Characteristics Of Female Patients Research Articles

Early detection of elderly female patients with delayed cardiac tamponade after PCI

Objective To summarize clinical characteristics of female patients with delayed cardiac tamponade after percutaneous coronary intervention (PCI).Methods Materiais on clinical characteristics of 1009 elderly patients who might have delayed cardiac tamponade after PCI from Aug 1999 to May 2011 was analyzed retrospectively.Results Two patients who had delayed cardiac tamponade after PCI were female,suggesting that elderly female patients with multi-vessel coronary disease and complex coronary lesions should be monitored closely after PCI.Bedside ultrasound should be performed promptly within 6 hours after operation for unexplained low pressure in case of delayed cardiac tamponade.Two patients were recovered and discharged after pericardiocentesis and appropriate treatment.Conclusions Elderly female patients with multi-vessel coronary disease and complex coronary lesions tend to have delayed cardiac tamponade after PCI easily,whose early clinical characteristics should be noted and evaluated. Key words: Elderly female patients; PCI; Delayed cardiac tamponade; Early characteristics

The Impact of Diabetes Mellitus on Prognosis of Early Breast Cancer in Asia

Diabetes mellitus (DM) has been implicated in influencing the survival duration of patients with breast cancer. However, less is known about the impact of DM and other comorbidities on the breast cancer-specific survival (BCS) and overall survival (OS) outcomes of Asian patients with early-stage breast cancer. The characteristics of female patients with newly diagnosed, early-stage breast cancer were collected from the Taiwan Cancer Registry database for 2003-2004. DM status and other comorbidities were retrieved from Taiwan's National Health Insurance database. The BCS and OS times of patients according to DM status were estimated via the Kaplan-Meier method. Cox's proportional hazard model was used to estimate adjusted hazard ratios (HRs) for the effects of DM, comorbidities, and other risk factors on mortality. In total, 4,390 patients were identified and 341 (7.7%) presented with DM. The 5-year BCS and OS rates were significantly greater in DM patients than in non-DM patients (BCS, 85% versus 91%; OS, 79% versus 90%). Furthermore, after adjusting for clinicopathologic variables and comorbidities, DM remained an independent predictor of shorter BCS (adjusted HR, 1.53) and OS (adjusted HR, 1.71) times. Subgroup analyses also demonstrated a consistent prognostic influence of DM across different groups. In Asian patients with early-stage breast cancer, DM is an independent predictor of lower BCS and OS rates, even after adjusting for other comorbidities. The integration of DM care as part of the continuum of care for early-stage breast cancer should be emphasized.

Adult candidates for heart transplantation with larger body surface area have better prognosis on waiting list after progression to critically ill status

Smaller body size is one of the characteristics of female patients. We analyzed whether lower body surface area (BSA) of adult patients affects their prognosis after listing for heart transplantation (HTx). Adult candidates (≥ 18 and <65 years) for de novo HTx in our center, who were newly listed as T (transplantable) by Eurotransplant without ventricular assist device (VAD) support between 2000 and 2009 (n = 545), were studied. The patients were divided into two groups: group S (n = 272): BSA<1.9563 m(2) (median value of total patients) and group L (n = 273): BSA ≥ 1.9563 m(2). Most female patients (82/84, 97.6%) belong to group S. Among all these patients, 286 progressed to critically ill status, that is, they were listed in urgent status or received a VAD. Actuarial survival rates were studied in each group. Overall survival rates after listing for HTx in group S were comparable to those in group L (43.0% vs 43.7% for 7-year survival, p=0.95). However, 1-year survival rate on waiting list after progression to critically ill status in group S (58.0%, n = 135) and that of female patients in group S (55.8%, n = 33) were significantly lower than those in group L (67.3%, n = 151, all were men; p = 0.042 and p = 0.044, respectively). After multivariate Cox analysis, BSA<1.9563 m(2) (hazard ratio 2.120, p = 0.0019), serum creatinine (hazard ratio 1.202, p = 0.033), obesity defined as body mass index ≥ 30 kg m(-2) (hazard ratio 2.043, p = 0.0096) and primary use of VAD (hazard ratio 3.243, p < 0.0001) were identified as independent risk factors for mortality on waiting list after progression to critically ill status. One-year survival rate on waiting list after VAD implantation in group S (44.4%, n = 65) and that of female patients in group S (38.1%, n = 14) were significantly lower than those in group L (63.0%, n = 78, all were men; p = 0.020 and p = 0.012, respectively). Adult HTx candidates with lower BSA, including most women, had worse prognosis on waiting list after progression to critically ill status, especially after VAD implantation. As almost all HTx are nowadays performed in critical status, this problem has emerged as important.

The clinical characteristics of female patients with Fournier’s gangrene

Our aim was to review our experience with Fournier's gangrene in female patients. A retrospective review of ten consecutive female patients with Fournier's gangrene was performed. Etiological and predisposing factors, causative microbiological organisms, and clinical outcome were investigated. Mean age of the patients was 52.7 years, and the mean duration of hospitalization was 17.6 days. The etiologic origin of the gangrene was anorectal, dermatological, and urogenital infection in 50%, 20%, and 10% of patients, respectively. All patients underwent aggressive surgical debridement and a diverting colostomy. Nine patients survived, and one patient died for an overall mortality rate of 10%. Fournier's gangrene occurred in females with a pattern similar to that in males. We believe that a colostomy is an integral part of management for patients requiring extensive debridement, especially if the infection arises in the anorectal region.

Clinical characteristics of female patients with chronic heart failure and survey of mental health

目的 了解女性慢性心力衰竭(CHF)患者住院时的一般临床特点和心理情绪状态.方法 选择男性和女性慢性心力衰竭患者各180例,比较其一般临床特点,采用症状自测量表对2组进行测量和比较.结果 女性CHF患者年龄、高血压、糖尿病、肥胖、心房纤颤及舒张功能不全均高于男性.女性和男性患者组在总分、阳性项目数、躯体化、抑郁、焦虑方面因子分均高于常模;而强迫、人际关系、敌对性、恐惧、精神病性等因子与正常人群无显著差异;女性患者在总分、阳性项目数、躯体化、抑郁、焦虑上均显著高于男性.结论 女性CHF临床特点与男性不同,男性和女性CHF患者均存在心理水平的失衡,女性较男性严重。

Emerging Problems of Heart Failure Practice in Japanese Women Lessons From the CHART Study

The prognosis of patients with chronic heart failure (CHF) is poor in both men and women. However, the characteristics of, and effective treatment strategy for, female CHF patients still remain unclear. This study was designed to evaluate the prognosis and characteristics of female patients in a CHF cohort termed the Chronic Heart Failure Analysis and Registry in the Tohoku District. Of 1,278 patients registered in the cohort, the study population comprised 1,166 symptomatic CHF patients with sufficient data. As compared with male patients, female patients were more likely to be older, have preserved systolic function and non-ischemic etiology of CHF, and underuse standard CHF medications. Although a previous study showed that sex-difference was not a significant prognostic factor in CHF patients, the unadjusted survival analysis revealed an increased event rate in female patients in the present study. Multivariate analysis revealed that older age, diabetes, ventricular tachycardia and anemia were significant prognostic risks in both men and women with CHF. Female sex had a significant link with elderly CHF patients. Given the explosive increase in elderly patients in Westernized countries, further studies are needed to elucidate the evidence for treatment of female CHF patients.

Demographic and Clinical Characteristics Predictive of Asthma Diary Use Among Women

Background. Current asthma guidelines encourage the use of an asthma diary for patients whose symptoms are not under control, who are being introduced to new treatments, or who need help in identifying environmental or occupational exposures. Despite the potential benefit of diaries in asthma management, gaps in the understanding of their use exist. Our objective was to identify demographic and clinical characteristics predictive of diary use by women with asthma as women patients predominate in asthma among adults and have higher rates of associated asthma management problems. Methods. Demographic and clinical characteristics associated with the use of a structured asthma diary were examined using data collected from 424 women with asthma over 18 years of age taking part in a randomized controlled study. Data were analyzed using chi-square statistics and logistic regression. Data reported are for women randomized to the intervention arm (N = 424) who were assigned the diary as part of the educational intervention. Results. Older age (OR = 1.614; p < 0.05) and higher education (OR = 1.835; p < 0.05) were associated with diary use. More severe asthma (OR = 0.479; p < 0.01) and a history of smoking (OR = 0.495; p < 0.05) were associated with nonuse of the diary. Conclusions. Both demographic and clinical characteristics are associated with asthma diary use. Clinicians and researchers should anticipate potential differences in use of an asthma diary according to demographic and/or clinical characteristics of female patients.

Clinical characteristics in female patients with Brugada syndrome

[in Japanese]

Endorectal coil magnetic resonance imaging for diagnosis of urethral and periurethral pathologic findings in women

ObjectivesTo report our experience with endorectal coil magnetic resonance imaging (ERC-MRI) in the evaluation of female patients with lower urinary tract symptoms (LUTS). We present the results of symptomatic patients who underwent this imaging modality, to better define its use and to try to identify applications relevant to everyday clinical practice. MethodsWe reviewed retrospectively 140 consecutive patients who presented with LUTS and underwent ERC-MRI between June 1997 and June 2000. Assessment included history, physical examination, urodynamic studies, and other radiologic evaluations (such as voiding cystourethrogram). Patients were divided into five groups on the basis of the main indication for ordering the MRI. The results in the subgroups of patients who had repeat ERC-MRI and transvaginal urethrolysis were also analyzed. ResultsFindings consistent with periurethral fibrosis were detected in 52% of the patients, most frequently in those with symptoms suggestive of, or with urodynamic evidence of, obstruction. Ten percent of the patients were found to have urethral diverticula; in 54% of this group, the diagnosis was made solely by MRI. Repeat ERC-MRI showed either periurethral fibrosis or a urethral diverticulum in most patients (17 of 22). No correlation was observed between the subjective estimate of scar tissue during urethrolysis and the amount determined by the interpretation of the images. ConclusionsOur 3-year experience suggests that ERC-MRI may help better define the diagnosis of urethral and periurethral pathologic features in female patients with LUTS. With improved patient selection, ERC-MRI will likely have a role in evaluating women with symptoms difficult to explain by other diagnostic modalities.

Rectal sensorimotor characteristics in female patients with idiopathic constipation with or without paradoxical sphincter contraction.

Patients with chronic constipation fulfilling the Thompson criteria can show paradoxical sphincter contraction. Aim of this study was to evaluate rectal sensorimotor characteristics in patients with constipation with or without paradoxical sphincter contraction. Thirty female patients with chronic constipation and 22 female controls were investigated with anal manometry and rectal barostat. Paradoxical sphincter contraction was shown with manometry as a paradoxical increase of anal pressure during straining. Visceral sensitivity and compliance were tested by intermittent and continuous pressure-controlled distension. Patients were classified according to their sensations and compliance into normal, hypersensitive, reduced compliant, insensitive or excessive compliant rectum. Postprandial rectal response (PRR) and phasic volume events (PVEs) were registered for 1 h after a 600-kCal meal. Paradoxical sphincter contraction was found in 13 (43%) patients. In these patients, rectal sensitivity scores were higher (P = 0.045) than in patients without paradoxical contractions, but rectal compliance was not different. In 90% of patients an abnormal rectal sensitivity or compliance was found: excessively compliant in 35%, reduced compliant in 10%, hypersensitive in 27% and hyposensitive in 17%. Both patients with constipation (11%; P = 0.042) and controls (25%; P = 0.002) exhibited the presence of a postprandial rectal response. This response was not significantly different between idiopathic constipation, paradoxical sphincter contraction and controls. Patients with rectal hypersensitivity had lower response than other patients (P = 0.04). Patients with constipation had fewer basal PVEs compared controls (P = 0.03). Postprandial PVEs increased in both patients (P = 0.014) and controls (P < 0.001). Postprandial rectal response and PVE were not different in patients with or without paradoxical sphincter contraction. A total of 90% of female patients with idiopathic constipation show an abnormality in rectal sensation or compliance. The postprandial rectal response was comparable between patients with constipation and controls, however, PVEs were diminished. Patients with paradoxical sphincter contraction had higher rectal sensitivity but an unaltered compliance and postprandial rectal response. Future trials should investigate whether the classification of rectal abnormalities in patients with constipation has clinical importance.

Characteristics of Female Patients with Sexual Dysfunction Who Also Had A History of Blunt Perineal Trauma

Perineal trauma can occur in both genders, however, data supporting the relationship between sexual dysfunction and blunt perineal trauma in women is lacking. This study reviewed the patient characteristics of women with sexual dysfunction who also had a history of blunt perineal trauma. A neurogenic form of sexual dysfunction has been implicated, with primary complaints of orgasm disorder and abnormalities noted on genital sensory testing. Further research in this area is needed.

Epidemiological Characteristics of 250 Women with Sexual Dysfunction Who Presented for Initial Evaluation

There have been limited literature reports concerning the epidemiological characteristics of female patients who present for initial evaluation of sexual health problems to an outpatient sexual health clinic. This study is a single-institution, retrospective, IRB-approved, observational assessment of 250 female patients undergoing management for sexual dysfunction. In our clinic, women with sexual dysfunction were, in general, young, healthy, and free of vascular risk factors; complained of an acquired multidimensional combination of decreased desire, arousal, and orgasm; and had significantly low serum androgen levels. More research in the management of women with sexual health problems is needed.

Current status of thromboangiitis obliterans (Buerger’s disease) in Japan

We analysed clinical features and outcome in 850 patients with thromboangiitis obliterans (TAO), based on the 1993 Nationwide Survey of Vasculitis database collected from 3722 clinical sites in Japan. The survey was designed to assess clinical manifestation categorized by Fontaine’s classification, distribution of lesions (arterial involvement and migratory superficial phlebitis), response to medical and surgical treatment, and outcome. There were 771 males (90.7%) and 79 females (9.3%), with a mean age of 50.8±0.4 (range: 17–81) years. Clinical manifestations at the first consultation were Fontaine I in 8.0%, Fontaine II in 29.6%, Fontaine III in 23.9%, and Fontaine IV in 38.1%. These symptoms had been significantly improved by the time of survey. Ulcer formation in the past history had occurred in 45.2%, which was the most common in toes (85.9%). Failure of smoking cessation significantly affected the risk of ulcer formation (odds ratio=1.71, 95%CI=1.19–2.47; P=0.004) and amputation (odds ratio=2.73, 95%CI=1.86–4.01; P<0.0001). Clinical features in female patients with TAO were equal to those in male patients, except for the fact that non-smokers were more common in female patients. Abstinence from tobacco significantly reduces the risk of ulcer formation and amputation, and thus improves the quality of life in patients with TAO.

Illness behavior and somatization in general practice

In the primary care setting, the early recognition that a patient has psychological problems is frequently hindered by the deceptive mode of presentation known as somatization. In a cross-sectional survey of patients attending suburban General Practitioners in a large metropolitan city, the General Health Questionnaire-30 (GHQ-30) and the Illness Behavior Questionnaire (IBQ) were completed by 201 patients. A comparison was made between somatizing and nonsomatizing patients with new inceptions of illness in terms of the risk of the presence of a mild nonpsychotic psychiatric illness and aspects of illness behavior. For the group as a whole, somatizing patients were more likely to be older and female. Male somatizers differed from male nonsomatizers by showing greater disease conviction and affective disturbance and more readiness to acknowledge difficulties in their lives other than health problems. No differences were found between female somatizing and nonsomatizing patients. We conclude that, while male patients who somatize psychological distress may be distinguished from male nonsomatizers early in their illness, in terms of their illness behavior, these differences are not seen as early distinguishing characteristics in female patients who present to their General Practitioners with physical problems for which no organic cause can be established.

Rheumatoid arthritis: determination of pain characteristics and comparison of RAI and VAS in its measurement

The purposes of this study were to determine pain characteristics in female patients with rheumatoid arthritis (RA) and to determine the relationship between the outcome of the Ritchie Articular Index (RAI) and pain intensity as measured by the visual analogue scale (VAS). The sample consisted of 30 female patients with a definite diagnosis of RA and a functional capacity of class II. The results indicated that the pain fluctuated during the day. The intensity level of present pain was lower than that of usual pain. Eight patients reported that their worse pain occurred several times/day. Ache was the word most frequently chosen by the subjects to denote their pain sensations. A high correlation r = 0.86 ( P < 0.01) was found between the scores of RAI and present pain on the VAS. This finding suggests that the pain in RA is associated with the hyperalgesic state induced by the inflammatory condition associated with RA. There was no significant correlation between blood tests like ERS, WBC and VAS or RAI.

Some EEG features in female patients complaining of sexual inadequacies a pilot study

Some EEG features in female patients complaining of sexual inadequacies a pilot study