Four years' experience with the gravigard in nulliparous women

A study of the Gravigard in nulliparous patients is presented. Experience with the use of the device in 348 other patients is drawn upon for the discussion. The Gravigard is shown to be an acceptable form of contraception for nulliparous females who cannot take oral contraceptives. The failure rate was 2-6 per hundred woman-years (HWY) (corrected 1-3/HWY).     

Barriers and pathways to testing among HIV-infected women

N-acetylcysteine (NAC), the acetylated variant of the amino acid L-cysteine, is an excellent source of sulfhydryl (SH) groups, and is converted in the body into metabolites capable of stimulating glutathione (GSH) synthesis, promoting detoxification, and acting directly as free radical scavengers. Administration of NAC has historically been as a mucolytic agent in a variety of respiratory illnesses; however, it appears to also have beneficial effects in conditions characterized by decreased GSH or oxidative stress, such as HIV infection, cancer, heart disease, and cigarette smoking. An 18-dose oral course of NAC is currently the mainstay of treatment for acetaminophen-induced hepatotoxicity. N-acetylcysteine also appears to have some clinical usefulness as a chelating agent in the treatment of acute heavy metal poisoning, both as an agent capable of protecting the liver and kidney from damage and as an intervention to enhance elimination of the metals.     

Determinants of increased energy expenditure in HIV-infected women

The recently discovered endogenous mu receptor selective endomorphin 2 was prepared in tritiated form by a catalytic dehalogenation method resulting in a specific radioactivity of 1.98 TBq/mmol (53.4 Ci/mmol), and used for in vitro labelling of rat brain membranes. The binding was saturable, stereospecific and of high affinity (Kd: 0.97 and 1.12 nM based on kinetic and equilibrium binding studies, respectively). The maximal number of binding sites (Bmax) was found to be 114.8 fmol/mg protein. [3H]Endomorphin 2 was displaced by mu-receptor selective specific peptides and heterocyclic compounds with high affinity, whereas kappa and delta receptor specific ligands were much less potent. The Ki values of endomorphin 1 and 2 in inhibiting [3H]naloxone binding increased by 15-fold in the presence of 100 mM NaCl which indicates the agonist property of these peptides. Endomorphins stimulated [35S]GTPgammaS binding and inhibited adenylyl cyclase activity which also provides evidence for the agonist character of endomorphins.     

Symptom experience and functional status among HIV-infected women

Irrespective of powerful drug therapies, there has been a slight increase in newly diagnosed cases of AIDS in women. HIV/AIDS-related symptoms develop from the illness itself, treatments or medications. Symptoms and their reoccurrence remain problematic. This study is a secondary analysis of data exploring symptoms, symptom distress and functional status in 104 ethnically diverse HIV-positive women. Measures included the Brief Symptom Inventory, a General Symptom Questionnaire, the Center for Epidemiological Studies Depression Scale, and the Inventory of Functional Status. Findings indicate that this sample of women was distressed, at risk for depression and had a moderate level of physical functioning. These findings support the need for symptom management interventions that enhance emotional wellbeing and self-care activities for HIV-infected women.     

Life experiences, coping, and weight preoccupation in young adult women.

Relationships among stress, 3 different styles of coping (task-, emotion-, or avoidance-oriented) and weight preoccupation were examined in 206 female college students (aged 19–55 yrs). The relationships among these variables were examined using the Life Experiences Survey (I. G. Sarason et al, 1978), the Coping Inventory for Stressful Situations (N. S. Endler and J. D. A. Parker, 1999), and the Eating Disorder Inventory (D. M. Garner and M. P. Olmsted, 1984). A hierarchical regression analysis was used to examine whether coping styles and life stress would predict weight preoccupation in this nonclinical sample of university women. Results showed that emotion-oriented coping predicted weight preoccupation regardless of stress. These findings suggest that how one copes with stress is associated with weight preoccupation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of victimization experiences to psychological well-being among homeless women and low-income housed women.

Stressful experiences and their effects on the psychological well-being of 113 homeless women and 116 low-income housed women were investigated. Measures of victimization assessed multiple dimensions of this construct, including criminal victimization, sexual harassment, and sexual abuse. Measures of current daily environmental hassles and quality of family environment while growing up also were included. Additional measures assessed positive and negative interpersonal exchanges, sense of coherence, and overall psychological distress. Regression analyses indicated that victimization experiences were significant predictors of psychological well-being for both samples. Results also highlighted the importance of investigating both the positive and negative dimensions of interpersonal influences as well as internal resources, and suggested that these resources for coping with stress may be differentially perceived and utilized by these groups. These findings also suggest the need for specific preventive and remedial interventions to empower homeless and low-income housed women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' experiences treating Asian American women with eating disorders.

How do psychologists treat eating disorders (EDs) and subclinical issues in Asian American women in a culturally competent manner? Disordered eating and body dissatisfaction are so common in women that most therapists work with the issues to some degree, and it is increasingly likely they will see women of color. Asian American women are at significant risk and yet little treatment literature exists. Twelve therapists with experience in ED treatment were interviewed about their work with Asian American women. Grounded theory and consensual qualitative analysis methods were used to analyze the data, resulting in two central domains of conceptualization within the cultural context and treatment approach. Therapists reported that their clients were mostly first- and second-generation Americans who experienced acculturation stress and cultural conflict, particularly with elders. Other results suggested therapists perceived a strong connection between clients' desires to be thin and successful, and clients' efforts to conform to traditional Asian cultural values and fit in with U.S. mainstream culture. Therapists emphasized the cultural contextualization of family dynamics, developmental processes (e.g., individuation), and intergenerational conflicts. They viewed EDs as providing clients with culturally congruent coping strategies to affectively disconnect and to express distress. Treatment themes centered on psychoeducation and the importance of including parents in the treatment of their adult daughters. Helping clients navigate autonomy within the family and cultural context, and challenging clients and parents on the cultural (both Asian and mainstream U.S.) pressures regarding achievement and beauty were particularly important. Implications for therapy are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pregnancy in women with spinal cord injuries

Most women with spinal cord injuries (SCI) resume normal reproductive function, can have sexual relationships, and become pregnant. Pregnancy is not contraindicated in women with SCI, but pregnant women with acute or chronic SCI pose unique challenges for perinatal health care providers. The normal physiologic changes of pregnancy may predispose women with SCI to potentially life-threatening complications, including autonomic hyperreflexia, pyelonephritis, respiratory insufficiency, thrombophlebitis, and unattended delivery of the infant. This article reviews the effect of SCI on female reproduction, pregnancy, and labor, and summarizes the treatment of the pregnant woman with a spinal cord injury.     

Guepar hinge prosthesis: complications and results with two years' follow-up

Experience with the GUEPAR prosthesis in 292 cases of which 103 have been followed for more than 2 years, suggests that: implanting a hinge prosthesis is major surgery on elderly patients in whom severe complications have occurred and for this reason, the operations should be reserved for extremely damaged and unstable knees; the most important local complications have been deep sepsis for which we have noted a rate of 6.6 per cent; in the treatment of sepsis, everything must be done to preserve the prosthesis because arthrodesis is difficult to obtain; pain relief has been significant as a result of the operation. The prosthetic design allows flexion of more than 90 degrees in 85 per cent of the cases and 120 degrees in 26 per cent; after two years, the results seem relatively stable. We have not observed aseptic loosening after this period but a longer observation period is necessary to be reassured on this point; patellar pain remains a major concern because this arthroplasty has not solved the problem, and other solutions will have to be found.     

Sub-urethral diverticulum in women. Apropos of 12 cases]

Buccopharyngeal motor disorders causing difficulties in swallowing are frequently encountered in clinical medicine. Affected patients manifest distinctive clinical features and pose special problems in their management. A case report is described and summarize the pathogenesis, consequences, evaluation, treatment and some selected clinical conditions that are associated with buccopharyngeal dysphagia.     

Differentiated thyroid cancers. 20 years' results of a protocol based on simple prognostic criteria

OBJECTIVES: To study the long-term results of an aggressive management protocol based on a new-simple classification and to determine the duration for patient follow-up according to this classification. MATERIAL AND METHODS: For the 509 patients with differentiated thyroid carcinoma, the classification was: group 1: cancer < 1 cm (n = 117), group 2A: cancer without extension in patients of age less than 45 years (n = 100), group 2B: cancer without extension in patients aged more than 45 (n = 94), group 3: cancer with nodal extension alone (n = 102), group 4: high risk cancer in patients having either distant metastases or local tissular extension or in whom after iodine-131 ablation, Tg level was > 3 micrograms/l off hormone therapy (n = 96). Total thyroidectomy was the rule except for group 1 and some patients of group 2A in whom the tumor was solitary, relatively small, well-differentiated, with no capsular or capillary invasion. Iodine 131 ablation was carried out after a total thyroidectomy and repeat treatments with iodine 131 were given whenever necessary. RESULTS: In group 1, 2A and 3, the 20 years death rate of cancer was 0 p. 100. For group 2B, patients cancer death rate was 8 p. 100 and for group 4 it was 32 p. 100. Distant metastases were the cause of death except for one patient who died from local recurrence. Clinical inspection, Tg measurement, iodine 131 whole-body scan and chest X-ray were all useful in discovering local or distant recurrences. CONCLUSION: Our results justify the use of an aggressive initial management for differentiated thyroid carcinoma and an appropriate scoring system. When this protocol is applied, patients of group 1, 2 and 3 should have an excellent prognosis. However patients follow-up should not be shorter than 15 years for patients of group 1 and 2A and than 20 years for all other groups.