Статті в журналах: "Women, co-morbidities"

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Tracy, Elizabeth. "Physical, mental co-morbidities and recovery outcomes among women." Journal of Substance Abuse Treatment 43, no. 3 (October 2012): e7. http://dx.doi.org/10.1016/j.jsat.2012.08.047.

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Ulla, Anttalainen, Saaresranta Tarja, Tero Vahlberg, and Polo Olli. "P424 Co-morbidities of women with sleep-disordered breathing." Sleep Medicine 7 (September 2006): S100. http://dx.doi.org/10.1016/j.sleep.2006.07.234.

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Nikolopoulos, Manolis, Michelle A. L. Godfrey, and Rekha Wuntakal. "Medically unfit women with early-stage endometrial cancer treated with the levonorgestrel intrauterine system." Obstetrics & Gynecology Science 63, no. 3 (May 30, 2020): 337–45. http://dx.doi.org/10.5468/ogs.2020.63.3.337.

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ObjectiveTo assess the clinical efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the treatment of early-stageendometrial cancer in elderly morbidly obese women, whose multiple co-morbidities made the standard surgicaltreatment too risky to undertake.MethodsA retrospective review was conducted and case series reports were prepared of all women diagnosed withendometrial cancer, from April 2011 to December 2016 at the Queen's Hospital, London, to identify women unfit forsurgery and treated with the LNG-IUS.ResultsOut of 438 women with endometrial cancer, Eight women with early-stage endometrial cancer were deemed unfitfor surgery and underwent treatment with the LNG-IUS. All had grade 1 endometrioid endometrial adenocarcinoma,radiologically staged as 1a. Four women died of their co-morbidities, not related to endometrial cancer. One of themhad 68 months of progression-free survival before death due to co-morbidities. One patient required a hysterectomyafter 32 months of treatment with LNG-IUS and oral progestogens due to heavy vaginal bleeding. Three women havecontinued the LNG-IUS treatment with no evidence of progressive disease symptoms till date at a mean follow-up of35.7 months.ConclusionFor women with multiple co-morbidities, the LNG-IUS offers an effective and safe treatment for early-stage, lowgradeendometrial cancer, with no cases of symptomatic progression reported in our case series. In the frail andelderly, where the quality of life is of paramount importance, surgical treatment may not offer additional long-termsurvival benefits.

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Bhattarai, N., J. Charlton, C. Rudisill, and M. C. Gulliford. "Prevalence of depression and utilization of health care in single and multiple morbidity: a population-based cohort study." Psychological Medicine 43, no. 7 (November 1, 2012): 1423–31. http://dx.doi.org/10.1017/s0033291712002498.

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BackgroundThis study aimed to determine whether depression in patients with long-term conditions is associated with the number of morbidities or the type of co-morbidity.MethodA cohort study of 299 912 participants aged 30–100 years. The prevalence of depression, rates of health-care utilization and costs were evaluated in relation to diagnoses of diabetes mellitus (DM), coronary heart disease (CHD), stroke and colorectal cancer.ResultsThe age-standardized prevalence of depression was 7% in men and 14% in women with no morbidity. The frequency of depression increased in single morbidities including DM (men 13%, women 22%), CHD (men 15%, women 24%), stroke (men 14%, women 26%) or colorectal cancer (men 10%, women 21%). Participants with concurrent diabetes, CHD and stroke had a very high prevalence of depression (men 23%, women 49%). The relative rate of depression for one morbidity was 1.63 [95% confidence interval (CI) 1.59–1.66], two morbidities 1.96 (95% CI 1.89–2.03) and three morbidities 2.35 (95% CI 2.03–2.59). Compared to those with no morbidity, depression was associated with higher rates of health-care utilization and increased costs at any level of morbidity. In women aged 55 to 64 years without morbidity, the mean annual health-care cost was £513 without depression and £1074 with depression; when three morbidities were present, the cost was £1495 without depression and £2878 with depression.ConclusionsDepression prevalence and health-care costs are more strongly associated with the number of morbidities than the nature of the co-morbid diagnosis.

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Connors, Casey, Melissa Gott, and Gus J. Slotman. "Pre-operative weight, BMI and the incidence of obesity co-morbidities vary by sex in bariatric surgery patients: analysis of 166,601 women and men with obesity." Advances in Obesity, Weight Management & Control 10, no. 4 (August 8, 2020): 106–9. http://dx.doi.org/10.15406/aowmc.2020.10.00315.

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Background: Variations in pre-operative characteristics by sex in bariatric surgery cannot be easily extrapolated from current literature. Objective: to identify pre-operative differences between males and females across the spectrum of bariatric procedures, weight and co-morbidities. Methods: Data from 166,601 pre-operative Surgical Review Corporation Bariatric Longitudinal Database (BOLD) patients undergoing bariatric surgery were divided into females (n=130,612) and males (n=35, 989). Statistics: Chi-square and Analysis of Variance (ANOVA). Results: Males displayed higher pre-operative age, BMI, weight, and rates of cardiopulmonary obesity co-morbidities, diabetes, gout, dyslipidemia, abdominal hernia, liver disease, alcohol, tobacco and substance abuse. Females suffered more from asthma, GERD, cholelithiasis, stress urinary incontinence, abdominal panniculitis, somatic obesity co-morbidities and mental health conditions (p<0.0001). Conclusions: Pre-operative weight, BMI, and weight-related medical problems vary by sex among patients undergoing bariatric surgery. With this advance knowledge, surgeons managing obese patients can anticipate co-morbidities by sex and adjust pre- and post- surgical preparations accordingly.

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Vine, Donna, Mahua Ghosh, and Grace Wang. "ODP422 PCOS is Associated with Increased Incidence of Co-morbidities." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A666. http://dx.doi.org/10.1210/jendso/bvac150.1378.

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Abstract Background PCOS is the most common metabolic-endocrine disorder impacting women over their lifespan. It is important to understand the scope of health outcomes that impact the health and quality of life of those with PCOS in order to improve clinical and patient-centered health care in this population. Aim The aim of this study was to determine the incidence of co-morbidities in PCOS compared to age matched controls. We hypothesised that women with PCOS would have increased incidence of co-morbidities. Methods A retrospective observational case-control study in those diagnosed with PCOS and age-matched controls (>12 yrs of age in a ratio of 1: 3) was undertaken using the Alberta Health Services Health Analytics database from 2002-2019 in Alberta, Canada. International classification codes (ICD9 and ICD10) were used to determine PCOS diagnosis including visits to a health care provider, Alberta ambulatory care reporting system and Discharge Abstract Data databases. Results The incidence of several co-morbidities were 20-40% higher in PCOS (n=16531) including hypertension, dyslipidemia, cardiovascular, cerebrovascular, gastrointestinal and renal disease, metabolic syndrome, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections and all cancers compared to controls (n=49335) (p<0. 0001). Overweight-obesity, non-alcoholic liver disease, Type 1 diabetes and Type 2 Diabetes had a 3-fold greater incidence in PCOS compared to controls (p<0. 0001). Conclusion These findings demonstrate PCOS is a major public health concern due to increased risk of co-morbidities and associated health-care costs. These findings provide evidence-based research to support the development of strategies to improve health care; screening, management and prevention of co-morbidities in high-risk PCOS populations. Presentation: No date and time listed

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Pfalzer, L. A., M. D. Henderson, and J. S. Drouin. "COMPLICATIONS, CO-MORBIDITIES, LYMPHEDEMA, AND EXERCISE TRAINING IN WOMEN WITH BREAST CANCER." Medicine & Science in Sports & Exercise 34, no. 5 (May 2002): S266. http://dx.doi.org/10.1097/00005768-200205001-01492.

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Conti-Ramsden, Frances, Michael McEwan, Rachel Hill, Julie Wade, Georgina Abraham, Olivia Buckeldee, Catherine Williamson, Caroline L. Knight, Joanna Girling, and Lucy C. Chappell. "Detection of additional abnormalities or co-morbidities in women with suspected intrahepatic cholestasis of pregnancy." Obstetric Medicine 13, no. 4 (September 2, 2019): 185–91. http://dx.doi.org/10.1177/1753495x19868873.

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Background Current guidelines recommend viral, autoimmune, coagulation and liver ultrasound testing in intrahepatic cholestasis of pregnancy to exclude alternative diagnoses. Methods Electronic health records were searched for investigations and diagnoses in women with raised bile acid concentrations (>10 µmol/L) between January 2016 and December 2017 at two UK maternity units. Results Five hundred and thirty-one women had a raised bile acid concentration (median (IQR): 18 (13–32 µmol/L)) at a median gestation of 35.1 (IQR 31.8–37.0) weeks. Out of 531 women, 250 (47.1%) had full virology, autoimmune and ultrasound tests, and 348 (65.5%) had coagulation performed. Positive hepatitis B and C results were previously known. No new Epstein–Barr virus, cytomegalovirus or hepatitis A diagnoses were made. There were 11 positive autoimmune results, but no new diagnoses. No woman had an unexplained prolonged prothrombin time. No ultrasound liver ( n = 38) or gallbladder ( n = 85) abnormalities were of acute clinical significance. Conclusion Intrahepatic cholestasis of pregnancy investigations provided no new diagnoses that influenced clinical management during pregnancy.

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Harris, E. E., S. L. Urtishak, W. Hwang, B. Kinosian, and L. J. Solin. "Comorbidity and outcomes in elderly women treated with breast-conserving therapy." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 599. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.599.

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599 Background: Breast cancer incidence increases with age and is a major cause of morbidity and mortality among elderly women. Co-morbidities are often considered in treatment management of elderly women. Methods: Between 1979 and 2002, 238 women age 70 or older with unilateral stage I or II invasive breast cancer underwent conventional breast conservation treatment with radiation. The age distribution was 122 women (51%) age 70–74 years, 71 women (30%) age 75–79 years, and 45 women (19%) age ≥80 years. Surgical axillary staging was performed in 73% (n= 173) of patients, of which 73% (n=126) were N0, and 27% (n=47) were N1. Co-morbidities were scored using the Charlson Comorbidity Index and Cumulative Illness Rating Scale (CIRS). Median follow-up was 6.2 years. Results: On analysis by age groups, the 10-year cancer specific outcomes were not significantly different (see Table ). However, distant metastases were the most common site of first failure in all age groups: 9% for age 70–74; 12% for age 75–79 and 11% for age >/= 80. Second malignancies were the second most common cause of first failure in all age groups. Death from intercurrent disease was significantly more likely in the older age groups. In this cohort, moderate and severe co-morbidities were not significantly more common in the older age groups, and CIRS score did not correlate with overall survival. Conclusions: Breast conserving surgery and definitive breast irradiation provide excellent outcomes in appropriately selected elderly women. Older age itself is not a contraindication to breast conserving therapy. Women of any age with lower co-morbidity indices should be offered standard treatment. [Table: see text] No significant financial relationships to disclose.

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Shrestha, S., D. KC, and A. Dongol. "Co-morbidities, Maternal and Fetal Outcome of Teenage Pregnancy at Tertiary Care Hospital, Nepal." Kathmandu University Medical Journal 18, no. 1 (January 6, 2020): 59–63. http://dx.doi.org/10.3126/kumj.v18i1.33363.

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Background Teenage pregnancies constitute a serious health and social problem worldwide. World estimates in 2008 report about 16 million births to adolescent mothers, most of them occurring in low and middle income countries. Objective To assess pregnancy co-morbidities and outcome of teenage pregnancy. Method A cross-sectional study was conducted at obstetrics and gynecological department of Dhulikhel Hospital. Study was conducted for 18 month period from 1-07-2013 to 30-12-2014. All teenage pregnancy cases admitted at the time of study period were enrolled. Purposive sampling technique was used. Data were collected by face to face interview using clinical Performa and through record file of the patient. Collected data were analyzed in SPSS version 21.0. Result Total of 527 teenage mothers of varying age group (15 to 19 years) were enrolled in the study. Teenagers who had never been to school were 3.0%; 66.2% of them were from low socioeconomic background , and 58.6% were from rural areas. Pregnancy co-morbidities detected were, Urinary tract infection (UTI) 18.4%, threatened preterm 12.9% followed by ante partum hemorrhage 4.7%. However, other major co-morbidities such as hypertensive disorder, gestational diabetes found to be very less such as, hypertension 0.8% and gestational diabetes found in only one woman. Conclusion Maternal and newborn outcome and co-morbidities among teenage pregnant women found less compare to other studies. Major pregnancy related morbidities such as hypertension, pre-eclampsia and diabetes were found very less. Most common maternal morbidity found was urinary tract infection during pregnancy but statistically not significant. Similarly, newborn mean weight was more than 2.5 kg and neonatal death found very less. However, teenage pregnancy is significantly associated with low economic status, illiteracy status, willingness to marriage by teenagers and ethnicity.

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Rodgers, Raymond J., Jodie C. Avery, Vivienne M. Moore, Michael J. Davies, Ricardo Azziz, Elisabet Stener-Victorin, Lisa J. Moran, et al. "Complex diseases and co-morbidities: polycystic ovary syndrome and type 2 diabetes mellitus." Endocrine Connections 8, no. 3 (March 2019): R71—R75. http://dx.doi.org/10.1530/ec-18-0502.

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Objective Many complex diseases exhibit co-morbidities often requiring management by more than one health specialist. We examined cross-speciality issues that ultimately affect the health and wellbeing of patients with polycystic ovary syndrome (PCOS). PCOS was originally described as a reproductive condition but is now recognised to also be a metabolic and psychological condition affecting 8–13% of women of reproductive age. With a four-fold increased risk of type 2 diabetes (DM2), the Population Attributable Risk of DM2 that could be avoided if PCOS were eliminated is a substantial 19–28% of women of reproductive age. To determine the extent to which PCOS is an important consideration in diabetes development, we examined publications, funding, guidelines and predictors of risk of developing DM2. Results We found that the topic of PCOS appeared in specialist diabetes journals at only 10% the rate seen in endocrinology journals – about 1 in 500 articles. We found research funding to be substantially less than for diabetes and found that diabetes guidelines and predictive tools for DM2 risk mostly ignore PCOS. This is surprising since insulin resistance in women with PCOS has a different aetiology and additionally women with PCOS are at increased risk of becoming overweight or obese – high risk factors for DM2. Conclusions We consider the causes of these concerning anomalies and discuss current activities to address the co-morbidities of PCOS, including the recent development of international guidelines, an international PCOS awareness program and potentially changing the name of PCOS to better reflect its metabolic consequences.

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Shah, Duru. "Menopausal Hormone Therapy, can we safely use it in women with co-morbidities?" Journal of Mid-life Health 6, no. 1 (2015): 1. http://dx.doi.org/10.4103/0976-7800.153590.

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Atkins, Janice, Jane Masoli, Joao Delgado, Luke Pilling, Chia-Ling Kuo, George Kuchel, and David Melzer. "Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort." Innovation in Aging 5, Supplement_1 (December 1, 2021): 342–43. http://dx.doi.org/10.1093/geroni/igab046.1329.

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Abstract Hospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes or CHD, but whether these co-morbidities are more common than in the general older population is unclear. We estimated associations between pre-existing diagnoses and hospitalized COVID-19 alone or with mortality (during the first COVID-19 outbreak, tests performed between March 16 and April 26, 2020). In 269,070 UK Biobank participants aged 65+, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common preexisting co-morbidities in hospitalized inpatients were hypertension (59.6%), history of falls/fragility fractures (29.4%), CHD (21.5%), T2 diabetes (19. 9%) and asthma (17.6%). However, in adjusted models, pre-existing diagnoses of dementia, T2 diabetes, COPD, pneumonia, depression, atrial fibrillation and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first five remaining statistically significant for related mortality. There are specific high risk pre-existing co-morbidities for COVID-19 hospitalization and deaths in community based older men and women.

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Cheung, Jim W., Edward P. Cheng, ,. Xian Wu, Ilhwan Yeo, Paul J. Christos, Hooman Kamel, Steven M. Markowitz, et al. "Sex-based differences in outcomes, 30-day readmissions, and costs following catheter ablation of atrial fibrillation: the United States Nationwide Readmissions Database 2010–14." European Heart Journal 40, no. 36 (March 29, 2019): 3035–43. http://dx.doi.org/10.1093/eurheartj/ehz151.

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Abstract Aims Although catheter ablation has emerged as an important therapy for patients with symptomatic atrial fibrillation (AF), there are limited data on sex-based differences in outcomes. We sought to compare in-hospital outcomes and 30-day readmissions of women and men undergoing AF ablation. Methods and results Using the United States Nationwide Readmissions Database, we analysed patients undergoing AF ablation between 2010 and 2014. Based on ICD-9-CM codes, we identified co-morbidities and outcomes. Multivariable logistic regression and inverse probability-weighting analysis were performed to assess female sex as a predictor of endpoints. Of 54 597 study patients, 20 623 (37.7%) were female. After adjustment for age, co-morbidities, and hospital factors, women had higher rates of any complication [adjusted odds ratio (aOR) 1.39; P < 0.0001], cardiac perforation (aOR 1.39; P = 0.006), and bleeding/vascular complications (aOR 1.49; P < 0.0001). Thirty-day all-cause readmission rates were higher for women compared to men (13.4% vs. 9.4%; P < 0.0001). Female sex was independently associated with readmission for AF/atrial tachycardia (aOR 1.48; P < 0.0001), cardiac causes (aOR 1.40; P < 0.0001), and all causes (aOR 1.25; P < 0.0001). Similar findings were confirmed with inverse probability-weighting analysis. Despite increased complications and readmissions, total costs for AF ablation were lower for women than men due to decreased resource utilization. Conclusions Independent of age, co-morbidities, and hospital factors, women have higher rates of complications and readmissions following AF ablation. Sex-based differences and disparities in the management of AF need to be explored to address these gaps in outcomes.

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Fountain, Daniel, Mohammed Al Kharaiji, Sherif Awad, David Hughes, and Iskandar Idris. "Prevalence of co-morbidities in a specialist weight management programme prior to bariatric surgery." British Journal of Diabetes 19, no. 1 (June 27, 2019): 8–13. http://dx.doi.org/10.15277/bjd.2019.205.

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Objective: There is limited evidence on the prevalence of patients’ obesity-related co-morbidities and the effectiveness of specialist multidisciplinary weight management (Tier 3) programmes prior to bariatric surgery. We therefore evaluate and report the prevalence of co-morbidities in patients attending a Tier 3 service within the National Health Service.Methods: This was a prospective observational study of consecutive patients who attended the Tier 3 service at the East Midlands Bariatric Metabolic Institute throughout 2017.Results: 430 patients attended the service over the study observation period. Twelve patients (2.8%) were excluded from our analysis due to incomplete data. 70.8% of patients were women, mean age at baseline was 46.4 years, mean±SD weight and body mass index at baseline were 137.8±29.2 kg and 48.0±8.6 kg/m2, respectively. The most common co-morbidities recorded at baseline were type 2 diabetes mellitus (31.1%), hypertension (31.1%), depression (26.1%), obstructive sleep apnoea (23.2%) and osteoarthritis (15.6%). Significant weight loss was observed at the 3-month and 6-month follow-up points, but not at the 9- or 12-month follow-up points. 22.5% of patients achieved weight loss of ≥5%.Conclusion: The prevalence of co-morbidities within this Tier 3 service was high. While specialised weight management services may achieve moderate weight loss through a multidisciplinary intervention, future evaluation of clinical outcomes of specialist weight services should also include co-morbidity outcomes.

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Makhashvili, N., J. Javakhishvili, I. Pinchuk, and B. Roberts. "Mental Health Conditions and Co-morbidities Among Internally Displaced Populations (IDPs) in Ukraine." European Psychiatry 41, S1 (April 2017): s245. http://dx.doi.org/10.1016/j.eurpsy.2017.02.024.

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Reliable epidemiological data on the burden of mental health conditions and key risk factors is crucial in helping to design appropriate trauma-informed mental health and psychosocial support responses for the estimated 1.4 million IDPs in Ukraine. The aim of the proposed study is to collect evidence on mental health and psychosocial support needs among IDPs in order to help inform mental health policy in Ukraine.The specific objectives were to:– measure the prevalence of mental health conditions of post-traumatic stress disorder (PTSD), depression, anxiety, and their co-morbidity;– examine the characteristics associated with the mental disorders (e.g. gender, age, trauma exposure, socio-economic stressors);– draft evidence-based recommendations for mental health and psychosocial support to relevant governmental and professional bodies in Ukraine.The study used a cross-sectional survey conducted throughout Ukraine in 2016 with 2203 IDPs aged 18 years and over. Descriptive and multivariate regression analyses were used. PTSD prevalence was 32% (22% men; 36% women), depression–22% (16% men; 25% women), and anxiety prevalence was 17% (13% men; 20% women). There were also high levels of co-morbidity between PTSD, anxiety and depression. Key factors statistically significantly associated with mental disorders included female gender, older age, cumulative trauma exposure, more recent displacement and a bad household economic situation. The findings provided sufficient evidence to draft the trauma-informed mental health policy recommendations to key policy-makers in Ukraine.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Mabandla, Shannice, and Thinh H. Duong. "Safety and Efficacy of Total Vaginal Reconstruction in Elderly Women with Medical Co-Morbidities." Journal of the National Medical Association 112, no. 5 (October 2020): S37—S38. http://dx.doi.org/10.1016/j.jnma.2020.09.097.

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Clemens, J. Quentin, Richard T. Meenan, Maureen C. O’Keeffe Rosetti, Teresa M. Kimes, and Elizabeth A. Calhoun. "130: A Case-Control Study of Medical Co-Morbidities in Women with Interstitial Cystitis." Journal of Urology 177, no. 4S (April 2007): 45. http://dx.doi.org/10.1016/s0022-5347(18)30395-1.

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Daemers, Darie O. A., Hennie A. A. Wijnen, Evelien B. M. van Limbeek, Luc M. Budé, and Raymond G. de Vries. "Patterns of gestational weight gain in healthy, low-risk pregnant women without co-morbidities." Midwifery 29, no. 5 (May 2013): 535–41. http://dx.doi.org/10.1016/j.midw.2012.04.012.

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M. N., Soumyashree, and R. G. Viveki. "Prevalence of hypertension and co-morbidities among elderly women in rural area: a cross sectional study." International Journal Of Community Medicine And Public Health 5, no. 9 (August 24, 2018): 4018. http://dx.doi.org/10.18203/2394-6040.ijcmph20183589.

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Background: NCDs have been the leading causes of death among women globally for the past three decades and are now responsible for two in every three deaths among women each year. India endorsed the Sustainable Development Goal for health to set a target to decrease premature deaths from non-communicable diseases (NCDs) by one-third by 2030. Aims of the study were to estimate the prevalence of hypertension among the elderly women from rural area and to know the associated co-morbidities among the elderly women from rural area.Methods: A community based cross sectional study was conducted among elderly women >60 yrs. Data was collected by using pre tested structured questionnaire, which contained basic information like name, age, education & socioeconomic status, occupation, marital status, known case of hypertension, family history, any other co- morbidities.Results: 65.2% of the participants had normal blood pressure, 34.7% were hypertensive. 38% of study subjects living in joint family were hypertensive, majority (53.8% and 85.6%) of them who were obese and had a history of tobacco intake were hypertensive. The association between hypertension and these variables was found to be statistically significant.Conclusions: 15.4% of the study participants were newly detected hypertensives. This indicates a need for awareness to be created among the elderly women regarding hypertension risk factors, to sensitize them for regular medical check-ups to ensure prevention and early detection of hypertension.

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Harjoto, Budi Setiawan, I. Nyoman Hariyasa Sanjaya, I. Gede Mega Putra, and Evert Solomon Pangkahila. "HIV and SARS-CoV-2 Coinfection in Pregnancy: Case Report." European Journal of Medical and Health Sciences 4, no. 5 (October 22, 2022): 41–43. http://dx.doi.org/10.24018/ejmed.2022.4.5.1484.

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The ongoing outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with worse outcomes in several populations, including those with co-morbidities. Pregnant women are one such group of individuals that may be at increased risk of infection related to physiologic changes in metabolic and maternal immune system changes in normal pregnancy. This risk may increase with underlying immunocompromised states such as in people living with HIV (PLWH). However, there is currently limited data on pregnant women with coronavirus disease (COVID-19) and HIV. In this paper, a case of pregnant women infected with COVID-19 and HIV co-infection is reported.

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Dawson, Angela, Debra Jackson, and Michelle Cleary. "Mothering on the Margins: Homeless Women with an SUD and Complex Mental Health Co-Morbidities." Issues in Mental Health Nursing 34, no. 4 (April 2013): 288–93. http://dx.doi.org/10.3109/01612840.2013.771522.

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Chappell, Lucy, Rachel Hill, Frances Conti-Ramsden, Julie Wade, and Catherine Williamson. "419. Detection of additional abnormalities or co-morbidities in women with intrahepatic cholestasis of pregnancy." Pregnancy Hypertension 13 (October 2018): S49. http://dx.doi.org/10.1016/j.preghy.2018.08.146.

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Hayes, Victoria, Elena Kraus, James DuBois, Jennifer Goldkamp, and Niraj R. Chavan. "Perspectives toward contraceptive counseling among women with complex medical co-morbidities: A Mixed-Methods Study." American Journal of Obstetrics and Gynecology 228, no. 1 (January 2023): S758—S759. http://dx.doi.org/10.1016/j.ajog.2022.11.1263.

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Ladeira, Filipa, Manuel Salavisa, André Caetano, Raquel Barbosa, Francisca Sá, and Ana Sofia Correia. "The Influence of Menopause in Multiple Sclerosis Course: A Longitudinal Cohort Study." European Neurology 80, no. 3-4 (2018): 223–27. http://dx.doi.org/10.1159/000496374.

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Background: Hormonal variations are known to influence the course of multiple sclerosis (MS). Objectives: We aimed to evaluate the impact of menopause in MS course, including disease activity and disability progression. Methods: We conducted a retrospective longitudinal cohort study including all women, older than 44, post-menopausal, with a diagnosis of MS at least 1 year before menopause. We evaluated the impact of menopause in MS course comparing clinical and radiologic outcomes within 5 years before and after menopause. We repeated the analysis in subgroups of patients without disease-modifying treatment (DMT) change or co-morbidities diagnosed during the observation period, considering that those factors might also impact MS outcomes. Results: Thirty-seven women, with a mean age at the time of menopause of 49.8 (±4.06) years were included in the analysis. Within 5 years following menopause, we observed a decrease in the annualized relapse rate (0.37 ± 0.35 pre-menopause vs. 0.08 ± 0.18 post-menopause, p < 0.001) compared with the same period before menopause, while the EDSS progression rate remained stable (0.13 ± 0.24 EDSS point/year pre-menopausal vs. 0.13 ± 0.18 post-menopause, p = 0.935). EDSS progression events frequency was similar before and after the menopause (37.8 vs. 48.6%, respectively, p = 0.424). These observations persisted in patients’ subgroups without DMT switch or co-morbidities. Conclusions: Following menopause, we observed a reduction in the relapse rate, but the disability progression continued at a similar rate, compared to the pre-menopausal period. These observations persisted in the subgroup of patients without changes in DMT or co-morbidities diagnosed during the observation period.

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Boog, Katie, and Michelle Cooper. "Contraception for women aged 40 and over." Journal of Prescribing Practice 2, no. 3 (March 2, 2020): 136–41. http://dx.doi.org/10.12968/jprp.2020.2.3.136.

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Although fertility naturally declines with age, women who do not wish to become pregnant require contraception until menopause. The safety profile for contraception in women over 40 is different to that of younger women, due to an increased background risk of co-morbidities such as venous thromboembolism, osteoporosis and breast cancer. Conversely, contraception may alleviate or mask symptoms of perimenopause, such as vasomotor symptoms or problematic periods, conferring additional non-contraceptive benefits to women in this age group. For these reasons, the risk-benefit ratio for women over 40 using contraception is different to that of younger women and requires specific consideration when working with women to choose a suitable method of contraception.

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Salini, Dr Mrs Asok, and Dr Govindaswamy Poornima Jeyanthi. "Impact of Estradiol on Circulating Markers of Oxidative Stress among Hypertensive Postmenopausal Women with Co-morbidities." International Journal of Medical Research and Review 2, no. 6 (December 31, 2014): 544–52. http://dx.doi.org/10.17511/ijmrr.2014.i06.07.

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Warren-Jeanpiere, Lari, Heather Dillaway, Pilar Hamilton, Mary Young, and Lakshmi Goparaju. "Taking It One Day at a Time: African American Women Aging with HIV and Co-Morbidities." AIDS Patient Care and STDs 28, no. 7 (July 2014): 372–80. http://dx.doi.org/10.1089/apc.2014.0024.

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Arnaudo, Camila L., Barbara Andraka-Christou, and Kacy Allgood. "Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment." Current Addiction Reports 4, no. 1 (March 2017): 1–13. http://dx.doi.org/10.1007/s40429-017-0132-4.

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Kuroda, Tatsuhiko, Masataka Shiraki, Shiro Tanaka, and Hiroaki Ohta. "Contributions of 25-hydroxyvitamin D, co-morbidities and bone mass to mortality in Japanese postmenopausal women." Bone 44, no. 1 (January 2009): 168–72. http://dx.doi.org/10.1016/j.bone.2008.03.023.

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Joshi, R. G., D. R. Shakya, P. M. Shyangwa, and B. Pradhan. "Co-morbidity in women with alcohol dependence syndrome (ADS) in Eastern Nepal." Journal of Psychiatrists' Association of Nepal 5, no. 1 (September 29, 2017): 18–21. http://dx.doi.org/10.3126/jpan.v5i1.18326.

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Introduction: Women with ADS may have psychiatric comorbidites along with physical comorbidities. Societal attitudes towards women and alcohol are barriers to the detection and treatment of their alcohol related problems.Objective: To explore the magnitude of co-morbidity among women with ADS in Eastern Nepal.Method: This is a hospital based cross-sectional study of women with ADS. Those who scored two or more than two in T-ACE questionnaire were enrolled. The diagnosis was made according to ICD-10 criteria. Consultation with concerned physician was done to assess physical condition.Result: Fifty one patients with ADS were enrolled. Among them, 21.6% had no comorbidity, 52.9% had single co-morbidity (psychiatric or physical) and 25.5% had both psychiatric and physical co-morbidity. In psychiatric comorbidity, mood disorder in 35.29% was the commonest followed by nicotine use in 26.47%. Among mood disorders 83.3% had depression. In physical comorbidity, disease of gastrointestinal tract and hepatobiliary system in 50.9% was the commonest followed by hypertension in 11.5%.Conclusion: : Psychiatric as well as physical co-morbidities are common in women with ADS. The finding points to the importance of exploring comorbidities and their optimal treatment.

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Millington, Sandra, Suzanne Edwards, Robyn A. Clark, Gustaaf A. Dekker, and Margaret Arstall. "The association between guidelines adherence and clinical outcomes during pregnancy in a cohort of women with cardiac co-morbidities." PLOS ONE 16, no. 7 (July 23, 2021): e0255070. http://dx.doi.org/10.1371/journal.pone.0255070.

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Background/Aims Maternal and infant morbidities associated with pregnant women with cardiac conditions are a global issue contingent upon appropriate care. This study aimed to describe the clinical variables and their association with the adherence scores to perinatal guidelines for pregnant women with cardiac conditions. The clinical variables included cardiac, perinatal, and neonatal outcomes and complications. Methods Using a retrospective cross-sectional medical record audit, data were abstracted and categorised as cardiac, obstetric, and neonatal predictors. Linear regression modelling was used to find the mean difference (MD) in adherence scores for each predictor, including a 95% confidence interval (CI) and a significance value for all the three categories’ clinical outcomes. Results This maternal cohort’s (n = 261) cardiac complications were primarily arrhythmias requiring treatment (29.9%), particularly SVT (28%), a new diagnosis of valvular heart disease and congenital heart disease (24%) and decompensated heart failure (HF) (16%). Women with HF had associated increased adherence scores (MD = 3.546, 95% CI: 1.689, 5.403) compared to those without HF. Elective LSCS mode of delivery was associated with a higher adherence score (MD = 5.197, 95% CI: 3.584, 6.811) than non-elective LSCS subgroups. Babies admitted to intensive /special care had greater adherence to the guidelines (MD = 3.581, 95% CI: 1.822, 5.340) than those not requiring the same care. Conclusions Some pregnancy associated complications and morbidities were associated with higher adherence scores, reflecting that a diagnosis, identification of morbidities or risk factors, initiation of appropriate multidisciplinary involvement and adherence to guidelines were associated. Conversely, potentially avoidable major complications such as sepsis were associated with a low adherence score. Trial registration ACTRN12617000417381.

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Ku, Grace, Richard H. White, Helen K. Chew, Danielle Harvey, Hong Zhou, and Ted Wun. "Incidence of Venous Thromboembolism in Patients with Acute Leukemia." Blood 108, no. 11 (November 16, 2006): 1497. http://dx.doi.org/10.1182/blood.v108.11.1497.1497.

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Abstract Introduction: Although the association between solid tumors and venous thromboembolism (VTE: lower extremity deep venous thrombosis and pulmonary embolism) is well known, less is known about the risk of thrombosis and its clinical impact in acute leukemia. Recent reports suggest that VTE in hematological malignancies is not rare. Materials and Methods: The California Cancer Registry was linked to both the California Patient Discharge Data Set and the master death registry to determine the incidence of VTE (exclusive of upper extremity DVT) in patients with acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL) over a 6-year period and overall survival. Cox proportional hazards modeling was performed to analyze the effect of potential risk factors on the incidence of VTE and death. Results: There were 5394 cases with AML (45.4% women, mean age 60.4 ± 21 years). The cumulative incidence and person-time rate of VTE are shown in the table. Significant predictors of VTE were female sex (hazard ratio (HR)=1.4, CI: 1.0–1.9), 2 chronic co-morbidities (HR= 1.8, CI: 1.2–2.6), the presence of a catheter (HR=1.6, CI: 1.1–2.3), and advancing age (HR ≥4 for each decade starting at 16 years), but not FAB category. Diagnosis of VTE was not associated with reduced survival. Significant predictors of death within 2 years were an increasing number of chronic co-morbidities (HR ≥1.3 for increasing co-morbidities), and advancing age (referent age < 16) (HR ≥1.6 for each decade). FAB M3 was associated with improved survival. There were 2482 cases of ALL (42.7% women, mean age 25.3 ± 25 years). The cumulative incidence and person-time incidence rate of VTE are shown in the table. Three or more co-morbidities (HR=2.5, CI: 1.2–5.0), increasing age (HR ≥5.4 for each decade), and the presence of a catheter (HR=2.3, CI: 1.3–4.3) were risks factors for VTE, but not FAB classification. Predictors of death in patients with ALL were ≥3 co-morbidities (HR=1.5, CI: 1.2–1.9), increasing age (HR ≥3.6 for each decade), and FAB L3, but not VTE. Conclusions: VTE in patients with AML/ALL was not rare. The two-year cumulative incidence of VTE in patients with either AML or ALL was about 3.6%, with over half the cases diagnosed in the first 3 months. This incidence and time course are similar to the findings reported among patients with solid tumors. Presence of chronic medical co-morbidities was associated with development of VTE, as was the presence of a catheter. The higher risk of VTE in females with AML is unexplained. In contrast to patients with solid tumors, VTE was not a predictor for shortened survival in acute leukemia patients. Thromboprophylaxis should be considered in patients hospitalized with acute leukemia. Cumulative Incidence and Rate of VTE in Acute Leukemia Cumulative Incidence (%) Rate per 100 patient years Time AML (n=5394) ALL (n=2482) AML ALL < 3 months 120 (2.2) 52 (2.1) 12.6 9.3 4–6 months 34 (0.6) 18 (0.7) 5.1 3.5 7–12 months 27 (0.5) 13 (0.5) 2.8 1.4 13–24 months 14 (0.3) 9 (0.4) 1.1 0.5 Total 195 (3.6) 92 (3.7) 5.0 2.5

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Cook, M. J., S. M. M. Verstappen, M. Lunt, and T. W. O’Neill. "514 FRAILTY IN OSTEOARTHRITIS AND THE INFLUENCE OF CO-MORBIDITY." Age and Ageing 50, Supplement_2 (June 2021): ii5—ii7. http://dx.doi.org/10.1093/ageing/afab118.10.

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Abstract Introduction Risk factors for frailty, including low physical activity and chronic pain, are common among people with osteoarthritis. The aim of this analysis was to determine the association between osteoarthritis and frailty and to determine whether comorbidities interact additively with OA to increase the likelihood of frailty. Methods Men and women aged 40-69 years who contributed to the UK Biobank were analysed. Data about self-reported physician-diagnosed diseases was collected, as well physical measurements, including hand-grip strength. Frailty (robust, pre-frail, frail) was assessed using a modified frailty phenotype, comprising five components: low grip strength, slow walking speed, weight loss, low physical activity, and exhaustion. The association between osteoarthritis and the frailty phenotype was determined using negative binomial regression, adjusting for age, sex, body mass index, smoking status, and Townsend deprivation score. We calculated the attributable proportion of risk of frailty due to additive interaction between osteoarthritis and common co-morbidities (cardiovascular disease, diabetes, COPD, and depression). Results 457,561 people were included, 35,884 (7.8%) had osteoarthritis. The adjusted relative risk ratio (95% CI) for pre-frailty and frailty (versus robust), respectively was higher among people with (versus without) osteoarthritis: 1.58 (1.54, 1.62) and 3.41 (3.26, 3.56). There was significant additive interaction between the presence of osteoarthritis and each of the co-morbidities considered in increasing risk of frailty, particularly diabetes (attributable proportion of risk due to additive interaction with osteoarthritis (95% CI)), 0.49 (0.42, 0.55), coronary heart disease 0.48 (0.41, 0.55), and depression 0.47 (0.41, 0.53). Conclusions Our results suggest that people with OA are at increased risk of pre-frailty and frailty. The mechanisms are not fully understood, though co-morbidity appears to contribute to the risk of frailty beyond the expected additivity of risk due to OA and co-morbidity. Early diagnosis and optimal management of co-morbidities in people with OA may be beneficial.

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Forbrig, Robert, Philipp Renner, Piotr Kasprzak, Marc-H. Dahlke, René Müller-Wille, Christian Stroszczynski, and Peter Heiss. "Outcome of primary percutaneous stent-revascularization in patients with atherosclerotic acute mesenteric ischemia." Acta Radiologica 58, no. 3 (July 12, 2016): 311–15. http://dx.doi.org/10.1177/0284185116647212.

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Background Patients with acute mesenteric ischemia (AMI) often exhibit severe co-morbidities and significant surgical risks, leading to high perioperative morbidity. Purpose To investigate the feasibility of primary percutaneous stent-revascularization (PPSR) in atherosclerotic AMI and its impact on patients’ outcome. Material and Methods Retrospective analysis of 19 consecutive patients (7 women, 12 men; median age, 69 years) with AMI caused by atherosclerotic, non-embolic stenoses/occlusions of the splanchnic arteries and PPSR. Alternative minimally invasive techniques were excluded. Clinical characteristics including the Charlson Comorbidity Index adjusted by age (CCIa) and symptom duration, technical and clinical success of PPSR, clinical course, 30-day mortality, and follow-up were evaluated and compared to literature data for surgical approaches. Technical success was defined as residual stenosis of <30% in diameter. Clinical success was defined as resolution of symptoms of AMI and/or normalization of serum lactate after sole PPSR. Results The majority of patients presented with severe co-morbidities (CCIa >4 in 17 of 19 patients, 89%). Median symptom duration was 50 h. Technical and clinical success rates of PPSR were 95% (21 of 22 arteries) and 53% (10 of 19 patients). Seven patients underwent subsequent laparotomy with bowel resection in four cases. Thirty-day mortality was 42% (8 of 19 patients). Conclusion In our study population of patients with atherosclerotic AMI, severe co-morbidities, prolonged acute symptoms, and significant perioperative risks PPSR of splanchnic stenoses were technically feasible and the clinical outcome was acceptable.

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Palomba, Stefano. "Is fertility reduced in ovulatory women with polycystic ovary syndrome? An opinion paper." Human Reproduction 36, no. 9 (August 1, 2021): 2421–28. http://dx.doi.org/10.1093/humrep/deab181.

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Abstract Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility; however, whether women with PCOS and spontaneous or drug-induced ovulatory cycles have the same reproductive potential as non-PCOS controls is a matter of debate. In the present opinion paper, the author takes the opportunity to summarize the collective evidence supporting the hypothesis of reduced fertility potential in women with PCOS, regardless of ovulatory status, and speculate that reduced reproductive potential may be caused by altered oocytes, embryo and endometrial competence, and infertility-related co-morbidities as well as an increased risk of pregnancy complications.

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Dioun, Shayan M., Eirwen Murray Miller, Joan Tymon-Rosario, Dennis Yi-Shin Kuo, and Nicole Suzanne Nevadunsky. "A retrospective evaluation of unplanned hospital admission rates for women with ovarian cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18129-e18129. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18129.

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e18129 Background: Unplanned admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates 10-35% in women with ovarian cancer receiving chemotherapy. It is unclear whether the Oncology Care Model is sustainable based on these admission rates. We sought to evaluate the rate and risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, all patients with epithelial ovarian cancer who received chemotherapy at our institution from 2005-2016 were identified. Charts were retrospectively reviewed for clinicopathologic data. Categorical variables were compared with chi-squared and continuous variables with the student t-test. Results: 222 evaluable patients were identified. 37 (17%) patients had unplanned admissions following initial chemotherapy. Indications for admission included neutropenic fever (9), abdominal pain (15), metabolic disturbances (2), infection (3), and other (8). The median number of days from chemotherapy to admission was 8 (IQR 7-18.5). No significant differences were seen in race, medical co-morbidities, age, or BMI in admitted patients. Stage and primary neoadjuvant chemotherapy were predictive of admission. Conclusions: Unplanned hospital admission rates following initial chemotherapy in our racially diverse patient population are consistent with previously reported rates. Though age and medical co-morbidities did not predict admission, stage and primary neoadjuvant chemotherapy were predictive of subsequent admission. The Oncology Care Model may not account for hospital admission rates of this magnitude and further investigation is needed to identify predictors of hospitalization and poor outcomes. [Table: see text]

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Rao, Vibhuti Samarth, Stephanie Cowan, Mike Armour, Caroline A. Smith, Birinder S. Cheema, Lisa Moran, Siew Lim, et al. "A Global Survey of Ethnic Indian Women Living with Polycystic Ovary Syndrome: Co-Morbidities, Concerns, Diagnosis Experiences, Quality of Life, and Use of Treatment Methods." International Journal of Environmental Research and Public Health 19, no. 23 (November 28, 2022): 15850. http://dx.doi.org/10.3390/ijerph192315850.

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Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is highly prevalent in women of Indian ethnicity. Clinical practice guidelines do not adequately consider ethnic–cultural differences in the diagnosing and care of women with PCOS. This study aimed to understand co-morbidities, key concerns, quality of life (QoL), and diagnosis experiences of ethnic Indian women living with PCOS. Methods: Global online survey of ethnic Indian women of reproductive age living with PCOS. Results: Respondents (n = 4409) had a mean age of 26.8 (SD 5.5) years and reported having a family history of type 2 diabetes (43%) and PCOS (18%). Most of them (64%) were diagnosed with one or more co-morbidities (anxiety/depression being the most common). Irregular periods, cysts on the ovaries, and excess unwanted facial hair growth were their three top concerns. On average, women experienced symptoms of PCOS at the age of 19.0 (SD 5.0) and were diagnosed at the age of 20.8 years (SD 4.8). We report a one-year delay in seeking medical help and a seven-month diagnostic delay, which were associated with poor satisfaction with the information provided related to PCOS and its treatment options (p < 0.01). Women living outside India reported difficulty losing weight as their most key concern; however, they had higher dissatisfaction with the information provided on diet (OR, 0.74; 95% CI, 0.6 to 0.8; p = 0.002), exercise (OR, 0.74; 95% CI, 0.6 to 0.9; p = 0.002) and behavioural advice (OR, 0.74; 95% CI, 0.6 to 0.9; p = 0.004) than women living in India. Most women reported poor QoL in weight and emotion domains. Conclusions: Ethnic Indian women experience early onset of PCOS symptoms and delay in seeking professional help. Timely diagnosis, providing cultural-specific education related to lifestyle and weight management, and improving psycho-emotional support are key areas that should be addressed in clinical practice and future research.

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Zahid, Mohammed. "Journal Watch." Acute Medicine Journal 10, no. 3 (July 1, 2011): 150–52. http://dx.doi.org/10.52964/amja.0498.

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The aim of this study was to look at the association between new onset atrial fibrillation (AF) and mortality as well as the influence of cardiovascular co-morbidities on risk in middle-aged women without cardiovascular disease at baseline. This large study demonstrated that those women who developed AF had an increased risk of all-cause, cardiovascular, and non-cardiovascular mortality compared with women who did not develop AF. Excess mortality associated with AF appears attributable to the occurrence of nonfatal cardiovascular events prior to death. It would seem that cardiovascular risk factors should be managed aggressively in patients with AF to try to reduce these deaths. Conen D, et al. JAMA 2011 May 25; 2080 – 87

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Hsu, Li-Chuan, Kuan-Hao Tsui, James Cheng-Chung Wei, Hei-Tung Yip, Yao-Min Hung, and Renin Chang. "Female Human Papillomavirus Infection Associated with Increased Risk of Infertility: A Nationwide Population-Based Cohort Study." International Journal of Environmental Research and Public Health 17, no. 18 (September 7, 2020): 6505. http://dx.doi.org/10.3390/ijerph17186505.

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Objective. This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility. Material and Methods. All patients with an HPV infection (n = 11,198) in Taiwan’s National Health Insurance Research Database (2000–2012) were propensity score matched with control subjects (n = 11,198) without an HPV infection by age, sex, index year, and relevant co-morbidities. Both groups were tracked until a diagnosis of infertility was recorded. The Chi-square test was used to analyze the distribution of demographic characteristics in the HPV group and non-HPV group. A Cox proportional hazards regression was used to estimate the hazard ratios (HRs) for the development of infertility, adjusting for age, sex, and co-morbidities. The Kaplan–Meier method was used to plot the cumulative incidence curves. We also performed negative controls to test for possible unmeasured confounding. Results. The HPV cohort had a higher risk of infertility. The adjusted HR (aHR) was found to be 1.39 (95% CI = 1.19–1.63) after adjusting for demographic characteristics and relevant co-morbidities. In the age subgroup analysis, patients with an HPV infection had an increased risk of infertility compared to the non-HPV cohort in the group aged 26 to 35 years (aHR, 1.53; 95% CI = 1.24–1.88). As we used propensity score matching to treat measurable confounders and negative controls to access unmeasured confounders, the findings of the study are robust. Conclusions. Among females of reproductive age, HPV infection is a potential risk factor that predisposes individuals to subsequent infertility.

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Chawan, Amba Prasad, Yashwant Singh Rathore, Sunil Chumber, and Kamal Kataria. "Surgical diseases and surgical outcomes in geriatric patients." International Surgery Journal 7, no. 10 (September 23, 2020): 3315. http://dx.doi.org/10.18203/2349-2902.isj20204129.

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Background: To study the demography, disease distribution and co morbid conditions, complications and mortality among elderly patients undergoing operation in general surgical wards.Methods: A prospective observational study was conducted among elderly patients of age ≥60 years admitted in General Surgery wards at our institute for a period of a year. Results: A total of 137 patients were recruited in this study. Out of them 62.04% were men and 37.96% were women. Most common system involved was hepatobiliary with a total of 38 cases (27.7%), most common surgical disease in our study was hernias (27%) and gallstone disease (25%). About 55.5% of our study population had co morbid medical conditions. Hypertension was the most common co morbidity (38%) in our study. Out of 137 cases, 115 cases were elective cases and 22 were emergency cases, operated in emergency settings. About 16.7% of the study population had surgical complications. Post-operative seroma formation at the surgical site was the most common complication. About 7 cases were succumbed to death and mortality rate was about 5.1% in our study population.Conclusion: Prevalence of medical co morbidities is higher in elderly population. Out of them, hypertension and diabetes mellitus are the most common co morbid conditions. Most common indications for elective surgery in our study are hernias and gallstone disease. Early elective surgical intervention is preferred in elderly population when presented, as age, co morbidities and emergency settings increase risk of perioperative mortality.

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Ansule, Ilze, Anda Kīvīte - Urtāne, and Inga Millere. "PATIENTS NEED TO RECEIVE THE SAME KIND OF INFORMATION ABOUT THE SAME ISSUE FROM EACH PROFESSIONAL." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 4 (May 28, 2021): 265–73. http://dx.doi.org/10.17770/sie2021vol4.6405.

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The questionnaire has been developed from a validated instrument “Women’s Experience of Maternity Care” (author - National Health Service, (Great Britain, 2019) and adapted to the situation in Latvia. The permission to use it has been obtained from authors. The questionnaire is meant for women regardless of their health status during the perinatal period or who have no co-morbidities, diagnosed in perinatal period of care. The questionnaire is designed to find out patients' experiences of receiving healthcare and its compliance with the guidelines, identifying potential problems and creating opportunities to correct them. There were 50 patients in Maternity Hospital postpartum unit interviewed. 12 of them were women living with HIV. Results. One of five main comment themes was - patients felt the need to receive the same kind of information about the same issue from all health care professional regardless of staff changes on call. The women point out that they have no problems with content in communication process during intranatal period, at labor unit. The problem with different kind of information about the same matter is emerging in postpartum period, at maternity unit. This issue is bothering both groups of patients in postnatal period, those women who live with HIV and those who have no co-morbidities, diagnosed in perinatal period. This shows that there is different kind of knowledge and professional skills among health care professionals, even if they work in the same field, the same hospital and the same unit. There should be done more research to identify the source of this problem. Is it the different experience, knowledge, informational field where professionals seek for information or totally different reason for this phenomena.

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Brandt, Rachael, Cristina Polinsky, Jessica Katz, Minal Dhamankar, Rosemarie Tucci, Jennifer L. Sabol, and Terri McHugh. "Factors influencing risk reduction surgery among BRCA mutation carriers: A qualitative analysis." Journal of Clinical Oncology 30, no. 27_suppl (September 20, 2012): 53. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.53.

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53 Background: Women known to carry deleterious mutations in BRCA1 and BRCA2 have a substantially increased lifetime risk to develop breast and ovarian cancer. Current risk management options include increased surveillance, chemoprevention and risk reducing surgery. Several studies have quantitatively evaluated the reasoning of high risk women for electing surgical intervention, noting mutation carrier status as a significant, but not sole rationale for this decision. The decision for surgery has also been associated with family cancer history, anxiety, demographics, healthcare setting and prior counseling. More insights regarding factors influencing women’s choice for risk reduction are needed. Methods: To further assess factors influencing the decision to have risk reduction surgery among women in a community hospital system, 129 BRCA mutation carriers in a community-based genetic counseling program were invited to participate in a qualitative study using questionnaires. A thematic analysis was performed by two independent reviewers on open dialogue responses. Results: Of the 59 respondents, 54 completed the question specifically addressing factors regarding the decision on surgery. Of them, 32 opted for mastectomy, salpingo-oophorectomy or both and 22 opted against surgical risk reduction. Themes emerging in support of surgery included: vicarious experience attributable to a strong family history of cancer; desire for control over risk through surgical intervention; high risk perception; co-morbidities; desire for living, regarding longevity and for loved ones; fear of cancer; and skepticism related to cancer detection methods. For women opting against surgery, themes included: co-morbidities; age (too old/young); incomplete childbearing; logistics (scheduling, finances); lack of disease; and skepticism in effectiveness of surgery. Conclusions: While various factors have been studied regarding the association with or probability of women’s decisions for risk reduction surgery, a deeper comprehension of women’s reasoning can be attained through qualitative analysis. This understanding may enhance health care providers’ ability to counsel women regarding this choice.

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Gupta, Kalpana, Thomas M. Hooton, Kurt G. Naber, Björn Wullt, Richard Colgan, Loren G. Miller, Gregory J. Moran, et al. "International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases." Clinical Infectious Diseases 52, no. 5 (March 1, 2011): e103-e120. http://dx.doi.org/10.1093/cid/ciq257.

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Abstract A Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the 1999 Uncomplicated Urinary Tract Infection Guidelines by the IDSA. Co-sponsoring organizations include the American Congress of Obstetricians and Gynecologists, American Urological Association, Association of Medical Microbiology and Infectious Diseases–Canada, and the Society for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. The issues of in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) were considered as important factors in making optimal treatment choices and thus are reflected in the rankings of recommendations.

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Gupta, Kalpana, Thomas M. Hooton, Kurt G. Naber, Björn Wullt, Richard Colgan, Loren G. Miller, Gregory J. Moran, et al. "Executive Summary: International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases." Clinical Infectious Diseases 52, no. 5 (March 1, 2011): 561–64. http://dx.doi.org/10.1093/cid/cir102.

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Abstract A Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the 1999 Uncomplicated Urinary Tract Infection Guidelines by the IDSA. Co-sponsoring organizations include the American Congress of Obstetricians and Gynecologists, American Urological Association, Association of Medical Microbiology and Infectious Diseases–Canada, and the Society for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. The issues of in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) were considered as important factors in making optimal treatment choices and thus are reflected in the rankings of recommendations.

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Jega, F., A. El Ayadi, S. Miller, S. Raifman, R. Lechtenberg, C. Heiberg, D. Isaacson, and R. Jayaweera. "I160 CO-MORBIDITIES AND LACK OF BLOOD NEGATIVELY AFFECT MATERNAL OUTCOMES OF WOMEN TREATED WITH NASGS IN NIGERIA." International Journal of Gynecology & Obstetrics 119 (October 2012): S200—S201. http://dx.doi.org/10.1016/s0020-7292(12)60190-8.

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Dennison, Elaine M., Juliet E. Compston, Julie Flahive, Ethel S. Siris, Stephen H. Gehlbach, Jonathan D. Adachi, Steven Boonen, et al. "Effect of co-morbidities on fracture risk: Findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)." Bone 50, no. 6 (June 2012): 1288–93. http://dx.doi.org/10.1016/j.bone.2012.02.639.

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48

Ratu, Felisita Tupou, Kathleen Ryan, Netsanet Workneh Gidi, Ilisapeci Vereti, Tsinuel Girma, Jeremy Oats, Ingrid Bucens, Alexandra Robinson, Claire von Mollendorf, and Fiona M. Russell. "Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries." Gates Open Research 4 (July 21, 2021): 108. http://dx.doi.org/10.12688/gatesopenres.13156.2.

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Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.

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Ratu, Felisita Tupou, Kathleen Ryan, Netsanet Workneh Gidi, Ilisapeci Vereti, Tsinuel Girma, Jeremy Oats, Ingrid Bucens, Alexandra Robinson, Claire von Mollendorf, and Fiona M. Russell. "Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries." Gates Open Research 4 (July 16, 2020): 108. http://dx.doi.org/10.12688/gatesopenres.13156.1.

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Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.

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Collins, Lauren F., Anandi N. Sheth, C. Christina Mehta, Elizabeth T. Golub, Phyllis C. Tien, Kathryn Anastos, Audrey L. French, et al. "977. The Prevalence and Burden of Non-AIDS Co-Morbidities in Women with or At-risk for HIV Infection in the United States." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S36. http://dx.doi.org/10.1093/ofid/ofz359.079.

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Abstract Background Age-related non-AIDS comorbidities (NACM) increasingly account for morbidity and mortality in persons living with HIV. The burden of NACM and its association with HIV is poorly described in women. Methods We analyzed data from HIV+ and at-risk HIV− participants who were followed in the Women’s Interagency HIV Study (WIHS) after 2009 (when >80% of participants used antiretroviral therapy). The prevalence of each NACM (defined by a combination of self-report, clinical measurements, and laboratory data) and the number of NACM were summarized at a most recent follow-up visit and were compared by age and HIV serostatus using unadjusted linear regression models. Results There were 3232 women (2309 HIV+, 923 HIV–) with a median follow-up of 15.3 years. The median age was 50 years, 65% were black, 38% currently smoked, 71% had ever used illicit drugs, 50% had annual income < $12,000, and median body mass index was 30 kg/m2. HIV+ women had a median CD4 count of 618 cells/mm3 and 66% had HIV viral suppression. Among 10 NACM evaluated, the following were more prevalent in HIV+ vs. HIV– women (all P < 0.01): psychiatric illness (57%/48%), liver disease (45%/26%), hyperlipidemia (40%/35%), bone disease (40%/33%), chronic kidney disease (15%/7%), and non-AIDS cancer (11%/7%). There was little difference in the prevalence of hypertension (66%/64%), lung disease (41%/43%), diabetes (22%/24%), and cardiovascular disease (19%/19%). Mean number of NACM was higher in HIV+ vs. HIV– women (3.6 vs. 3.0, P < 0.0001). Regardless of HIV serostatus, NACM burden significantly increased with age (P < 0.0001). Compared with women aged <40 of the same HIV serostatus, the estimated mean difference in NACM (HIV+/HIV–) for those 40–49, 50–59, ≥60 years was 1.1/0.7, 2.3/2.3, and 3.6/3.2, respectively (P < 0.0001 for all). Within-age-group comparisons revealed significantly greater NACM burden in HIV+ vs. HIV− women aged 40–49 years (P < 0.0001) and ≥60 years (P = 0.003), but not in those aged <40 or 50–59 years (HIV*age interaction P = 0.02) (figure). Conclusion NACM burden was high in both HIV+ and at-risk HIV– women, but higher in HIV+ women overall and in certain age groups. Accumulation of NACM has complex implications for clinical care, medication management, and healthcare screening that must be further examined in this population. Disclosures Anandi N. Sheth, MD, MS, Gilead Sciences, Inc.: Research Grant.

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