scholarly journals Prevalence of endometriosis in women undergoing laparoscopic surgery for various gynaecological indications at a Jordanian referral centre: gaining insight into the epidemiology of an important women's health problem

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Muhaidat ◽  
Shawqi Saleh ◽  
Kamil Fram ◽  
Mohammed Nabhan ◽  
Nadia Almahallawi ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Women’S Health ◽  
Women's Health ◽  
Reproductive Age ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
High Parity ◽  
Patient Demographics ◽  
Gynaecological Laparoscopy ◽  
The Mean

Abstract Background Endometriosis is a considerable health challenge for women of reproductive age. Information about its prevalence in the Jordanian population is sparse. The objective of this research was to evaluate the presence of endometriosis in gynaecological patients undergoing laparoscopic surgery for various indications and to correlate the finding of endometriosis with variables, including patient demographics, obstetric history, type, and indication of laparoscopic procedure. Methods A retrospective cohort study involving 460 women who underwent different laparoscopic procedures for a variety of indications was conducted in the Department of Obstetrics and Gynaecology in Jordan University Hospital, a tertiary referral hospital in Jordan, between January 2015 and September 2020. Results The prevalence of endometriosis in this patient group was higher than that of the general population (13.7% vs. 2.5%), and the mean age at diagnosis (31.9 years) was younger than the general population's age of peak incidence (35–45 years). It was significantly higher in women with lower numbers of pregnancies (p = 0.01) and a lower number of Caesarean sections (p = 0.05) and in those where the indication for surgery was related to decreased fertility or pelvic pain (p = 0.02). Women with high parity or where the surgery's indication suggested normal fertility, such as family planning, were less likely to have endometriosis. Conclusion To our knowledge, this is the first Jordanian study to assess the prevalence of endometriosis in women undergoing gynaecological laparoscopy. This study suggests that the epidemiology of endometriosis in this region follows similar trends to what has been previously documented in international literature, while emphasizing the need for further research into this important women's health issue in this part of the world.

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

scholarly journals Moyamoya vasculopathy – Patient demographics and characteristics in the Finnish population

2016 ◽  
Vol 12 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Marika Saarela ◽  
Satu Mustanoja ◽  
Johanna Pekkola ◽  
Tiina Tyni ◽  
Juha Hernesniemi ◽  
...  
Keyword(s):  
Disease Onset ◽  
Clinic Visit ◽  
University Hospital ◽  
Genetic Profile ◽  
German Population ◽  
Patient Demographics ◽  
Presenting Symptoms ◽  
Female Predominance ◽  
The Mean ◽  
Revascularization Surgery

Background and purpose Moyamoya vasculopathy, a rare steno-occlusive progressive cerebrovascular disorder, has not been thoroughly studied in Caucasian populations. We established a registry of Finnish patients treated at the Helsinki University Hospital, to collect and report demographic and clinical data. Methods We collected data both retrospectively and prospectively from all the patients with a moyamoya vasculopathy referred to our hospital between January 1987 and December 2014. All patients underwent a neurological outpatient clinic visit. Results We diagnosed 61 patients (50 females, 10 children) with moyamoya vasculopathy. The mean age at the disease-onset was 31.5 ± 17.9 years. The two most common presenting symptoms were ischemic stroke (n = 31) and hemorrhage (n = 8). Forty-four percent underwent revascularization surgery, and 70% were prescribed antithrombotic treatment. Conclusions The results support in part the Western phenotype of the disease considering the later presentation and larger female predominance compared to the Asian moyamoya vasculopathy reports. However, the proportion of ischemic strokes and hemorrhagic strokes is closer to Japanese population than German population. The absence of familial cases points to a different genetic profile in the Finnish patients.

scholarly journals Determinants of rural-urban differences in health care provider visits among women of reproductive age in the United States

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0240700
Author(s):  
Hyunjung Lee ◽  
Ashley H. Hirai ◽  
Ching-Ching Claire Lin ◽  
John E. Snyder
Keyword(s):  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Rural Women ◽  
Reproductive Age ◽  
County Level ◽  
Care Providers ◽  
Provider Type ◽  
Women Of Reproductive Age

Background Rural health disparities and access gaps may contribute to higher maternal and infant morbidity and mortality. Understanding and addressing access barriers for specialty women’s health services is important in mitigating risks for adverse childbirth events. The objective of this study was to investigate rural-urban differences in health care access for women of reproductive age by examining differences in past-year provider visit rates by provider type, and quantifying the contributing factors to these findings. Methods and findings Using a nationally-representative sample of reproductive age women (n = 37,026) from the Medical Expenditure Panel Survey (2010–2015) linked to the Area Health Resource File, rural-urban differences in past-year office visit rates with health care providers were examined. Blinder-Oaxaca decomposition analysis quantified the portion of disparities explained by individual- and county-level sociodemographic and provider supply characteristics. Overall, there were no rural-urban differences in past-year visits with women’s health providers collectively (65.0% vs 62.4%), however differences were observed by provider type. Rural women had lower past-year obstetrician-gynecologist (OB-GYN) visit rates than urban women (23.3% vs. 26.6%), and higher visit rates with family medicine physicians (24.3% vs. 20.9%) and nurse practitioners/physician assistants (NPs/PAs) (24.6% vs. 16.1%). Lower OB-GYN availability in rural versus urban counties (6.1 vs. 13.7 providers/100,000 population) explained most of the rural disadvantage in OB-GYN visit rates (83.8%), and much of the higher family physician (80.9%) and NP/PA (50.1%) visit rates. Other individual- and county-level characteristics had smaller effects on rural-urban differences. Conclusion Although there were no overall rural-urban differences in past-year visit rates, the lower OB-GYN availability in rural areas appears to affect the types of health care providers seen by women. Whether rural women are receiving adequate specialized women’s health care services, while seeing a different cadre of providers, warrants further investigation and has particular relevance for women experiencing high-risk pregnancies and deliveries.

scholarly journals Antimullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women's Health Across the Nation

2020 ◽  
Vol 75 (9) ◽  
pp. 554-555
Author(s):  
Joel S. Finkelstein ◽  
Hang Lee ◽  
Arun Karlamangla ◽  
Robert M. Neer ◽  
Patrick M. Sluss ◽  
...  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Reproductive Age ◽  
Antimullerian Hormone ◽  
Antimüllerian Hormone

scholarly journals Antimullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women’s Health Across the Nation

2020 ◽  
Vol 105 (4) ◽  
pp. e1862-e1871 ◽  
Author(s):  
Joel S Finkelstein ◽  
Hang Lee ◽  
Arun Karlamangla ◽  
Robert M Neer ◽  
Patrick M Sluss ◽  
...  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Outcome Measure ◽  
Reproductive Age ◽  
Antimullerian Hormone ◽  
Perimenopausal Women ◽  
Antimüllerian Hormone ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort ◽  
Better Than

Abstract Background A test that helps predict the time to the final menstrual period (FMP) has been sought for many years. Objective To assess the ability of antimullerian hormone (AMH) measurements to predictions the time to FMP. Design Prospective longitudinal cohort study. Setting The Study of Women’s Health Across the Nation. Participants and Measurements AMH and FSH were measured in 1537 pre- or early perimenopausal women, mean age 47.5 ± 2.6 years at baseline, then serially until 12 months of amenorrhea occurred. AMH was measured using a 2-site ELISA with a detection limit of 1.85 pg/mL. Main Outcome Measure Areas under the receiver operating curves (AUC) for AMH-based and FSH-based predictions of time to FMP, stratified by age. Probabilities that women would undergo their FMP in the next 12, 24, or 36 months across a range of AMH values were assessed. Results AUCs for predicting that the FMP will occur within the next 24 months were significantly greater for AMH-based than FSH-based models. The probability that a woman with an AMH <10 pg/mL would undergo her FMP within the next 12 months ranged from 51% at h<48 years of age to 79% at ≥51 years. The probability that a woman with an AMH >100 pg/mL would not undergo her FMP within the next 12 months ranged from 97% in women <48 years old to 90% in women ≥51 years old. Conclusions AMH measurement helps estimate when a woman will undergo her FMP, and, in general, does so better than FSH.

International Diabetes Federation –Putting Women and Diabetes on the Global Agenda

2010 ◽  
Vol 6 (2) ◽  
pp. 10
Author(s):  
Ann Keeling ◽  
Katie Dain ◽  
◽  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
International Diabetes Federation ◽  
Evidence Base ◽  
Reproductive Age ◽  
Political Commitment ◽  
Access To Health Services ◽  
Health Seeking ◽  
Middle Income ◽  
The Impact

Eighty per cent of the 300 million people with diabetes live in low- and middle-income countries and women represent half of this worldwide diabetes community. Gender roles and power dynamics shape vulnerability to diabetes, affect women’s health-seeking behaviour, access to health services and influence the impact of diabetes on women’s health. This creates a set of concerns that are specific to women. In addition, as the prevalence of type 2 diabetes in women of reproductive age has increased, so has the prevalence of gestational diabetes mellitus (GDM), a form of diabetes with onset or that is first recognised during pregnancy. GDM is a major cause of maternal and infant morbidity and mortality and a major factor in the intergenerational transmission of diabetes. The International Diabetes Federation (IDF) is responding to this aspect of the global diabetes epidemic by launching a new programme on women and diabetes. This programme will build the evidence base, promote awareness and political commitment, support gender-responsive health systems and empower women to take a leading role in diabetes prevention.

International Diabetes Federation—Putting Women and Diabetes on the Global Agenda

2010 ◽  
Vol 06 (01) ◽  
pp. 10 ◽  
Author(s):  
Ann Keeling ◽  
Katie Dain ◽  
◽  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
International Diabetes Federation ◽  
Evidence Base ◽  
Reproductive Age ◽  
Political Commitment ◽  
Access To Health Services ◽  
Health Seeking ◽  
Middle Income ◽  
The Impact

Eighty percent of the 300 million people with diabetes live in low- and middle-income countries and women represent half of this worldwide diabetes community. Gender roles and power dynamics shape vulnerability to diabetes, affect women’s health-seeking behavior and access to health services, and influence the impact of diabetes on women’s health. This creates a set of concerns that are specific to women. In addition, as the prevalence of type 2 diabetes in women of reproductive age has increased, so has the prevalence of gestational diabetes mellitus (GDM), a form of diabetes with onset or that is first recognised during pregnancy. GDM is a major cause of maternal and infant morbidity and mortality and a major factor in the intergenerational transmission of diabetes. The International Diabetes Federation (IDF) is responding to this aspect of the global diabetes epidemic by launching a new program on women and diabetes. This programme will build the evidence base, promote awareness and political commitment, support gender-responsive health systems and empower women to take a leading role in diabetes prevention.

P–303 Similar long term recurrence rates with cystectomy and CO2-laser vaporization for endometrioma: a retrospective study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Moura. Tawfic ◽  
C Bafort ◽  
C Meuleman ◽  
A Laenen ◽  
D Va. Schoubroeck ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Co2 Laser ◽  
Reproductive Age ◽  
University Hospital ◽  
Laser Vaporization ◽  
Recurrence Rates ◽  
Laparoscopic Excision ◽  
Cyst Recurrence ◽  
The Mean

Abstract Study question Is there a difference in recurrence rate of endometrioma(s) after cystectomy versus CO2-laser vaporization of the cyst wall? Summary answer Similar rates of imaging based recurrence or need for reintervention for endometrioma were observed after cystectomy versus CO2-laser vaporization. What is known already Surgical treatment of endometrioma(s) is mainly performed by 2 types of procedures: cystectomy and ablation. When performing surgery for endometrioma(s), a balance should be made between minimal destruction of normal ovarian cortex and maximal completeness to avoid (early) recurrence. Previous studies have shown that cyst recurrence rates were higher with ablation using bipolar current than after cystectomy. However, only 2 groups have evaluated recurrence rates after cystectomy versus CO2 laser vaporization and found no difference with extended follow-up. Furthermore, ablation with CO2 laser may be less invasive than conventional cystectomy with increased preservation of antral follicles in favor of ablation. Study design, size, duration Single-center retrospective study on data of 271 patients operated between January 2010 and December 2014. Participants/materials, setting, methods Women of reproductive age (18–45 years), undergoing CO2 laser laparoscopic excision of any rAFS-stage endometriosis with at least one endometrioma, were eligible for the study. All 271 included patients were treated in a tertiary referral center for endometriosis of a University Hospital, and underwent complete CO2-laser laparoscopic surgery for endometrioma(s). 155 underwent cystectomy, 77 CO2 laser vaporization, and 46 a mixed technique. Main results and the role of chance The mean duration of follow-up was 58 months. Primary outcome studied was the comparison of recurrence rates between cystectomy and vaporization; secondary outcomes included pregnancy rate and ovarian reserve testing. Recurrence was defined as either imaging based (i.e. cyst recurrence identified at ultrasound and/or MRI) or need for reintervention for suspected cyst recurrence. Imaging based recurrence was reported in 9.92% of patients (n = 12/121) treated with cystectomy and in 11.76% of patients (n = 6/51) who underwent a CO2 laser vaporization (p = .62). The need for reintervention for endometrioma(s) was also similar in both groups, with a rate of 3.23% (n = 5/155) after cystectomy and 4.29% (n = 3/70) after CO2 laser vaporization (p = .567). No difference was seen regarding AMH drop pre- versus postoperatively (p=.233). The 2 study groups were similar, except for the mean cyst diameter, which was higher in the cystectomy group (42.36 ± 25.49 mm) compared to the CO2 laser vaporization group (31.7 ± 26.98 mm) (p = <.001). This suggests that smaller endometriomas might be more likely to undergo CO2 laser vaporization. Limitations, reasons for caution The retrospective character of the study may induce information bias concerning the registration of recurrence. Moreover, regarding the evaluation of imaging-based recurrence, a selection bias cannot be excluded, because most likely only patients complaining about pain would be referred for an ultrasound or planned for a reintervention. Wider implications of the findings: In this study, similar rates of recurrence for endometrioma(s) were observed after cystectomy versus CO2-laser vaporization. Since previous studies suggested that CO2-laser vaporization may cause less damage to the adjacent ovarian tissue, we consider this a valuable alternative technique, especially for women with a future child wish. Trial registration number S59032

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