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Menstruation
Kinds of Menstruation Selected AbstractsThe Modern Period: Menstruation in Twentieth-Century America by Lara FreidenfeldsAMERICAN ANTHROPOLOGIST, Issue 1 2010Patricia Whelehan No abstract is available for this article. [source] Menstruation does not cause anemia: Endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal womenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2006Kathryn B.H. Clancy Menstruation has often been cited as a risk factor for iron-deficiency anemia. This study tested whether normal, premenopausal women's luteal endometrial thickness (ET) was associated with their red blood cell count (RBC) and hemoglobin concentrations (Hg), and therefore whether a high ET put women at risk for anemia. Endometrial thickness can be considered a reasonable proxy for menstrual blood loss in normal women. Twenty-six healthy women from the Mogielica Human Ecology Study Site in Poland, aged 20,40 years (29 ± 5.3 years, mean ± SD), were selected. Subjects' ET was measured by transvaginal ultrasound in the luteal phase of the menstrual cycle, and their red blood cell count and hemoglobin concentrations were measured by fasting morning blood samples. Controlling for day of ET measurement, RBC and Hg were positively correlated with ET (r2 = 0.24, P = 0.05; r2 = 0.25, P = 0.04, respectively). We propose that, contrary to popular understanding, a thicker endometrium suggests greater iron reserves, rather than greater risk for anemia, in healthy women. Am. J. Hum. Biol. 18:710,713, 2006. © 2006 Wiley-Liss, Inc. [source] How does premenstrual dysphoric disorder relate to depression and anxiety disorders?DEPRESSION AND ANXIETY, Issue 3 2003Mikael Landén M.D., Ph.D. Abstract Premenstrual dysphoric disorder (PMDD) is a severe variant of premenstrual syndrome that afflicts approximately 5% of all women of fertile age. The hallmark of this condition is the surfacing of symptoms during the luteal phase of the menstrual cycle, and the disappearance of symptoms shortly after the onset of menstruation. Whereas many researchers have emphasized the similarities between PMDD and anxiety disorders, and in particular panic disorder, others have suggested that PMDD should be regarded as a variant of depression. Supporting both these notions, the treatment of choice for PMDD, the serotonin reuptake inhibitors (SRIs), is also first line of treatment for depression and for most anxiety disorders. In this review, the relationship between PMDD on the one hand, and anxiety and depression on the other, is being discussed. Our conclusion is that PMDD is neither a variant of depression nor an anxiety disorder, but a distinct diagnostic entity, with irritability and affect lability rather than depressed mood or anxiety as most characteristic features. The clinical profile of SRIs when used for PMDD, including a short onset of action, suggests that this effect is mediated by other serotonergic synapses than the antidepressant and anti-anxiety effects of these drugs. Although we hence suggest that PMDD should be regarded as a distinct entity, it should be emphasized that this disorder does display intriguing similarities with other conditions, and in particular with panic disorder, which should be the subject of further studies. Also, the possibility that there are subtypes of PMDD more closely related to depression, or anxiety disorders, than the most common form of the syndrome, should not be excluded. Depression and Anxiety 17:122,129, 2003. © 2003 Wiley-Liss, Inc. [source] Female Adolescents and Their Sexuality: Notions of Honour, Shame, Purity and Pollution during the FloodsDISASTERS, Issue 1 2000Sabina Faiz Rashid This paper explores the experiences of female adolescents during the 1998 floods in Bangladesh, focusing on the implications of socio-cultural norms related to notions of honour, shame, purity and pollution. These cultural notions are reinforced with greater emphasis as girls enter their adolescence, regulating their sexuality and gender relationships. In Bangladeshi society, adolescent girls are expected to maintain their virginity until marriage. Contact is limited to one's families and extended relations. Particularly among poorer families, adolescent girls tend to have limited mobility to safeguard their ,purity'. This is to ensure that the girl's reputation does not suffer, thus making it difficult for the girl to get married. For female adolescents in Bangladesh, a disaster situation is a uniquely vulnerable time. Exposure to the unfamiliar environment of flood shelters and relief camps, and unable to maintain their ,space' and privacy from male strangers, a number of the girls were vulnerable to sexual and mental harassment. With the floods, it became difficult for most of the girls to be appropriately `secluded'. Many were unable to sleep, bathe or get access to latrines in privacy because so many houses and latrines were underwater. Some of the girls who had begun menstruation were distressed at not being able to keep themselves clean. Strong social taboos associated with menstruation and the dirty water that surrounded them made it difficult for the girls to wash their menstrual cloths or change them frequently enough. Many of them became separated from their social network of relations, which caused them a great deal of anxiety and stress. Their difficulty in trying to follow social norms have had far-reaching implications on their health, identity, family and community relations. [source] Age,environment model for breast cancerENVIRONMETRICS, Issue 3 2004Nobutane Hanayama Abstract In the field of breast cancer study, it has become accepted that crucial exposures to environmental risks might have occurred years before a malignant tumor is evident in human breasts, while age factors such as ages at menstruation have been known as risks for the disease already. To project trends in two such kinds of risks for the disease, the concept of environment effects is introduced for (age, period)-specific breast cancer mortality rates. Also, a new model, named the age,environment (AE) model, which assumes that the logarithm of the expected rate is a linear function of environment effects and age effects, is proposed. It is shown that, although environment effects have different meanings from period effects or cohort effects, in the age,period,cohort (APC) model, the range space of the design matrix for the AE model is included in that for APC model. It is seen, however, that the AE model provides a better fit to the data for females in Japan and the four Nordic countries than does the APC model in terms of AIC. From the results of ML estimation of the parameters in the AE model based on the data obtained in Japan, we see high levels of environment effects associated with the Sino,Japanese war, World War II and the environmental pollution due to the economy in the recovery period from the defeat. Besides, from those based on the data obtained in the four Nordic countries, we see high levels of environment effects associated with the environment becoming worse after the year of Helsinki Olympics and low levels of them associated with the period including the year of ,Miracle of the Winter War' in Finland. Copyright © 2004 John Wiley & Sons, Ltd. [source] Variability in bleeding phenotype in Amish carriers of haemophilia B with the 31008 C,T mutationHAEMOPHILIA, Issue 1 2009A. SHARATHKUMAR Summary., The aim of this study was to characterize the variability of bleeding phenotype and its association with plasma factor IX coagulant activity (FIX:C) in haemophilia B carriers in a large Amish pedigree with a unifying genetic mutation, C-to-T transition at base 31008 of the factor IX gene (Xq27.1,27.2). A cross-sectional survey of haemophilia B carriers included a multiple choice questionnaire evaluating symptoms of mucocutaneous bleeding, joint bleeding and bleeding after haemostatic stress [menstruation, postpartum haemorrhage (PPH), dental extractions and invasive surgeries]. Severity of bleeding was graded as 0 to 4, 0 being no bleeding whereas 4 being severe bleeding. Association between total bleeding scores and the FIX:C was evaluated. Sixty-four haemophilia B carriers participated in this study. Median age: 18 years (range 1,70 years); median bleeding score: 1 (range 0,8). Besides PPH, isolated symptoms of bruising, epistaxis, menorrhagia and postsurgical bleeding including dental extraction were not associated with lower FIX:C. Bleeding score ,3 was associated with involvement of at least two bleeding sites and a lower mean FIX:C of 42 ± 10.3% (95% CI 36.4,47.7) while a score >3 had involvement of ,2 sites and higher mean FIX:C of 54.9 ± 21.5% (95% CI 49,61), P = 0.005. Subcutaneous haematoma formation and bleeding after haemostatic stress requiring treatment were associated with bleeding scores ,3. Phenotypic variability existed among the carriers of haemophilia B who belonged to a single pedigree carrying a single unifying mutation. The utility of bleeding scores to define bleeding phenotype precisely in haemophilia B carriers needs further evaluation. [source] Epidemiology and Biology of Menstrual MigraineHEADACHE, Issue 2008Vincent T. Martin MD Migraine is frequently associated with menstruation in female migraineurs, and consequently it is commonly referred to as menstrually associated migraine. The trigger thought to be partially responsible for menstrually associated migraine is a significant drop in circulating estrogen that is noted during 2-3 days prior to onset of menses. It is estimated that approximately 50% of women have an increased risk of experiencing migraine during the premenstrual phase of decreasing estrogen levels. Understanding the biological basis of migraine associated with menses will facilitate an accurate diagnosis and help patients recognize time susceptible to migraine exacerbations. This paper will review the biological bases for the hormonal changes that occur during the menstrual cycle and review the prevalence and burden of menstrual migraine among female headache sufferers. [source] Menstrual Migraine: Case Studies of Women with Estrogen-Related HeadachesHEADACHE, Issue 2008Susan L. Hutchinson MD This paper presents 2 case scenarios that illustrate the complexity of diagnosing and managing migraine associated with hormonal changes. Migraine is commonly associated with comorbidies such as depression, anxiety, obesity, cardiovascular disease, as well as other conditions, thereby making management more challenging for the physician and the patient. The first case is a 35-year-old woman who has migraine almost exclusively during menstruation. She is under a physician's care for long-term management of premenstrual dysphoric disorder (PMDD). Achieving a differential diagnosis of pure menstrual migraine is illustrated, and a detailed treatment plan including use of a migraine miniprophylaxis protocol, management of her PMDD, and prescription of acute treatment medications is reviewed. The second case scenario describes the diagnosis of menstrually associated migraine in a woman who suffers from a frequent disabling migraine along with work-related anxiety and depression. This paper reviews her differential diagnosis, laboratory testing, treatment plan, including management of her comorbid anxiety and depressive symptoms. [source] Patterns of weight change after treatment for bulimia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2004Frances A. Carter Abstract Objective The current study examined changes in weight and body mass index (BMI) at 5-year follow-up among women treated for bulimia nervosa. Method The study comprised 80 women who had participated in a randomized clinical trial evaluating cognitive-behavior therapy for bulimia nervosa. The women had attended assessments at posttreatment and at 5-year follow-up while not pregnant. Results Changes in mean weight and BMI between posttreatment and 5-year follow-up were small in absolute terms and were not statistically significant. However, by the 5-year follow-up, approximately one half of the participants had either lost (31%) or gained (18%) 5 or more kilograms or were underweight (31%) or overweight (24%) as defined by BMI. Univariate analyses suggest that it is the patients who gain weight over the follow-up that are distinctive. Patients who gained weight over the follow-up were more likely to have commenced menstruation at a younger age, to have a lifetime history of being heavier, and to have been heavier and more dissatisfied with their body at pretreatment, posttreatment, and at 5-year follow-up. Conclusion Five years after treatment for bulimia nervosa, approximately one half of the participants had changed substantially in weight. For those who had changed, weight loss was more common than weight gain. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 36: 12,21, 2004. [source] Theoretical substruction: establishing links between theory and measurement of military women's attitudes towards menstrual suppression during military operationsJOURNAL OF ADVANCED NURSING, Issue 7 2009Lori L. Trego Abstract Title.,Theoretical substruction: establishing links between theory and measurement of military women's attitudes towards menstrual suppression during military operations. Aim., The aim of this paper is to establish a theoretical model for the exploration of the phenomenon of menstruation and women's attitudes towards menstrual suppression during military operations. Background., In the emerging field of literature that explores menstruation among military women, there are indications that menstrual symptoms and hygiene are problematic under the circumstances of deployment to military operations. While menstrual suppression may be a solution to problems that women encounter with menstruation during deployment, there is little research exploring the phenomenon. Data sources., CINAHL and Medline were used to locate peer reviewed journal papers published from 1977 to 2007. International military reports were obtained through an internet search engine (GoogleÔ). Discussion., Issues that military women encounter surrounding menstruation during deployment are framed according to components of human ecology and social ecology theories, creating a theoretical model for the study of military women's menstrual health. Theoretical substruction is then used to evaluate the proposed theoretical and operational systems for measuring military women's attitudes during deployment. The process of theoretical substruction validates the model and the theoretical integrity of the proposed research on women's attitudes towards suppression. Conclusion., A theory-based model for women's health under challenging environmental conditions will enhance the holistic consideration of women's health issues by care providers. The theoretical model clearly explicates the phenomenon of menstruation during deployment and the theoretical and operational systems are soundly linked in the proposed measurement model of military women's attitudes towards menstrual suppression. [source] Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samplesJOURNAL OF ADVANCED NURSING, Issue 3 2009Mehmet Z. Firat Abstract Title.,Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samples. Aim., This study is a report of an investigation of the psychometric properties of the Turkish version of the Menstrual Attitude Questionnaire. Background., Cultural, social and family environments influence women's beliefs about and attitudes towards menstruation. Awareness of these beliefs and/or attitudes and their cultural origins is necessary to understand women and their reactions to menstruation when offering health care. Although the Menstrual Attitude Questionnaire has been used in several studies, the psychometric properties of the Turkish version have not been investigated. Methods., Confirmatory factor analyses were carried out with two different samples , high school (n = 650) and undergraduate university students (n = 569) , in Turkey in the spring semester of 2006. Exploratory factor analyses were then used to modify the factor structure. Results., Confirmatory factor analysis did not confirm the factor model reported in the United States of America. However, compared with British and Indian samples, Turkish attitudes showed better fit than both British and Indian samples with comparative fit index values of 0·776 and 0·797 for the high school and university samples respectively. Finally, exploratory factor analysis yielded a 28-item measure for the high school sample and 31-item measure for the university sample, with a 5-factor solution. Reliability estimates of both scales were satisfactory, being 0·73 for the high school and 0·79 for the university sample. Conclusion., The modified 5-factor Menstrual Attitude Questionnaire could be a useful tool for assessing menstrual attitudes among Turkish high school and university students. The overall score permits comparison with results from earlier studies using the original instrument. [source] Adhesion molecules in endometrial epithelium: tissue integrity and embryo implantationJOURNAL OF ANATOMY, Issue 1 2009Harmeet Singh Abstract Cell adhesion in endometrial epithelium is regulated to maintain the continuity and protectiveness of the luminal covering cell layer while permitting interstitial implantation of the embryo during a restricted period of about 4 days. Many apparently normal embryos fail to implant, and epithelial-embryo adhesion remains a poorly understood phenomenon. After menstruation, epithelial regeneration occurs by epiboly from the basal residues of glands, an activity that requires migration on extracellular matrix as well as cell,cell cohesion. Here we review current knowledge of adhesion molecules in the epithelium. [source] Necrolytic acral erythema without hepatitis C infectionJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2009Yu-Hung Wu Necrolytic acral erythema is a newly described entity characterized by sharply demarcated scaly plaques on the dorsum of the hands and feet. More than 30 patients have been reported since 1996, all of whom had anti-hepatitis C virus antibody. A 32-year-old Taiwanese woman had been diagnosed with and treated for systemic lupus erythematosus with lupus nephritis about 10 years earlier. Soon thereafter, she noted several well-demarcated keratotic plaques with erythematous borders on her feet, with sparing of the soles. Histopathology showed diffuse parakeratosis with a neutrophil infiltrate, hypogranulosis, pale upper keratinocytes, scattered and grouped dyskeratotic cells, psoriasiform hyperplasia and a mild lymphocytic infiltrate in the upper dermis. The diagnosis was made after three biopsies. The lesions regularly worsened just before and during menstruation, but patch and intradermal tests for progesterone and estrogen were negative. There was no evidence of either hepatitis B or hepatitis C infection. The lesions did not respond to treatment with zinc. The rash regressed spontaneously when corticosteroids were stopped and recurred when they were restarted, finally resolving completely after she was treated with high-dose pulse steroids for her lupus. [source] Assessment of progestin-only therapy for endometriosis in macaqueJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008G. Maginnis Abstract Background, Endometriosis is a condition where endometrium-like tissue forms lesions at ectopic sites outside the uterus. In women, oral contraceptive pills and progestins are often prescribed as therapy for early stage endometriosis. In contrast, in macaques the disease is frequently advanced at the time of diagnosis and ovariectomy is the standard therapy. However, surgery is contraindicated in many patients. A review of 15 endometriosis cases over the past 10 years at the Oregon National Primate Research Center (ONPRC) revealed that 5 failed to show improvement after ovariectomy and were subsequently euthanized. Therefore, our goal was to assess the feasibility of treating endometriosis in macaques with chronic progesterone (P) as an alternative therapy for the disease. Methods, Seven adult rhesus macaques with advanced endometriosis were identified by clinical symptoms and endometriosis was confirmed by abdominal palpation, ultrasound examination, and/or aspiration of menstrual blood from abdominal cysts. The patients were chronically treated with Silastic capsules that released 5,7 ng P /ml in blood for up to 20 months. During treatment the patients were assessed daily and scored numerically for appetite, activity, attitude, abdominal discomfort and menstruation by the Clinical Veterinary staff. The patients were then re-examined by abdominal palpation and ultrasound for the disease at the end of treatment. Results, During the first 2 weeks of treatment, endometriotic symptoms improved significantly in all the patients (P < 0.05). This was associated with a significant increase in body weight and significant reduction in abdominal discomfort and menstrual bleeding. Two of the patients gradually developed increased symptoms of the disease after 5 months of treatment. Post-treatment abdominal examination revealed that 2/5 patients continued to have an abdominal mass even though symptoms were suppressed. Conclusions, We conclude that continuous P treatment of rhesus monkeys provides therapeutic benefit to reduce symptoms of endometriosis and may provide an option for cases where ovariectomy is contraindicated. Supported by RR-00163. [source] Risk Factors for Breast Cancer in Jordanian WomenJOURNAL OF NURSING SCHOLARSHIP, Issue 1 2002Wasileh Petro-Nustas Purpose: To investigate risk factors associated with breast cancer in Jordanian women. Design: Retrospective case-control study based on data from the Jordanian Cancer Registry in 1996. Methods: One hundred women with breast cancer (cases) and 100 women without breast cancer (controls) were interviewed in their homes. A questionnaire was developed in Arabic to investigate the risk factors associated with breast cancer in Jordanian women. Findings: Bivariate analysis indicated significant differences between the cases and controls, including age of menarche and menopause, use of households' pesticides, stressful life events, and direct trauma to the breast. Logistic regression analysis indicated higher odds ratios for breast enlargement, irregular menstruation, use of hair dye, oral contraceptives, and fertility drugs. Conclusions: Significant differences in correlates of breast cancer were found between the cases and the controls. [source] Soy extract phytoestrogens with high dose of isoflavones for menopausal symptomsJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2009Augusto Ferrari Abstract Aim:, The aim of the present study was to assess the efficacy and safety of a standardized compound based on an extract of soy phytoestrogens, with high doses of isoflavones in the management of menopausal hot flushes. Methods:, A total of 180 women aged 40,65 years with a minimum of five moderate-to-severe hot flushes in the last 7 days at baseline and absence of menstruation for at least 6 months participated in a 12-week prospective, randomized, double-blind, placebo-controlled multicenter trial. After a 2-week run-in period, women received one tablet a day of 80 mg isoflavones (corresponding to 60 mg of genistein) or a matching placebo. Results:, The mean daily number of moderate-to-severe hot flushes decreased in both study groups, but the reduction was greater in the isoflavones arm at 6 (36.2%) and 12 weeks (41.2%) than in the placebo arm (24.0% at 6 weeks, 29.3% at 12 weeks), with a difference of 1.1 (95% CI [,2.0 to ,0.06]) (P = 0.038) at 6 weeks and 1.1 (95% CI [,2.05 to ,0.15]) (P = 0.023) at 12 weeks. Similar findings were obtained for hot flushes of any intensity. The Kupperman index decreased in both study groups. Relief of hot flushes was greater when time to menopause was ,12 months and in cases of BMI ,27 kg/m2. Conclusion:, In daily practice conditions, high doses of isoflavones, particularly genistein, can be used for the management of hot flushes in postmenopausal women not treated with hormone replacement therapy due to their superior efficacy to placebo and very good safety profile. [source] Clinical efficacy of Kampo medicine (Japanese traditional herbal medicine) in the treatment of primary dysmenorrheaJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2008Atsuko Oya Abstract Objective:, We intended to evaluate the clinical efficacy of Kampo medicine, a Japanese traditional herbal medicine, for primary dysmenorrhea which was prescribed according to the Kampo diagnosis, with classification of its severity. Method:, A retrospective evaluation of Kampo treatment in 176 subjects with dysmenorrhea during the previous 12 years was performed. In order to minimize the subjective discretion of the severity of symptoms, classification of the severity level of abdominal pain during menstruation was applied by considering the requirement for non-steroidal anti-inflammatory drugs (NSAIDs) and disturbance of daily activities. The following severity levels were used: no abdominal pain (level 0), abdominal pain with no requirement of NSAIDs (level 1), abdominal pain with no daily activity disturbances with use of NSAIDs (level 2), and painful menstruation which required absenteeism even with use of NSAIDs (level 3). Results:, Severity levels before and after Kampo treatment were defined in 108 subjects. Distribution of the severity levels in 108 subjects was significantly changed by Kampo treatment; the numbers of cases in levels 0, 1, 2, and 3 changed from 0 (0%), 0 (0%), 47 (43.5%), and 61 (56.5%) to 5 (4.6%), 42 (38.9%), 51 (47.2%), and 10 (9.3%), respectively. (P < 0.0001) There were 25 kinds of Kampo formulae prescribed in effective cases. Conclusion:, Kampo medicine prescribed according to Kampo diagnosis reduced the severity of primary dysmenorrhea and is therefore suggested to be beneficial in improving quality of life. [source] Immunological factors and their role in the genesis and development of endometriosis ARTICLE HAS BEEN RETRACTEDJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2006Charalambos Siristatidis Abstract The article presents an overview of immunological factors and their role in the genesis and development of endometriosis, with emphasis on inflammatory cytokines and growth and adhesion factors. Although retrograde menstruation is a common phenomenon among women of reproductive age, not all women with retrograde menstruation suffer the disease. Development of endometriosis seems to be a complex process, facilitated by several factors, including quantity and quality of endometrial cells in peritoneal fluid (PF), increased inflammatory activity in PF, increased endometrial,peritoneal adhesion and angiogenesis, reduced immune surveillance and clearance of endometrial cells, and increased production of autoantibodies against endometrial cells. Potential biomarkers like cytokines and autoantibodies, upregulated during development of endometriosis, seem useful in the development of a non-surgical diagnostic tool. In this review work, the immune role in endometriosis is examined through the role of immunological factors in the genesis and development of the disease. Furthermore, it could be concluded that, although endometriosis can be treated using hormonal suppression, there is a need today for non-hormonal drugs, probably to modulate immune function, in order to confront the disease and alleviate pain or infertility without inhibition of ovulation. [source] The natural history of hidradenitis suppurativaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2000JM Von Der Werth Abstract Aim,To investigate aspects of the natural history of hidradenitis. Background,The natural history of hidradenitis suppurativa (HS) is not well known. There is incomplete published data on the average age of disease onset, progression of the disease, average monthly incidence and duration of boils, and factors that relieve or exacerbate disease symptoms. Study design,Questionnaire-based survey among HS patients identified from hospital records of three hospitals in Nottinghamshire, UK. Results,One hundred and ten of 156 questionnaires (70.5%) were returned, 93 from females and 17 from males. The average patient's age was 40.1 years and the average reported age of disease onset was 21.8 years. At the time of the survey patients had suffered an average disease duration of 18.8 years. Most patients (98 of 110) still had experienced active disease within the past year. There was some evidence that in women the condition has a tendency to ease or subside after the menopause. Forty-four per cent of women felt that their condition was aggravated by menstruation. Thirty-eight per cent of patients gave a positive family history of the disorder. The average duration of painful boils was 6.9 days. In addition, 62% of patients acknowledged the presence of permanently painful boils that failed to subside. Patients developed a median of two boils per month. Factors that could aggravate the condition were primarily sweating or heat, stress or fatigue and tight clothing or friction. Factors that could improve the condition consisted largely of a variety of medical treatments and a number of life-style measures, such as swimming or baths. Twenty-four per cent of patients had failed to find anything at all to help their condition, despite an average disease duration of almost 19 years. Conclusions,The study highlights several of the factors that make HS one of the most distressing dermatological diseases, such as the average monthly incidence of painful lesions, their average duration and the chronicity of the disease. It seems striking that the mean duration of an HS boil (6.9 days) roughly equals the duration of an average course of antibiotics. The postulated response of HS to oral antibiotics may thus simply have its explanation in the natural history of the condition itself. [source] Wheat-dependent exercise-induced anaphylaxis exclusively during menstruationALLERGY, Issue 10 2010J. Fischer No abstract is available for this article. [source] The evolution of progesterone receptor ligandsMEDICINAL RESEARCH REVIEWS, Issue 3 2007Kevin P. Madauss Abstract Progesterone is one of the first nuclear receptor hormones to be described functionally and subsequently approached as a drug target. Because progesterone (1) affects both menstruation and gestation via the progesterone receptor (PR), research aimed at modulating its activity is usually surrounded by controversy. However, ligands for PR were developed into drugs, and their evolution can be crudely divided into three periods: (1) drug-like steroids that mimic the gestational properties of progesterone; (2) drug-like steroids with different properties from progesterone and expanded therapeutic applications; and (3) non-steroidal PR ligands with improved selectivity and modulator properties and further expanded therapeutic applications. Although the latter have yet to see widespread clinical applications, their development is founded on a half century of research, and they represent the future for this drug target. © 2006 Wiley Periodicals, Inc. Med Res Rev, 27, No. 3, 374,400, 2007 [source] Gender-medicine aspects in allergologyALLERGY, Issue 5 2008E. Jensen-Jarolim Despite the identical immunological mechanisms activating the release of mediators and consecutive symptoms in immediate-type allergy, there is still a clear clinical difference between female and male allergic patients. Even though the risk of being allergic is greater for boys in childhood, almost from adolescence onwards it seems to be a clear disadvantage to be a woman as far as atopic disorders are concerned. Asthma, food allergies and anaphylaxis are more frequently diagnosed in females. In turn, asthma and hay fever are associated with irregular menstruation. Pointing towards a role of sex hormones, an association of asthma and intake of contraceptives, and a risk for asthma exacerbations during pregnancy have been observed. Moreover, peri- and postmenopausal women were reported to increasingly suffer from asthma, wheeze and hay fever, being even enhanced by hormone replacement therapy. This may be on account of the recently identified oestradiol-receptor-dependent mast-cell activation. As a paradox of nature, women may even become hypersensitive against their own sex hormones, resulting in positive reactivity upon intradermal injection of oestrogen or progesterone. More importantly, this specific hypersensitivity is associated with recurrent miscarriages. Even though there is a striking gender-specific bias in IgE-mediated allergic diseases, public awareness of this fact still remains minimal today. [source] A Study of Triggers of Migraine in IndiaPAIN MEDICINE, Issue 1 2010Rama K. Yadav DM ABSTRACT Objective., To evaluate the migraine triggers in consecutive patients and correlate these with demographic and clinical variables. Design., A prospective study. Setting., Tertiary care teaching hospital. Subject and Methods., A total of 182 patients with migraine were included whose age ranged between 14 to 58 years and 131 were females. Duration of migraine ranged between 6 and 260 months. Endogenous and exogenous migraine triggers were inquired using a questionnaire. Severity of migraine, associated symptoms, and functional disability were recorded. Presence of trigger was correlated with various demographic and clinical variables. Results., Migraine triggers were present in 160 (87.9%) patients and included emotional stress in 70%, fasting in 46.3%, physical exhaustion or traveling in 52.5%, sleep deprivation in 44.4%, menstruation in 12.8%, and weather changes in 10.1% patients. Multiple triggers (>2) were present in 34.4% patients. Conclusion., The triggers in the Indian migraine patients are similar to other populations but for dietary factors. [source] Compound melanocytic nevus arising in a mature cystic teratoma of the ovaryPATHOLOGY INTERNATIONAL, Issue 11 2001Naoto Kuroda A 28-year-old woman complained of irregular menstruation. Abdominal ultrasound and magnetic resonance imaging (MRI) examinations revealed a cystic tumor in the left ovary. A histological examination of the resected ovary revealed that the lesion was a mature cystic teratoma. In this tumor, components such as skin with appendages, a thyroid gland, mucosa of the digestive tract and a submandibular gland were observed. Interestingly, compound melanocytic nevus was also present in the skin component. To the best of our knowledge, this is the sixth reported case of nevus arising in a mature cystic teratoma of the ovary. Despite the extreme rarity of such a lesion, pathologists should recognize the possibility of such lesions occurring in ovarian teratoma. [source] Agreement between administrative databases and medical charts for pregnancy-related variables among asthmatic women,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Anne Vilain MSc Abstract Purpose To determine the validity of pregnancy variables recorded in administrative databases of Quebec using patient medical charts as the gold standard among asthmatic pregnant women. Methods Three administrative databases were linked and provided information on maternal, pregnancy and infant characteristics for 726 pregnant asthmatic women who delivered in 1990,2000. Algorithms were developed to measure variables that were not recorded directly in the databases or to minimize the number of missing values for variables recorded in two or more databases. Medical file data were collected by two trained research nurses in 43 hospitals. The validity of categorical variables was assessed with sensitivity, specificity, predictive positive values (PPVs) and predictive negative values (PNVs), whereas the validity of continuous variables was assessed with Pearson correlation using the medical chart as the gold standard. Results The sensitivity of the sex of the baby, previous live birth and previous pregnancy ranged from 0.97 to 0.99. Corresponding figures were 0.92,0.98 for specificity. We also found high correlation coefficients, ranging from 0.875 to 0.999 for the length of gestation, dates of last menstruation and delivery, maternal age and birth weight. Conclusion Pregnancy-related variables recorded in administrative databases or derived from algorithms based on two or more databases were found to be highly valid as compared to the medical chart among asthmatic women. Copyright © 2008 John Wiley & Sons, Ltd. [source] Regulating menstruation: Beliefs, practices, interpretationsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2002Zxy-Yann Jane LuArticle first published online: 21 JUN 200 No abstract is available for this article. [source] Treatment with intravenous hyperalimentation for severely anorectic patients and its outcomePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2004TAKASHI TONOIKE md Abstract In treating patients with severe anorexia nervosa, it is important to improve their physical condition first. Patients who had lost close to 60% standard bodyweight (SBW) were candidates for inpatient treatment due to the mortality risk. With 80% SBW as the target for therapy, they were given both intravenous hyperalimentation and food by oral intake in order to improve their physical condition. In total, 51 patients were admitted. One died and four patients dropped out in the course of treatment. Forty-six patients who completed the inpatient treatment were reviewed. Although ,admitted ,with ,an ,average ,weight ,of ,approximately ,60%,SBW, ,they ,were ,discharged with a weight of approximately 80% SBW after approximately 60 days. An average follow up of 25.0 months was conducted, and two patients were found to have died. The mean weight, percentage resuming menstruation, and rehospitalization rate of the 44 survivors were 79% SBW, 23%, and 32%, respectively. The patients with the restricting type of anorexia had an earlier onset of the disorder and a better social outcome. Patients in whom onset occurred at a younger age had a better social outcome. After being discharged, the majority of the patients continued treatment as outpatients. Although the results were similar to those of conventional studies in terms of outcome, the shorter hospitalization was significant. Overall, in the treatment of patients with severe anorexia nervosa, it is important to begin psychotherapy while trying to improve their physical condition. [source] Reproductive ecology and the endometrium: Physiology, variation, and new directionsAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue S49 2009Kathryn B.H. Clancy Abstract Endometrial function is often overlooked in the study of fertility in reproductive ecology, but it is crucial to implantation and the support of a successful pregnancy. Human female reproductive physiology can handle substantial energy demands that include the production of fecund cycles, ovulation, fertilization, placentation, a 9-month gestation, and often several years of lactation. The particular morphology of the human endometrium as well as our relative copiousness of menstruation and large neonatal size suggests that endometrial function has more resources allocated to it than many other primates. The human endometrium has a particularly invasive kind of hemochorial placentation and trophoblast that maximizes surface area and maternal,fetal contact, yet these processes are actually less efficient than the placentation of some of our primate relatives. The human endometrium and its associated processes appear to prioritize maximizing the transmission of oxygen and glucose to the fetus over efficiency and protection of maternal resources. Ovarian function controls many aspects of endometrial function and thus variation in the endometrium is often a reflection of ecological factors that impact the ovaries. However, preliminary evidence and literature from populations of different reproductive states, ages and pathologies also suggests that ecological stress plays a role in endometrial variation, different from or even independent of ovarian function. Immune stress and psychosocial stress appear to play some role in the endometrium's ability to carry a fetus through the mechanism of inflammation. Thus, within reproductive ecology we should move towards a model of women's fecundity and fertility that includes many components of ecological stress and their effects not only on the ovaries, but on processes related to endometrial function. Greater attention on the endometrium may aid in unraveling several issues in hominoid and specifically human evolutionary biology: a low implantation rate, high rates of early pregnancy loss, prenatal investment in singletons but postnatal support of several dependent offspring at once, and higher rate of reproductive and pregnancy-related pathology compared to other primates, ranging from endometriosis to preeclampsia. The study of the endometrium may also complicate some of these issues, as it raises the question of why humans have a maximally invasive placentation method and yet slow fetal growth rates. In this review, I will describe endometrial physiology, methods of measurement, variation, and some of the ecological variables that likely produce variation and pregnancy losses to demonstrate the necessity of further study. I propose several basic avenues of study that leave room for testable hypotheses in the field of reproductive ecology. And finally, I describe the potential of this work not just in reproductive ecology, but in the resolution of broader women's health issues. Yrbk Phys Anthropol 52:137,154, 2009. © 2009 Wiley-Liss, Inc. [source] Dynamics of circulating concentrations of gonadotropins and ovarian hormones throughout the menstrual cycle in the bonnet monkey: role of inhibin A in the regulation of follicle-stimulating hormone secretionAMERICAN JOURNAL OF PRIMATOLOGY, Issue 10 2009P.S. Suresh Abstract In higher primates, increased circulating follicle-stimulating hormone (FSH) levels seen during late menstrual cycle and during menstruation has been suggested to be necessary for initiation of follicular growth, recruitment of follicles and eventually culminating in ovulation of a single follicle. With a view to establish the dynamics of circulating FSH secretion with that of inhibin A (INH A) and progesterone (P4) secretions during the menstrual cycle, blood was collected daily from bonnet monkeys beginning day 1 of the menstrual cycle up to 35 days. Serum INH A levels were low during early follicular phase, increased significantly coinciding with the mid cycle luteinizing hormone (LH) surge to reach maximal levels during the mid luteal phase before declining at the late luteal phase, essentially paralleling the pattern of P4 secretion seen throughout the luteal phase. Circulating FSH levels were low during early and mid luteal phases, but progressively increased during the late luteal phase and remained high for few days after the onset of menses. In another experiment, lutectomy performed during the mid luteal phase resulted in significant decrease in INH A concentration within 2,hr (58.3±2 vs. 27.3±3,pg/mL), and a 2- to 3-fold rise in circulating FSH levels by 24,hr (0.20±0.02 vs. 0.53±0.14,ng/mL) that remained high until 48,hr postlutectomy. Systemic administration of Cetrorelix (150,µg/kg body weight), a gonadotropin releasing hormone receptor antagonist, at mid luteal phase in monkeys led to suppression of serum INH A and P4 concentrations 24,hr post treatment, but circulating FSH levels did not change. Administration of exogenous LH, but not FSH, significantly increased INH A concentration. The results taken together suggest a tight coupling between LH and INH A secretion and that INH A is largely responsible for maintenance of low FSH concentration seen during the luteal phase. Am. J. Primatol. 71:817,824, 2009. © 2009 Wiley-Liss, Inc. [source] Cytologic, hormonal, and ultrasonographic correlates of the menstrual cycle of the New World monkey Cebus apellaAMERICAN JOURNAL OF PRIMATOLOGY, Issue 3 2005R.E. Ortiz Abstract Few reports on the reproductive physiology of Cebus apella have been published. In this study we characterized menstrual cycle events by means of vaginal cytology, ultrasonography (US), and hormonal measurements in serum during three consecutive cycles in 10 females, and assessed the probability that ovulation would occur in the same ovary in consecutive cycles in 18 females. The lengths and phases of the cycles were determined according to vaginal cytology. Taking the first day of endometrial bleeding as the first day of the cycle, the mean cycle length ± SEM was 19.5±0.4 days, with follicular and luteal phases lasting 8.2±0.2 and 11.3±0.4 days, respectively. The follicular phase included menstruation and the periovulatory period, which was characterized by the presence of a large number of superficial eosinophilic cells in the vaginal smear. The myometrium, endometrium, and ovaries were clearly distinguished on US examination. During each menstrual cycle a single follicle was recruited at random from either ovary. The follicle grew from 3 mm to a maximum diameter of 8,9 mm over the course of 8 days, in association with increasing estradiol (E2) serum levels (from 489±41 to 1600±92 pmol/L). At ovulation, the mean diameter of the dominant follicle usually decreased by >20%, 1 day after the maximum E2 level was reached. Ovulation was associated with an abrupt fall in E2, a decreased number of eosinophilic cells, the presence of leukocytes and intermediate cells in the vaginal smear, and a progressive increase in progesterone (P) levels that reached a maximum of 892±65 nmol/L on days 3,6 of the luteal phase. The menstrual cycle of Cebus apella differs in several temporal and quantitative aspects from that in humans and Old World primates, but it exhibits the same correlations between ovarian endocrine and morphologic parameters. Am. J. Primatol. 66:233,244, 2005. © 2005 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||