Letteratura scientifica selezionata sul tema "Women physicians – Colorado – Biography"

The aim of this study was to review the life of Mary E. O'Sullivan and to summarize her important contributions to the study of migraine. Mary E. O'Sullivan underwent extensive training to become a neurologist at a time when only 5% of women in America were physicians. She published five papers on migraine. In a 1936 Journal of the American Medical Association article, she described a patient with ergotamine overuse headache and recommended that daily doses of oral ergotamine should be avoided. Three years later she described migraine as a ‘complex’ syndrome with multiple causes and multiple cures. Mary E. O'Sullivan, an ambitious female headache specialist of the 1930s, was an early advocate of the use of ergotamine to treat migraine, yet she was one of the first to report ergotamine overuse headache. Although her life was short, her research, knowledge and ambition at a time when women had limited opportunities in medicine have left a mark.

<p>The focus of this article is on the biography and medical activity of Gisela Januszewska (nee Rosenfeld) in Austro-Hungarian (AH) occupied Bosnia and Herzegovina (BH) between 1899 and 1912. Rosenfeld, later Januszewska and then Kuhn(ova) by marriage, was the fifth of a total of nine official female physicians who were employed by the AH administration to improve the health and hygienic conditions among Bosnian and Bosnian Muslim women. In 1893, Gisela Kuhn moved from Brno, Moravia to Switzerland to pursue her medical studies; she was awarded her Doctorate in Medicine (MD) from the University of Zurich in 1898. In the same year, she took up her first position as a local health insurance doctor for women and children in Remscheid but was prohibited from practising in the German Empire. In 1899, she successfully applied to the AH authorities for the newly established position of a female health officer in Banjaluka and began working there in July 1899. She lost her civil service status upon marrying her colleague, Dr Wladislaw Januszewski, in 1900 but carried out her previously officially assigned tasks as a private physician. In 1903, she was employed as a ‘woman doctor for women’ at the newly established municipal outpatient clinic in Banjaluka. Upon her husband’s retirement in 1912, the couple left BH and settled in Graz, Styria. After, World War I Januszewska ran a general medical practice in Graz until 1935 and worked as a health insurance-gynaecologist until 1933. She received several AH and Austrian awards and medals for her merits as a physician and a volunteer for humanitarian organisations. Upon Austria’s annexation to Nazi Germany 1938, however, she was classified a Jew and was deported to Theresienstadt concentration camp (Terezin, Bohemia), where she died in 1943.</p><p><strong>Conclusion. </strong>Gisela Januszewska, nee Rosenfeld (1867–1943) viewed her medical practice as a social medicine mission which she put into practice as a ‘woman doctor for woman’ in Banjaluka, BH (1899–1912) and Graz, Austria (1919–1935).</p>

Background:The estimated prevalence of axial Spondyloarthritis (axSpA) in the U.S. is 0.4 to 1.3 percent. Undiagnosed axSpA patients suffer from symptoms on average 7 to 10 years, which can also contribute to psychological suffering and healthcare burden due to the prolonged search for diagnosis and treatment.Objectives:To explore the experiences of diagnostic delay of axSpA patients as part of the SpondyloArthritis Screening and Early Detection (SpA-SED) Study.Methods:We conducted exploratory semi-structured patient focus groups. English-speaking participants ≥18 years of age with a rheumatologist-verified clinical diagnosis of axSpA were recruited from three rheumatology practices in Massachusetts, Colorado, and Pennsylvania. Six focus groups were conducted with 26 total participants (16 men, 10 women, age range 21-76 years). Discussions ranged from 1.33 to 2.13 hours. Verbatim transcripts were deidentified, cleaned and coded using NVivo qualitative software. A coding list was generated and summary themes were constructed.Results:Participants described meandering and frustrating journeys in search of a diagnosis. When doctors gave up, it was experienced by patients as profoundly negative. Intermittent axSpA symptoms confused some physicians and caused some patients to either delay seeking medical care (e.g., sporadic flare-up) or use dramatic language to convey the magnitude of the impact on their symptoms. Patients explained their experiences where physicians presumed that patients were trying to obtain narcotics or were “imagining/exaggerating” symptoms. Early symptom stories fell into five areas of importance for patients: pain, stiffness and lack of mobility, impact on sleep, impact on daily life, and changes with weather. Tenacity on the part of the patient and/or their family, patient research and confidence to challenge their physicians were important. Self-advocacy was challenging but necessary and particularly difficult when patients were sick. During the typically lengthy time that participants waited to be diagnosed, they experienced frustration and mental suffering due to lack of answers and/or not being heard, believed, or taken seriously. Some participants described the fatigue they experienced after trying without success to obtain a diagnosis or receive treatment. Early administration of a definitive diagnostic test or screening tools for axSpA would have alleviated both physical and emotional suffering for these participants.Conclusion:Overall, participants expressed satisfaction with physicians who sought to understand them and believed them, took them seriously, and did not give up even with long delays. Patients with axSpA described significant suffering prior to diagnosis which could have been prevented and treated. Further research is needed with axSpA patients who are early in their diagnostic journey to determine best practices to support patients and reduce diagnostic delay.Disclosure of Interests:Catherine Dubé Grant/research support from: Novartis, as personnel on such studies, Kate Lapane: None declared, Katarina Ferrucci: None declared, Ariel Beccia: None declared, Sara Khan: None declared, Esther Yi Employee of: Novartis Pharmaceuticals, Jonathan Kay Consultant of: AbbVie, Inc.; Boehringer Ingelheim GmbH; Celltrion Healthcare Co. Ltd.; Jubilant Radiopharma; Merck & Co.,Inc.; Pfizer Inc.; Samsung Bioepis; Sandoz Inc.; Scipher Medicine; UCB, Inc., Grant/research support from: (paid to UMass Medical School) Gilead Sciences Inc.; Novartis Pharmaceuticals Corp.; Pfizer Inc., Kristine A. Kuhn Consultant of: UCB, Eli Lilly, Novartis, Grant/research support from: Pfizer, Alexis Ogdie Consultant of: Abbvie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Shao-Hsien Liu Grant/research support from: Novartis

The phenomenon of multiple deliveries primarily attracts the attention of physicians, who are mostly focused on the study of its physiological aspects and consequences. However, it is important to know the demographic characteristics of this phenomenon to understand development trends and patterns. The study of the features of the twins biography creates a unique opportunity to determine the causes and eff ects of human behaviour, the possibility of adaptation, development, to identify the role of the genetic factors, environment, events in human life and more. The national registers of twins are maintained in many developed countries. Unfortunately, Ukraine does not have complete statistical information about the number of twins, the age of the mother at their birth, the order of their birth, the sex and age structure of twins, triplets and quadruplets living in our country, so in our country a systematic analysis of multiple births is not carried out. The aim of this paper is to investigate the demographic characteristics of the phenomenon of multiple births. The study was conducted using methods of comparison, analysis, generalization, graphical method and based on statistical information of demographic yearbooks of the Czech Republic and Poland, which published quite detailed information on the births of multiple deliveries by sex and age of mother, and data from the State Statistics Service of Ukraine on the number of births with twins, triplets and more twins in diff erent types of settlements. Such studies have not been conducted in our country for the last 50 years. In Ukraine, the frequency of multiple births and births of twins has increased in the new millennium; in 2019 there were 13.6 multiple deliveries per 1,000 deliveries, or 27.1 newborn twins per 1,000 births (in 2001 respectively 6.9 and 13.8). However, in diff erent countries the trends of the frequency of multiple births may diff er signifi cantly, in particular, in the last decade in Poland index of frequency has stabilized, but in the Czech Republic it has declined quite rapidly. The example of these countries has shown that increased fertility is not necessarily accompanied by increase in the frequency of multiple births, and the highest frequency is not always characteristic of women aged 35-39 years as early research has shown. In Ukraine, the share of multiple births among all live births with the use of reproductive technologies is declining. In order to study the phenomenon of multiple births, it would be advantageous in Ukraine to introduce in statistical observations the forms of distribution of multiple births by maternal age, order of birth, to identify cases of twin births using reproductive technologies.

Opening remarks by the President, Sir John Walton: The Lloyd Roberts Lecture is one of the major events of the Society year. It is given in rotation at the invitation of the Royal College of Physicians of London, the Medical Society of London and the Royal Society of Medicine, and this year it is our turn. For those of you who do not know who Lloyd Roberts was — he died in 1920, at which time he was the Consulting Obstetric Physician, a very modern term indeed, to Manchester Royal Infirmary because, although he practised throughout his professional life as an obstetrician and gynaecologist, he was also a Fellow of the Royal College of Physicians of London and was particularly interested in medical aspects of obstetrics and gynaecology. He was one of that long line of medical polymaths who distinguished British medical affairs in the last century and in the early part of this century in that he had a major interest in literary matters. Quite apart from publishing his very well known Students' Guide to the Practice of Midwifery, he also published a revised edition of Sir Thomas Browne's Religio Medici, and was responsible for writing a major work on The Scientific Knowledge of Dante. A great collector of art treasures, including a specially fine collection of mezzotints, glass and books, he was in many, many ways a man of outstanding breadth of interest and culture. One of the most interesting things that was said about Lloyd Roberts in a very long obituary after he died was that, even if he had died thirty years earlier, his biography would have had a very large sale. Hospital work done, he was to be found by midday standing, always standing, compact, alert, close cropped, by his consulting room fire with a glass of milk warming in the fender and, amongst the instruments on the mantelpiece, there were walnuts, which he cracked at intervals with explosive violence. These served for lunch. One of his most famous quotes, which apparently has always been remembered, was that he used to say he was not a consultant but ‘a general specialist, with a leaning towards women’, and his definition of gynaecology was ‘anything either curable or lucrative’. But everyone said that he was a born healer and it did people good merely to see him, so that he was clearly one of the most notable members of our profession of the day. Now, who could we have chosen better than Baroness Warnock to deliver this year's Lloyd Roberts Lecture? Educated at Lady Margaret Hall, subsequently Fellow and Tutor of Philosophy at St Hugh's College and then later Headmistress of Oxford High School for six years, she has chaired many special enquiries of particular interest to this profession, such as the Committee of Enquiry into Special Education. She served on the Advisory Committee on Animal Experiments as Chairman until recently and we know very well of her work in chairing the Committee of Enquiry into Human Fertilization and Embryology. She has also found the time to write widely on Existentialism, Imagination and Education, and other topics. Now, if there has been an occasion when simultaneously a husband and wife have been respectively Head of House, one in Oxford and the other in Cambridge, then as a very new boy at Oxford it is not something which I personally have been aware. Interest in education makes it particularly fitting that she should have chosen tonight, following upon the lecture given in this series some fifteen years ago by Lord James of Rusholme, to talk about ‘Another ten years in education’.

BackgroundPatients with chronic kidney disease (CKD) are at increased risk for developing gout1 and vice versa.2 Those with both gout and CKD present distinct challenges for patients and physicians because of the high prevalence of other comorbidities and restrictions on gout medication use, including non-steroidal anti-inflammatories3,4 and some oral urate-lowering therapies (ULTs).5 This unique patient population has not been well characterized using real-world data.ObjectivesThis retrospective chart review study of patients with coincident gout and CKD was conducted to better understand patient characteristics and treatment patterns of this population. This study is unique in that patient data were obtained from nephrologists, allowing a glimpse of how they view gout and its management.Methods111 nephrologists provided de-identified medical record data of their most-recently seen advanced (stage 3─5) CKD patients. Patients met study criteria for gout if any of the following were true: gout listed as a comorbidity, ULT use, or visible tophi or gout flares documented. A patient’s gout was determined to be uncontrolled if they had serum uric acid >6 mg/dL in addition to ≥1 visible tophus, ≥2 gout flares in the past year, or gouty arthritis (≥1 tender or swollen joint). Characteristics of this unique population were examined, along with gout management patterns. Differences between patients with controlled and uncontrolled gout were also investigated using data from patients’ most recent evaluation.Results173 patients with stages 3-5 CKD and who met study criteria for gout were included. Mean age was 58.3±18.1 years and BMI averaged 32.0 ± 11.8 kg/m2. A higher than expected proportion of patients were female (47%). The most common comorbidities were hypertension (85%), diabetes mellitus (47%), anemia of CKD (42%), CKD-mineral bone disorder (41%), ischemic heart disease (23%), and congestive heart failure (21%). Mean CKD duration was 4.1 ± 5.5 years, mean estimated glomerular filtration rate (eGFR) at most recent visit was 32.3 ± 13.9 ml/min/1.73 m2, and 62% were using a ULT. 23 patients (13%) had uncontrolled gout (48% female, 63.1 ± 16.4 years, mean eGFR 32.0 ± 14.6 ml/min/1.73 m2), all of whom had been prescribed a ULT. Compared with controlled gout patients, uncontrolled patients had higher rates of pulmonary hypertension (14% vs. 4%), gout-related chronic pain in the 12-months prior to data collection (63% vs. 42%), and joint involvement (joint swelling, tenderness, flexibility loss, and/or damage/lesions on x-ray; 26% vs. 9%). Colchicine was also used more frequently in uncontrolled gout patients (26% vs. 7%).ConclusionThe coincident gout with advanced CKD population described here shows unique differences from the general gout population, including a high proportion of females (47%). Given that women have a lower likelihood of developing gout at the same serum uric acid level,6 this finding was particularly surprising (general gout population: 67% male7). Importantly, nearly 40% of included patients were not utilizing a ULT, leaving them susceptible to developing the painful and debilitating sequalae of uncontrolled gout. Additionally, 41% of the study population had a CKD-related mineral bone disorder, indicating that patients with coincident gout and CKD may have bones that are more vulnerable to gout-related bone damage. Our study confirms a high prevalence of gout and its associated comorbidities in patients with advanced CKD and suggests another nephrology education opportunity to highlight the potential benefits of gout monitoring, earlier intervention, and management.References[1]Safiri S, et al. Arthritis Rheumatol 2020;72:1916-27.[2]Feig DI. Curr Opin Nephrol Hypertens 2009; 18: 526–530.[3]Stamp LK, et al. Nat Rev Rheumatol. 2021; 17(10): 633–641.[4]Wallace SL, et al. J Rheumatol 1991; 18(2): 264-9.[5]Abdelatif AA and Elkhalili N. Am J Ther 2014; 21: 523-34.[6]Bhole V, et al. Arthritis Rheum 2010;62:1069-76.[7]Francis-Sedlak M, et al. Rheumatol Ther 2021;8:183-97.Disclosure of InterestsLeonard Stern Speakers bureau: Horizon Therapeutics, Consultant of: Horizon Therapeutics, Richard Johnson Shareholder of: Colorado Research Partners LLC and XORTX Therapeutics, Speakers bureau: Horizon Therapeutics, Consultant of: Horizon Therapeutics, Payam Shakouri Speakers bureau: Horizon Therapeutics and Relypsa, Consultant of: Horizon Therapeutics, Amod Athavale Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brad Marder Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Sreedhar Mandayam Shareholder of: Medingenii Capital LLC and Prosalus Capital LLC, Speakers bureau: Otsuka and Alexion, Consultant of: US Renal Care and Aurinia, Grant/research support from: Travere, Norvartis, Omeros, Roche, Vertex, Equillium, Goldfinch Bio, and Pfizer

Summary Throughout its history, American child psychiatry has been a hospitable specialty for women physicians. In its early years when practitioners were often steeped in psychoanalysis and influenced by theorists such as Anna Freud, many leaders within the field were women. By the 1960s and 1970s, child psychiatry was moving away from analysis and towards more research-based practice. The biography of an important leader in this area, New York University’s Stella Chess, illustrates the mechanism of that transformation and the role of ideas about mothers and working women. Chess, along with her husband and collaborator Alexander Thomas, gathered data to disprove the popular notion that mothers were to blame for children’s behaviour problems and demonstrated instead that issues resulted from a poor fit between a child’s temperament and his/her environment. Chess not only demanded that facts support theory, but also used her own parenting experiences and common sense to guide her work.