Disease In Young Women Research Articles

The postpartum period constitutes an important risk for the development of clinical Graves' disease in young women.

In the present study, 93 consecutive women, 20-40 years of age, referred to our clinic from 1976-85 with Graves' disease, were examined with respect to a possible relation between onset of disease and previous pregnancy. An increased relative risk of 6.5 (3.8-11.0, 95% confidence interval) of developing Graves' disease within one year following delivery was found. After excluding the nulliparous women, almost 2 out of 3 women who developed Graves' disease in the principal child-bearing age of 20-35 years had a postpartum onset, suggesting an important role of immunomodulatory events following delivery for the development of this disease in young women. Future studies will ascertain to which extent the recognition of postpartum Graves' disease has implications on the choice of therapy in this group of women.

Increased incidence of adenocarcinoma of the cervix in young women in the United States.

This is the second report demonstrating an increase in the incidence of adenocarcinoma of the cervix in young white women since the early 1970s. The trend does not appear to be due to improved histologic classification over time. Case-control studies are clearly needed to investigate the reasons for the increase, including the hypothesized association with use of oral contraceptives before 20 years of age. However, the low incidence of the disease in young women (in whom an increased risk is most likely to be detectable, should it exist) suggests that collaborative efforts will be required to achieve even modest sample sizes.

Cardiovascular responsivity, type A behavior, and parental history of heart disease in young women.

ABSTRACTThe purpose of this study was to examine the physiological responsiveness of Type A and Type B women during interpersonal and individual, competitive stressors. Extreme groups of Types A and B college‐age women were monitored on heart rate and blood pressure while they engaged in an oral history quiz and the Stroop color/word test. Subjects were also subdivided by presence or absence of family history of coronary heart disease. Types A and B women did not differ on blood pressure levels or reactivity; Type A women did show a trend toward a greater increase in heart rate to the color/word task. Women with a positive family history had higher levels of systolic and a trend toward higher levels of diastolic blood pressure. There were no significant interactions of Type A/B with family history. Our conclusion is that Type A behavior is only very weakly, if at all, associated with physiological responsivity in young adult women.

CO2 laser vaporization for chronic cervicitis.

Chronic cervicitis is the most common disease occurring during the period of greatest sexual activity and reproductivity, and it is the most common gynecologic disease in young women. The disease is a common sequel to normal delivery and one of the main causes of infertility; it also may be precancerous. All the treated women in the present study exhibited preoperatively severe subjective symptoms for chronic cervicitis, and 32 out of 60 (53%) exhibited colposcopically atypical squamous epithelium. The women were examined 3, 6, and 12 months following laser surgery: 58 (97%) of them reported a decreasing intensity of their symptoms, and colposcopy revealed a normal postlaser transformation zone as well as a decreasing edema of cervical epithelium.

The disease spectrum, epidemiology, and etiology of toxic-shock syndrome.

From this composite picture of the history and recent developments related to TSS, several points are clear. TSS is not a new disease, and TST-producing strains of S. aureus are not new. What is new is the recent dramatic increase of this disease in young women who use tampons during menses and who lack antibody to TST. What is also new is the recognition that the disease commonly recurs but only in menstrually associated cases. What remains to be determined are the precise role of tampons, the factors leading to toxin induction, and the mechanism of action of this potent toxin. In order to better determine what these factors and mechanism of action are, and to determine if the TST marker protein is in fact the critical toxin, a reliable animal model is badly needed. Finally, a reliable laboratory test to confirm the clinical diagnosis is another high-priority need. The further unraveling of the secrets of this complex disease may greatly enhance our understanding of the disease associated with this toxin, of the intricacies of toxin production by other bacteria, and of the role that exogenous cofactors play in disease processes.

Breast disease in young women. When is biopsy indicated?

The low incidence of breast cancer among women under the age of 25 years may not justify the routine excision biopsy of breast lumps in this age group. A policy of conservative management has been tested in 70 women between the ages of 17 and 25 years. Excision biopsy was eventually performed in 23 women - fewer than half of those with a palpable mass. No cancerous lesions were found; a high proportion of lumps removed were fibroadenomas. The accuracy of clinical diagnosis was high and, of 31 breast lumps diagnosed as benign mammary dysplasia, more than three-quarters resolved without surgical intervention. Indications for surgery are defined. Because breast cancer does occasionally occur in this age group, accurate clinical diagnosis and review are essential components of conservative management.

The epidemiology of endometrial cancer in young women.

A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case-control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer.

Acute salpingitis in the adolescent female

Acute salpingitis is an important complication of sexually transmitted disease in young women and should be considered in the differential diagnosis of abdominal pain in all young women. Many organisms, in addition to N. gonorrhoeae, have been associated with this tubal infection giving support to polymicrobial etiology. However, the exact pathophysiologic role of these organisms needs to be clearly defined. The microbiology of acute salpingitis, through direct culture from the site of infection, the fallopian tubes, needs to be clearly elucidated. Early recognition and treatment of acute salpingitis is essential in preventing the major long-term problem, involuntary infertility. Curran has estimated the reproductive outcome for a cohort of adolescent women reaching reproductive age in 1970. By the year 2000, there will have been one episode of salpingitis for every two women; 15% will be hospitalized for salpingitis with over half of these women requiring major gynecologic surgery; 10% will be rendered nonsurgically sterile; and 3% will have experienced an ectopic pregnancy. Adolescent females may be more susceptible to upper genital tract infection than older women due to possible unique biologic characteristics and sexual behaviors. Prospective microbiologically controlled studies of women with salpingitis using laparoscopy need to be developed to evaluate treatment regimens. Until such studies are undertaken, diagnosis, treatment, and fertility in women with acute salpingitis will remain unsatisfactory.

Elevation of serum HDL and HDL cholesterol in cholesterol in cholesterol-FED male rabbits treated with estrogen

The effect of cholesterol feeding and estrogen administration on serum lipoproteins and lipoprotein lipid composition was investigated in male rabbits. The lipoprotein fractions were separated by preparative ultracentrifugation and the purity of each fraction was determined by polyacrylamide disc gel electrophoresis. The amount of cholesterol, cholesterol ester, triglycerides and phospholipids was determined in each of the lipoprotein fractions. It was found that treatment of the cholesterol-fed animals with estrogen resulted in an increase of their serum HDL, HDL cholesterol, HDL phospholipids and HDL triglycerides. This increase was accompanied by a decrease in serum VLDL, VLDL cholesterol and VLDL phospholipids. Since increased HDL and HDL cholesterol have been known to be associated with lower coronary heart disease, the increased serum HDL and HDL cholesterol resulting from estrogen treatment might account for the reported lower incidence of coronary heart disease in young women than in young men and the protective effect of estrogen against diet-induced and spontaneous atherosclerosis in animals.

Cigarette smoking in relation to the risk of myocardial infarction in young women. Modifying influence of age and predisposing factors.

We evaluated the relation between myocardial infarction (MI) and cigarette smoking in women 30 to 49 years of age. Among 318 women who had survived recent first infarctions and 1272 age-matched controls, the proportions of cigarette smokers were 83% and 54%, respectively (p < 0.001). The estimated relative risk rose progressively with amount smoked: compared with women who had never smoked, the estimate was 1.8 for smokers of less than 15 cigarettes per day and 6.9 for smokers of 35 or more cigarettes per day. At each level of smoking, the relative increase in risk was greater at younger ages and among those not apparently predisposed from other factors. Although MI is a rare disease in young women, our data indicate that the risks faced by those who smoke heavily are appreciable.

Coronary Heart Disease in Young Women

Coronary Heart Disease in Young Women

Myocardial Infarction and Other Vascular Diseases in Young Women

We studied 83 women younger than 46 years with acute myocardial infarction (MI) and 154 controls. There was a strong positive association between MI and the following: (1) age, (2) both oral contraceptive and noncontraceptive estrogen use, (3) cigarette smoking, and (4) the presence of predisposing medical conditions, eg, past MI, hypertension, and diabetes. ABO blood type and family history of arterial disease were also positively associated with MI. Whereas the risks for idiopathic stroke and venous thromboembolism have also been shown to be increased among oral contraceptive users, there is comparatively little correlation between these two illnesses and age or smoking in young women. The present study, taken together with previously published work, provides reasonable estimates of the vascular risks associated with oral contraceptive use.

Myocardial infarction and other vascular diseases in young women. Role of estrogens and other factors

Myocardial infarction and other vascular diseases in young women. Role of estrogens and other factors

Coronary artery disease in young women: Clinical and angiographic features and correlation with risk factors

Coronary arteriography was performed because of suspected coronary disease in 239 women less than 45 years of age. Normal coronary arteries were found in 112 women, and a further 23 had insignificant stenosis (less than 50 percent narrowing of luminal diameter). Of the remaining 104 women, 56 had one vessel, 22 two vessel and 26 three vessel disease. Hyperlipidemia, hypertension, diabetes, smoking and a family history of coronary disease were significantly more frequent in women with significant stenosis than in women with normal arteries. Significant coronary disease was found in 55 percent (100 of 182) of women with more than two risk factors but in only 7 percent (4 of 57) of those with less than two risk factors (P <0.0001). Evaluation of symptoms and the resting electrocardiogram also discriminated between women with and without coronary disease, but exercise testing was of little value. Only 4 of the 46 women with previous myocardial Infarction had normal or near-normal coronary arteries. Among women with segmental wall motion abnormalities on ventriculography, the site was anterior in 90 percent (19 of 21) of women who used oral contraceptive drugs but in only 60 percent (21 of 35) of nonusers (P <0.05). However, in most respects, coronary artery disease in young women does not appear to differ from coronary disease in other patients.

Clinical and angiographic features of coronary artery disease in young women

Clinical and angiographic features of coronary artery disease in young women

Endometrial adenocarcinoma and the polycystic ovary syndrome

While endometrial adenocarcinoma is the second most common female genital malignancy, only four per cent of the cases occur in women less than 40 years of age. The relative rarity of this disease in young women requires that we be especially attuned to those who are at high risk. This paper presents two case reports of women with polycystic ovarian disease who developed endometrial adenocarcinoma at 24 years of age. The pathophysiology ovarian disease and its relationship to the development of endometrial adenocarcinoma are discussed.

Letter: Ischaemic heart disease in young women.

Letter: Ischaemic heart disease in young women.

Letter: Ischaemic heart disease in young women.

Letter: Ischaemic heart disease in young women.

Coronary Artery Disease in Young Women

Advanced coronary atherosclerosis was angiographically demonstrated in 21 women aged 40 years or younger. To facilitate the recognition of women susceptible to coronary atherosclerosis from those with chest pain of other cause, the patients' conditions were investigated with regard to various easily identifiable atherogenic risk factors. Eighty-six percent of the patients had at least three of five predisposing factors: family history (of coronary artery disease, hypertension, or diabetes mellitus), hypertension, hyperlipidemia, glucose intolerance, and cigarette smoking. Only three of the 21 patients were free of both hypertension and elevated serum cholesterol levels. Obesity and hyperuricemia were not found to improve the predictive yield. Data on pregnancies, menstruation, oophorectomies, and estrogen therapy did not afford clues regarding the cause of precocious coronary atherosclerosis in these young women. (JAMA230:1531-1534, 1974)

Coronary artery disease in young women

Coronary artery disease in young women