Journal of women's health
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Journal of women's health · Oct 2024
Abnormal Pathology Following Vaginal Hysterectomy for Pelvic Organ Prolapse Repair.
Objective: Uterine-sparing surgery for pelvic organ prolapse (POP) repair has shown good results, but the potential negative implications of leaving the uterus in place are yet to be fully defined. We aimed to assess the risk of unanticipated abnormal gynecological pathology at the time of reconstructive pelvic surgery. Methods: A retrospective consecutive case series including women who underwent vaginal hysterectomy for POP repair at a tertiary medical center in 2006-2020. ⋯ In the 35 patients after BSO, adnexal findings were normal (77.2%) or benign (22.8%). Conclusions: Premenopausal women with uterovaginal prolapse and normal preoperative evaluation have a minimal risk of significant abnormal uterine pathology. In postmenopausal women, the risk of unanticipated malignant uterine pathology is 0.7% and 3.2% for significant premalignancy.
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Background: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are risk factors for future cardiovascular disease, yet few individuals receive postpartum care with primary care clinicians (PCP). To facilitate transitions of care to PCPs and improve cardiovascular health monitoring within the first 13 months postpartum, we developed and piloted an enhanced postpartum referral pathway for patients with GDM or HDP. Methods: Eligible patients included those who received perinatal care at a large, urban, academic medical center, experienced GDM or HDP during their most recent pregnancy, and lacked an existing PCP. ⋯ Results: Of 129 individuals referred, 48.1% attended a PCP visit, 31.8% completed cholesterol screening, and 41.9% completed HbA1c screening within 13 months postpartum. After adjusting for age, parity, insurance, and referral indication, referred individuals had greater odds for each outcome (PCP visit: aOR = 6.0, 95% CI 4.0-9.0; cholesterol: aOR = 2.4, 95% 1.6-3.9; HbA1c: aOR = 2.5, 95% CI 1.7-3.7) compared with nonreferred individuals in the same time period. Discussion: A enhanced postpartum PCP referral pathway pilot for birthing individuals was associated with improved follow-up in the first year postpartum.
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Journal of women's health · Oct 2024
Gender and Professional Title Use in Internal Medicine Resident Narrative Assessments.
Background: Residency is a time of personal and professional growth. Resident assessment and feedback are an integral part of that process. However, assessment may be influenced by various types of bias, including gender bias. ⋯ After adjusting for repeated faculty and resident encounters with random-effects model, secondary analysis found no significant difference in evaluation of word count between gendered dyads. Conclusions: The analysis found no significant difference in professional title usage based on resident-faculty dyads. In our analysis, female residents were significantly more likely to have their professional title used on assessments than male residents.
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Journal of women's health · Oct 2024
Association between Age at First Birth and Long-Term Dental Caries Experience among Women in the United States.
Background: Pregnant women are at a higher risk of caries compared to nonpregnant women, and higher parity is a risk factor for untreated caries and tooth loss. However, it is unknown whether the timing of birth is associated with dental caries experience over time. Materials and Methods: This study is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES), 2011-2018. ⋯ After adjusting for sociodemographic variables, time since last dental visit, and reproductive health factors, women with an AFB of <18 years (IRR, 1.10; 95% CI, 1.01-1.21) or 18-20 years (IRR, 1.11; 95% CI, 1.01-1.21) had significantly higher DMFT index scores compared to those with an AFB of 30-32 years. Conclusions: This study suggests that younger maternal AFB may be associated with greater dental caries experience. More rigorous studies are necessary to determine how to improve oral health outcomes during pregnancy and postpartum.
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Journal of women's health · Oct 2024
Sex Differences in the Blood Metabolome During Acute Response to Ischemic Stroke.
Introduction: Females suffer greater lifetime risk of stroke and greater morbidity and mortality from stroke compared with males. This study's objective was to identify differences in metabolomic profiling of females and males with stroke and which differences were associated with neurological outcome. Methods: Females and males with acute ischemic stroke enrolled in the Emergency Medicine Specimen Bank at a comprehensive stroke center provided whole blood samples upon arrival for mass spectrometry-based metabolomics. ⋯ GDP and dehydroascorbate were significantly associated with 24-hour NIHSS (p = 0.0991). Conclusions: Few metabolites were differentially abundant in blood after a stroke when comparing females with males and controlling for confounders, but the interactions between biological sex and GDP, as well as biological sex and dehydroascorbate, were associated with 24-hour neurological function. This has important implications for future studies that evaluate the therapeutic potential of these metabolites in ischemic stroke.