Prevalence Of Disease In Women Research Articles

Epidemiological and Clinical Characteristics of Women Living with HIV in Korea.

While Korea maintains a low prevalence of human immunodeficiency virus (HIV), the number of newly diagnosed cases has been steadily rising, reaching approximately 1,000 annually in recent years. The 2022 annual report from the Korea Disease Control and Prevention Agency revealed that women living with HIV (WLWH) constitute 6.4% of the total confirmed people living with the HIV population, totaling 1,219 individuals. Despite this, only a few studies have focused on WLWH in Korea. This study aims to analyze the epidemiological and clinical characteristics of WLWH in Korea. We retrospectively collected data by reviewing the medical records of all WLWH who visited 10 urban referral hospitals across Korea between January 2005 and May 2023. A total of 443 WLWH were enrolled in this study. The predominant risk exposure was heterosexual contact, with 235 (53%) participants either married or cohabiting with a male partner at their initial clinic visit. Among the participants, 334 (77.7%) were Korean, 27 (6.1%) were Southeast Asian, and 19 (4.3%) were African. Antiretroviral therapy was initiated by 404 WLWH (91.2%). We observed 118 pregnancies in WLWH following their HIV diagnosis, resulting in 78 live births (66.1%), 18 induced abortions (15.2%), 10 pre-viable fetal losses (8.5%), and four stillbirths (3.4%). Over a cumulative follow-up duration of 3,202.1 years, the incidence rates of breast and cervical cancers were both 2.18 per 1,000 person-years. Additionally, the incidence rates of pelvic inflammatory disease, cervical intraepithelial neoplasm (above grade II), and osteoporosis were 4.67, 11.21, and 13.39 per 1,000 patient-years, respectively. This is the first multicenter study to investigate the clinical and epidemiological characteristics of WLWH in Korea. The incidence and prevalence of diseases in women, including breast cancer, cervical cancer, and chronic comorbidities, are high in WLWH in Korea; therefore, further research and efforts are needed to manage these diseases.

The Lifestyle Profile of Individuals with Cardiovascular and Endocrine Diseases in Cyprus: A Hierarchical, Classification Analysis.

The study aims to explore the lifestyle profile of adult individuals with cardiovascular and endocrine diseases in Cyprus. Age and sex-specific analyses were applied. A representative sample of the general adult population was recruited during 2018–2019 using stratified sampling among the five government-controlled municipalities of the Republic of Cyprus. Data on Mediterranean diet adherence, quality of sleep, smoking status, physical activity, Body Mass Index, and the presence of cardiovascular and endocrine diseases were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, Tenth Revision (ICD-10). A total of 1140 men and women over 18 years old (range: 18–94) participated in the study. The prevalence of cardiovascular and endocrine diseases among the adult general population of Cyprus was 24.8% and 17.2%, respectively, with a higher prevalence of cardiovascular diseases in men, and a higher prevalence of endocrine diseases in women. Among individuals with cardiovascular disease, 23.3% were aged between 18–44 years old, while the corresponding percentage among endocrine disease individuals was 48%. The prevalence of smoking, physical activity, a low adherence to the Mediterranean diet, poor quality of sleep and obesity among the study population was 35.5%, 48.0%, 32.9%, 39.0% and 13.6%, respectively. Individuals with cardiovascular and endocrine diseases were characterized by poor quality of sleep, inadequate physical activity, and a higher BMI. This is the first study in Cyprus exploring the profile of individuals with cardiovascular and endocrine diseases in Cyprus. Health promotion and educational programs focusing on the importance of sleep quality, healthier dietary habits, physical activity, and lower BMIs among people with cardiovascular and endocrine diseases should be developed.

A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited.

Clinical observations have long suggested that women are protected against paracoccidioidomycosis. 17β-estradiol, the main female estrogen, inhibits conidia-to-yeast transformation (C-to-Y), which is required for the infection establishment. However, experiments in murine models have yielded conflicting results, suggesting that C-to-Y inhibition, alone, fails to explain the female-associated protection and that sexual hormones may also act by modulating the host’s immune responses. Therefore, this issue remains unsolved. Strikingly, no studies have compared the severity of paracoccidioidomycosis between men and women. This retrospective case-control study compared 36 women with 72 age-matched men for clinical–demographic, laboratory, and chest imaging findings. Overall, paracoccidioidomycosis in women presented the main features described in the acute/subacute and chronic forms seen in men. Women also showed similar demographic features and clinical–laboratory and imaging severity scores as men. We additionally reviewed 58 paracoccidioidin skin test surveys undertaken by volunteers from endemic areas. Data accumulated from 10.873 tests showed that females and males are infected with similar magnitudes (21.9% vs. 25.2%) and that reactivity steadily increased with age, peaking after the age of 60. We discuss the paradox of similar infection rates but much lower disease prevalence in women, considering the current pathogenetic views of paracoccidioidomycosis, and we raise alternative hypotheses to account for this paradox.

Predictors Factors of Onset de Novo Heart failure after STEMI

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION STEMI gets complicated very often by a heart failure (HF), which it is important to know associated factors. The aim of this study was to determinate the predictor factors of onset of de novo HF after STEMI in patients with no prior history of heart failure recorded at baseline. METHODS A retrospective, descriptive study from 1 center in Morocco, including 210 patients hospitalized in a cardiology intensive care unit for STEMI from September 2019 to November 2020. The main outcomes were HF Killip class at hospital presentation and intra-hospital mortality. RESULTS The main age was 59.3 ± 7.02 and Sex ratio: 2, 86. The incidence of de novo HF at admission was higher in women (40, 4% vs. 29.5%, [OR 1, 61; 95%, [CI] 0, 83-3, 11). Forty-nine point eight percent were in Killip≥ 2. The method of early revascularization was Thrombolysis in 82, 3% compared to primary coronary angioplasty without significant difference in onset of the novo HF. There was no association of age, comorbidities, delay to hospital presentation and coronary involvement with incidence of onset of de novo HF. Women had higher mortality than men with the novo HF (28, 6% vs. 20.5%; OR: 1, 55; 95%). CONCLUSION Gender has appeared associated to onset of de novo HF after STEMI with a superiority of the female sex after controlling for others factors described in the literature. Anterior studies have related this to the increased prevalence of microvascular disease in women predisposing them to heart failure after STEMI.

Динамика распространенности болезней среди женщин фертильного возраста, проживающих вблизи районов падения отделяющихся частей ракет-носителей в Алтайском крае

For many years a part of the Altai Territory has been subjected to the negative factors of rocket and space activities. With support of State Space Corporation, Regional State Budget Institution ‘Scientific Institute of Medical-Ecological Problems’ provides regular medical check-ups for the population of the territories bordering the drop zones for separating parts of launch vehicles. The given work presents the results of a comparative analysis of the prevalence of diseases in women of reproductive age in Baranovsky village council of Zmeinogorsky Area in 2002, 2007, 2013, and 2018. The most significant pathology and the peculiarities of the dynamics of prevalence of diseases have been revealed.

Doenças crônicas não transmissíveis e os fatores de risco em mulheres de Guaporé (RS)

Objetivo: Avaliar a prevalência de doenças crônicas não transmissíveis e sua associação com fatores de risco em mulheres de Guaporé (RS). Materiais eMétodos: Estudo transversal, realizado na microárea 23, durante os meses de maio e junho de 2016, com 165 mulheres. Dados coletados referentes à prevalência de doenças crônicas não transmissíveis (Diabetes Mellitus, Hipertensão Arterial e Dislipidemias) e medicamentação autorreferida, tabagismo, consumo de bebidas alcoólicas, atividade física, índice de massa corporal, circunferência da cintura e consumo alimentar. A análise estatística foi realizada através do programa Statistical Package for the Social Sciences. Os testes foram t-student para as médias, teste qui-quadrado de Pearson para associações e teste qui-quadrado para variáveis ordinais, sendo o nível de significância de 5%.Resultados: Avaliaram-se 165 mulheres, das quais 29,1% possuíam ≥60 anos, 69,7% eram casadas ou moravam com companheiro, 44,8% possuíam ≥13 anos de escolaridade, 83,6% possuíam renda de 1-2 salários mínimos. Verificou-se que o índice de massa corporal foi 27,8±5,6 kg/m², encontrando-se em sobrepeso. A circunferência da cintura foi 98,9±13,9 cm, classificando-se em risco. Ao associar os fatores de risco consumo alimentar, atividade física, tabagismo, bebidas alcóolicas, não se encontrou associação significativa. No entanto encontrou-se maior prevalência de doenças crônicas não transmissíveis em mulheres com maior faixa etária, de menor escolaridade e renda, viúvas, com circunferência da cintura elevada e índice de massa corporal de sobrepeso. Constatou-se a presença de doenças crônicas não transmissíveis em 38,2% das mulheres.Conclusão: A prevalência de doenças crônicas não transmissíveis associou-se com alguns dos fatores de risco estudados, desses o estado civil entre as viúvas, menor escolaridade, menor renda, com baixa ingestão de álcool e risco mais elevado para complicações metabólicas, conforme circunferência da cintura.

Abstract P318: Wide State-By-State Variation in Maternal Mortality and Chronic Diseases That Contribute to Pregnancy Complications

Background: Among developed countries, the United States has the highest maternal mortality rate. Between 1987 and 2011, the US maternal mortality rate more than doubled from 7.2 to 17.8 deaths per 100,000 live births. More than 1,300 pregnancy-related deaths occurred in the United States in 2011-2012. Additionally, an increasing number of women have chronic health conditions, such as hypertension, diabetes, and chronic heart disease, that increase their risk of pregnancy complications, including maternal mortality. Reducing the prevalence of these diseases may be an important step toward reducing maternal mortality. To examine the current state of maternal mortality and chronic diseases in the United States, the geographical variation of these factors was examined. Methodology: State-level prevalence estimates were calculated for diabetes, heart disease, and hypertension awareness among women of reproductive age (18 to 44 years) using data from the 2013-2014 Behavioral Risk Factor Surveillance System. State-level maternal mortality rates were calculated using CDC’s 2010-2014 National Vital Statistics System. Maternal mortality was defined as the number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. Results: The maternal mortality rate is 6.8 times higher in Georgia (39.3 deaths per 100,000 live births) than in Massachusetts (5.8 deaths per 100,000 live births). Nationally, there are an estimated 19.9 maternal deaths per 100,000 live births. The prevalence of chronic diseases that increase risk of pregnancy complications also vary by state. For example, diabetes (excluding gestational diabetes) ranges from a low of 1.9% of women aged 18 to 44 in Alaska, Minnesota, and Wisconsin to a high of 4.8% in Alabama. Nationally, an estimated 3.1% of women aged 18 to 44 have been told by a doctor that they have diabetes. Conclusion: The prevalence of chronic diseases in women of reproductive age vary based on state of residence, as does the maternal mortality rate. Raising awareness about the variation in these measures is an important step toward identifying what strategies are being utilized in states with a low prevalence of diabetes, heart disease, and hypertension, and determining how their public health efforts may help those states facing challenges in these areas.

Gender Disparities Across the Spectrum of Advanced Cardiac Therapies: Real or Imagined?

Cardiovascular disease has been responsible for more deaths in women than in men each year since 1985. This review discusses federal laws that have influenced the inclusion of women in research and reporting sex-specific differences, then addresses gender differences and gender disparities in four areas of clinical cardiovascular medicine: coronary heart disease, valvular heart disease, electrophysiology, and heart failure. The prevalence of disease in women is highlighted, the clinical characteristics of women at the time of referral for advanced therapies are reviewed, and the clinical outcomes of women are discussed. With the emergence of new technology such as smaller devices and less invasive procedures, more women are being referred for advanced therapies. However, a gap in awareness and diagnosis remains, contributing to later referrals for women. Women who do undergo advanced therapies often have more comorbidities and worse outcomes than men. A call is made to increase awareness, educate healthcare providers, and report more sex-specific data to resolve these gender disparities.

Chronic disease prevalence in women and air pollution — A 30-year longitudinal cohort study

BackgroundAir pollution, such as fine particulate matter (PM2.5), can increase risk of adverse health events among people with heart disease, diabetes, asthma and chronic obstructive pulmonary disease (COPD) by aggravating these conditions. Identifying the influence of PM2.5 on prevalence of these conditions may help target interventions to reduce disease morbidity among high-risk populations. ObjectivesThe objective of this study is to measure the association of exposure of PM2.5 with prevalence risk of various chronic diseases among a longitudinal cohort of women. MethodsWomen from Ontario who enrolled in the Canadian National Breast Screening Study (CNBSS) from 1980 to 1985 (n=29,549) were linked to provincial health administrative data from April 1, 1992 to March 31, 2013 to determine the prevalence of major chronic disease and conditions (heart disease, diabetes, asthma, COPD, acute myocardial infarction, angina, stroke and cancers). Exposure to PM2.5 was measured using satellite data collected from January 1, 1998 to December 31, 2006 and assigned to resident postal-code at time of entry into study. Poisson regression models were used to describe the relationship between exposure to ambient PM2.5 and chronic disease prevalence. Prevalence rate ratios (PRs) were estimated while adjusting for potential confounders: baseline age, smoking, BMI, marital status, education and occupation. Separate models were run for each chronic disease and condition. ResultsCongestive heart failure (PR=1.31, 95% CI: 1.13, 1.51), diabetes (PR=1.28, 95% CI: 1.16, 1.41), ischemic heart disease (PR=1.22, 95% CI: 1.14, 1.30), and stroke (PR=1.21, 95% CI: 1.09, 1.35) showed over a 20% increase in PRs per 10μg/m3 increase in PM2.5 after adjusting for risk factors. Risks were elevated in smokers and those with BMI greater than 30. ConclusionsThis study estimated significant elevated prevalent rate ratios per unit increase in PM2.5 in nine of the ten chronic diseases studied.

Su1432 Prevalence of Celiac Disease Is Higher Among Women With Infertility

BACKGROUND: Celiac disease is an immune-mediated enteropathy that is secondary to gluten ingestion and is classically associated with gastrointestinal symptoms. Some studies suggest that reproductive disorders may be the first symptoms of Celiac disease in otherwise asymptomatic women. Our objective was to determine the prevalence of Celiac disease in women presenting with infertility. STUDY DESIGN: Prospective cohort study. METHODS: We collected data on demographics, screening test results, and diagnosis among women presenting with infertility from March 2012 through March 2013. Women were screened for Celiac disease using serologic testing for antibodies against tissue transglutaminase (IgAtTG). RESULTS: 1112 women presented for an initial infertility evaluation. 20 women had a previous diagnosis of Celiac disease, 20 were on a self-imposed gluten-free diet, and 839 were screened. Seven women screened positive, yielding an incidence of 0.83% among women presenting with infertility to our clinic. Median age and body mass index as well as screening results are reported in Table 1. The prevalence of Celiac disease among women presenting with infertility was 3.1% (95% CI 2.54.5). The prevalence of Celiac disease among women with unexplained infertility was 5.2% (95% CI 3.1-8.5). CONCLUSION: The prevalence of Celiac disease is approximately 3 times higher in women with infertility than the general U.S. population (0.8%); however, routine screening at the time of infertility evaluation is likely not warranted given the low incidence. Table 1. Characteristics and Laboratory Values Median (interquartile range)

Su1435 Hypothyroid Patients Requiring Elevated Doses of Levothyroxine to Maintain a Euthyroid State Should Be Tested for Celiac Disease (CD)

BACKGROUND: Celiac disease is an immune-mediated enteropathy that is secondary to gluten ingestion and is classically associated with gastrointestinal symptoms. Some studies suggest that reproductive disorders may be the first symptoms of Celiac disease in otherwise asymptomatic women. Our objective was to determine the prevalence of Celiac disease in women presenting with infertility. STUDY DESIGN: Prospective cohort study. METHODS: We collected data on demographics, screening test results, and diagnosis among women presenting with infertility from March 2012 through March 2013. Women were screened for Celiac disease using serologic testing for antibodies against tissue transglutaminase (IgAtTG). RESULTS: 1112 women presented for an initial infertility evaluation. 20 women had a previous diagnosis of Celiac disease, 20 were on a self-imposed gluten-free diet, and 839 were screened. Seven women screened positive, yielding an incidence of 0.83% among women presenting with infertility to our clinic. Median age and body mass index as well as screening results are reported in Table 1. The prevalence of Celiac disease among women presenting with infertility was 3.1% (95% CI 2.54.5). The prevalence of Celiac disease among women with unexplained infertility was 5.2% (95% CI 3.1-8.5). CONCLUSION: The prevalence of Celiac disease is approximately 3 times higher in women with infertility than the general U.S. population (0.8%); however, routine screening at the time of infertility evaluation is likely not warranted given the low incidence. Table 1. Characteristics and Laboratory Values Median (interquartile range)

Su1433 Elective Caesarean Delivery Is Associated With Increased Celiac Disease Risk in Boys, but Not in Girls

BACKGROUND: Celiac disease is an immune-mediated enteropathy that is secondary to gluten ingestion and is classically associated with gastrointestinal symptoms. Some studies suggest that reproductive disorders may be the first symptoms of Celiac disease in otherwise asymptomatic women. Our objective was to determine the prevalence of Celiac disease in women presenting with infertility. STUDY DESIGN: Prospective cohort study. METHODS: We collected data on demographics, screening test results, and diagnosis among women presenting with infertility from March 2012 through March 2013. Women were screened for Celiac disease using serologic testing for antibodies against tissue transglutaminase (IgAtTG). RESULTS: 1112 women presented for an initial infertility evaluation. 20 women had a previous diagnosis of Celiac disease, 20 were on a self-imposed gluten-free diet, and 839 were screened. Seven women screened positive, yielding an incidence of 0.83% among women presenting with infertility to our clinic. Median age and body mass index as well as screening results are reported in Table 1. The prevalence of Celiac disease among women presenting with infertility was 3.1% (95% CI 2.54.5). The prevalence of Celiac disease among women with unexplained infertility was 5.2% (95% CI 3.1-8.5). CONCLUSION: The prevalence of Celiac disease is approximately 3 times higher in women with infertility than the general U.S. population (0.8%); however, routine screening at the time of infertility evaluation is likely not warranted given the low incidence. Table 1. Characteristics and Laboratory Values Median (interquartile range)

Periodontal disease prevalence in patients treated with tamoxifen.

e11600 Background: Periodontal diseases arise from inflammatory diseases involving the periodontal connective tissue as a common factor. Estrogen produces inflammatory changes that worseness the periodontal preexistent status; and alters the microbiologic environment acting as a nutrient. The objective of this study is to determinate the relation between the treatment with tamoxifen and the prevalence of periodontal disease in women with breast cancer. Methods: Observational study. Sample: 70 postmenopausal patients, distributed in the following groups: Group 1 (N: 17) patients with breast cancer diagnosis and treated with tamoxifen less than one year; Group 2 (N: 18) patients with breast cancer and treated with tamoxifen for 1 to 2 years; Group 3 (N: 18) patients with breast cancer and treated with tamoxifen for 2 to 5 years; Group 4 (N:17) patients with breast cancer that have finalized their treatment with tamoxifen. A poll was performed between these patients, a periodontal scale and a mouth hispid was performed. Microbiologic standard tests were performed for Candida and also molecular biologic tests. Results: Group 1: health: 0%, severe periodontal diseases: 22% Group 2: health: 0% severe periodontal disease: 25% Group 3: health: 25% severe periodontal disease: 10% Group 4: health: 35% severe periodontal disease: 5%. Microbiologic cultives: presence of Candida albicans, tropicalis, parapsilosis, dubliniensis and glabrata. The maoyor variety of species were isolated from Group 1. Conclusions: The time frame with Tamoxifen treatment shows differences in the Periodontal status and reveals differences in the growth of Candida species because a decrease in number and species of yeast, this means an additional benefit in the studied population. We believe it is important to run this study with larger populations in order to determine the benefits of the treatment with Tamoxifen.

Urinary 11-dehydro-thromboxane B2 and 2,3-dinor-6-keto-prostaglandin-F1α in healthy post-menopausal and pre-menopausal women receiving aspirin 100 mg

The prevalence of cardiovascular diseases in women increases sharply after menopause. In postmenopausal women, thromboxane production increases while prostacyclin decreases. Low dose aspirin reduces the production of both thromboxane and prostacyclin. The present study was an open-label clinical trial with two parallel groups of 15 premenopausal women and 15 postmenopausal women. Twenty-four hours urine was collected from each subject before and after aspirin 100 mg daily for 7 days. The concentration of thromboxane and prostacyclin was measured as their metabolites (11-dehydro-thromboxane B(2) and 2,3-dinor-6-keto-prostaglandin-F(1α)) in urine using enzyme immunoassay methods. This study showed that aspirin significantly reduced thromboxane in both groups with significantly larger percentage reduction in postmenopausal women compared to premenopausal women (73.32 vs. 61.13%, p = 0.021). This study also showed that aspirin reduced prostacyclin significantly in both groups, but the percentage reduction between the groups was not significantly different. The decrease in the ratio of 11-dTXB(2)/2,3-dinor-6-keto-PGF(1α) should be compared to assess aspirin efficacy as an antithrombotic. Calculation of the ratio of 11-dTXB(2)/2,3-dinor-6-keto-PGF(1α) before aspirin consumption was higher in postmenopausal women than in premenopausal women. The decrease in 11-dTXB(2)/2,3-dinor-6-keto-PGF(1α) ratio by aspirin was greater in postmenopausal women than in premenopausal women (1.91 vs. 0.17; p = 0.022). It was concluded that aspirin reduced thromboxane and prostacyclin significantly in each group with significant 11-dTXB(2) percentage reduction between groups and non-significant 2,3-dinor-6-keto-PGF(1α) percentage reduction between groups, but reduced the 11-dTXB(2)/2,3-dinor-6-keto-PGF(1α) ratio much larger in postmenopausal women compared to that in premenopausal women.

High Prevalence of Celiac Disease in women With Young Onset Collagenous Colitis: 2011 ACG Presidential Poster

High Prevalence of Celiac Disease in women With Young Onset Collagenous Colitis: 2011 ACG Presidential Poster

The Importance of Gender Differences in the Diagnosis and Management of Cardiovascular Disease

For many years, the majority of the observational and epidemiological studies assessing coronary artery disease patients, national and international clinical guidelines, registries and randomized trials have focused almost exclusively on men whereas women were usually excluded in most series. This underrepresentation of women in the medical literature in this field has resulted in few data being available regarding the clinical course of the condition, its management and clinical outcomes in this specific population, despite the relatively high prevalence of ischemic heart disease in women. The situation has changed -at least partially- in the past few years with publications focusing on this issue and reporting the existence of inequalities between genders regarding the diagnosis and treatment of coronary heart disease. This article will briefly review gender differences in the clinical presentation, diagnostic strategies and prognosis of coronary heart disease.

Gender differences in the treatment of chronic ischemic heart disease: prognostic implications

Despite the relatively high prevalence of coronary artery disease in women, there are little data on the investigation and treatment of ischemic heart disease in this population. In the last couple of decades authors have addressed health problems in minorities, including women. The great majority of these studies included the acute coronary syndrome population but most recent ones have focused on the management of stable angina from a gender perspective. Many of those studies showed that there are inequities between genders regarding the care of patients with ischemic heart disease. Although little is known about the prognostic implications of such differences, studies have shown that suboptimal treatment in women leads to poor clinical outcomes. Gender-specific and both epidemiological and pathophysiological data are needed.

Breast cancer screening – prevalence of disease in women who only respond after an invitation reminder

An analysis of the Norwegian Breast Cancer Screening Programme, including 1,390,310 screening examinations, showed an attendance rate of 71.7% in response to one invitation letter (ordinary attendees) and a further 4.5% increase only after an additional reminder (reminded attendees). Our aim was to examine the prevalence of breast cancer in ordinary and reminded attendees, the frequency of positive mammograms, and the positive predictive value in the two groups. The prevalence of breast cancer in ordinary attendees was 5.6 per 1000 screens compared with 6.3 per 1000 screens in reminded attendees (p<0.001). The frequencies of positive mammograms were 3.5% and 4.0% (p<0.001), and the positive predictive values were 15.9% and 15.2% (p=0.387), respectively, in ordinary and reminded attendees. The risk of breast cancer is higher in women who respond only after a reminder letter, indicating that the value of sending a reminder should be assessed in the light of these results, as well as by the increase in the attendance rate.

The prevalence of benign breast disease in women with polycystic ovary syndrome: a review of a 12-year follow-up

A cross-sectional study of benign breast disease (BBD) was conducted to determine the actual prevalence and follow-up importance of BBD among women with polycystic ovary syndrome (PCOS) in conjunction with an ongoing prospective cohort study. The present study involved a subset of the original group of 244 women with a diagnosis of PCOS and 244 control women matched by age and race. A total of 240 women (116 cases and 124 controls) were included in the present analysis. The majority of women in each group were Caucasians (93 and 96%, respectively). The median age was 46 years in the cases and 47 years in the controls. Screening mammography begins at the age of 40 and has been carried out in 69% of cases and 66% of controls since the study began. Family history of breast disease was observed in 27 cases of both the groups (p > 0.05). Neither fibrocystic breast disease, lump thickening, calcification, fibroadenoma, pain, redness, discharge nor hyperplasia showed a significantly higher prevalence rate in cases than in controls. Eleven (9%) women with PCOS and 21 (17%) controls underwent diagnostic or curative surgery (relative risk: 0.56). These results, in contrast to the previously published literature, do not allow us to conclude that there is a higher risk for BBD among women with PCOS, and the proportion of women with a positive family history of breast cancer was significantly greater in women with PCOS compared with controls. Our observation is that having PCOS does not appear to affect surgeons' decisions to remove BBD.

Prevalence of risk factors, and not gender per se, determines short- and long-term survival after coronary artery bypass surgery

Objective: Much attention has been directed towards female gender as an independent risk factor for in-hospital mortality after coronary artery bypass grafting surgery; however, the effects of surgery are known to persist for 6 months or more. Studies that have compared postoperative survival in women and men beyond hospital discharge report disparate results with regard to the independent effect of gender per se on ultimate survival. Design: This investigation was a prospective, observational study. Setting: The study was a multicenter investigation involving 24 US medical centers. Participants: There were 2,048 patients undergoing isolated coronary artery bypass graft surgery enrolled between September 1991 and September 1993 and after discharge. Interventions: There were no interventions with this prospective observational study. Measurements and main results: Preoperative demographic variables, medical history, and angiographic data were collected for each patient at the time of enrollment. Patients’ vital status through the National Death Index up to August 31, 1998, were added to assess postoperative long-term survival. For survivorship analysis, the Kaplan-Meier product-limit method was used with Cox regression model. Survivorship analyses were performed separately and in combination on mortality within 30 days and 6 months of coronary artery bypass graft surgery and during the entire postoperative follow-up period. Among women, preoperative disease status, as expected, was more severe than that in men. Women were older ( p = 0.0001) and had more comorbidity, such as congestive heart failure ( p = 0.0019), diabetes ( p = 0.0001), anemia, and hypertension ( p = 0.0001). After surgery, unadjusted survival of 6 months and 5 years in women was worse than that in men. However, there were no gender-related differences in short- or long-term survival after adjusting for covariates in the multivariate model. Preoperative conditions, such as congestive heart failure, anemia, diabetes, and advanced age, are indicative of greater risk in both women and men for lower survival after coronary artery bypass graft surgery. Conclusions: Disease prevalence in women, and not gender per se, affects mid- and long-term survival after cardiac surgery. Attention, therefore, should be focused on efforts to reduce or modify such disease prevalence earlier in women, which may in turn allow longer survival after surgical intervention. Differences in postoperative survival between women and men were related to the gender differences in the distribution of preoperative risk factors.