Journal of women's health
-
Journal of women's health · Oct 2009
Effect of hospital setting and volume on clinical outcomes in women with gestational and type 2 diabetes mellitus.
Efforts to improve health care outcomes in the United States have led some organizations to recommend specific hospital settings or case volumes for complex medical diagnoses and procedures. But there are few studies of the effect of setting and volume on maternal outcomes, particularly in complicated conditions, such as diabetes. Our objective was to estimate the effect of hospital setting and volume on childbirth morbidity and length of stay in pregnancies complicated by type 2 and gestational diabetes. ⋯ Among women with type 2 and gestational diabetes, hospital setting is associated with a higher likelihood of severe maternal morbidity and length of stay, independent of volume. Patient case mix accounts for some of the variation across settings. The volume-outcome relationship found with other complex medical conditions or procedures was not found among diabetic pregnancies. Further investigations are needed to explain variations in outcomes across hospital settings and volumes.
-
Journal of women's health · Oct 2009
ReviewCurrent and emerging pharmacologic therapies for the management of postmenopausal osteoporosis.
Postmenopausal osteoporosis is an asymptomatic skeletal disease that is often underdiagnosed and undertreated. Osteoporotic fractures are associated with substantial morbidity and mortality and impaired quality of life-socially, emotionally, and financially. Considering the growing burden of osteoporotic fractures worldwide, there remains an ongoing need for progress in the diagnosis of osteoporosis, identification of individuals at high fracture risk, and treatment to prevent fractures. ⋯ Emerging therapies for postmenopausal osteoporosis include novel SERMs (bazedoxifene, lasofoxifene, ospemifene, arzoxifene) and denosumab. Because SERMs can display mixed functional estrogen receptor agonist or antagonist activity depending on the target tissue, they may confer beneficial effects on bone with limited stimulation of other tissues (e.g., breast, endometrium). Clinical investigation of these promising new agents is ongoing to evaluate efficacy and safety, with the goal of developing effective strategies to maximize long-term tolerance, compliance, and persistence with therapy.
-
Journal of women's health · Oct 2009
Comparative StudyCharacteristics associated with mammography screening among both Hispanic and non-Hispanic white women.
This study explores whether certain population characteristics are associated with adherence to mammography screening guidelines among Hispanic and non-Hispanic white (NHW) women living in the southwestern United States. ⋯ Ethnic-specific characteristics appear to explain differences in mammography adherence among Hispanic and NHW women. Disparities in screening rates, late-stage disease and breast cancer mortality that impact Hispanic women could potentially be addressed more effectively by interventions that specifically target the unique characteristics of the Hispanic population.
-
Journal of women's health · Oct 2009
Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination.
To describe human papillomavirus (HPV) vaccine uptake, predictors of vaccination, and barriers to vaccination in young women. ⋯ Interventions to increase HPV vaccination rates in women in the catch-up age group for vaccination should ensure that vaccine costs are covered, promote HPV vaccination as normative, and establish clinic-based systems to prevent missed opportunities for vaccination.
-
Journal of women's health · Oct 2009
Prevalence of urinary incontinence and its association with body mass index among women in Puerto Rico.
Urinary incontinence (UI) affects the quality of life of millions of women world-wide. Prevalence estimates for UI range from 10% to 40%, but information on young and mid-life women, especially among Hispanics, is limited. This study estimated UI prevalence and its association with body mass index (BMI) in a population-based sample of 276 female residents of Bayamón, Puerto Rico (PR) aged 21-64 years. ⋯ UI is a public health problem among this population, and obesity marginally increases the possibility of having this condition. Public health efforts should focus on reducing obesity in PR, in order to have an impact on UI morbidity.