Clinical Characteristics Of Women Research Articles

Clinical Characteristics of Women in this New Global Immunodeficiency

Introduction: We are facing another kind of immunodeficiency caused by a different mechanism of HIV and the use of some medications such as corticosteroids and immunosuppresses. This article will show that the human being is affected by energy deficiency inside the five internal massive organs (Liver, Heart, Spleen, Lungs and Kidneys) caused by the chronic exposition to electromagnetic radiation after the implementation of cell phones, computers and 4G and 5G technology. It will be shown as to which are the clinical characteristics presented by these women patients that are suffering from this energy deficiency situation (because energy alterations are the main cause of manifestation of many different clinical presentations), and what we need to do to treat this condition accordingly.

A prognostic score to identify women at increased risk for abnormal uterine bleeding during anticoagulation for venous thromboembolism

IntroductionLittle is known about the clinical characteristics of women at increased risk for abnormal uterine bleeding (UB) during anticoagulation for venous thromboembolism (VTE). MethodsWe used the RIETE registry to identify the baseline characteristics of women developing abnormal UB during anticoagulation. We used logistic regression analysis to identify independent predictors for abnormal UB. Then, we built a prognostic score to identify at-risk women. ResultsFrom March 2001 through October 2022, there were 54,372 women with VTE. During anticoagulation (median, 181 days), 318 (0.6%) developed abnormal UB (major bleeding = 88, clinically relevant non-major (CRNM) = 230). On multivariable analysis, women aged <50 years, weighing >70 kg, with uterine cancer, recent UB, anemia, estrogen-related VTE, or receiving rivaroxaban or apixaban were at increased risk for abnormal UB. Using the prognostic score, 42,273 women (78%) were at low-risk, 8,828 (16%) intermediate-, and 3,271 (6.1%) at high-risk for abnormal UB. Their rates of abnormal UB were: 0.28 (95%CI: 0.23–0.35), 1.32 (95%CI: 1.07–1.61) and 7.12 (95%CI: 5.98–8.41) bleeds per 100 patient-years, respectively. The c-statistic was 0.80 (95%CI: 0.77–0.83). The rates of major UB were: 0.06 (95%CI: 0.04–0.09), 0.43 (95%CI: 0.30–0.60) and 1.85 (95%CI: 1.31–2.53) per 100 patient-years, respectively (c-statistic: 0.84; 95%CI: 0.80–0.89). The rates of CRNM uterine bleeding were: 0.21 (95%CI: 0.17–0.26), 0.85 (95%CI: 0.65–1.08), and 5.02 (95%CI: 4.09–6.10) bleeds per 100 patient-years, respectively (c-statistic: 0.78; 95%CI: 0.75–0.82). ConclusionsUsing 7 variables easily available at admission, we built a prognostic score that reliably identified women with VTE at increased risk for abnormal UB during anticoagulation.

Clinical characteristics of women with major depression who suffered sexual abuse in childhood

Clinical characteristics of women with major depression who suffered sexual abuse in childhood

The association of Wnt-signalling and EMT markers with clinical characteristics in women with endometrial cancer.

Endometrial cancer is the most common gynecologic malignancy in the developed world. Risk stratification and treatment approaches are changing due to better understanding of tumor biology. Upregulated Wnt signaling plays an important role in cancer initiation and progression with promising potential for development of specific Wnt inhibitor therapy. One of the ways in which Wnt signaling contributes to progression of cancer, is by activating epithelial-to-mesenchymal transition (EMT) in tumor cells, causing the expression of mesenchymal markers, and enabling tumor cells to dissociate and migrate. This study analyzed the expression of Wnt signaling and EMT markers in endometrial cancer. Wnt signaling and EMT markers were significantly correlated with hormone receptors status in EC, but not with other clinico-pathological characteristics. Expression of Wnt antagonist, Dkk1 was significantly different between the ESGO-ESTRO-ESP patient risk assessment categories using integrated molecular risk assessment.

Socio-demographic and clinical characteristics of women with unsafe abortion in south-western Nigeria

Background: Unsafe abortion is within the five leading causes of maternal mortality in sub Saharan Africa. For every one death related to unsafe abortion, about 25 more women suffer significant morbidity from complications of abortion The aim is to highlight their socio-demographic and clinical characteristics of women with unsafe abortion. Methodology: This was a 5-year retrospective cross-sectional study of 84 women managed for complications of unsafe abortion, at the Federal Teaching Hospital Ido-Ekiti, in South Western Nigeria. Socio-demographic, clinical and abortion related data were obtained from their medical records. Data obtained were expressed in descriptive statistics. Results: Unsafe Abortion accounted for 5.4% of gynaecological admission during the study period. The mean age of the women was 23.2years. They were majorly single (63%), nulliparous (50%) and had secondary level of education (39.3%). Of the 54 (64.3%) who were aware of modern contraceptive options, only 20.4% (11/54) had used contraception previously. About 57% (48/84) was having induced abortion for the first time. Not being ready for a child was the commonest (22.6%) reason provided for procuring abortion. About 85% (71/84) terminated their pregnancy in the first trimester with a mean gestational age of 10.1weeks. Dilatation and curettage was the commonest (56%) method employed. Sepsis and hemorrhage were the leading complications reported in 52.4% (44/84) and 40.5% (34/84) of the women respectively. The fatality rate observed was 2.4% (2/84). Conclusion: Young, single, nulliparous, lowly educated women with no knowledge and usage of modern contraceptive options were identified to have more commonly had unsafe abortion. Sepsis and hemorrhage were the leading associated complications.

Socio-demographic and clinical characteristics of women with unsafe abortion in south-western Nigeria

Socio-demographic and clinical characteristics of women with unsafe abortion in south-western Nigeria

Breast cancer subtype and clinical characteristics in women from Peru.

Breast cancer is a heterogeneous disease, and the distribution of the different subtypes varies by race/ethnic category in the United States and by country. Established breast cancer-associated factors impact subtype-specific risk; however, these included limited or no representation of Latin American diversity. To address this gap in knowledge, we report a description of demographic, reproductive, and lifestyle breast cancer-associated factors by age at diagnosis and disease subtype for The Peruvian Genetics and Genomics of Breast Cancer (PEGEN-BC) study. The PEGEN-BC study is a hospital-based breast cancer cohort that includes 1943 patients diagnosed at the Instituto Nacional de Enfermedades Neoplásicas in Lima, Peru. Demographic and reproductive information, as well as lifestyle exposures, were collected with a questionnaire. Clinical data, including tumor Hormone Receptor (HR) status and Human Epidermal Growth Factor Receptor 2 (HER2) status, were abstracted from electronic medical records. Differences in proportions and mean values were tested using Chi-squared and one-way ANOVA tests, respectively. Multinomial logistic regression models were used for multivariate association analyses. The distribution of subtypes was 52% HR+HER2-, 19% HR+HER2+, 16% HR-HER2-, and 13% HR-HER2+. Indigenous American (IA) genetic ancestry was higher, and height was lower among individuals with the HR-HER2+ subtype (80% IA vs. 76% overall, p=0.007; 152 cm vs. 153 cm overall, p=0.032, respectively). In multivariate models, IA ancestry was associated with HR-HER2+ subtype (OR=1.38,95%CI=1.06-1.79, p=0.017) and parous women showed increased risk for HR-HER2+ (OR=2.7,95%CI=1.5-4.8, p<0.001) and HR-HER2- tumors (OR=2.4,95%CI=1.5-4.0, p<0.001) compared to nulliparous women. Multiple patient and tumor characteristics differed by age at diagnosis (<50 vs. >=50), including ancestry, region of residence, family history, height, BMI, breastfeeding, parity, and stage at diagnosis (p<0.02 for all variables). The characteristics of the PEGEN-BC study participants do not suggest heterogeneity by tumor subtype except for IA genetic ancestry proportion, which has been previously reported. Differences by age at diagnosis were apparent and concordant with what is known about pre- and post-menopausal-specific disease risk factors. Additional studies in Peru should be developed to further understand the main contributors to the specific age of onset and molecular disease subtypes in this population and develop population-appropriate predictive models for prevention.

Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction

The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.

Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction

The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.

Safety of vaginal delivery in women with placental chorioangiomas diagnosed by prenatal ultrasound: A retrospective cohort study.

This study aimed to examine the maternal and neonatal outcomes in different mode of delivery in pregnant women with placental chorioangiomas, in order to determine the safety of vaginal delivery.We conducted a retrospective study of 54 women with placental chorioangioma diagnosed by prenatal ultrasound and subsequently proven histologically, excluding those who underwent cesarean section for obstetric indications. The mode of delivery was divided into a vaginal delivery group (23 women) and a cesarean section group (31 women). The indication of cesarean section group was only for placental chorioangioma, no other obstetric indications. The maternal characteristics, pregnancy outcomes and the color doppler imaging characteristics of placental chorioangioma of the 2 groups were compared, and the clinical characteristics of women in the vaginal delivery group were described in detail.The incidence of placental chorioangioma was nearly 0.43‰ in our study. There was no significant difference in the maternal characteristics and pregnancy outcomes between the 2 groups. 82.6% (19/23) of the women successfully delivered vaginally and 4 failed who turned to cesarean section in the vaginal delivery group; among them, 17 women had giant chorioangiomas (>4 cm in diameter). The direct cause of vaginal delivery failure was fetal distress, persistent occiput posterior fetal position and cephalopelvic disproportion.Pregnant women with placental chorioangiomas and no other obstetric indications for cesarean section may attempt a vaginal delivery, even with giant chorioangiomas. If there are risk factors of vaginal delivery failure, the progress of labor needs to be closely monitored.

Antidepressants Are the Most Commonly Discontinued Psychotherapeutic Medications in Pregnancy.

Psychiatric illnesses are common during the perinatal period. The use of antipsychotic medication during pregnancy has increased over the past two decades. In many instances, clinicians agree that untreated psychiatric illness during the perinatal period is more dangerous than the risks imposed by continuing psychotherapeutic medication. We describe patterns of psychotherapeutic medication continuation and discontinuation during pregnancy in a large U.S. We assessed the relationship between the demographic and clinical characteristics of women who continued or discontinued psychotherapeutic medications-antidepressants, anxiolytics/sedatives, anticonvulsants, antipsychotics, mood stabilizers, and stimulants-during pregnancy. This study used data from 2008 to 2015 from the Medical Expenditure Panel Survey. We used t tests and Medical Expenditure Panel Survey Household Component longitudinal sampling weights in the analysis of this data. There were few significant differences noted in clinical and demographic characteristics between women who continued and discontinued medications during pregnancy. Those who continued were less likely to be employed (46.95% of continuers were employed vs. 80.55% of discontinuers; p=.0053). Women taking antipsychotics were more likely to continue medications during pregnancy (64.60% continually used antipsychotics vs. 35.40% discontinued antipsychotics; p=.008), whereas women taking antidepressants were more likely to discontinue their use (19.62% continually used antidepressants vs. 80.38% discontinued antidepressants; p=.032). For each medication category, women resumed medication after pregnancy. Antidepressants are the most commonly discontinued psychotherapeutic medication during pregnancy. We recommend further research examining factors that may influence this observed difference.

Age and competing concerns in treatment selection for women with non-metastatic HR+ and HER2- breast cancer: Current clinical practice

BackgroundNewer adjuvant treatment options for non-metastatic breast cancer have increased survival. There is a need to investigate whether demographic and clinical characteristics of women with hormone receptor-positive, human epidermal growth receptor 2-negative non-metastatic breast cancer (stages I-III) differentially influence treatment decisions in older (age 65 or older) versus younger patients (under age 65). MethodsIn a retrospective electronic medical record review, prevalence ratio with 95% confidence interval for treatment decisions in older vs younger patients was calculated using log binomial regression adjusted for race, stage, and total number of comorbidities. ResultsIn a sample of 537 patients, 66% were age < 65 and 34% age ≥ 65. Older patients included a higher proportion of White women (85% vs 75%, P = .02), higher number of comorbidities (P ≤0.0001), and lower stage tumors (P = .0004). In multivariable analysis, age ≥ 65 was independently associated with fewer mastectomies (95% CI 0.65–0.96, P = .02), more lumpectomies (95% CI 1.05–1.42, P = .01), and less receipt of radiation treatment (95% CI 0.78–0.97, P = .01) and/or chemotherapy (95% CI 0.73–0.95, P = .006). In multivariate analysis, stage was independently significant for all treatment modalities, except endocrine therapy, and race was not. ConclusionsThis study suggests that age, in addition to breast cancer stage, is a predictor of treatment modality, independent of race and number of comorbidities. Treatment modality reflects a combination of patient preference and clinician assessment of fitness for current standard of care.

Obstructive sleep apnoea and adherence to continuous positive airway therapy among Australian women.

Clinical characteristics of women with different obstructive sleep apnoea (OSA) severity and adherence to continuous positive airway pressure (CPAP) therapy have not been previously explored. To assess OSA prevalence, predictors, clinical and polysomnographic (PSG) characteristics and adherence to CPAP therapy among adult Australian women in a retrospective study. All female patients who underwent a diagnostic PSG between 2014 and 2015 were included. CPAP adherence was assessed during the study period between 2018 and 2019 using multiple regression models. Among a total of 591 women included in this study (Aboriginal, n = 86), OSA was diagnosed in 458/591 (78%) patients; mild, moderate and severe OSA was present in 44%, 27% and 29% respectively. Older age, higher BMI and hypertension predicted the presence and severity of OSA. The Epworth Sleepiness Scale (ESS) score was not significantly different with (8 (5, 12)) or without (10 (5, 13)) OSA. PSG showed the rapid eye movement (REM) sleep-associated apnoea-hypopnea index (AHI) was higher with all severity of OSA. Adherence to CPAP therapy was noted in 171 (57%) patients; 47% mild, 57% moderate and 63% with severe OSA respectively. Three multiple regression models (clinical, PSG parameters, OSA severity, combined (clinical and PSG)) showed the combined model had the strongest predictive value and demonstrated that higher ESS and more severe oxygen desaturation were associated with CPAP adherence irrespective of OSA severity. Older age, higher BMI and the presence of hypertension predicted the presence of OSA. The REM sleep-related AHI was higher. Adherence to CPAP was associated with symptomatic OSA and severe oxygen desaturation.

Gender differences in clinical characteristics in wild-type transthyretin amyloidosis cardiomyopathy

Abstract Aims A significant male predominance has been reported in wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). In other words, the female ATTRwt-CM may be overlooked and gender differences in ATTRwt-CM remain unclear. This study aims to examine gender differences in clinical characteristics and diagnostic approaches in ATTRwt-CM. Methods and results We retrospectively evaluated 171 consecutive ATTRwt-CM patients diagnosed at our university hospital between December 2002 and December 2020. Twenty-two patients (12%) were women. Women were significantly older at diagnosis (77.3 years vs. 83.3 years; P&amp;lt;0.001) and had a higher advanced New York Health Association functional class (2.23±0.70 vs. 2.57±0.81; P=0.04) than men. In echocardiography, mean interventricular septum diameter was less thick (15.8 mm vs. 14.5 mm; P=0.03) and ejection fraction was preserved (51.7% vs. 57.7%; P=0.08) in women. The mean heart-to-contralateral ratio obtained using 99mTc-labeled pyrophosphate (99mTc-PYP) was significantly lower in women than in men (1.89 vs. 1.64; P=0.001). There was no significant gender difference in high-sensitivity median cardiac troponin T levels at diagnosis (0.055 ng/mL vs. 0.069 ng/mL; P=0.30) or history of carpal tunnel syndrome (57% vs. 55%; P=0.93) and electrocardiograms findings. However, the median B-type natriuretic peptide level was significantly higher (254 pg/mL vs. 434 pg/mL; P=0.02) in women. Moderate to severe aortic stenosis was more frequently observed in women (5% vs. 50%; P&amp;lt;0.001). Histological (78% vs. 59%; P=0.07) and genetic confirmation (78% vs. 59%; P=0.003) of ATTRwt-CM were not performed in women. Conclusion Women with ATTRwt-CM were predominantly octogenarians, less hypertrophic, and had weaker cardiac uptake of the 99mTc-PYP tracer than men with ATTRwt-CM. These characteristics contribute to the underdiagnosis of ATTRwt-CM in women. The diagnosis of ATTRwt-CM in women is challenging. Therefore, we must be familiar with the clinical characteristics of women with ATTRwt-CM. Funding Acknowledgement Type of funding sources: None.

Clinical characteristics of women with high risk of Great obstetrical syndromes

The objective: to conduct clinical and statistical analyses of somatic and reproductive history of women of Great obstetrical syndromes (GOS) high risk group. Materials and methods. We have conducted clinical and statistical analyses of somatic and reproductive history of 200 pregnant women of GOS high risk group, who were divided by a random selection into 2 groups: I (main) group – 100 pregnant women, that further during research undergone pregravid preparation, obstetrical and perinatal support and delivery according to our method of medical and organization algorithms, prognostication, treatment and prophylactic schemes; II group – 100 pregnant women, who received routine prognostication and treatment and prophylactic measures and III group (control group) -50 almost healthy pregnant women with positive reproductive history and noncomplicated course of this pregnancy. Statistical analyses was conducted using program package StatSoft Statistica 8.0. Results. In I and II groups the age more than 30 was observed in 32,0% and 34,0% respectively, compared to 18% of healthy pregnant, (p &lt;0,05), that corresponds to the data, that indicate higher incidence of GOS in pregnant women of older patients. It should be noted, that pregnant of GOS risk group, had significantly higher incidence of infectious diseases (р&lt;0,05), such as diseases of respiratory tract (pneumonia, bronchitis), renal diseases and also pathology of thyroid gland, diabetes mellitus and arterial hypertension. Later might indicate, that somatic pathology in history can play a role in GOS pathogenesis. The incidence of genital inflammatory diseases was 12,0% compared to 28,0% and 31,0% respectively (р&lt;0,05), cervical intraepithelial neoplasia 4,0% compared to 17,0% and 19,0% respectively (р&lt;0,05). Mentioned data suggest that gynecological diseases play a specific role in early placentation disorders, development of placental disfunction and further to fetal development pathology. High level of complicated somatic and reproductive history, as we suppose, may be GOS risk factors in these pregnant women. Shown data indicate the need of further improvement of measures, aimed on pregnancy planning, pregravid preparation, antenatal fetal guard and decrease of incidence of complications from maternal and fetal side in these pregnant. Conclusions. When analyzing data after conducted research of premorbid background, somatic and reproductive history of women from GOS risk group, no significant difference was found, that gives us the possibility to further compare them in ongoing research.

Maternal deaths by suicide in Queensland, Australia, 2004\u20132017: an analysis of maternal demographic, psychosocial and clinical characteristics

To characterise the demographic and clinical characteristics of women who died by suicide in the perinatal period to inform and improve suicide prevention strategies. Retrospective analysis of maternal suicides during and within 1 year after the end of pregnancy in Queensland between January 2004 and December 2017. Outcomes measured included timing of death in relation to pregnancy, sociodemographic and clinical characteristics and health service use prior to death. There were 65 deaths by suicide in the study period; six occurred during pregnancy, 30 occurred after a live birth, 22 occurred after a termination of pregnancy and seven followed a miscarriage or stillbirth. Most suicides were late maternal deaths. Women were younger, and more likely to identify as Aboriginal or Torres Strait Islander, when compared to all women giving birth for the same time period. Most women had a prior mental health diagnosis, most commonly depression. Over half of women had recent relationship separation or conflict prior to death. Perinatal women had higher rates of death by violent means than all women in Queensland who died by suicide during the same time period. The demographic, psychosocial and clinical characteristics of a group of women who died by suicide have been described, and this shows a high proportion of women with a prior mental health diagnosis. To reduce maternal mortality, psychosocial screening must be implemented broadly and continued until the end of the first year postpartum. Similar screening attention is needed for women who had a termination of pregnancy, miscarriage or stillbirth.

Pregnancy-triggered atypical hemolytic uremic syndrome (aHUS): a Global aHUS Registry analysis

BackgroundAtypical hemolytic uremic syndrome (aHUS) is a rare disease in which uncontrolled terminal complement activation leads to systemic thrombotic microangiopathy (TMA). Pregnancy can trigger aHUS and, without complement inhibition, many women with pregnancy-triggered aHUS (p-aHUS) progress to end-stage renal disease (ESRD) with a high risk of morbidity. Owing to relatively small patient numbers, published characterizations of p-aHUS have been limited, thus the Global aHUS Registry (NCT01522183, April 2012) provides a unique opportunity to analyze data from a large single cohort of women with p-aHUS.MethodsThe demographics and clinical characteristics of women with p-aHUS (n = 51) were compared with those of women of childbearing age with aHUS and no identified trigger (non-p-aHUS, n = 397). Outcome evaluations, including renal survival according to time to ESRD, were compared for patients with and without eculizumab treatment (a complement C5 inhibitor) in both aHUS groups.ResultsBaseline demographics and clinical characteristics were broadly similar in both groups. The proportion of women with p-aHUS and non-p-aHUS with pathogenic variant(s) in complement genes and/or anti-complement factor H antibodies was similar (45% and 43%, respectively), as was the proportion with a family history of aHUS (12% and 13%, respectively). Eculizumab treatment led to significantly improved renal outcomes in women with aHUS, regardless of whether aHUS was triggered by pregnancy or not: adjusted hazard ratio for time to ESRD was 0.06 (p = 0.006) in the p-aHUS group and 0.20 (p < 0.0001) in the non-p-aHUS group.ConclusionFindings from this study support the characterization of p-aHUS as a complement-mediated TMA.Graphic abstract

Suicide and self-harm in women with mental disorders during pregnancy and the year after birth

IntroductionThere is little prospective data on the risk factors for later suicide in women who experience perinatal mental disorders, particularly beyond one-year postnatal.ObjectivesAmong a cohort of women who were in contact with a mental healthcare provider during the perinatal period, to: (1) Describe sociodemographic and clinical characteristics of the women who died by suicide (2) Understand when, in relation to childbirth, most suicides tended to occur.MethodsData-linkage of de-identified service-user electronic healthcare records, national hospital episode statistics and mortality data generated a cohort of women in contact with a mental healthcare service provider in London, UK, perinatally. Using Natural Language Processing and structured field extraction, we identified clinical, socio-demographic characteristics, self-harm exposure, and suicide.ResultsAmong 5204 women, clinical and demographic characteristics of women who did and did not die by suicide were similar apart from indicators of illness severity including perinatal sedative medication prescription, clinician-rated functional impairment and smoking, which were more common in women who died by suicide. Suicide deaths occurred most frequently in the second year post-delivery. The most common method of suicide ocurring wihtin two years was by violent means, whereas after two years postnatal, the most common method was non-violent.ConclusionsOur findings support the extension of perinatal mental healthcare service provision to two years post-delivery.DisclosureNo significant relationships.

Quality of life, its factors, and sociodemographic characteristics of Polish women with lipedema

BackgroundLipedema is a type of subcutaneous adipose tissue disorder that affects mainly women. Its main symptom is bilateral fat accumulation on the extremities with associated pain in the affected areas. Despite growing interest in lipedema among patients and medical health professionals, lipedema is still often misdiagnosed, misunderstood, and mistreated. To promote better understanding of lipedema, we aimed to investigate factors related to the quality of life and describe selected sociodemographic and clinical characteristics of women with lipedema in Poland.MethodsWe conducted a cross-sectional online survey that was completed by 98 women with lipedema. The participants responded to questionnaires regarding quality of life, sociodemographic and clinical characteristics, and depression symptom severity.ResultsThe participants reported low quality of life and high severity of depressive symptoms. The more severe the symptoms related to pain, heaviness, and swelling, the lower the quality of life. Further analyses showed that depression severity mediated this relationship.ConclusionsThe current study provides initial information on screening questions, lipedema symptoms, and comorbidities, pointing to the areas needing in-depth investigation. Further steps to improve quality of life in women with lipedema and to reduce health costs should include the education of medical health professionals, using diagnostic tools that allow for differentiation among diagnoses and precise health risk assessment, and creating Polish treatment guidelines for lipedema.

Social, demographic and clinical characteristics of female patients with schizophrenia and HIV

To evaluate social, demographic and clinical characteristics of women with schizophrenia and HIV. Medical histories of patients who were in inpatient treatment during 2017 were retrospectively studied. A total of 174 medical histories were analyzed, but the final analysis included 40 HIV-infected patients (main groups) and 48 patients without HIV infection (comparison group). These groups included patients with a diagnosis of schizophrenia or acute polymorphic psychotic disorder. All patients with HIV infection were examined by a specialist and an immunological analysis was performed. Correlation analysis was performed between quantitative clinical indicators (duration of illness, number of hospitalizations, the number and duration of remissions, etc.) and immunological parameters. Patients with schizophrenia and HIV infection are more often hospitalized and stay in the hospital longer than patients with schizophrenia without HIV infection, which may in part be determined by the social problems of this cohort of patients. There is a relationship between individual indicators of the immune status of the patients, the duration and some features of the course of mental illness. Regular treatment of HIV infection correlates with a lower frequency of hospitalizations in a psychiatric hospital due to an exacerbation of the mental state.