 (95% CI: 5.93–21.11) in women versus 14.75 (95% CI: 8.35–26.07) in men at ages of 50–59 years, 21.67 (95% CI: 11.05–42.47) versus 24.4 (95% CI: 13.00–45.80) at ages 60–69 years, and 18.78 (95% CI: 6.61–53.36) versus 12.09 (95% CI: 4.35–33.61) in those over 70 years. In conclusion, the protective effect of female gender against cirrhosis gradually lost with increasing age, therefore disease progression should be monitored more closely in elderly women with CHB. PMID:27892487

  10. A fe/male transsexual patient in psychoanalysis.

    PubMed

    Quinodoz, D

    1998-02-01

    The author describes the analysis of a transsexual who had undergone a vaginoplasty as a young man and had since been living as a woman. The complexity of the psychic reality is epitomised by the analyst's difficulty in deciding whether to use masculine or feminine grammatical forms to refer to this patient. The author tells how she assumed the fantasy role of parents expecting a baby whose sex they did not yet know. She discusses at length her hesitation about accepting a transsexual patient into analysis and reports how she overcame her misgivings after analysing her own countertransference and consulting the literature. Noting that this borderline analysand resorted to both psychotic and neurotic mechanisms, the analyst decided to rely on the capacity for symbolisation and mental representation evinced in the latter. On the psychotic level, the delusional neo-reality of the appearance of a woman sought to replace the unbearable reality of being a man, whereas the neurotic part was aware that s/he could never really be a woman. The author observes that in this analysand sexualisation served to conceal a fundamental narcissistic fault. She also describes how she worked with her own madness to help the patient emerge from a situation of paradoxical fusion with the mother in madness.

  11. Female Genital Dialogues: Female Genital Self-Image, Sexual Dysfunction, and Quality of Life in Patients With Vitiligo With and Without Genital Affection.

    PubMed

    Sarhan, Deena; Mohammed, Ghada F A; Gomaa, Amal H A; Eyada, Moustafa M K

    2016-01-01

    Vitiligo has a major effect on sexual health because of the disfiguring skin lesions affecting self-image and self-esteem. However, this topic has not explored. This article aimed to assess the effect of vitiligo on genital self-image, sexual function, and quality of life in female patients. This cross-sectional study included 50 sexually active women with vitiligo and 25 women without vitiligo. All participants subjected to full history taking and examination. Extent of vitiligo was assessed with the Vitiligo Area Scoring Index score, sexual function with the Female Sexual Function Index, genital self-image with Female Genital Self-Image Score and quality of life with the Dermatology Life Quality Index questionnaires. The main outcome measures were correlation between Vitiligo Area Scoring Index, Female Genital Self-Image Score, Female Sexual Function Index, and Dermatology Life Quality Index domains was determined using t test and Pearson correlation. This study revealed a negative correlation between the Vitiligo Area Scoring Index score and sexual satisfaction. Vitiligo Area Scoring Index and Dermatology Life Quality Index score was significantly correlated with Arabic Version of the Female Genital Self-Image Score alone and with Arabic Version of the Female Sexual Functioning Index alone and with both the Arabic Version of the Female Genital Self-Image Score and the Arabic Version of the Female Sexual Functioning Index (p <.05). Sexual and psychological assessment of patients with vitiligo is imperative to improve outcomes and increase patients' compliance with treatment.

  12. Quality of life, depression, and sexual dysfunction in spouses of female patients with fibromyalgia.

    PubMed

    Tutoglu, Ahmet; Boyaci, Ahmet; Koca, Irfan; Celen, Esra; Korkmaz, Nurdan

    2014-08-01

    The aim of this study was to investigate the effects of the quality of life and psychological condition of female patients with fibromyalgia and their spouses on sexual function. A total of 32 female patients diagnosed with fibromyalgia and their spouses were analyzed. Thirty married couples were included in the study as the control group. The demographic data of the fibromyalgia patients were recorded, a visual analog scale was used to evaluate the level of pain, and the Fibromyalgia Impact Questionnaire was used to evaluate the impact of the symptoms on the quality of life of the patients. The quality of life of both the patients and the control group were evaluated using the Short Form 36 (SF-36), and psychological variables were evaluated using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory. Sexual function was assessed using the Female Sexual Function Index for female participants and the International Index of Erectile Function (IIEF) for male participants. The IIEF erectile dysfunction scores were significantly lower in the spouses of female patients with fibromyalgia than in the control group (p < 0.05), and the BDI scores were significantly higher in the spouses of the female patients with fibromyalgia (p < 0.05). Among the SF-36 scores, the emotional and physical roles were significantly lower in the spouses of the female patients with fibromyalgia (p = 0.003 and p = 0.004, respectively). In all spouses of FMS patients and controls, there was a significantly negative correlation between erectile function, the BDI score, and to be married with FMS patient and positive correlations between erectile function and emotional role, social function, mental health, SF-36 pain score, and general health (p < 0.05 for all). In a linear regression model, BDI, to be married with FMS patient and general health were found to affect erectile function (beta regression coefficient = -0.572, SE = 0.082, p = 0.001; beta regression coefficient = -0.332, SE = 1

  13. Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer.

    PubMed

    Wallace, Sumer Allensworth; Blough, Kiara L; Kondapalli, Laxmi A

    2014-01-01

    While the field of oncofertility raised awareness about fertility concerns in oncology patients, new applications for fertility preservation are emerging, such as transgender medicine. As transgender medicine evolves, the number of individuals seeking gender reassignment hormone therapy is drastically increasing, generating a population of patients with unmet fertility needs and unknown reproductive potential. We present the first case report of a female-to-male (FtM) transgender patient to undergo oocyte cryopreservation before initiating androgen therapy. Our patient is a 17-year-old FtM transgender person undergoing gender transition throughout adolescence with an endocrinologist. The patient wished to complete androgen therapy before starting his first year of college to avoid gender ambiguity. After extensive consultation and psychological assessment, the patient was considered an appropriate candidate and proceeded with oocyte cryopreservation. He underwent baseline fertility testing followed by successful ovarian stimulation and surgical retrieval. We recommend that a discussion of reproductive health concerns and fertility preservation options be incorporated into the comprehensive care of transgender patients.

  14. Fertility preservation in female cancer patients: An overview

    PubMed Central

    Mahajan, Nalini

    2015-01-01

    Fertility preservation is becoming increasingly important to improve the quality of life in cancer survivors. Despite guidelines suggesting that discussion of fertility preservation should be done prior to starting cancer therapies, there is a lack of implementation in this area. A number of techniques are available for fertility preservation, and they can be used individually or together in the same patient to maximize efficiency. Oocyte and embryo cryopreservation are now established techniques but have their limitations. Ovarian tissue cryopreservation though considered experimental at present, has a wider clinical application and the advantage of keeping the fertility window open for a longer time. Both chemotherapy and radiotherapy have a major impact on reproductive potential and fertility preservation procedures should be carried out prior to these treatments. The need for fertility preservation has to be weighed against morbidity and mortality associated with cancer. There is thus a need for a multidisciplinary collaboration between oncologists and reproductive specialists to improve awareness and availability. PMID:25838742

  15. Dietary Intake In Adult Female Coeliac Disease Patients In Slovenia

    PubMed Central

    Mičetić-Turk, Dušanka

    2016-01-01

    Abstract Objectives The aim of the study was to assess dietary intake of coeliac disease (CD) patients and to determine if they are meeting the dietary reference values for a balanced diet. Subjects/Methods 40 women with CD, aged from 23 to 76 participated in our study. Total daily intake was assessed by a three-day food diary. Resting metabolic rate (RMR) was calculated using Harris-Benedict equation. Considering physical activity level (PAL) 1.4, the recommended total energy expenditure (TEE) value was determined. The data was evaluated with professional evaluation software Prodi and statistically analysed. Results 40 participants returned the food diary. The average energy intake was significantly too low to ensure the meeting of all-day energy needs (p<0.05). The meals contained a recommended proportion of protein, but a statistically significantly higher proportion of fat (p<0.05), lower proportion of carbohydrates and a significantly lower intake of dietary fibre (p<0.05). Regarding macro-, micro- elements and vitamins, there was a significant lack in the intake of calcium and iodine, folic acid, vitamin D and vitamin A (p<0.05), meanwhile iron intake was at the lower limit of the recommended intake, whereas zinc, potassium and vitamin K intake were significantly higher according to the recommended values, but were comparable with the intake of the general population in the Central European area. Conclusion Even in subjects with adequate or low daily energy intake, their meals contained too much fat, too few carbohydrates and dietary fibre as well as inorganic substances. The patients with CD should get regular nutritional monitoring and education on the quality and balance of a gluten-free diet. PMID:27284377

  16. Identification of Intellectual Disability Genes in Female Patients with a Skewed X-Inactivation Pattern.

    PubMed

    Fieremans, Nathalie; Van Esch, Hilde; Holvoet, Maureen; Van Goethem, Gert; Devriendt, Koenraad; Rosello, Monica; Mayo, Sonia; Martinez, Francisco; Jhangiani, Shalini; Muzny, Donna M; Gibbs, Richard A; Lupski, James R; Vermeesch, Joris R; Marynen, Peter; Froyen, Guy

    2016-08-01

    Intellectual disability (ID) is a heterogeneous disorder with an unknown molecular etiology in many cases. Previously, X-linked ID (XLID) studies focused on males because of the hemizygous state of their X chromosome. Carrier females are generally unaffected because of the presence of a second normal allele, or inactivation of the mutant X chromosome in most of their cells (skewing). However, in female ID patients, we hypothesized that the presence of skewing of X-inactivation would be an indicator for an X chromosomal ID cause. We analyzed the X-inactivation patterns of 288 females with ID, and found that 22 (7.6%) had extreme skewing (>90%), which is significantly higher than observed in the general population (3.6%; P = 0.029). Whole-exome sequencing of 19 females with extreme skewing revealed causal variants in six females in the XLID genes DDX3X, NHS, WDR45, MECP2, and SMC1A. Interestingly, variants in genes escaping X-inactivation presumably cause both XLID and skewing of X-inactivation in three of these patients. Moreover, variants likely accounting for skewing only were detected in MED12, HDAC8, and TAF9B. All tested candidate causative variants were de novo events. Hence, extreme skewing is a good indicator for the presence of X-linked variants in female patients.

  17. CDKL5 mutations cause infantile spasms, early onset seizures, and severe mental retardation in female patients

    PubMed Central

    Archer, H L; Evans, J; Edwards, S; Colley, J; Newbury‐Ecob, R; O'Callaghan, F; Huyton, M; O'Regan, M; Tolmie, J; Sampson, J; Clarke, A; Osborne, J

    2006-01-01

    Objective To determine the frequency of mutations in CDKL5 in both male and female patients with infantile spasms or early onset epilepsy of unknown cause, and to consider whether the breadth of the reported phenotype would be extended by studying a different patient group. Methods Two groups of patients were investigated for CDKL5 mutations. Group 1 comprised 73 patients (57 female, 16 male) referred to Cardiff for CDKL5 analysis, of whom 49 (42 female, 7 male) had epileptic seizure onset in the first six months of life. Group 2 comprised 26 patients (11 female, 15 male) with infantile spasms previously recruited to a clinical trial, the UK Infantile Spasms Study. Where a likely pathogenic mutation was identified, further clinical data were reviewed. Results Seven likely pathogenic mutations were found among female patients from group 1 with epileptic seizure onset in the first six months of life, accounting for seven of the 42 in this group (17%). No mutations other than the already published mutation were found in female patients from group 2, or in any male patient from either study group. All patients with mutations had early signs of developmental delay and most had made little developmental progress. Further clinical information was available for six patients: autistic features and tactile hypersensitivity were common but only one had suggestive Rett‐like features. All had a severe epileptic seizure disorder, all but one of whom had myoclonic jerks. The EEG showed focal or generalised changes and in those with infantile spasms, hypsarrhythmia. Slow frequencies were seen frequently with a frontal or fronto‐temporal predominance and high amplitudes. Conclusions The spectrum of the epileptic seizure disorder, and associated EEG changes, in those with CDKL5 mutations is broader than previously reported. CDKL5 mutations are a significant cause of infantile spasms and early epileptic seizures in female patients, and of a later intractable seizure disorder

  18. Catastrophic antiphospholipid antibody syndrome presenting as acute vascular occlusion in a young female patient.

    PubMed

    Alonso, Joaquín Valle; Del Pozo, Francisco Javier Fonseca; Álvarez, Manuel Vaquero; Pedraza, Jorge; Aguayo, Miguel Angel; Sanchez, Almudena

    2016-10-10

    Acquired thrombotic and thromboembolic disorders may be presented initially with symptoms and signs of acute ischaemia or organ dysfunction that will lead many of these patients to seek care in the emergency department. We report a case of a 19-year-old female patient who developed catastrophic antiphospholipid syndrome (CAPS syndrome or Asherson syndrome) 6 weeks post stillbirth with an initial presentation of acute vascular occlusion. The patient was immediately operated and anticoagulated with significant improvement.

  19. A De Novo Arisen Case of Primary Adrenal Insufficiency in an Adolescent Patient With Crohn Disease

    PubMed Central

    Qiu, Yun; Mao, Ren; Chen, Min-hu

    2015-01-01

    Abstract Several recent population-based studies have demonstrated that patients with inflammatory bowel disease are likely to have other autoimmune diseases. Here we describe the first de novo arisen case of primary adrenal insufficiency in an adolescent female patient with Crohn disease (CD). A 17-year-old female diagnosed with stricturing colonic CD received the maintenance regimen of Remicade (infliximab) 5 mg/kg every 8 weeks following the standard induction regimen. She had an ileocecostomy due to acute small bowel obstruction at 1.5-year since the last infusion of Remicade. She was presented with skin hyperpigmentation of her face, neck, upper limbs, buccal mucosa and lips, which worsened when commenced on 6-mercaptopurine treatment for prophylaxis of postoperative recurrence. An increased adrenocorticotropic hormone (20.3 pmol/L, range 2–11) measurement was obtained. Radiography of the sella turcica region showed no signs of pituitary disease, or abnormality of bilateral adrenal cortex. Since serum aldosterone was below the reference range, more importantly, assessments for both antiadrenal antibodies and anti-21-hydroxylase antibodies were positive, she was then diagnosed as primary adrenal insufficiency. The symptoms improved after supplement of hydrocortisone. This case highlights a rare immune-mediated comorbidity in an adolescent patient with CD. Recognition of a new pattern of autoimmune endocrine comorbidity enables clinicians to be alert about the possibility of concurrence of primary adrenal insufficiency with CD. PMID:26061303

  20. Association of autoimmune diseases with lichen sclerosus in 532 male and female patients.

    PubMed

    Kreuter, Alexander; Kryvosheyeva, Yulia; Terras, Sarah; Moritz, Rose; Möllenhoff, Katrin; Altmeyer, Peter; Scola, Nina; Gambichler, Thilo

    2013-03-27

    Lichen sclerosus is a relatively common chronic inflammatory skin disease that predominantly affects the anogenital area. Accumulating evidence indicates that lichen sclerosus in women may be associated with other autoimmune disease, whereas this association seems to lack in male patients. We retrospectively evaluated the prevalence of autoimmune diseases and serological parameters indicative for autoimmunity in male and female patients with lichen sclerosus. Of the 532 patients (396 women, 136 men; 500 adults, 32 children; mean age: 49 years; range 1-89 years; female:male ratio 3:1), 452 (85%) had genital and 80 (15%) had extragenital disease. In women, lichen sclerosus was significantly more often associated with at least one autoimmune disease as compared to men (odds ratio [OR] 4.3, 95% confidence interval [CI] 1.9-9.6; p<0.0001). Moreover, female patients with lichen sclerosus had sinificantly more often associated autoimmune thyroid diseases (OR 4.7, 95% CI 1.8-11.9; p<0.0002), antithyroid-antibodies (OR 2.7, 95% CI 1.1-6.5; p=0.023), and elevated autoantibodies (OR 4.1, 95% CI 1.9-9.3; p<0.0001) as compared to male patients. This observation is suggestive for a different pathogenetic background in male and female patients.

  1. Differences in the treatment of male and female patients with end-stage renal disease.

    PubMed Central

    Florakas, C; Wilson, R; Toffelmire, E; Godwin, M; Morton, R

    1994-01-01

    OBJECTIVE: To determine whether there is a difference in the allocation of types of dialysis to male and female patients with end-stage renal disease (ESRD). DESIGN: Descriptive study. SETTING: Canada. PATIENTS: All patients registered with the Canadian Organ Replacement Register (CORR) whose treatment began between 1981 and 1991. Data were obtained for 19,732 patients, of whom 18,010 had sufficiently complete data and were being treated with either peritoneal dialysis or hemodialysis 3 months after the diagnosis of ESRD. OUTCOME MEASURES: Proportions of patients receiving peritoneal dialysis and hemodialysis according to sex. RESULTS: Significantly more male (58.1%) than female (50.8%) patients were receiving hemodialysis 3 months after diagnosis (p < 0.00001). Multivariate analysis to control for the possible confounding effects of age, province of treatment, diagnosis, concurrent illness and year of diagnosis did not explain the difference. CONCLUSIONS: In Canada from 1981 to 1991 male patients were more likely than female patients to receive hemodialysis for the treatment of ESRD. Additional research is needed to explain this finding. PMID:7954176

  2. Proinflammatory proteins in female and male patients with primary antiphospholipid syndrome: preliminary data.

    PubMed

    Bećarević, Mirjana; Ignjatović, Svetlana

    2016-10-01

    The latest classification criteria for the diagnosis of the antiphospholipid syndrome (APS, an autoimmune disease characterized by thromboses, miscarriages and presence of antiphospholipid antibodies (Abs)) emphasized that thrombotic manifestations of APS should be without any signs of an inflammatory process. However, atherosclerosis (a chronic inflammatory response to the accumulation of lipoproteins in the walls of arteries) and APS are characterized by some similar features. We evaluated whether proinflammatory proteins were associated with the features of the primary APS (PAPS). PAPS patients without obstetric complications and with impaired lipid profile were included in the study. Antiphospholipid antibodies, TNF-alpha, and apo(a) were determined by ELISA. Complement components and hsCRP were measured by immunonephelometry. Decreased C3c was observed in female patients with increased titers of IgG anti-β2gpI (χ(2) = 3.939, P = 0.047) and in male patients with increased IgM anticardiolipin Abs (χ(2) = 4.286, P = 0.038). Pulmonary emboli were associated with interleukin (IL)-6 in male (χ(2) = 6.519, P = 0.011) and in female (χ(2) = 10.405, P = 0.001) patients. Cerebrovascular insults were associated with LDL-cholesterol (P = 0.05, 95 % CI: 1.003 - 12.739) in female and with apo(a) (P = 0.016, 95 % CI: 0.000-0.003) in male patients. Older female patients had increased LDL-cholesterol levels and frequency of myocardial infarctions. Proinflammatory proteins were associated with features of primary APS. No real gender differences in regard to proinflammatory protein levels were observed. Premenopausal state of female PAPS patients confers lower cardiovascular risk.

  3. Atrial Fibrillation is Associated With Morphine Treatment in Female Breast Cancer Patients

    PubMed Central

    Lee, Cynthia Wei-Sheng; Muo, Chih-Hsin; Liang, Ji-An; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract We investigated the relationship between morphine treatment and the risk of atrial fibrillation (AF) in female patients with breast cancer. We identified a malignancy cohort of 73,917 female breast cancer patients without an AF history before the date of breast cancer diagnosis between 2000 and 2010 by using the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. This malignancy cohort was divided into morphine and comparison cohorts comprising 18,671 and 55,246 patients, respectively, and the incidences of newly diagnosed AF were calculated. We used the Cox proportional hazard model with time-dependent exposure covariates to estimate the risk of AF. The effect of morphine was assessed through multivariable Cox proportional hazard regression controlling for age, the Charlson comorbidity index (CCI) score, and the use of bisphosphonates and paclitaxel. Compared with nonmorphine users, patients who received morphine exhibited a 4.37-fold (95% CI = 3.56–5.36) increase in the risk of developing AF. The risk of AF increased as the CCI score increased, but decreased in patients with tamoxifen treatment. This risk is especially significant in current morphine users of all ages and with low CCI score. AF risk increased as the duration of morphine use lengthened (P for trend <0.0001). The incidence of AF in female breast cancer patients in Taiwan is associated with morphine, but prevented by tamoxifen treatment. PMID:26986153

  4. A De Novo Arisen Case of Primary Adrenal Insufficiency in an Adolescent Patient With Crohn Disease: A Case report.

    PubMed

    Qiu, Yun; Mao, Ren; Chen, Min-hu

    2015-06-01

    Several recent population-based studies have demonstrated that patients with inflammatory bowel disease are likely to have other autoimmune diseases. Here we describe the first de novo arisen case of primary adrenal insufficiency in an adolescent female patient with Crohn disease (CD). A 17-year-old female diagnosed with stricturing colonic CD received the maintenance regimen of Remicade (infliximab) 5 mg/kg every 8 weeks following the standard induction regimen. She had an ileocecostomy due to acute small bowel obstruction at 1.5-year since the last infusion of Remicade. She was presented with skin hyperpigmentation of her face, neck, upper limbs, buccal mucosa and lips, which worsened when commenced on 6-mercaptopurine treatment for prophylaxis of postoperative recurrence. An increased adrenocorticotropic hormone (20.3 pmol/L, range 2-11) measurement was obtained. Radiography of the sella turcica region showed no signs of pituitary disease, or abnormality of bilateral adrenal cortex. Since serum aldosterone was below the reference range, more importantly, assessments for both antiadrenal antibodies and anti-21-hydroxylase antibodies were positive, she was then diagnosed as primary adrenal insufficiency. The symptoms improved after supplement of hydrocortisone. This case highlights a rare immune-mediated comorbidity in an adolescent patient with CD. Recognition of a new pattern of autoimmune endocrine comorbidity enables clinicians to be alert about the possibility of concurrence of primary adrenal insufficiency with CD.

  5. Elephantiasis nostras verrucosa on the abdomen of a Turkish female patient caused by morbid obesity.

    PubMed

    Buyuktas, D; Arslan, E; Celik, O; Tasan, E; Demirkesen, C; Gundogdu, S

    2010-08-15

    Elephantiasis Nostras Verrucosa is a rare disorder of an extremity or a body region, which is associated with chronic lymphedema. There are 7 reported cases of abdominal elephantiasis in the medical literature. Here we report a morbidly obese female patient with elephantiasis nostras verrucosa on the abdominal wall.

  6. Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance.

    PubMed

    Urban, Renata R; Teng, Nelson N H; Kapp, Daniel S

    2011-05-01

    We report a case of uterine cancer and invasive cervical cancer, detected incidentally during the female-to-male sex reassignment surgery. The management of these patients is presented. Such individuals may not be receiving regular gynecologic care appropriate to their remaining genital organs; symptoms of malignant disease may be missed.

  7. Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia

    PubMed Central

    Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

    2016-01-01

    Background We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). Methods This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). Conclusion SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. PMID:26937190

  8. Examining Patient Conceptions: A Case of Metastatic Breast Cancer in an African American Male to Female Transgender Patient

    PubMed Central

    Dhand, Amar

    2009-01-01

    An African American male to female transgender patient treated with estrogen detected a breast lump that was confirmed by her primary care provider. The patient refused mammography and 14 months later she was diagnosed with metastatic breast cancer with spinal cord compression. We used ethnographic interviews and observations to elicit the patient’s conceptions of her illness and actions. The patient identified herself as biologically male and socially female; she thought that the former protected her against breast cancer; she had fears that excision would make a breast tumor spread; and she believed injectable estrogens were less likely than oral estrogens to cause cancer. Analysis suggests dissociation between the patient’s social and biological identities, fear and fatalism around cancer screening, and legitimization of injectable hormones. This case emphasizes the importance of eliciting and interpreting a patient’s conceptions of health and illness when discordant understandings develop between patient and physician. PMID:19898907

  9. Clinical, biochemical, and genetic analysis of two korean patients with trichorhinophalangeal syndrome type I and growth hormone deficiency.

    PubMed

    Sohn, Young Bae; Ki, Chang-Seok; Park, Sung Won; Cho, Sung-Yoon; Ko, Ah-Ra; Kwon, Min-Jung; Kim, Ji-Youn; Park, Hyung-Doo; Kim, Ok-Hwa; Jin, Dong-Kyu

    2012-01-01

    Tricho-rhino-phalangeal syndrome type I (TRPSI) is a rare autosomal dominant hereditary disorder characterized by sparse hair, bulbous nose, long philtrum, thin upper lip, and skeletal abnormalities including cone-shaped epiphyses, shortening of the phalanges, and short stature. TRPSI is caused by mutations in the TRPS1 gene. Herein, we report two Korean cases of TRPSI. Although both patients (a 17-year-old-female and a 14-year-old male) had typical clinical findings, Patient 1 had an additional growth hormone (GH) deficiency. Treatment with recombinant human growth hormone (rhGH) 0.7 IU/kg/week led to an increase in growth velocity. Over 10 years of GH therapy, the mean growth velocity was 5.7 ± 0.9 cm/year. However, the patient 2 did not show apparent GH deficiency by GH stimulation test, had a poor response with rhGH therapy and GH therapy was discontinued after 6 months. Upon genetic analysis of the TRPS1 gene, two mutations were found. Patient 1 had a heterozygous mutation c.2520dupT (p.Arg841LysfsX3) which had not been previously reported. Patient 2 had a known nonsense mutation c.1630C>T (p.Arg544X). In summary, we were the first to report Korean patients with mutation of TRPS1.

  10. Pharmacokinetics of Peramivir in an Adolescent Patient Receiving Continuous Venovenous Hemodiafiltration

    PubMed Central

    Witcher, Robert; Cies, Jeffrey J.; Moore, Wayne S.; Chopra, Arun

    2017-01-01

    Critically ill patients requiring renal replacement therapy commonly experience pharmacokinetic alterations. This case report describes the pharmacokinetics of peramivir (Rapivab, BioCryst Pharmaceuticals, Inc, Durham, NC), the first US Food and Drug Administration–approved intravenous neuraminidase inhibitor for the treatment of influenza, in an adolescent patient receiving continuous renal replacement therapy (CRRT). A 49.5-kg, 17-year-old Caucasian female presented with fever, cough, and persistent hypoxia. She quickly progressed to acute respiratory and renal failure in the setting of viral septic shock as a result of a severe influenza H1N1 infection. On hospital day 3, therapy was switched from oseltamivir (Tamiflu, Roche Laboratories Inc, Nutley, NJ) to peramivir owing to the concern for inadequate enteral absorption. On the third day of peramivir treatment, at a dose of 200 mg daily, peramivir serum concentrations revealed a smaller peak concentration, larger volumes of distribution, similar 24-hour area under the curve, and a shorter half-life as compared to adult patients with normal renal function. This illustrated the significant differences in pharmacokinetics when administered in the setting of CRRT. The patient had resolution of viral infection as evidenced by negative respiratory viral panel polymerase chain reaction at hospital day 14 and was eventually discharged at her baseline.

  11. Serum adipocytokine profile and metabolic syndrome in young adult female dermatomyositis patients

    PubMed Central

    Silva, Marilda Guimarães; Borba, Eduardo Ferreira; de Mello, Suzana Beatriz Veríssimo; Shinjo, Samuel Katsuyuki

    2016-01-01

    OBJECTIVES: To analyse the frequency of metabolic syndrome in young adult female dermatomyositis patients and its possible association with clinical and laboratory dermatomyositis-related features and serum adipocytokines. METHOD: This cross-sectional study included 35 dermatomyositis patients and 48 healthy controls. Metabolic syndrome was defined according to the 2009 Joint Interim Statement. RESULTS: Patient age was comparable in the dermatomyositis and control groups, and the median disease duration was 1.0 year. An increased prevalence of metabolic syndrome was detected in the dermatomyositis group (34.3% vs. 6.3%; p=0.001). In addition, increased serum adiponectin and resistin levels were noted in contrast to lower leptin levels. In dermatomyositis patients, adipocytokine levels were correlated with the levels of total cholesterol, low-density cholesterol, triglycerides and muscle enzymes. A comparison of dermatomyositis patients with (n=12) and without (n=23) syndrome metabolic revealed that adipocytokine levels were also correlated with age, and that dermatomyositis patients with metabolic syndrome tended to have more disease activity despite similar adipocytokine levels. CONCLUSIONS: Metabolic syndrome is highly prevalent in young adult female dermatomyositis patients and is related to age and disease activity. Moreover, increased serum adiponectin and resistin levels were detected in dermatomyositis patients, but lower serum leptin levels were observed. PMID:28076515

  12. Frequency of Fabry disease in male and female haemodialysis patients in Spain

    PubMed Central

    2010-01-01

    Background Fabry disease (FD), an X-linked lysosomal storage disorder, is caused by a reduced activity of the lysosomal enzyme α-galactosidase A. The disorder ultimately leads to organ damage (including renal failure) in males and females. However, heterozygous females usually present a milder phenotype with a later onset and a slower progression. Methods A combined enzymatic and genetic strategy was used, measuring the activity of α-galactosidase A and genotyping the α-galactosidase A gene (GLA) in dried blood samples (DBS) of 911 patients undergoing haemodialysis in centers across Spain. Results GLA alterations were found in seven unrelated patients (4 males and 3 females). Two novel mutations (p.Gly346AlafsX347 and p.Val199GlyfsX203) were identified as well as a previously described mutation, R118C. The R118C mutation was present in 60% of unrelated patients with GLA causal mutations. The D313Y alteration, considered by some authors as a pseudo-deficiency allele, was also found in two out of seven patients. Conclusions Excluding the controversial D313Y alteration, FD presents a frequency of one in 182 individuals (0.55%) within this population of males and females undergoing haemodialysis. Moreover, our findings suggest that a number of patients with unexplained and atypical symptoms of renal disease may have FD. Screening programmes for FD in populations of individuals presenting severe kidney dysfunction, cardiac alterations or cerebrovascular disease may lead to the diagnosis of FD in those patients, the study of their families and eventually the implementation of a specific therapy. PMID:20122163

  13. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris

    PubMed Central

    Kim, Grace K.

    2012-01-01

    Oral spironolactone has been used for over two decades in the dermatological setting. Although it is not generally considered a primary option in the management of female patients with acne vulgaris, the increase in office visits by post-teenage women with acne vulgaris has recently placed a spotlight on the use of this agent in this subgroup of patients. This article reviews the literature focusing on the use of oral spironolactone in this subset of women with acne vulgaris, including discussions of the recommended starting dose, expected response time, adjustments in therapy, potential adverse effects, and patient monitoring. PMID:22468178

  14. De novo SHANK3 mutation causes Rett syndrome-like phenotype in a female patient.

    PubMed

    Hara, Munetsugu; Ohba, Chihiro; Yamashita, Yushiro; Saitsu, Hirotomo; Matsumoto, Naomichi; Matsuishi, Toyojiro

    2015-07-01

    Rett syndrome (RTT) is a neurodevelopmental disorder predominantly affecting females. Females with the MECP2 mutations exhibit a broad spectrum of clinical manifestations ranging from classical Rett syndrome to asymptomatic carriers. Mutations of genes encoding cyclin-dependent kinase-like 5 (CDKL5) and forkhead box G1 (FOXG1) are also found in early onset RTT variants. Here, we present the first report of a female patient with RTT-like phenotype caused by SHANK3 (SH3 and multiple ankylin repeat domain 3) mutation, indicating that the clinical spectrum of SHANK3 mutations may extend to RTT-like phenotype in addition to (severe) developmental delay, absence of expressive speech, autistic behaviors and intellectual disability.

  15. AIB1 Genomic Amplification Predicts Poor Clinical Outcomes in Female Glioma Patients

    PubMed Central

    Chen, Lihong; Wang, Changwei; Zhang, Xinyuan; Gao, Ke; Liu, Rui; Shi, Bingyin; Hou, Peng

    2016-01-01

    Amplified in breast cancer 1 (AIB1) gene, a coactivator for steroid receptor, is frequently amplified in diverse cancers and is considered as an oncogene in tumorigenesis. However, the prognostic significance of AIB1 amplification in gliomas remains totally unclear. In this study, 115 gliomas and 16 benign meningiomas as control subjects were enrolled, and the copy number of AIB1 was analyzed in these samples. In addition, we explored potential correlation of AIB1 amplification with clinicopathological characteristics and clinical outcomes of glioma patients. Our data showed that glioma samples exhibited a significantly higher AIB1 copy number than control subjects as determined by quantitative polymerase chain reaction (qPCR) approach. Moreover, univariate analysis showed that AIB1 amplification (≥3.5 copies) was strongly correlated with cancer-related death (P =0.03). Interestingly, our data revealed a significant association of AIB1 amplification with WHO grade (P =0.03), tumor recurrence (P =0.03) and survival status (P =0.03) in female patients but not in male patients. Multivariate analysis further demonstrated that AIB1 amplification was independent factor for cancer-related death in female patients. Importantly, AIB1 amplification was closely relevant to worse survival in female patients (P =0.001), but not in male patients (P =1.00). In addition, the patients with AIB1 amplification were resistant to radiotherapy. Altogether, our data demonstrate that AIB1 amplification is a common genetic event in glioma tumorigenesis, and suggest that AIB1 amplification is not only a prognostic factor for poor clinical outcomes in glioma patients, but also a predictor of radiotherapy resistance in gliomas. PMID:27877220

  16. Low Serum Urate Levels Are Associated to Female Gender in Multiple Sclerosis Patients

    PubMed Central

    Zoccolella, Stefano; Tortorella, Carla; Iaffaldano, Pietro; Direnzo, Vita; D’Onghia, Mariangela; Luciannatelli, Elena; Paolicelli, Damiano; Livrea, Paolo; Trojano, Maria

    2012-01-01

    Background Urate is a natural antioxidant and may prevent CNS tissue damage and the clinical manifestations of experimental autoimmune encephalitis. Results from clinical studies are conflicting and the contribution of urate to the pathogenesis of Multiple Sclerosis (MS) remains uncertain. Objective To evaluate serum urate levels in MS patients and their relationships with clinical, demographic and MRI variables. Methods Levels of non-fasting serum uric acid and creatinine were determined by an automated enzymatic assay and glomerular filtration rate was assessed in 245 MS patients, in 252 age/sex-matched neurological controls (NC) and in 59 Healthy controls (HC). Results Median serum urate levels did not differ between MS patients (3.8 mg/dL), HC (4.0 mg/dl) and NC (4.0 mg/dL). Serum urate levels were lower in females than in males in all groups (p = <0.0001). In female-MS, serum urate levels (3.2 mg/dL) were lower compared to those in female HC (3.8; p = 0.01) and NC (3.5 mg/dL; p = 0.02), whereas in male-MS they(4.8 mg/dL) did not differ from those in male HC (4.5 mg/dl) and NC (4.8 mg/dL). Urate concentrations trended to be lower in Clinically isolated syndromes suggestive of MS (3.7 mg/dL) and in relapsing MS (3.7 mg/dL), compared to patients with progressive MS (4.4 mg/dL; p = 0.06), and in patients with an annual relapse rate (ARR) >2 (3.3 mg/dL) than in those with an ARR ≤2: 3.9 mg/dL; p = 0.05). Significant lower serum urate levels were found in females than in males in all clinical MS subtypes (p<0.01), separately evaluated. Female sex (beta: −0.53; p<0.00001) was the most significant determinant of serum urate concentrations in MS patients on multivariate regression analysis. Conclusions Our findings suggest that low urate levels could be of significance in predominantly inflammatory phases of MS even at the early stage and mainly in females. PMID:22848387

  17. Successful pregnancy in a female patient with congenital chloride diarrhea (CLD) and renal impairment.

    PubMed

    Shimizu, Yoshio; Kamoda, Tomohiro; Nagata, Michio; Yoh, Keigyo; Hashimoto, Yuko; Matsui, Akira; Yoshikawa, Hiroyuki; Yamagata, Kunihiro; Koyama, Akio

    2009-01-01

    We report a successful case of pregnancy in a female patient with congenital chloride diarrhea (CLD) and reduced renal function due to interruption of treatment. CLD is an autosomal recessive disorder of intestinal electrolyte absorption caused by mutations in the solute carrier family 26, member 3 (SLC26A3) gene, and continuous production of watery diarrhea induces dehydration, metabolic alkalosis and many kinds of electrolyte disturbances in CLD patients. The patient in our case was a 24-year-old female CLD patient with moderate renal impairment; a renal biopsy specimen showed minimal glomerular changes, but tubulointerstitial damage by crystal formation, consistent with renal function data. One year after our initial examination and reinstitution of therapy, the patient got married and soon conceived. There were no major problems during the course of pregnancy, and the patient successfully delivered a healthy full-term infant vaginally. The symptoms and clinical course of the patient were particularly mild, and we discuss possible reasons for these observations from a perspective of genotype, phenotype and environmental conditions.

  18. Alteration of prolactin serum levels during alcohol withdrawal correlates with craving in female patients.

    PubMed

    Hillemacher, Thomas; Bayerlein, Kristina; Wilhelm, Julia; Reulbach, Udo; Frieling, Helge; Bönsch, Dominikus; Kornhuber, Johannes; Bleich, Stefan

    2005-12-01

    Dopaminergic transmission has been suggested to be a main mechanism mediating reinforcement, withdrawal and craving in alcohol dependency. Dopamine is associated with prolactin secretion, acting as a prolactin inhibitor. The aim of the present study was to investigate whether there is an association between altered prolactin levels and craving during early and late alcohol withdrawal. Therefore, we examined 145 patients suffering from alcohol dependency after admission to the detoxification unit, assessing craving with the Obsessive Compulsive Drinking Scale (OCDS) and measuring prolactin serum levels during early withdrawal (-EW: day 0 or day 1) and late withdrawal (-LW: day 7-day 10). We observed a significant influence of the alteration of prolactin during withdrawal on craving in female patients (Spearman's rho, OCDS-EW: r=-0.607, p=0.001; OCDS-LW: r=-0.730, p<0.001; n=26). The association between prolactin alteration in percentage and craving in females was confirmed with general linear models (OCDS-EW: F=15.819, p=0.001, r(2)=0.530; OCDS-LW: F=17.091, p<0.001, r(2)=0.535). In male patients we did not find any significant results. Our findings support the previously described role of the hypothalamic-pituitary-adrenal (HPA) axis in the neurobiology of alcohol craving and show evidence of an association between increased prolactin serum levels and lower craving during alcohol withdrawal in female patients.

  19. Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses

    PubMed Central

    Liu, Yan; Zhang, Hui; Li, Xiaoqian

    2016-01-01

    Purpose. The current study aimed to evaluate whether combined application of ultrasound and CT had increased Diagnostic Value in Female Patients with Pelvic Masses over either method alone. Patients and Methods. 240 female patients with pelvic masses were detected preoperatively with ultrasound and CT prior to surgery. The sensitivity, specificity, and accuracy of ultrasound, CT, and combined ultrasound/CT application were evaluated, respectively. Results. The sensitivity, specificity, and accuracy of ultrasound were 52.8%, 86.7%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of CT were 80.3%, 90.3%, and 85%, respectively. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were 89%, 94.7%, and 91.7%. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were higher than those of either ultrasound or CT. Conclusions. The combined application of ultrasound and CT had higher Diagnostic Value in Female Patients with Pelvic Masses than either method alone. PMID:27867419

  20. Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses.

    PubMed

    Liu, Yan; Zhang, Hui; Li, Xiaoqian; Qi, Guiqin

    2016-01-01

    Purpose. The current study aimed to evaluate whether combined application of ultrasound and CT had increased Diagnostic Value in Female Patients with Pelvic Masses over either method alone. Patients and Methods. 240 female patients with pelvic masses were detected preoperatively with ultrasound and CT prior to surgery. The sensitivity, specificity, and accuracy of ultrasound, CT, and combined ultrasound/CT application were evaluated, respectively. Results. The sensitivity, specificity, and accuracy of ultrasound were 52.8%, 86.7%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of CT were 80.3%, 90.3%, and 85%, respectively. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were 89%, 94.7%, and 91.7%. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were higher than those of either ultrasound or CT. Conclusions. The combined application of ultrasound and CT had higher Diagnostic Value in Female Patients with Pelvic Masses than either method alone.

  1. FISH analysis of a subtle familial Xp deletion in a female patient with Madelung deformity

    SciTech Connect

    Hsu, T.Y.; Gibson, L.H.; Pober, B.R.

    1994-09-01

    A subtle deletion of Xp [del(X)(p22.32)]was identified by high-resolution chromosome analysis in a twelve-year-old female with short stature (<2 percentile) and Madelung deformity suggestive of Turner syndrome. The proband`s mother, who has short stature (<2 percentile) and demyelinating disorder, also showed this deletion. The maternal grandmother is of normal height and carries two normal X chromosomes. Both the patient and her mother have no other physical abnormalities and are of normal intelligence. To confirm and delineate this Xp deletion, fluorescence in situ hybridization (FISH) was performed on metaphases from the patient and her mother using probes of DXYS20 (a pseudoautosomal locus), DXS232A, and a newly isolated Xp YAC clone, YHX2, whose relative map position is unknown. Hybridization signals of DXS232A were detected on both X chromosomes, and DXYS20 and YHX2 were missing from one of the X`s of both the patient and her mother. YHX2 was thus placed distal to DXS232A (tel-DXYS20-YHX2-S232A-cen). This familial deletion with a breakpoint distal to DXS232A, which is located at -900 Kb telomeric to STS locus, appears to be the smallest Xp deletion reported thus far. Short stature is consistently associated with females carrying Xp deletions. Madelung deformity has been found in some patients with Turner syndrome or Dyschondrosteosis but it has not been reported in patients with Xp deletion. Our results suggest that the phenotype of our patient is associated with her chromosome abnormality. Due to the subtlety of the deletion identified in our patient and her mother, females presenting with short stature warrant careful clinical and cytogenetic evaluation.

  2. Transaxillary Subpectoral Placement of Cardiac Implantable Electronic Devices in Young Female Patients

    PubMed Central

    Oh, Joo Hyun; Kim, Chae Min; Song, Seung Yong; Uhm, Jae Sun; Lew, Dae Hyun

    2017-01-01

    Background The current indications of cardiac implantable electronic devices (CIEDs) have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach. Methods From July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of 20.1 kg/m2. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously. Results One case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others. Conclusions With superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients. PMID:28194345

  3. [Clinical and laboratory features of pheochromocytoma in a 52-year-old female patient].

    PubMed

    Aranguren, Otmara; Mora, Idania Teresa; Cardosa, Maritza; León, Olga; López, María Victoria; Portales, Ramón

    2014-04-22

    The article aims to describe the clinical and laboratory features of a female patient suffering from pheochromocytoma. The case is a 52-year-old female patient who presents to our healthcare center with high blood pressure, cold limbs, sweating, jitteriness, and episodes of oppressive chest pain that appear several times per day. She also reports fatigue and a 13-kilogram weight loss. The sonogram revealed a nodular image in the right adrenal gland that had low echogenicity and regular margins measuring 5 mm. The image was confirmed with a contrast-enhanced adrenal CAT scan. Urine vanillylmandelic acid levels were high and an adrenal biopsy confirmed a pheochromocytoma measuring 4.5 x 3.5 x 3 cm.

  4. Prolactin levels and autoantibodies in female patients with systemic lupus erythematosus.

    PubMed

    Kozáková, D; Rovenský, J; Cebecauer, L; Bosák, V; Jahnová, E; Vigas, M

    2000-01-01

    We investigated the relationships between prolactin (PRL) levels and antibody occurrence in systemic lupus erythematosus (SLE). No significant association between PRL levels and the majority of the autoantibodies studied (anti-U1 RNP, anti-rRNP, anti-Sm, anti-dsDNA, anti-DNP, auto-LCA, anti-EACA) could be confirmed (P > 0.05), anti-Ro/SSA antibodies being an exception. Our results showed significantly increased frequencies of these antibodies in the group of female SLE patients with normal PRL levels (< 20 micrograms/L): anti Ro/SSA in 53% (P < 0.025, chi 2 = 5.80, RR = 4.0) and anti-Ro/SSA + anti-Ro/La in 60% (P < 0.05, chi 2 = 4.05) compared with female SLE patients with hyperprolactinemia.

  5. Gender Identity and Gender Role in DSD Patients Raised as Females: A Preliminary Outcome Study.

    PubMed

    Ercan, Oya; Kutlug, Seyhan; Uysal, Omer; Alikasifoglu, Mujgan; Inceoglu, Derya

    2013-01-01

    Gender identity and gender role are expected to be consistent with gender assignment for optimal DSD management outcome. To our knowledge, our study is the first to attempt evaluation of gender related outcomes in Turkish DSD patients. After receiving institutional ethical board approval and subject (or parent) informed consent, subjects with DSD raised as girls (22 patients 46 XX DSD, 11 patients 46 XY DSD) answered 566 questions of the Minnesota Multiphasic Personality Inventory (MMPI) questionnaire including 60-item Masculinity-Femininity (MF) subscale which was the focus in this study. Controls (n: 50) were females similar to the probands in age, level of education, relationship status, and having a job or not also answered all questions. The answers were evaluated by a trained psychologist (Derya Inceoglu) on MMPI. For statistical purposes, seven findings were obtained from the data related to the MF subscale from the patients and controls. Of these seven findings (S1-S7), two were associated with masculinity (S3-S4) and another two were associated with femininity (S5-S6). In DSD patients, the percentages of masculinity findings were significantly higher when compared to controls (p < 0.001 and p < 0.001 for S3 and S4, respectively). In controls, the percentages of femininity findings were significantly higher when compared to DSD females (p < 0.001 and p < 0.001 for S5 and S6 respectively). There was no significant difference between 46 XX DSD patients and 46 XY DSD patients with respect to the percentage of any of the seven findings. Two patients requested gender change to male; only these two patients had the finding stating that sexual impulses could come to existence as actions (S7). In conclusion efforts to identify modifiable factors with negative impact and thus modifying them, and professional guidance may be important in minimizing the encountered gender related problems in DSD patients.

  6. Determinants of sexual disability and dissatisfaction in female patients with rheumatoid arthritis.

    PubMed

    Abdel-Nasser, Ahmed M; Ali, Essam I

    2006-11-01

    Previous research has identified two main problems of sexuality in female rheumatoid arthritis (RA) patients: difficulties in sexual performance and diminution of sexual desire and satisfaction. This study attempts to determine the clinical and psychological factors significantly contributing to sexual disability and dissatisfaction in female RA patients. Ninety consecutive female RA outpatients were assessed by a gynecologist. After excluding patients who were not sexually active and those with genital tract abnormalities, 52 patients were examined and investigated rheumatologically and given questionnaires assessing sexual performance, desire, and satisfaction, as well as demographic variables, pain, disability, anxiety, and depression. Following a correlation analysis, the contributions of demographic, disease, and psychological variables to sexual disability and dissatisfaction were explored by hierarchical and stepwise regression. Thirty-two patients (62%) had difficulties in sexual performance including nine patients (17%) who were totally unable to engage in sexual intercourse because of arthritis. Sexual desire or satisfaction were diminished in 24 patients (46%) and completely lost in 24 patients (46%). Sexual disability was not significantly correlated with any psychodemographic variables, but with parameters of disease activity (p<0.001), Health Assessment Questionnaire (HAQ)-disability (p<0.001), hip (p<0.001) but not knee joint disease, seropositivity (p<0.05), and diminished desire (p<0.05). However, HAQ-disability and hip joint disease were the only independent and significant determinants of sexual disability in the regression model after controlling for the effects of age and disease duration. These variables together explained 64% of the variance of sexual disability. On the other hand, pain (p<0.001), age (p<0.05), and depression (p<0.05) were the significant determinants in the regression model for sexual dissatisfaction, all together

  7. Occurrence of epidermolysis bullosa along with Amelogenesis imperfecta in female patient of India.

    PubMed

    Javed, A P; Shenai, Prashanth; Chatra, Laxmikanth; Veena, K M; Rao, Prasanna Kumar; Prabhu, Rachana

    2013-11-01

    Epidermolysis bullosa (EB) is an inherited disorder, which is characteristically presented as skin blisters developing in response to minor injury. Junctional variety of EB is also associated with enamel hypoplasia. Amelogenesis imperfecta presents with abnormal formation of the enamel both in deciduous and permanent dentition. This article describes a previously unreported case of Amelogenesis imperfecta with complete loss of enamel in a young female patient with EB.

  8. Epigenetic abnormality of SRY gene in the adult XY female with pericentric inversion of the Y chromosome.

    PubMed

    Mitsuhashi, Tomoko; Warita, Katsuhiko; Sugawara, Teruo; Tabuchi, Yoshiaki; Takasaki, Ichiro; Kondo, Takashi; Hayashi, Fumio; Wang, Zhi-Yu; Matsumoto, Yoshiki; Miki, Takanori; Takeuchi, Yoshiki; Ebina, Yasuhiko; Yamada, Hideto; Sakuragi, Noriaki; Yokoyama, Toshifumi; Nanmori, Takashi; Kitagawa, Hiroshi; Kant, Jeffrey A; Hoshi, Nobuhiko

    2010-06-01

    In normal ontogenetic development, the expression of the sex-determining region of the Y chromosome (SRY) gene, involved in the first step of male sex differentiation, is spatiotemporally regulated in an elaborate fashion. SRY is expressed in germ cells and Sertoli cells in adult testes. However, only few reports have focused on the expressions of SRY and the other sex-determining genes in both the classical organ developing through these genes (gonad) and the peripheral tissue (skin) of adult XY females. In this study, we examined the gonadal tissue and fibroblasts of a 17-year-old woman suspected of having disorders of sexual differentiation by cytogenetic, histological, and molecular analyses. The patient was found to have the 46,X,inv(Y)(p11.2q11.2) karyotype and streak gonads with abnormally prolonged SRY expression. The sex-determining gene expressions in the patient-derived fibroblasts were significantly changed relative to those from a normal male. Further, the acetylated histone H3 levels in the SRY region were significantly high relative to those of the normal male. As SRY is epistatic in the sex-determination pathway, the prolonged SRY expression possibly induced a destabilizing effect on the expressions of the downstream sex-determining genes. Collectively, alterations in the sex-determining gene expressions persisted in association with disorders of sexual differentiation not only in the streak gonads but also in the skin of the patient. The findings suggest that correct regulation of SRY expression is crucial for normal male sex differentiation, even if SRY is translated normally.

  9. Adrenocortical response to low-dose ACTH test in female patients with rheumatoid arthritis.

    PubMed

    Radikova, Zofia; Rovensky, Jozef; Vlcek, Miroslav; Penesova, Adela; Kerlik, Jana; Vigas, Milan; Imrich, Richard

    2008-12-01

    Alterations in adrenal steroid production have been suggested in females with rheumatoid arthritis (RA). The aim of the present study was to assess adrenocortical function in RA females. We examined 11 female RA patients (RA: age 30 +/- 2 years, BMI 21.0 +/- 0.7 kg/m(2)) and 10 matched healthy controls (C: age 31 +/- 1 years, BMI 21.6 +/- 0.6 kg/m(2)). Low-dose adrenocorticotropic hormone (ACTH) test (i.v. bolus of 1 microg synthetic ACTH) was performed at 10.00 h with blood sampling every 15 min for 90 min. Cortisol, 17-OH-progesterone (17OHP), androstenedione (ASD), and dehydroepiandrosterone (DHEA) were assayed in plasma. Baseline cortisol levels were higher in RA patients (RA: 385 +/- 38 versus C: 229 +/- 28 nmol/L, P= 0.007). In both study groups, ACTH administration increased all the four steroids measured (P < 0.001). Cortisol response to ACTH administration was diminished in RA patients when compared to controls (Delta(max): 284 +/- 24 in RA versus 424 +/- 31 nmol/L in C, P= 0.002). ACTH-induced maximal rise in plasma DHEA was significantly lower in RA patients when compared to controls (Delta(max): 2.59 +/- 0.68 in RA versus 5.57 +/- 1.25 ng/mL in C, P= 0.015). No significant between-groups differences were found in responses of ASD or 17OHP. The molar ratio of ASD:cortisol was significantly lower (P < 0.05) in RA patients at base line, but did not differ during ACTH test. After ACTH bolus, the cortisol:17OHP ratio decreased significantly in the RA group (P < 0.001), whereas there was no change in the control group. The present results show decreased secretion of cortisol and DHEA in RA patients in response to ACTH, suggesting a subtle HPA hypofunction at the adrenocortical level.

  10. Decreased functional connectivity density in pain-related brain regions of female migraine patients without aura.

    PubMed

    Gao, Qing; Xu, Fei; Jiang, Cui; Chen, Zhifeng; Chen, Huafu; Liao, Huaqiang; Zhao, Ling

    2016-02-01

    Migraine is one of the most prevalent neurological disorders which is suggested to be associated with dysfunctions of the central nervous system. The purpose of the present study was to detect the altered functional connectivity architecture in the large-scale network of the whole brain in migraine without aura (MWoA). Meanwhile, the brain functional hubs which are targeted by MWoA could be identified. A new voxel-based method named functional connectivity density (FCD) mapping was applied to resting-state functional magnetic resonance imaging data of 55 female MWoA patients and 44 age-matched female healthy controls (HC). Comparing to HC, MWoA patients showed abnormal short-range FCD values in bilateral hippocampus, bilateral insula, right amygdale, right anterior cingulate cortex, bilateral putamen, bilateral caudate nucleus and the prefrontal cortex. The results suggested decreased intraregional connectivity of these pain-related brain regions in female MWoA. In addition, short-range FCD values in left prefrontal cortex, putamen and caudate nucleus were significantly negatively correlated with duration of disease in MWoA group, implying the repeated migraine attacks over time may consistently affect the resting-state functional connectivity architecture of these brain hubs. Our findings revealed the dysfunction of brain hubs in female MWoA, and suggested the left prefrontal cortex, putamen and caudate nucleus served as sensitive neuroimaging markers for reflecting the disease duration of female MWoA. This may provide us new insights into the changes in the organization of the large-scale brain network in MWoA.

  11. Effect of Leptin Replacement on PCSK9 in ob/ob Mice and Female Lipodystrophic Patients.

    PubMed

    Levenson, Amy E; Haas, Mary E; Miao, Ji; Brown, Rebecca J; de Ferranti, Sarah D; Muniyappa, Ranganath; Biddinger, Sudha B

    2016-04-01

    Leptin treatment has beneficial effects on plasma lipids in patients with lipodystrophy, but the underlying mechanism is unknown. Proprotein convertase subtilisin/kexin type 9 (PCSK9) decreases low-density lipoprotein (LDL) clearance, promotes hypercholesterolemia, and has recently emerged as a novel therapeutic target. To determine the effect of leptin on PCSK9, we treated male and female ob/ob mice with leptin for 4 days via sc osmotic pumps (∼24 μg/d). Leptin reduced body weight and food intake in all mice, but the effects of leptin on plasma PCSK9 and lipids differed markedly between the sexes. In male mice, leptin suppressed PCSK9 but had no effect on plasma triglycerides or cholesterol. In female mice, leptin suppressed plasma triglycerides and cholesterol but had no effect on plasma PCSK9. In parallel, we treated female lipodystrophic patients (8 females, ages 5-23 y) with sc metreleptin injections (∼4.4 mg/d) for 4-6 months. In this case, leptin reduced plasma PCSK9 by 26% (298 ± 109 vs 221 ± 102 ng/mL; n = 8; P = .008), and the change in PCSK9 was correlated with a decrease in LDL cholesterol (r(2) = 0.564, P = .03). In summary, in leptin-deficient ob/ob mice, the effects of leptin on PCSK9 and plasma lipids appeared to be independent of one another and strongly modified by sex. On the other hand, in lipodystrophic females, leptin treatment reduced plasma PCSK9 in parallel with LDL cholesterol.

  12. Body positions and movement patterns in female patients with congenital adrenal hyperplasia.

    PubMed

    Dittmann, R W

    1992-12-01

    Female patients with congenital adrenal hyperplasia (CAH; N = 33; 11-41 years), simple-virilizing (SV) patients (N = 19), salt-wasting (SW) patients (N = 13), and sister controls (N = 14) were compared with regard to their body positions and movement patterns. Data collection comprised both self assessments and mothers' assessments using 20 sex-dimorphic items with corresponding "more masculine" and "more feminine" versions for each variable, represented in photographs (forced-choice approach). Primarily based on mothers' assessments, single-item results suggested slightly more masculine positions and patterns for female CAH patients compared to sisters, for SW patients more distinct than for SV patients. Results from an 11-item scale ("motor behavior", alpha = 0.59) revealed differences between SW (more masculine) and SV patients for self assessments (P, one-tailed, < 0.09); sisters were in an intermediate position closer to the SV patients. According to mothers' assessments, the CAH patient group as a whole differed (more masculine) from sisters (P < 0.06); this finding was mainly accounted for by the SW group (P < 0.04). Complex analyses on the relationship of motor behavior and intervening variables (e.g., postnatal androgenization, onset of puberty, menarche, height, weight, sexual orientation) revealed very few significant results. Findings rather suggested organizational hormonal effects on body positions and movements prenatally; they are in line with main results from the interview section of the Hamburg CAH study (e.g., "Gender-related behavior"). An approach of this kind seems to be justified for investigating motor behavior in future psychoendocrine studies.

  13. Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

    PubMed Central

    Zhang, Shu; Jiang, Zhi-Wei; Wang, Gang; Feng, Xiao-Bo; Liu, Jiang; Zhao, Jian; Li, Jie-Shou

    2015-01-01

    AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction (TVSE) for gastric cancer patients. METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE. RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3 (range, 42-69) years, and the mean body mass index was 23.2 (range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224 (range, 200-298) min and 62.5 (range, 50-150) mL, respectively. The mean postoperative hospital stay was 3.6 (range, 3-5) d. The mean number of lymph nodes resected was 23.6 (range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected. CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients. PMID:26715817

  14. Factitious proteinuria - the most dominant feature in a young female patient with Munchausen syndrome.

    PubMed

    Lela, Ivana Vuković; Karanović, Sandra; Matišić, Danica; Kuzmanić, Duško; C Orić, Marijana; Šimić, Mirjana; Jelaković, Bojan

    2013-02-01

    Munchausen syndrome is a factitious disorder with predominantly physical signs and symptoms, resulting from the patient's high motivation for assuming a sick role, without any external incentives or boundaries. We report the case of a young female patient with factitious proteinuria in the nephrotic range and a fairly eventful medical history. After performing many expensive and unnecessary investigations and procedures,the real origin of the proteinuria was determined;it was found to be caused by the patient carefully adding calibrated egg albumin to her urine samples. This discovery roused suspicions about multiple, non-corroborated conditions from her history (e.g., multiple miscarriages, breast cancer, and thyroid disorders).The diversity of diseases presented by a single Munchausen patient tends to be bizarre,and thus is a challenge for health care providers to diagnose the condition. Teamwork is therefore of the utmost necessity to diagnose Munchausen syndrome.

  15. The first isolation of Zika virus from a Japanese patient who returned to Japan from Fiji in 2016.

    PubMed

    Taira, Masakatsu; Ogawa, Tomoko; Nishijima, Haruna; Yamamoto, Kojiro; Hotta, Chiemi; Akita, Mamiko; Tajima, Shigeru; Saijo, Masayuki

    2017-03-28

    Outbreaks of Zika virus (ZIKV) infection in tropical and subtropical regions are cause of worldwide concern and represents a public health emergency. ZIKV was isolated from a 17-year-old patient with fever and maculopapular rash. The patient returned to Japan from the Republic of Fiji in late April 2016. The complete genome sequence of the ZIKV isolate, ZIKV/Hu/S36/Chiba/2016, which might be the first strain to be isolated in Japan, was determined and reported.

  16. Pulmonary neuroendocrine tumor in a female wolf (Canis lupus lupus)

    PubMed Central

    SHIRAKI, Ayako; YOSHIDA, Toshinori; KAWASHIMA, Masahi; MURAYAMA, Hirotada; NAGAHARA, Rei; ITO, Nanao; SHIBUTANI, Makoto

    2017-01-01

    A 17-year-old female wolf (Canis lupus lupus) had a right lung mass that was adhered to the thoracic cavity. Histopathological examination revealed that the mass consisted of sheets, cord or ribbon-like structures of monotonous, small, cuboidal cells with round, oval or short-spindle nuclei and scant clear cytoplasm, demarcated by a fine fibrovascular stroma. Focal necrosis, congestion and thrombi were observed. Immunohistochemically, the tumor cells diffusely expressed cytokeratin AE1/AE3, and some expressed chromogranin A, neural cell adhesion molecule (CD56) and thyroid transcription factor-1. The number of proliferating cell nuclear antigen-positive tumor cells was low. A diagnosis of pulmonary neuroendocrine tumor was based on the resemblance to carcinoids. PMID:28190820

  17. Increased serum levels of C21 steroids in female patients with multiple sclerosis.

    PubMed

    Kanceva, R; Stárka, L; Kancheva, L; Hill, M; Veliková, M; Havrdová, E

    2015-01-01

    Multiple sclerosis (MS) is one of the most common neurological diseases. This neurodegenerative autoimmune disease manifests as inflammatory and demyelinating impairment of the central nervous system (CNS). Although some studies demonstrated associations between altered steroidogenesis and pathophysiology of MS as well as the importance of steroids in the pathophysiology of MS, the knowledge concerning the steroid metabolome in female patients is limited. Hence, 51 steroids and steroid polar conjugates were measured in the serum of 12 women with MS, untreated with steroids and 6 age-corresponding female controls with the use of gas chromatography - mass spectrometry (GC-MS). The data were processed using age adjusted ANCOVA, receiver operating characteristics (ROC) analysis and orthogonal projections to latent structures (OPLS). Our data show higher levels of circulating C21 steroids including steroid modulators of ionotropic type A gamma-aminobutyric acid (GABA A) receptors and glutamate receptors. Furthermore, the levels of GABAergic androsterone and 5-androsten-3beta,7alpha,17beta-triol were also higher in the female MS patients. In conclusion, the data demonstrate higher levels of circulating C21 steroids and their polar conjugates and some bioactive C19 steroids in women with MS, which may influence neuronal activity and affect the balance between neuroprotection and excitotoxicity.

  18. The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients.

    PubMed

    Rehman, J; Lazer, S; Benet, A E; Schaefer, L C; Melman, A

    1999-02-01

    From 1980 to July 1997 sixty-one male-to-female gender transformation surgeries were performed at our university center by one author (A.M.). Data were collected from patients who had surgery up to 1994 (n = 47) to obtain a minimum follow-up of 3 years; 28 patients were contacted. A mail questionnaire was supplemented by personal interviews with 11 patients and telephone interviews with remaining patients to obtain and clarify additional information. Physical and functional results of surgery were judged to be good, with few patients requiring additional corrective surgery. General satisfaction was expressed over the quality of cosmetic (normal appearing genitalia) and functional (ability to perceive orgasm) results. Follow-up showed satisfied who believed they had normal appearing genitalia and the ability to experience orgasm. Most patients were able to return to their jobs and live a more satisfactory social and personal life. One significant outcome was the importance of proper preparation of patients for surgery and especially the need for additional postoperative psychotherapy. None of the patients regretted having had surgery. However, some were, to a degree, disappointed because of difficulties experienced postoperatively in adjusting satisfactorily as women both in their relationships with men and in living their lives generally as women. Findings of this study make a strong case for making a change in the Harry Benjamin Standards of Care to include a period of postoperative psychotherapy.

  19. Psychosocial reaction patterns to alopecia in female patients with gynecological cancer undergoing chemotherapy.

    PubMed

    Ishida, Kazuko; Ishida, Junko; Kiyoko, Kanda

    2015-01-01

    This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing

  20. Valproic Acid and topiramate induced hyperammonemic encephalopathy in a patient with normal serum carnitine.

    PubMed

    Blackford, Martha G; Do, Stephanie T; Enlow, Thomas C; Reed, Michael D

    2013-04-01

    A 17-year-old female developed hyperammonemic encephalopathy 2 weeks after valproic acid (VPA), 500 mg twice a day, was added to her regimen of topiramate (TPM), 200 mg twice a day. She presented to the emergency department (ED) with altered mental status, hypotension, bradycardia, and lethargy. Laboratory analysis showed mild non-anion gap hyperchloremic acidosis, serum VPA concentration of 86 mg/L, and urine drug screen result that was positive for marijuana. She was admitted to the pediatric intensive care unit for persistent symptoms, prolonged QTc, and medical history. Blood ammonia concentrations were obtained because of her persistent altered mental status, initially 94 μmol/L and a peak of 252 μmol/L. A serum carnitine profile was obtained at the time of hyperammonemia and was found to be normal (results were available postdischarge). VPA and TPM were discontinued on day 1 and day 2, respectively, as the patient's blood ammonia concentration remained elevated. On day 3, her mental status had returned to baseline, and blood ammonia concentrations trended downward; by day 4 her blood ammonia concentration was 23 μmol/L. VPA has been associated with numerous side effects including hyperammonemia and encephalopathy. Recently, drug interactions with TPM and VPA have been reported; however, serum carnitine concentrations have not been available. We discuss the possible mechanisms that VPA and TPM may affect serum ammonia and carnitine concentrations and the use of levocarnitine for patients or treating toxicity.

  1. Valproic Acid and Topiramate Induced Hyperammonemic Encephalopathy in a Patient With Normal Serum Carnitine

    PubMed Central

    Blackford, Martha G.; Do, Stephanie T.; Enlow, Thomas C.; Reed, Michael D.

    2013-01-01

    A 17-year-old female developed hyperammonemic encephalopathy 2 weeks after valproic acid (VPA), 500 mg twice a day, was added to her regimen of topiramate (TPM), 200 mg twice a day. She presented to the emergency department (ED) with altered mental status, hypotension, bradycardia, and lethargy. Laboratory analysis showed mild non-anion gap hyperchloremic acidosis, serum VPA concentration of 86 mg/L, and urine drug screen result that was positive for marijuana. She was admitted to the pediatric intensive care unit for persistent symptoms, prolonged QTc, and medical history. Blood ammonia concentrations were obtained because of her persistent altered mental status, initially 94 μmol/L and a peak of 252 μmol/L. A serum carnitine profile was obtained at the time of hyperammonemia and was found to be normal (results were available postdischarge). VPA and TPM were discontinued on day 1 and day 2, respectively, as the patient's blood ammonia concentration remained elevated. On day 3, her mental status had returned to baseline, and blood ammonia concentrations trended downward; by day 4 her blood ammonia concentration was 23 μmol/L. VPA has been associated with numerous side effects including hyperammonemia and encephalopathy. Recently, drug interactions with TPM and VPA have been reported; however, serum carnitine concentrations have not been available. We discuss the possible mechanisms that VPA and TPM may affect serum ammonia and carnitine concentrations and the use of levocarnitine for patients or treating toxicity. PMID:23798907

  2. Health concerns related to radiation exposure of the female nuclear medicine patient.

    PubMed Central

    Stabin, M G

    1997-01-01

    The female nuclear medicine patient is of special concern in evaluating radiation dose and risk in nuclear medicine. The female's overall body size and organ sizes generally are smaller than those of her male counterpart (thus her radiation doses will be higher, given the same amounts of administered activity and similar biokinetics); female gonads are inside the body instead of outside and are near several organs often important as source organs in internal dosimetry (urinary bladder, liver, kidneys, intestines); risk of breast cancer is significantly higher among females than males; and in the case of pregnancy, exposure to radiation of the embryo/fetus and the nursing infant are of special concern in such an analysis. All these concerns are addressed in this study through a comparative study of radiation doses for males and females over a large number (approximately 60) of nuclear medicine studies and through a study of what is known about radiation dosimetry in pregnancy and breast feeding. It was found that women's critical organ doses and effective doses (as defined by the International Commission on Radiological Protection 60 [ICRP 60] are about 25% higher than those for men across all these studies. Women's gonad doses, however, may be as much as 10 to 30 times higher than those in men, although 2- to 3-fold differences are common. Many radiopharmaceuticals are administered to women of childbearing age; however, little is known about how much activity crosses the placenta and about the biokinetics in the fetus should it occur. Nonetheless, dose estimates are provided at four stages of pregnancy (early, 3-month, 6-month, and 9-month gestation) for a large number of radiopharmaceuticals, whether or not quantitative estimates of placental crossover can be made. Many radiopharmaceuticals are also excreted in breast milk of nursing mothers. Breast feeding interruption schedules are suggested through analysis of the observed kinetics of these pharmaceuticals and

  3. The evolution of a token economy programme for female chronic schizophrenic patients.

    PubMed

    Butler, R J

    1979-05-01

    Token economy programmes are becoming an increasingly familiar sight in British psychiatric hospitals, yet many remain inflexible and prone to breakdown after a period in operation. This paper describes the evolution of a token economy for female chronic schizophrenic patients, where the nursing staff with minimal 'psychological' support and in dealing with a programme free of research constraints, aimed to increase the therapeutic potential of the system. The major developments arose from the need: (i) to extinguish the emergence of undesirable behaviour; (2) to develop a more individualized approach to treating patients' problems; (3) to keep consistent adequate records; (4) to re-establish contact with the community and (5) to cater for patients' varied responses to treatment.

  4. Long-Term Effects of Continuous Positive Airway Pressure Treatment on Sexuality in Female Patients with Obstructive Sleep Apnea

    PubMed Central

    Petersen, Marian; Kristensen, Ellids; Berg, Søren; Midgren, Bengt

    2013-01-01

    Introduction Results from a previous study showed that sexuality was negatively affected in females with untreated obstructive sleep apnea (OSA). Data are sparse on the long-term effects of nocturnal continuous positive airway pressure (CPAP) treatment on sexual difficulties and sexual distress in female patients with OSA. Aim The aim of the present study was to investigate the effects after 1 year of CPAP treatment on sexual difficulties, sexual distress, and manifest sexual dysfunction in female patients with OSA. The effect of CPAP on life satisfaction was also investigated. Methods Fifty-four therapy-compliant, female patients (age 22–71) received a survey before and after 1 year of nocturnal CPAP treatment. The questions on this survey were drawn from three self-administered questionnaires: two on sexuality and one on life satisfaction. The results were compared with a population sample. The Epworth Sleepiness Scale was used for assessment of daytime sleepiness. Main Outcome Measures The Female Sexual Function Index, Female Sexual Distress Scale, Manifest Female Sexual Dysfunction, four questions from Life Satisfaction 11, and the Epworth Sleepiness Scale were all used to measure outcome. Results In total, 44 patients responded to the survey (81% response rate). The results were a significant, positive change in manifest female sexual dysfunction, but no significant changes in isolated sexual difficulties or sexual distress. Daytime sleepiness significantly decreased after 1 year. The results from the Life Satisfaction 11 questionnaire remained unchanged after 1 year. Conclusions After 1 year of CPAP treatment, female patients with OSA reported reduced manifest sexual dysfunction. However, it cannot be concluded if this result is due to CPAP treatment alone. Furthermore, reduced daytime tiredness was found in the surveyed population. CPAP treatment, per se, does not seem to affect partner relationships. Petersen M, Kristensen E, Berg S, and Midgren B. Long

  5. Variables related to behavioral and emotional problems and gender typed behaviors in female patients with congenital adrenal hyperplasia.

    PubMed

    Oner, Ozgur; Aycan, Zehra; Tiryaki, Tugrul; Soy, Derya; Cetinkaya, Ergun; Kibar, Esin

    2009-02-01

    We investigated the effects of type of congenital adrenal hyperplasia (CAH), treatment, endocrinological, surgical, and socio-demographic factors as well as patients' body perception on the gender-typed play and behavioral and emotional problems in female children with CAH. The sample included 28 females with CAH (mean age: 12.6 years). We compared patients with CAH to 28 age-matched patients with type 1 diabetes mellitus and 28 healthy controls. Patients with CAH had significantly higher externalization and total problems scores and were less interested in typically female behaviors. The behavioral and emotional problems in patients with CAH were associated with patient satisfaction with the appearance of their genitalia, the surgeons' assessment of the success of the surgical procedures, and mean testosterone level. Our results showed the severity of the behavioral and emotional problems was associated with severity of androgenization, patients' perception of their genitalia and the surgical outcome.

  6. Impact of Radiotherapy on Fertility, Pregnancy, and Neonatal Outcomes in Female Cancer Patients

    SciTech Connect

    Wo, Jennifer Y.; Viswanathan, Akila N.

    2009-04-01

    Purpose: Radiation has many potential long-term effects on cancer survivors. Female cancer patients may experience decreased fertility depending on the site irradiated. Oncologists should be aware of these consequences and discuss options for fertility preservation before initiating therapy. Methods and Materials: A comprehensive review of the existing literature was conducted. Studies reporting the outcomes for female patients treated with cranio-spinal, abdominal, or pelvic radiation reporting fertility, pregnancy, or neonatal-related outcomes were reviewed. Results: Cranio-spinal irradiation elicited significant hormonal changes in women that affected their ability to become pregnant later in life. Women treated with abdomino-pelvic radiation have an increased rate of uterine dysfunction leading to miscarriage, preterm labor, low birth weight, and placental abnormalities. Early menopause results from low-dose ovarian radiation. Ovarian transposition may decrease the rates of ovarian dysfunction. Conclusions: There is a dose-dependent relationship between ovarian radiation therapy (RT) and premature menopause. Patients treated with RT must be aware of the impact of treatment on fertility and explore appropriate options.

  7. Relationship between biological factors and catastrophizing and clinical outcomes for female patients with knee osteoarthritis

    PubMed Central

    Ikemoto, Tatsunori; Miyagawa, Hirofumi; Shiro, Yukiko; Arai, Young-Chang Park; Akao, Machiko; Murotani, Kenta; Ushida, Takahiro; Deie, Masataka

    2017-01-01

    AIM To investigate the correlations between clinical outcomes and biopsychological variables in female patients with knee osteoarthritis (OA). METHODS Seventy-seven patients with symptomatic knee OA were enrolled in this study. We investigated the age, body mass index (BMI), pain catastrophizing scale (PCS) and radiographic severity of bilateral knees using a Kellgren-Lawrence (K-L) grading system of the subjects. Subsequently, a multiple linear regression was conducted to determine which variables best correlated with main outcomes of knee OA, which were pain severity, moving capacity by measuring timed-up-and-go test and Japanese Knee Osteoarthritis Measure (JKOM). RESULTS We found that the significant contributor to pain severity was PCS (β = 0.555) and BMI (β = 0.239), to moving capacity was K-L grade (β = 0.520) and to PCS (β = 0.313), and to a JKOM score was PCS (β = 0.485) and K-L grade (β = 0.421), respectively. CONCLUSION The results suggest that pain catastrophizing as well as biological factors were associated with clinical outcomes in female patients with knee OA, irrespective of radiographic severity. PMID:28361021

  8. Hypercalcemia in a male-to-female transgender patient after body contouring injections: a case report

    PubMed Central

    2014-01-01

    Introduction Body contouring injections by non-licensed providers are frequently sought out by a subset of the male-to-female transgender community. Although short-term side effects such as pulmonary embolism and injection site infection are well known, long-term consequences of such practices are less well studied. Case presentation Here we describe the case of a 40-year-old African American male-to-female transgender patient who presented to our institution with hypercalcemia and acute renal failure secondary to body contouring injections with industrial strength silicone by non-licensed providers, a decade prior to her visit. Work-up revealed an extensive granulomatous inflammatory process in the injection area resulting in electrolyte abnormalities and kidney injury. The patient’s lab results and symptoms responded well to long-term corticosteroid treatment and correlated with treatment adherence. Conclusion Affected patients can sometimes present with unusual clinical symptoms many years after silicone injections. In a constantly growing transgender community that often utilizes non-licensed providers for silicone injections, the medical community will likely face an increasing number of patients with long-term side effects of such practices. Therefore, it is imperative for physicians to recognize such cases promptly and initiate potentially life-saving treatment. PMID:24572248

  9. Association between TLR-9 polymorphisms and colon cancer susceptibility in Saudi Arabian female patients

    PubMed Central

    Semlali, Abdelhabib; Parine, Narasimha Reddy; Al Amri, Abdullah; Azzi, Arezki; Arafah, Maha; Kohailan, Muhammad; Shaik, Jilani P; Almadi, Majid Abdulrahman; Aljebreen, Abdulrahman M; Alharbi, Othman; Ali Azzam, Nahla; Rouabhia, Mahmoud; Alanazi, Mohammad Saud

    2017-01-01

    Objective The authors aimed to explore the relationship between the expression/polymorphisms of TLR-9 and susceptibility to colon cancer development in the Saudi Arabian population. Methods In total, blood samples from 115 patients with colon cancer and 102 participants without colon cancer were analyzed in this study. Three single-nucleotide polymorphisms (SNPs) were selected from the TLR-9 gene, including two sites within the TLR-9 gene’s promoter region (rs352144 and rs187084) and one site in a TLR-9 intron region (rs5743839). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed from logistic regression models after adjusting for age, gender, and tumor localization. To investigate the differential expression of TLR-9 in colon cancer, TLR-9 expression was evaluated using quantitative real-time reverse transcription polymerase chain reaction on 40 matched normal and colon tissues. Results The authors found that TLR-9 expression was decreased in colon cancer tissues as compared with that in normal tissues. Moreover, significant associations between the TLR-9 rs187084 SNP and colon cancer risk were observed in female patients only. In rs187084, the T allele had a significantly lower frequency (2.8 times) in female cancer patients than in controls (0.27 vs 0.41). The TLR-9 rs352139 and rs352144 SNPs were significantly associated with colon cancer development when the tumor was located in the rectal area. Conclusion The findings support the hypothesis that TLR-9 has an anticancer role in colon cancer development. Furthermore, genetic variation may influence colon cancer development, and SNPs in TLR-9 could serve as biomarkers for decision making in the treatment of females with rectal cancer. PMID:28031717

  10. Gender Identity and Gender Role in DSD Patients Raised as Females: A Preliminary Outcome Study

    PubMed Central

    Ercan, Oya; Kutlug, Seyhan; Uysal, Omer; Alikasifoglu, Mujgan; Inceoglu, Derya

    2013-01-01

    Gender identity and gender role are expected to be consistent with gender assignment for optimal DSD management outcome. To our knowledge, our study is the first to attempt evaluation of gender related outcomes in Turkish DSD patients. After receiving institutional ethical board approval and subject (or parent) informed consent, subjects with DSD raised as girls (22 patients 46 XX DSD, 11 patients 46 XY DSD) answered 566 questions of the Minnesota Multiphasic Personality Inventory (MMPI) questionnaire including 60-item Masculinity-Femininity (MF) subscale which was the focus in this study. Controls (n: 50) were females similar to the probands in age, level of education, relationship status, and having a job or not also answered all questions. The answers were evaluated by a trained psychologist (Derya Inceoglu) on MMPI. For statistical purposes, seven findings were obtained from the data related to the MF subscale from the patients and controls. Of these seven findings (S1–S7), two were associated with masculinity (S3–S4) and another two were associated with femininity (S5–S6). In DSD patients, the percentages of masculinity findings were significantly higher when compared to controls (p < 0.001 and p < 0.001 for S3 and S4, respectively). In controls, the percentages of femininity findings were significantly higher when compared to DSD females (p < 0.001 and p < 0.001 for S5 and S6 respectively). There was no significant difference between 46 XX DSD patients and 46 XY DSD patients with respect to the percentage of any of the seven findings. Two patients requested gender change to male; only these two patients had the finding stating that sexual impulses could come to existence as actions (S7). In conclusion efforts to identify modifiable factors with negative impact and thus modifying them, and professional guidance may be important in minimizing the encountered gender related problems in DSD patients. PMID:23874323

  11. Primary mucinous adenocarcinoma of the larynx in female patient: a rare entity.

    PubMed

    Ebru, Tastekin; Omer, Yalcin; Fulya, Oz Puyan; Ufuk, Usta; Kemal, Kutlu

    2012-10-01

    Laryngeal malignant tumors are mainly composed of squamous cell carcinomas. Glandular carcinomas of the larynx are rare tumors that constitute less than 1% of all laryngeal malignancies where "adenocarcinoma not otherwise specified" is the most common histologic subtype. Here we report a case of a 70-year-old female patient with primary laryngeal mucinous adenocarcinoma. The rarity of the tumor type and the differential diagnosis of this tumor before reporting it as a primary adenocarcinoma of the larynx are discussed here with literature findings.

  12. An elderly female patient with tardive oromandibular dystonia after prolonged use of the histamine analog betahistine.

    PubMed

    De Riu, G; Sanna, M P; De Riu, P L

    2010-10-01

    Tardive oromandibular dystonia (OMD) is iatrogenic in origin and is characterised by orofacial and lingual stereotypes more frequently than the idiopathic form of OMD Tardive OMD is often associated with anti-dopaminergic treatment involving drugs such as anti-psychotics, anti-emetics, and anti-vertigo agents, although the syndrome can also be triggered by anti-epileptic or anti-depressant drugs that do not have anti-dopaminergic properties. We report an elderly female patient with OMD after prolonged, self-administered treatment with betahistine dihydrochloride, a histamine analogue.

  13. What Every 17-Year Old Should Know about Planet Earth: The Report of a Conference of Educators and Geoscientists.

    ERIC Educational Resources Information Center

    Mayer, Victor J.; Armstrong, Ronald E.

    1990-01-01

    Presented are the background, conference charge, organization, and results from the "Planet Earth" conference. Discussed were the goals and concepts that every high school senior should know when completing a pre-college education. The issues, goals, and concepts of a curriculum are suggested. (KR)

  14. An Exploration of High School (12 17 Year Old) Students' Understandings of, and Attitudes Towards Biotechnology Processes

    NASA Astrophysics Data System (ADS)

    Dawson, Vaille

    2007-03-01

    The products of modern biotechnology processes such as genetic engineering, DNA testing and cloning will increasingly impact on society. It is essential that young people have a well-developed scientific understanding of biotechnology and associated processes so that they are able to contribute to public debate and make informed personal decisions. The aim of this study was to examine the development of understandings and attitudes about biotechnology processes as students progress through high school. In a cross-sectional case study, data was obtained from student interviews and written surveys of students aged 12 to 17 years. The results indicate that students' ability to provide a generally accepted definition and examples of biotechnology, cloning and genetically modified foods was relatively poor amongst 12 13 year old students but improved in older students. Most students approved of the use of biotechnology processes involving micro-organisms, plants and humans and disapproved of the use of animals. Overall, 12 13 year old students' attitudes were less favourable than older students regardless of the context. An awareness of the development and range of students' understandings and attitudes may lead to a more appropriate use of biotechnology curriculum materials and thus improved biotechnology education in schools.

  15. Height, weight, body composition, and waist circumference references for 7- to 17-year-old children from rural Portugal.

    PubMed

    Chaves, R; Baxter-Jones, A; Souza, M; Santos, D; Maia, J

    2015-06-01

    The purpose of this study was (1) to develop references of height, weight, body mass index (BMI), waist circumference and body fat for rural Portuguese children and adolescents and (2) to compare these results with other international references. The sample comprised 3094 children and adolescents aged 7-17 years from Vouzela, a central region in Portugal. Height, weight, BMI, waist circumference and body fat were measured. Centile curves were constructed using the LMS method. The Vouzela sample showed similar height median values compared to Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) percentile curves but greater values for weight and BMI. Percent body fat 50th percentile was greater in Vouzela children and adolescents compared to their international peers, except for boys aged 8-12 years. Boys' waist circumference median values were similar to those from the USA, whilst girls were similar until 12 years of age, after which the differences increased with age. The percentile curves constructed provide population specific references for growth and body composition of children and adolescents from rural Portugal. It is expected that they will be a useful tool for clinical and public health settings in rural Portugal.

  16. An Exploration of High School (12-17 Year Old) Students' Understandings of, and Attitudes towards Biotechnology Processes

    ERIC Educational Resources Information Center

    Dawson, Vaille

    2007-01-01

    The products of modern biotechnology processes such as genetic engineering, DNA testing and cloning will increasingly impact on society. It is essential that young people have a well-developed scientific understanding of biotechnology and associated processes so that they are able to contribute to public debate and make informed personal…

  17. Corrosion process and structural performance of a 17 year old reinforced concrete beam stored in chloride environment

    SciTech Connect

    Vidal, T. Castel, A. Francois, R.

    2007-11-15

    The long-term corrosion process of reinforced concrete beams is studied in this paper. The reinforced concrete elements were stored in a chloride environment for 17years under service loading in order to be representative of real structural conditions. At different stages, cracking maps were drawn, total chloride contents were measured and mechanical tests were performed. Results show that the bending cracks and their width do not influence significantly the service life of the structure. The chloride threshold at the reinforcement depth, used by standards as a single parameter to predict the end of the initiation period, is a necessary but not a sufficient parameter to define service life. The steel-concrete interface condition is also a determinant parameter. The bleeding of concrete is an important cause of interface de-bonding which leads to an early corrosion propagation of the reinforcements. The structural performance under service load (i.e.: stiffness in flexure) is mostly affected by the corrosion of the tension reinforcement (steel cross-section and the steel-concrete bond reduction). Limit-state service life design based on structural performance reduction in terms of serviceability shows that the propagation period of the corrosion process is an important part of the reinforced concrete service life.

  18. Medical examination of Israeli 17-year-olds before military service as a national resource for health information.

    PubMed

    Kark, J D; Kedem, R; Revach, M

    1986-01-01

    At age 17 years Israelis undergo medical examination for the purpose of health classification for military service. The potential use of this extensive data collection system for epidemiologic studies is illustrated for selected conditions. Trends in diagnosed disorders over a 25-year period are exemplified in the changing prevalence of tuberculosis, bronchial asthma, diabetes, epilepsy and heart defects. Within birth cohorts, cross-sectional analyses of height, body mass, blood pressure and disorders--such as bronchial asthma, allergic rhinitis, diabetes, psychiatric diagnoses and such genetic conditions as familial Mediterranean fever--point to clear ethnic differences. Educational level is strongly associated with measures of health status. Potential uses of this resource include: detecting groups in need of preventive, curative and rehabilitative care, assessing changing needs and priorities of health care, evaluation of intervention programs and health services provided in childhood, a wide spectrum of etiologic studies including assessment of health effects of social change, follow-up studies including the natural history of disorders, and developing data systems such as national registries of rare or important conditions. Issues relating to data reliability and validity, changing disease classification and nonexamination of groups exempted from military service limit interpretation of findings and restrict uses of this resource. Emphasis on standardization of data collection and diagnostic criteria, quality assurance and improved data management will be necessary.

  19. Developmental Gender Differences on the Naglieri Nonverbal Ability Test in a Nationally Normed Sample of 5-17 Year Olds

    ERIC Educational Resources Information Center

    Rojahn, Johannes; Naglieri, Jack A.

    2006-01-01

    Lynn [Lynn, R., 2002. Sex differences on the progressive matrices among 15-16 year olds: some data from South Africa. "Personality and Individual Differences 33," 669-673.] proposed that biologically based developmental sex differences produce different IQ trajectories across childhood and adolescence. To test this theory we analyzed the…

  20. Venous and arterial thrombo-embolic complications of hormonal treatment in a male-to-female transgender patient.

    PubMed

    Mullins, G M; O'Sullivan, S S; Kinsella, J; McEnroy, D; Crimmins, D; Whyte, S; Sturm, J W

    2008-06-01

    We present a male-to-female (MTF) transgender patient admitted with a pulmonary embolism. The patient had been treated with high-dose oestrogens since the age of 16. Following a prolonged period of hypotension, our patient sustained cerebral border zone infarcts. There was evidence of bilateral carotid stenosis on Doppler ultrasound. We discuss the treatment and vascular complications of gender dysphoria.

  1. Autonomous prolactin secretion in two male-to-female transgender patients using conventional oestrogen dosages

    PubMed Central

    Bunck, Mathijs C; Debono, Miguel; Giltay, Erik J; Verheijen, Andreas T; Diamant, Michaela; Gooren, Louis J

    2009-01-01

    Oestrogen-induced prolactinomas have been reported in male-to-female (MTF) transgender patients after excessive oestrogen self-administration. Here, two prolactinoma cases after 14 years (case 1) and 30 years (case 2) of relatively low-dose oestrogen treatment are reported. Both resolved after treatment with dopamine agonists. During the first year of oestrogen treatment the patient in case 1 showed a remarkable (7.2-fold) increase in serum prolactin concentration, returning to within the normal range for 13 years until the start of autonomous prolactin secretion. It is hypothesised that this strong first-year prolactin response may be a sign of increased pituitary oestrogen sensitivity. Therefore the patient’s increase in prolactin concentration during the first 18 months was compared to 74 matched control patients from a database, and this increase was found to be significantly greater in the case patient. It is suggested that in MTF patients an excessive first year increase in serum prolactin concentration may identify patients at risk for autonomous prolactin secretion later in life. PMID:21829422

  2. Adolescent patient with bilateral crossbite treated with surgically assisted rapid maxillary expansion: a case report evaluated by the 3d laser scanner, and using FESA method.

    PubMed

    Ivanov, Ch I; Velemínská, J; Dostálová, T; Foltán, R

    2011-01-01

    Our purpose in this case report is to present an orthodontic treatment obtained and the results achieved in 17-year-old white female patient with Angle Class II malocclusion and bilateral posterior crossbite. Patient was treated with bonded acrylic Hyrax appliance and surgically assisted rapid maxillary expansion (SARME). The multiloop system 0.16 TMA (ß titanium) arch wire was used in the alignment phase and on purpose to prohibit bite opening and optimize threedimensional movement control. After treatment bonded lingual retainers were placed in between maxillary central incisors and in mandible canine-to-canine. A functional removable Klammt appliance was used for retention. The 3D Laser Scanner Roland LPX-250 was used in order to obtain digital dental casts. Evaluation of the treatment results was measured on these models and using finite element scaling analysis (FESA). An Angle Class I relationship was obtained after 2½ years of treatment, function and facial aesthetics were improved. The shape of the palate changed significant in the width direction, not significantly in length and high direction. The greatest expansion of palate was found in the region between the palatal cusps of the first molars 26.6%, followed by first 21.9% and second premolars 16.5%. SARME in adult patients with bilateral cross bite and maxillary deficiency lead to satisfactory results. The 3D laser scanned models and their measurements, using advanced software's are successfully used for precise studies.

  3. Acute Renal Failure, Microangiopathic Haemolytic Anemia, and Secondary Oxalosis in a Young Female Patient

    PubMed Central

    Stepien, Karolina M.; Prinsloo, Peter; Hitch, Tony; McCulloch, Thomas A.; Sims, Rebecca

    2011-01-01

    A 29-year old female presented with a one-week history of vomiting, diarrhoea, abdominal pain, and headache. On admission, she had acute renal failure requiring dialysis. Tests revealed a hemolytic anemia with thrombocytopenia. An initial diagnosis of thrombotic thrombocytopenic microangiopathy was made and plasma exchange was instigated. However, renal biopsy did not show thrombotic microangiopathy but instead revealed acute kidney injury with mild tubulointerstitial nephritis and numerous oxalate crystals, predominantly in the distal tubules. The patient had been taking large doses (>1100 mg daily) of vitamin C for many months. She also gave a history of sclerotherapy using injections of an ethylene glycol derivative for superficial leg veins. The patient completed five sessions of plasma exchange and was able to discontinue dialysis. She eventually achieved full renal recovery. She has now discontinued sclerotherapy and vitamin supplementation. PMID:21785726

  4. Orthotopic ileal neobladder in female patients after radical cystectomy: 2-year experience.

    PubMed

    Cancrini, A; De Carli, P; Fattahi, H; Pompeo, V; Cantiani, R; Von Heland, M

    1995-03-01

    We describe a surgical technique to conserve urinary continence in 7 women who underwent radical cystectomy with construction of an orthotopic ileal neobladder for infiltrating bladder carcinoma. The selection of the patients and the surgical procedure to preserve the anatomical and functional integrity of the female urethra are described. Followup ranged from 7 to 28 months. There were no postoperative deaths or serious clinical complications. The urinary continence rate was 100% during the day and 71% at night with micturition at regular 3-hour intervals. The vesical capacity varied from 250 to 400 cc and pressure at maximum capacity from 10 to 25 cm. water. Urinary flow was satisfactory and the urethral pressure profile showed a normal sphincteric mechanism at rest. Two patients died of metastases at 14 and 8 months postoperatively, and 5 are alive and disease-free. We believe that these results confirm the possibility of obtaining micturition in women via the urethra following radical cystectomy.

  5. A study on the use of imiquimod for the treatment of genital molluscum contagiosum and genital warts in female patients

    PubMed Central

    Puri, Neerja

    2009-01-01

    The clinical effect of imiquimod stems from cytokine-induced activation of the immune system. A randomized study was conducted to study the efficacy and safety of daily applications of 5% imiquimod cream in female patients with external genital warts and molluscum contagiosum (MC). The clearance rate of lesions was 75% in genital MC patients and 50% in patients with genital warts. Erythema was the commonest adverse reaction seen in 24% patients with the use of 5% imiquimod. Other side effects were excoriation seen in 16% patients, erosions in 10% patients, excoriation in 6% patients and pain was seen in 4% patients. PMID:21938126

  6. Acupuncture in the Treatment of a Female Patient Suffering from Chronic Schizophrenia and Sleep Disorders

    PubMed Central

    Bosch, Peggy; Lee, Sook-Hyun; Staudte, Heike

    2016-01-01

    Background. The use of acupuncture in the treatment of sleep disorders in patients with chronic schizophrenia is investigated. Case Presentation. We report the case of a 44-year-old female outpatient of German origin who had been suffering from long-term schizophrenia and sleep disorders. The patient was treated with manual acupuncture weekly for 12 weeks, and a psychological assessment was performed before, immediately after, and three months after the acupuncture treatment period. In addition, actiwatch data were collected for 14 days both before and after the acupuncture treatment period. Conclusion. Acupuncture treatment led to a decrease in general psychopathology, less severe sleep problems, and markedly improved cognitive functioning (working memory) in the patient; however, the positive and the negative symptoms remained stable. The actiwatch data revealed a beneficial effect of acupuncture, showing better sleep latency, a trend towards better sleep efficiency, and a decrease in the number of minutes that the patient was awake during the night after acupuncture treatment. In sum, this study showed that acupuncture might be beneficial in the treatment of sleep disorders in patients suffering from chronic schizophrenia, but future, large, randomized (placebo), controlled, clinical trials are needed in order to replicate the present preliminary findings. PMID:28101392

  7. Attachment and mentalization in female patients with comorbid narcissistic and borderline personality disorder.

    PubMed

    Diamond, Diana; Levy, Kenneth N; Clarkin, John F; Fischer-Kern, Melitta; Cain, Nicole M; Doering, Stephan; Hörz, Susanne; Buchheim, Anna

    2014-10-01

    We investigated attachment representations and the capacity for mentalization in a sample of adult female borderline patients with and without comorbid narcissistic personality disorder (NPD). Participants were 22 borderline patients diagnosed with comorbid NPD (NPD/BPD) and 129 BPD patients without NPD (BPD) from 2 randomized clinical trials. Attachment and mentalization were assessed on the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996). Results showed that as expected, compared with the BPD group, the NPD/BPD group was significantly more likely to be categorized as either dismissing or cannot classify on the AAI, whereas the BPD group was more likely to be classified as either preoccupied or unresolved for loss and abuse than was the NPD/BPD group. Both groups of patients scored low on mentalizing, and there were no significant differences between the groups, indicating that both NPD/BPD and BPD individuals showed deficits in this capacity. The clinical implications of the group differences in AAI classification are discussed with a focus on how understanding the attachment representations of NPD/BPD patients helps to illuminate their complex, contradictory mental states.

  8. Irony and proverb comprehension in schizophrenia: do female patients "dislike" ironic remarks?

    PubMed

    Rapp, Alexander M; Langohr, Karin; Mutschler, Dorothee E; Wild, Barbara

    2014-01-01

    Difficulties in understanding irony and sarcasm are part of the social cognition deficits in patients with schizophrenia. A number of studies have reported higher error rates during comprehension in patients with schizophrenia. However, the relationships of these impairments to schizotypal personality traits and other language deficits, such as the comprehension of proverbs, are unclear. We investigated irony and proverb comprehension in an all-female sample of 20 schizophrenia patients and 27 matched controls. Subjects indicated if a statement was intended to be ironic, literal, or meaningless and furthermore rated the meanness and funniness of the stimuli and certainty of their decision. Patients made significantly more errors than controls did. Globally, there were no overall differences in the ratings. However, patients rated the subgroup of stimuli with answers given incorrectly as having significantly less meanness and in case of an error indicated a significantly higher certainty than controls. Across all of the study participants, performances in irony (r = -0.51) and proverb (r = 0.56) comprehension were significantly correlated with schizotypal personality traits, suggesting a continuum of nonliteral language understanding. Because irony is so frequent in everyday conversations, this makes irony an especially promising candidate for social cognition training in schizophrenia.

  9. Irony and Proverb Comprehension in Schizophrenia: Do Female Patients “Dislike” Ironic Remarks?

    PubMed Central

    Rapp, Alexander M.; Langohr, Karin; Mutschler, Dorothee E.; Wild, Barbara

    2014-01-01

    Difficulties in understanding irony and sarcasm are part of the social cognition deficits in patients with schizophrenia. A number of studies have reported higher error rates during comprehension in patients with schizophrenia. However, the relationships of these impairments to schizotypal personality traits and other language deficits, such as the comprehension of proverbs, are unclear. We investigated irony and proverb comprehension in an all-female sample of 20 schizophrenia patients and 27 matched controls. Subjects indicated if a statement was intended to be ironic, literal, or meaningless and furthermore rated the meanness and funniness of the stimuli and certainty of their decision. Patients made significantly more errors than controls did. Globally, there were no overall differences in the ratings. However, patients rated the subgroup of stimuli with answers given incorrectly as having significantly less meanness and in case of an error indicated a significantly higher certainty than controls. Across all of the study participants, performances in irony (r = −0.51) and proverb (r = 0.56) comprehension were significantly correlated with schizotypal personality traits, suggesting a continuum of nonliteral language understanding. Because irony is so frequent in everyday conversations, this makes irony an especially promising candidate for social cognition training in schizophrenia. PMID:24991434

  10. Polymicrobial Purulent Pericarditis Probably caused by a Broncho-Lymph Node-Pericardial Fistula in a Patient with Tuberculous Lymphadenitis

    PubMed Central

    Lee, Kanglok; Ko, Jun Kwon; Park, Jaekeun; Yu, Mi Yeon; Oh, Chang Kyo; Hong, Seung Pyo; Kim, Yeonjae; Lim, Younghyo; Kim, Hyuck

    2015-01-01

    Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibiotic, antifungal, and antituberculous medication in addition to pericardiectomy. PMID:26788411

  11. Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients.

    PubMed

    Zaba, Monika; Kirmeier, Thomas; Ionescu, Irina A; Wollweber, Bastian; Buell, Dominik R; Gall-Kleebach, Dominique J; Schubert, Christine F; Novak, Bozidar; Huber, Christine; Köhler, Katharina; Holsboer, Florian; Pütz, Benno; Müller-Myhsok, Bertram; Höhne, Nina; Uhr, Manfred; Ising, Marcus; Herrmann, Leonie; Schmidt, Ulrike

    2015-05-01

    Analysis of the function of the hypothalamic-pituitary-adrenal (HPA)-axis in patients suffering from posttraumatic stress disorder (PTSD) has hitherto produced inconsistent findings, inter alia in the Trier Social Stress Test (TSST). To address these inconsistencies, we compared a sample of 23 female PTSD patients with either early life trauma (ELT) or adult trauma (AT) or combined ELT and AT to 18 age-matched non-traumatized female healthy controls in the TSST which was preceded by intensive baseline assessments. During the TSST, we determined a variety of clinical, psychological, endocrine and cardiovascular parameters as well as expression levels of four HPA-axis related genes. Using a previously reported definition of HPA-axis responsive versus non-responsive phenotypes, we identified for the first time two clinically and biologically distinct HPA-axis reactivity subgroups of PTSD. One subgroup ("non-responders") showed a blunted HPA-axis response and distinct clinical and biological characteristics such as a higher prevalence of trauma-related dissociative symptoms and of combined AT and ELT as well as alterations in the expression kinetics of the genes encoding for the mineralocorticoid receptor (MR) and for FK506 binding protein 51 (FKBP51). Interestingly, this non-responder subgroup largely drove the relatively diminished HPA axis response of the total cohort of PTSD patients. These findings are limited by the facts that the majority of patients was medicated, by the lack of traumatized controls and by the relatively small sample size. The here for the first time identified and characterized HPA-axis reactivity endophenotypes offer an explanation for the inconsistent reports on HPA-axis function in PTSD and, moreover, suggest that most likely other factors than HPA-axis reactivity play a decisive role in determination of PTSD core symptom severity.

  12. Changes in the tumor marker concentration in female patients with hyper-, eu-, and hypothyroidism.

    PubMed

    Hashimoto, T; Matsubara, F

    1989-12-01

    The levels of 6 circulating tumor markers were evaluated in a total of 131 female subjects with altered thyroid states; 36 normal subjects, 46 hyperthyroid patients with Graves' disease, and 49 primary hypothyroid patients. The mean CEA concentration was observed to be significantly higher (p less than 0.02) in hypothyroid patients than in normal and hyperthyroid patients (1.1 +/- 0.1 ng/ml, 0.8 +/- 0.1 ng/ml and 0.8 +/- 0.1 ng/ml, respectively). Similarly, the mean serum CA 125 concentration in hypothyroid patients was higher (p less than 0.02) than in normal and hyperthyroid patients (13.0 +/- 2.6 U/ml, 7.6 +/- 1.1 U/ml and 5.5 +/- 0.8 U/ml, respectively), and the mean serum CA 15-3 concentration in hypothyroid patients was significantly higher than in normal subjects (p less than 0.01) and hyperthyroid patients (p less than 0.001) (16.2 +/- 0.9 U/ml, 13.9 +/- 0.6 U/ml and 10.6 +/- 0.5 U/ml, respectively). No statistical difference was found in mean CA 19-9 in the three subject groups. AFP in the hypothyroid patients (3.6 +/- 0.3 ng/ml) was significantly higher (p less than 0.05) than in normal subjects (2.6 +/- 0.2 ng/ml) and hyperthyroid patients (1.7 +/- 0.2 ng/ml) (p less than 0.01). On the other hand, serum ferritin was low in the hypothyroid patients (65.9 8.0 ng/ml) and significantly increased (69.1 +/- 9.0 ng/ml) (p less than 0.02) with the normalization of thyroid function. In hyperthyroidism, serum ferritin (70.2 +/- 7.0 ng/ml) was significantly higher than in the hypothyroid patients (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Endoscopic vein harvesting is influenced by patient-related risk factors and may be of specific benefit in female patients

    PubMed Central

    Andreas, Martin; Wiedemann, Dominik; Stasek, Sebastian; Kampf, Stephanie; Ehrlich, Marek; Eigenbauer, Ernst; Laufer, Guenther; Kocher, Alfred

    2013-01-01

    OBJECTIVES The standard of care regarding endoscopic vein harvesting (EVH) is still inhomogeneous across Europe. The current study aimed at elucidating patient-related factors favouring its application and procedure-related outcome in a tertiary care centre. METHODS All patients who underwent coronary artery bypass grafting with or without concomitant valve procedures between 2008 and 2011 were included. Emergency surgery and all arterial revascularization patients were excluded. RESULTS A total of 262 endoscopically harvested patients and 623 open vein harvested patients were included. Mortality, perfusion time and cross-clamp time were not significantly different. Peripheral artery disease predisposed open vein harvesting (odds ratio [OR] 1.9; P = 0.001); diabetes and a higher number of diseased coronary vessels favoured EVH (OR 0.6; P = 0.003 and 0.002). Further, the number of bypass grafts was significantly increased in the endoscopic group, but these patients required less periprocedural blood transfusions (1.4 ± 1.8 vs 1.8 ± 3.0; P = 0.035). Minor wound healing complications were more common in the open group (10.3 vs 3.8%; P = 0.001). Severe complications in the leg requiring surgical revision occured in 2.4% of open vein harvested patients compared with 1.1% for endoscopic patients (P = ns). After a multivariate regression analysis, only female gender remained as a significant risk factor for impaired wound healing (OR 2.4; P = 0.001), whereas EVH reduced the risk of wound-healing complications (OR 0.4; P = 0.008). CONCLUSIONS EVH dramatically reduced postoperative would healing complications. Women were more likely to develop mild and severe leg wound complications. Therefore, women may benefit even more from EVH. In general, the favourable outcomes of EVH should result in a more widespread use of this technology in men and women. PMID:23817680

  14. Serum Vitamin D3 Level in Patients with Female Pattern Hair Loss

    PubMed Central

    Banihashemi, Mahnaz; Nahidi, Yalda; Meibodi, Naser Tayyebi; Jarahi, Lida; Dolatkhah, Mojgan

    2016-01-01

    Background: Female pattern hair loss (FPHL) is the most common cause of alopecia in women, characterized by diffuse nonscarring hair loss in frontal, central, and parietal areas of the scalp. Pathophysiology of FPHL is still not well known, and it is probably a multifactorial genetic trait. FPHL is also observed in women without increased androgen levels, which raises the likelihood of androgen-independent mechanisms and explains the lack of response to antiandrogen treatments in some patients. Vitamin D is a factor that has recently been considered in dealing with these patients. The purpose of this study was to evaluate the serum levels of Vitamin D in patients with FPHL and compare it with healthy controls. Methods: In this case-control study, 45 women with FPHL were evaluated as well as the same number of healthy women matched for age, hours spent under sunlight per day, and body mass index. Serum 25(OH) D3 level was measured using ELISA. Results: 60% of FPHL patients were in 15–30 years old age group with the mean standard deviation (SD) age of 29.11 (7.30) years. In the majority of patients (66.7%), severity of hair loss was Ludwig I. Mean (SD) serum Vitamin D3 level in patient and control group was 13.45 (8.40) and 17.16 (8.96), respectively. T-test showed a significant difference between the two groups in terms of Vitamin D3 serum levels (P = 0.04). Conclusions: This study indicated the correlation between the incidence of FPHL and decreased serum levels of Vitamin D3. It is recommended to evaluate serum Vitamin D3 levels as well as other hormone assays in these patients. PMID:27625563

  15. Posturographic destabilization in eating disorders in female patients exposed to body image related phobic stimuli.

    PubMed

    Forghieri, M; Monzani, D; Mackinnon, A; Ferrari, S; Gherpelli, C; Galeazzi, G M

    2016-08-26

    Human postural control is dependent on the central integration of vestibular, visual and proprioceptive inputs. Psychological states can affect balance control: anxiety, in particular, has been shown to influence balance mediated by visual stimuli. We hypothesized that patients with eating disorders would show postural destabilization when exposed to their image in a mirror and to the image of a fashion model representing their body ideal in comparison to body neutral stimuli. Seventeen females patients attending a day centre for the treatment of eating disorders were administered psychometric measures of body dissatisfaction, anxiety, depression and underwent posturographic measures with their eyes closed, open, watching a neutral stimulus, while exposed to a full length mirror and to an image of a fashion model corresponding to their body image. Results were compared to those obtained by eighteen healthy subjects. Eating disordered patients showed higher levels of body dissatisfaction and higher postural destabilization than controls, but this was limited to the conditions in which they were exposed to their mirror image or a fashion model image. Postural destabilization under these conditions correlated with measures of body dissatisfaction. In eating disordered patients, body related stimuli seem to act as phobic stimuli in the posturographic paradigm used. If confirmed, this has the potential to be developed for diagnostic and therapeutic purposes.

  16. A Rare Case of Stroke Secondary to Iron Deficiency Anemia in a Young Female Patient

    PubMed Central

    Gopalratnam, Kavitha; Sena, Kanaga; Gupta, Manisha

    2017-01-01

    Ischemic strokes occur when there is a sudden obstruction of an artery supplying blood flow to an area of the brain, leading to a focal neurological deficit. Strokes can be thrombotic or embolic in etiology and are associated with underlying conditions such as hypertension and atherosclerosis. Possible etiologies of strokes include cardioembolic disease, hematologic disorders, connective tissue disorders, and substance abuse or can be cryptogenic. Most stroke cases are seen in patients over 65 years of age. However, about one-fourth of strokes occur in young adults. Iron deficiency anemia (IDA) has been described as a known cause for strokes in children, but very few case reports describe this association in adults. We describe a 20-year-old female who presented with sudden onset left side weakness. Magnetic Resonance Imaging (MRI) of the brain demonstrated ischemic infarctions. Patient was also found to be severely anemic. Patient had a thorough work-up including Magnetic Resonance Angiography (MRA) of the brain, echocardiogram, and an extensive screen for thrombophilia disorders. This, however, did not demonstrate a clear etiology. As it has been suggested that IDA is a potential cause for stroke, it is possible the stroke in this young patient was attributable to severe IDA. PMID:28348599

  17. Microdeletions Including FMR1 in Three Female Patients with Intellectual Disability – Further Delineation of the Phenotype and Expression Studies

    PubMed Central

    Zink, A.M.; Wohlleber, E.; Engels, H.; Rødningen, O.K.; Ravn, K.; Heilmann, S.; Rehnitz, J.; Katzorke, N.; Kraus, C.; Blichfeldt, S.; Hoffmann, P.; Reutter, H.; Brockschmidt, F.F.; Kreiß-Nachtsheim, M.; Vogt, P.H.; Prescott, T.E.; Tümer, Z.; Lee, J.A.

    2014-01-01

    Fragile X syndrome (FXS) is one of the most common causes of intellectual disability/developmental delay (ID/DD), especially in males. It is caused most often by CGG trinucleotide repeat expansions, and less frequently by point mutations and partial or full deletions of the FMR1 gene. The wide clinical spectrum of affected females partly depends on their X-inactivation status. Only few female ID/DD patients with microdeletions including FMR1 have been reported. We describe 3 female patients with 3.5-, 4.2- and 9.2-Mb de novo microdeletions in Xq27.3-q28 containing FMR1. X-inactivation was random in all patients, yet they presented with ID/DD as well as speech delay, macrocephaly and other features attributable to FXS. No signs of autism were present. Here, we further delineate the clinical spectrum of female patients with microdeletions. FMR1 expression studies gave no evidence for an absolute threshold below which signs of FXS present. Since FMR1 expression is known to be highly variable between unrelated females, and since FMR1 mRNA levels have been suggested to be more similar among family members, we further explored the possibility of an intrafamilial effect. Interestingly, FMR1 mRNA levels in all 3 patients were significantly lower than in their respective mothers, which was shown to be specific for patients with microdeletions containing FMR1. PMID:24715853

  18. Abnormal functional global and local brain connectivity in female patients with anorexia nervosa

    PubMed Central

    Geisler, Daniel; Borchardt, Viola; Lord, Anton R.; Boehm, Ilka; Ritschel, Franziska; Zwipp, Johannes; Clas, Sabine; King, Joseph A.; Wolff-Stephan, Silvia; Roessner, Veit; Walter, Martin; Ehrlich, Stefan

    2016-01-01

    Background Previous resting-state functional connectivity studies in patients with anorexia nervosa used independent component analysis or seed-based connectivity analysis to probe specific brain networks. Instead, modelling the entire brain as a complex network allows determination of graph-theoretical metrics, which describe global and local properties of how brain networks are organized and how they interact. Methods To determine differences in network properties between female patients with acute anorexia nervosa and pairwise matched healthy controls, we used resting-state fMRI and computed well-established global and local graph metrics across a range of network densities. Results Our analyses included 35 patients and 35 controls. We found that the global functional network structure in patients with anorexia nervosa is characterized by increases in both characteristic path length (longer average routes between nodes) and assortativity (more nodes with a similar connectedness link together). Accordingly, we found locally decreased connectivity strength and increased path length in the posterior insula and thalamus. Limitations The present results may be limited to the methods applied during preprocessing and network construction. Conclusion We demonstrated anorexia nervosa–related changes in the network configuration for, to our knowledge, the first time using resting-state fMRI and graph-theoretical measures. Our findings revealed an altered global brain network architecture accompanied by local degradations indicating wide-scale disturbance in information flow across brain networks in patients with acute anorexia nervosa. Reduced local network efficiency in the thalamus and posterior insula may reflect a mechanism that helps explain the impaired integration of visuospatial and homeostatic signals in patients with this disorder, which is thought to be linked to abnormal representations of body size and hunger. PMID:26252451

  19. Searching for patent foramen ovale in a 44-year-old female patient after ischemic stroke – diagnostic problems

    PubMed Central

    Kralisz, Paweł; Bachórzewska-Gajewska, Hanna; Dobrzycki, Sławomir

    2016-01-01

    Patent foramen ovale (PFO) is associated with the occurrence of cryptogenic strokes in young patients. Transesophageal echocardiography with contrast is the established standard in PFO diagnostics. We present the case of a 44-year-old female patient after ischemic stroke, in whom PFO was not detected by echocardiography; the defect was ultimately diagnosed by right heart catheterization. PMID:27516797

  20. Coping Styles of Female Adolescent Cancer Patients with Potential Fertility Loss

    PubMed Central

    Murphy, Devin; Knapp, Caprice A.; Christie, Juliette; Phares, Vicky; Wells, Kristen J.

    2013-01-01

    Purpose The purpose of this qualitative study was to assess the coping styles of female adolescent cancer patients regarding potential loss of fertility. Expectations and desires for the future, coping styles in typical adolescence, and coping styles when faced with potential loss of fertility due to cancer treatment are discussed. Methods Female adolescents diagnosed with cancer aged 12–18 years at study (N=14) were administered a 10-item values clarification tool to pilot test the readability and relevance of the items on reproductive concerns, followed by a cognitive debriefing interview asking participants how they would respond to each item. These qualitative responses were assessed for coping style type using the constant comparative approach. Results All adolescent participants reported having a strong desire for biological children in the future. Reactions to questions regarding the loss of fertility fell into two categories of coping styles: emotion-focused coping or problem-focused (engagement) coping. Within emotion-focused coping, there were three distinct styles: externalizing attribution style, internalizing attribution style, and repressive adaptation. Problem-focused coping adolescents displayed optimism. Conclusion Successful interventions aimed at promoting adaptive coping styles should seek to uncover adolescents' values about future parenthood and reproduction. Development of an age-appropriate assessment to stimulate dialogue regarding fertility and initiate an adolescent's cognitive processing of potential fertility loss is warranted. PMID:23781403

  1. Effects of gyrokinesis exercise on the gait pattern of female patients with chronic low back pain

    PubMed Central

    Seo, Kook-Eun; Park, Tae-Jin

    2016-01-01

    [Purpose] The purpose of the present study was to use kinematic variables to identify the effects of 8/weeks’ performance of a gyrokinesis exercise on the gait pattern of females with chronic low back pain. [Subjects] The subjects of the present study were females in their late 20s to mid 30s who were chronic back pain patients. [Methods] A 3-D motion analysis system was used to measure the changes in their gait patterns between pre and post-gyrokintic exercise. The SPSS 21.0 statistics program was used to perform the paired t-test, to compare the gait patterns of pre-post-gyrokinesis exercise. [Results] In the gait analysis, pre-post-gyrokinesis exercise gait patterns showed statistically significant differences in right and left step length, stride length, right-left step widths, and stride speed. [Conclusion] Gait pattern analysis revealed increases in step length, stride length, and stride speed along with a decrease in step width after 8 weeks of gyrokinesis exercise, demonstrating it improved gait pattern. PMID:27065537

  2. Histopathological evidence of Fabry disease in a female patient with left ventricular noncompaction.

    PubMed

    Martins, Elisabete; Pinho, Teresa; Carpenter, Stirling; Leite, Sérgio; Garcia, Raquel; Madureira, António; Oliveira, João Paulo

    2014-09-01

    Fabry disease is a rare X-linked lysosomal storage disorder caused by mutations in the alpha-galactosidase gene. The most frequent cardiac presentation of Fabry disease is cardiomyopathy characterized by left ventricular (LV) hypertrophy, usually concentric. Heart disease in affected females tends to be clinically recognized later than in males and cardiac complications are the most frequently reported cause of death in females with Fabry disease. There are few data regarding the association between Fabry disease and LV noncompaction. We report a case of a 30-year-old asymptomatic woman, heterozygous for a nonsense alpha-galactosidase gene mutation (p.R220X), who presented LV noncompaction on cardiac magnetic resonance imaging, without LV wall hypertrophy. Histopathological examination of myocardial fragments showed marked deposition of glycosphingolipids in cardiomyocytes, confirming the diagnosis of Fabry cardiomyopathy. Based on this finding, the patient was proposed for enzyme replacement therapy. This case illustrates the role of endomyocardial biopsy in the clarification of doubtful or atypical findings related to cardiac Fabry disease, even in heterozygous women, and corroborates the contention that Fabry disease should be included in the differential diagnosis of LV hypertrabeculation/noncompaction.

  3. Effects of gyrokinesis exercise on the gait pattern of female patients with chronic low back pain.

    PubMed

    Seo, Kook-Eun; Park, Tae-Jin

    2016-01-01

    [Purpose] The purpose of the present study was to use kinematic variables to identify the effects of 8/weeks' performance of a gyrokinesis exercise on the gait pattern of females with chronic low back pain. [Subjects] The subjects of the present study were females in their late 20s to mid 30s who were chronic back pain patients. [Methods] A 3-D motion analysis system was used to measure the changes in their gait patterns between pre and post-gyrokintic exercise. The SPSS 21.0 statistics program was used to perform the paired t-test, to compare the gait patterns of pre-post-gyrokinesis exercise. [Results] In the gait analysis, pre-post-gyrokinesis exercise gait patterns showed statistically significant differences in right and left step length, stride length, right-left step widths, and stride speed. [Conclusion] Gait pattern analysis revealed increases in step length, stride length, and stride speed along with a decrease in step width after 8 weeks of gyrokinesis exercise, demonstrating it improved gait pattern.

  4. Sporotrichosis of Maxillary Sinuses in a Middle Aged Female Patient from Rural Area of Eastern India

    PubMed Central

    Das, Saumik; Sinha, Ramanuj; Aggarwal, Neeraj; Chakravorty, Sriparna

    2016-01-01

    Sporotrichosis is commonly a chronic infection caused by Sporothrix schenckii, a saprophytic fungus and is usually limited to cutaneous and subcutaneous tissues. Disseminated systemic, osteoarticular or pulmonary sporotrichosis have been reported but nasal sinusitis by this fungus is extremely infrequent. Earlier report from southern India documented a case of maxillary sinusitis by Sporothrix schenckii. Here we report a similar case of bilateral maxillary sinusitis in a middle aged female from a village of Bihar, a state in eastern India. She underwent endoscopic maxillary sinus surgery for nasal symptoms and diagnosed to have sporotrichotic infection of maxillary sinuses. The diagnosis was done by mycological and histopathological examination and patient improved under antifungal chemotherapy. PMID:27134873

  5. Alcohol Use Predicts Number of Sexual Partners for Female but not Male STI Clinic Patients

    PubMed Central

    Carey, Kate B.; Senn, Theresa E.; Walsh, Jennifer L.; Scott-Sheldon, Lori A. J.; Carey, Michael P.

    2015-01-01

    This study tested the hypothesis that greater alcohol involvement will predict number of sexual partners to a greater extent for women than for men, and that the hypothesized sex-specific, alcohol—sexual partner associations will hold when controlling for alternative sex-linked explanations (i.e., depression and drug use). We recruited 508 patients (46% female, 67% African American) from a public STI clinic. Participants reported number of sexual partners, drinks per week, maximum drinks per day, frequency of heavy drinking; they also completed the AUDIT-C and a measure of alcohol problems. As expected, men reported more drinking and sexual partners. Also as expected, the association between alcohol use and number of partners was significant for women but not for men, and these associations were not explained by drug use or depression. A comprehensive prevention strategy for women attending STI clinics might include alcohol use reduction. PMID:26310596

  6. Reproductive outcomes of female patients with congenital adrenal hyperplasia due to 21-hydroxylase defi ciency

    PubMed Central

    Mnif, Mouna Feki; Kamoun, Mahdi; Kacem, Faten Hadj; Mnif, Fatma; Charfi, Nadia; Naceur, Basma Ben; Rekik, Nabila; Abid, Mohamed

    2013-01-01

    Fertility in women with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) appears to be reduced, especially in women with the classic salt-wasting type. Several factors have been suggested to contribute to this subfertility such as androgen excess, adrenal progesterone hypersecretion, consequences of genital reconstructive surgery, secondary polycystic ovaries syndrome, and psychosexual factors. In contrast to this subfertility, pregnancies are commonly normal and uneventful. Adequate glucocorticoid therapy and improvement of surgical and psychological management could contribute to optimize fertility in CAH female patients, even among women with the classic variant. This review provides current information regarding the reproductive outcomes of women with CAH due to 21-OHD and the fertility and pregnancy issues in this population. PMID:24083158

  7. Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis

    PubMed Central

    Krentel, H.; Tchartchian, G.; De Wilde, R. L.

    2012-01-01

    In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical differentiation between endometriosis and fibromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid fibromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid fibromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor. PMID:22778752

  8. [Repeated perioperative administration of fructose and sorbitol in a female patient with hereditary fructose intolerance [HFI)].

    PubMed

    Sachs, M; Asskali, F; Förster, H; Encke, A

    1993-03-01

    The present paper reports on an adult female patient whose hereditary fructose intolerance (HFI) was at first not diagnosed and who, within the space of 2 years after repeated elective surgery and the perioperative administration of fructose and sorbitol, developed "hepatic and renal failure of unclear origin." At a later stage we were able to establish the diagnosis of HFI by means of a fructose tolerance test in both she and her brother, for whom intolerance to fruit and desserts had been known since early childhood. In addition, literature references to fatalities following the parenteral application of fructose and sorbitol were analyzed. During the course of fructose infusion in both the patient and her brother with HFI, the following metabolic changes were noted: hypoglycemia, elevated rise in the blood fructose concentration, hyperlactacidemia, elevated rise in the blood fructose concentration, hyperlactacidemia, and hyperammonemia. These metabolic changes proved to be reversible after discontinuing the fructose infusion. Analysis of the literature on the fatalities following parenteral fructose administration established that fruit and dessert intolerance was known for all collated patients with HFI, and that, clearly, no regular metabolic tests had been conducted.

  9. Quality of Life Differences in Female and Male Patients with Fecal Incontinence

    PubMed Central

    Mundet, Lluís; Ribas, Yolanda; Arco, Sandra; Clavé, Pere

    2016-01-01

    Background/Aims To explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence. Methods Ninety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D). Results External and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men (P < 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P < 0.001) and the EQ-5D depression subscale (P < 0.01). EQ-5D index was 0.687 (0.20) for women and 0.835 (0.15) for men (P < 0.001). QoL was negatively affected by female gender (−1.336), anxiety/depression (−1.324) and clinical severity (−0.302), whereas age had a positive impact (0.055 per year) (P < 0.01). Conclusions The pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols. PMID:26486375

  10. A Distinct Urinary Biomarker Pattern Characteristic of Female Fabry Patients That Mirrors Response to Enzyme Replacement Therapy

    PubMed Central

    Kistler, Andreas D.; Siwy, Justyna; Breunig, Frank; Jeevaratnam, Praveen; Scherl, Alexander; Mullen, William; Warnock, David G.; Wanner, Christoph; Hughes, Derralynn A.; Mischak, Harald; Wüthrich, Rudolf P.; Serra, Andreas L.

    2011-01-01

    Female patients affected by Fabry disease, an X-linked lysosomal storage disorder, exhibit a wide spectrum of symptoms, which renders diagnosis, and treatment decisions challenging. No diagnostic test, other than sequencing of the alpha-galactosidase A gene, is available and no biomarker has been proven useful to screen for the disease, predict disease course and monitor response to enzyme replacement therapy. Here, we used urine proteomic analysis based on capillary electrophoresis coupled to mass spectrometry and identified a biomarker profile in adult female Fabry patients. Urine samples were taken from 35 treatment-naïve female Fabry patients and were compared to 89 age-matched healthy controls. We found a diagnostic biomarker pattern that exhibited 88.2% sensitivity and 97.8% specificity when tested in an independent validation cohort consisting of 17 treatment-naïve Fabry patients and 45 controls. The model remained highly specific when applied to additional control patients with a variety of other renal, metabolic and cardiovascular diseases. Several of the 64 identified diagnostic biomarkers showed correlations with measures of disease severity. Notably, most biomarkers responded to enzyme replacement therapy, and 8 of 11 treated patients scored negative for Fabry disease in the diagnostic model. In conclusion, we defined a urinary biomarker model that seems to be of diagnostic use for Fabry disease in female patients and may be used to monitor response to enzyme replacement therapy. PMID:21698285

  11. Operative and early results of coronary artery bypass grafting in female patients in different body mass indexes

    PubMed Central

    2010-01-01

    Background Female gender has been reported to be an independent risk factor for coronary artery bypass grafting (CABG) in European System for Cardiac Risk Evaluation. The effect of the body size on the CABG outcome is less clear. There is ongoing debate about obesity as a risk factor for adverse outcomes after cardiovascular procedures. The goal of this retrospective study is to evaluate the in hospital and early postoperative outcomes in severe obese, obese and normal-slightly obese female patients after CABG. Methods In a four year period a total of 427 female patients underwent isolated CABG under cardiopulmonary bypass. The patients were allocated into three groups according to the Body Mass Index (BMI) as follows; group 1: severe obese patients; BMI > 35, group 2: obese patients; 30≤BMI≤35, group 3: normal-slightly obese patients; BMI < 30 Results The patients in group 3 were older than the group1 and group 2 (65,6 ± 8,3 year vs 63,01 ± 8,0 and 63,57 ± 8,4 year p < 0,05). In group 1 diabetic patients were more than in group 2 and group 3 respectively (54,4% vs 43,4% and 40%, p < 0,05). Urgent operation was more in group 1 than in group 2 and 3 respectively (37,6% vs 17,2% and 21,2% p < 0,05). The patients in group 3 had significantly greater postoperative drainage at 24 h compared with values in group 1 and group 2 (647 ± 142 ml vs. 539 ± 169 ml and 582 ± 133 ml, p < 0,05). Mortality rate in group 1 was 0,8%, 0% in group 2 and 1,2% in group 3 respectively. Wound problem has occured in 41 patients (9,6%).The percentage of postoperative wound problems was higher in group 1 but did not show statiscially difference. Following discharge a total of 43 (10,1%) patients re-hospitalized within 30 days. Re-hospitalization rate was 16,1% in group1, 9,8% in group 2 and 6,5% in group 3 (p < 0,05). Conclusion This study may give an aspect for evaluations of the inhospital-early mortality and morbidity after CABG in female patients in different BMI. Severe obesity

  12. Congenital adrenal hyperplasia. I: Gender-related behavior and attitudes in female patients and sisters.

    PubMed

    Dittmann, R W; Kappes, M H; Kappes, M E; Börger, D; Stegner, H; Willig, R H; Wallis, H

    1990-01-01

    Thirty-five female patients with congenital adrenal hyperplasia (CAH) were compared to a group of 16 healthy sisters in regard to gender-related behavioral patterns, present attitudes, and plans for the future. A semi-structured interview with the subjects, ages 11 to 41 yr, and their mothers concentrated on four to five age stages. Results of retrospective data from single items as well as from several related composite scales ("interests and behavior," "appearance," "overall scores") revealed significant group differences: Both in mother-assessment and self-assessment, CAH patients showed a "more masculine" orientation than their sisters, but this was far from consistent across all age stages, especially for single items. Unexpectedly, the gender-behavior differences between CAH patients and sisters did not hold for certain items and scales of "social behavior" (e.g., assertiveness, dominance, acceptance in peer groups) and, in contrast to some of the existing literature, also not for "high-energy expenditure." With regard to expectations for the future, CAH patients had less of a "wish to have their own children" and a higher preference for "having a career versus staying at home." Age, socioeconomic status, intelligence, and presence or absence of a sister as possibly intervening psychosocial/demographic factors could not explain the group differences in behavior. Degree of genital masculinization (Prader stages) or "onset and quality" of therapy as measures of pre- and postnatal androgenization, respectively, could also not account for the degree of the "more masculine" orientation in the CAH group. Nevertheless, the overall results are compatible with earlier findings on the masculinizing effects of prenatal androgens on behavior in humans and point to a time period after sexual differentiation of the genitalia and before birth as the most likely one for the effects of prenatal hormones on behavioral masculinization in humans.

  13. Effects of combined traditional Chinese exercises on blood pressure and arterial function of adult female hypertensive patients.

    PubMed

    Zhang, Yihong; Li, Ning; Sun, Junzhi; Su, Quansheng

    2013-01-01

    This study examined the effects of combined traditional Chinese physical and mental exercises on the blood pressure of adult female hypertensive patients. Twenty female hypertensive patients aged between 50 and 60 years voluntarily participated in the study. The participants performed the combined exercises for 24 weeks, twice a week, and 60 min each time in low-to-moderate intensity. After the 24-week training, the participants showed significant decreases in systolic blood pressure (p = 0.000), diastolic blood pressure (p = 0.006), pulse pressure (p = 0.001), and right ankle brachial pressure index (p = 0.041). The combined Chinese traditional physical and mental exercises were found to have beneficial effects on adult female hypertensive patients.

  14. FOXL2-mutations in blepharophimosis-ptosis-epicanthus inversus syndrome (BPES); challenges for genetic counseling in female patients.

    PubMed

    Fokstuen, Siv; Antonarakis, Stylianos E; Blouin, Jean-Louis

    2003-03-01

    Mutations in the forkhead transcription factor gene 2 (FOXL2) were recently reported to cause blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) types I and II. Evidence was provided that BPES type I (eyelid abnormalities and female infertility) is caused by mutations resulting in a truncated FOXL2 protein. In contrast, mutant FOXL2 proteins, either with inserted aminoacids in the forkhead domain or polyalanine tract, or with novel aminoacids at the carboxyl end, were found in BPES type II, in which fertility is generally normal. We report a 32-year-old female patient with sporadic BPES and a history of menstrual cycle irregularities and periods of secondary amenorrhoea. A heterozygous frameshift mutation (c959-960insG) was found in the FOXL2 gene, resulting in a predicted FOXL2 protein with 212 novel aminoacids in the carboxyl end, suggesting BPES type II despite menstrual irregularities. The clinical presentations of our patient and of three female patients with BPES type II in the report of De Baere et al. [2001: Hum Mol Genet 10:1591-1600.] indicate phenotypic overlap between BPES type I and II. These observations do not support a clear-cut prediction of female fertility based on the FOXL2 molecular defect. As a consequence, FOXL2 mutation testing in female patients of child-bearing age with BPES should be handled with caution, and a two-step genetic counseling approach, including an initial pre-test information session, is proposed.

  15. Research on quality of life in female patients with congenital adrenal hyperplasia and issues in developing nations.

    PubMed

    Zainuddin, Ani Amelia; Grover, Sonia R; Shamsuddin, Khadijah; Mahdy, Zaleha Abdullah

    2013-12-01

    Congenital adrenal hyperplasia (CAH) is the commonest cause of ambiguous genitalia for female newborns and is one of the conditions under the umbrella term of "Disorders of Sex Development" (DSD). Management of these patients require multidisciplinary collaboration and is challenging because there are many aspects of care, such as the most appropriate timing and extent of feminizing surgery required and attention to psychosexual, psychological, and reproductive issues, which still require attention and reconsideration, even in developed nations. In developing nations, however, additional challenges prevail: poverty, lack of education, lack of easily accessible and affordable medical care, traditional beliefs on intersex, religious, and cultural issues, as well as poor community support. There is a paucity of long-term outcome studies on DSD and CAH to inform on best management to achieve optimal outcome. In a survey conducted on 16 patients with CAH and their parents in a Malaysian tertiary center, 31.3% of patients stated poor knowledge of their condition, and 37.5% did not realize that their medications were required for life. This review on the research done on quality of life (QOL) of female patients with CAH aims: to discuss factors affecting QOL of female patients with CAH, especially in the developing population; to summarize the extant literature on the quality of life outcomes of female patients with CAH; and to offer recommendations to improve QOL outcomes in clinical practice and research.

  16. Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

    PubMed Central

    Park, Bo-yong; Park, Hyunjin

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients. PMID:26981099

  17. Coincidence of thymoma and breast cancer and in a 56-year-old female patient

    PubMed Central

    Athanasiou, Evangelia; Michalopoulou-Manoloutsiou, Electra; Bobos, Mattheos; Hatzibougias, Dimitris I.; Katsikogiannis, Nikolos; Sarika, Eirini; Karapantzos, Ilias; Barbetakis, Nikolaos; Paliouras, Dimitrios; Chatzinikolaou, Fotis; Charalampidis, Charalampos; Kougioumtzi, Ioanna; Kolettas, Alexandros; Bakas, Andreas; Tzelepi, Keraso; Kalaitzis, Efstratios; Tsakiridis, Kosmas

    2016-01-01

    We present a case of a 56-year-old female, with a familial history of breast, lung and brain cancer, which revealed a breast tumor, located in the upper outer quadrant of the left breast. During the routinely staging examinations, a 15 cm intrathoracic tumor was found in the upper left mediastinum, penetrating the pericardium and a smaller tumor, in the left side of parietal pleura. Core biopsies from both lesions, revealed a lobular carcinoma of the breast classic type, grade II (e-cadherin-, ER+, PR+, Her-2−, Ki-67 10%) and a B3 thymoma (CK19+, CD5+) penetrating the pericardium and the left lung. A synchronous removal of both tumors was scheduled, including median sternotomy and left intrapericardial pneumonectomy, followed by a modified radical left mastectomy and a sentinel lymph node biopsy. The postoperative course was uneventful. This case advocates that thymoma patients appear to have a predisposition towards developing additional neoplasms, as breast carcinoma. Clinicians should be aware of the increased incidence of extrathymic cancers, occurring in thymoma patients. PMID:27999780

  18. Dental implants inserted in male versus female patients: a systematic review and meta-analysis.

    PubMed

    Chrcanovic, B R; Albrektsson, T; Wennerberg, A

    2015-09-01

    The aim of this meta-analysis was to test the null hypothesis of no difference in the failure rates, marginal bone loss (MBL) and post-operative infection for implants inserted in male or female patients, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in December 2014. Eligibility criteria included clinical human studies, either randomized or not. Ninety-one publications were included, with a total of 27,203 implants inserted in men (1185 failures), and 25,154 implants inserted in women (1039 failures). The results suggest that the insertion of dental implants in male patients statistically affected the implant failure rates (RR 1.21, 95% CI 1.07-1.37, P = 0.002). Due to the limited number of studies reporting results on MBL, it is difficult to estimate the real effect of the insertion of implants in different sexes on the marginal bone level. Due to lack of satisfactory information, meta-analysis for the outcome 'post-operative infection' was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.

  19. Lipid and protein oxidation in female patients with chronic fatigue syndrome

    PubMed Central

    Tomic, Slavica; Brkic, Snezana; Mikic, Aleksandra Novakov

    2012-01-01

    Introduction Chronic fatigue syndrome (CFS) is a widely recognized problem, characterized by prolonged, debilitating fatigue and a characteristic group of accompanying symptoms, that occurs four times more frequently in women than in men. The aim of the study was to determine the existence of oxidative stress and its possible consequences in female patients with CFS. Material and methods Twenty-four women aged 15-45 who fulfilled the diagnostic criteria for CFS with no comorbidities were recruited and were age matched to a control group of 19 healthy women. After conducting the routine laboratory tests, levels of the lipid oxidation product malondialdehyde (MDA) and protein oxidation protein carbonyl (CO) were determined. Results The CFS group had higher levels of triglycerides (p = 0.03), MDA (p = 0.03) and CO (p = 0.002) and lower levels of HDL cholesterol (p = 0.001) than the control group. There were no significant differences in the levels of total protein, total cholesterol or LDL cholesterol. Conclusions The CFS group had an unfavorable lipid profile and signs of oxidative stress induced damage to lipids and proteins. These results might be indicative of early proatherogenic processes in this group of patients who are otherwise at low risk for atherosclerosis. Antioxidant treatment and life style changes are indicated for women with CFS, as well as closer observation in order to assess the degree of atherosclerosis. PMID:23185200

  20. Domestic violence among male and female patients seeking emergency medical services.

    PubMed

    Phelan, Mary Beth; Hamberger, L Kevin; Guse, Clare E; Edwards, Shauna; Walczak, Suzanne; Zosel, Amy

    2005-04-01

    Gender differences among a cohort of injured patients seeking emergency medical services were examined with respect to their experiences as perpetrators and/or victims of domestic violence. Contextual issues, including violence initiation, emotional and behavioral responses to partner-initiated violence, and injury frequency and severity were analyzed. Women reported male partner-initiated violence more frequently than men reported female partner-initiated violence. Behavioral responses to partner initiated violence varied. Women were more likely to report using force back and to involve law enforcement. Women were more likely to be injured in a domestic assault over their lifetime, within the last year, and at the time of recruitment. Comparison of injury severity revealed that women reported higher rates of injuries than men in all possible severity categories. Women also reported experiencing more fear than men during partner-initiated violence, as well as being subjected to larger numbers of dominating and controlling behaviors, and greater intimidation secondary to their partner's size. Understanding contextual differences in partner violence for women and men has significant implications for policy development, identification, treatment, and referral of patients identified as living in violent relationships.

  1. Pseudohypertension-Like Presentation: An Exceptionally Rare Presentation in an Athletic Female Patient with Morphea

    PubMed Central

    2016-01-01

    Introduction. Pseudohypertension is a condition which mainly occurs due to thickening-calcification of tunica intima of the arterial wall, leading to a faulty measurement of the intra-arterial blood pressure. To the best of our knowledge, this is the first case report in literature, of a pseudohypertension-like presentation in association with Morphea en plaque. Case Presentation. This is a rare presentation of a young athletic female and a professional tennis player, with pseudohypertension-like presentation. The patient had a traumatic injury to the right elbow joint; the injury occurred during a professional tennis match. The injury was managed by immobilization, physiotherapy, and Low-Level Laser Therapy. Soon after that, the patient had a circumscribed sclerotic ivory plaque affecting the skin of the right cubital fossa. The histopathology analysis, together with the serological-hematological tests and the clinical picture, along with positive Osler's signs, leads to the conclusive diagnosis of Morphea en plaque. The peculiar anatomic localization of the plaque anterior to the brachial artery leads to faulty blood pressure measurement as recorded by mercurial sphygmomanometer. Conclusion. This unique presentation of Morphea en plaque carries an important message in relation to the basic medical practice and in relation to the accurate measurement of the vital signs. PMID:28127475

  2. Unusual presentation of pelizaeus-merzbacher disease: female patient with deletion of the proteolipid protein 1 gene.

    PubMed

    Brender, Teva; Wallerstein, Donna; Sum, John; Wallerstein, Robert

    2015-01-01

    Pelizaeus-Merzbacher disease (PMD) is neurodegenerative leukodystrophy caused by dysfunction of the proteolipid protein 1 (PLP1) gene on Xq22, which codes for an essential myelin protein. As an X-linked condition, PMD primarily affects males; however there have been a small number of affected females reported in the medical literature with a variety of different mutations in this gene. No affected females to date have a deletion like our patient. In addition to this, our patient has skewed X chromosome inactivation which adds to her presentation as her unaffected mother also carries the mutation.

  3. Unusual Presentation of Pelizaeus-Merzbacher Disease: Female Patient with Deletion of the Proteolipid Protein 1 Gene

    PubMed Central

    Brender, Teva; Wallerstein, Donna; Sum, John; Wallerstein, Robert

    2015-01-01

    Pelizaeus-Merzbacher disease (PMD) is neurodegenerative leukodystrophy caused by dysfunction of the proteolipid protein 1 (PLP1) gene on Xq22, which codes for an essential myelin protein. As an X-linked condition, PMD primarily affects males; however there have been a small number of affected females reported in the medical literature with a variety of different mutations in this gene. No affected females to date have a deletion like our patient. In addition to this, our patient has skewed X chromosome inactivation which adds to her presentation as her unaffected mother also carries the mutation. PMID:25789183

  4. Physical performance characteristics of high-level female soccer players 12-21 years of age.

    PubMed

    Vescovi, J D; Rupf, R; Brown, T D; Marques, M C

    2011-10-01

    Performance assessment has become an invaluable component of monitoring player development and within talent identification programs in soccer, yet limited performance data are available for female soccer players across a wide age range. The aim of this study was to describe the physical performance characteristics of female soccer players ranging in age from 12 to 21 years. High-level female soccer players (n=414) were evaluated on linear sprinting (36.6 m with 9.1 m splits), countermovement jump (CMJ), and two agility tests. Separate one-way ANOVAs were used to compare performance characteristics between (1) each year of chronological age and (2) three age groups: 12-13 years, n=78, 14-17 years, n=223, and 18-21 years, n=113. Mean linear sprint speed over 9.1 m was similar across all chronological ages, however sprint speed over the final 9.1 m, CMJ height and agility scores improved until approximately 15-16 years. Outcomes from the group data indicated better performance on all tests for the 14-17-year-old group compared with the 12-13-year-old group. Additionally, sprint speed on the second and fourth 9.1 m splits and 36.6 m sprint speed as well as performance on the Illinois agility test was better in the 18-21-year-old group compared with the 14-17-year-old group. The findings from this study indicate that marked improvements of high intensity short duration work occur up until 15-16 years. Smaller gains in performance were observed beyond 16 years of age as evidenced by better performance on 36.6 m sprint speed, several sprint splits and the Illinois agility test in the college aged players (i.e., 18-21-year-old group).

  5. Serum free thyroxine levels are associated with the efficacy of weight reduction therapy in obese female patients.

    PubMed

    Hashimoto, Koshi; Tagami, Tetsuya; Yamakage, Hajime; Muranaka, Kazuya; Tanaka, Masashi; Odori, Shinji; Kono, Shigeo; Shimatsu, Akira; Ogawa, Yoshihiro; Satoh-Asahara, Noriko

    2016-01-01

    Thyroid function is strongly associated with obesity. The aim of this study is to investigate whether serum free thyroxine (FT4) and/or thyrotropin (TSH) levels are associated with the efficacy of weight reduction therapy in obese patients. We enrolled a total of 283 obese patients and cross-sectionally investigated the association of serum FT4 and/or TSH levels with metabolic features. Furthermore, in 97 obese patients who received 6-month weight reduction therapy, we assessed the relationship of serum FT4 and/or TSH levels to the efficacy of weight reduction therapy. Neither baseline serum FT4 nor TSH levels showed any correlations with body weight (BW) and body mass index (BMI) in these obese patients. However, in 57 obese female patients who underwent weight reduction therapy for six months, serum FT4 levels prior to the therapy was negatively correlated with the degrees of reduction of BW (r = -0.354, p = 0.007) and BMI (r = -0.373, p = 0.004). The correlation between baseline serum FT4 levels with the efficacy of weight reduction therapy was not observed in obese male or postmenopausal female patients. This study demonstrates that baseline serum FT4 levels are associated with weight reduction in obese female premenopausal patients. Therefore, baseline FT4 levels can be used as a clinical, noninvasive, hormonal predictor of weight reduction efficacy in obese patients.

  6. Resistance Training and Vibration Improve Muscle Strength and Functional Capacity in Female Patients with Multiple Sclerosis

    PubMed Central

    Eftekhari, Elham; Mostahfezian, Mina; Etemadifar, Masoud; Zafari, Ardeshir

    2012-01-01

    Purpose The purpose of this study was to evaluate the effect of an eight-week progressive resistance training and vibration program on strength and ambulatory function in multiple sclerosis (MS) patients. Methods Twenty-Four female MS patients with the following demographics: age 27-45 years, and expanded disability status scale (EDSS) 2-4, participated in this study. The subjects were randomly allocated to one of two groups. The exercise group (n = 12) trained according to a progressive program, mainly consisting of resistance training and vibration, three times a week for eight weeks and compared with subjects in the control group (n = 12) that received no intervention. Subjects completed one set of 5-12 reps at%50-70 maximal voluntary contraction (MVC). After 5-10 minutes rest, six postures on plate vibration were done. Isotonic MVC of knee extensors, abduction of the scapula and downward rotation of the scapular girdle muscle groups were predicted by using the Brzycki formula. Right leg balance (RLB), left leg balance (LLB), and walking speed (10-Meter Walk Test) were assessed before and after the training program. Descriptive statistics and Co-variance were used for analyzing data. Results After eight weeks of training the exercise group showed significant increase in MVC of Knee extensors (32.3%), Abduction of the scapula (24.7%) and Downward Rotation Scapular (39.1%) muscle groups, RLB (33.5%), LLB (9.5%), and decrease in 10-Meter Walk Test (10MWT) (9.3%), (P<0.05). Conclusions The results of this study indicated this type of training can cause improvements in muscle strength and functional capacity in patients with multiple sclerosis. PMID:23342227

  7. Associations between MDR1 gene polymorphisms and schizophrenia and therapeutic response to olanzapine in female schizophrenic patients.

    PubMed

    Bozina, Nada; Kuzman, Martina Rojnic; Medved, Vesna; Jovanovic, Nikolina; Sertic, Jadranka; Hotujac, Ljubomir

    2008-01-01

    Multidrug resistant protein (MDR1) gene, which codes for P-glycoprotein and functions as an efflux transporter in different cells, is widely localized in normal tissues including the gastrointestinal tract, blood cells, biliary tract, kidney and brain and plays a major role in absorption, distribution and elimination of various xenobiotics. Therefore, MDR1 gene variants were proposed as potential susceptibility factors for diseases and as determinants of treatment response to various drugs. We investigated the relationships between exon 21 G2677T and exon 26 C3435T genetic variants of MDR1 gene with susceptibility and treatment response in female schizophrenic patients. The study was conducted in two steps. We first compared allele, genotype and haplotype distributions between 117 female schizophrenic patients and 123 control female subjects. Afterwards, we studied treatment response to olanzapine, in 87 out of 117 previously unmedicated female patients. Overall, we found lower representation of G2677/C3435 haplotype in schizophrenic female patients compared to controls. Test result for linkage disequilibrium between loci was found to be significant. Furthermore, we found significant associations between MDR1 exon 21 G2677T genotypes and treatment response measured with positive PANSS percentage changes, with T allele and TT genotype being associated with significantly better treatment response. A borderline, non-significant statistical association was found between MDR1 exon 26 C3435T genotypes and treatment response, with TT genotype being associated with better treatment response. Our data support functional importance of the MDR1 mutations for the susceptibility and treatment response in female schizophrenic patients.

  8. Reduced brain activity in female patients with non-alcoholic fatty liver disease as measured by near-infrared spectroscopy.

    PubMed

    Takahashi, Atsushi; Kono, Soichi; Wada, Akira; Oshima, Sachie; Abe, Kazumichi; Imaizumi, Hiromichi; Fujita, Masashi; Hayashi, Manabu; Okai, Ken; Miura, Itaru; Yabe, Hirooki; Ohira, Hiromasa

    2017-01-01

    Patients with non-alcoholic fatty liver disease (NAFLD) have impaired health-related quality of life including physical and mental state. Near-infrared spectroscopy (NIRS) is a useful tool for evaluation of brain activity and depressive state. This study aimed to determine the brain activity of female NAFLD patients using NIRS. Cerebral oxygenated hemoglobin (oxy-Hb) concentration during a verbal fluency task (VFT) was measured using NIRS in 24 female NAFLD patients and 15 female healthy controls. The Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire was administered to both groups before NIRS. There was no significant difference in CES-D score between groups. However, the oxy-Hb concentration and number of words during the VFT were less in NAFLD compared to healthy controls. The mean value of oxy-Hb concentration during 0-60 s VFT in the frontal lobe was also smaller in NAFLD patients compared to healthy controls (0.082 ± 0.126 vs. 0.183 ± 0.145, P < 0.001). Cerebral oxygen concentration is poorly reactive in response to VFT in female NAFLD patients. This may indicate an association between decreased brain activity and NAFLD regardless of depression.

  9. Hair cortisol as a marker of hypothalamic-pituitary-adrenal Axis activity in female patients with major depressive disorder.

    PubMed

    Pochigaeva, Ksenia; Druzhkova, Tatiana; Yakovlev, Alexander; Onufriev, Mikhail; Grishkina, Maria; Chepelev, Aleksey; Guekht, Alla; Gulyaeva, Natalia

    2017-04-01

    Hair cortisol is regarded as a promising marker of hypothalamic-pituitary-adrenal axis (HPAA) activity alterations due to stress, somatic and mental health conditions. Hair cortisol was previously reported to be elevated in patients with depression, however the data related to remission and recurrent depressive episodes are different. In this study, levels of hair cortisol were assessed in female patients with major depressive disorder (MDD) and the validity of hair cortisol as a marker of HPAA activity in this condition was evaluated. Hair cortisol was measured in 1 cm hair segments of 21 female patients with MDD and 22 female age-matched controls using enzyme-immunoassay analysis. Concurrently, serum cortisol was assessed and psychological status was evaluated using 17-item Hamilton Depression Rating Scale (HAMD-17), Beck Depression Inventory (BDI) and the Spielberger state trait anxiety inventory (STAI). The levels of hair cortisol were significantly lower in the MDD group, while serum cortisol levels were significantly higher in patients, as compared with controls. A significant negative correlation was found between HAMD-17 scores and hair cortisol. Decreased hair cortisol found in female patients with MDD as compared to controls suggests downregulation of HPAA activity during the preceding month. Further studies are needed to investigate the profiles of hair cortisol at different stages of depressive disorder to establish this parameter as a handy clinical tool.

  10. Hypermethylation of FOXP3 Promoter and Premature Aging of the Immune System in Female Patients with Panic Disorder?

    PubMed Central

    Prelog, Martina; Hilligardt, Deborah; Schmidt, Christian A.; Przybylski, Grzegorz K.; Leierer, Johannes; Almanzar, Giovanni; El Hajj, Nady; Lesch, Klaus-Peter; Arolt, Volker; Zwanzger, Peter; Haaf, Thomas; Domschke, Katharina

    2016-01-01

    Immunological abnormalities associated with pathological conditions, such as higher infection rates, inflammatory diseases, cancer or cardiovascular events are common in patients with panic disorder. In the present study, T cell receptor excision circles (TRECs), Forkhead-Box-Protein P3 gene (FOXP3) methylation of regulatory T cells (Tregs) and relative telomere lengths (RTLs) were investigated in a total and subsamples of 131 patients with panic disorder as compared to 131 age- and sex-matched healthy controls in order to test for a potential dysfunction and premature aging of the immune system in anxiety disorders. Significantly lower TRECs (p = 0.004) as well as significant hypermethylation of the FOXP3 promoter region (p = 0.005) were observed in female (but not in male) patients with panic disorder as compared to healthy controls. No difference in relative telomere length was discerned between patients and controls, but significantly shorter telomeres in females, smokers and older persons within the patient group. The presently observed reduced TRECs in panic disorder patients and FOXP3 hypermethylation in female patients with panic disorder potentially reflect impaired thymus and immunosuppressive Treg function, which might partly account for the known increased morbidity and mortality of anxiety disorders conferred by e.g. cancer and cardiovascular disorders. PMID:27362416

  11. Illness perception and fibromyalgia impact on female patients from Spain and the Netherlands: do cultural differences exist?

    PubMed

    Ruiz-Montero, Pedro J; Van Wilgen, C Paul; Segura-Jiménez, Victor; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel

    2015-12-01

    The purpose of this study was to examine the differences in illness perception and overall impact on fibromyalgia females from Spain and the Netherlands. A total of 325 fibromyalgia females from Spain (54.3 ± 7.1 years) and the Netherlands (51.8 ± 7.2 years) participated in the study. Illness perception and impact of fibromyalgia were assessed by the Revised Illness Perception Questionnaire and the Fibromyalgia Impact Questionnaire, respectively. Spanish fibromyalgia females perceived more symptoms related to their fibromyalgia (identity) such as nausea, breathlessness, wheezing or fatigue (P < 0.001) and had greater emotional representation (P < 0.01). Dutch fibromyalgia females experienced less timeline (acute/chronic) and consequences (all, P < 0.05), had a better cyclical timeline, personal control, treatment control and illness coherence (all, P < 0.001). Spanish fibromyalgia females reported higher impact of fibromyalgia than Dutch females (61.2 + 14.8 vs. 54.9 + 16.4, respectively; P < 0.001), but the effect size was small (Cohen's d = 0.41) . Impact of fibromyalgia and negative views of fibromyalgia were higher in Spanish fibromyalgia females, whereas Dutch fibromyalgia females presented higher score of positive beliefs about the controllability of the illness. Psychological interventions which help patients to cope with their illness perception might lead to an improvement of the impact of the disease on fibromyalgia females.

  12. Long-Term Effects of Incest: Life Events Triggering Mental Disorders in Female Patients with Sexual Abuse in Childhood.

    ERIC Educational Resources Information Center

    Kinzl, Johannes; Biebl, Wilfried

    1992-01-01

    Psychosocial, psychosomatic, and psychodynamic factors were evaluated in 33 female psychiatric patients who had been victims of incest. Sexual abuse experiences in childhood were related to feelings of anxiety, helplessness, and powerlessness, which, with a lack of support from the mother, led to ego weakness, and an autoplastic model of coping…

  13. A clinical and demographic comparison between a forensic and a general sample of female patients with schizophrenia.

    PubMed

    Landgraf, Steffen; Blumenauer, Katrin; Osterheider, Michael; Eisenbarth, Hedwig

    2013-12-30

    Diagnoses of psychiatric diseases do not include criminal behavior. In schizophrenia, a non-negligible subgroup is incarcerated for capital and other crimes. Most studies that compared offender and non-offender patients with schizophrenia have only focused on male patients. With this study, we compared demographic and disease-related characteristics between 35 female incarcerated forensic patients (fSZ) and 35 female inpatients with schizophrenia (SZ). Basic clinical documentation and basic forensic clinical documentation revealed significant clinical and demographic differences between the two groups. Compared to SZ, fSZ were more severely clinically impaired, showing higher rates of comorbid alcohol and substance disorder, more suicide attempts, had more previous hospitalizations, and were younger at disease onset. Regarding demographic variables, fSZ showed a higher rate of unemployment and homelessness and had to rely more often on housing and legal guardianships compared to SZ. These results suggest that female forensic patients with schizophrenia are more severely affected by clinical and non-clinical variables requiring an adapted intervention program. These results may also indicate two developmental trajectories for criminal and non-criminal schizophrenia in females.

  14. Awakening arterial blood and end-tidal concentrations of isoflurane in female surgical patients

    PubMed Central

    Lin, Tso-Chou; Lu, Chih-Cherng; Hsu, Che-Hao; Pergolizz, Joseph V.; Chang, Cheng-Chang; Lee, Meei-Shyuan; Ho, Shung-Tai

    2016-01-01

    Abstract Delayed extubation occurs after isoflurane anesthesia, especially following prolonged surgical duration. We aimed to determine the arterial blood concentrations of isoflurane and the correlation with end-tidal concentrations for predicting emergence from general anesthesia. Thirty-four American Society of Anesthesiologists physical status class I–II gynecologic patients were included. General anesthesia was maintained with a fixed 2% inspiratory isoflurane in 6 L/minute oxygen, which was discontinued after surgery. One milliliter of arterial blood was obtained for the determination of isoflurane concentration by gas chromatography at 20 and 10 minutes before and 0, 5, 10, 15, and 20 minutes after discontinuation, in addition to the time of eye opening to verbal command, defined as awakening. Inspiratory and end-tidal concentrations were simultaneously detected by an infrared analyzer. The mean awakening arterial blood concentration of isoflurane was 0.20%, which was lower than the simultaneous end-tidal concentration 0.23%. The differences between arterial and end-tidal concentrations during emergence fell into an acceptable range (±1.96 standard deviation). After receiving a mean time of 108-minute general anesthesia, the time to eye opening after discontinuing isoflurane was 18.5 minutes (range 11–30, median 18 minutes), without statistical significance with anesthesia duration (P = 0.078) and body mass index (P = 0.170). We demonstrated the awakening arterial blood concentration of isoflurane in female patients as 0.20%. With well-assisted ventilation, the end-tidal concentration could be an indicator for the arterial blood concentration to predict emergence from shorter duration of isoflurane anesthesia. PMID:27472727

  15. Depression, anxiety and stress among female patients of infertility; A case control study

    PubMed Central

    Yusuf, Lamia

    2016-01-01

    Objectives: Infertility, in many ways, is a very distressing condition that can have its impact on social and marital life of a couple. Depression, anxiety and stress associated with infertility may affect treatment and outcomes for such couples. The purpose of this study was to find out prevalence of depression, anxiety and stress among females suffering from infertility. Methods: One hundred females suffering from infertility as study subjects and 100 females accompanying them as controls were randomly selected from infertility clinic at Arif Memorial Teaching Hospital, Lahore, Pakistan. Females with diagnosed mental health issues and those from couples having male factor infertility were not included. Validated Urdu version of Depression, anxiety, stress scale (DASS) was used for assessment of depression, anxiety and stress scores. Results from both groups were compared and independent sample t-test was used to analyze the results. Results: There was high prevalence of depression, anxiety and stress among females suffering from infertility compared to females in control group (p < 0.05). Level of education did not appear to have any positive effect on these scores. Similarly, results did not appear to change when occupations of infertile females were used for stratified analysis. Conclusion: Depression, anxiety and stress are very common among females suffering from infertility. Healthcare professionals should consider psychological counseling, and psychiatric help if required, when they offer fertility treatment for such females. PMID:28083022

  16. Mixed Form of Hirsutism in an Adolescent Female and Laser Therapy

    PubMed Central

    Gacaferri Lumezi, Besa; Goci, Aferdita; Lokaj, Violeta; Latifi, Hatixhe; Karahoda, Natyra; Minci, Ganimete; Telaku, Drita; Gercari, Antigona; Kocinaj, Allma

    2014-01-01

    Introduction: Hirsutism is a common disorder of excess growth of terminal hair in an androgen-dependent male distribution in women, including the chin, upper lip, breasts, back, and abdomen. It is very important to identify the etiology of hirsutism and adequate treat is prior to any cosmetic therapy. Case Presentation: The case was a 17-year-old female with severe hirsutism, oligomenorrhea, and obesity. She was evaluated to identify the etiology and diagnosed as a case of polycystic ovarian syndrome (PCOS), nonclassic congenital adrenal hyperplasia (NC-CAH), and hyperandrogenic insulin-resistant acanthosis nigricans (HAIR-AN) syndrome, which is a rare combination of hirsutism etiology. She was successfully treated according to the underlying pathology, and laser photoepilation was used as the preferred hair removal method. Discussion: Establishing the etiology, using the evidence–based strategies to improve hirsutism, and treating the underlying disorder, are essential for proper management of women with hirsutism. PMID:25068069

  17. Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients

    PubMed Central

    Merchant, Roland C; Gee, Erin M; Bock, Beth C; Becker, Bruce M; Clark, Melissa A

    2007-01-01

    all questions about each cancer screening or contraceptive method. Conclusion Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods. PMID:17519020

  18. A Rare Case of an Early Postoperative Obstructive Ileus in a Young Female Patient due to a Residual Trichobezoar Mass

    PubMed Central

    Christopoulos, P.; Ross-Thriepland, S.; McCarthy, H.; Day, C. S.; Sasi, W.

    2016-01-01

    Trichobezoar is a rare cause of small bowel obstruction, whereby a mass forms most commonly in the stomach and duodenum of young females, from ingestion of hair, a condition known as trichophagia. We present a case of recurrent small bowel obstruction due to a residual hair mass that was removed surgically in a young female patient who had a laparotomy and gastrotomy for removal of a large gastric trichobezoar just two weeks prior to the current admission. This case illustrates the importance of a thorough inspection of the whole bowel to ensure that no residual bezoars remain after surgery. PMID:27148464

  19. Scapular notching and osteophyte formation after reverse shoulder replacement: Radiological analysis of implant position in male and female patients.

    PubMed

    Roche, C P; Marczuk, Y; Wright, T W; Flurin, P-H; Grey, S; Jones, R; Routman, H D; Gilot, G; Zuckerman, J D

    2013-04-01

    This study provides recommendations on the position of the implant in reverse shoulder replacement in order to minimise scapular notching and osteophyte formation. Radiographs from 151 patients who underwent primary reverse shoulder replacement with a single prosthesis were analysed at a mean follow-up of 28.3 months (24 to 44) for notching, osteophytes, the position of the glenoid baseplate, the overhang of the glenosphere, and the prosthesis scapular neck angle (PSNA). A total of 20 patients (13.2%) had a notch (16 Grade 1 and four Grade 2) and 47 (31.1%) had an osteophyte. In patients without either notching or an osteophyte the baseplate was found to be positioned lower on the glenoid, with greater overhang of the glenosphere and a lower PSNA than those with notching and an osteophyte. Female patients had a higher rate of notching than males (13.3% vs 13.0%) but a lower rate of osteophyte formation (22.9% vs 50.0%), even though the baseplate was positioned significantly lower on the glenoid in females (p = 0.009) and each had a similar mean overhang of the glenosphere. Based on these findings we make recommendations on the placement of the implant in both male and female patients to avoid notching and osteophyte formation.

  20. [Combined Chemotherapy with Radiation was Tolerable and Effective Treatment in Female Octogenarian Patients with Urethral Cancer -Two Case Reports].

    PubMed

    Tachibana, Takashi; Matsumoto, Kazumasa; Nagi, Shoji; Hagiwara, Masahiro; Kobayashi, Kentaro; Tsumura, Hideyasu; Yoshida, Kazunari; Iwamura, Masatsugu

    2016-07-01

    We report two octogenarian patients with primary urethral cancer treated with chemotherapy and external beam radiation therapy. An 85-year-old female presented with perineal bleeding. Magnetic resonance imaging (MRI) showed a locally advanced tumor in the urethra. Biopsy was performed and pathologic findings demonstrated squamous cell carcinoma. After receiving one cycle of a half dose of gemcitabine and nedaplatin, the patient received external beam radiation therapy with gemcitabine and nedaplatin treatment followed by two more cycles of chemotherapy. Complete response was achieved. An 87-year-old female presented with vaginal bleeding. MRIrevealed locally advanced urethral tumor with bilateral inguinal lymph node metastases. Scratch and urine cytology of tumor demonstrated squamous cell carcinoma. After the same treatment as in case 1, primary cancer and lymph node metastases were significantly decreased. There have been no signs of recurrence or progression after treatment, and no severe adverse events in either patient during 53 and 26 months'follow up, respectively.

  1. Hydroxychloroquine-induced seizure in a patient with systemic lupus erythematosus.

    PubMed

    Malcangi, G; Fraticelli, P; Palmieri, C; Cappelli, M; Danieli, M G

    2000-12-01

    We report on a case of a 17-year-old female with systemic lupus erythematosus (SLE), with a clinical history of complex partial seizure, who developed a tonicoclonic crisis after receiving hydroxychloroquine for 2 weeks at a dosage of 200 mg/day (5 mg/kg). The absence of previous similar episodes and of recurrences after withdrawal of the drug in subsequent months, the short latency after administration and the favourable short-term evolution raised suspicions for a potential role of the drug in the development of the isolated convulsive crisis. It is possible for hydroxychloroquine to be responsible for tonicoclonic seizures in predisposed subjects.

  2. Signs of ongoing inflammation in female patients with chronic widespread pain

    PubMed Central

    Gerdle, Björn; Ghafouri, Bijar; Ghafouri, Nazdar; Bäckryd, Emmanuel; Gordh, Torsten

    2017-01-01

    Abstract This cross-sectional study investigates the plasma inflammatory profile of chronic widespread pain (CWP) patients compared to healthy controls (CON). Rather than analyzing a relatively few substances at a time, we used a new multiplex proximity extension assay (PEA) panel that enabled the simultaneous analysis of 92 inflammation-related proteins, mainly cytokines and chemokines. Seventeen women with CWP and 21 female CON participated and a venous blood sample was drawn from all subjects. Pain intensity and pain thresholds for pressure, heat, and cold were registered. A PEA panel (92 proteins) was used to analyze the blood samples. Multivariate data analysis by projection was used in the statistical analyses. Eleven proteins significantly differentiated the CON and CWP subjects (R2 = 0.58, Q2 = 0.37, analysis of variance of cross-validated predictive residuals P = 0.006). It was not possible to significantly regress pain thresholds within each group (CON or CWP). Positive significant correlations existed between several proteins and pain intensities in CWP, but the model reliability of the regression was poor. CWP was associated with systemic low-grade inflammation. Larger studies are needed to confirm the results and to investigate which alterations are condition-specific and which are common across chronic pain conditions. The presence of inflammation could promote the spreading of pain, a hallmark sign of CWP. As it has been suggested that prevalent comorbidities to pain (e.g., depression and anxiety, poor sleep, and tiredness) also are associated with inflammation, it will be important to determine whether inflammation may be a common mediator. PMID:28248866

  3. Metformin use and cervical cancer risk in female patients with type 2 diabetes

    PubMed Central

    Tseng, Chin-Hsiao

    2016-01-01

    This study evaluated whether metformin may affect the risk of cervical cancer. The reimbursement databases of the Taiwan's National Health Insurance were used. Female patients with type 2 diabetes at an onset age of 25-74 years during 1999-2005 and newly treated with metformin (n=132971, “ever users of metformin”) or other antidiabetic drugs (n=6940, “never users of metformin”) were followed for at least 6 months until December 31, 2011. The treatment effect of metformin (for ever versus never users, and for tertiles of cumulative duration of therapy) was estimated by Cox regression incorporated with the inverse probability of treatment weighting using propensity score. Analyses were also conducted in a 1:1 matched pair cohort based on 8 digits of propensity score. Results showed that the respective numbers of incident cervical cancer in ever users and never users were 438 (0.33%) and 38 (0.55%), with respective incidences of 68.29 and 121.38 per 100,000 person-years. The overall hazard ratio suggested a significantly lower risk in metformin users (0.558, 95% confidence intervals: 0.401-0.778). In tertile analyses, the hazard ratios (95% confidence intervals) for the first (<23.0 months), second (23.0-47.9 months) and third (>47.9 months) tertile of cumulative duration were 1.272 (0.904-1.790), 0.523 (0.366-0.747) and 0.109 (0.070-0.172), respectively. Findings were supported by the analyses in the matched cohort. In conclusion, metformin may significantly reduce the risk of cervical cancer, especially when the cumulative duration is more than 2 years. PMID:27486978

  4. [Domestic violence against women and health care demands. Results of a female emergency department patient survey].

    PubMed

    Brzank, P; Hellbernd, H; Maschewsky-Schneider, U; Kallischnigg, G

    2005-03-01

    Domestic violence (DV) is a serious risk for women's health. So far, little attention has been paid to this area in research and medical care in Germany. Acknowledging this deficit, the S.I.G.N.A.L.-Intervention Project has started to develop a program to improve the medical care for victimized women. For the first time in Germany, data on the health care needs of victimized women have been collected within the S.I.G.N.A.L.-Evaluation Research Project. This article presents the results of a female patient survey (n=806) on DV conducted in the emergency department (ED) of a university hospital in Berlin. The results demonstrate that 36.6% of women reported at least one episode of DV after the age of 16. A total of 4.6% were victims of DV over the past year, and 1.5% of women came to the ED for treatment of injuries caused by violence. A total of 57% of the victims of at least one episode of DV in their lifetime after the age of 16 described a negative impact on their health. The most frequently reported sequelae were head injuries, haematomas and fractures, gastrointestinal disorders, headache/migraine and heart disease. The psychological symptoms were anxiety, depression and suicide/self-mutilation attempts. Some 52% of the victims who reported health consequences had received medical care. In case of DV occurring, 67% of all women said that they would discuss it with their physicians. Approximately 80% of all respondents favoured a routine inquiry for DV as part of the medical history protocol of the ED.

  5. Patient-specific FDG dosimetry for adult males, adult females, and very low birth weight infants

    NASA Astrophysics Data System (ADS)

    Niven, Erin

    Fluorodeoxyglucose is the most commonly used radiopharmaceutical in Positron Emission Tomography, with applications in neurology, cardiology, and oncology. Despite its routine use worldwide, the radiation absorbed dose estimates from FDG have been based primarily on data obtained from two dogs studied in 1977 and 11 adults (most likely males) studied in 1982. In addition, the dose estimates calculated for FDG have been centered on the adult male, with little or no mention of variations in the dose estimates due to sex, age, height, weight, nationality, diet, or pathological condition. Through an extensive investigation into the Medical Internal Radiation Dose schema for calculating absorbed doses, I have developed a simple patient-specific equation; this equation incorporates the parameters necessary for alterations to the mathematical values of the human model to produce an estimate more representative of the individual under consideration. I have used this method to determine the range of absorbed doses to FDG from the collection of a large quantity of biological data obtained in adult males, adult females, and very low birth weight infants. Therefore, a more accurate quantification of the dose to humans from FDG has been completed. My results show that per unit administered activity, the absorbed dose from FDG is higher for infants compared to adults, and the dose for adult women is higher than for adult men. Given an injected activity of approximately 3.7 MBq kg-1, the doses for adult men, adult women, and full-term newborns would be on the order of 5.5, 7.1, and 2.8 mSv, respectively. These absorbed doses are comparable to the doses received from other nuclear medicine procedures.

  6. DNA methylation patterns of protein coding genes and long noncoding RNAs in female schizophrenic patients.

    PubMed

    Liao, Qi; Wang, Yunliang; Cheng, Jia; Dai, Dongjun; Zhou, Xingyu; Zhang, Yuzheng; Gao, Shugui; Duan, Shiwei

    2015-02-01

    Schizophrenia (SCZ) is a complex mental disorder contributed by both genetic and epigenetic factors. Long noncoding RNAs (lncRNAs) was recently found playing an important regulatory role in mental disorders. However, little was known about the DNA methylation of lncRNAs, although numerous SCZ studies have been performed on genetic polymorphisms or epigenetic marks in protein coding genes. We presented a comprehensive genome wide DNA methylation study of both protein coding genes and lncRNAs in female patients with paranoid and undifferentiated SCZ. Using the methyl-CpG binding domain (MBD) protein-enriched genome sequencing (MBD-seq), 8,163 and 764 peaks were identified in paranoid and undifferentiated SCZ, respectively (p < 1 × 10-5). Gene ontology analysis showed that the hypermethylated regions were enriched in the genes related to neuron system and brain for both paranoid and undifferentiated SCZ (p < 0.05). Among these peaks, 121 peaks were located in gene promoter regions that might affect gene expression and influence the SCZ related pathways. Interestingly, DNA methylation of 136 and 23 known lncRNAs in Refseq database were identified in paranoid and undifferentiated SCZ, respectively. In addition, ∼20% of intergenic peaks annotated based on Refseq genes were overlapped with lncRNAs in UCSC and gencode databases. In order to show the results well for most biological researchers, we created an online database to display and visualize the information of DNA methyation peaks in both types of SCZ (http://www.bioinfo.org/scz/scz.htm). Our results showed that the aberrant DNA methylation of lncRNAs might be another important epigenetic factor for SCZ.

  7. Fontan Operation in a Patient with Severe Hypoplastic Right Pulmonary Artery, Single Ventricle, and Heterotaxy Syndrome

    PubMed Central

    Pan, Jun-Yen; Lin, Chu-Chuan; Chang, Jen-Ping

    2016-01-01

    Assessment of the pulmonary circulation status including pressure, resistance, size, and absence of anatomical distortion, is crucial to the successful Fontan operation. Most patients are found to have acceptable pulmonary arteries after previous palliation, although some degree of distortion is not uncommon. However, in rare instances, some patients have only one functioning lung with another pulmonary artery seriously hypoplastic or atretic. For theses patients, completion of a Fontan operation will be challenging. We reported a 17-year-old girl with a single ventricle and heterotaxy syndrome and only her left lung functioning, who underwent one-lung Fontan operation with a satisfactory result. PMID:27713611

  8. [Problematic substance abuse and history of suicidal behavior in female patients in an acute mental health service].

    PubMed

    Camino, Sebastián; Expósito, Ramiro; Rodante, Demián

    2016-07-01

    Current publications that analyze operational and epidemiologic variables in the Argentinian Mental Health System are scarce. Several international studies have found a correlation between substance abuse and suicidal behavior. However, to our knowledge, there are no local studies that verify this association, especially in hospitalized female patients. The aim of this study is to verify this association in a population of female patients hospitalized in a Mental Health Hospital between august 2007 and july 2013. The electronic database of the Emergency department of the "Braulio A. Moyano" Neuropsychiatric Hospital was used as secondary source. The correlation between problematic substance use and history of suicidal behavior was studied, according to the type of substance used, diagnosis and age of the sample. These results might allow the creation of hypotheses that may benefit the planning and clinical practice in mental health in the local area.

  9. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome

    PubMed Central

    Chevidikunnan, Mohamed Faisal; Al Saif, Amer; Gaowgzeh, Riziq Allah; Mamdouh, Khaled A

    2016-01-01

    [Purpose] Patellofemoral pain syndrome is a frequent musculoskeletal disorder, which can result from core muscles instability that can lead to pain and altered dynamic balance. The objective of this study is to assess the effect of core muscle strengthening on pain and dynamic balance in female patients with patellofemoral pain syndrome. [Subjects and Methods] Twenty female patients with age ranging from 16 to 40 years with patellofemoral pain syndrome were divided into study (N=10) and control (N=10) groups. Both groups were given 4 weeks of conventional physical therapy program and an additional core muscle strengthening for the study group. The tools used to assess the outcome were Visual Analogue Scale and Star Excursion Balance Test. [Results] The results of the study show that participants in the study group revealed a significantly greater improvement in the intensity of pain and dynamic balance as compared to the control group. [Conclusion] Adding a core muscle-strengthening program to the conventional physical therapy management improves pain and dynamic balance in female patients with patellofemoral pain syndrome. PMID:27313363

  10. Effects of Hatha yoga exercise on plasma malondialdehyde concentration and superoxide dismutase activity in female patients with shoulder pain

    PubMed Central

    Ha, Min-Sung; Kim, Do-Yeon; Baek, Yeong-Ho

    2015-01-01

    [Purpose] The purpose of this study was to analyze the effects of Hatha yoga exercise on plasma malondialdehyde (MDA) concentration and superoxide dismutase (SOD) activity in female patients with shoulder pain. [Subjects] Subjects comprised 20 female patients with shoulder pain. [Methods] Subjects were divided into 2 groups: a Hatha yoga exercise group (n = 10) and a control group that performed no exercise (n = 10). The subjects’ body composition, plasma malondialdehyde concentrations, and superoxide dismutase activities were measured before and after a 16-week Hatha yoga exercise program. [Results] After the 16-week Hatha yoga exercise program, the exercise group had significantly lower plasma MDA concentrations than the control group. In addition, the exercise group had significantly higher plasma SOD activity than the control group. [Conclusions] Hatha yoga exercise improves flexibility, muscle tone and strength, balance, and joint function. Our findings indicate that regular and continuous yoga exercise effectively improved body composition, decrease plasma MDA concentration, and increase plasma SOD activity in female patients with shoulder pain. PMID:26311934

  11. The Effects of VR-based Wii Fit Yoga on Physical Function in Middle-aged Female LBP Patients.

    PubMed

    Kim, Seong-Sik; Min, Won-Kyu; Kim, Jung-Hee; Lee, Byoung-Hee

    2014-04-01

    [Purpose] The purpose of this research was to determine the effects of a virtual reality-based yoga program on middle-aged female low back pain patients. [Subjects and Methods] Thirty middle-aged female patients who suffered from low back pain were assigned to either a physical therapy program or a virtual reality-based yoga program for a period of four weeks. Participants could check their posture and weight bearing on a monitor as they shifted their weight or changed their postures on a Wii balance board. There were a total of seven exercise programs. A 30-minute, three times per week, virtual reality-based Wii Fit yoga program or trunk stabilizing exercise was performed, respectively. [Results] Repeated-measures analysis of covariance revealed significant differences in between pre- and post-training VAS, algometer, Oswestry low-back pain disability index (ODI), Roland Morris disability questionnaire (RMDQ), and fear avoidance beliefs questionnaire (FBQ) scores. The VAS, algometer, ODI, RMDQ, and FBQ scores showed significant differences in groups. Regarding the effect of time-by-group interaction, there were significant differences in VAS, ODI, ODI, and FBQ scores. [Conclusion] In conclusion, for middle-aged female patients who have low back pain, a virtual reality-based yoga program was shown to have positive effects on physical improvements, and this program can be employed as a therapeutic medium for prevention and cure of low back pain.

  12. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome.

    PubMed

    Chevidikunnan, Mohamed Faisal; Al Saif, Amer; Gaowgzeh, Riziq Allah; Mamdouh, Khaled A

    2016-05-01

    [Purpose] Patellofemoral pain syndrome is a frequent musculoskeletal disorder, which can result from core muscles instability that can lead to pain and altered dynamic balance. The objective of this study is to assess the effect of core muscle strengthening on pain and dynamic balance in female patients with patellofemoral pain syndrome. [Subjects and Methods] Twenty female patients with age ranging from 16 to 40 years with patellofemoral pain syndrome were divided into study (N=10) and control (N=10) groups. Both groups were given 4 weeks of conventional physical therapy program and an additional core muscle strengthening for the study group. The tools used to assess the outcome were Visual Analogue Scale and Star Excursion Balance Test. [Results] The results of the study show that participants in the study group revealed a significantly greater improvement in the intensity of pain and dynamic balance as compared to the control group. [Conclusion] Adding a core muscle-strengthening program to the conventional physical therapy management improves pain and dynamic balance in female patients with patellofemoral pain syndrome.

  13. The Effects of VR-based Wii Fit Yoga on Physical Function in Middle-aged Female LBP Patients

    PubMed Central

    Kim, Seong-Sik; Min, Won-Kyu; Kim, Jung-Hee; Lee, Byoung-Hee

    2014-01-01

    [Purpose] The purpose of this research was to determine the effects of a virtual reality-based yoga program on middle-aged female low back pain patients. [Subjects and Methods] Thirty middle-aged female patients who suffered from low back pain were assigned to either a physical therapy program or a virtual reality-based yoga program for a period of four weeks. Participants could check their posture and weight bearing on a monitor as they shifted their weight or changed their postures on a Wii balance board. There were a total of seven exercise programs. A 30-minute, three times per week, virtual reality-based Wii Fit yoga program or trunk stabilizing exercise was performed, respectively. [Results] Repeated-measures analysis of covariance revealed significant differences in between pre- and post-training VAS, algometer, Oswestry low-back pain disability index (ODI), Roland Morris disability questionnaire (RMDQ), and fear avoidance beliefs questionnaire (FBQ) scores. The VAS, algometer, ODI, RMDQ, and FBQ scores showed significant differences in groups. Regarding the effect of time-by-group interaction, there were significant differences in VAS, ODI, ODI, and FBQ scores. [Conclusion] In conclusion, for middle-aged female patients who have low back pain, a virtual reality-based yoga program was shown to have positive effects on physical improvements, and this program can be employed as a therapeutic medium for prevention and cure of low back pain. PMID:24764631

  14. Churg-Strauss syndrome (CSS) in a patient receiving pranlukast.

    PubMed

    Kobayashi, Shigeto; Ishizuka, Shyugo; Tamura, Naoto; Takaya, Makiyo; Kaneda, Kazuhiko; Hashimoto, Hiroshi

    2003-12-01

    Pranlukast is a cysteinyl leukotriene receptor I antagonist (LTRAs) approved for treatment of asthma in Japan since 1995. Compared to other LTRAs, such as zafilukast and montelukast, only few cases with Churg-Strauss syndrome (CSS) have been reported in association with treatment with pranlukast. We describe a 17-year-old Japanese male patient who developed CSS with a 13 month history of mild asthma receiving pranlukast for 11 months without systemic and/or inhaled corticosteroid administration prior to development of CSS. From the aspect of temporal relationship between treatment with pranlukast and development of CSS, a direct induction of CSS by pranlukast is suggested in our case.

  15. Cross-sensitization between poppy seed and buckwheat in a food-allergic patient with poppy seed anaphylaxis.

    PubMed

    Oppel, Tilmann; Thomas, Peter; Wollenberg, Andreas

    2006-01-01

    The opium poppy, Papaver somniferum L., is the source of both poppy seeds and opium. The commercially available seeds are widely used as ingredients for various kinds of food. IgE-mediated sensitization to poppy seeds is rare, but, if present, clinical symptoms are usually severe. Cross-sensitizations between poppy seeds and other food allergens have been described with sesame, hazelnut, rye grain and kiwi fruit. We report the case of a 17-year-old female with an apparently food-allergic reaction after ingestion of a poppy seed cake. Allergological workup revealed a poppy seed anaphylaxis and led to the identification of a novel cross-sensitization with buckwheat.

  16. Physiologic and thermal responses of male and female patients with multiple sclerosis to head and neck cooling

    NASA Technical Reports Server (NTRS)

    Ku, Y. T.; Montgomery, L. D.; Wenzel, K. C.; Webbon, B. W.; Burks, J. S.

    1999-01-01

    Personal cooling systems are used to alleviate symptoms of multiple sclerosis and to prevent increased core temperature during daily activities. The objective of this study was to determine the thermal and physiologic responses of patients with multiple sclerosis to short-term maximal head and neck cooling. A Life Support Systems, Inc. Mark VII portable cooling system and a liquid cooling helmet were used to cool the head and neck regions of 24 female and 26 male patients with multiple sclerosis in this study. The subjects, seated in an upright position at normal room temperature (approximately 22 degrees C), were cooled for 30 min by the liquid cooling garment, which was operated at its maximum cooling capacity. Oral, right, and left ear temperatures and cooling system parameters were logged manually every 5 min. Forearm, calf, chest, and rectal temperatures, heart rate, and respiration rate were recorded continuously on a U.F.I., Inc. Biolog ambulatory monitor. This protocol was performed during the winter and summer to investigate the seasonal differences in the way patients with multiple sclerosis respond to head and neck cooling. No significant differences were found between the male and female subject group's mean rectal or oral temperature responses during any phase of the experiment. The mean oral temperature decreased significantly (P < 0.05) for both groups approximately 0.3 degrees C after 30 min of cooling and continued to decrease further (approximately 0.1-0.2 degrees C) for a period of approximately 15 min after removal of the cooling helmet. The mean rectal temperatures decreased significantly (P < 0.05) in both male and female subjects in the winter studies (approximately 0.2-0.3 degrees C) and for the male subjects during the summer test (approximately 0.2 degrees C). However, the rectal temperature of the female subjects did not change significantly during any phase of the summer test. These data indicate that head and neck cooling may, in

  17. Body composition and risk for metabolic alterations in female adolescents

    PubMed Central

    de Faria, Eliane Rodrigues; Gontijo, Cristiana Araújo; Franceschini, Sylvia do Carmo C.; Peluzio, Maria do Carmo G.; Priore, Silvia Eloiza

    2014-01-01

    OBJECTIVE: To study anthropometrical and body composition variables as predictors of risk for metabolic alterations and metabolic syndrome in female adolescents. METHODS: Biochemical, clinical and corporal composition data of 100 adolescents from 14 to 17 years old, who attended public schools in Viçosa, Southeastern Brazil, were collected. RESULTS: Regarding nutritional status, 83, 11 and 6% showed eutrophia, overweight/obesity and low weight, respectively, and 61% presented high body fat percent. Total cholesterol presented the highest percentage of inadequacy (57%), followed by high-density lipoprotein (HDL - 50%), low-density lipoprotein (LDL - 47%) and triacylglycerol (22%). Inadequacy was observed in 11, 9, 3 and 4% in relation to insulin resistance, fasting insulin, blood pressure and glycemia, respectively. The highest values of the fasting insulin and the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) were verified at the highest quartiles of body mass index (BMI), waist perimeter, waist-to-height ratio and body fat percent. Body mass index, waist perimeter, and waist-to-height ratio were the better predictors for high levels of HOMA-IR, blood glucose and fasting insulin. Waist-to-hip ratio was associated to arterial hypertension diagnosis. All body composition variables were effective in metabolic syndrome diagnosis. CONCLUSIONS: Waist perimeter, BMI and waist-to-height ratio showed to be good predictors for metabolic alterations in female adolescents and then should be used together for the nutritional assessment in this age range. PMID:25119752

  18. Long-term outcome of peroral endoscopic myotomy for achalasia treatment in a 9-year-old female patient.

    PubMed

    Yamashita, Kanefumi; Shiwaku, Hironari; Hirose, Ryuichiro; Kai, Hiroki; Nakashima, Ryo; Kato, Daisuke; Beppu, Richiko; Takeno, Shinsuke; Sasaki, Takamitsu; Nimura, Satoshi; Iwasaki, Akinori; Inoue, Haruhiro; Yamashita, Yuichi

    2016-11-01

    Achalasia is a primary motility disorder with incomplete lower esophageal sphincter relaxation; it has an annual incidence of 0.11 cases per 100 000 children. Peroral endoscopic myotomy (POEM) is a new endoscopic treatment method for achalasia. Reports about POEM in pediatric patients are rare. We herein report the case of a 9-year-old female patient with achalasia who underwent POEM. The patient underwent endoscopic balloon dilatation because medication was not effective at a previous hospital; however, endoscopic balloon dilatation was not effective either. She then underwent successful POEM upon admission at our hospital. The patient was symptom-free at 2 years postoperatively with no signs of esophagitis in the absence of proton-pump inhibitor therapy.

  19. Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians.

    PubMed

    Potter, Jennifer; Peitzmeier, Sarah M; Bernstein, Ida; Reisner, Sari L; Alizaga, Natalie M; Agénor, Madina; Pardee, Dana J

    2015-12-01

    Guidelines for cervical cancer screening have evolved rapidly over the last several years, with a trend toward longer intervals between screenings and an increasing number of screening options, such as Pap/HPV co-testing and HPV testing as a primary screening. However, gynecological recommendations often do not include clinical considerations specific to patients on the female-to-male (FTM) spectrum. Both patients and providers may not accurately assess risk for HPV and other sexually transmitted infections, understand barriers to care, or be aware of recommendations for cervical cancer screening and other appropriate sexual and reproductive health services for this patient population. We review the evidence and provide guidance on minimizing emotional discomfort before, during, and after a pelvic exam, minimizing physical discomfort during the exam, and making adaptations to account for testosterone-induced anatomical changes common among FTM patients.

  20. An Intervention to Promote the Female Condom to Sexually Transmitted Disease Clinic Patients

    ERIC Educational Resources Information Center

    Artz, Lynn; Macaluso, Maurizio; Kelaghan, Joseph; Austin, Harland; Fleenor, Michael; Robey, Lawrence; Hook, III, Edward W.; Brill, Ilene

    2005-01-01

    This article describes a 1-hour behavioral intervention designed to promote female condoms and safer sex to women at a high risk for sexually transmitted diseases (STDs). The intervention includes a promotional videotape; a skills-oriented counseling session with a nurse clinician; assorted take-home items, including a videotape for men; and free…

  1. The ratio of alpha-galactosidase to beta-glucuronidase activities in dried blood for the identification of female Fabry disease patients.

    PubMed

    Lukacs, Z; Keil, A; Kohlschütter, A; Beck, M; Mengel, E

    2005-01-01

    Female heterozygous patients with Fabry disease are difficult to identify because of the relatively high residual activity of alpha-galactosidase. We systematically evaluated the activities of various lysosomal enzymes in dried blood samples from Fabry patients and found that the beta-glucuronidase activity was frequently elevated. The ratio of alpha-galactosidase to beta-glucuronidase proved to be a helpful tool for the diagnosis of female Fabry disease patients.

  2. Worse health-related quality of life and hip function in female patients with elevated chromium levels.

    PubMed

    Hussey, Daniel K; Madanat, Rami; Donahue, Gabrielle S; Rolfson, Ola; Muratoglu, Orhun K; Malchau, Henrik

    2016-10-01

    Background and purpose - Blood metal ion levels can be an indicator for detecting implant failure in metal-on-metal (MoM) hip arthroplasties. Little is known about the effect of bilateral MoM implants on metal ion levels and patient-reported outcomes. We compared unilateral patients and bilateral patients with either an ASR hip resurfacing (HR) or an ASR XL total hip replacement (THR) and investigated whether cobalt or chromium was associated with a broad spectrum of patient outcomes. Patients and methods - From a registry of 1,328 patients enrolled in a multicenter prospective follow-up of the ASR Hip System, which was recalled in 2010, we analyzed data from 659 patients (311 HR, 348 THR) who met our inclusion criteria. Cobalt and chromium blood metal ion levels were measured and a 21-item patient-reported outcome measures (PROMs) questionnaire was used mean 6 years after index surgery. Results - Using a minimal threshold of ≥7 ppb, elevated chromium ion levels were found to be associated with worse health-related quality of life (HRQoL) (p < 0.05) and hip function (p < 0.05) in women. These associations were not observed in men. Patients with a unilateral ASR HR had lower levels of cobalt ions than bilateral ASR HR patients (p < 0.001) but similar levels of chromium ions (p = 0.09). Unilateral ASR XL THR patients had lower chromium and cobalt ion levels (p < 0.005) than bilateral ASR XL THR patients. Interpretation - Chromium ion levels of ≥7 ppb were associated with reduced functional outcomes in female MoM patients.

  3. Profile of female patients seeking in-patient treatment for prescription opioid abuse from a tertiary care drug dependence treatment centre from India

    PubMed Central

    Dayal, Prabhoo; Balhara, Yatan Pal Singh

    2016-01-01

    Background & objectives: There has been a limited focus on prescription drug abuse among women in the country. Choice of psychoactive substance, reasons for initiation and co-occurring disorders have been found to be different among men and women. The current study was aimed at studying the profile of female patients seeking in-patient treatment for prescription drug use over a period of five years at a tertiary care drug dependence treatment centre in India. Methods: Case records of all female patients admitted with substance use disorder at a national level drug dependence treatment centre in north India across five years (between January 2008 and December 2012) were reviewed retrospectively to study their socio-demographic and clinical profile. The information was gathered using a semi-structured proforma and detailed case records. Abstinence, relapse and retention rates were calculated. Results: Over the five years, 31 female patients were admitted with prescription drug abuse. Of them, 12 (39%) used prescription opioids and 11 (36%) used prescription opioid along with benzodiazepines. Commonest prescription opioid was pentazocine used by 87 per cent of the women. Twenty two (71%) women were introduced to opioid by medical practitioners and commonest reason for introduction was pain (among 48%). Common co-occurring psychiatric diagnoses were depressive disorder (26%), cluster B traits/disorder (19%) and somatoform disorder (13%). Eight women did not complete treatment and left against medical advice. Thirteen women were advised maintenance treatment, and 70 per cent of them were retained for at least six months. Interpretation & conclusions: Our findings revealed a link between mental illness, pain and non-medical use of prescription opioids among women. Majority of these women received opioids as a legitimate prescription form physician. Therefore, these legitimate prescribers should be trained for pain management to facilitate proper treatment of pain and to

  4. Structure and strength of the distal radius in female patients with rheumatoid arthritis: a case-control study.

    PubMed

    Zhu, Tracy Y; Griffith, James F; Qin, Ling; Hung, Vivian W Y; Fong, Tsz-Ning; Au, Sze-Ki; Tang, Xiao Lin; Kwok, Anthony W; Leung, Ping-Chung; Li, Edmund K; Tam, Lai-Shan

    2013-04-01

    The purpose of this work was to investigate the volumetric bone mineral density (vBMD), bone microstructure, and mechanical indices of the distal radius in female patients with rheumatoid arthritis (RA). We report a cross-sectional study of 66 middle-aged female RA patients and 66 age-matched healthy females. Areal BMD (aBMD) of the hip, lumbar spine, and distal radius was measured by dual-energy X-ray absorptiometry (DXA). High-resolution peripheral quantitative computed tomography (HR-pQCT) was performed at the distal radius, yielding vBMD, bone microstructure, and mechanical indices. Cortical and trabecular vBMD were 3.5% and 10.7% lower, respectively, in RA patients than controls, despite comparable aBMD. Trabecular microstructural indices were -5.7% to -23.1% inferior, respectively, in RA patients compared to controls, with significant differences in trabecular bone volume fraction, separation, inhomogeneity, and structural model index. Cortical porosity volume and percentage were 128% and 93% higher, respectively, in RA patients, with stress being distributed more unevenly. Fourteen RA patients had exaggerated periosteal bone apposition primarily affecting the ulnovolar aspect of the distal radius. These particular patients were more likely to have chronic and severe disease and coexisting wrist deformity. The majority of the differences in density and microstructure between RA patients and controls did not depend on menstrual status. Recent exposure to glucocorticoids did not significantly affect bone density and microstructure. HR-pQCT provides new insight into inflammation-associated bone fragility in RA. It detects differences in vBMD, bone microstructure, and mechanical indices that are not captured by DXA. At the distal radius, deterioration in density and microstructure in RA patients involved both cortical and trabecular compartments. Excessive bone resorption appears to affect cortical more than trabecular bone at distal radius, particularly

  5. Prolonged Exposure for Treating PTSD Among Female Methadone Patients Who Were Survivors of Sexual Abuse in Israel.

    PubMed

    Schiff, Miriam; Nacasch, Nitsa; Levit, Shabtay; Katz, Noam; Foa, Edna B

    2015-01-01

    The aims of this pilot study were: (a) to test the feasibility of prolonged exposure (PE) therapy conducted by a social worker staff on female patients in methadone program clinics who were survivors of child sexual abuse or rape and (b) to examine preliminary outcomes of PE on posttraumatic stress disorder (PTSD), depression, and illicit drug use at pre- and posttreatment, and up to 12-month follow-ups. Twelve female methadone patients who were survivors of child sexual abuse or rape diagnosed with PTSD were enrolled in 13-19 weekly individual PE sessions. Assessments were conducted at pre-, mid-, and posttreatment, as well as at 3, 6, and 12-month follow-ups. The treatment outcomes measures included PTSD symptoms, depressive symptoms, and illicit drug use. Ten of the 12 study patients completed treatment. PTSD and depressive symptoms showed significant reduction. No relapse to illicit drug use was detected. These preliminary results suggest that PE may be delivered by methadone social workers with successful outcomes. Further research should test the efficacy of PE among methadone patients in a randomized control trial with standard care as the control condition.

  6. Association study of olanzapine-induced weight gain and therapeutic response with SERT gene polymorphisms in female schizophrenic patients.

    PubMed

    Bozina, Nada; Medved, Vesna; Kuzman, Martina Rojnic; Sain, Ivica; Sertic, Jadranka

    2007-09-01

    We investigated the relationships between L/S promoter (SERTPR) and l/s intron2 (SERTin2) genetic variants of serotonin transporter (SERT) polymorphisms with olanzapine-induced weight gain and treatment response in 94 female schizophrenic patients treated with olanzapine for up to 3 months. Body mass index (BMI) was calculated for each patient prior to olanzapine administration and 3 months afterwards. To assess and evaluate improvement of clinical psychotic symptoms and therapeutic response to the antipsychotic, all patients were rated using the Positive and Negative Syndrome ScaLe (PANSS). Overall, the presence of S SERTPR allelic variant and SS genotype was associated with significantly higher weight gain in subjects who were non-obese at the time of admission. The presence of L SERTPR variant was associated with significantly better treatment response measured with total PANSS and general PANSS subscale, while the presence of l SERTin2 variant determined better treatment response only in several items. No evidence of linkage disequilibrium between the two loci was found in the sample. These findings identify genetic factors associated with oLanzapine-induced weight gain and treatment response in femaLe schizophrenic patients.

  7. Disseminate and recurrent infundibulo-folliculitis in an Indian patient: A case report with review of literature

    PubMed Central

    Nair, Sukumaran Pradeep; Gomathy, Mini; Kumar, Gopinathan Nanda

    2017-01-01

    A 17-year-old male patient presented with multiple discrete and confluent monomorphic skin-colored pinhead-sized follicular papules, with occasional pustules distributed on the neck, upper chest, upper posterior trunk, and proximal extremities of 4 months duration. The lesions were asymptomatic, and there was no prior history of topical application or history of atopic dermatitis. Routine investigations were normal. Histopathology of the papules showed a mononuclear infiltrate at the infundibulum of the hair follicle. We made a final diagnosis of disseminate and recurrent infundibulo-folliculitis. The patient was started on NB-UVB and topical tacrolimus. We are reporting an interesting case in an Indian patient. PMID:28217471

  8. Surgical outcomes and complications of reconstructive surgery in the female congenital adrenal hyperplasia patient: What every endocrinologist should know.

    PubMed

    Wang, Lily C; Poppas, Dix P

    2017-01-01

    Surgical management of classical congenital adrenal hyperplasia (CAH) in 46, XX females has evolved significantly. Virilization of the genitalia of 46, XX females with CAH begins prenatally as a result of excess fetal androgen production. Improved understanding of anatomy and surgical outcomes has driven changes in surgical techniques as well as the timing of surgery. For endocrinologists treating these patients, it is important to understand the outcome of genitoplasty, identify patients who need further treatment and direct these patients to experienced surgeons. We performed a literature search on PubMed of publications addressing CAH and genital reconstruction published in the English language from 1990 to the present. In accordance with our institutional review board, we performed a retrospective analysis of clitoroplasty and/or vaginoplasty procedures performed by a single surgeon at our institution from 1996 to 2015. We found that genital reconstruction in 46, XX CAH patients is associated with few immediate post-operative, infectious, and urinary complications. Vaginal stenosis is a common complication of vaginal reconstruction and requires evaluation by an experienced surgeon. Clitoral pain or decreased sensation can be associated with clitoral recession and clitorectomy. Outcomes in sexual satisfaction and gender identity can also be impacted by surgical technique and success. Long term follow up and patient reported feedback are crucial to our understanding and management of this special group of patients. Improved awareness and understanding of the complications of genital surgery will allow endocrinologists to know what to ask patients and be ready to provide them with a resource with the understanding and experience to help them improve their quality of life.

  9. Long-term Outcome of Peripherally Implanted Venous Access Ports in the Forearm in Female Cancer Patients

    SciTech Connect

    Klösges, Laura Meyer, Carsten Boschewitz, Jack Andersson, Magnus; Rudlowski, Christian; Schild, Hans H.; Wilhelm, Kai

    2015-06-15

    PurposeThe aim of this retrospective study was to analyze the long-term outcome of peripherally implanted venous access ports in the forearm at our institution in a female patient collective.MethodsBetween June 2002 and May 2011, a total of 293 female patients with an underlying malignancy had 299 forearm ports implanted in our interventional radiology suite. The mean age of the cohort was 55 ± 12 years (range 26–81 years). The majority of women suffered from breast (59.5 %) or ovarian cancer (28.1 %). Complications were classified as infectious complications, thrombotic and nonthrombotic catheter dysfunction (dislocation of the catheter or port chamber, fracture with/without embolization or kinking of the catheter, port occlusion), and others.ResultsWe analyzed a total of 90,276 catheter days in 248 port systems (47 patients were lost to follow-up). The mean device service interval was 364 days per catheter (range 8–2,132, median 223 days, CI 311–415, SD 404). Sixty-seven early (≤30 days from implantation) or late complications (>30 days) occurred during the observation period (0.74/1,000 catheter days). Common complications were port infection (0.18/1,000 days), thrombotic dysfunction (0.12/1,000 days), and skin dehiscence (0.12/1,000 days). Nonthrombotic dysfunction occurred in a total of 21 cases (0.23/1,000 days) and seemed to cumulate on the venous catheter entry site on the distal upper arm.ConclusionPeripherally implanted venous access ports in the forearm are a safe alternative to chest or upper-arm ports in female oncology patients. Special attention should be paid to signs of skin dehiscence and nonthrombotic dysfunction, especially when used for long-term treatment.

  10. Eosinophilic Esophagitis in Brazilian Pediatric Patients

    PubMed Central

    Pinheiro, Mayra Isabel Correia; de Góes Cavalcanti, Luciano Pamplona; Honório, Rodrigo Schuler; de Alencar Moreno, Luís Hélder; Fortes, Mayara Carvalho; da Silva, Carlos Antônio Bruno

    2013-01-01

    We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils. PMID:24106430

  11. ARHGEF9 disruption in a female patient is associated with X linked mental retardation and sensory hyperarousal

    PubMed Central

    Marco, E J; Abidi, F E; Bristow, J; Dean, W B; Cotter, P; Jeremy, R J; Schwartz, C E; Sherr, E H

    2009-01-01

    We identified a female patient with mental retardation and sensory hyperarousal. She has a de novo paracentric inversion of one X chromosome with completely skewed inactivation of the normal X chromosome. We aimed to identify whether a single gene or gene region caused her cognitive and behavioural impairment and that of others. Fluorescent in situ hybridisation (FISH) showed that the centromeric breakpoint disrupts a single gene: ARHGEF9 (CDC42 guanine nucleotide exchange factor (GEF) 9). We also found that the levels of the ARHGEF9 transcript from the patient are 10-fold less than those found in control samples. ARHGEF9 encodes a RhoGEF family protein: collybistin (hPEM), which is highly expressed in the brain. Collybistin can regulate actin cytoskeletal dynamics and may also modulate GABAergic and glycinergic neurotransmission through binding of a scaffolding protein, gephyrin, at the synapse. This potential dual role may explain both the mental retardation and hyperarousal observed in our patient. PMID:21731583

  12. Do female patients with nonpathological vaginal discharge need the same evaluation as for Dhat syndrome in males?

    PubMed Central

    Grover, Sandeep; Avasthi, Ajit; Gupta, Sunil; Hazari, Nandita; Malhotra, Nidhi

    2016-01-01

    Aim: The aim of this study was to evaluate the concept of female Dhat syndrome characterized by the complaint of nonpathological vaginal discharge in association with somatic, anxiety, and depressive symptoms. Materials and Methods: A total of 26 female subjects with nonpathological vaginal discharge along with depressive and somatic complaints were assessed on a self-rated questionnaire modified from Comprehensive Questionnaire for Assessment of Dhat Syndrome designed for males. They were also assessed for psychiatric comorbidity as per ICD-10. Results: All female subjects received an ICD-10 psychiatric diagnosis, with somatoform/dissociative disorder (57.7%) being the most common. The mean age of onset of vaginal discharge was 24.6 (standard deviation - 7.0) years, noted every day or for 2–3 times per week by more than two-third of the participants. Two-fifth (61.5%) of the women described it as a milky discharge. The most common reason reported for passage of vaginal discharge was that of urinary infection or problems of urinary tract infections (42.3%) followed by vaginal infection/disease (34.6%). More than half (53.8%) of the subjects considered vaginal discharge to be responsible for weakness in the body, weakness in stamina and thinness of physique, while slightly more than two-third (69.2%) of them reported bodily weakness and sleep disturbances. Overall the clinical picture in females was similar to male patients with Dhat syndrome on most of the account. Conclusions: Subgroup of patients with vaginal discharge attribute their somatic and mental symptoms to the passage of whitish vaginal discharge and are distressed due to the same. The clinical picture is similar to Dhat syndrome in males. There is a need to recognize female variant of Dhat syndrome as a culture-bound syndrome. Identification of the same may help in managing this subgroup of patients seeking help from the gynecologists for their nonpathological vaginal discharge or from mental health

  13. Intraoperative Blood Loss in Female Patients with Adolescent Idiopathic Scoliosis during Different Phases of the Menstrual Cycle

    PubMed Central

    Yang, Mingyuan; Sun, Xiaofei; Fan, Jianping; Zhu, Honglei Yi Xiaodong; Wang, Chuanfeng; Li, Ming

    2014-01-01

    Background The vast majority of AIS patients who require surgical intervention are women. Blood loss is a major concern during the operation. Methods The medical records of all female AIS patients who underwent posterior correction and fusion operations using the all-pedicle screw system from January 2012 to January 2014 were reviewed. Patients with irregular menstruation; underwent osteotomy; use coagulants were excluded from the study. The remaining patients were divided into 4 groups according to the operation date in the menstrual cycle (A: premenstrual group, 24–30 d; B: follicle group, 6–11 d; C: ovulatory group, 12–17 d; D: luteal group, 18–23 d). The information of patients from the 4 groups was reviewed. The data was analyzed using analysis of variance, the Student-Newman-Keels test and Kruskal-Wallis Test. Results A total of 161 patients were included in this study. There were 40 patients included in group A, 38 patients in group B, 41 patients in group C and 42 patients in group D. The 4 groups were matched in age (P = 0.238), body height (P = 0.291), body weight (P = 0.756), Risser sign (P = 0.576), mean curve Cobb angle (P = 0.520), and bending flexibility index (P = 0.547), the number of levels fused (P = 0.397). The activated partial thromboplastin time (P = 0.235) and prothrombin time (P = 0.074) tended to be higher in group A, but the difference was not statistically significant. The fibrinogen level was lower in group B than the other 3 groups (P = 0.039). Blood loss and normalized intraoperative blood loss (NBL) was significantly higher in group A than the other 3 groups (P<0.01). Conclusions The hemostatic function tended to be lower in the premenstrual phase. The fibrinogen level was lowest in the mid-follicle phase. Female AIS patients tended to endure more intraoperative blood loss when the operation was performed in the premenstrual phase during the menstrual cycle. PMID:25422893

  14. Personality dimensions and type D personality in female patients with ulcerative colitis

    PubMed Central

    Sajadinejad, Marzieh Sadat; Molavi, Hossein; Asgari, Karim; Kalantari, Mehrdad; Adibi, Peyman

    2012-01-01

    Aim: Psychological factors such as personality traits may affect the adjustment capacity and Quality of Life (QOL) in Ulcerative Colitis (UC) patients. Type D personality has some similarities with general personality traits of UC patients. The aims of this study were to compare NEO personality profile and type D personality between healthy normal group and UC patients; and to determine the possible relationship between type D personality and QOL in UC patients. Materials and Methods: The sample of study comprised of 58 UC patients and 59 healthy control subjects (from their family members). All participants were requested to fill out NEO-FFI, Type D personality (Ds14) Scale and WHO-Quality of Life Questionnaire. Results: The findings indicated that UC patients scored higher in neuroticism (P<0/01); lower in extraversion (P<0/01) and openness (P<0/05) than healthy controls but their differentiation were not significant in agreeableness and conscientiousness. The findings showed that 59% of UC patients and 33% of the control subjects had type D personality; and the differences in frequency of type D between the two groups were significant (P<0/05). The mean QOL scores of type D personality in UC patients was significantly lower than patients without type D personality (F= 7/55, P<0/01). Type D personality could better predict QOL of UC patients than NEO dimensions. Conclusions: Differences were observed between UC patients and their healthy family members, in terms of personality factors. Type D personality may be regarded as an important factor that may bring about some adverse effects in QOL among UC patients. PMID:23825986

  15. Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist.

    PubMed

    Lindau, Stacy Tessler; Abramsohn, Emily M; Baron, Shirley R; Florendo, Judith; Haefner, Hope K; Jhingran, Anuja; Kennedy, Vanessa; Krane, Mukta K; Kushner, David M; McComb, Jennifer; Merritt, Diane F; Park, Julie E; Siston, Amy; Straub, Margaret; Streicher, Lauren

    2016-05-01

    Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society.

  16. Peripheral Blood Cell Gene Expression Diagnostic for Identifying Symptomatic Transthyretin Amyloidosis Patients: Male and Female Specific Signatures

    PubMed Central

    Kurian, Sunil M.; Novais, Marta; Whisenant, Thomas; Gelbart, Terri; Buxbaum, Joel N.; Kelly, Jeffery W.; Coelho, Teresa; Salomon, Daniel R.

    2016-01-01

    Background: Early diagnosis of familial transthyretin (TTR) amyloid diseases remains challenging because of variable disease penetrance. Currently, patients must have an amyloid positive tissue biopsy to be eligible for disease-modifying therapies. Endomyocardial biopsies are typically amyloid positive when cardiomyopathy is suspected, but this disease manifestation is generally diagnosed late. Early diagnosis is often difficult because patients exhibit apparent symptoms of polyneuropathy, but have a negative amyloid biopsy. Thus, there is a pressing need for an additional early diagnostic strategy for TTR-aggregation-associated polyneuropathy and cardiomyopathy. Methods and Findings: Global peripheral blood cell mRNA expression profiles from 263 tafamidis-treated and untreated V30M Familiar Amyloid Neuropathy patients, asymptomatic V30M carriers, and healthy, age- and sex-matched controls without TTR mutations were used to differentiate symptomatic from asymptomatic patients. We demonstrate that blood cell gene expression patterns reveal sex-independent, as well as male- and female-specific inflammatory signatures in symptomatic FAP patients, but not in asymptomatic carriers. These signatures differentiated symptomatic patients from asymptomatic V30M carriers with >80% accuracy. There was a global downregulation of the eIF2 pathway and its associated genes in all symptomatic FAP patients. We also demonstrated that the molecular scores based on these signatures significantly trended toward normalized values in an independent cohort of 46 FAP patients after only 3 months of tafamidis treatment. Conclusions: This study identifies novel molecular signatures that differentiate symptomatic FAP patients from asymptomatic V30M carriers as well as affected males and females. We envision using this approach, initially in parallel with amyloid biopsies, to identify individuals who are asymptomatic gene carriers that may convert to FAP patients. Upon further validation

  17. Breast cancer in male-to-female (MtF) transgender patients: is hormone receptor negativity a feature?

    PubMed

    Teoh, Zhi Hao; Archampong, David; Gate, Tim

    2015-05-20

    A 41-year-old male-to-female (MtF) transgender patient presented with a symptomatic tender lump in the left breast. There was no family history of breast cancer. She had been receiving estrogen therapy for 14 years to maintain her secondary sexual characteristics. Triple assessment revealed a 13 mm triple-negative grade 3 invasive ductal carcinoma. The tumour was completely excised following a left wide local excision and sentinel lymph node biopsy. There was no regional lymph node involvement. She was referred to the oncologist for adjuvant chemotherapy and radiotherapy.

  18. Management of a 59-year-old female patient with adult degenerative scoliosis using manipulation under anesthesia

    PubMed Central

    Morningstar, Mark W.; Strauchman, Megan N.

    2010-01-01

    Objective Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA. Clinical Features A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success. Intervention and Outcome The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up. Conclusion Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient. PMID:21629554

  19. Eating attitudes of anorexia nervosa, bulimia nervosa, binge eating disorder and obesity without eating disorder female patients: differences and similarities.

    PubMed

    Alvarenga, M S; Koritar, P; Pisciolaro, F; Mancini, M; Cordás, T A; Scagliusi, F B

    2014-05-28

    The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the "Relationship with food" and "Idea of normal eating." BED patients were worst than OBS for "Relationship with food" and as dysfunctional as AN patients - besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes.

  20. Congenital adrenal hyperplasia. II: Gender-related behavior and attitudes in female salt-wasting and simple-virilizing patients.

    PubMed

    Dittmann, R W; Kappes, M H; Kappes, M E; Börger, D; Meyer-Bahlburg, H F; Stegner, H; Willig, R H; Wallis, H

    1990-01-01

    The salt-wasting (SW) and simple-virilizing (SV) forms of congenital adrenal hyperplasia (CAH) are characterized by distinct prenatal hormonal milieus. To test whether these hormonal milieus differentially influence the development of a "more masculine" behavioral pattern in female CAH patients (Dittmann et al., 1990), SW patients (N = 13) were compared both to SV patients (N = 20) and healthy sisters of both groups (N = 16). The data are based on semi-structured interviews in which subjects (11-41 yr) and mothers were asked about aspects of "Gender-related interests and behavior," "Level of activity," "Social behavior," (reflecting e.g., assertiveness, dominance, and acceptance by peer groups) and "Appearance"; these areas of interest were represented by composite scales. On most scales, and by both mother-assessment and self-assessment, SW patients differed significantly from both SV patients and sisters in having a "more masculine" orientation. SW patients also showed a higher "Level of activity." These SW group results probably account for much of the CAH/sister differences reported in the companion article (Dittmann et al., 1990). In contrast, SV patients differed from the sister sample on only a few scales. There were no significant differences between SV and SW subjects in the degree of virilization of the external genitalia (indicating no group difference in prenatal androgenization). SW patients were treated "earlier" and "better" after birth (indicating less postnatal androgenization). However, these medical conditions, as well as several psychosocial/demographic variables, could not explain the group behavioral differences. These results do not support a primarily psychosocial explanation of behavioral development in CAH patients, especially those with the SW condition; they rather suggest differential organizational effects of two different hormonal environments (SV vs. SW) during critical periods of prenatal CNS development.

  1. [48-year-old female patient with Crohn's disease and new hematuria and proteinuria].

    PubMed

    Kündiger, T; Wirths, K; Wegjan, E; Zöpf, T

    2011-08-01

    We report on a 48-year-old patient with Crohn's disease and left abdominal pain, who presented with hematuria and proteinuria. As reason we found a left renal vein thrombosis. This diagnosis was based on magnetic resonance imaging and doppler ultrasound. The incidence of thrombembolic complications in patients with chronic inflammatory bowel disease is increased, however renal vein thrombosis is a very rare complication of Crohn's disease. We started a conservative treatment with phenprocoumon. Thereafter the patient remained asymptomatic and the thrombus dissipated during follow-up.

  2. Negative pressure pulmonary edema after nasal fracture reduction in an obese female patient: a case report

    PubMed Central

    Choi, Eunkyung; Yi, Junggu; Jeon, Younghoon

    2015-01-01

    Postoperative negative pressure pulmonary edema (NPPE) is a rare, but well-known life-threatening complication of acute upper airway obstruction (UAO) which develops after general anesthesia. The pronounced inspiratory efforts following UAO lead to excessive negative inspiratory pressure, which may cause acute pulmonary edema. Early recognition and prompt treatment of NPPE is necessary to prevent patient morbidity and mortality. In addition, the physician should carefully manage the patient who has risk factors of UAO to prevent this situation. We experienced a case of NPPE following laryngospasm after tracheal extubation in an obese patient who underwent open reduction of orbital wall and nasal bone surgery. PMID:26316826

  3. Evaluation of overall setup accuracy and adequate setup margins in pelvic image-guided radiotherapy: Comparison of the male and female patients

    SciTech Connect

    Laaksomaa, Marko; Kapanen, Mika; Tulijoki, Tapio; Peltola, Seppo; Hyödynmaa, Simo; Kellokumpu-Lehtinen, Pirkko-Liisa

    2014-04-01

    We evaluated adequate setup margins for the radiotherapy (RT) of pelvic tumors based on overall position errors of bony landmarks. We also estimated the difference in setup accuracy between the male and female patients. Finally, we compared the patient rotation for 2 immobilization devices. The study cohort included consecutive 64 male and 64 female patients. Altogether, 1794 orthogonal setup images were analyzed. Observer-related deviation in image matching and the effect of patient rotation were explicitly determined. Overall systematic and random errors were calculated in 3 orthogonal directions. Anisotropic setup margins were evaluated based on residual errors after weekly image guidance. The van Herk formula was used to calculate the margins. Overall, 100 patients were immobilized with a house-made device. The patient rotation was compared against 28 patients immobilized with CIVCO's Kneefix and Feetfix. We found that the usually applied isotropic setup margin of 8 mm covered all the uncertainties related to patient setup for most RT treatments of the pelvis. However, margins of even 10.3 mm were needed for the female patients with very large pelvic target volumes centered either in the symphysis or in the sacrum containing both of these structures. This was because the effect of rotation (p ≤ 0.02) and the observer variation in image matching (p ≤ 0.04) were significantly larger for the female patients than for the male patients. Even with daily image guidance, the required margins remained larger for the women. Patient rotations were largest about the lateral axes. The difference between the required margins was only 1 mm for the 2 immobilization devices. The largest component of overall systematic position error came from patient rotation. This emphasizes the need for rotation correction. Overall, larger position errors and setup margins were observed for the female patients with pelvic cancer than for the male patients.

  4. [Application of navigation system ExacTrac in radiation therapy of a female patient with disseminated pineoblastoma].

    PubMed

    2010-01-01

    Neuronavigation is a modem and perspective technique widely applied not only in neurosurgery but in radiation treatment of neurosurgical diseases as well. Radiographic control of patient and target positioning during irradiation increases accuracy and improves treatment outcomes. Application of neuronavigation significantly expands the possibilities of radiation therapy allowing irradiation of extracranial lesions, application of mask fixation for radiation treatment, and hypofractionated radiotherapy of intracranial and spinal targets. We describe 1 illustrative case of a female patient with 2 metastases of pineoblastoma located in left cerebellar hemisphere and at the level of CVII vertebra. Both lesions were irradiated in hypofractionated mode using ExacTrac XRay 6D neuronavigation system. After 7 months these foci completely resolved.

  5. Stress-induced cardiomyopathy following infection of the upper respiratory tract in an elderly female patient: A case report

    PubMed Central

    Ding, Huaiyu; Huang, Rongchong; Shi, Xiaoli; Wu, Baolin

    2016-01-01

    Stress-induced cardiomyopathy (SIC), also known as takotsubo cardiomyopathy (TTC), is a relatively newly-described condition, which has been increasingly reported in the literature. It is characterized by acute onset of symptoms and electrocardiogram changes mimicking myocardial infarction, with transient but completely reversible left ventricular (LV) dysfunction. SIC commonly occurs following physical or emotional stress. The present study discusses the case of a 68-year-old female patient who had suffered from infection of the upper respiratory tract for 10 days before admission to the hospital with symptoms of chest stuffiness and dyspnea that persisted for 2 days. Coronary angiography showed normal coronary artery function, while LV angiography demonstrated systolic apical ballooning. Based on these observed characteristics, the patient was diagnosed with SIC and was successfully treated. PMID:27882121

  6. The relationship among compulsive buying, compulsive internet use and temperament in a sample of female patients with eating disorders.

    PubMed

    Claes, Laurence; Müller, Astrid; Norré, Jan; Van Assche, Leen; Wonderlich, Steve; Mitchell, James E

    2012-03-01

    The aim of the present study was to investigate the association among compulsive buying (CB), compulsive internet use (CIU) and reactive/regulative temperament in a sample of 60 female patients with eating disorders. All patients were assessed by means of the Compulsive Buying Scale, the CIU scale, the Eating Disorder Inventory-2, the Behavioral Inhibition System/Behavioral Activation System scales, the Dimensional Assessment of Personality Pathology and the effortful control scale of the Adult Temperament Questionnaire. The results showed a positive association between CB and CIU, both categorized as impulse control disorders, not otherwise specified. Both CB and CIU showed significantly positive correlations with emotional lability, excitement seeking and lack of effortful control (more specifically lack of inhibitory and lack of activation control). The implication of these findings for the treatment of both disorders will be discussed.

  7. Griseofulvin and/or Terbinafine Induced Toxic Epidermal Necrolysis in an Adult Female Patient - A Case Report.

    PubMed

    Jadeja, Dharamvirsinh; Jaiswal, Chandra S; Panchasra, Ashwin; Tripathi, Chandrabhanu B

    2016-01-01

    An 18 years old female patient, who was taking treatment for tinea cruris developed Toxic Epidermal Necrolysis (TEN) due to therapeutic dose of griseofulvin with concomitant use of terbinafine. Both the drugs were stopped; patient's condition was gradually improved after starting the treatment. As per WHO-UMC causality assessment criteria, association between reaction and drug was possible (for both griseofulvin and terbinafine). Griseofulvin and terbinafine, both are widely used as an oral antifungal agent to treat fungal infections, careful monitoring is required in the initial periods of the treatment to prevent such type of serious adverse drug reaction. We report a case of TEN possibly caused by griseofulvin with concomitant use of terbinafine resulting in diagnostic difficulty.

  8. A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

    PubMed Central

    2016-01-01

    Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis), but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient's complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases. PMID:27293927

  9. Effect of biofeedback-assisted autogenic training on headache activity and mood states in Korean female migraine patients.

    PubMed

    Kang, Eun-Ho; Park, Joo-Eon; Chung, Chin-Sang; Yu, Bum-Hee

    2009-10-01

    Biofeedback with or without combined autogenic training is known to be effective for the treatment of migraine. This study aimed to examine the effect of biofeedback treatment on headache activity, anxiety, and depression in Korean female patients with migraine headache. Patients were randomized into the treatment group (n=17) and monitoring group (n=15). Mood states including anxiety and depression, and psychophysiological variables such as mean skin temperature of the patients were compared with those of the normal controls (n=21). We found greater treatment response rate (defined as > or =50% reduction in headache index) in patients with biofeedback-assisted autogenic training than in monitoring group. The scores on the anxiety and depression scales in the patients receiving biofeedback-assisted autogenic training decreased after the biofeedback treatment. Moreover, the decrease in their anxiety levels was significantly related to the treatment outcome. This result suggests that the biofeedback-assisted autogenic training is effective for the treatment of migraine and its therapeutic effect is closely related to the improvement of the anxiety level.

  10. Biomedical practices from a patient perspective. Experiences of Polish female migrants in Barcelona, Berlin and London.

    PubMed

    Main, Izabella

    2016-08-01

    This paper focuses on the diversity in patients' experience of bio-medicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations.

  11. Indoor Tanning, Skin Cancer and the Young Female Patient: A Review of the Literature.

    PubMed

    Friedman, Blake; English, Joseph C; Ferris, Laura K

    2015-08-01

    Young, non-Hispanic white females represent the population most likely to use indoor tanning facilities. This population may be at increased risk of skin cancer as recent meta-analyses support a strong association between cutaneous malignancy and indoor tanning. Public perception of the purported health benefits of indoor tanning may be partially to blame for the popularity of tanning salons as a desire to prepare skin prior to sun exposure is among the most commonly cited motivations for indoor tanning. Improving education and counseling to address misconceptions regarding tanning safety will require the participation of healthcare providers for both physical and psychological screenings as well as for information dissemination. This review presents the association between tanning bed use and skin cancer, biological effects of UV radiation exposure, UV burden associated with tanning devices, public perception of tanning, demographic and psychological profile of indoor tanners, and current legislation regulating tanning bed use.

  12. A warm water pool-based exercise program decreases immediate pain in female fibromyalgia patients: uncontrolled clinical trial.

    PubMed

    Segura-Jiménez, V; Carbonell-Baeza, A; Aparicio, V A; Samos, B; Femia, P; Ruiz, J R; Delgado-Fernández, M

    2013-07-01

    Fibromyalgia is characterized by chronic and extended musculoskeletal pain. The combination of exercise therapy with the warm water may be an appropriate treatment. However, studies focusing on the analysis of immediate pain during and after an exercise session are rare. This study aimed to determine the immediate changes of a warm water pool-based exercise program (12 weeks) on pain (before vs. after session) in female fibromyalgia patients. 33 Spanish women with fibromyalgia were selected to participate in a 12 weeks (2 sessions/week) low-moderate intensity warm water pool-based program. We assessed pain by means of a Visual Analogue Scale before and after each single session (i. e., 24 sessions). We observed immediate benefits on pain with a mean decrease ~15% in all sessions, except in the fourth one. There was an association of pain difference (pre-post) session with pain pre session (p=0.005; β=0.097±0.034) and with age (p<0.001; β=0.032±0.008). There were no significant accumulative differences on pain, pre session, post session, and pre-post changes (all p>0.05). Therefore this study showed that a warm water pool-based exercise program for 12 weeks (2 times/week) led to a positive immediate decrease in level of pain in female patients with fibromyalgia. Improvements were higher in older women and in those with more intense pain.

  13. Diffuse alveolar hemorrhage in a patient with acute poststreptococcal glomerulonephritis caused by impetigo.

    PubMed

    Yoshida, Masahiro; Yamakawa, Hideaki; Yabe, Masami; Ishikawa, Takeo; Takagi, Masamichi; Matsumoto, Kei; Hamaguchi, Akihiko; Ogura, Makoto; Kuwano, Kazuyoshi

    2015-01-01

    We herein report a case of pulmonary renal syndrome with nephritis in a 17-year-old boy with diffuse alveolar hemorrhage (DAH) associated with acute poststreptococcal glomerulonephritis (APSGN). The patient exhibited hemoptysis two weeks after developing impetigo, and DAH was diagnosed on bronchoscopy. Respiratory failure progressed, and high-dose methylprednisolone therapy was administered; the respiratory failure regressed immediately after the onset of therapy. Streptococcus pyogenes was detected in an impetigo culture, and, together with the results of the renal biopsy, a diagnosis of APSGN was made. This case demonstrates the effects of high-dose methylprednisolone therapy in improving respiratory failure.

  14. Better survival in PMRT of female breast cancer patients with >5 negative lymph nodes

    PubMed Central

    Wang, Haiyong; Zhang, Chenyue; Kong, Li; Zhu, Hui; Yu, Jinming

    2017-01-01

    Abstract Many studies have confirmed the role of postmastectomy radiotherapy (PMRT) for breast cancer patients with at least 4 lymph nodes invasion in the postoperative therapy. Recently, the number of negative lymph nodes (NLNs) has been increasingly paid attention to and recognized as a prognostic indicator in different kinds of caners. Therefore, it is very necessary to study the association between the number of NLNs and the prognosis of PMRT in breast cancer patients. In our study, we used Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 16,686 breast cancer patients to explore their correlation. The ROC curve and the log-rank χ2 test were applied to determine the appropriate cutoff point of the number of NLNs and 5 was selected as the cutoff point. Furthermore, the cutoff point 5 was validated as an independent prognostic factor affecting cancer-specific survival (CSS) and overall survival (OS) in breast cancer patients, as confirmed by both univariate and multivariate analysis (P < 0.001). In addition, subgroup analysis showed that the number of NLNs >5 can be a prognostic indicator in patients with PMRT according to different clinical variables (all, P < 0.001). Importantly, our results showed that PMRT obviously improved CSS and OS in patients regardless of the number of NLNs (P < 0.001). In conclusion, our study showed the number of NLNs is an independent prognostic factor for breast cancer patients with PMRT, and those who have higher number of NLNs have an increased CSS and OS. PMID:28121956

  15. [Female spouses of cancer patients with minor children--psychological distress in comparison with the general population and the cancer partner].

    PubMed

    Götze, Heide; Brähler, Elmar; Romer, Georg; Bergelt, Corinna; von Klitzing, Kai; Herzog, Wolfgang; Flechtner, Hans-Henning; Lehmkuhl, Ulrike; Ernst, Jochen

    2012-05-01

    A cancer disease in the family is an emotional crisis with psychological distress for the partner. The study observed the psychological distress of female partners of cancer patients with underage children (HADS-D). The results were compared with the psychological distress of the cancer patient as well as a representative comparison group of women from the general population. Every second female partner showed clinically anxiety scores. On average, the female partners were significantly more anxious than male cancer patients and even more afraid than women from the general population. Regarding the degree of depression, between the partners there were no differences. With regard to mental distress, a medium correlation was found on the pair level. Based on the use of psycho-oncological support the high emotional distress on the female partners is discussed.

  16. Growth of a progesterone receptor-positive meningioma in a female patient with congenital adrenal hyperplasia

    PubMed Central

    O’Shea, T; Crowley, R K; Farrell, M; MacNally, S; Govender, P; Feeney, J; Gibney, J

    2016-01-01

    Summary Meningioma growth has been previously described in patients receiving oestrogen/progestogen therapy. We describe the clinical, radiological, biochemical and pathologic findings in a 45-year-old woman with congenital adrenal hyperplasia secondary to a defect in the 21-hydroxylase enzyme who had chronic poor adherence to glucocorticoid therapy with consequent virilisation. The patient presented with a frontal headache and marked right-sided proptosis. Laboratory findings demonstrated androgen excess with a testosterone of 18.1 nmol/L (0–1.5 nmol) and 17-Hydroxyprogesterone >180 nmol/L (<6.5 nmol/L). CT abdomen was performed as the patient complained of rapid-onset increasing abdominal girth and revealed bilateral large adrenal myelolipomata. MRI brain revealed a large meningioma involving the right sphenoid wing with anterior displacement of the right eye and associated bony destruction. Surgical debulking of the meningioma was performed and histology demonstrated a meningioma, which stained positive for the progesterone receptor. Growth of meningioma has been described in postmenopausal women receiving hormone replacement therapy, in women receiving contraceptive therapy and in transsexual patients undergoing therapy with high-dose oestrogen and progestogens. Progesterone receptor positivity has been described previously in meningiomas. 17-Hydroxyprogesterone is elevated in CAH and has affinity and biological activity at the progesterone receptor. Therefore, we hypothesise that patients who have long-standing increased adrenal androgen precursor concentrations may be at risk of meningioma growth. Learning points: Patients with long-standing CAH (particularly if not optimally controlled) may present with other complications, which may be related to long-standing elevated androgen or decreased glucocorticoid levels. Chronic poor control of CAH is associated with adrenal myelolipoma and adrenal rest tissue tumours. Meningiomas are sensitive to

  17. Multiple preinvasive and invasive HPV-related lesions of the anogenital tract in a female patient with HIV infection

    PubMed Central

    Clemente, Nicolò; Alessandrini, Lara; Vaccher, Emanuela; De Paoli, Antonino; Buttignol, Monica; Canzonieri, Vincenzo; Sopracordevole, Francesco

    2017-01-01

    Abstract Rationale: Patients with human immunodeficiency virus (HIV) infection have been shown to be at increased risk for high-risk human papillomavirus (HR-HPV) infection of the anogenital tract. Furthermore, in the last decades, the introduction of highly active antiretroviral therapy (HAART) has increased the longevity of these patients who now live long enough to develop HPV-related cancers; hence, the impact of HPV infection on HIV-positive patients is of increasing concern. Patient concerns: We reported the case of an HIV-positive female patient on HAART with a good virological and immunological response and with a long history of HPV-related intraepithelial and invasive lesions of the anogenital tract. Diagnoses: From 1996 to 2016, this patient was diagnosed with a high grade cervical intraepithelial neoplasia; a HR-HPV positive inguinal lymph node metastasis from clinically undetectable primary squamous cell carcinoma; a HPV-related vulvar high-grade squamous intraepithelial lesion and an invasive squamous cell carcinoma of the anus. Interventions: All the intraepithelial and invasive lesions detected were properly treated, and subsequent follow up visits with gynecologic examination, anoscopy, pap smear and anal cytology were performed. Outcomes: After a recurrence of the anal cancer and a subsequent salvage surgery with abdominoperineal resection, at the last available follow up visit no sign of disease recurrence was found. Lessons: This case stresses the importance of an accurate multidisciplinary follow-up in HIV-positive patients, including not only the routine medical, immunological, and virological evaluation, but also a periodical complete examination of the anogenital tract with cervicovaginal and anal cytology, colposcopy, high resolution anoscopy, and vulvar examination. PMID:28121939

  18. Multiple malignancies in a female patient with common variable immunodeficiency syndrome.

    PubMed

    Todorovic, Milena; Balint, Bela; Andjelic, Bosko; Mihaljevic, Biljana

    2014-10-01

    We herein present the case of a 55-year-old woman with a previous history of malignancies--uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL.

  19. Hashimoto's thyroiditis and acute chest syndrome revealing sickle cell anemia in a 32 years female patient.

    PubMed

    Igala, Marielle; Nsame, Daniela; Ova, Jennie Dorothée Guelongo Okouango; Cherkaoui, Siham; Oukkach, Bouchra; Quessar, Asmae

    2015-01-01

    Sickle cell anemia results from a single amino acid substitution in the gene encoding the β-globin subunit. Polymerization of deoxygenated sickle hemoglobin leads to decreased deformability of red blood cells. Hashimoto's thyroiditis is a common thyroid disease now recognized as an auto-immune thyroid disorder, it is usually thought to be haemolytic autoimmune anemia. We report the case of a 32 years old women admitted for chest pain and haemolysis anemia in which Hashimoto's thyroiditis and sickle cell anemia were found. In our observation the patient is a young woman whose examination did not show signs of goitre but the analysis of thyroid function tests performed before an auto-immune hemolytic anemia (confirmed by a high level of unconjugated bilirubin and a Coombs test positive for IgG) has found thyroid stimulating hormone (TSH) and positive thyroid antibody at rates in excess of 4.5 times their normal value. In the same period, as the hemolytic anemia, and before the atypical chest pain and anguish they generated in the patient, the search for hemoglobinopathies was made despite the absence of a family history of haematological disease or painful attacks in childhood. Patient electrophoresis's led to research similar cases in the family. The mother was the first to be analyzed with ultimately diagnosed with sickle cell trait have previously been ignored. This case would be a form with few symptoms because the patient does not describe painful crises in childhood or adolescence.

  20. Innovating a Writing Group for Female Cancer Patients: A Counselling Field Description

    ERIC Educational Resources Information Center

    Larsen, Denise J.; Cumming, C.; Hundleby, M.; Kuiken, D.

    2003-01-01

    The effects of a cancer diagnosis can be devastating and far-reaching. Expressive-supportive group therapy has proven useful for treating patients struggling with many of these effects. In addition, individual therapeutic writing methods have shown benefit for many individuals addressing a variety of difficult life circumstances including cancer.…

  1. Cardiac transplant in young female patient diagnosed with diffuse systemic sclerosis.

    PubMed

    Bennasar, Guillermo; Carlevaris, Leandro; Secco, Anastasia; Romanini, Felix; Mamani, Marta

    2016-01-01

    Systemic sclerosis (SS) in a multifactorial and systemic, chronic, autoimmune disease that affects the connective tissue. We present this clinical case given the low prevalence of diffuse SS with early and progressive cardiac compromise in a young patient, and treatment with cardiac transplantation.

  2. Effects of 12-week combined exercise therapy on oxidative stress in female fibromyalgia patients.

    PubMed

    Sarıfakıoğlu, Banu; Güzelant, Aliye Yıldırım; Güzel, Eda Celik; Güzel, Savaş; Kızıler, Ali Rıza

    2014-10-01

    The aims of this study were to investigate the effect of exercise therapy on the oxidative stress in fibromyalgia patients and relationship between oxidative stress and fibromyalgia symptoms. Thirty women diagnosed with fibromyalgia according to the American College of Rheumatology preliminary criteria, and 23 healthy women whose age- and weight-matched women were enrolled the study. Pain intensity with visual analog scale (VAS), the number of tender points, the fibromyalgia impact questionnaire (FIQ), the Beck depression inventory (BDI) were evaluated. The oxidative stress parameters thiobarbituric acid reactive substances, protein carbonyls, and nitric oxide, and antioxidant parameters thiols and catalase were investigated in patients and control group. After, combined aerobic and strengthen exercise regimen was given to fibromyalgia group. Exercise therapy consisted of a warming period of 10 min, aerobic exercises period of 20 min, muscle strengthening exercises for 20 min, and 10 min cooling down period. Therapy was lasting 1 h three times per week over a 12-week period. All parameters were reevaluated after the treatment in the patient group. The oxidative stress parameters levels were significantly higher, and antioxidant parameters were significantly lower in patients with fibromyalgia than in the controls. VAS, FIQ, and BDI scores decreased significantly with exercise therapy. The exercise improved all parameters of oxidative stress and antioxidant parameters. Also, all clinical parameters were improved with exercise. We should focus on oxidative stress in the treatment for fibromyalgia with the main objective of reducing oxidative load.

  3. Radiological evaluation by magnetic resonance of the 'new anatomy' of transsexual patients undergoing male to female sex reassignment surgery.

    PubMed

    Brunocilla, E; Soli, M; Franceschelli, A; Schiavina, R; Borghesi, M; Gentile, G; Pultrone, C V; Martorana, G; Orrei, M G; Colombo, F

    2012-09-01

    Magnetic resonance (MR) is the best way to assess the new anatomy of the pelvis after male to female (MtF) sex reassignment surgery. The aim of the study was to evaluate the radiological appearance of the small pelvis after MtF surgery and to compare it with the normal women's anatomy. Fifteen patients who underwent MtF surgery were subjected to pelvic MR at least 6 months after surgery. The anthropometric parameters of the small pelvis were measured and compared with those of ten healthy women (control group). Our personal technique (creation of the mons Veneris under the pubic skin) was performed in all patients. In patients who underwent MtF surgery, the mean neovaginal depth was slightly superior than in women (P=0.009). The length of the inferior pelvic aperture and of the inlet of pelvis was higher in the control group (P<0.005). The inclination between the axis of the neovagina and the inferior pelvis aperture, the thickness of the mons Veneris and the thickness of the rectovaginal septum were comparable between the two study groups. MR consents a detailed assessment of the new pelvic anatomy after MtF surgery. The anthropometric parameters measured in our patients were comparable with those of women.

  4. Evaluation of the Sympathetic Skin Response to the Dry Needling Treatment in Female Myofascial Pain Syndrome Patients

    PubMed Central

    Ozden, Ali Veysel; Alptekin, Hasan Kerem; Esmaeilzadeh, Sina; Cihan, Cem; Aki, Semih; Aksoy, Cihan; Oncu, Julide

    2016-01-01

    Background The aim of this study was to evaluate sympathetic nervous system (SNS) activity following dry needling (DN) treatment, by using the sympathetic skin response (SSR) method in female patients diagnosed with myofascial pain syndrome (MPS). Methods Twenty-nine MPS patients with trapezius muscle pain and 31 healthy subjects were included in this study. During a single treatment session, DN treatment was applied into trigger points, for a duration of 10 minutes. Healthy patients were subjected to SSR in weeks 1 and 4; whereas the patient group was subjected to SSR 1 week prior to their treatment and in the first, second, third and fourth weeks following the completion of their treatment. Results We found diminished latency on both sides. A significantly high algometer measurement (P < 0.05) was observed in the control group. DN treatment was effective in diminishing the visual analog scale (VAS) (P < 0.001), pressure pain threshold (PPT) (P < 0.01), and SSR (P < 0.001). No SSR change was detected in the healthy group after the follow-up period (P > 0.05). Conclusion DN is an effective treatment in MPS and trigger point (TP). This original study is the first to deal with the SSR in MPS and weekly SSR trailing, requiring further investigation to solidy findings. PMID:27298659

  5. Constitutional telomeric association (Y;7) in a patient with a female phenotype.

    PubMed

    Beneteau, Claire; Baron, Sabine; David, Albert; Jossic, Frédérique; Poulain, Damien; Schmitt, Sébastien; Leclair, Marc-David; Piloquet, Philippe; Le Caignec, Cédric

    2013-06-01

    Telomeric associations (TAs) are fusions between two telomeres of two different chromosomes without visible loss of chromosomal material. Constitutional telomeric associations are rare chromosomal anomalies. We report on the cytogenetic and molecular analyses of a TA involving chromosomes Y and 7 in a child with a female phenotype. Prenatal cytogenetic analysis showed a 45,X chromosome complement in all cells. No fetal abnormality was identified at ultrasound examinations and the pregnancy went to term. During childhood, the proband had gonadal dysgenesis but no other phenotypic manifestations of Turner syndrome. Molecular genetic analyses showed the presence of genomic DNA of the SRY gene without any mutation. Karyotyping and fluorescent in situ hybridization (FISH) analyses on blood showed two cell lines: one cell line with a TA involving chromosomes Y and 7 [46,X,tas(Y;7)(p11.32;q36.3)] and a second cell line with a 45,X pattern. A human pantelomeric repeat TTAGGG probe hybridized to the junction of the TA within the derivative chromosome. FISH and array comparative genomic hybridization (aCGH) analyses demonstrated that tas(Y;7) occurred without detectable loss of any sequence at the derivative chromosome. SNP array analysis excluded an uniparental isodisomy of chromosome 7. Knowing more about TAs will help geneticists to deliver accurate genetic counseling.

  6. Sensor-controlled scalp cooling to prevent chemotherapy-induced alopecia in female cancer patients

    PubMed Central

    Fehr, M.K.; Welter, J.; Sell, W.; Jung, R.; Felberbaum, R.

    2016-01-01

    Background Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cooling systems demonstrate varying results in terms of effectiveness and tolerability. Methods For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (who) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy. Results Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel–carboplatin experienced less alopecia. The compound successful outcome (“no head covering” plus “who grade 0/1”) was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel–cyclophosphamide or 6 cycles of paclitaxel–carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel–doxorubicin–cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil–epirubicin–cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin–cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens. Conclusions The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the

  7. The Problem of Polypharmacy in Female Patients with Overactive Bladders – Cross-Sectional Study in a Specialist Outpatient Department

    PubMed Central

    Schneidinger, C. S.; Umek, W.; Böhmdorfer, B.

    2016-01-01

    Background: The consumption of certain drugs can cause urinary incontinence. The aim of this study is to determine the frequency of consumption of drugs that can favour incontinence, the incidence of polypharmacy and the incidence of potentially dangerous drug-drug interactions in female patients suffering from overactive bladder (OAB) who presented to a urogynaecological outpatient department. Methods: We undertook a retrospective case series study. The data from 100 female patients who attended the urogynaecological outpatient department of the Vienna General Hospital [VGH; Allgemeinen Krankenhauses Wien (AKH)] in the period from 20. 07. 2010 to 30. 08. 2011 were evaluated. The patients suffered either from an OAB or mixed incontinence with predominantly urge components. Among other factors, we were interested in the drugs taken for longer periods of time as well as the general and the urogynaecological case histories. 15 parameters were recorded: age, BMI, menopausal status, parity, pelvic organ prolapse, DIAPPERS criteria (delirium, infection (urinary), atrophic urethritis and vaginitis, pharmaceuticals, psychological disorders (especially depression), excessive urine output, restricted mobility, stool impaction), drug side effects and drug-drug interactions. A descriptive statistical analysis was performed. The drugs were checked with the help of a drug information system (Intranet-KH [V 6.0]). Of particular interest was the consumption of drugs that could favour urinary incontinence as an adverse side effect. In addition the frequency of polypharmacy and the frequency of potentially health-threatening drug combinations were registered. Results: 57 % of the patients consumed at least one drug that could reinforce urinary incontinence. The frequency of polypharmacy was 38 %. In 45 % of the patients the possibility for health-damaging interactions existed as a result of the consumed drugs. Conclusion: The frequencies of consumption of drugs that

  8. Multiple malignancies in a female patient with common variable immunodeficiency syndrome

    PubMed Central

    Todorovic, Milena; Balint, Bela; Andjelic, Bosko; Mihaljevic, Biljana

    2014-01-01

    We herein present the case of a 55-year-old woman with a previous history of malignancies – uterine adenocarcinoma, basal cell carcinoma (which occurred twice consecutively), recurrent respiratory infections due to common variable immunodeficiency (CVID), and systemic granulomatous disease diagnosed at a later age. The patient suffered from diffuse large B cell lymphoma (DLBCL), which was successfully treated with R-CHOP chemotherapy, and continued with immunoglobulin supplementation. The patient was free of lymphoma and infectious complications for over 20 months despite her persistent immunodeficiency, but eventually developed colorectal adenocarcinoma. To the best of our knowledge, this is the first reported case of CVID associated with multiple solid tumours and DLBCL. PMID:25631905

  9. [Sequential spontaneous coronary artery dissection in a female patient on oral ephedrine].

    PubMed

    Misuraca, Leonardo; Pasqualini, Paola; Baratta, Pasquale; Calabria, Paolo; Picchi, Andrea; Cresti, Alberto; Limbruno, Ugo; Severi, Silva

    2015-09-01

    Spontaneous coronary artery dissection (SCAD) is an infrequent, but not rare, cause of acute coronary syndrome. It mainly affects young women, often with few or no traditional cardiovascular risk factors. In the case described, a 57-year-old woman experienced a first episode of SCAD involving a distal branch of the circumflex coronary artery--treated conservatively--followed, after a few hours, by a second episode of SCAD involving the left anterior descending coronary artery, complicated by hemodynamic instability and treated with emergency angioplasty. During the previous months, the patient was taking a slimming drug containing ephedrine. Dual spontaneous coronary dissection of different type and involving two different vessels, which occurred in the same patient within a few hours, testifies the heterogeneity of the clinical picture of this syndrome and of the therapeutic approach.

  10. Fertility Risk Assessment and Preservation in Male and Female Prepubertal and Adolescent Cancer Patients

    PubMed Central

    Zavras, Nikolaos; Siristatidis, Charalampos; Siatelis, Argyris; Koumarianou, Anna

    2016-01-01

    Cancer represents the second cause of death in prepubertal children and adolescents, although it is currently associated with an overall survival rate of 80%–85%. The annual incidence rate is 186.6 per 1 million children and adolescents aged up to 19 years. Both disease and treatment options are associated with life-altering, long-term effects that require monitoring. Infertility is a common issue, and as such, fertility preservation represents an essential part in the management of young patients with cancer who are at risk of premature gonadal failure. This review deals with the up-to-date available data on fertility risk assessment and preservation strategies that should be addressed prior to antineoplastic therapy in this vulnerable subgroup of cancer patients. PMID:27398041

  11. [A female patient with late-onset schizophrenia and fear of Katwijk disease].

    PubMed

    Veerman, S R T; Sno, H N; Ravelli, D P; Roos, R A C

    2009-01-01

    A 66-year-old patient had suffered from late-onset schizophrenia from the age of 44. Her family history included reports of brain haemorrhages, possibly resulting from hereditary amyloidal angiopathy of the Dutch type (Katwijk disease). She was very afraid for having this disease. The progression of the psychiatric symptoms and the age at which they began, led us to suspect an organic process. Differential diagnoses that were discussed included cerebral amyloidal angiopathy, frontal lobe dementia and Huntington's disease.

  12. A Hispanic female patient with heartburn: A rare presentation of Paroxysmal Nocturnal Hemoglobinuria

    PubMed Central

    Figueroa-Jiménez, Luis A.; González-Márquez, Amy Lee; Alicea-Guevara, Ricardo; Santiago-Casiano, Mόnica; de la Paz-López, Maryknoll; Negrón-Garcia, Luis; Báez-Dίaz, Luis; Cáceres-Pérkins, William

    2017-01-01

    Paroxysmal nocturnal hemoglobinuria (PNH) is a non-malignant, acquired clonal hematopoietic stem cell disease that can present with bone marrow failure, hemolytic anemia, smooth muscle dystonias, and thrombosis. We present a case of a 32 year-old-female, G2P2A0 with no past medical history of any systemic illnesses who refers approximately 2 months of progressively worsening constant heartburn with associated abdominal discomfort. CBC showed leukopenia (WBC 2.9 × 103 /μL) with neutropenia (segmented neutrophils 48%), macrocytic anemia (Hgb 6.1 g/dL, hematocrit 20%, MCV 113 fL) and thrombocytopenia (platelet count 59 × 109/L). Abdomino-pelvic CT scan revealed a superior mesenteric vein thrombosis, which was treated initially with low-molecular-weight heparin for full anticoagulation. Peripheral blood flow cytometry assays revealed diminished expression of CD55 and CD59 on the erythrocytes, granulocytes and monocytes. Paroxysmal nocturnal hemoglobinuria is a rare, clonal, hematopoietic stem-cell disorder whose manifestations are almost entirely explained by complement-mediated intravascular hemolysis. The natural history of PNH is highly variable, ranging from indolent to life-threatening. The median survival is 10 to 15 years, but with a wide range. Thrombosis is the leading cause of death, but others may die of complications of bone marrow failure, renal failure, myelodysplastic syndrome, and leukemia. Anticoagulation is only partially effective in preventing thrombosis in PNH; thus, thrombosis is an absolute indication for initiating treatment with Eculizumab. Nevertheless, bone marrow transplantation (BMT) is still the only curative therapy for PNH but is associated with significant morbidity and mortality. PMID:26742189

  13. Crohn's disease with ankylosing spondylitis in an adolescent patient who had undergone long ileo-colonic anastomosis for Hirschsprung's disease as an infant

    PubMed Central

    Kim, Ha Yeon

    2017-01-01

    Crohn's disease (CD) is a chronic, idiopathic, inflammatory disorder of the gastrointestinal tract. In rare cases, CD has been associated with Hirschsprung's disease (HD); however, the underlying pathophysiology of this and other comorbidities is not yet fully understood. In this report, we describe the case of a 17-year-old patient who was diagnosed with both CD and ankylosing spondylitis (AS), having undergone a long ileo-colonic anastomosis to treat HD at 12 months of age. To our knowledge, this is the first documented case of CD combined with AS in a patient with HD. PMID:28239325

  14. An Update on Genital Reconstruction Options for the Female-to-Male Transgender Patient: A Review of the Literature.

    PubMed

    Frey, Jordan D; Poudrier, Grace; Chiodo, Michael V; Hazen, Alexes

    2017-03-01

    Although many transgender individuals are able to realize their gender identity without surgical intervention, a significant and increasing portion of the trans population is seeking gender-confirming surgery (alternatively, gender reassignment surgery, sexual reassignment surgery, or gender-affirming surgery). This review presents a robust overview of genital reconstruction in the female-to-male transgender patient-an operation that, historically, was seldom performed and has remained less surgically feasible than its counterpart (male-to-female genital reconstruction). However, as the visibility and public awareness of the trans community continues to increase, the demand for plastic surgeons equipped to perform these reconstructions is rising. The "ideal" neophallus is aesthetic, maintains tactile and erogenous sensibility, permits sexual function and standing urination, and possesses minimal donor-site and operative morbidity. This article reviews current techniques for surgical construction, including metoidioplasty and phalloplasty, with both pedicled and free flaps. Emphasis is placed on the variety of techniques available for constructing a functional neophallus and neourethra. Preparative procedures (such as vaginectomy, hysterectomy, and oophorectomy) and adjunctive reconstructive procedures (including scrotoplasty and genital prosthesis insertion) are also discussed.

  15. [Marked weight loss in two female patients with prader-willi syndrome by behavioral modification and improvement of the environment].

    PubMed

    Nishida, Keiko; Okada, Yosuke; Mori, Hiroko; Hirose, Akiko; Tanikawa, Takahisa; Arao, Tadashi; Morita, Emiko; Tanaka, Yoshiya

    2006-03-01

    Prader-Willi Syndrome (PWS) is a complex neurogenetic disorder with considerable clinical variability, and is considered to be mainly the result of a hypothalamic defect. PWS is characterized by hyperphagia, obesity, mental retardation and hypogonadism from a young age. Hyperphagia is one of the most serious problems, which is organic in origin, inducing morbid obesity and leading to respiratory failure. Most studies attempting to control obesity in children with PWS by dietary management reported limited success due to difficulty in controlling foraging and food stealing. Here we report 16- and 20-year-old female patients with PWS who showed marked weight loss and improvement of respiratory failure by behavior modification and improvement of the environment.

  16. Spontaneous Bacterial Peritonitis and Anasarca in a Female Patient with Ovarian Hyperstimulation Syndrome Complicated by Respiratory and Kidney Failure

    PubMed Central

    Khalil, Muhammad Abdul Mabood; Ghazni, Muhammad Salman; Tan, Jackson; Naseer, Nazish; Khalil, Muhammad Ashhad Ullah

    2016-01-01

    Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output. She was found to have edema, ascites, effusion and acute kidney injury (AKI). Considering the symptoms preceding the drug history and anasarca, a diagnosis of severe OHSS was made. Ascites was further complicated by spontaneous bacterial peritonitis (SBP), which had already been reported before. We speculate that low immunity due to decreased immunoglobulin in patients with OHSS makes them prone to SBP. In our case, septicemia secondary to SBP and fluid loss due to capillary leakage from OHSS resulted in AKI and respiratory failure. This critically ill patient was treated in a special care unit, and she fully recovered with supportive measures. Severe OHSS may present as anasarca including ascites which can develop SBP leading to sepsis and multiorgan failure. PMID:27721728

  17. Anti-Yo antibody-mediated paraneoplastic cerebellar degeneration in a female patient with pleural malignant mesothelioma.

    PubMed

    Tanriverdi, Ozgur; Meydan, Nezih; Barutca, Sabri; Ozsan, Nazan; Gurel, Duygu; Veral, Ali

    2013-05-01

    Paraneoplastic cerebellar degeneration is a rare non-metastatic complication of malignancies. It presents with acute or subacute onset of ataxia, dysarthria and intention tremor. Paraneoplastic cerebellar degeneration is most commonly associated with malignancies of the ovary, breast and lung. The anti-Yo (anti-Purkinje cells) antibodies that specifically damage the Purkinje cells of the cerebellum are found in the serum and cerebrospinal fluid. Anti-Yo-related paraneoplastic cerebellar degeneration is most commonly found in women with gynecological and breast cancers, but it is reported in other malignancies. Patients with paraneoplastic syndromes most often present with neurologic symptoms before an underlying cancer is detected. We report a case of anti-Yo-related paraneoplastic cerebellar degeneration associated with pleural malignant mesothelioma in a 51-year-old female patient. She presented to our department with a 2-week history after the last chemotherapy of progressive dizziness related to head movement, nausea, vomiting, ataxia and unsteady gait. A western blot assay was negative for anti-Hu, anti-Ri, anti-Ma2, anti-CV2 and anti-amphiphysin paraneoplastic antibody markers but positive for anti-Yo. In conclusion, we report a case of paraneoplastic cerebellar degeneration in a patient with pleural malignant mesothelioma because of the rarity of this neurologic presentation after the diagnosis of malignant mesothelioma and of the association with anti-Yo antibodies.

  18. Management of acne vulgaris with hormonal therapies in adult female patients.

    PubMed

    Husein-ElAhmed, Husein

    2015-01-01

    Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition. In particular, adult women with acne have been shown to be adversely impacted by the effect of acne on their quality of life. For the last four decades, dermatologists have used hormonal therapies for the management of acne vulgaris in adult women, which are considered a rational choice given the severity and chronicity of this condition in this group of patients. The aim of this work is to review the hormonal drugs for management of acne.

  19. Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder.

    PubMed

    Nakamura, Aya; Watanabe, Masami; Sugimoto, Morito; Sako, Tomoko; Mahmood, Sabina; Kaku, Haruki; Nasu, Yasutomo; Ishii, Kazushi; Nagai, Atsushi; Kumon, Hiromi

    2013-01-01

    Gender identity disorder (GID) is a conflict between a person's actual physical gender and the one they identify him or herself with. Testosterone is the key agent in the medical treatment of female to male GID patients. We conducted a dose-response analysis of testosterone replacement therapy (TRT) in 138 patients to determine the onset of the therapeutic effects. The TRT consisted of intramuscular injection of testosterone enanthate and patients were divided into three groups; 250 mg every two weeks, 250 mg every three weeks and 125 mg every two weeks. The onset of deepening of voice, increase in facial hair and cessation of menses was evaluated in each group. At one month after the start of TRT, the onset of these physical changes was more prevalent in the group receiving the higher dose of testosterone, and there were dose-dependent effects observed between the three treatment groups. On the other hand, at six months after the start of TRT, most of the patients had achieved treatment responses and there were no dose-dependent effects with regard to the percentage of patients with therapeutic effects. No significant side effects were observed in any of the treatment groups. We demonstrated that the early onset of the treatment effects of TRT is dose-dependent, but within six months of starting TRT, all three doses were highly effective. Current study provides useful information to determine the initial dose of TRT and to suggest possible changes that should be made in the continuous dosage for long term TRT.

  20. NUCB2/nesfatin-1 is associated with elevated scores of anxiety in female obese patients.

    PubMed

    Hofmann, Tobias; Stengel, Andreas; Ahnis, Anne; Buße, Petra; Elbelt, Ulf; Klapp, Burghard F

    2013-11-01

    Nesfatin-1 is derived from nucleobindin2 (NUCB2) and implicated in the regulation of food intake and body weight. Plasma levels are altered under conditions of chronically altered body weight such as obesity. Nesfatin-1 was also shown to be involved in the modulation of emotion. Since obesity is often associated with anxiety and depression we investigated plasma NUCB2/nesfatin-1 levels in obese women (n=77) over a broad range of body mass index (BMI, 32-67 kg/m(2)) with different levels of anxiety assessed by the generalized anxiety disorder questionnaire (GAD-7). Stress was assessed using the perceived stress questionnaire (PSQ-20) and depression using the patient health questionnaire (PHQ-9). The study population was divided in patients with low anxiety (n=40, GAD scores, mean ± SD, 5.0 ± 2.7) and high anxiety (n=37, 14.2 ± 3.3, p<0.001). Patients with high anxiety showed higher levels of NUCB2/nesfatin-1 (+33%), perceived stress (+60%) and depression (+98%) compared to the low anxiety group (p<0.001). NUCB2/nesfatin-1 levels positively correlated with GAD-7 (r=0.68, p<0.001), total PSQ-20 (r=0.57, p<0.001) and PHQ-9 scores (r=0.45, p<0.001), while no significant correlation was observed with BMI (r=-0.21, p=0.09). Also the subscales of the PSQ-20, "worries", "tension" and "demands" were higher in the high anxiety group and correlated positively with NUCB2/nesfatin-1 (p<0.001), whereas "joy" was lower and correlated negatively with NUCB2/nesfatin-1 (p=0.015). Summarized, plasma NUCB2/nesfatin-1 levels were altered under conditions of perceived anxiety, stress and depression in obese women. No correlation was observed with BMI. These data point toward an involvement of NUCB2/nesfatin-1 in the regulation of emotion in addition to its impact on body weight.

  1. Novel GLA Deletion in a Cypriot Female Presenting with Cornea Verticillata.

    PubMed

    Georgiou, Theodoros; Mavrikiou, Gavriella; Alexandrou, Angelos; Spanou-Aristidou, Elena; Savva, Isavella; Christodoulides, Theodoros; Krasia, Maria; Christophidou-Anastasiadou, Violetta; Sismani, Carolina; Drousiotou, Anthi; Tanteles, George A

    2016-01-01

    Fabry disease is an X-linked lysosomal storage disorder resulting from a deficiency of the hydrolytic enzyme α-galactosidase A (α-Gal-A). It is characterized by progressive lysosomal accumulation of globotriaosylceramide (Gb3) and multisystem pathology, affecting the skin, nervous and cerebrovascular systems, kidneys, and heart. Heterozygous females typically exhibit milder symptoms and a later age of onset than males. Rarely, they may be relatively asymptomatic throughout a normal life span or may have symptoms as severe as those observed in males with the classic phenotype. We report on a 17-year-old female in whom cornea verticillata was found during a routine ophthalmological examination but with no other clinical symptoms. Leucocyte α-galactosidase activity was within the overlap range between Fabry heterozygotes and normal controls. Sanger sequencing of the GLA gene failed to reveal any pathogenic variants. Multiplex Ligation-dependent Probe Amplification (MLPA) analysis revealed a deletion of exon 7. Using a long-range PCR walking approach, we managed to identify the deletion breakpoints. The deletion spans 1182 bp, with its 5' end located within exon 6 of the GLA gene and its 3' end located 612 bp downstream of exon 7. This finding represents a novel deletion identified in the first reported Cypriot female carrier of Fabry disease.

  2. The kaleidoscopic presentation of the spondyloarthritis concept in a female patient.

    PubMed

    De Langhe, Ellen; Lories, Rik; Maenaut, Kristin; De Vlam, Kurt

    2011-12-01

    Spondyloarthritis is a group of chronic joint diseases that share clinical, pathological and genetic features and is divided into distinct diagnostic entities, including ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease-associated spondyloarthritis, reactive arthritis, juvenile onset and undifferentiated spondyloarthritis. Since the spectrum of spondyloarthritides is wider than the sum of aforementioned disorders suggests, the term "Spondyloarthritis concept" might prove to be appropriate. Here, we present a case in which many features of the spondyloarthritis concept, but also unexpected osteitis in the skull and tibia, emerge during the disease course. A 45-year-old HLA-B27 positive woman with a family history of psoriasis, a former diagnosis of ankylosing spondylitis, reactive arthritis and fulminating acne, was referred to our department with a painful tibial swelling, symmetrical polyarthritis and severe headache. Conventional radiography and bone scintigraphy demonstrated large osteolytic lesions on the left parietal side of the skull and the right anterior tibia. She was treated with surgery and pamidronate. Etanercept treatment was initiated as the arthritis deteriorated and was replaced by infliximab when new onset Crohn's disease became apparent. This case is the illustration of spondyloarthritis as a disease concept, covering the entire spectrum, from ankylosing spondylitis, urogenital reactive arthritis and psoriatic arthritis to inflammatory bowel disease. Cases like this illustrate that the clinical classification of spondyloarthritis patients into distinct diagnostic entities is bypassing the value of the "concept" and provides support for the new classification criteria that were recently proposed.

  3. Patients’ silence towards the healthcare system after ethical transgressions by staff: associations with patient characteristics in a cross-sectional study among Swedish female patients

    PubMed Central

    Brüggemann, A Jelmer; Swahnberg, Katarina

    2012-01-01

    Objectives To identify which patient characteristics are associated with silence towards the healthcare system after experiences of abusive or ethically wrongful transgressive behaviour by healthcare staff. Design Cross-sectional questionnaire study using the Transgressions of Ethical Principles in Health Care Questionnaire. Setting A women's clinic in the south of Sweden. Participants Selection criteria were: consecutive female patients coming for an outpatient appointment, ≥18-year-old, with the ability to speak and understand the Swedish language, and a known address. Questionnaires were answered by 534 women (60%) who had visited the clinic, of which 293 were included in the present study sample. Primary outcome measure How many times the respondent remained silent towards the healthcare system relative to the number of times the respondent spoke up. Results Associations were found between patients’ silence towards the healthcare system and young age as well as lower self-rated knowledge of patient rights. Both variables showed independent effects on patients’ silence in a multivariate model. No associations were found with social status, country of birth, health or other abuse. Conclusions The results offer opportunities for designing interventions to stimulate patients to speak up and open up the clinical climate, for which the responsibility lies in the hands of staff; but more research is needed. PMID:23204076

  4. Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture

    PubMed Central

    Han, Jun

    2016-01-01

    Background Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD. Methods This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed. Results There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD. Conclusions We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD. PMID:27622182

  5. Evaluation of minimum interdental threshold ability in dentate female temporomandibular disorder patients.

    PubMed

    Kogawa, E M; Calderon, P D S; Lauris, J R P; Pegoraro, L F; Conti, P C R

    2010-05-01

    Minimum interdental threshold is the smallest thickness that can be detected between teeth during an occlusion and has an influence on the occlusal force and on the control of mandibular movements. The aim of this study was to assess the possible association of the signs and symptoms of temporomandibular disorders (TMD) with the ability to detect a minimum interdental threshold. Two hundred women were equally divided into four groups: asymptomatic (control), subjects with masticatory muscle pain, with articular [temporomandibular joint (TMJ)] pain and mixed (muscular and articular pain). Evaluation of the ability to detect a minimum interdental threshold was performed using aluminium foils with 0.010, 0.024, 0.030, 0.050, 0.080 and 0.094 mm of thickness in the premolar region. A total of 20 tests with each thickness for each patient were performed, starting with the thickest foil (0.094 mm) and ending with the thinnest one. The myogenic pain and articular groups presented significantly higher threshold values (0.020 and 0.022 mm, respectively), when compared to the control. Both groups reached the level of certain perceptiveness only at 0.030 mm. No significant correlation was found between minimum interdental threshold and age. These results suggest that discrimination of thicknesses can be disturbed as a consequence of TMD manifestations and not the cause of it. Clinicians should, therefore, be aware that changes on muscles and TMJ can secondarily lead to occlusion changes. The mechanisms involved in this process, however, are not well understood and warrant further investigation.

  6. Passive body heating improves sleep patterns in female patients with fibromyalgia

    PubMed Central

    Silva, Andressa; de Queiroz, Sandra Souza; Andersen, Monica Levy; Mônico-Neto, Marcos; da Silveira Campos, Raquel Munhoz; Roizenblatt, Suely; Tufik, Sergio; de Mello, Marco Túlio

    2013-01-01

    OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36±1°C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia. PMID:23525306

  7. Effect of liming and organic and inorganic fertilization on soil carbon sequestered in macro-and microaggregates in a 17-year old Pinus radiata silvopastoral system.

    PubMed

    Mosquera-Losada, M R; Rigueiro-Rodríguez, A; Ferreiro-Domínguez, N

    2015-03-01

    Agroforestry systems have been recognized as a potential greenhouse gas mitigation strategy under the Kyoto Protocol because of their ability to absorb carbon dioxide from the atmosphere and store carbon mainly in the soil. Soil particle size and land management practices are known to have a considerable influence on carbon storage in soils. This study evaluated changes in soil chemical and physical properties, and quantified and compared the amount of C stored in the bulk soil and in three different soil fractions (250-2000, 53-250 and <53 μm) at each of four soil depths (0-25, 25-50, 50-75 and 75-100 cm) in a silvopastoral system located on an acidic forest soil under Pinus radiata D. Don. Areas of this system were subjected ten years ago to one of nine fertilization treatments: three different doses of sewage sludge or no fertilization, all with or without the addition of lime, and mineral fertilizer with no liming. Seventeen years after reforestation and seven years after canopy closure, strong gradients with soil depth were found regarding soil bulk density, pH and carbon storage. Intense soil management (high doses of sewage sludge and liming) generally reduced soil carbon storage, mainly in coarse aggregates, but this could be compensated by the increase in tree and pasture development observed in soils subject to intermediate sewage sludge doses.

  8. Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents

    PubMed Central

    Hildebrand, Janina; Maycock, Bruce; Burns, Sharyn; Zhao, Yun; Allsop, Steve; Howat, Peter; Lobo, Roanna

    2013-01-01

    Introduction Harmful drinking among young people is common in Australia and many other countries. Social norms and their influence on adolescents’ alcohol consumption behaviours have received much research attention in recent years. However, there is limited understanding of how social norms related to alcohol are developed and transmitted across social networks and a specific tool that measures these constructs has yet to be developed. This paper outlines the rationale and protocol for the design and validation of a multidimensional survey instrument which measures the development and transmission pathways of alcohol-related norms among adolescents. A longer term aim is to apply the instrument in a respondent-driven sampling study with a large adolescent cohort. Methods and analysis Social Cognitive Theory (SCT) and relevant literature will guide the design of the online survey instrument. Feedback from a practitioner-based stakeholder committee, academic expert panel reviews, focus groups and interviews with adolescents aged 13–17 years in Perth, Western Australia (WA) will serve to ascertain content and face validity. A test–retest will be conducted using a purposive sample of students (n=400) at secondary schools in Perth. The instrument's psychometric properties will be analysed, including exploratory factor analyses, discriminant validity, internal consistency and test–retest reliability. Ethics and dissemination The results of this research will provide public health researchers and practitioners with a comprehensive standardised instrument to explore the characteristics of individual-level and community-level social influences and norms associated with use of alcohol by adolescents and the routes through which these norms are transmitted. The data collected by the instrument is anticipated to inform the design of youth specific interventions with the potential to reduce alcohol-related harms. The Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The study has received approval from the Curtin University Human Research Ethics Committee. PMID:23959761

  9. [Effectiveness of educational interventions conducted in latin america for the prevention of overweight and obesity in scholar children from 6-17 years old; a systematic review].

    PubMed

    Mancipe Navarrete, Jenny Alejandra; Garcia Villamil, Shanen Samanta; Correa Bautista, Jorge Enrique; Meneses-Echávez, José Francisco; González-Jiménez, Emilio; Schmidt Rio-Valle, Jacqueline

    2014-10-03

    Introducción: El sobrepeso y la obesidad representan un serio problema de salud pública, de orden creciente en la población infantil. Objetivo: Determinar la efectividad de las intervenciones educativas realizadas en América Latina para la prevención del sobrepeso y la obesidad en niños escolares de 6 a 17 años. Metodología: Las bases de datos MEDLINE, LILACS y EMBASE fueron consultadas entre febrero y mayo de 2014 para identificar estudios controlados aleatorizados y estudios longitudinales que evaluaran los efectos de intervenciones educativas dirigidas a la prevención del sobrepeso y la obesidad en niños latinoamericanos. El riesgo de sesgo y la calidad metodológica se evaluó con la escala de PEDro y el instrumento CASPe. Resultados: Veintiún estudios fueron incluidos (n=12,092). Se identificaron diferentes tipos de intervenciones, tales como estrategias nutricionales, promoción de la práctica de actividad física y cambios en el entorno. Las intervenciones mixtas, que combinaron cambios nutricionales con la promoción de actividad física, fueron las más efectivas, pues sus resultados evidenciaron cambios positivos en las variables asociadas al sobrepeso y obesidad infantil. No se observaron evidencias de sesgo de publicación. Conclusión: Las intervenciones realizadas en el ámbito escolar que combinan la nutrición adecuada y la promoción de la práctica de actividad física son efectivas en la prevención del sobrepeso y la obesidad infantil en escolares latinoamericanos, aunque se deben incorporar intervenciones en el ambiente familiar para permitir un abordaje integral, asociado con mayores respuestas sobre el cambio comportamental de los escolares.

  10. [Results of self image studies in children and adolescents (11/12-years-old to 16/17-years-old)].

    PubMed

    Göth, N

    1978-02-01

    The author in his present paper reports the results of studies made in an effort to reconstructively validate a method of self-imaging during childhood and adolescence. From the investigative results obtained it is apparent that during adolescence large self-image/ideal-image differences and low self-image values correlate with neuroticism, a situation which is similar to that which is usually observed in adults. Timid and introverted juveniles differ significantly from less timid and extroverted juveniles in both the self-image level and the self-image/ideal-image difference. Aside from the fact that the self-image level has been found to be relatively independent of intelligence, there are correlations between the maternal and child's self-image. It is of interest to note that the self-image level of children whose parents got a divorce is lower than that of children coming from intact families.

  11. Loss, Trauma Exposure, and Mental Health in a Representative Sample of 12-17-Year-Old Youth: Data from the National Survey of Adolescents

    ERIC Educational Resources Information Center

    Rheingold, Alyssa A.; Smith, Daniel W.; Ruggiero, Kenneth J.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

    2004-01-01

    More than 2 million children and adolescents experience the death of a close relative each year. Additionally, a substantial number of adolescents experience the death of a friend. This study investigated various factors that may be associated with exposure to the death of a family member or friend, including gender, age, race, socioeconomic…

  12. Seroprevalence of pertussis antibodies in 6-17-year-old students in Ahvaz, south-west Islamic Republic of Iran.

    PubMed

    Shamsizadeh, A; Nikfar, R; Yusefi, H; Abbasi-Montazeri, E; Cheraghian, B

    2014-10-20

    Although pertussis is a vaccine-preventable infection, vaccine-induced immunity is not lifelong and booster doses are recommended according to national disease epidemiology. The aim of this study was to evaluate pertussis-IgG levels in school-aged students in Ahvaz, south-west Islamic Republic of Iran. In a descriptive, cross-sectional study, blood samples were obtained from 640 students (382 boys and 258 girls) aged 6-17 years during 2010-2011. All students had received a full course of pertussis whole-cell vaccination at ages 2, 4, 6 and 18 months and 4-6 years. Using a Bordetella IgG ELISA kit, pertussis-IgG was detected in 301 (47.0%) students. No statistically significant differences in pertussis-IgG levels were found between girls and boys or across different age groups. The findings show that the overall level of pertussis-IgG seropositivity was unacceptable. Booster vaccination with an acellular pertussis vaccine should be considered in adolescents and/or adults in our region.

  13. Self-Reported Sexual Function Measures Administered to Female Cancer Patients: A Systematic Review, 2008–2014

    PubMed Central

    Jeffery, Diana D.; Barbera, Lisa; Andersen, Barbara L.; Siston, Amy K.; Jhingran, Anuja; Baron, Shirley R.; Reese, Jennifer Barsky; Coady, Deborah J.; Carter, Jeanne; Flynn, Kathryn E.

    2016-01-01

    Background A systematic review was conducted to identify and characterize self-reported sexual function (SF) measures administered to women with a history of cancer. Methods Using 2009 PRISMA guidelines, we searched electronic bibliographic databases for quantitative studies published January 2008–September 2014 that used a self-reported measure of SF, or a quality of life (QOL) measure that contained at least one item pertaining to SF. Results Of 1,487 articles initially identified, 171 were retained. The studies originated in 36 different countries with 23% from U.S.-based authors. Most studies focused on women treated for breast, gynecologic, or colorectal cancer. About 70% of the articles examined SF as the primary focus; the remaining examined QOL, menopausal symptoms, or compared treatment modalities. We identified 37 measures that assessed at least one domain of SF, eight of which were dedicated SF measures developed with cancer patients. Almost one-third of the studies used EORTC QLQ modules to assess SF, and another third used the Female Sexual Function Inventory. There were few commonalities among studies, though nearly all demonstrated worse SF after cancer treatment or compared to healthy controls. Conclusions QOL measures are better suited to screening while dedicated SF questionnaires provide data for more in depth assessment. This systematic review will assist oncology clinicians and researchers in their selection of measures of SF and encourage integration of this quality of life domain in patient care. PMID:25997102

  14. The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder.

    PubMed

    Naoum, Janina; Reitz, Sarah; Krause-Utz, Annegret; Kleindienst, Nikolaus; Willis, Franziska; Kuniss, Sarah; Baumgärtner, Ulf; Mancke, Falk; Treede, Rolf-Detlef; Schmahl, Christian

    2016-12-30

    Patients with Borderline Personality Disorder (BPD) often engage in non-suicidal self-injury (NSSI), to reduce arousal levels under stress. However, the importance of seeing blood for the effect of NSSI is yet unknown. The present pilot study examined 20 female BPD patients and 20 healthy controls (HC) to assess the role of seeing blood on arousal, pain, urge for NSSI (ratings) and heart rate (continuously measured). Participants completed two sessions consisting of stress induction (forced mental arithmetics with white noise), followed by a seven second non-invasive pain stimulus with a blade to the volar forearm. At one session, only the painful blade stimulus was applied, at the other, artificial blood was added. For arousal, a significantly stronger decrease was revealed in the BPD than in the HC group, however with no significant effects between blood and non-blood conditions. Concerning urge for NSSI, the BPD showed a significantly greater decrease in blood condition over time than the HC group. Interestingly, heart rate decreased stronger over time in the HC group during the blood condition than in BPD. For tension relief by non-damaging mechanical painful stimulus the addition of visible blood showed neither subjective (arousal, urge for NSSI), nor objective (heart rate) advantages.

  15. Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome

    PubMed Central

    Kang, Seol-Jung; Kim,, Eon-ho; Ko, Kwang-Jun

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness or female patients with metabolic syndrome. [Subjects and Methods] Subjects were randomly assigned to an exercise group (n=12) or a control group (n=11). Subjects in the exercise group performed aerobic exercise at 60–80% of maximum heart rate for 40 min 5 times a week for 12 weeks. The changes in metabolic syndrome risk factors, resting heart rate, physical fitness, and arterial stiffness were measured and analyzed before and after initiation of the exercise program to determine the effect of exercise. Arterial stiffness was assessed based on brachial-ankle pulse wave velocity (ba-PWV). [Results] Compared to the control group; The metabolic syndrome risk factors (weight, % body fat, waist circumference, systolic blood pressure, diastolic blood pressure, and HDL-Cholesterol) were significantly improved in the exercise: resting heart rate was significantly decreased; VO2max, muscle strength and muscle endurance were significantly increased; and ba-PWV was significantly decreased. [Conclusion] Aerobic exercise had beneficial effects on the resting heart rate, physical fitness, and arterial stiffness of patients with metabolic syndrome. PMID:27390411

  16. Incidentally discovered diffuse large B-cell lymphoma limited to the endocervical mucosa in a young female patient.

    PubMed

    Pósfai, Éva; Nagy, Károly; Marton, Imelda; Bánfalvi, Attila; Kocsis, Lajos; Cserni, Gábor

    2015-01-01

    Primary high-grade non-Hodgkin lymphoma of the female genital tract is extremely rare. Vaginal bleeding, abdominal pain or urinary complaints might be its most frequent symptoms. We report a 27-year-old multipara who underwent large loop excision of the transformation zone because of the repeated finding of a low-grade squamous intraepithelial lesion identified during routine cancer screening. Incidentally, CD20-positive, primary, diffuse large B-cell lymphoma infiltrating the mucosa of the endocervix was also diagnosed from this specimen. The case is unusual because the patient had no symptoms, specific colposcopic signs or visible mass. R-CHOP 21 immunochemotherapy was introduced and resulted in complete remission without hysterectomy. The patient is without any evidence of disease after 49 months of follow-up. Primary cervical lymphomas are mainly subepithelial initially, and therefore they may be under-recognized due to the inefficiency of smears to diagnose such lesions. Early diagnosis and available targeted treatment allowed a cure in the reported example.

  17. Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome.

    PubMed

    Kang, Seol-Jung; Kim, Eon-Ho; Ko, Kwang-Jun

    2016-06-01

    [Purpose] The purpose of this study was to investigate the effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness or female patients with metabolic syndrome. [Subjects and Methods] Subjects were randomly assigned to an exercise group (n=12) or a control group (n=11). Subjects in the exercise group performed aerobic exercise at 60-80% of maximum heart rate for 40 min 5 times a week for 12 weeks. The changes in metabolic syndrome risk factors, resting heart rate, physical fitness, and arterial stiffness were measured and analyzed before and after initiation of the exercise program to determine the effect of exercise. Arterial stiffness was assessed based on brachial-ankle pulse wave velocity (ba-PWV). [Results] Compared to the control group; The metabolic syndrome risk factors (weight, % body fat, waist circumference, systolic blood pressure, diastolic blood pressure, and HDL-Cholesterol) were significantly improved in the exercise: resting heart rate was significantly decreased; VO2max, muscle strength and muscle endurance were significantly increased; and ba-PWV was significantly decreased. [Conclusion] Aerobic exercise had beneficial effects on the resting heart rate, physical fitness, and arterial stiffness of patients with metabolic syndrome.

  18. Homozygous c.1160C>T (P38L) in the MECP2 gene in a female Rett syndrome patient.

    PubMed

    Bhanushali, Aparna A; Mandsaurwala, A; Das, Bibhu R

    2016-03-01

    Rett syndrome is a severe X-linked dominant neurodevelopmental disorder. Mutations in the MECP2 gene on chromosome Xq28 have been shown to be the cause of Rett syndrome. Sequencing of the MECP2 gene in a patient with clinical suspicion of Rett syndrome revealed c.1160C>T (P387L) in exon 4 of the MECP2 gene homozygously. Females with Rett syndrome are usually heterozygous for a mutation in MECP2. Uniparental disomy as a probable cause for the homozygous presence of this mutation was ruled out by quantitative fluorescence-polymerase chain reaction. Moreover to our knowledge this mutation has only been reported in males with X-linked mental retardation (MRX). We hypothesize that the presence of this mutation c.1160C>T (P387L) in the homozygous form is responsible for the Rett syndrome-like phenotype seen in this patient. This novel report reveals for the first time the homozygous presence of a mutation which has hitherto only been reported in males with MRX.

  19. Female condoms

    MedlinePlus

    Condoms for women; Contraception - female condom; Family planning - female condom; Birth control - female condom ... care provider or pharmacy for information about emergency contraception (Plan B) if the condom tears or the ...

  20. Gastrointestinal Symptoms in HIV-Infected Patients: Female Sex and Smoking as Risk Factors in an Outpatient Cohort in Brazil

    PubMed Central

    Santos, Annelisa Silva e Alves de Carvalho; Silveira, Erika Aparecida; Falco, Marianne de Oliveira

    2016-01-01

    This study aimed to estimate the incidence of gastrointestinal symptoms (GIS) and associated factors in an outpatient cohort of people living with HIV/AIDS (PLWHA) followed between October 2009 and July 2011. We evaluated nausea and/or vomiting, dyspepsia, heartburn, diarrhea, constipation, and flatulence. The outcome variable was the presence of three or more GIS. Sociodemographic (sex, skin color, age, income, years of schooling), lifestyle (smoking status, alcohol consumption, physical activity level), clinical (antiretroviral therapy, time of HIV infection, CD4 lymphocyte count, viral load), and anthropometric (nutritional status and waist circumference) variables were investigated. Data on sociodemographic and lifestyle variables were collected through a pre-tested and standardized questionnaire. CD4 count was determined by flow cytometry and viral load by branched DNA (bDNA) assays for HIV-1. All variables were analyzed at a p<0.05 significance level. Among 290 patients, the incidence of three or more GIS was 28.8% (95% CI 23.17 to 33.84) and 74.48% presented at least one symptom. Female gender (IR 2.29, 95% CI 1.63 to 3.22) and smoking status (IR 1.93, 95% CI 1.30 to 2.88) were risk factors for the presence of three or more GIS after multivariate Poisson regression. A high incidence of gastrointestinal symptoms was found among PLWHA, and it was significantly associated with female sex and tobacco use. Those results reinforce the relevance of investigating the presence of GIS in PLWHA as it may affect treatment adherence. PMID:27749931

  1. Body composition in young female eating-disorder patients with severe weight loss and controls: evidence from the four-component model and evaluation of DXA

    PubMed Central

    Wells, J C K; Haroun, D; Williams, J E; Nicholls, D; Darch, T; Eaton, S; Fewtrell, M S

    2015-01-01

    Background/Objectives: Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED involving substantial weight loss, relative to healthy controls using the four-component (4C) model, and (2) to explore the validity of DXA body composition assessment in ED patients. Subjects/Methods: Body composition of 13 females with ED and 117 controls, aged 10–18 years, was investigated using the 4C model. Accuracy of DXA for estimation of FFM and fat mass (FM) was tested using the approach of Bland and Altman. Results: Adjusting for age, height and pubertal stage, ED patients had significantly lower whole-body FM, FFM, protein mass (PM) and mineral mass (MM) compared with controls. Trunk and limb FM and limb lean soft tissue were significantly lower in ED patients. However, no significant difference in the hydration of FFM was detected. Compared with the 4C model, DXA overestimated FM by 5±36% and underestimated FFM by 1±9% in ED patients. Conclusion: Our study confirms that ED patients are depleted not only in FM but also in FFM, PM and MM. DXA has limitations for estimating body composition in individual young female ED patients. PMID:26173868

  2. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group.

    PubMed

    Gailledrat, Lucie; Rousselet, Morgane; Venisse, Jean-Luc; Lambert, Sylvain; Rocher, Bruno; Remaud, Manon; Guilleux, Alice; Sauvaget, Anne; Eyzop, Emeline; Grall-Bronnec, Marie

    2016-01-01

    Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61]), 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3), the use of laxatives (OR = 49.8), a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7), a higher minimum body mass index (OR = 1.73), and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74). These results are consistent with previous studies, and highlight the importance of denial.

  3. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group

    PubMed Central

    Gailledrat, Lucie; Rousselet, Morgane; Venisse, Jean-Luc; Lambert, Sylvain; Rocher, Bruno; Remaud, Manon; Guilleux, Alice; Sauvaget, Anne; Eyzop, Emeline; Grall-Bronnec, Marie

    2016-01-01

    Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with “no / mild” or “marked” body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to “marked” body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16–61]), 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3), the use of laxatives (OR = 49.8), a high score on the item “body dissatisfaction” of the Eating Disorders Inventory scale (OR = 1.7), a higher minimum body mass index (OR = 1.73), and a high score on the item “loss of control over behavior, thoughts and emotions” from the dissociation questionnaire (OR = 10.74). These results are consistent with previous studies, and highlight the importance of denial. PMID:27776159

  4. Efficacy of various chiropractic treatments, age distribution and incidence of accident- and nonaccident-caused low back pain in male and female patients.

    PubMed

    Sheladia, V L; Johnston, D A

    1986-12-01

    From a total pool of 1189 male and female patients with accident- (AC) and nonaccident- (NA) caused low back pain, 465 cases with completed therapy were studied for effectiveness of various chiropractic treatments. For those who completed therapy, the age distribution and incidence of this disorder were also studied. At the completion of the therapy, the response was evaluated as very good (pain-free, cured), better (very small degree of discomfort), relief (some reduction in pain) or no response to the treatment. The females with NA responded better than AC cases (p less than .001). However, male NA cases showed an increase in "no relief," but it was not significant (p = 0.052). The response of male AC cases was better than that of female AC cases (p less than 0.001). The cervical, thoracic, lumbar and ilium adjustment levels in female and male NA did not show any differences in response (p = 0.15, female; p = 0.46, male). The incidence of NA back pain disorders in both male and female was higher as compared to AC-caused back problems (p less than 0.001). The lower back pain problems did not show any age-specific association in either sex. Manipulative approaches in addition to nonmanipulative methods are superior to nonmanipulative measures alone, and females responded better to nonmanipulative care than did males.

  5. Faun tail: a rare cutaneous sign of spinal dysraphism.

    PubMed

    Kurtipek, Gülcan Saylam; Cihan, Fatma Göksin; Öner, Vefa; Ataseven, Arzu; Özer, İlkay; Akman, Zahide

    2015-01-01

    Faun tail is a triangle-shaped hypertrichosis of the lumbosacral region. It is a rare condition and it can be a cutaneous marker of underlying spinal cord anomaly. We report on a 17-year-old female patient with hypertrichosis on the lumbosacral area since birth that was later diagnosed with tethered cord in magnetic resonance imaging.

  6. Cephalometric Analysis of the Facial Skeletal Morphology of Female Patients Exhibiting Skeletal Class II Deformity with and without Temporomandibular Joint Osteoarthrosis

    PubMed Central

    Chen, Shuo; Lei, Jie; Fu, Kai-Yuan; Wang, Xing; Yi, Biao

    2015-01-01

    Purpose This study evaluated the differences in the facial morphological characteristics of female patients exhibiting skeletal class II deformity with and without temporomandibular joint osteoarthrosis. Methods Eighty-three female patients with skeletal class II deformity were included in this study; these patients were classified into three groups on the basis of the condylar features shown in cone-beam computed tomography scans: normal group, indeterminate for osteoarthrosis group, and osteoarthrosis group. The cephalometric differences among the three groups were evaluated through one-way ANOVA. Results Of the 83 patients, 52.4% were diagnosed with osteoarthrosis, as indicated by the changes in the condylar osseous component. The cephalometric measurements that represented skeletal characteristics, including mandibular position relative to the cranial base, mandibular plane angle (MP-SN), posterior facial height (S-Go), and facial height ratio, were significantly different among the three groups (p < 0.05). The patients in the osteoarthrosis group yielded the smallest S-Go, the highest MP-SN, and the most retruded mandible. Conclusions Temporomandibular joint osteoarthrosis is commonly observed in female patients with skeletal class II deformity. The morphological characteristics of the facial skeleton in patients with bilateral condylar osteoarthrosis may be altered. PMID:26474490

  7. Validating the eating disorder inventory (EDI-2) in two Danish samples: a comparison between female eating disorder patients and females from the general population.

    PubMed

    Clausen, Loa; Rokkedal, Kristian; Rosenvinge, Jan H

    2009-11-01

    The Eating Disorder Inventory, Version 2 (EDI-2) is a questionnaire used clinically and in research all over the world. EDI-2 is cross-culturally valid, yet normative values may depend on culture. Norms and reliability of the Danish version have to date been lacking, and will be presented in this article, comparing patients (N = 575) and controls (N = 881). Also, internal reliability of scales is tested for both groups. Differences between norms of the Danish and the North American version of EDI were small but significant for all scales except asceticism (eating disorder patients) and ineffectiveness, interpersonal distrust and maturity fears (normal controls). For both groups the internal consistency was >0.70 for all subscales except asceticism. Although differences across the eating disorder diagnostic groups were dubious, the EDI-2 is useful to screen for eating problems in the general population as well as to rate progress and outcome among eating disorder patients.

  8. Pruritus in Female Patients

    PubMed Central

    Lambert, Julien

    2014-01-01

    Pruritus is a frequent symptom in many dermatological diseases. In this review we want to focus on not only itch problems specific to women, namely, pruritic vulvodermatoses, but also the specific pruritic dermatoses of pregnancy. The specific characteristics of the vulva and the hormonal changes during the different age periods make these dermatoses very particular. It seems that vulvar diseases are still underdiagnosed and undertreated. Pruritic vulvar diseases have a huge impact on quality of life. The most common pruritic diseases will be discussed, such as atopic and contact dermatitis, psoriasis, lichen sclerosis, lichen planus, and infectious vulvaginitis. We focus on the diagnostic issue of these diseases and will consider the general principles of therapy. PMID:24711996

  9. Aborted Sudden Cardiac Death in a Female Patient Presenting with Takotsubo-Like Cardiomyopathy due to Epicardial Coronary Vasospasm

    PubMed Central

    Eisele, Tom; Nunninger, Peter; Münz, Benedikt

    2017-01-01

    Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV) in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy. The prognosis of takotsubo cardiomyopathy is generally more favourable compared to myocardial infarction; however, severe complications such as rupture of the LV and life-threatening arrhythmias may occur. Herein, we describe a case of an 84-year-old female, who presented with aborted sudden cardiac death due to ventricular fibrillation. Echocardiography suggested LV apical ballooning with severely impaired LV-function, so that takotsubo cardiomyopathy was suspected. However, coronary angiography revealed epicardial spasm of the left anterior ascending, which resolved after intracoronary injection of 0.2 mg nitroglycerine. Cardiac magnetic resonance exhibited subendocardial late enhancement and echocardiography showed normalization of LV dysfunction during follow-up. The patient was put on conservative treatment with nitrates and calcium inhibitors and ICD implantation were deferred.

  10. Short-Term Pulmonary Rehabilitation for a Female Patient with Chronic Scleroderma under a Single-Case Research Design

    PubMed Central

    Leelarungrayub, Jirakrit; Pinkaew, Decha; Wonglangka, Khanittha; Eungpinichpong, Wichai; Klaphajone, Jakkrit

    2016-01-01

    Although previously proposed that chronic scleroderma should be cared for clinically and early rehabilitation should be performed in hospital by a chest physical therapist, little evidence is currently available on its benefits. Therefore, this study demonstrated the benefits of short-term pulmonary rehabilitation during hospitalization in a female patient with chronic scleroderma. The aim of rehabilitation was to improve ventilation and gas exchange by using airway clearance, chest mobilization, and breathing-relearning techniques, including strengthening the respiratory system and the muscles of the limbs by using the BreathMax® device and elastic bands. Gross motor function and activities of daily life were regained by balancing, sitting, and standing practices. Data on minimal chest expansion, high dyspnea, high respiratory rate, and low maximal inspiratory mouth pressure were recorded seven days before rehabilitation or at the baseline period. But there was a clinically significant improvement in dyspnea, chest expansion, maximal inspiratory mouth pressure, and respiratory rate, when compared to baseline data, which were recorded by a chest physical therapist during seven days of rehabilitation. Furthermore, physicians decided to stop using a mechanical ventilator, and improvement in functional capacity was noted. Therefore, in the case of chronic and stable scleroderma, short-term rehabilitation during hospitalization for chest physical therapy possibly shows clinical benefits by improving both pulmonary function and physical performance. PMID:27721661

  11. Short-Term Pulmonary Rehabilitation for a Female Patient with Chronic Scleroderma under a Single-Case Research Design.

    PubMed

    Leelarungrayub, Jirakrit; Pinkaew, Decha; Wonglangka, Khanittha; Eungpinichpong, Wichai; Klaphajone, Jakkrit

    2016-01-01

    Although previously proposed that chronic scleroderma should be cared for clinically and early rehabilitation should be performed in hospital by a chest physical therapist, little evidence is currently available on its benefits. Therefore, this study demonstrated the benefits of short-term pulmonary rehabilitation during hospitalization in a female patient with chronic scleroderma. The aim of rehabilitation was to improve ventilation and gas exchange by using airway clearance, chest mobilization, and breathing-relearning techniques, including strengthening the respiratory system and the muscles of the limbs by using the BreathMax(®) device and elastic bands. Gross motor function and activities of daily life were regained by balancing, sitting, and standing practices. Data on minimal chest expansion, high dyspnea, high respiratory rate, and low maximal inspiratory mouth pressure were recorded seven days before rehabilitation or at the baseline period. But there was a clinically significant improvement in dyspnea, chest expansion, maximal inspiratory mouth pressure, and respiratory rate, when compared to baseline data, which were recorded by a chest physical therapist during seven days of rehabilitation. Furthermore, physicians decided to stop using a mechanical ventilator, and improvement in functional capacity was noted. Therefore, in the case of chronic and stable scleroderma, short-term rehabilitation during hospitalization for chest physical therapy possibly shows clinical benefits by improving both pulmonary function and physical performance.

  12. Persistence of uropathogenic Escherichia Coli in the bladders of female patients with sterile urine after antibiotic therapies.

    PubMed

    Liu, Shu-Cheng; Han, Xiao-Min; Shi, Ming; Pang, Zi-Li

    2016-10-01

    This study aimed to provide evidence of persistent uropathogenic Escherichia coli (UPEC) in female patients with recurrent urinary tract infection (UTI) after antibiotic therapy. We collected biopsies of the bladder, and clean-catch urine samples from 32 women who had episodes of recurrent UTI and were given antibiotic therapy. Urine samples and biopsies were analyzed by conventional bacteriological techniques. Phylogenetic group and 16 virulence factors (VFs) of UPEC were determined using polymerase chain reaction (PCR). The infection capability of UPEC was confirmed in a mouse model. Immunofluorescence and electron microscopy were used to detect intracellular bacterial communities (IBCs) in the mouse model. The results showed that all urine specimens were detected sterile. E. coli was found in 6 of 32 biopsies (18.75%), and was identified to be UPEC by PCR. Different VFs associated with the formation of IBCs were identified in all six UPEC isolates. Each UPEC isolate was capable of forming IBCs within the bladder epithelial cells of mice. In conclusion, UPEC with distinctive pathological traits and the capability of IBC formation was first found in the bladders of women after antibiotic therapy, suggesting that the IBC pathogenic pathway may occur in humans and it plays an important role in UTI recurrence.

  13. [Female sexual disorders nowadays].

    PubMed

    Rajtman, Marta

    2013-01-01

    This article makes a brief overview of the most frequent female sexual disorders seen in our clinical practice. It highlights the increasing number of women presenting with hypoactive sexual desire and the efforts practitioners put on helping these female patients. The article also shows the pharmacological strategies that are investigated to solve these dysfuntions.

  14. Common carotid intima-media thickness and von Willebrand factor serum levels in rheumatoid arthritis female patients without cardiovascular risk factors.

    PubMed

    Daza, Leonel; Aguirre, Martin; Jimenez, Martin; Herrera, Rafael; Bollain, J J

    2007-04-01

    High atherosclerosis prevalence was found in rheumatoid arthritis (RA), and the von Willebrand factor (vWF) was shown to be a marker for endothelial damage. The aim of this study was to evaluate the association of intima-media thickness of the left common carotid artery with vWF serum levels in rheumatoid arthritis patients without cardiovascular risk factors. We included 55 RA female patients, each with at least 5 years of duration of the disease, and 20 healthy female subjects as members of the control group. The vWF, cholesterol, triglycerides, and the immune variables-rheumatoid factor and reactive C protein-were evaluated. The media thickness and intima-media thickness (IMT) in patients and in the control subjects were assessed by Doppler ultrasound of the left common carotid artery. Although the ages for RA patients and healthy female controls were not different, the IMT of the left common carotid artery (IMT CCA) in rheumatoid arthritis patients was increased in comparison with healthy control measurements, the mean being 0.67 mm (SD 0.18) vs 0.58 mm (SD 0.10) with a p value 0.01. The vWF serum levels showed differences in RA patients from those in control patients, 145.6 (SD 30.08) vs 121.8 (SD 37.17), respectively, with p=0.007. A correlation was also found between vWF with IMT CCA in the RA patients: r=0.390 and p<0.05. We concluded that the measurements of the left common carotid artery intima-media thickness together with the von Willebrand factor serum levels could give valuable information about the artery status and the atherosclerosis process in early stages in patients with rheumatoid arthritis without cardiovascular risk factors.

  15. Lifespan attention deficit/hyperactivity disorder and borderline personality disorder symptoms in female patients: a latent class approach.

    PubMed

    van Dijk, Fiona; Lappenschaar, Martijn; Kan, Cornelis; Verkes, Robbert-Jan; Buitelaar, Jan

    2011-12-30

    Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are frequently comorbid. To contribute to a better understanding of the associations regularly found between ADHD and BPD, on the one hand, and the developmental pathways for these disorders, on the other hand, latent class analyses (LCA) were undertaken to identify classes differing in profiles of childhood symptoms of ADHD and adult symptoms of ADHD and BPD. Diagnostic interviews with 103 female outpatients meeting the criteria for ADHD and/or BPD were used to assess current DSM-IV symptoms; childhood symptoms of ADHD were assessed in parent interviews. The latent classes were examined in relation to the DSM-IV conceptualizations of ADHD and BPD. And relations between childhood and adult classes were examined to hypothesize about developmental trajectories. LCA revealed an optimal solution with four distinct symptom profiles: only ADHD symptoms; BPD symptoms and only ADHD symptoms of hyperactivity; BPD symptoms and ADHD symptoms of inattention and hyperactivity; BPD symptoms and ADHD symptoms of inattention, hyperactivity and impulsivity. All patients with BPD had some ADHD symptoms in both adulthood and childhood. Hyperactivity was least discriminative of adult classes. Adult hyperactivity was not always preceded by childhood hyperactivity; some cases of comorbid ADHD and BPD symptoms were not preceded by significant childhood ADHD symptoms; and some cases of predominantly BPD symptoms could be traced back to combined symptoms of ADHD in childhood. The results underline the importance of taking ADHD diagnoses into account with BPD. ADHD classification subtypes may not be permanent over time, and different developmental pathways to adult ADHD and BPD should therefore be investigated.

  16. Dose-response curve and time-course of effect of vecuronium in male and female patients.

    PubMed

    Xue, F S; Liao, X; Liu, J H; Tong, S Y; Zhang, Y M; Zhang, R J; An, G; Luo, L K

    1998-06-01

    To determine the differences between men and women in the dose-response curve and the time-course of effect of vecuronium, we studied 60 adult patients (30 male and 30 female), ASA I, age 18-51 yr, undergoing elective plastic surgery. Anaesthesia was maintained with nitrous oxide 60% in oxygen; thiopentone and incremental doses of fentanyl were given as required. Neuromuscular function was assessed mechanomyographically using the train-of-four (TOF) stimulation at the wrist every 12 s. The percentage depression of T1 was used as the study variable. The dose-response relationship of vecuronium was determined by a cumulative dose-response technique. The dose-response curve in men was shifted in a parallel fashion to the right, indicating a decrease in the sensitivity to vecuronium-induced neuromuscular block, compared with women. The ED50, ED90 and ED95 of vecuronium were 23.9 (4.7), 45.4 (11.2) and 55.7 (14.3) micrograms kg-1 in men and 18.4 (3.7), 33.5 (7.8) and 39.8 (9.6) micrograms kg-1 in women respectively. There were statistically significant differences in these values between the two groups (P < 0.01 in each instance). After a total dose of vecuronium 80 micrograms kg-1, neuromuscular block was significantly longer in women than in men. The duration of peak effect, clinical duration, and the total duration were 18.7 (7.1), 26.6 (8.8) and 50.6 (16.0) min respectively in men and 26.0 (7.2), 37.1 (11.2) and 65.9 (20.7) min in women. They differed significantly between men and women (P < 0.005 in each case).

  17. Aspects of Health-Related Factors and Nutritional Care Needs by Survival Stage among Female Cancer Patients in South Korea

    PubMed Central

    Bae, Eunjoo; Lim, Hyunjung

    2016-01-01

    Purpose This study examined diet-related problems and needs associated with nutritional care according to survival stage in Korean female cancer survivors. Methods 186 outpatients (breast or gynecologic cancer survivors) recruited. Subjects were classified as (1) extended stage (ES, 2–5 years from diagnosis) and (2) long-term stage (LS, ≥5 years from diagnosis). Eating habits, changes in health related factors, nutritional needs, and quality of life were investigated. Results 43% of ES survivors had diet-related problems (p = .031); ES group reported dyspepsia and LS group reported anorexia/nausea as the major problem. Half of ES survivors had taste change, decreasing amount of intake, and reduced quality of life (p < .05). The LS group had a greater preference for sweet tastes than the ES group. According to their diagnosis, ES survivors with breast cancer gained weight (27.1%), whereas ES survivors with gynecologic cancer lost their body weight (34.5%) significantly. LS breast cancer patients showed great food preference for vegetables, whereas those with gynecologic cancer showed an increased preference for fish, meat and grain. Approximately 90% of survivors demanded nutritional care regarding restricted foods, preventing recurrence, particularly in ES survivors (p < .01). Moreover, main factors for nutritional care needs were body weight control for breast cancer and food environment for gynecologic cancer. Conclusion Survivors have different aspects of diet-related problems by survival stage as dyspepsia in ES and anorexia in LS. ES stage had changes in dietary patterns and their food consumption have decreased. Most of survivors have demanded nutritional care regardless of survival stage. These features of each stage should be considered to improve their health. PMID:27695041

  18. Randomized trial outcomes of a TTM-tailored condom use and smoking intervention in urban adolescent females

    PubMed Central

    Redding, Colleen A.; Prochaska, James O.; Armstrong, Kay; Rossi, Joseph S.; Hoeppner, Bettina B.; Sun, Xiaowu; Kobayashi, Hisanori; Yin, Hui-Qing; Coviello, Donna; Evers, Kerry; Velicer, Wayne F.

    2015-01-01

    Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females were recruited and randomized within four urban family planning clinics. Participants received TTM or standard care (SC) computerized feedback and stage-targeted or SC counseling at baseline, 3, 6 and 9 months. Blinded follow-up telephone surveys were conducted at 12 and 18 months. Analyses revealed significantly more consistent condom use in the TTM compared with the SC group at 6 and 12, but not at 18 months. In baseline consistent condom users (40%), significantly less relapse was found in the TTM compared with the SC group at 6 and 12, but not at 18 months. No significant effects for smoking prevention or cessation were found, although cessation rates matched those found previously. This TTM-tailored intervention demonstrated effectiveness for increasing consistent condom use at 6 and 12 months, but not at 18 months, in urban adolescent females. This intervention, if replicated, could be disseminated to promote consistent condom use and additional health behaviors in youth at risk. PMID:24794584

  19. Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgaris.

    PubMed

    Matsuoka, Yoshie; Yoneda, Kozo; Sadahira, Chieko; Katsuura, Junko; Moriue, Tetsuya; Kubota, Yasuo

    2006-11-01

    Acne vulgaris significantly affects patients' quality of life (QOL) and their lives in various ways, including social behavior and body dissatisfaction. This may be heightened by acne's typical involvement of the face. We investigated whether the use of skin care and makeup could influence the QOL of affected patients without deteriorating conventional acne treatments. Fifty female patients with acne were recruited for our study. Twenty-five patients were instructed how to use skin care and cosmetics, while 25 patients received no specific instructions from dermatologists. Both groups received conventional topical and/or oral medication for acne during the study period for 4 weeks. Both groups did not show any significant difference in clinical improvement of acne severity. Two validated QOL questionnaires, World Health Organization (WHO)QOL26 and the Dermatology Life Quality Index (DLQI) were administered to all patients at first visit and 4 weeks later. The mean scores of psychological and overall domains in WHOQOL26 for patients with instructions were improved significantly, while only the overall score was significantly improved for patients without instructions. The total mean scores and all domains except work/school in DLQI for patients with instructions were improved significantly, while the total scores and all domains except discomfort for treatment in DLQI were significantly improved for patients without instructions. Thus, instructions on the use of skin care and cosmetics for female acne patients did not deteriorate acne treatment and influenced patients' QOL effectively. We therefore suggest that instructions for using skin care and cosmetics complement conventional medical treatments for acne.

  20. Tophaceous gout in a female premenopausal patient with an unexpected diagnosis of glycogen storage disease type Ia: a case report and literature review.

    PubMed

    Zhang, Bingqing; Zeng, Xuejun

    2016-11-01

    A young female with recurrent tophaceous gout and infertility presented to our clinic. On clinical evaluation, hypoglycaemia, hypertriglyceridaemia, lactic acidosis, and hepatomegaly were noted. Targeted gene sequencing revealed a novel composite heterozygous c.190G>T/c.508C>T mutation in the G6PC gene of the patient, leading to a diagnosis of glycogen storage disease type Ia. Her father possessed a heterozygous c.190G>T mutation, and her mother possessed a heterozygous c.508C>T mutation. A search of the previous literature revealed 16 reported cases of glycogen storage disease type Ia with gout. Here, we describe a female patient with gout, review previous cases, and discuss the mechanisms of gout and hyperuricaemia in glycogen storage disease type Ia.

  1. Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary?

    PubMed

    Yitta, Silaja; Mausner, Elizabeth V; Kim, Alice; Kim, Danny; Babb, James S; Hecht, Elizabeth M; Bennett, Genevieve L

    2011-10-01

    To determine the added value of reimaging the female pelvis with ultrasound (US) immediately following multidetector CT (MDCT) in the emergent setting. CT and US exams of 70 patients who underwent MDCT for evaluation of abdominal/pelvic pain followed by pelvic ultrasound within 48 h were retrospectively reviewed by three readers. Initially, only the CT images were reviewed followed by evaluation of CT images in conjunction with US images. Diagnostic confidence was recorded for each reading and an exact Wilcoxon signed rank test was performed to compare the two. Changes in diagnosis based on combined CT and US readings versus CT readings alone were identified. Confidence intervals (95%) were derived for the percentage of times US reimaging can be expected to lead to a change in diagnosis relative to the diagnosis based on CT interpretation alone. Ultrasound changed the diagnosis for the ovaries/adnexa 8.1% of the time (three reader average); the majority being cases of a suspected CT abnormality found to be normal on US. Ultrasound changed the diagnosis for the uterus 11.9% of the time (three reader average); the majority related to the endometrial canal. The 95% confidence intervals for the ovaries/adnexa and uterus were 5-12.5% and 8-17%, respectively. Ten cases of a normal CT were followed by a normal US with 100% agreement across all three readers. Experienced readers correctly diagnosed ruptured ovarian cysts and tubo-ovarian abscesses (TOA) based on CT alone with 100% agreement. US reimaging after MDCT of the abdomen and pelvis is not helpful: (1) following a normal CT of the pelvic organs or (2) when CT findings are diagnostic and/or characteristic of certain entities such as ruptured cysts and TOA. Reimaging with ultrasound is warranted for (1) less-experienced readers to improve diagnostic confidence or when CT findings are not definitive, (2) further evaluation of suspected endometrial abnormalities. A distinction should be made between the need for

  2. Predicted Risk of Radiation-Induced Cancers After Involved Field and Involved Node Radiotherapy With or Without Intensity Modulation for Early-Stage Hodgkin Lymphoma in Female Patients

    SciTech Connect

    Weber, Damien C.; Johanson, Safora; Peguret, Nicolas; Cozzi, Luca; Olsen, Dag R.

    2011-10-01

    Purpose: To assess the excess relative risk (ERR) of radiation-induced cancers (RIC) in female patients with Hodgkin lymphoma (HL) female patients treated with conformal (3DCRT), intensity modulated (IMRT), or volumetric modulated arc (RA) radiation therapy. Methods and Materials: Plans for 10 early-stage HL female patients were computed for 3DCRT, IMRT, and RA with involved field RT (IFRT) and involvednode RT (INRT) radiation fields. Organs at risk dose--volume histograms were computed and inter-compared for IFRT vs. INRT and 3DCRT vs. IMRT/RA, respectively. The ERR for cancer induction in breasts, lungs, and thyroid was estimated using both linear and nonlinear models. Results: The mean estimated ERR for breast, lung, and thyroid were significantly lower (p < 0.01) with INRT than with IFRT planning, regardless of the radiation delivery technique used, assuming a linear dose-risk relationship. We found that using the nonlinear model, the mean ERR values were significantly (p < 0.01) increased with IMRT or RA compared to those with 3DCRT planning for the breast, lung, and thyroid, using an IFRT paradigm. After INRT planning, IMRT or RA increased the risk of RIC for lung and thyroid only. Conclusions: In this comparative planning study, using a nonlinear dose--risk model, IMRT or RA increased the estimated risk of RIC for breast, lung, and thyroid for HL female patients. This study also suggests that INRT planning, compared to IFRT planning, may reduce the ERR of RIC when risk is predicted using a linear model. Observing the opposite effect, with a nonlinear model, however, questions the validity of these biologically parameterized models.

  3. Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma

    PubMed Central

    Yavuz, Atacan; Ağralı, Ömer Birkan; Çalışkan, Zeynep Lale; Türkaydın, Dilek; Sertgöz, Atilla; Doğan, Başak

    2014-01-01

    Radiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient's aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy. PMID:24523971

  4. Review and Recommendations on Management of Adult Female Thalassemia Patients with Hypogonadism based on Literature Review and Experience of ICET-A Network Specialists

    PubMed Central

    De Sanctis, Vincenzo; Soliman, Ashraf T.; Elsedfy, Heba; Albu, Alice; Al Jaouni, Soad; Anastasi, Salvatore; Bisconte, Maria Grazia; Canatan, Duran; Christou, Soteroula; Daar, Shahina; Di Maio, Salvatore; El Kholy, Mohamed; Khater, Doaa; Elshinawy, Mohamed; Kilinc, Yurdanur; Mattei, Roberto; Mosli, Hala H.; Quota, Alessandra; Roberti, Maria Grazia; Sobti, Praveen; Yaarubi, Saif AL; Canpisi, Saveria; Kattamis, Christos

    2017-01-01

    Background Multi-transfused thalassemia major (TM) patients frequently develop severe endocrine complications, mainly due to iron overload, anemia, and chronic liver disease, which require prompt diagnosis, treatment and follow-up by specialists. The most common endocrine complication documented is hypogonadotropic hypogonadism which increases with age and associated comorbidities. It is thus important for physicians to have a clear understanding of the pathophysiology and management of this disorder. Also to be aware of the side effects, contraindications and monitoring of sex steroid therapy. In this paper, practical ICET-A recommendations for the management of hypogonadism in adult females with TM are addressed. Methods In March 2015, the Coordinator of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A) conducted a two-step survey to assess the attitudes and practices of doctors in the ICET-A network taking care of adult female TM patients with hypogonadism. They were clinically characterized by the absence of pubertal development or discontinuation or regression of the maturation of secondary sex characteristics, and biochemically by persistent low FSH, LH and estradiol levels. Recently a supplementary survey on adult female hypogonadism in TM was undertaken within the ICET-A network. Results The completed questionnaires were returned by 16 of 27 specialists (59.2%) following 590 female TM patients over the age of 18 years; 315 patients (53.3%) had hypogonadism, and only 245 (74.6%) were on hormone replacement therapy (HRT). Contraceptive oral pills (COC) were the first treatment choice in 11 centers (68.7%). A wide range of COCs was used with different progestin contents. In general, the patients’ compliance to treatment was reported as good in 81.2 % of centers. The frequency of required tests for follow-up HRT, in addition to the regular check-up for thalassemia, was variable in the participating

  5. Female circumcision.

    PubMed

    Abu Daia, J M

    2000-10-01

    It is uncertain when female circumcision was first practiced, but it certainly preceded the founding of both Christianity and Islam. A review of past and current historical, popular and professional literature was undertaken, and 4 types of female circumcision were identified. Typically female circumcision is performed by a local village practitioner, lay person or by untrained midwives. Female genital mutilation is not accepted by any religious or medical opinion, and is a violation of human rights against helpless individuals who are unable to provide informed consent and who must therefore be protected through education and legislation. Complications of female circumcision can present after many years. Any medical practitioner (either for adult or pediatric) can be confronted with this issue of female circumcision, even in countries where this custom is not present, thus mandating the understanding of this complex issue.

  6. Hematochezia due to Caecal Angiodysplazia led to Diagnosis of a Transverse Colon Cancer in a Young Female Patient: Case Report and Literature Review.

    PubMed

    Andrei, G N; Popa, B; Popiel, M; Diaconescu, B I; Martian, B V; Beuran, M

    2015-01-01

    We present an unusual case of a caecal angiodysplasia whose bleeding determined the discovery of a mid-transverse colon cancer in a 26 years old female patient. After the initial successful angiographic treatment of the caecal lesion the patient underwent laparoscopic - assisted transverse colectomy. The postoperative evolution was favorable, without resumption of bleeding episodes and rapid social reintegration. The histopathology revealed mucinous adenocarcinoma that penetrates the visceral serous with 7 lymph nodes invasion of 18 examined. As a result of the advanced stage, pT4aN2bM0 - stage IIIC, the life expectancy at 5 years is between 30 to 50%.

  7. Risky Sexual Behavior among Rural Female Adolescents in Malaysia: A Limited Role of Protective Factors

    PubMed Central

    Ahmadian, Maryam; Hamsan, Hanina H.; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

    2014-01-01

    Purpose: This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. Methods: We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Results: Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. Conclusion: The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents’ risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia. PMID:24762359

  8. Assessment of Proportion of Hidden Patients Having Symptoms of Overactive Bladder and Why Has It Been Hidden in Female Outpatients Admitted to Hospital

    PubMed Central

    Demir, Ömer; Zeren, Mehmet Fatih; Ceylan, Yasin; Çelen, İlker; Zümrütbaş, Ali Ersin; Temeltaş, Gökhan; Bozkurt, Ozan; Günlüsoy, Bülent; Çelik, Orçun; Ekin, Gökhan; Mertoğlu, Oğuz

    2016-01-01

    Purpose: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. Methods: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score≥8 were defined as having OAB symptoms. Results: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: “I did not think I had a disease” and “The symptoms did not bother me,” with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P<0.001). Conclusions: This is the first study to demonstrate a significant proportion of women with undetected OAB symptoms. The main reasons the women did not admit themselves to a hospital were their unawareness of the disease and because the LUTS were not bothersome. Public awareness programs on this disease may resolve this problem. PMID:27032557

  9. Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial

    PubMed Central

    Gunnarsson, Anna-Karin; Gunningberg, Lena; Larsson, Sune; Jonsson, Kenneth B

    2017-01-01

    Background Urinary tract infection (UTI) is a common complication among patients with hip fractures. Receiving an indwelling urinary catheter is a risk factor for developing UTIs. Treatment of symptomatic UTIs with antibiotics is expensive and can result in the development of antimicrobial resistance. Cranberries are thought to prevent UTI. There is no previous research on this potential effect in patients with hip fracture who receive urinary catheters. Aim The aim of this study is to investigate whether intake of cranberry juice concentrate pre-operatively decreases the incidence of postoperative UTIs in hip fracture patients that received a urinary catheter. Design This study employed a randomized, placebo-controlled double-blind trial. Method Female patients, aged 60 years and older, with hip fracture (n=227) were randomized to receive cranberry or placebo capsules daily, from admission, until 5 days postoperatively. Urine cultures were obtained at admission, 5 and 14 days postoperatively. In addition, Euro Qual five Dimensions assessments were performed and patients were screened for UTI symptoms. Result In the intention-to-treat analysis, there was no difference between the groups in the proportion of patients with hospital-acquired postoperative positive urine cultures at any time point. When limiting the analysis to patients that ingested at least 80% of the prescribed capsules, 13 of 33 (39%) in the placebo group and 13 of 47 (28%) in the cranberry group (P=0.270) had a positive urine culture at 5 days postoperatively. However, this difference was not statistically significant (P=0.270). Conclusion Cranberry concentrate does not seem to effectively prevent UTIs in female patients with hip fracture and indwelling urinary catheter. PMID:28144131

  10. A Retrospective Analysis of Spontaneous Adverse Drug Reactions Reports Relating to Paediatric Patients

    PubMed Central

    Rosli, Rosliana; Abd Aziz, Noorizan; Manan, Mohamed Mansor

    2016-01-01

    Background Spontaneous reporting on adverse drug reactions (ADR) has been established in Malaysia since 1987, and although these reports are monitored by the Malaysia drug monitoring authority, the National Pharmaceutical Control Bureau, information about ADRs in the paediatric patient population still remains unexplored. The aims of this study, therefore, were to characterize the ADRs reported in respect to the Malaysian paediatric population and to relate the data to specific paediatric age groups. Methods Data on all ADRs reported to the National Pharmaceutical Control Bureau between 2000 and 2013 for individuals aged from birth to 17 years old were analysed with respect to age and gender, type of reporter, suspected medicines (using the Anatomical Therapeutic Chemical classification), category of ADR (according to system organ class) as well as the severity of the ADR. Results In total, 11,523 ADR reports corresponding to 22,237 ADRs were analysed, with half of these reporting one ADR per report. Vaccines comprised 55.7% of the 11,523 ADR reports with the remaining being drug related ADRs. Overall, 63.9% of ADRs were reported for paediatric patients between 12 and 17 years of age, with the majority of ADRs reported in females (70.7%). The most common ADRs reported were from the following system organ classes: application site disorders (32.2%), skin and appendages disorders (20.6%), body as a whole general disorders (12.8%) and central and peripheral nervous system disorders (11.2%). Meanwhile, ADRs in respect to anti-infectives for systemic use (2194/5106; 43.0%) were the most frequently reported across all age groups, followed by drugs from the nervous system (1095/5106; 21.4%). Only 0.28% of the ADR cases were reported as fatal. A large proportion of the reports were received from healthcare providers in government health facilities. Discussion ADR reports concerning vaccines and anti-infectives were the most commonly reported in children, and are mainly

  11. Vandetanib Successfully Controls Medullary Thyroid Cancer-Related Cushing Syndrome in an Adolescent Patient

    PubMed Central

    Nella, A. A.; Fox, E.; Balis, F. M.; Quezado, M. M.; Whitcomb, P. O.; Derdak, J.; Kebebew, E.; Widemann, B. C.; Stratakis, C. A.

    2014-01-01

    Context: Ectopic Cushing syndrome due to ACTH secretion from metastatic medullary thyroid cancer (MTC) is associated with significant morbidity and mortality. Objective: The aim of the study was to describe the first case of Cushing syndrome associated with MTC in a pediatric patient and the successful reversal of Cushing syndrome with tyrosine kinase inhibitor (vandetanib) therapy. Patient and Methods: A 17-year-old Brazilian adolescent presented with metastatic MTC and associated ACTH-dependent ectopic Cushing syndrome in the context of multiple endocrine neoplasia type 2B. When the patient was treated with the tyrosine kinase inhibitor vandetanib, rapid decrease in serum cortisol and improvement of clinical symptoms were observed. Conclusion: We describe the first pediatric case of clinical and biochemical improvement of paraneoplastic MTC-related Cushing syndrome after treatment with vandetanib. Vandetanib and possibly other tyrosine kinase inhibitors may be a novel beneficial option in patients with neuroendocrine tumor-related ectopic Cushing syndrome. PMID:24617713

  12. [Functional state of the hypothalamo-hypophyseal-ovarian system in female patients with tuberculosis of the genital organs].

    PubMed

    Kolachevskaia, E N; Smetnik, V P; Malysheva, O K; Smirnova, N A

    1991-01-01

    Blood concentrations of LH, FSH, estradiol, prolactin, growth hormone, cortisol, testosterone and progesterone have been examined in 76 patients with active tuberculosis of the internal genitalia (group 1), 18 patients with longterm sequelae of clinically asymptomatic tuberculosis (group 2) and 41 patients with nontuberculous diseases of the internal genitalia. Abnormalities were identified in 56.5% of group 1 patients, 33% of group 2 and 46.4% of group 3 patients. The patients with active tuberculosis characteristically had a low gonadotropin and estradiol secretion. High prolactin levels were related to pituitary adenoma or tuberculous infection; polycystic ovaries were a cause of testosterone and stress of examination of cortisol elevation.

  13. Radiation for Hodgkin's Lymphoma in Young Female Patients: A New Technique to Avoid the Breasts and Decrease the Dose to the Heart

    SciTech Connect

    Dabaja, Bouthaina S.; Rebueno, Neal C.S.; Mazloom, Ali; Thorne, Scott; Perrin, Kelly J.; Tolani, Naresh; Das, Pragnan; Delclos, Marc E.; Iyengar, Puneeth; Reed, Valerie K.; Horace, Patrecia; Salehpour, Mohammad R.

    2011-02-01

    Purpose: To demonstrate how, in young female patients with Hodgkin's lymphoma, using an inclined board technique can further decrease the volume of breasts and heart in the treatment field. Methods and Materials: An inclined board was constructed with the ability to mount an Aquaplast face mask, a Vacu-Lock, and a hip stopper. Eight female patients with early-stage Hodgkin's lymphoma were planned and compared using the conventional flat position and the inclined board position. All patients on the inclined board were planned with 90{sup o} degree table position and 15{sup o} gantry angle rotation to compensate for the beam divergence resulting from the patient's position on the inclined board. Dose-volume histograms were generated, as well as the mean V30 and V5 of both breasts and heart using both treatment positions. Results: The mean value of V30 of the right breast, left breast, and heart decreased from 3%, 3%, and 13%, respectively, using the flat position to 0, 0.4%, and 5%, respectively, using the inclined board. The mean value of V5 of the right breast, left breast, and heart decreased from 6%, 13%, and 36%, respectively, using the flat position to 2%, 8%, and 29%, respectively, using the inclined board. Conclusions: Compared with conventional flat positioning, this simple device and technique allows better sparing of the breasts and the heart while maintaining comparable target coverage and total lung dose.

  14. The influence of 5-HT(2C) and MDR1 genetic polymorphisms on antipsychotic-induced weight gain in female schizophrenic patients.

    PubMed

    Kuzman, Martina Rojnic; Medved, Vesna; Bozina, Nada; Hotujac, Ljubomir; Sain, Ivica; Bilusic, Hrvoje

    2008-09-30

    We investigated the relationships between functional genetic variants of the 5-HT(2C) receptor and multidrug-resistant protein (MDR1), coding for P-glycoprotein, and second generation antipsychotic (SDA)-induced weight gain among 108 female schizophrenic patients treated with olanzapine or risperidone for up to 4 months. No significant differences in -759C/T allelic and genotype variants of 5-HT(2C) were found between patients who gained more than 7% of their initial weight compared with those who gained less. Haplotype-based analysis of two MDR1 loci, exon 21 G2677T and exon 26 C3435T, revealed a slightly lower representation of the G2677/C3435 haplotype in the >or=7% group. In the subgroup of patients treated with risperidone, we found borderline overrepresentation of 2677T, significant overrepresentation of 3435T variant and borderline overrepresentation of 2677T/3435T haplotype the >or=7% group, whereas G2677/C3435 haplotype was found to be less represented in the >or=7% group. Our data indicate a nonsignificant role of 759C/T 5-HT(2C) in SDA-induced weight gain, and a stronger influence of the MDR1 G2677T and C3435T polymorphisms on risperidone-induced weight gain in female schizophrenic patients. 3435T and 2677T MDR1 variants, both associated with lower P-gp function, might predispose to higher risperidone accessibility to the brain that would lead to stronger effects, including weight gain.

  15. Changes in Female Support Network Systems and Adaptation after Breast Cancer Diagnosis: Differences between Older and Younger Patients

    ERIC Educational Resources Information Center

    Ashida, Sato; Palmquist, Aunchalee E. L.; Basen-Engquist, Karen; Singletary, S. Eva; Koehly, Laura M.

    2009-01-01

    Purpose: This study evaluates the changes in social networks of older and younger breast cancer patients over a 6-month period following their first diagnosis and how such modifications are associated with changes in the patients' mood state. Design and Methods: Newly diagnosed breast cancer patients were interviewed shortly after their diagnosis…

  16. Female genetic distribution bias in mitochondrial genome observed in Parkinson’s Disease patients in northern China

    PubMed Central

    Chu, Qiaohong; Luo, Xiaoguang; Zhan, Xiaoni; Ren, Yan; Pang, Hao

    2015-01-01

    Genetic polymorphisms associated with susceptibility to Parkinson’s disease (PD) have been described in mitochondrial DNA (mtDNA). To explore the potential contribution of mtDNA mutations to the risk of PD in a Chinese population, we examined the linkage relationship between several single nucleotide polymorphisms (SNPs) and haplotypes in mtDNA and PD. We genotyped 5 SNPs located on coding genes using PCR-RFLP analysis. A specific allele 10398G demonstrated an increased risk of PD (OR 1.30; 95% CI 0.95–1.76; P = 0.013). After stratification by gender, the increased risk appeared to be more significant in females (OR 1.91; 95% CI 1.16–3.16; P = 0.001). But the significance only appeared in females under Bonferroni correction. No significant differences were detected for other SNPs (T4336C, G5460A, G9055A, and G13708A). Individual haplotype composed of 4336T-5460G-9055G-10398A-13708G was found to be associated with protective effect regarding PD (P = 0.0025). The haplotypes 4336T-5460G-9055G-10398G-13708G and 4336T-5460G-9055G-10398A-13708G were more significantly associated in females (P = 0.0036 for risk and P = 0.0006 for protective effects). These data suggest that the A10398G and two haplotypes coupled with 10398A or 10398G are closely associated with susceptibility to PD in a northern Chinese population. This association demonstrated a female genetic distribution bias. PMID:26602989

  17. Prevalence of low back disorders among female workers and biomechanical limits on the handling of load and patients.

    PubMed

    Gutiérrez, Manuel; Monzó, Jorge

    2012-01-01

    The purpose of this investigation was to determine the association between prevalence of low back disorders in female workers and biomechanical demands of compressive and shear forces at the lumbar spine. A descriptive, cross-sectional and correlational study was carried out in 11 groups of female workers in the Province of Concepción. An interview was performed to investigate the prevalence of low back pain. To estimate biomechanical demands on the lumbar spine, it was used the 3DSSPP software. The Pearson correlation coefficient between the prevalence of low back disorders and peak compression force at the lumbar spine was r = (p<0.005). The Spearman correlation coefficient between the prevalence of low back disorders and peak shear force was r = 0.9 (p <0.005). To protect 90% of female workers studied, the limits of compression and shear forces should be at 2.8 kN and 0.3 kN, respectively. These values differ from the recommendations currently used, 3.4 kN for peak compression force and 0.5 kN for peak shear force.

  18. Factors predictive of clinical pregnancy in the first intrauterine insemination cycle of 306 couples with favourable female patient characteristics.

    PubMed

    Aydin, Yunus; Hassa, Hikmet; Oge, Tufan; Tokgoz, Vehbi Yavuz

    2013-12-01

    The objective of this study was to evaluate the factors predictive of clinical pregnancy in the first superovulation/intrauterine insemination (SO/IUI) cycle of couples with favourable female characteristics. We analyzed retrospectively the first SO/IUI cycle of 306 infertile couples with mild male factor infertility and unexplained infertility. The women had a favourable prognosis in terms of ovarian reserve. Univariate logistic regression analyses identified body mass index (BMI) [odds ratio (OR) = 0.9, P = 0.014], sperm concentration [OR = 1.007, P = 0.007] and inseminating motile sperm count (IMC) [OR = 1.007, P = 0.032] as significant predictive factors of clinical pregnancy. Multivariate logistic regression analysis identified BMI [OR = 0.87, P = 0.008] and sperm concentration [OR = 1.008, P = 0.011] as significant factors. Pregnant and non-pregnant groups did not differ significantly in terms of the age and smoking status of the woman, duration and type of infertility, length of the stimulation, total gonadotropin dosage or antral follicle count. Of the female characteristics investigated, BMI was the most significant predictive factor of clinical pregnancy in the first SO/IUI cycle of couples with unexplained or mild male factor infertility and favourable female characteristics. In overweight women, weight loss should be advised before starting SO/IUI. Sperm concentration and IMC were significant male predictive factors for clinical pregnancy in the first SO/IUI.

  19. Extensive ameloblastic fibroma of the mandibula in a female adult patient: A case report with a follow-up of 3 years

    PubMed Central

    Tozoglu, Sinan; Hatipoglu, Mukerrem; Aytekin, Zeliha; Gurer, Elif Inanc

    2016-01-01

    Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years. PMID:27011753

  20. Dysregulations in circulating sphingolipids associate with disease activity indices in female patients with systemic lupus erythematosus: a cross-sectional study.

    PubMed

    Checa, A; Idborg, H; Zandian, A; Sar, D Garcia; Surowiec, I; Trygg, J; Svenungsson, E; Jakobsson, P-J; Nilsson, P; Gunnarsson, I; Wheelock, C E

    2017-01-01

    Objective The objective of this study was to investigate the association of clinical and renal disease activity with circulating sphingolipids in patients with systemic lupus erythematosus. Methods We used liquid chromatography tandem mass spectrometry to measure the levels of 27 sphingolipids in plasma from 107 female systemic lupus erythematosus patients and 23 controls selected using a design of experiment approach. We investigated the associations between sphingolipids and two disease activity indices, the Systemic Lupus Activity Measurement and the Systemic Lupus Erythematosus Disease Activity Index. Damage was scored according to the Systemic Lupus International Collaborating Clinics damage index. Renal activity was evaluated with the British Island Lupus Activity Group index. The effects of immunosuppressive treatment on sphingolipid levels were evaluated before and after treatment in 22 female systemic lupus erythematosus patients with active disease. Results Circulating sphingolipids from the ceramide and hexosylceramide families were increased, and sphingoid bases were decreased, in systemic lupus erythematosus patients compared to controls. The ratio of C16:0-ceramide to sphingosine-1-phosphate was the best discriminator between patients and controls, with an area under the receiver-operating curve of 0.77. The C16:0-ceramide to sphingosine-1-phosphate ratio was associated with ongoing disease activity according to the Systemic Lupus Activity Measurement and the Systemic Lupus Erythematosus Disease Activity Index, but not with accumulated damage according to the Systemic Lupus International Collaborating Clinics Damage Index. Levels of C16:0- and C24:1-hexosylceramides were able to discriminate patients with current versus inactive/no renal involvement. All dysregulated sphingolipids were normalized after immunosuppressive treatment. Conclusion We provide evidence that sphingolipids are dysregulated in systemic lupus erythematosus and associated with

  1. Female Condom

    MedlinePlus

    ... Nov. 13, 2014. Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media; 2011:391. FC2 female condom. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/ ...

  2. Targeted next-generation sequencing as a comprehensive test for patients with and female carriers of DMD/BMD: a multi-population diagnostic study.

    PubMed

    Wei, Xiaoming; Dai, Yi; Yu, Ping; Qu, Ning; Lan, Zhangzhang; Hong, Xiafei; Sun, Yan; Yang, Guanghui; Xie, Shuqi; Shi, Quan; Zhou, Hanlin; Zhu, Qian; Chu, Yuxing; Yao, Fengxia; Wang, Jinming; He, Jingni; Yang, Yun; Liang, Yu; Yang, Yi; Qi, Ming; Yang, Ling; Wang, Wei; Wu, Haitao; Duan, Jing; Shen, Cheng; Wang, Jun; Cui, Liying; Yi, Xin

    2014-01-01

    Duchenne and Becker muscular dystrophies (DMD/BMD) are the most commonly inherited neuromuscular disease. However, accurate and convenient molecular diagnosis cannot be achieved easily because of the enormous size of the dystrophin gene and complex causative mutation spectrum. Such traditional methods as multiplex ligation-dependent probe amplification plus Sanger sequencing require multiple steps to fulfill the diagnosis of DMD/BMD. Here, we introduce a new single-step method for the genetic analysis of DMD patients and female carriers in real clinical settings and demonstrate the validation of its accuracy. A total of 89 patients, 18 female carriers and 245 non-DMD patients were evaluated using our targeted NGS approaches. Compared with traditional methods, our new method yielded 99.99% specificity and 98.96% sensitivity for copy number variations detection and 100% accuracy for the identification of single-nucleotide variation mutations. Additionally, this method is able to detect partial deletions/duplications, thus offering precise personal DMD gene information for gene therapy. We detected novel partial deletions of exons in nine samples for which the breakpoints were located within exonic regions. The results proved that our new method is suitable for routine clinical practice, with shorter turnaround time, higher accuracy, and better insight into comprehensive genetic information (detailed breakpoints) for ensuing gene therapy.

  3. Association between fish and shellfish, and omega-3 PUFAs intake and CVD risk factors in middle-aged female patients with type 2 diabetes

    PubMed Central

    Kim, Hyesook; Park, Seokyung; Yang, Hyesu; Choi, Young Ju; Huh, Kap Bum

    2015-01-01

    BACKGROUND/OBJECTIVES This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D. PMID:26425279

  4. Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study

    PubMed Central

    2017-01-01

    A recently developed diagnostic tool, trabecular bone score (TBS), can provide quality of trabecular microarchitecture based on images obtained from dual-energy X-ray absorptiometry (DXA). Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. In this pre-post study of female patients, TBS and fracture risk assessment tool (FRAX) adjusted with TBS (T-FRAX) were evaluated along with bone mineral density (BMD) and FRAX. Medical records of patients with (n = 30) and without (n = 16) glucocorticoid treatment were retrospectively reviewed. All patients had undergone DXA twice within a 12- to 24-month interval. Analysis of covariance was conducted to compare the outcomes between the two groups of patients, adjusting for age and baseline values. Results showed that a significant lower adjusted mean of TBS (p = 0.035) and a significant higher adjusted mean of T-FRAX for major osteoporotic fracture (p = 0.006) were observed in the glucocorticoid group. Conversely, no significant differences were observed in the adjusted means for BMD and FRAX. These findings suggested that TBS and T-FRAX could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy. PMID:28127556

  5. Deciding Factors for the Referral of a Female Patient to a Specific Hospital from the Viewpoint of Practice-Based Specialists

    PubMed Central

    Baum, S.; Meyberg-Solomayer, G.; Baum, A.; Radosa, J.; Hamza, A.; Gronwald, B.; Friedrich, M.; Solomayer, E. F.; Joukhadar, R.

    2015-01-01

    Background: One of the key points of patient care is the cooperation between practice-based specialists and clinical facilities. The present study was undertaken in order to illustrate the deciding factors, from the viewpoint of practice-based specialists, for the referral of a female patient to a specific hospital. Methods: Altogether a total of 322 practice-based specialists from various disciplines were contacted in writing and sent a questionnaire. In this survey the recipients were questioned about the criteria, in order of importance, applied for the referral of a (female) patient to a specific clinical facility. Results: In the foreground for the referral of a patient to a specific hospital are the aspects of medical quality and competence. On a closer look we find the surgical spectrum, especially the availability of endoscopic and special operations as a main factor. Further factors are a low rate of complications and the availability of modern diagnostic methods. Also evaluated as an important aspect was the easy reachability of a competent consultant. Factors of lower relevance for referral behaviour were personal familiarity with the colleagues employed in the hospital, specific further training events and the course of previous cooperation. Conclusions: A modern diagnostic and therapeutic spectrum coupled with an easy reachability of competent contact partners are the main factors for cooperation from the viewpoint of the practice-based specialist. Of lowest relevance, among others, was the aspect of previous cooperation. Thus, it can be seen that by means of changes in cooperation an improvement in patient care can be achieved at any time. PMID:26097249

  6. Axis-I comorbidity in female patients with dissociative identity disorder and dissociative identity disorder not otherwise specified.

    PubMed

    Rodewald, Frauke; Wilhelm-Göling, Claudia; Emrich, Hinderk M; Reddemann, Luise; Gast, Ursula

    2011-02-01

    The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.

  7. Epiglottis cross-sectional area and oropharyngeal airway length in male and female obstructive sleep apnea patients

    PubMed Central

    Ma, Melinda A; Kumar, Rajesh; Macey, Paul M; Yan-Go, Frisca L; Harper, Ronald M

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is a male-predominant condition, characterized by repeated upper-airway collapse with continued diaphragmatic efforts during sleep, and is accompanied by severe physiological consequences. Multiple morphological aspects, including epiglottis cross-sectional area (CSA) and oropharyngeal airway length (OPAL), can contribute to airway collapsibility in the condition. This study focused on the effects of OSA severity, sex, and race on OPA dimensions. Materials and methods Two high-resolution T1-weighted image series were collected from 40 mild-to-severe OSA subjects (age 46.9±9 years, body mass index 30.4±5.4 kg/m2, Apnea–Hypopnea Index score 32.8±22.5, 28 males) and 54 control subjects (47±9 years, 24.7±3.8 kg/m2, 32 males) using a 3 T magnetic resonance-imaging scanner. Caucasian, Asian, African-American, and “other” subjects constituted the study pool. Both image series were realigned and averaged, and reoriented to a common space. CSA and OPAL were measured, normalized for subject height, and compared between sexes and disease-severity levels in OSA and control subjects. Results Significantly reduced epiglottis CSA appeared only in severe OSA vs controls (P=0.009). OPAL increased significantly with OSA severity vs controls (mild, P=0.027; moderate, P<0.001; severe, P<0.001). OSA males showed increased CSA and greater OPAL than OSA females, which may underlie the increased proportion of affected males with higher apnea–hypopnea index scores. However, no significant differences appeared between CSA and OPAL measures for male and female controls, suggesting that airway morphology may not be the sole contributor for airway collapse. No ethnic or racial differences appeared for CSA or OPAL measures. Conclusion Sex-based reductions in epiglottis CSA and increased OPAL in OSA subjects may enhance airway-collapse vulnerability, more so with greater disease severity, and partially underlie male vs female susceptibility

  8. Prelamination of Neourethra with Uterine Mucosa in Radial Forearm Osteocutaneous Free Flap Phalloplasty in the Female-to-Male Transgender Patient

    PubMed Central

    Salgado, Christopher J.; Chim, Jimmy; Medina, Carlos A.; Demaso, Stephanie; Gomez, Christopher

    2016-01-01

    Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM) transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts. We present the successful use of uterine mucosa for prelamination of the neourethra in an FtM patient who underwent hysterectomy and vaginectomy at the prelamination stage of a radial forearm phalloplasty. Three months postoperatively, the patient was able to void while standing and showed no evidence of stricture or fistula on retrograde cystogram. These results suggest that uterine mucosa may be used for prelamination of the penile neourethra in patients undergoing phalloplasty. PMID:27069708

  9. Prelamination of Neourethra with Uterine Mucosa in Radial Forearm Osteocutaneous Free Flap Phalloplasty in the Female-to-Male Transgender Patient.

    PubMed

    Salgado, Christopher J; Fein, Lydia A; Chim, Jimmy; Medina, Carlos A; Demaso, Stephanie; Gomez, Christopher

    2016-01-01

    Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM) transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts. We present the successful use of uterine mucosa for prelamination of the neourethra in an FtM patient who underwent hysterectomy and vaginectomy at the prelamination stage of a radial forearm phalloplasty. Three months postoperatively, the patient was able to void while standing and showed no evidence of stricture or fistula on retrograde cystogram. These results suggest that uterine mucosa may be used for prelamination of the penile neourethra in patients undergoing phalloplasty.

  10. A Study on Fractional Erbium Glass Laser Therapy Versus Chemical Peeling for the Treatment of Melasma in Female Patients

    PubMed Central

    Puri, Neerja

    2013-01-01

    Introduction: Melasma is a commonly acquired hypermelanosis and a common dermatologic skin disease that occurs on sun-exposed areas of face. Aims: To assess the efficacy and safety of non-ablative 1,550 nm Erbium glass fractional laser therapy and compare results with those obtained with chemical peeling. Materials and Methods: We selected 30 patients of melasma aged between 20 years and 50 years for the study. The patients were divided into two groups of 15 patients each. Group I patients were subjected to four sessions of 1,550 nm Erbium glass non-ablative fractional laser at 3 weeks interval. In group II patients, four sessions of chemical peeling with 70% glycolic acid was performed. Results: After 12 weeks of treatment, percentage reduction in Melasma Area and Severity Index (MASI) score was seen in 62.9% in the laser group and 58.7% in the peels group. Conclusion: It was observed that 1,550 nm fractional laser is as effective as 70% glycolic acid peel in reducing MASI score in patients with melasma. PMID:24163531

  11. Hybrid computational phantoms of the male and female newborn patient: NURBS-based whole-body models

    NASA Astrophysics Data System (ADS)

    Lee, Choonsik; Lodwick, Daniel; Hasenauer, Deanna; Williams, Jonathan L.; Lee, Choonik; Bolch, Wesley E.

    2007-07-01

    Anthropomorphic computational phantoms are computer models of the human body for use in the evaluation of dose distributions resulting from either internal or external radiation sources. Currently, two classes of computational phantoms have been developed and widely utilized for organ dose assessment: (1) stylized phantoms and (2) voxel phantoms which describe the human anatomy via mathematical surface equations or 3D voxel matrices, respectively. Although stylized phantoms based on mathematical equations can be very flexible in regard to making changes in organ position and geometrical shape, they are limited in their ability to fully capture the anatomic complexities of human internal anatomy. In turn, voxel phantoms have been developed through image-based segmentation and correspondingly provide much better anatomical realism in comparison to simpler stylized phantoms. However, they themselves are limited in defining organs presented in low contrast within either magnetic resonance or computed tomography images—the two major sources in voxel phantom construction. By definition, voxel phantoms are typically constructed via segmentation of transaxial images, and thus while fine anatomic features are seen in this viewing plane, slice-to-slice discontinuities become apparent in viewing the anatomy of voxel phantoms in the sagittal or coronal planes. This study introduces the concept of a hybrid computational newborn phantom that takes full advantage of the best features of both its stylized and voxel counterparts: flexibility in phantom alterations and anatomic realism. Non-uniform rational B-spline (NURBS) surfaces, a mathematical modeling tool traditionally applied to graphical animation studies, was adopted to replace the limited mathematical surface equations of stylized phantoms. A previously developed whole-body voxel phantom of the newborn female was utilized as a realistic anatomical framework for hybrid phantom construction. The construction of a hybrid

  12. Cloning of the anhidrotic ectodermal dysplasia gene: Identification of cDNAs associated with CpG islands mapped near translocation breakpoint in two female patients

    SciTech Connect

    Srivastava, A.K.; Schlessinger, D.; Kere, J.

    1994-09-01

    The gene for the X chromosomal developmental disorder anhidrotic ectodermal dysplasia (EDA) has been mapped to Xq12-q13 by linkage analysis and is expressed in a few females with chromosomal translocations involving band Xq12-q13. A yeast artificial chromosome (YAC) contig (2.0 Mb) spanning two translocation breakpoints has been assembled by sequence-tagged site (STS)-based chromosomal walking. The two translocation breakpoints (X:autosome translocations from the affected female patients) have been mapped less than 60 kb apart within a YAC contig. Unique probes and intragenic STSs (mapped between the two translocations) have been developed and a somatic cell hybrid carrying the translocated X chromosome from the AK patient has been analyzed by isolating unique probes that span the breakpoint. Several STSs made from intragenic sequences have been found to be conserved in mouse, hamster and monkey, but we have detected no mRNAs in a number of tissues tested. However, a probe and STS developed from the DNA spanning the AK breakpoint is conserved in mouse, hamster and monkey, and we have detected expressed sequences in skin cells and cDNA libraries. In addition, unique sequences have been obtained from two CpG islands in the region that maps proximal to the breakpoints. cDNAs containing these sequences are being studied as candidates for the gene affected in the etiology of EDA.

  13. Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia

    PubMed Central

    Alzahrani, Turki A.; Abaalkhail, Bahaa A.; Ramadan, Iman K.

    2016-01-01

    Objectives: To estimate the prevalence of intimate partner violence (IPV) among female patients, age 18-60 years, attending primary health care centers (PHCCs) and to measure its determinants, and reporting behavior. Methods: A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA) from January to February 2015 was employed. A 2-stage probability sampling was adopted for selection of PHCCs in the first stage, and then participants in the second stage. Results: The estimated prevalence of IPV during the last year was 11.9%. Predictors of IPV related to abused women included divorced status and divorced parents; while those related to abusers (husbands) included widowed parents, exposure to violence in childhood, and alcohol or drugs addiction. Most of the abused wives (56%) talked regarding their IPV to their families, their husbands’ families (15.2%), or their friends (11.8%); while only a minority (3.3%) complained to the police or to a judge, and no one reported this to a family physician, or to women protection agency. Conclusion: One out of 10 women is a victim of IPV in Taif, KSA. Intimate partner violence is significantly associated with a number of victim and abuser-related psychosocial factors, the detection of which might help screening for individuals at risk. PMID:26739983

  14. Morphological changes in the pharyngeal airway of female skeletal class III patients following bimaxillary surgery: a cone beam computed tomography evaluation.

    PubMed

    Li, Y-M; Liu, J-L; Zhao, J-L; Dai, J; Wang, L; Chen, J-W

    2014-07-01

    Using cone beam computed tomography (CBCT), the present study compared three-dimensional (3D) changes in the pharyngeal airway and surrounding tissues in female skeletal class III patients treated with bimaxillary surgery. Twenty-nine female skeletal class III patients with both maxillary hypoplasia and a mandibular excess underwent bilateral sagittal split ramus osteotomy for mandibular setback combined with Le Fort I osteotomy for maxillary advancement. Volumetric measurements were performed using CBCT scans taken at 1 week presurgery and 6 months post-surgery. The oropharynx volumes and the cross-sectional area behind the soft palate decreased significantly. There was an insignificant change in the volume of the nasopharynx (P>0.05). The hyoid bone moved downward and posteriorly after surgery. The morphology of the soft palate also changed dramatically, with an increase in the length and thickness. Negative correlations were found between the pharyngeal airway space and the position of the hyoid bone. The change in morphology of the soft palate was significantly correlated with the changes in hyoid bone position. These 3D results suggest that bimaxillary orthognathic surgery significantly changes the position of the hyoid bone and the soft palate together with a significant decrease in the pharyngeal airway space in the correction of skeletal class III malocclusion.

  15. Antihypertensive Drug Use and New-Onset Diabetes in Female Patients with Coronary Artery Disease: A Population-based Longitudinal Cohort Study.

    PubMed

    Liou, Yi-Sheng; Chen, Hung-Yi; Tien, Lyun; Gu, Yi-Sian; Jong, Gwo-Ping

    2015-09-01

    Antihypertensives have been linked to new-onset diabetes (NOD) and different classes of antihypertensives may alter the risk for the development of NOD; however, the effect of different antihypertensives on the development of NOD in women with hypertension and coronary artery disease (CAD) has not been well studied. The purpose of this study is to investigate the association between usage of different antihypertensive drugs and the development of NOD in female patients with hypertension and CAD.Data in this retrospective cohort study were obtained from claim forms submitted to the Taiwan Bureau of National Health Insurance in central Taiwan during the period 2006-2011. We estimated the odds ratios (OR) to approximate the relative risk of NOD development associated with antihypertensive drug use.Of the 20,108 female patients with CAD at baseline, 2288 patients developed NOD during the 6-year follow-up. Subjects treated with angiotensin-converting enzyme (ACE) inhibitors (OR, 0.92; 95% confidence interval [CI], 0.84-1.00), angiotensin receptor blockers (OR, 0.92; 95% CI, 0.82-0.99), and alpha-blockers (OR, 0.88; 95% CI, 0.79-0.98) in the adjusted analyses had greater reductions of the risk than among nonusers. Patients who took diuretics (OR, 1.10; 95% CI, 1.01-1.20), beta-blockers (OR, 1.12; 95% CI, 1.04-1.21), and calcium channel blockers (OR, 1.10; 95% CI, 1.02-1.18) were at high risk of developing NOD than nonusers. Vasodilators were not associated with risk of NOD.We conclude that women with hypertension who take ACE inhibitors, angiotensin receptor blockers, and alpha-blockers are at lower risk of NOD and that use of diuretics, beta-blockers, and calcium channel blockers was associated with a significantly increased risk of developing NOD during the 6-year follow-up.

  16. Hodgkin lymphoma in a patient with mosaic trisomy 18: First clinical observation.

    PubMed

    Motta, Serena; Sala, Debora; Sala, Alessandra; Cazzaniga, Giovanni; Giudici, Giovanni; Villa, Nicoletta; Biondi, Andrea; Selicorni, Angelo

    2016-03-01

    We report the case of a 17-year-old boy with a mosaic trisomy 18, who was diagnosed with Hodgkin lymphoma. The patient showed only poor growth and two muscular ventricular septal defects; no facial dysmorphims were present. He was admitted to our hospital because of asthenia and weight loss; a mediastinal enlargement was found and an histological diagnosis of nodular sclerosis Hodgkin lymphoma on mediastinal biopsy was performed. Contextually, a chromosomal analysis on bone marrow aspirate and on peripheral blood revealed a mosaic trisomy 18. This result was confirmed also with cytogenetic analysis on skin fibroblasts. While there is a well-documented association between trisomy 18 and solid cell tumors, this is, to our knowledge, the first reported case of Hodgkin lymphoma in a patient with a mosaic trisomy 18, enlarging the spectrum of possible oncologic manifestations of the disease.

  17. [A patient with muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM)].

    PubMed

    Hemmi, Shoji; Murakami, Tatufumi; Shirabe, Teruo; Sunada, Yoshihide

    2002-09-01

    Nodular fasciitis is a benign pseudosarcomatous proliferative lesion which is frequently misdiagnosed as malignant tumor clinically and microscopically. It usually occurs as a rapidly enlarging subcutaneous mass on the upper extremities, especially on the forearm. Here we report a patient showing muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM). A 17-year-old woman was hospitalized because of rapidly progressive torticollis. The right SCM was markedly enlarged and firm on palpation. Muscle biopsy taken from the right SCM revealed massive proliferation of spindle shaped fibroblasts infiltrating into the endomysium. These findings coincided with the intramuscular nodular fasciitis. However, different from typical nodular fasciitis, no apparent nodule formation was found in this patient. Instead, diffuse proliferative lesion extended widely into the neck soft tissue. To our knowledge, this is the first report of muscular torticollis caused by nodular fasciitis involving the SCM.

  18. Sub-Regional Assessment of HPV Vaccination Among Female Adolescents in the Intermountain West and Implications for Intervention Opportunities.

    PubMed

    Bodson, Julia; Ding, Qian; Warner, Echo L; Hawkins, Amy J; Henry, Kevin A; Kepka, Deanna

    2017-01-13

    Objectives We investigated the similarities and differences in the factors related to human papillomavirus (HPV) vaccination of female adolescents in three sub-regions of the Intermountain West (IW). Methods We analyzed 2011-2012 National Immunization Survey-Teen data. Respondents (parents) who were living in the IW and who had daughters aged 13-17 years old with provider-verified immunization records were included in our analyses. East, Central, and West sub-regions were defined based on geographic contiguity and similarity in HPV vaccination rates and sociodemographic characteristics. Survey-weighted Chi square tests and multivariable Poisson regressions were performed. Results In all three sub-regions, older teen age and receipt of other recommended adolescent vaccinations were significantly associated with HPV vaccination. In the East sub-region, providers' facility type and source of vaccines were significantly related to HPV vaccination. In the Central sub-region, teens with married parents were significantly less likely to be vaccinated than were those with unmarried parents. In the West sub-region, non-Hispanic teens were significantly less likely to be vaccinated than were Hispanic teens. Conclusions for Practice In order to improve HPV vaccine coverage in the IW, region-wide efforts to target younger teens and to promote the HPV vaccine with other recommended adolescent vaccinations should be supplemented with sub-regional attention to the health care system (East sub-region), to married parents (Central sub-region), and to non-Hispanic teens (West sub-region).

  19. ACL injury risk in elite female youth soccer: Changes in neuromuscular control of the knee following soccer-specific fatigue.

    PubMed

    De Ste Croix, M B A; Priestley, A M; Lloyd, R S; Oliver, J L

    2015-10-01

    Fatigue is known to influence dynamic knee joint stability from a neuromuscular perspective, and electromechanical delay (EMD) plays an important role as the feedback activation mechanism that stabilizes the joint. The aim of this study was to investigate the influence of soccer-specific fatigue on EMD in U13-, U15-, and U17-year-old female soccer players. Thirty-six youth soccer players performed eccentric actions of the hamstrings in a prone position at 60, 120, and 180°/s before and after a soccer-specific fatigue trial. Surface electromyography was used to determine EMD from the semitendinosus, biceps femoris and gastrocnemius. A time × age × muscle × velocity repeated measures analysis of variance was used to explore the influence of fatigue on EMD. A significant main effect for time (P = 0.001) indicated that EMD was significantly longer post- compared with pre-fatigue (58.4% increase). A significant time × group interaction effect (P = 0.046) indicated EMD was significantly longer in the U13 age group compared with the U15 (P = 0.011) and U17 (P = 0.021) groups and greater post-fatigue. Soccer-specific fatigue compromised neuromuscular feedback mechanisms and the age-related effects may represent a more compliant muscle-tendon system in younger compared with older girls, increasing risk of injury.

  20. Hybrid computational phantoms of the 15-year male and female adolescent: Applications to CT organ dosimetry for patients of variable morphometry

    SciTech Connect

    Lee, Choonsik; Lodwick, Daniel; Williams, Jonathan L.; Bolch, Wesley E.

    2008-06-15

    Currently, two classes of the computational phantoms have been developed for dosimetry calculation: (1) stylized (or mathematical) and (2) voxel (or tomographic) phantoms describing human anatomy through mathematical surface equations and three-dimensional labeled voxel matrices, respectively. Mathematical surface equations in stylized phantoms provide flexibility in phantom design and alteration, but the resulting anatomical description is, in many cases, not very realistic. Voxel phantoms display far better anatomical realism, but they are limited in terms of their ability to alter organ shape, position, and depth, as well as body posture. A new class of computational phantoms - called hybrid phantoms - takes advantage of the best features of stylized and voxel phantoms - flexibility and anatomical realism, respectively. In the current study, hybrid computational phantoms representing reference 15-year male and female body anatomy and anthropometry are presented. For the male phantom, organ contours were extracted from the University of Florida (UF) 14-year series B male voxel phantom, while for the female phantom, original computed tomography (CT) data from two 14-year female patients were used. Polygon mesh models for the major organs and tissues were reconstructed for nonuniform rational B-spline (NURBS) surface modeling. The resulting NURBS/polygon mesh models representing body contour and internal anatomy were matched to anthropometric data and reference organ mass data provided by the Centers for Disease Control and Prevention (CDC) and the International Commission on Radiation Protection (ICRP), respectively. Finally, two hybrid 15-year male and female phantoms were completed where a total of eight anthropometric data categories were matched to standard values within 4% and organ masses matched to ICRP data within 1% with the exception of total skin. To highlight the flexibility of the hybrid phantoms, 10th and 90th weight percentile 15-year male and

  1. 17β-estradiol reduces expression of MMP-1, -3, and -13 in human primary articular chondrocytes from female patients cultured in a three dimensional alginate system.

    PubMed

    Claassen, Horst; Steffen, Reinhard; Hassenpflug, Joachim; Varoga, Deike; Wruck, Christoph Jan; Brandenburg, Lars Ove; Pufe, Thomas

    2010-11-01

    Clinical observations have suggested a relationship between osteoarthritis and a changed sex-hormone metabolism, especially in menopausal women. This study analyzes the effect of 17β-estradiol on expression of matrix metalloproteinases-1, -3, -13 (MMP-1, -3, -13) and tissue inhibitors of metalloproteinases-1, -2 (TIMP-1, -2) in articular chondrocytes. An imbalance of matrix metalloproteinases (MMPs) specialized on degradation of articular cartilage matrix over the respective inhibitors of these enzymes (TIMPs) that leads to matrix destruction was postulated in the pathogenesis of osteoarthritis. Primary human articular chondrocytes from patients of both genders were cultured in alginate beads at 5% O(2) to which 10(-11)M-10(-5)M 17β-estradiol had been added and analyzed by means of immunohistochemistry, immunocytochemistry and real-time RT-PCR. Since articular chondrocytes in vivo are adapted to a low oxygen tension, culture was performed at 5% O(2). Immunohistochemical staining in articular cartilage tissue from patients and immunocytochemical staining in articular chondrocytes cultured in alginate beads was positive for type II collagen, estrogen receptor α, MMP-1, and -13. It was negative for type I collagen, MMP-3, TIMP-1 and -2. Using real-time RT-PCR, it was demonstrated that physiological and supraphysiological doses of 17β-estradiol suppress mRNA levels of MMP-3 and -13 significantly in articular chondrocytes of female patients. A significant suppressing effect was also seen in MMP-1 mRNA after a high dose of 10(-5)M 17β-estradiol. Furthermore, high doses of this hormone led to tendentially lower TIMP-1 levels whereas the TIMP-2 mRNA level was not influenced. In male patients, only incubations with high doses (10(-5)M) of 17β-estradiol were followed by a tendency to suppressed MMP-1 and TIMP-1 levels while TIMP-2 mRNA level was decreased significantly. There was no effect on MMP-13 expression of cells from male patients. Taken together, application of

  2. Rhinocerebral mucormycosis in a patient with type 1 diabetes presenting as toothache: a case report from Himalayan region of India.

    PubMed

    Singh, Vikram; Singh, Mridu; Joshi, Chitra; Sangwan, Jyoti

    2013-10-30

    Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis.

  3. Rhinocerebral mucormycosis in a patient with type 1 diabetes presenting as toothache: a case report from Himalayan region of India

    PubMed Central

    Singh, Vikram; Singh, Mridu; Joshi, Chitra; Sangwan, Jyoti

    2013-01-01

    Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis. PMID:24172773

  4. Safety of biological therapies for psoriasis: effects on reproductive potential and outcomes in male and female patients.

    PubMed

    Yiu, Z Z N; Griffiths, C E M; Warren, R B

    2014-09-01

    The effects of biological therapies for psoriasis on pregnancy outcomes and lactation, and male fertility and mutagenicity are common concerns in the clinical setting. There is relatively little evidence to guide the clinician and patient. Here, we review the safety profile of the commonly used biological therapies for psoriasis in individuals of reproductive potential. Safety data were derived from large-scale registries, adverse event reporting databases, clinical trials and case reports. We assessed the effect of each therapy on adverse pregnancy outcomes including congenital malformations, and lactation with maternal administration, and male fertility and potential mutagenicity with paternal administration. We provide applicable guidance to inform clinician and patient before and after conception.

  5. [Gabapentin treatment in a female patient with panic disorder and adverse effects under carbamazepine during benzodiazepine withdrawal].

    PubMed

    Himmerich, Hubertus; Nickel, Thomas; Dalal, Mira A; Müller, Marianne B

    2007-03-01

    Despite their addictive potential, benzodiazepines belong to the most often prescribed drugs. We report on a patient with alprazolam dependence, who initially was treated with carbamazepine because of severe withdrawal symptoms. Due to liver enzyme elevation related to carbamazepine, we had to stop this treatment and instead of that started gabapentin treatment. Under this new therapy, the patient showed a dramatic relief of withdrawal symptoms and of the panic attacks recurring during withdrawal. Hence, due to their effectiveness and tolerability, newer anticonvulsants could be considered as medication for benzodiazepine withdrawal and as an alternative for benzodiazepine treatment in panic disorders.

  6. [Recurrent intrahepatic cholestasis of pregnancy and chain-like choledocholithiasis in a female patient with stop codon in the ABDC4-gene of the hepatobiliary phospholipid transporter].

    PubMed

    Muehlenberg, K; Wiedmann, K; Keppeler, H; Sauerbruch, T; Lammert, F

    2008-01-01

    We report the case of a 40-years-old female patient with recurrent cholestatic liver disease who presented twice with severe intrahepatic cholestasis of pregnancy and pronounced choledocholithiasis between pregnancies. Bile duct stones were removed endoscopically and a laparoscopic cholecystectomy was performed after the second pregnancy. Liver histology revealed intrahepatic cholestasis with portal inflammation and fibrosis, resembling progressive familial intrahepatic cholestasis (PFIC). Molecular genetic studies identified the heterozygous mutation c.957C > T in the ABCB4 gene encoding the hepatobiliary phospholipid transporter. This is the first report of this mutation that introduces a stop codon in an index patient with intrahepatic cholestasis of pregnancy and multiple bile duct stones. In addition, we detected the ABCB11 polymorphism V 444A, which is associated with a decreased expression of the bile salt export pump. Whereas homozygous carriers of the ABCB4 mutation develop PFIC type 3, the heterozygous ABC transporter mutations represent genetic risk factors for cholelithiasis and recurrent cholestatic hepatitis upon challenge with oral contraceptives or during pregnancy. Of note, the patient presented with normal serum gamma-glutamyltranspeptidase activities during pregnancy-associated cholestatic episodes but normal liver enzymes after delivery, whereas choledocholithiasis was associated with high gamma-glutamyl transpeptidase levels. It is unknown whether ursodeoxycholic acid prevents cholestasis or gallstones in patients with ABCB4 deficiency.

  7. Association between FokI, ApaI and TaqI RFLP polymorphisms in VDR gene and Hashimoto's thyroiditis: preliminary data from female patients in Serbia.

    PubMed

    Djurovic, J; Stojkovic, O; Ozdemir, O; Silan, F; Akurut, C; Todorovic, J; Savic, K; Stamenkovic, G

    2015-06-01

    Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder caused by an interaction between genes and environmental triggers. Intrathyroid lymphocytic infiltration may lead to progressive destruction of thyroid tissue and consequently to hypothyroidism. Many studies in different populations have shown association between vitamin D receptor (VDR) gene polymorphisms and various autoimmune diseases, including HT. The study included 44 female patients (mean age ± standard deviation 38 ± 5.4) with Hashimoto's thyroiditis and 32 healthy age-matched, sex-matched and geographically matched controls without personal history of autoimmune and endocrine diseases. Genomic DNA was isolated from peripheral blood-EDTA, and the target VDR gene was genotyped by PCR-RFLP technique after VDR-FokI (rs2228570), VDR-ApaI (rs7975232) and VDR-TaqI (rs731236) restriction enzymes digestion. We used spss 20.0 integrated software for data analysis and found a significant difference in the genotype distribution of VDR-FokI polymorphism between patients with HT and controls (P = 0.009). For ApaI and TaqI, we observed a higher frequency of variant allele in patients with HT, which was not significantly different compared to control women (P > 0.05). The current first and preliminary results identified the association between VDR-FokI gene polymorphism and Hashimoto's thyroiditis in Serbian population. Results need to be supported by further investigations that define haplotype patterns for VDR gene polymorphisms in a larger group of HT patients of both sexes.

  8. Teacher and Friend Social Support: Association with Body Weight in African-American Adolescent Females

    PubMed Central

    Stanford, Jevetta; Webb, Fern J.; Lee, Jenny; Doldren, Michelle; Rathore, Mobeen

    2016-01-01

    The purpose of this study was to examine the direct and indirect ecological influences of teacher and friend social support on body weight and diet behaviors in African-American adolescent females. Using a quantitative, cross-sectional research design, a convenience sample of 182 urban African-American adolescent females (12–17 years old) completed a 39-item questionnaire. The questionnaire assessed perceived teacher social support, friend social support, nutrition self-efficacy, and diet behaviors (with internal reliability values of scale items: alpha=0.74, 0.81, 0.77, and 0.69 respectively). Anthropometric assessments were conducted to measure height and weight to compute BMI. Majority of the participants were in middle or early high school (65 %) and were overweight or obese (57.7 %). Both teacher social support and friend social support demonstrated a positive, indirect influence on child weight status through nutrition self-efficacy and diet behaviors following two different and specific paths of influence. Diet behaviors, in turn, demonstrated a positive, direct effect on child weight status. In the structural model, teacher social support had the greatest effect on diet behaviors, demonstrating a direct, positive influence on diet behaviors (B=0.421, p<0.05), but its direct effect on nutrition self-efficacy was not significant. Friend social support demonstrated a positive, direct effect on nutrition self-efficacy (B=0.227, p<0.05), but its direct effect on diet behaviors was not statistically significant. The study’s findings call for actively addressing the childhood obesity epidemic in the school environment by implementing health behavior change strategies at various social and ecological environmental levels. PMID:26863465

  9. Teacher and Friend Social Support: Association with Body Weight in African-American Adolescent Females.

    PubMed

    Stanford, Jevetta; Khubchandani, Jagdish; Webb, Fern J; Lee, Jenny; Doldren, Michelle; Rathore, Mobeen

    2015-09-01

    The purpose of this study was to examine the direct and indirect ecological influences of teacher and friend social support on body weight and diet behaviors in African-American adolescent females. Using a quantitative, cross-sectional research design, a convenience sample of 182 urban African-American adolescent females (12-17 years old) completed a 39-item questionnaire. The questionnaire assessed perceived teacher social support, friend social support, nutrition self-efficacy, and diet behaviors (with internal reliability values of scale items: alpha = 0.74, 0.81, 0.77, and 0.69 respectively). Anthropometric assessments were conducted to measure height and weight to compute BMI. Majority of the participants were in middle or early high school (65 %) and were overweight or obese (57.7 %). Both teacher social support and friend social support demonstrated a positive, indirect influence on child weight status through nutrition self-efficacy and diet behaviors following two different and specific paths of influence. Diet behaviors, in turn, demonstrated a positive, direct effect on child weight status. In the structural model, teacher social support had the greatest effect on diet behaviors, demonstrating a direct, positive influence on diet behaviors (B = 0.421, p < 0.05), but its direct effect on nutrition self-efficacy was not significant. Friend social support demonstrated a positive, direct effect on nutrition self-efficacy (B = 0.227, p < 0.05), but its direct effect on diet behaviors was not statistically significant. The study's findings call for actively addressing the childhood obesity epidemic in the school environment by implementing health behavior change strategies at various social and ecological environmental levels.

  10. Dosimetric Comparison of Involved-Field Three-Dimensional Conformal Photon Radiotherapy and Breast-Sparing Proton Therapy for the Treatment of Hodgkin's Lymphoma in Female Pediatric Patients

    SciTech Connect

    Andolino, David L.; Hoene, Ted; Xiao, Lu; Buchsbaum, Jeffrey; Chang, Andrew L.

    2011-11-15

    Purpose: To assess the potential reduction in breast dose for young girls with Hodgkin's lymphoma (HL) treated with breast-sparing proton therapy (BS-PT) as compared with three-dimensional conformal involved-field photon radiotherapy (3D-CRT). Methods and Materials: The Clarian Health Cancer Registry was queried for female pediatric patients with the diagnosis of HL who received radiotherapy at the Indiana University Simon Cancer Center during 2006-2009. The original CT simulation images were obtained, and 3D-CRT and BS-PT plans delivering 21 Gy or cobalt gray equivalent (CGE) in 14 fractions were created for each patient. Dose-volume histogram data were collected for both 3D-CRT and BS-PT plans and compared by paired t test for correlated samples. Results: The cancer registry provided 10 female patients with Ann Arbor Stage II HL, aged 10-18 years at the time of treatment. Both mean and maximum breast dose were significantly less with BS-PT compared with 3D-CRT: 0.95 CGE vs. 4.70 Gy (p < 0.001) and 21.07 CGE vs. 23.11 Gy (p < 0.001), respectively. The volume of breast receiving 1.0 Gy/CGE and 5.0 Gy/CGE was also significantly less with BS-PT, 194 cm{sup 3} and 93 cm{sup 3}, respectively, compared with 790 cm{sup 3} and 360 cm{sup 3} with 3D-CRT (p = 0.009, 0.013). Conclusion: Breast-sparing proton therapy has the potential to reduce unnecessary breast dose in young girls with HL by as much as 80% relative to involved-field 3D-CRT.

  11. Dietary and Lifestyle Changes in the Treatment of a 23-Year-Old Female Patient With Migraine

    PubMed Central

    Martin, Brett R.; Seaman, David R.

    2015-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with atypical migraine headache. Clinical Features A 23-year-old woman experienced migraines for 3 months. She had no previous history of migraines and was unresponsive to pharmaceutical and musculoskeletal therapies. The migraine headaches could not be classified according to the common categories associated with migraines. She had a change in diet due to severe gastroesophageal reflux causing her to reduce or avoid consuming foods. She also had a history of smoking and alcohol consumption. Intervention and Outcome Dietary and lifestyle changes were recommended in conjunction with the administration of a multivitamin, magnesium oxide, and Ulmus rubra. Her migraine headaches improved with the resolution of her gastroesophageal reflux symptoms. Conclusion This patient with atypical migraines and a history of poor dietary and lifestyle choices improved using nutritional changes and supplementing with a multivitamin and magnesium oxide. PMID:26778934

  12. Subcutaneous Facial and Neck Emphysema as First Sign of Intestinal Perforation in a Female Patient After a Routine Colonoscopy

    PubMed Central

    Anyfantakis, Dimitrios; Kastanakis, Miltiades; Karona, Paraskevi; Papadomichelakis, Alexandros; Bobolakis, Emmanouil

    2016-01-01

    Colonoscopy is a safe procedure for the diagnosis and management of colorectal diseases. Colonic perforation due to colonoscopy represents an uncommon complication. Here we present an unusual case of iatrogenic bowel perforation resulting in subcutaneous facial and neck emphysema, pneumomediastinum and pneumoretroperitoneum. Taking a detailed recent medical history information is always required when encountering patients with subcutaneous emphysema after invasive examination procedures. Alertness on iatrogenic complication eventualities may improve prognosis and avoid life-threatening conditions. PMID:28149153

  13. Ethically justified guidelines for family planning interventions to prevent pregnancy in female patients with chronic mental illness.

    PubMed

    McCullough, L B; Coverdale, J; Bayer, T; Chervenak, F A

    1992-07-01

    On the basis of a review of the literature, ethical clinical guidelines for the prevention of pregnancy in women with chronic mental illness have been developed. Such women are characterized as having chronically and variably impaired autonomy in terms of their ability to make decisions about health care, including family planning. The overall strategy should be to restore impaired autonomy in health care decision making. The decision-making process involves 6 steps: 1) attending to information provided by the physician; 2) absorbing, retaining, and recalling this information; 3) cognitive understanding of the significance of the information for the woman and any potential offspring; 4) evaluation of these consequences; 5) expression of both cognitive and evaluative understanding; and 6) communication of a decision based on such understanding. Patients who can negotiate this process are capable of informed consent; those who cannot should be provided with interventions aimed at improving impaired aspects of decision making. Patients who are irreversibly near the thresholds for autonomous decision making can at least assent to medical care and should be presented with alternatives that are consistent with their values. More complex is the management of patients who are irreversibly below thresholds of autonomy in their decision-making abilities. In such cases, consideration must be given to the patient's interests (e.g.., whether pregnancy is likely to pose significant mental health and physical benefits or risks), risks to possible future children (genetic and social), and the social costs. In no case is it ethically justifiable to force the most impaired mentally ill woman to accept surgical sterilization.

  14. Application of (1)H NMR-based serum metabolomic studies for monitoring female patients with rheumatoid arthritis.

    PubMed

    Zabek, Adam; Swierkot, Jerzy; Malak, Anna; Zawadzka, Iga; Deja, Stanisław; Bogunia-Kubik, Katarzyna; Mlynarz, Piotr

    2016-01-05

    Rheumatoid arthritis is a chronic autoimmune-based inflammatory disease that leads to progressive joint degeneration, disability, and an increased risk of cardiovascular complications, which is the main cause of mortality in this population of patients. Although several biomarkers are routinely used in the management of rheumatoid arthritis, there is a high demand for novel biomarkers to further improve the early diagnosis of rheumatoid arthritis, stratification of patients, and the prediction of a better response to a specific therapy. In this study, the metabolomics approach was used to provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy. The results indicated that twelve metabolites were important for the discrimination of healthy control and rheumatoid arthritis. Notably, valine, isoleucine, lactate, alanine, creatinine, GPC  APC and histidine relative levels were lower in rheumatoid arthritis, whereas 3-hydroxyisobutyrate, acetate, NAC, acetoacetate and acetone relative levels were higher. Simultaneously, the analysis of the concentration of metabolites in rheumatoid arthritis and 3 months after induction treatment revealed that L1, 3-hydroxyisobutyrate, lysine, L5, acetoacetate, creatine, GPC+APC, histidine and phenylalanine were elevated in RA, whereas leucine, acetate, betaine and formate were lower. Additionally, metabolomics tools were employed to discriminate between patients with different IL-17A genotypes. Metabolomics may provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy in rheumatoid arthritis.

  15. Recognition and management of BPPV for an elderly female patient referred for low back pain: a resident's case study.

    PubMed

    Massey, B James; Osborne, Raine; Beneciuk, Jason M; Rowe, Robert H

    2014-08-01

    Benign paroxysmal positional vertigo (BPPV) is common among older adults and frequently misdiagnosed or unidentified. Undiagnosed BPPV has been associated with depression, falls and ADL limitations. This case study describes the diagnostic process and management of BPPV for a 65-year-old patient with a primary complaint of chronic low back pain (LBP) in an outpatient orthopedic physical therapy setting. Following routine screening performed on initial evaluation, the patient was educated about examination findings that indicated the potential for BPPV and given the option to proceed with further assessment or defer until LBP was under control. The patient attended 16 visits over the course of care and the complaint of vertigo, described as a true spinning sensation, was assessed further on the visit 5. Continued assessment confirmed BPPV and the canalith repositioning procedure was administered. Following positive response to this intervention, the maneuver was re-administered on visit 6. Complete resolution of symptoms was reported on visit 7 and for the remainder of physical therapy services over the following month. Physical therapists may play a vital role in reducing healthcare expenses associated with cost to arrive at the diagnosis of BPPV, as well as improving the quality of life and safety of the older adult population affected by BPPV.

  16. Outcome of hybrid stem fixation in osteoporotic female patients. A minimum five-year follow-up study

    PubMed Central

    Tassinari, Enrico; Pilla, Federico; De Fine, Marcello; Biondi, Federico; Cristofolini, Luca; Toni, Aldo

    2008-01-01

    In osteoporotic patients cemented stems are usually used to achieve a good primary stability. However, when patients are obese or active the long-term survival of cemented prostheses is questioned. In these patients, a partially-cemented stem with a hybrid fixation could be advantageous. A hybrid stem was retrospectively evaluated at a minimum follow-up of 60 months (mean, 75 months) in 58 osteoporotic women: seventeen with a body mass index (BMI) >30 (obese), 41 with a BMI between 25 and 29.9 (overweight), and an UCLA score for activity level >6. At the latest follow up, the Harris hip score improved from 33.5 points preoperatively to 81.6 points, and the WOMAC score improved significantly. Three stems (4.9%) had an asymptomatic subsidence of less than 2.5 mm; no stem was revised. These results support the use of partially-cemented stems in heavy or active osteoporotic women. PMID:18712386

  17. Female sexuality.

    PubMed

    Rao, T S Sathyanarana; Nagaraj, Anil Kumar M

    2015-07-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35-40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality.

  18. Female sexuality

    PubMed Central

    Rao, T.S. Sathyanarana; Nagaraj, Anil Kumar M.

    2015-01-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35–40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality. PMID:26330647

  19. Female hair restoration.

    PubMed

    Unger, Robin H

    2013-08-01

    Female hair loss is a devastating issue for women that has only relatively recently been publicly acknowledged as a significant problem. Hair transplant surgery is extremely successful in correcting the most cosmetically problematic areas of alopecia. This article discusses the surgical technique of hair transplantation in women in detail, including pearls to reduce postoperative sequelae and planning strategies to ensure a high degree of patient satisfaction. A brief overview of some of the medical treatments found to be helpful in slowing or reversing female pattern hair loss is included, addressing the available hormonal and topical treatments.

  20. A novel mutation (c. 341A>G) in the SRY gene in a 46,XY female patient with gonadal dysgenesis.

    PubMed

    Helszer, Zofia; Dmochowska, Anita; Szemraj, Janusz; Słowikowska-Hilczer, Jolanta; Wieczorek, Marek; Jędrzejczyk, Sławomir; Kałużewski, Bogdan

    2013-09-10

    SRY (sex-determining region Y) gene, MIM 480000, NM_005634) is crucial for sex differentiation which encodes the protein responsible for initiating testis differentiation. SRY mutations are associated with the presence of XY gonadal dysgenesis symptoms. We studied a 46,XY female patient with primary amenorrhoea and negative family history. The clinical, endocrine, histopathologic and cytogenetic data are consistent with gonadal dysgenesis. Using a molecular analysis, a novel (c.341A>G, p. N65D) missense mutation within the HMGbox of SRY gene was detected. Escherichia coli expression of SRY study showed reduced expression of the mutated protein and gel retardation assay method revealed lowered DNA-binding ability in N65D variant of SRY. The novel mutation detected in the SRY gene may be an aetiopathogenic factor in clinically defined 46,XY complete gonadal dysgenesis (CGD). Because of an increased risk of gonadoblastoma, proper early diagnosis and treatment prevent development of malignancies.

  1. Effects of Bacillus subtilis var. natto products on symptoms caused by blood flow disturbance in female patients with lifestyle diseases.

    PubMed

    Hitosugi, Masahito; Hamada, Katsuo; Misaka, Kazutaka

    2015-01-01

    The fermented soybean product natto is a popular traditional food in Japan and is considered a health supplement. NKCP(®), a natto-derived dietary food supplement whose main component is bacillopeptidase F, has antithrombotic, fibrinolytic, and blood pressure-lowering effects. We examined whether daily intake of NKCP(®) effectively improves subjective symptoms in patients with lifestyle diseases in this cross-over, double-blind study. Fermented soya extract with subtilisin NAT (nattokinase) as the main component was used as an active placebo. A 4-week course of NKCP(®) significantly decreased the visual analog scale (VAS) score for shoulder stiffness from 42.3 to 32.4 (P=0.009), the VAS score for low back pain from 25.5 to 18.8 (P=0.02), and the VAS score for coldness of the extremities from 33.1 to 25.7 (P=0.002). However, no significant difference was found in the VAS score for headache. After a 4-week course of active placebo, no significant changes in the VAS score were found for any symptoms. The significant improvement in the symptoms secondary to blood flow disturbance was caused by the improvement in blood flow by NKCP(®). The use of dietary supplements based on the Japanese traditional food natto helps to relieve subjective symptoms for patients with lifestyle diseases receiving medical care.

  2. Effects of Bacillus subtilis var. natto products on symptoms caused by blood flow disturbance in female patients with lifestyle diseases

    PubMed Central

    Hitosugi, Masahito; Hamada, Katsuo; Misaka, Kazutaka

    2015-01-01

    The fermented soybean product natto is a popular traditional food in Japan and is considered a health supplement. NKCP®, a natto-derived dietary food supplement whose main component is bacillopeptidase F, has antithrombotic, fibrinolytic, and blood pressure-lowering effects. We examined whether daily intake of NKCP® effectively improves subjective symptoms in patients with lifestyle diseases in this cross-over, double-blind study. Fermented soya extract with subtilisin NAT (nattokinase) as the main component was used as an active placebo. A 4-week course of NKCP® significantly decreased the visual analog scale (VAS) score for shoulder stiffness from 42.3 to 32.4 (P=0.009), the VAS score for low back pain from 25.5 to 18.8 (P=0.02), and the VAS score for coldness of the extremities from 33.1 to 25.7 (P=0.002). However, no significant difference was found in the VAS score for headache. After a 4-week course of active placebo, no significant changes in the VAS score were found for any symptoms. The significant improvement in the symptoms secondary to blood flow disturbance was caused by the improvement in blood flow by NKCP®. The use of dietary supplements based on the Japanese traditional food natto helps to relieve subjective symptoms for patients with lifestyle diseases receiving medical care. PMID:25653551

  3. A successful healthy live birth from a female patient with hypogonadotropic hypogonadism and oocytes with unusually large cytoplasmic inclusions.

    PubMed

    Duvan, Candan İltemir; Pekel, Aslıhan; Ercan, Ummu Gulsum; Arıkan, Yuksel Onaran

    2016-03-01

    This study aimed to report the case of a successful live birth from a woman having oocytes with abnormally large cytoplasmic inclusions. The patient described in this case is a 28 year-old woman with hypogonadotropic hypogonadism (HH) with a history of two previous unsuccessful in vitro fertilization (IVF) attempts offered an antagonist protocol. Stimulation was performed with human menopausal gonadotropin 300 IU/day. The intracytoplasmic sperm injection (ICSI) procedure was performed 4-6 hours after oocyte aspiration for all mature oocytes. Six oocytes were retrieved, five of which mature (MII). All oocytes had abnormal cytoplasmic structures. Two were fertilized after ICSI and two top quality embryos were transferred on Day 2. Our case report suggests that HH patients with refractile bodies/lipofuscin in their oocytes may not have their pregnancies negatively affected. While there have been several reports of successful births from dysmorphic oocytes, no cases of successful pregnancies followed by live births from young women with HH and oocytes with large cytoplasmic inclusions had been reported to date.

  4. Hyaline globules and papillary fragments in cytologic smears from two intra-abdominal tumors (ovarian and hepatic) in female patients: A diagnostic pitfall with histologic correlation.

    PubMed

    Machado, Isidro; López-Soto, María Victoria; Pérez-López, Albadio Samir; Domínguez-Álvarez, Carlos; Llombart-Bosch, Antonio

    2016-11-01

    Hyaline globules and papillary fragments in cytologic samples from two intra-abdominal tumors in young females are presented including the cytological features and the correlation with the histopathologic and immunohistochemical findings. In the first case a cytologic study from an ovarian mass showed papillary structures and isolated tumor cells with epithelioid morphology, irregular reniform-like nuclear contour, pale or vacuolated cytoplasm, abundant hyaline globules and occasional glomeruloid structures resembling Schiller-Duval bodies. Yolk sac tumor (YST) was the diagnosis on the histological slides. Tumor cells showed positivity for cytokeratin (AE1/AE3), epithelial membrane antigen (EMA), alpha-fetoprotein (AFP) and Sal-like protein 4 (SALL4). In case number two the cytologic study from a liver metastasis displayed papillary and rosette-like clusters composed of uniform and bland cells showing occasional long cytoplasmic tails, hyaline globules and nuclear grooves. A diagnosis of hepatic metastasis from solid pseudopapillary neoplasm of the pancreas (SPNP) was rendered from the histology. Tumor cells revealed immunoreactivity for cytokeratin (AE1/AE3), Vimentin, Galectin-1 (GAL-1), Neuron specific-enolase, CD10, progesterone and β-catenin (nuclear stain). Regarding differential diagnosis, in the patient with the ovarian mass an ovarian clear cell carcinoma was considered, as well as other germ cell tumors or metastatic carcinoma, while in the patient with a liver metastasis a neuroendocrine carcinoma was taken into account. YST and SPNP share some cytological findings, including hyaline globules, papillary structures, clear cells and intercellular eosinophilic basement membrane deposits. Thus, a detailed study and careful interpretation of the cytological, histological and immunohistochemical findings may be worthwhile to avoid a potential misdiagnosis, particularly in the cytologic specimens of the ovarian and/or intra-abdominal mass, when involving young

  5. Ivacaftor and sinonasal pathology in a cystic fibrosis patient with genotype deltaF508/S1215N.

    PubMed

    Vreede, C L; Berkhout, M C; Sprij, A J; Fokkens, W J; Heijerman, H G M

    2015-05-01

    In patients with Cystic Fibrosis and a type III mutation, ivacaftor (Kalydeco(®), Vertex) can increase the opening time of the CFTR channel and improve chloride transport. Research showed significant improvement of lung function and increase in weight following ivacaftor use. However, ivacaftor showed to have adverse events on the sinonasal system as well, such as upper respiratory tract infections, nasal congestion and headaches. This case report showed a positive effect of ivacaftor on the sinonasal pathology in a 17 year old patient with CF. After 5 months of ivacaftor use, the CT-sinus showed complete resolution of the opacification of the paranasal sinuses and a decrease in symptoms of sinonasal disease. This positive effect of ivacaftor on sinonasal pathology seems promising, therefore more research is needed to evaluate the effect of ivacaftor on the upper airways in CF.

  6. Celiac disease (CD), ulcerative colitis (UC), and primary sclerosing cholangitis (PSC) in one patient: a family study.

    PubMed

    Cadahía, V; Rodrigo, L; Fuentes, D; Riestra, S; de Francisco, R; Fernández, M

    2005-12-01

    We discuss the case of a 17-year-old male who at the age of 7 was diagnosed with celiac disease (CD) together with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). The patient was treated with gluten-free diet and immunosuppressive drugs (azathioprine), and currently remains asymptomatic. The patient's younger, 12-year-old sister was diagnosed with CD when she was 1.5 years old, and at 7 years she developed type-I diabetes mellitus, which was difficult to control. A family study was made, and both parents were found to be affected with silent CD. All were DQ2 (+). In relation to the case and family study, we provide a series of comments related to CD and its complications.

  7. Combined surgical and endovascular management of a giant fusiform PCA aneurysm in a pediatric patient. A case report.

    PubMed

    Shin, S H; Choi, I S; Thomas, K; David, C A

    2013-06-01

    Treatment of intracranial giant aneurysms presents is challenging. In the case of pediatric giant aneurysm, more challenges arise. We describe our experience with a 17-year-old pediatric patient who presented with severe headache. She was diagnosed as having a giant fusiform aneurysm at the right P1-P2-Pcom junction. The aneurysm was treated with superficial temporal artery-posterior cerebral artery bypass and subsequent coil embolization of the aneurysm with parent artery occlusion. The patient had an excellent outcome at one-year follow-up. Our case suggests a combined approach of surgical and endovascular management may yield a better outcome than surgery or endovascular management alone in the treatment of pediatric giant aneurysm.

  8. Sequential Supernumerary Teeth Development in a Non-Syndromic Patient; Report of a Rare Case

    PubMed Central

    Jafarian, Mohammad; Nazemi, Bahareh; Bargrizan, Majid; Ramezani, Jamileh; Ansari, Ghassem

    2013-01-01

    Isolated impacted supernumerary teeth are quite rare, but they can be seen associated with several syndromes such as cleidocranial dysostosis or Gardner’s syndrome. This article aims to discuss a case of sequential formation of supernumerary teeth with no other associated disease or syndrome. A 17-year-old Iranian male with 8 impacted supernumerary teeth was referred to the department of pediatric dental clinic at Shahid Beheshti Medical University in Tehran with a history of several impacted unerupted teeth. Repeated and periodical clinical and radiographic examinations revealed newly formed teeth buds in unusual dental ages. All extra teeth were associated with generalized enamel hypoplasia to some degree on their relative permanent adjacent teeth. The patient did not have any record of a systemic disease or any syndromic condition to relate his dental problem to. This rare condition involved repeated and continued formation of extra teeth out of the normal numbers and dental age evident in serial radiographs. PMID:24910667

  9. The female athlete triad.

    PubMed

    Horn, Elizabeth; Gergen, Nicole; McGarry, Kelly A

    2014-11-03

    The female athlete triad is a spectrum of interrelated pathophysiologic consequences of low energy availability, menstrual dysfunction, and low bone mineral density. Components of the triad are not only counterproductive to athletic performance goals, but can lead to serious long-term negative health outcomes. Practitioners caring for female athletes play an important role detecting at-risk athletes early in their course along the disease spectrum. Importantly, women who are evaluated for one component of the triad should always be screened for the other two. Detecting the disorder early is the most important factor for preventing the potentially severe consequences, and requires heightened vigilance on the part of all those who work with this special patient population. In this article, we discuss the epidemiology, pathophysiology, diagnosis, evaluation, and management of the female athlete triad.

  10. [Differences between female and male patients with eating disorders--results of a multicenter study on eating disorders (MZ-Ess)].

    PubMed

    Grabhorn, Ralph; Köpp, Werner; Gitzinger, Inez; von Wietersheim, Jörn; Kaufhold, Johannes

    2003-01-01

    Publications about men with eating disorders are still rare. Therefore, in view of the current status of the findings, it seems worthwhile to examine the differences that are empirically verified as well as the relevant common features between the sexes. Based on a representative sample, therefore, male and female patients with eating disorders in inpatient treatment are compared in terms of demographic and clinical variables (symptoms and personality), both at the beginning of treatment and two-and-a-half years after the inpatient treatment, and the findings are discussed with regard to their "gender specificity". The study covered 1,171 patients (male and female) with the diagnosis criteria for anorexia, bulimia and double diagnosis according to DSM-III-R; 33 of them were men. Anorexia cases (342 women and 13 men) and bulimia cases (629 women and 18 men) were compared at the beginning of treatment with the following instruments: Symptom Checklist 90-R; Eating Disorder Inventory; questionnaire for the symptom diagnosis of eating disorders; Freiburger Persönlichkeitsinventar and Narzissmus-Inventar. As a measure of success in the 2.5 year catamnesis (764 women and 20 men), operationalized criteria were defined using the LIFE. The 2.8 % share of men with eating disorders in inpatient treatment again confirms the special nature of this clinical disorder for men. An interesting result is the later onset of illness in male anorexia cases. Coinciding with comparable studies, there are only minor differences in eating behavior, but the differences in body experience are much more pronounced. In bulimic men, there is a higher percentage of homosexuals and they are more satisfied with their body. Anorectic men have a greater gain from the illness, are more concerned about their health and are less performance-minded than female anorectics. The differences that were found clearly indicate that these occur especially in the area of dealing with the body and the significance

  11. Extension of RPI-adult male and female computational phantoms to obese patients and a Monte Carlo study of the effect on CT imaging dose

    NASA Astrophysics Data System (ADS)

    Ding, Aiping; Mille, Matthew M.; Liu, Tianyu; Caracappa, Peter F.; Xu, X. George

    2012-05-01

    Although it is known that obesity has a profound effect on x-ray computed tomography (CT) image quality and patient organ dose, quantitative data describing this relationship are not currently available. This study examines the effect of obesity on the calculated radiation dose to organs and tissues from CT using newly developed phantoms representing overweight and obese patients. These phantoms were derived from the previously developed RPI-adult male and female computational phantoms. The result was a set of ten phantoms (five males, five females) with body mass indexes ranging from 23.5 (normal body weight) to 46.4 kg m-2 (morbidly obese). The phantoms were modeled using triangular mesh geometry and include specified amounts of the subcutaneous adipose tissue and visceral adipose tissue. The mesh-based phantoms were then voxelized and defined in the Monte Carlo N-Particle Extended code to calculate organ doses from CT imaging. Chest-abdomen-pelvis scanning protocols for a GE LightSpeed 16 scanner operating at 120 and 140 kVp were considered. It was found that for the same scanner operating parameters, radiation doses to organs deep in the abdomen (e.g., colon) can be up to 59% smaller for obese individuals compared to those of normal body weight. This effect was found to be less significant for shallow organs. On the other hand, increasing the tube potential from 120 to 140 kVp for the same obese individual resulted in increased organ doses by as much as 56% for organs within the scan field (e.g., stomach) and 62% for those out of the scan field (e.g., thyroid), respectively. As higher tube currents are often used for larger patients to maintain image quality, it was of interest to quantify the associated effective dose. It was found from this study that when the mAs was doubled for the obese level-I, obese level-II and morbidly-obese phantoms, the effective dose relative to that of the normal weight phantom increased by 57%, 42% and 23%, respectively. This set

  12. Serum levels of sex hormones and expression of their receptors in thyroid tissue in female patients with various types of thyroid neoplasms.

    PubMed

    Liu, Jia; Chen, Guang; Meng, Xian-Ying; Liu, Zhong-Hui; Dong, Su

    2014-12-01

    Previous studies have demonstrated the expression of estrogen receptor (ER) and progesterone receptor (PR) in thyroid cancer; however, little is known regarding the levels of estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in serum and the expression of ER, PR, FSH receptor (FSHR), and LH receptor (LHR) in thyroid tissues of patients with different types of thyroid neoplasms. Serum levels of estrogen, progesterone, FSH, and LH were measured by chemiluminescence, and expression of ER, PR, FSHR, and LHR in thyroid tissue was detected by immunohistochemistry in female patients with thyroid adenoma (n = 70), nodular goiter (n = 73), thyroid papillary cancer (n = 149), poorly differentiated thyroid carcinoma (n = 12), or undifferentiated thyroid carcinoma (n = 8) and in normal controls (n = 60). The positive rates of serum estrogen level and ERα expression were significantly greater in patients with various types of thyroid neoplasms than in normal controls. The positive rates of ERβ expression were significantly less in various types of thyroid neoplasms than in normal thyroid tissues, especially in poorly differentiated carcinoma and undifferentiated carcinoma. The negative rates of serum progesterone level and positive rates of PR expression in thyroid tissue were significantly greater in patients with thyroid adenoma, nodular goiter, or thyroid papillary cancer than in normal controls. The positive rates of serum FSH and LH levels and FSHR and LHR expression were significantly greater in the thyroid adenoma group than in other groups. Our findings suggest that thyroid neoplasms might be sex hormone-dependent. The positive expression of ERα and PR often indicates thyroid papillary carcinoma, and the ERβ expression status is important for the diagnosis of poorly differentiated carcinoma and undifferentiated carcinoma. In addition, thyroid adenoma is often accompanied by an increase in serum FSH and LH levels, as well as

  13. Female condoms.

    PubMed

    Bounds, W

    1997-06-01

    Early versions of a female condom were available in the 1920s and 1960s, but they were little used and soon forgotten. It took the arrival of AIDS, and the urgent need for a wider range of female-controlled barrier techniques, to rekindle scientific interest in this method. In the 1980s, three groups in Europe and the USA began development of new female condom designs, comprising 'Femidom (Reality)', the 'Bikini Condom', and 'Women's Choice'. Apart from differences in their physical design, Femidom differs from the others in that it is made of a polyurethane membrane, which has several advantages over latex. Of the three, Femidom is the most advanced in terms of development and clinical testing, and it is the only one to have reached the marketing stage. Laboratory studies and clinical trials suggest that its contraceptive efficacy is similar to that documented for the male condom, though a direct comparison is not possible because no comparative clinical trials have, as yet, been undertaken. Reported 'typical-use' pregnancy rates range from 12.4 to 22.2% at 6 months of use in the USA and Latin America, respectively, while a study in the UK observed a rate of 15% at 12 months. As with all barrier methods, most failures appear to be associated with poor compliance or incorrect use. 'Perfect-use' pregnancy rates were substantially lower, indicating that Femidom can be very effective, if used consistently and correctly. Evidence for Femidom's effectiveness to protect against transmission of sexual disease-causing organisms, including HIV, is still very limited and based largely on laboratory studies. Whilst, in theory, the condom should confer reliable protection, its efficacy in clinical use will depend upon correct and consistent use and upon the product's ability to maintain an effective physical barrier throughout penetrative intercourse. In this respect, the results of recent and ongoing clinical studies are expected with much interest. How valuable Femidom will

  14. When parenting fails: alexithymia and attachment states of mind in mothers of female patients with eating disorders

    PubMed Central

    Pace, Cecilia Serena; Cavanna, Donatella; Guiducci, Valentina; Bizzi, Fabiola

    2015-01-01

    Introduction: In recent years alexithymia and attachment theory have been recognized as two parallel research lines trying to improve the information on the development and maintenance of eating disorders (EDs). However, no research has analyzed these constructs among patients’ families. In this study we compared alexithymia and attachment in mothers of patients with EDs and a control group. Further, we hypothesized that mothers of daughters with EDs with insecure and unresolved states of mind will reported high levels of alexithymia. Lastly, we explored the daughters’ evaluations of maternal alexithymia. Methods: 45 mothers of ED women and 48 mothers of healthy controls (N = 93) matched for age and socio-demographic variables were administered by the Toronto Alexithymia Scale-20 (TAS-20) (S), while two sub-groups of “ED” mothers (n = 20) and “non-ED” ones (n = 22) were assessed by the Adult Attachment Interview (AAI). Moreover, the Observer Alexithymia Scale (OAS) was administered to the daughters for evaluating maternal alexithymia. Results: Regarding alexithymia, no differences were found between ED and non-ED mothers according to the TAS-20, while ED mothers showed more unresolved AAI classifications than non-ED mothers. No correlations were found between the TAS-20 and the AAI. Lastly, ED mothers were evaluated more alexithymic by their daughters with the OAS than those in the control group, and their alexithymic traits were significantly correlated with dismissing states of mind (idealization and lack of memory) in the AAIs. Discussion: Our results highlighted an interesting discrepancy among mothers with ED daughters between the low level of alexithymia provided by their self-reports and the high level of alexithymia observed by their daughters, although the OAS showed severe methodological limitations. Maternal attachment states of mind characterized by the lack of resolution of past losses could be connected to a confusing and incoherent

  15. The 6-minute walk test in female fibromyalgia patients: relationship with tenderness, symptomatology, quality of life, and coping strategies.

    PubMed

    Carbonell-Baeza, Ana; Ruiz, Jonatan R; Aparicio, Virginia A; Ortega, Francisco B; Delgado-Fernández, Manuel

    2013-12-01

    The purpose of this study was to examine the relationship between the 6-minute walk test (6-MWT) and tenderness, symptomatology, quality of life, and coping strategies in women with fibromyalgia. One hundred eighteen women with fibromyalgia aged 51.9 ± 7.3 years participated in the study. The examination included the 6-MWT, tender points, and the following questionnaires: Fibromyalgia Impact Questionnaire (FIQ), Short-Form Health Survey 36 (SF-36), and Vanderbilt Pain Management Inventory. Fair correlations between the 6-MWT and the subscales of physical impairment (FIQ) and physical function (SF-36) were observed (ρ -0.365 and 0.347, respectively, both p < .001). The 6-MWT showed a weak relationship with tenderness (ρ 0.201 and -0.191 for algometer score and tender points count, respectively, both p < .05). The relationship between the 6-MWT and global score of FIQ, and FIQ subscales of pain and fatigue were weak (ρ -0.201, -0.211, and -0.226, respectively, all p < .05). The 6-MWT showed a weak relationship with bodily pain and vitality scales of SF-36 (ρ 0.256 and 0.258, respectively, both p = .005) and with passive and active coping strategies (ρ -0.255 and 0.223, both p < .05). This study in women with fibromyalgia shows significant relationships, ranging from weak to fair, between the 6-MWT and tenderness, symptomatology, quality of life, and coping strategies. These findings indicate that functional capacity, as assessed by the distance walked in 6 minutes, might be important when planning the assessment, treatment, and monitoring of patients with fibromyalgia.

  16. A female patient with incomplete hemophagocytic lymphohistiocytosis caused by a heterozygous XIAP mutation associated with non-random X-chromosome inactivation skewed towards the wild-type XIAP allele.

    PubMed

    Yang, Xi; Hoshino, Akihiro; Taga, Takashi; Kunitsu, Tomoaki; Ikeda, Yuhachi; Yasumi, Takahiro; Yoshida, Kenichi; Wada, Taizo; Miyake, Kunio; Kubota, Takeo; Okuno, Yusuke; Muramatsu, Hideki; Adachi, Yuichi; Miyano, Satoru; Ogawa, Seishi; Kojima, Seiji; Kanegane, Hirokazu

    2015-04-01

    X-linked lymphoproliferative disease (XLP) is a rare inherited immunodeficiency that often leads to hemophagocytic lymphohistiocytosis (HLH). XLP can be classified as XLP1 or XLP2, caused by mutations in SH2D1A and XIAP, respectively. In women, X-chromosome inactivation (XCI) of most X-linked genes occurs on one of the X chromosomes in each cell. The choice of which X chromosome remains activated is generally random, although genetic differences and selective advantage may cause one of the X chromosomes to be preferentially inactivated. Here we describe three patients with pancytopenia, including one female patient, in a Japanese family with a novel XIAP mutation. All three patients exhibited deficient XIAP protein expression, impaired NOD2/XIAP signaling, and augmented activation-induced cell death. In the female patient, the paternally derived X chromosome was non-randomly and exclusively inactivated in her peripheral blood and hair root cells. In contrast to asymptomatic females, this patient exhibied non-random XCI skewed towards the wild-type XIAP allele. This is the first report of a female patient with incomplete HLH resulting from a heterozygous XIAP mutation in association with non-random XCI.

  17. The status of psychic reality in adolescence. An adult female patient's quasi-adolescent material and the analyst's counter transference response.

    PubMed

    Eiguer, A

    1996-12-01

    The author holds that the crisis of adolescence is in fact one of psychic reality, its elements being loss of boundaries, externalisation and the involvement of a third party. In this view, it is essential to conceive of adolescence differently from adulthood, in that, for example, an adolescent's acting out may not be solely a matter of regression but to a considerable extent a consequence of his or her physical development. It is noted that the boundaries between psychic and material reality are fluid throughout life and that adolescents crave identificatory models. The author stresses the importance of the psychic reality of the other in the adolescent's crisis. After considering various views, including those of Freud, on psychic reality and the crises of adolescence, he illustrates his thesis by the clinical example of two adolescent episodes of perversion forming part of an adult female patient's material. In the author's view, these instances of acting out had helped the patient to regain her auto-erotic capacity in the pleasure of fantasy life. He considers that a mutative interpretation must touch upon the primal fantasy and therefore involve the entire person of the analyst in the transference.

  18. Worsening of rest-activity circadian rhythm and quality of life in female breast cancer patients along progression of chemotherapy cycles.

    PubMed

    Sultan, Armiya; Choudhary, Vivek; Parganiha, Arti

    2017-02-16

    Chemotherapy and its associated side effects can induce the disruption of circadian rest-activity rhythm and may have negative consequences on health-related quality of life (HRQoL) of cancer patients. In the current study, repeated-measures cross-sectional design was implemented to determine the status of circadian rest-activity rhythm and to assess the HRQoL of newly diagnosed female breast cancer patients those were planned to receive six cycles of chemotherapy. Rest activity and HRQoL were assessed in twenty-five patients during chemotherapy cycles 1st (C1), 3rd (C3), and 6th (C6) immediately after they reported to the outdoor ward of the Regional Cancer Center, Pt. J.N.M. Medical College, Dr. B.R. Ambedkar Memorial Hospital, Raipur, India. Wrist actigraphs for consecutive spans of 3-4 days were used to record the rest-activity rhythm, and its parameters were computed with the help of Cosinor Rhythmometry. Quality of life (QoL) parameters were assessed using EORTC QLQ-C30 and QLQ-BR23. Results revealed that average scores of all rhythm parameters, such as MESOR, amplitude, acrophase, rhythm quotient, circadian quotient, peak activity, dichotomy index, and autocorrelation coefficient; and all functional scales of QLQ-C30, such as physical, role, emotional, cognitive, and social, and global quality of life statistically significantly decreased with the increasing number of chemotherapy cycles (C1 to C3 and C6). Scores of symptom scales of QLQ-C30, such as fatigue, pain, dyspnoea, insomnia, appetite loss, and diarrhea increased significantly from C1 to C6. Among the QLQ-BR23 scales, scores of sexual functioning, sexual enjoyment, breast symptoms, and arm symptoms significantly decreased, whereas scores of systemic therapy side effects, and upset by hair loss significantly increased across the chemotherapy cycles. We conclude that rest-activity rhythm disrupted and HRQoL of breast cancer patients worsened along the increasing number of chemotherapy cycles. We

  19. Solution of Azelaic Acid (20%), Resorcinol (10%) and Phytic Acid (6%) Versus Glycolic Acid (50%) Peeling Agent in the Treatment of Female Patients with Facial Melasma

    PubMed Central

    Faghihi, Gita; Taheri, Azam; Shahmoradi, Zabihollah; Nilforoushzadeh, Mohammad Ali

    2017-01-01

    Background: Melasma, a common acquired disorder of hyperpigmentation, especially in women, is often resistant to therapy. This study was aimed to evaluate the efficacy and safety of azelaic acid, resorcinol and phytic acid solution in chemical peeling of melasma in comparison to 50% glycolic acid. Materials and Methods: This clinical trial was performed, on 42 female patients with bilateral melasma. Severity of melasma was assessed by melasma area and severity index (MASI). Combination of (20% azelaic acid + 10% resorcinol + 6% phytic acid) was used as a new peeling agent on the right side of the face and 50% glycolic acid on the left side every 2 weeks for 6 times. Follow-up was carried out for 3 months after the last session. Any decrease in MASI score and unwanted complications following peeling were evaluated and compared during the trial. Results: Patients showed marked improvement as calculated with MASI score before and after treatment in both sides of the face. The efficacy of combination formula (azelaic acid, resorcinol and phytic acid) was similar to glycolic acid, but with fewer complications. There was no statistically difference in improvement between two groups (P > 0.05). However, the patient's discomfort following procedures was significantly lower with azelaic acid, resorcinol and phytic compared with the glycolic acid peels (P < 0.05) and there was the same duration in the beginning of the therapeutic response in both groups. Conclusion: Results showed that triple-combination was found to be an effective and safe peeling agent in the treatment of melasma and it was as effective as 50% glycolic acid peel. PMID:28299301

  20. Minority Reading Achievement: Motivational, Instructional, and Familial Variables for Black and White Males and Females.

    ERIC Educational Resources Information Center

    Guthrie, John T.; And Others

    A study examined the relationships of reading achievement and constructs about student literacy activities for four ethnic-gender groups. A secondary analysis of nearly 3,000 9-, 13-, and 17-year-olds' reading achievement and student questionnaire data from the 1986 National Assessment of Educational Progress was undertaken. The constructs varied…

  1. Noninvasive Intracranial Pressure Monitoring Using Advanced Machine Learning Techniques

    DTIC Science & Technology

    2013-11-01

    training regression models using VS features for given time durations. Our regression model of minimally invasive ICP monitoring predicts ICP in...TBI. Included were adult patients (older than 17 years) admitted to the STC with GCS ɡ and a clinically determined requirement for ICP monitoring...were eligible for the study, i.e., adults (>17 years old; 42 female and 149 male). Details of the electronic data capture, storage, and data point

  2. Socio-demographic, Behavioral and Health Characteristics of Underage Female Sex Workers in Mozambique: The Need to Protect a Generation from HIV Risk

    PubMed Central

    Horth, Roberta Z.; Miranda, Angélica E.; Young, Peter W.; Sathane, Isabel; Cummings, Beverley E.; Augusto, Ângelo; Raymond, Henry F.; Mcfarland, Willi

    2016-01-01

    Characteristics, HIV risk, and program coverage for underage female sex workers (FSW) are rarely systematically described worldwide. We compared characteristics of underage (15–17 years old) and adult (≥18 years old) FSW in three main urban areas of Mozambique (Maputo, Beira and Nampula) using data from three respondent-driven sampling surveys implemented in 2011–2012. Among survey participants, 9.8 % (39/400) in Maputo, 17.0 % (70/411) in Beira and 25.6 % (110/429) in Nampula were underage. Over half reported performing sex work to afford daily living, and 29.7–50.0 % had unprotected sex with their last client. The proportion of underage FSW having accessed care and prevention services was lower compared to adult FSW. While HIV prevalence among underage FSW was lower than in adults, it increased markedly with age. Our results point to the urgency of expanding prevention and care programs geared towards underage FSW. PMID:25931241

  3. The Female Athlete Triad

    PubMed Central

    Nazem, Taraneh Gharib; Ackerman, Kathryn E.

    2012-01-01

    Context: The female athlete triad (the triad) is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density; it is relatively common among young women participating in sports. Diagnosis and treatment of this potentially serious condition is complicated and often requires an interdisciplinary team. Evidence Acquisition: Articles from 1981 to present found on PubMed were selected for review of major components of the female athlete triad as well as strategies for diagnosis and treatment of the conditions. Results: The main goal in treatment of young female athletes with the triad is a natural return of menses as well as enhancement of bone mineral density. While no specific drug intervention has been shown to consistently improve bone mineral density in this patient population, maximizing energy availability and optimizing vitamin D and calcium intake are recommended. Conclusions: Treatment requires a multidisciplinary approach involving health care professionals as well as coaches and family members. Prevention of this condition is important to minimize complications of the female athlete triad. PMID:23016101

  4. Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients

    PubMed Central

    Kim, Jin Soo; Choi, Jong Bum; Lee, Sook Young; Kim, Wook Hwan; Baek, Nam Hyun; Kim, Jayoun; Park, Chu Kyung; Lee, Yeon Ju; Park, Sung Yong

    2016-01-01

    Abstract Background: Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients. Methods: We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study). Results: Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups. Conclusions: After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB. PMID:27495072

  5. The severe clinical phenotype for a heterozygous Fabry female patient correlates to the methylation of non-mutated allele associated with chromosome 10q26 deletion syndrome.

    PubMed

    Hossain, Mohammad Arif; Yanagisawa, Hiroko; Miyajima, Takashi; Wu, Chen; Takamura, Ayumi; Akiyama, Keiko; Itagaki, Rina; Eto, Kaoru; Iwamoto, Takeo; Yokoi, Takayuki; Kurosawa, Kenji; Numabe, Hironao; Eto, Yoshikatsu

    2017-03-01

    Heterozygous Fabry females usually have an attenuated form of Fabry disease, causing them to be symptomatic; however, in rare cases, they can present with a severe phenotype. In this study, we report on a 37-year-old woman with acroparesthesia, a dysmorphic face, left ventricular hypertrophy, and intellectual disability. Her father had Fabry disease and died due to chronic renal and congestive cardiac failure. Her paternal uncle had chronic renal failure and intellectual disability, and her paternal aunt was affected with congestive cardiac failure. The patient has two sisters with no significant medical illness. However, her nephew has acroparesthesia, anhidrosis, and school phobia, and her niece shows mild phenotypes. The patient's enzyme analysis showed very low α-galactosidase A (α-gal A) activity in dried blood spot (DBS), lymphocytes, and skin fibroblasts with massive excretion of Gb3 and Gb2 in urine and lyso-Gb3 in DBS and plasma. Electron microscopic examination showed a large accumulation of sphingolipids in vascular endothelial cells and keratinocytes. Chromosomal analysis and comparative genomic hybridization microarray showed 10q26 terminal deletion. Molecular data showed a novel heterozygous stop codon mutation in exon 1 of the GLA gene in her sisters and niece, and a hemizygous state in her nephew. When we checked the methylation status, we found her non-mutated allele in the GLA gene was methylated. However, the non-mutated alleles of her sisters were non-methylated, and those of her niece were partially methylated. The chromosomal and methylation study may speculate the severity of her clinical phenotypes.

  6. Prevalence and nature of nail alterations in pediatric patients.

    PubMed

    Iglesias, A; Tamayo, L; Sosa-de-Martínez, C; Durán-McKinster, C; Orozco-Covarrubias, L; Ruiz-Maldonado, R

    2001-01-01

    The purpose of this investigation was to explore the frequency and nature of ungual alterations in patients of a pediatric dermatology department at a third-level pediatric hospital. The first 20 patients with nail alterations seen each year during a 5-year period from 1992 through 1996 were included, totaling 100 patients. The rate of nail alterations was 11% (1/9) in pediatric dermatology patients. There were 5 infants, 19 preschoolers (2- to 5-year-olds), 38 school children (6- to 11-year-olds), and 38 adolescents (12- to 17-year-olds). The most frequent diagnoses were onychomycosis (23), nail alterations in a genodermatosis (23), nail alterations associated with dermatoses (16), onychocryptosis (11), and paronychia (10). Toenails were involved in 54 patients, fingernails in 25, and both in 21 patients. Twenty nails were involved in 21 patients. A high prevalence of nail alterations was found in pediatric dermatology patients, some of which were nonspecific, while others provided important diagnostic clues.

  7. Novel Use of Tolvaptan in a Pediatric Patient With Congestive Heart Failure Due to Duchenne Muscular Dystrophy and Congenital Adrenal Hyperplasia.

    PubMed

    Sami, Sarah A; Moffett, Brady S; Karlsten, Melissa L; Cabrera, Antonio G; Price, Jack F; Dreyer, William J; Denfield, Susan W; Jeewa, Aamir

    2015-01-01

    Successful management of hyponatremia in heart failure patients requires a multifaceted approach in order to preserve end-organ function. We describe the novel use of a selective vasopressin receptor antagonist, tolvaptan, for management of hyponatremia in a 17-year-old Caucasian male with severe Duchenne muscular dystrophy, congestive heart failure (CHF), and congenital adrenal hyperplasia. The medical history was significant for recurrent admissions for hyponatremia secondary to adrenal crises, which was also exacerbated by his CHF. After initiation of tolvaptan and its extended administration, he had no further hyponatremia-related admissions and no adverse reactions. The complexity of this combination of conditions is presented, and the efficacy of the drug and the rationale behind the treatment approach is discussed.

  8. Evaluation of organ doses and effective dose according to the ICRP Publication 110 reference male/female phantom and the modified ImPACT CT patient dosimetry.

    PubMed

    Kobayashi, Masanao; Asada, Yasuki; Matsubara, Kosuke; Matsunaga, Yuta; Kawaguchi, Ai; Katada, Kazuhiro; Toyama, Hiroshi; Koshida, Kichiro; Suzuki, Shouichi

    2014-09-07

    We modified the Imaging Performance Assessment of CT scanners (ImPACT) to evaluate the organ doses and the effective dose based on the International Commission on Radiological Protection (ICRP) Publication 110 reference male/female phantom with the Aquilion ONE ViSION Edition scanner. To select the new CT scanner, the measurement results of the CTDI100,c and CTDI100,p for the 160 (head) and the 320 (body) mm polymethylmethacrylate phantoms, respectively, were entered on the Excel worksheet. To compute the organ doses and effective dose of the ICRP reference male/female phantom, the conversion factors obtained by comparison between the organ doses of different types of phantom were applied. The organ doses and the effective dose were almost identical for the ICRP reference male/female and modified ImPACT. The results of this study showed that, with the dose assessment of the ImPACT, the difference in sex influences only testes and ovaries. Because the MIRD-5 phantom represents a partially hermaphrodite adult, the phantom has the dimensions of the male reference man including testes, ovaries, and uterus but no female breasts, whereas the ICRP male/female phantom includes whole-body male and female anatomies based on high-resolution anatomical datasets. The conversion factors can be used to estimate the doses of a male and a female accurately, and efficient dose assessment can be performed with the modified ImPACT.

  9. Endocrine disorders & female infertility.

    PubMed

    Unuane, David; Tournaye, Herman; Velkeniers, Brigitte; Poppe, Kris

    2011-12-01

    Female infertility occurs in about 37% of all infertile couples and ovulatory disorders account for more than half of these. The ovaries are in continuous interaction with the other endocrine organs. The interplay may account for infertility occurring at different levels and may render the diagnosis of infertility a difficult exercise for the involved physician. A hypothalamic cause of female infertility should be considered in an appropriate clinical context, with tests pointing to a hypogonadotropic hypogonadism. It can be functional, physiological or related to organic causes. Hyperprolactinemia has well characterized effects on the normal gonadal function and treatment is well established. Acromegaly and Cushing's disease may impair fertility at different levels, mechanisms involved however remain ill defined. Thyroid disorders, both hyperthyroidism and hypothyroidism, can interact with the ovaries, through a direct effect on ovarian function, but autoimmunity may be involved, as well as alterations of the sex hormone binding protein levels. Primary ovarian disorders, such as the polycystic ovary syndrome and primary ovarian insufficiency are frequent diseases, for which novel treatments are currently being developed and discussed. We will propose an algorithm for the diagnosis and approach of the female patient presenting with infertility on the basis of the available evidence in literature.

  10. Female Genital Mutilation

    MedlinePlus

    ... practice of FGM. In 2010, WHO published a "Global strategy to stop health care providers from performing female ... practices Health risks of female genital mutilation (FGM) Global strategy to stop health-care providers from performing female ...

  11. Normal Female Reproductive Anatomy

    MedlinePlus

    ... hyphen, e.g. -historical Searches are case-insensitive Reproductive System, Female, Anatomy Add to My Pictures View /Download : Small: ... Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer ...

  12. Self catheterization - female

    MedlinePlus

    ... bladder. You have signs of infection (a burning sensation when you urinate, fever, fatigue, or chills). Alternative Names Clean intermittent catheterization - female; CIC - female Images Bladder catheterization, female References Cepedes RD, Gerboc JL. Other therapies for storage ...

  13. Prevalence of female sexual dysfunction among Indian fertile females

    PubMed Central

    Mishra, Vineet V.; Nanda, Sakshi; Vyas, Bhumika; Aggarwal, Rohina; Choudhary, Sumesh; Saini, Suwa Ram

    2016-01-01

    Background: Female sexual dysfunction (FSD) is described as difficulty experienced by a female during any stage of a normal sexual activity including physical pleasure, desire, arousal, or orgasm. There are various factors responsible for FSD including psychological status of a person, gynecological or medical problems, long use of certain drugs, and social beliefs. Objectives: To study the prevalence and various factors associated with FSD. Materials and Methods: Study Design - This study design was a cross-sectional observational study conducted at Tertiary Care Centre, in Ahmedabad from June 2015 to March 2016. Sample Size - One hundred and fifty-three fertile females in reproductive age group (20–47 years) were included in the study. Written and informed consent was obtained from all the females. Methods - FSD was assessed with a detailed 19-item female sexual function index questionnaire. All six domains of sexual dysfunction, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain were studied. Various associated factors such as gynecological or psychological problems were also studied. Exclusion - Infertile patients were excluded from the study. Results: The prevalence of FSD was 55.55% among 153 fertile females. FSD was more prevalent in the age group of 26–30 years and with duration of marriage >16 years. FSD was also more common in females with middle education and those belonging to upper middle socioeconomic status. Psychological stress was significantly associated with FSD. Conclusion: It is right of every female to lead healthy sexual life as it is key to happiness in marriage. Females with FSD can be managed with proper counseling and treating the underlying etiology. PMID:28096637

  14. Understanding the roles of self-esteem, self-compassion, and fear of self-compassion in eating disorder pathology: an examination of female students and eating disorder patients.

    PubMed

    Kelly, Allison C; Vimalakanthan, Kiruthiha; Carter, Jacqueline C

    2014-08-01

    The present study examined the relative contributions of self-compassion, fear of self-compassion, and self-esteem in eating disorder pathology. One-hundred and fifty-five female undergraduate students and 97 females entering eating disorder treatment completed the Self-Compassion Scale, Fears of Compassion Scale, Rosenberg Self-Esteem Inventory, and Eating Disorder Examination Questionnaire. T-tests revealed that the patient group had lower mean self-compassion and higher mean fear of self-compassion than the student group. When controlling for self-esteem, high fear of self-compassion emerged as the strongest predictor of eating disorder pathology in the patient group, whereas low self-compassion was the strongest predictor in the student group. These preliminary results suggest that targeting fear of self-compassion may be important when intervening with individuals suffering from an eating disorder, whereas building self-compassion may be a valuable approach for eating disorder prevention.

  15. Female Reproductive System

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Female Reproductive System KidsHealth > For Parents > Female Reproductive System A A ... the egg or sperm. continue Parts of the Female Reproductive System Unlike the male, the human female has a ...

  16. [Female sexual dysfunction].

    PubMed

    Bitzer, Johannes; Alder, Judith

    2010-03-01

    Sexual medicine has become an integrated part of womens' health care. Physicians need therefore communication skills to talk about sexuality with their female patients and a knowledge about models of human sexuality, about classification systems, and diagnostic and therapeutic concepts and processes. The diagnostic reaches from a clear description of the sexual problem to an exploration of the conditioning factors. These can be differentiated into biological factors, intraindividual and interpersonal psychological factors and sociocultural factors. These factors can become effective as predisposing, precipitating and maintaining factors. The therapeutic process is based on several steps. The basic step consists in psychoeducation and basic counselling. Therapy usually includes the combination of pharmacologic intervention (hormones, PDE5) and specific psychotherapeutic techniques (sensate focus, cognitive techniques, couple counselling).

  17. Female obesity and infertility.

    PubMed

    Talmor, Alon; Dunphy, Bruce

    2015-05-01

    Infertility affects one in seven couples, and its rate is on the increase. Ovulatory defects and unexplained causes account for >50% of infertile aetiologies. It is postulated that a significant proportion of these cases are either directly or indirectly related to obesity. The prevalence of overweight and obese men and women has topped 50% in some developed countries. Obesity is on the increase worldwide; in turn, the consequences in terms of the associated morbidity and mortality have also been increasing. Obesity is associated with various reproductive sequelae including anovulation, subfertility and infertility, increased risk of miscarriage and poor neonatal and maternal pregnancy outcomes. Thus, the combination of infertility and obesity poses some very real challenges in terms of both the short- and long-term management of these patients. The mechanism with which obesity impacts female reproductive function is summarised in this review.

  18. Whole-body staging of female patients with recurrent pelvic malignancies: Ultra-fast 18F-FDG PET/MRI compared to 18F-FDG PET/CT and CT

    PubMed Central

    Sawicki, Lino Morris; Suntharalingam, Saravanabavaan; Grueneisen, Johannes; Ruhlmann, Verena; Aktas, Bahriye; Deuschl, Cornelius; Herrmann, Ken; Antoch, Gerald; Forsting, Michael

    2017-01-01

    Objectives To evaluate the diagnostic feasibility of an ultra-fast 18F-FDG PET/MRI protocol, including T2-w and contrast-enhanced T1-w imaging as well as metabolic assessment (PET) in comparison to 18F-FDG PET/CT and CT for whole-body staging of female patients with suspected recurrence of pelvic malignancies. Methods 43 female patients with suspected tumor recurrence were included in this study. Suspicion was based on clinical follow-up and abnormal findings on imaging follow-up. All patients underwent a PET/CT and a subsequent PET/MRI examination. Two readers were asked to evaluate ultra-fast PET/MRI, PET/CT as well as CT datasets of PET/CT separately for suspect lesions regarding lesion count, lesion localization and lesion characterization. Statistical analyses were performed both, on a per-patient and a per-lesion basis. Results Tumor relapse was present in 38 of the 43 patients. Based on CT readings 25/38 tumor relapses were correctly identified. PET/CT enabled correct identification of 37/38 patients, PET/MRI correctly identified 36 of the 38 patients with recurrent cancer. On a lesion-based analysis PET/MRI enabled the correct detection of more lesions, comprising a lesion-based sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 50%, 58%, 76%, 31%, and 53% for CT, 97%, 83%, 93%, 94%, and 92% for PET/CT and 98%, 83%, 94%, 94%, and 94% for PET/MRI, respectively. Mean scan duration of ultra-fast PET/MRI, PET/CT and whole-body CT amounted to 18.5 ± 1 minutes, 18.2 ± 1 minutes and 3.5 minutes, respectively. Conclusion Ultra-fast PET/MRI provides equivalent diagnostic performance and examination time when compared to PET/CT and superior diagnostic performance to CT in restaging female patients suspected to have recurrent pelvic cancer. PMID:28225831

  19. X-inactivation patterns in female Leber`s hereditary optic neuropathy patients do not support a strong X-linked determinant

    SciTech Connect

    Pegoraro, E.; Hoffman, E.P.; Carelli, V.; Cortelli, P.

    1996-02-02

    Leber`s hereditary optic neuropathy (LHON) accounts for about 3% of the cases of blindness in young adult males. The underlying mitochondrial pathogenesis of LHON has been well studied, with specific mitochondrial DNA (mtDNA) mutations of structural genes described and well characterized. However, enigmatic aspects of the disease are not explained by mutation data, such as the higher proportion of affected males, the later onset of the disease in females, and the presence of unaffected individuals with a high proportion of mutant mtDNA. A hypothesis which has been put forward to explain the unusual disease expression is a dual model of mtDNA and X-linked nuclear gene inheritance. If a nuclear X-linked modifier gene influences the expression of the mitochondrial-linked mutant gene then the affected females should be either homozygous for the nuclear determinant, or if heterozygous, lyonization should favor the mutant X. In order to determine if an X-linked gene predisposes to LHON phenotype we studied X-inactivation patterns in 35 females with known mtDNA mutations from 10 LHON pedigrees. Our results do not support a strong X-linked determinant in LHON cause: 2 of the 10 (20%) manifesting carriers showed skewing of X-inactivation, as did 3 of the 25 (12%) nonmanifesting carriers. 39 refs., 2 figs., 1 tab.

  20. [Benign neoplasms of female urethra].

    PubMed

    Usunova, I; Vladimirov, V

    2009-01-01

    In clinical practice neoplasms of female urethra are found usually in adult women. They can also be found in adolescent girls and as rare congenital abnormality. Those conditions are most frequently detected during gynecological or urological examination. Symptoms are few. Lesions are situated at the outer orifice of urethra at the broad basis. Authors have diagnosed and treated 331 patients between 26 and 87 years. Electro coagulation has been performed in 185 patients. Surgical excision has been performed in 41 patients. Excision with following electrocoagulation has been performed in 18 patients. Conservative treatment has been performed in 87 patients. Histological sample analysis has provided diagnosis of urethral polyp, caruncle and mucosal prolaps. Second electrocoagulation after surgical excision has been performed in 5 patients. Collaboration between urologists and gynecologists is essential for early diagnosis, prophylaxis and successful treatment of above mentioned diseases.

  1. Immune Aspects of Female Infertility

    PubMed Central

    Brazdova, Andrea; Senechal, Helene; Peltre, Gabriel; Poncet, Pascal

    2016-01-01

    Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present active immune mechanism may induce high levels of anti-seminal/sperm antibodies. It has already been proven that iso-immunization is associated with infertility. Comprehensive studies with regards to the identification of antibody-targets and the determination of specific antibody class contribute to the development of effective immuno-therapy and, on the other hand, potential immuno-contraception, and then of course to complex patient diagnosis. This review summarizes the aspects of female immune infertility. PMID:27123194

  2. Female Reproductive System (For Teens)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Female Reproductive System KidsHealth > For Teens > Female Reproductive System A A ... and female reproductive systems. continue What Is the Female Reproductive System? Most species have two sexes: male and female. ...

  3. Female Reproductive System (For Teens)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Female Reproductive System KidsHealth > For Teens > Female Reproductive System Print A ... and female reproductive systems. continue What Is the Female Reproductive System? Most species have two sexes: male and female. ...

  4. [Females with Fabry's disease - an interdisciplinary diagnostic and therapeutic challenge].

    PubMed

    Weidemann, Frank; Niemann, Markus; Sommer, Claudia; Beer, Meinrad; Breunig, Frank; Wanner, Christoph

    2010-09-01

    Fabry's disease is a rare genetic storage disorder leading to an accumulation of globotriaosylceramides in the lysosomes of various organs. Being X-chromosomal-linked, most studies in the past focused on involvement in male patients. However, it has been elucidated recently that female patients can present typical organ involvement and, thus, have to be treated respectively. This synopsis wants to systematically review the typical organ involvement in female Fabry patients. Moreover, therapy recommendations especially for female patients are discussed.

  5. Female Prisoners in Malaysia

    ERIC Educational Resources Information Center

    Teh, Yik Koon

    2006-01-01

    This is a study on 422 female prisoners in peninsular Malaysia. More than half of the female prisoners are foreigners, mainly from Indonesia and Thailand. This study surveys the background of the respondents and identifies factors that may have influenced them to commit the offences. Female prisoners in Malaysia, particularly those who are…

  6. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    PubMed Central

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  7. Frequency of the CCR5 delta 32 mutant allele in HIV-1-positive patients, female sex workers, and a normal population in Taiwan.

    PubMed

    Li, C; Yan, Y P; Shieh, B; Lee, C M; Lin, R Y; Chen, Y M

    1997-12-01

    A specific 32-nucleotide deletion mutant of the CCR5 gene (Accr5), the coreceptor gene for human immunodeficiency virus type 1 (HIV-1), can effectively suppress the transmission and pathogenesis of the virus. Individuals homozygous for the delta ccr5 allele resist primary macrophage-tropic HIV-1 infection, despite multiple high-risk sexual exposures. This gene deletion is relatively common among Caucasians but uncommon among Africans, Asians, and South Americans. We used polymerase chain reaction (PCR) technology to determine the frequency of the delta ccr5 allele in a Taiwanese population with diverse health status and social backgrounds. Subjects included 24 HIV-1-infected persons in the northern and southern parts of Taiwan; 131 HIV-1 high-risk, licensed female sex workers in the northern part of the island (21% of whom were aborigines); and 187 unrelated, healthy, HIV-1-negative individuals in southern Taiwan. PCR with primers encompassing the entire CCR5 gene was used to explore possible deletions at regions other than the 32-nucleotide area in the female sex workers. No ccr5 deletions were detected, indicating that they are rare or absent in the Taiwanese population. This finding implies that delta ccr5 is not likely to be part of the defense against the spread of HIV-1-infection in Taiwanese.

  8. Haplotypes of beta S chromosomes among patients with sickle cell anemia from Georgia.

    PubMed

    Hattori, Y; Kutlar, F; Kutlar, A; McKie, V C; Huisman, T H

    1986-01-01

    Fetal hemoglobin and G gamma levels have been correlated with the presence or absence of eight restriction sites within the beta globin gene cluster (haplotypes) for numerous sickle cell anemia patients from Georgia. The most common haplotypes were #19 (Benin) and #20 (CAR); all patients with haplotype combinations 19/19, 20/20, and 19/20 were severely affected with low Hb F and low G gamma levels. A modified #19 beta S chromosome with a -G gamma-G gamma- globin gene arrangement, instead of -G gamma-A gamma-, was present in SS and SC newborn babies with G gamma values above 80%. Haplotype #3 (Senegal) was present among 15% of the beta S chromosomes; the two adult patients with the 3/3 combination were mildly affected with high Hb F and G gamma values. The haplotype AT with the variant A gamma T chain was a rarity. A new haplotype was found in one 17-year-old SS patient and five of his Hb S heterozygous relatives. This haplotype is associated with an increased production of Hb F in heterozygous and homozygous Hb S individuals; this Hb F contained primarily A gamma chains. A comparison was made between the different haplotypes among SS patients and normal Black individuals, and a remarkable similarity was noted in the fetal hemoglobin data for subjects with these different chromosomes.

  9. Relationship Between Microbiota of the Colonic Mucosa vs Feces and Symptoms, Colonic Transit, and Methane Production in Female Patients With Chronic Constipation

    PubMed Central

    Parthasarathy, Gopanandan; Chen, Jun; Chen, Xianfeng; Chia, Nicholas; O'Connor, Helen M.; Wolf, Patricia G.; Gaskins, H. Rex; Bharucha, Adil E.

    2015-01-01

    Background & Aims In fecal samples from patients with chronic constipation, the microbiota differs from that of healthy subjects. However, the profiles of fecal microbiota only partially replicate those of the mucosal microbiota. It is not clear whether these differences are caused by variations in diet or colonic transit, or are associated with methane production (measured by breath tests). We compared the colonic mucosal and fecal microbiota in patients with chronic constipation and in healthy subjects to investigate the relationships between microbiota and other parameters. Methods Sigmoid colonic mucosal and fecal microbiota samples were collected from 25 healthy women (controls) and 25 women with chronic constipation and evaluated by 16S ribosomal RNA gene sequencing (average of 49,186 reads/sample). We assessed associations between microbiota (overall composition and operational taxonomic units) and demographic variables, diet, constipation status, colonic transit, and methane production (measured in breath samples after oral lactulose intake). Results Fourteen patients with chronic constipation had slow colonic transit. The profile of the colonic mucosal microbiota differed between constipated patients and controls (P<.05). The overall composition of the colonic mucosal microbiota was associated with constipation, independent of colonic transit (P<.05) and discriminated between patients with constipation and controls with 94% accuracy. Genera from Bacteroidetes were more abundant in the colonic mucosal microbiota of patients with constipation. The profile of the fecal microbiota was associated with colonic transit before adjusting for constipation, age, body mass index, and diet; genera from Firmicutes (Faecalibacterium, Lactococcus, and Roseburia) correlated with faster colonic transit. Methane production was associated with the composition of the fecal microbiota, but not with constipation or colonic transit. Conclusions After adjusting for diet and

  10. Lower levels of cannabinoid 1 receptor mRNA in female eating disorder patients: association with wrist cutting as impulsive self-injurious behavior.

    PubMed

    Schroeder, Marc; Eberlein, Christian; de Zwaan, Martina; Kornhuber, Johannes; Bleich, Stefan; Frieling, Helge

    2012-12-01

    The cannabinoid 1 (CB 1) receptor as the primary mediator of the endocannabinoid (EC) system was found to play a role in eating disorders (EDs), depression, anxiety, and suicidal behavior. The CB 1 receptor is assumed to play a crucial role in the central reward circuitry with impact on body weight and personality traits like novelty-seeking behavior. In a previous study we found higher levels of CB 1 receptor mRNA in patients with anorexia nervosa (AN) and bulimia nervosa (BN) compared to healthy control women (HCW). The aim of the present study was to investigate the possible influence of the EC and the CB 1 receptor system on wrist cutting as self-injurious behavior (SIB) in women with EDs (n=43; AN: n=20; BN: n=23). Nine ED patients with repetitive wrist cutting (AN, n=4; BN, n=5) were compared to 34 ED patients without wrist cutting and 26 HCW. Levels of CB 1 receptor mRNA were determined in peripheral blood samples using quantitative real-time PCR. ED patients with self-injurious wrist cutting exhibited significantly lower CB 1 receptor mRNA levels compared with ED patients without wrist cutting and HCW. No significant differences were found between ED patients without a history of wrist cutting and HCW. Furthermore, a negative association was detected between CB 1 receptor mRNA levels and Beck Depression Inventory (BDI) scores. To our knowledge, this is the first study reporting a down-regulation of CB 1 receptor mRNA in patients with EDs and wrist cutting as SIB. Due to the small sample size, our results should be regarded as preliminary and further studies are warranted to reveal the underlying mechanisms.

  11. [Critical infusion incident caused by incorrect use of a patient-controlled analgesia pump].

    PubMed

    Steffen, M; von Hintzenstern, U; Obermayer, A

    2002-01-01

    We report on the case of a 17-year-old male patient who received a PCA pump after nephrectomy for postoperative analgesia. The syringe of the PCA pump was filled with 50 mg morphine and positioned about 25 cm above the heart. Since the piston of the syringe was not bolted while the pump was switched off, an unnoticed accidental evacuation of the whole content of the syringe into the intravenous line of the patient occurred because of gravity. This problem exists not only with PCA pumps, but can happen with syringe pumps in general. The incident, which can only be explained by strongly reduced venous pressure, was detected by chance. No harm resulted for the patient, but under different conditions it could have been lethal. This critical incident was caused by various factors: incorrect application in combination with insufficient experience or training, stress, inadequate handing-over of the patient and a lack of arrangements and instructions for procedures in routine situations. Suggestions for preventing such dangerous critical incidents are made and discussed. In particular, an algorithm for the correct procedure when inserting or changing the syringe of a syringe pump is presented.

  12. Banding cytogenetic analysis in pediatric patients with acute lymphoblastic leukemia (ALL) in a Brazilian population

    PubMed Central

    2013-01-01

    Background Cytogenetic studies in Brazilian population about childhood acute lymphoblastic leukemia (ALL), the most common childhood malignancy, are scarce. Moreover, Brazilian race is very heterogeneous and is made by the confluence of people of several different origins, from the original Native Brazilians, with the influx of Portuguese colonizers, Black African slaves, and recent European, Arab and Japanese immigration. The purpose of this prospective, multicentric study was to assess the sociodemographic, clinic and cytogenetic characteristics of the children treated for ALL in the Northeast region of Brazil. Results This study includes thirty patients between 4 months and 17 years old treated for ALL from January 1st, 2009 to November 30th, 2010. Cytogenetic analysis showed that in nineteen out of thirty patients (64%) presented some chromosome abnormalities, in which 53% corresponds to numerical abnormalities, 21% structural and numerical abnormalities, and 26% only structural changes. Moreover, seven patients presented complexes karyotype not yet described in the literature. Taken together these results show the importance of the cytogenetic analysis in ALL pediatric patients and illustrates that the studied population presented unexpected complexes karyotypes which were correlated to poor outcome. Conclusion The results demonstrate the importance of banding cytogenetics for ALL diagnosis despite the use of most modern techniques such as FISH and aCGH, and provide reliable insight into the ALL in Brazil. PMID:24025689

  13. Female Suicide Bombers

    DTIC Science & Technology

    2006-05-31

    USAWC STRATEGY RESEARCH PROJECT FEMALE SUICIDE BOMBERS by Ms. Debra D. Zedalis Department of the Army Civilian Dr. Anna Waggener Project Advisor This... Female Suicide Bombers 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Debra Zedalis 5d. PROJECT NUMBER 5e. TASK...ii iii ABSTRACT AUTHOR: Debra D. Zedalis TITLE: Female Suicide Bombers FORMAT: Strategy Research Project DATE: 19 March 2004 PAGES: 43

  14. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin

    PubMed Central

    Bader, Nimrah; Mirza, Lubna

    2016-01-01

    We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin. We recommend reserving SGLT2 inhibitor therapy to type 2 diabetics, discontinuing medication and treating patients presenting with ketoacidosis due to SGLT-2 inhibitors with higher concentrations of dextrose with appropriate doses of insulin to help resolve acidosis. PMID:27375734

  15. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin.

    PubMed

    Bader, Nimrah; Mirza, Lubna

    2016-01-01

    We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin. We recommend reserving SGLT2 inhibitor therapy to type 2 diabetics, discontinuing medication and treating patients presenting with ketoacidosis due to SGLT-2 inhibitors with higher concentrations of dextrose with appropriate doses of insulin to help resolve acidosis.

  16. Long-term response to first-line trabectedin in an elderly female patient with a metastatic leiomyosarcoma unfit for anthracycline

    PubMed Central

    Maruzzo, Marco; Brunello, Antonella; Diminutto, Alberto; Rastrelli, Marco

    2016-01-01

    Systemic chemotherapy comprising anthracycline monotherapy is the standard regimen for metastatic soft tissue sarcomas, particularly leiomyosarcomas, which have limited sensitivity to ifosfamide. However, the optimal chemotherapy regimen for elderly patients, especially those considered unfit for anthracyclines, is undefined. Trabectedin is a potent marine-derived antineoplastic drug with documented activity in liposarcomas and leiomyosarcomas. It is registered in Europe for the treatment of adult patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents. We report the long-term response to first-line trabectedin therapy in an elderly patient with metastatic leiomyosarcoma unfit for standard therapy. A 66-year-old woman underwent resection of a pelvic epithelioid leiomyosarcoma with positive margins in December 2002, followed by postoperative radiotherapy. In February 2012, she was diagnosed with multiple lung lesions and local relapse in the pelvis. As she was considered unsuitable for both anthracycline and ifosfamide because of cardiovascular comorbidities and because she was highly anxious at the prospect of developing alopecia, vomiting, and fatigue, we commenced treatment with trabectedin at 75% of the standard dose of 1.5 mg/m2 every 3 weeks. Treatment was well tolerated, and the patient continued treatment for 25 cycles, with disease stabilization according to the RECIST criteria and a partial response according to the Choi criteria. Disease progression was observed in November 2013 and the patient died 20 months after the diagnosis of metastases. Trabectedin may represent an alternative option for highly selected elderly patients with metastatic sarcoma and unfit for anthracyclines; careful monitoring of toxicities is strongly recommended. PMID:26629769

  17. Long-term response to first-line trabectedin in an elderly female patient with a metastatic leiomyosarcoma unfit for anthracycline.

    PubMed

    Maruzzo, Marco; Brunello, Antonella; Diminutto, Alberto; Rastrelli, Marco; Basso, Umberto

    2016-03-01

    Systemic chemotherapy comprising anthracycline monotherapy is the standard regimen for metastatic soft tissue sarcomas, particularly leiomyosarcomas, which have limited sensitivity to ifosfamide. However, the optimal chemotherapy regimen for elderly patients, especially those considered unfit for anthracyclines, is undefined. Trabectedin is a potent marine-derived antineoplastic drug with documented activity in liposarcomas and leiomyosarcomas. It is registered in Europe for the treatment of adult patients with advanced soft tissue sarcoma, after failure of anthracyclines and ifosfamide, or who are unsuited to receive these agents. We report the long-term response to first-line trabectedin therapy in an elderly patient with metastatic leiomyosarcoma unfit for standard therapy. A 66-year-old woman underwent resection of a pelvic epithelioid leiomyosarcoma with positive margins in December 2002, followed by postoperative radiotherapy. In February 2012, she was diagnosed with multiple lung lesions and local relapse in the pelvis. As she was considered unsuitable for both anthracycline and ifosfamide because of cardiovascular comorbidities and because she was highly anxious at the prospect of developing alopecia, vomiting, and fatigue, we commenced treatment with trabectedin at 75% of the standard dose of 1.5 mg/m every 3 weeks. Treatment was well tolerated, and the patient continued treatment for 25 cycles, with disease stabilization according to the RECIST criteria and a partial response according to the Choi criteria. Disease progression was observed in November 2013 and the patient died 20 months after the diagnosis of metastases. Trabectedin may represent an alternative option for highly selected elderly patients with metastatic sarcoma and unfit for anthracyclines; careful monitoring of toxicities is strongly recommended.

  18. Effects of device‑guided slow breathing training on exercise capacity, cardiac function, and respiratory patterns during sleep in male and female patients with chronic heart failure.

    PubMed

    Kawecka-Jaszcz, Kalina; Bilo, Grzegorz; Drożdż, Tomasz; Dębicka-Dąbrowska, Dorota; Kiełbasa, Grzegorz; Malfatto, Gabriella; Styczkiewicz, Katarzyna; Lombardi, Carolina; Bednarek, Agnieszka; Salerno, Sabrina; Czarnecka, Danuta; Parati, Gianfranco

    2017-01-10

    INTRODUCTION Slow breathing training (SBT) has been proposed as a new nonpharmacologic treatment in patients with chronic heart failure (CHF). OBJECTIVES The aim of this study was to assess the effects of SBT on exercise capacity, hemodynamic parameters, and sleep respiratory patterns in a relatively large sample of CHF patients. PATIENTS AND METHODS A crossover open study was conducted. Patients completed, in a random order, 10- to 12‑week SBT, with 2 15‑minute sessions of device‑guided SBT each day, reaching 6 breaths/ min, and a 10- to 12‑week follow‑up under standard care. Clinical data collection, polysomnography, echocardiography, 6‑minute walk test (6MWT), and laboratory tests were performed. RESULTS A total of 96 patients (74 men, 22 women) in New York Heart Association classes I-III, with an average age of 65 years and an ejection fraction (EF) of 31%, completed the study. Home‑based SBT was safe. After training, EF and 6MWT distance improved (EF: 31.3% ±7.3% vs 32.3% ±7.7%; P = 0.030; 6MWT: 449.9 ±122.7 m vs 468.3 ±121.9 m; P <0.001), and the apnea-hypopnea index decreased (5.6 [interquartile range (IQR), 2.1; 12.8] vs. 5.4 [IQR, 2.0; 10.8]; P = 0.043). CONCLUSIONS SBT improved physical capacity and systolic heart function; it also diminished sleep disturbances. The results support the benefits of SBT as a novel component of cardiorespiratory rehabilitation programs in patients with CHF.

  19. Factors that determine body composition of female systemic lupus erythematosus (SLE) patients in Sri Lanka: a comparative study using dual-energy x-ray absorptiometry.

    PubMed

    Liyanage, A; Lekamwasam, S; Dissanayake, S P; Munidasa, D

    2013-08-01

    Studies on body composition and its determinants among SLE patients are limited. Estimation of body composition, analysis of determinants and associations of different body compartments are important in planning long-term care of these patients. The aim of the study was to identify the changes in body composition among SLE patients and assess the effect of corticosteroid use, patient and disease-related variables on body composition. We compared lean mass, fat mass, bone mineral density (BMD), and bone mineral content (BMC) determined by dual-energy x-ray absorptiometry technology, in a group of premenopausal women with SLE (n = 27) and an age-matched healthy group of women (n = 27). The median (IQR) duration of SLE was 3 (2-5) years while median (IQR) duration and dose of prednisolone therapy were 108 (88 - 172) weeks and 9730 (6160-15360) mg, respectively. No significant difference was observed in body mass index (BMI) or total fat mass between the two groups. SLE patients, however, had significantly lower lean mass (p < 0.001), BMD (p < 0.001) and BMC (p < 0.005) than healthy controls. Among cases, compared with lean mass, total body fat content showed stronger associations with total body BMD (r = 0.49, p < 0.01) and total body BMC (r = 0.63, p < 0.01). When a stepwise regression model was fitted,