Journal of women's health
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Recent studies have shown that stroke has a differential impact in women compared to men. Women are more likely to survive strokes than men, yet they experience more severe strokes resulting in greater poststroke disability. However, few studies have characterized sex differences in functional ability after stroke. This study examined sex differences in long-term disability among stroke survivors. ⋯ The functional outcomes of men stroke survivors were significantly greater than women. The specific factors that contribute to sex differences in stroke-related outcomes are not entirely clear. Future research is needed to better understand these differences to ensure that equity of care is received.
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Journal of women's health · Apr 2018
Representation of Women and Minorities in Clinical Trials for New Molecular Entities and Original Therapeutic Biologics Approved by FDA CDER from 2013 to 2015.
The U.S. Food and Drug Administration (FDA) has made efforts to encourage adequate assessment of women, racial/ethnic minorities, and geriatric participants in clinical trials through regulations and guidance documents. This study surveyed the demographics of clinical trial participants and the presence of efficacy and safety analyses by sex for new drugs approved between 2013 and 2015 by the FDA Center for Drug Evaluation and Research. ⋯ Sex data are now collected for almost all study participants, and this study shows appropriate sex participation for most new drugs when estimated disease prevalence by sex (PPR) is considered. Therapeutic area and disease indication are important considerations when assessing the sex of participants because variation occurs depending on the disease under study. Some racial minorities, especially Blacks/African Americans, are still not well represented in most drug development programs and remain an area where improvement is needed.
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As a leading cause of morbidity and mortality in the United States and worldwide, obesity is a disease that is frequently encountered in clinical practice today and requires a range of medical interventions. While obesity affects both men and women across all ages, multiple issues are particularly germane to women's health, particularly as obesity is more prevalent among women than men in the United States and obesity among women of reproductive health relates to the growing issue of childhood obesity. Discussed herein are the epidemiology and pathophysiology of obesity along with the impact of perinatal obesity on fetal programming. ⋯ With modest weight loss, women with obesity can achieve notable improvements in chronic medical conditions, fertility, pregnancy outcomes, and symptoms of pelvic floor disorders. Moreover, as children born to women after bariatric surgery-induced weight loss show improved metabolic outcomes, this demonstrates a role for maternal weight loss in reducing risk of development of metabolic disturbances in children. In light of the immense cost burden and mortality from obesity, it is important to emphasize the role of lifestyle intervention, pharmacologic management, and bariatric surgery for weight loss in clinical practice to mitigate the impact of obesity on women's health.
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Journal of women's health · Apr 2018
The Severity and Impact of Pelvic Girdle Pain and Low-Back Pain in Pregnancy: A Multinational Study.
Pelvic girdle pain (PGP) and low-back pain (LBP) are the most common musculoskeletal disorders experienced during pregnancy, yet they are not familiar to healthcare providers in some countries. The objective was to compare prevalence, severity, and impact of PGP and LBP among pregnant women in the United States, the United Kingdom, Norway, and Sweden. Women's desires for, access to, and experience of treatment were also examined. ⋯ PGP and/or LBP during pregnancy are common in the United States, the United Kingdom, Norway, and Sweden. Severity, concern, and treatment experiences differed across countries. The majority of women who received treatment reported a positive effect.
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Journal of women's health · Apr 2018
Intimate Partner Violence, Small for Gestational Age Birth and Cigarette Smoking in the Pregnancy Risk Assessment Monitoring System.
Exposure to intimate partner violence (IPV) in the perinatal period is associated with obstetric complications, poor maternal mental health, neonatal complications, and increased risk of infant mortality and morbidity. Less is known about how IPV may influence small for gestational age (SGA) birth. ⋯ Women who experienced perinatal IPV were significantly more likely to smoke prepregnancy and sustain smoking into the last 3 months of pregnancy. Through behavioral and physiological pathways, smoking cessation may be uniquely challenging for women experiencing IPV, yet critical to address clinically to mitigate risk for SGA.