Family History Of Women Research Articles

Exploring the Hidden Meaning of Care through the Life History of a 53-year-old Woman

This study is based on the story of a woman who has been caring for children and the elderly for a living. As a mother of three children she supported her mother-in-law with Alzheimer's for over 20 years. This paper tried to explore the meaning of care through the life history of a 53-year-old woman and discover its implications for pedagogy. As results, first, the meaning that 'life is a period of vulnerability(Donna J. Haraway)' came to light through the characters surrounding this woman's family history; Second, the fact that the relationship between the caregiver and the person being cared for is the core of a good care relationship became clear; Third, since care is already a relationship in itself, care work is a labor of love and relationships that cannot be standardized or objectified. Finally, the meaning of care work illuminated that self-care and care for others are constantly interacting. The family discord experienced by the participant due to solitary care work gave social, political and economic suggestions that care work was passed entirely on to women. This life history research with a participant K suggested also possibilities of inventing a new viewpoint of humanity and a new mode of human relationship through care work. So this study presented a new task for pedagogy in that care is the knowledge that anyone should and can learn.

A Risk Factor Which Can Induced Premature CAD in Women With Positive Family History : A Case Report

Background: Premature Coronary Artery Disease (CAD) was defined as the incidence of CAD in males younger than 45 years of age and in women younger than 55 years of age. Many factors can cause a woman under the age of 55 to develop a CAD. One of the major roles is the patient's family history associated with the occurrence of CAD which is then associated with one or more other CAD-related risk factors such as hypertension, history of Cerebrovascular Accident (CVA), obesity or dyslipidemia. Objective: This case report was made to elaborate on the importance of family history of PCAD on CAD diagnosis. Case Presentation: A 47-year-old woman who has not yet experienced menopause comes with complaints of Dyspneu on Effort (DOE). She had multiple history of CVA. She is the 2nd child of 3 siblings. Her father has died due to liver problem. Her mother had a CVA at the age of 62 with history of hypertension. Her uncle from different grandmothers, also had a history of sudden death. She was diagnosed with a coronary artery disease and percutaneous coronary intervention was performed. Conclusion: The mortality rate of women with CAD is higher than that of men, confirming that CAD in women who appear at the age of less than 55 years should receive more attention, and the task of health workers here is to strengthen history taking related to family history in women with traditional risk factors who have the possibility of developing CAD in the future.

Faktor yang memengaruhi Perilaku Masyarakat Pencegahan Penyakit ISPA di Puskesmas Madat Kabupaten Aceh Timur

<p><em>Acute Respiratory Infections (ARI) is one of the most infectious diseases and causes of death in children in developing countries. Based on the researchers' initial survey, it was found that the number of ARIs in Madat Community Health Center was 1971 people</em><em>. The </em><em>purpose of this study is to determine the factors associated with the implementation of the behavior of prevention of ISPA in infants in Madat District Health Center, East Aceh. T</em><em>he research design used in this study was Cross Sectional. The population in this study were 362 people and samples taken by accidental sampling were as many as 52 people. Data collection methods are primary data and secondary data. Data analysis used is binary logistic regression test.</em><em> </em><em>T</em><em>he results showed that knowledge had a sig-p value of 0.010 <0.05, sig-p ventilation 0.002 <0.05 and health services had a sig-p value of 0.010 <0.05. Based on the overall influencing factors, the most dominant factor affecting ARI is ventilation with a B value (4,489).</em><strong><em> T</em></strong><em>he conclusion in this study is that there is the influence of knowledge, ventilation and health services with the application of community behavior in the prevention of ARI, while the variables of occupancy density and family history of women do not have an influence on community behavior in the prevention of ARI.</em><em></em></p><em>Keywords: behavior factors, disease prevention, acute respiratory, ISPA</em>

257 White Women Are More Frequently Assessed for Hereditary Colon Cancer Risks Compared to Minority Women

INTRODUCTION: It is estimated that 5% of individuals with colon cancer inherited a mutation which increased their risk for the malignancy. Multi-generational family histories are recommended to preliminarily determine genetic risks and initiate referrals for genetic counselling. While women may frequently be assessed for genetic risks associated with breast cancer, it is unclear if GI providers consistently obtain family history in women seeking colon cancer screening. This study evaluated the rates of family histories obtained in women referred for colon cancer screening at a university medical center. METHODS: A retrospective chart review evaluated all women seen by GI providers for colorectal cancer (CRC) screening in the gastroenterology clinic of a university medical center during a 3 month period. Patient age, race, documentation of family history (3 or more generations) was obtained. A confidential database was generated using Microsoft Excel. Statistical analysis using Fisher's Exact Test was performed with significance set at P < 0.05. The study was approved by the institutional IRB. RESULTS: 500 medical records were reviewed. The mean age was 59.6 (range 33–89). Self-reported race/ethnicity included 276 African-American, 123 White, 32 Hispanic, 30 Asian, 20 other and 19 undocumented. 102 (20.4%) had a multi-generational family history. White women were significantly more likely to have a documented 3 generation history compared to all other women (30.08% vs 16.48%), P = 0.0016. African-American compared to white women were less likely to have detailed family histories obtained (17.03% vs 30.08%), P = 0.0050. CONCLUSION: This study demonstrated that multi-generational family histories were not adequately obtained in women by GI providers during colon cancer screening visits. White women compared to all other women more often had detailed family histories documented. Despite African-American women having the highest prevalence of colon cancer among all women in the United States, multi-generational family histories were less frequently obtained. While this study is limited by single institutional design, reliance upon provider documentation and short duration, it provides a foundation for additional research. Increased provider and patient education about the potential significance of family history in colon cancer risk assessment is critical to optimize outcomes.

Mammographic density and breast cancer risk by family history in women of white and Asian ancestry.

Mammographic density, i.e., the radiographic appearance of the breast, is a strong predictor of breast cancer risk. To determine whether the association of breast density with breast cancer is modified by a first-degree family history of breast cancer (FHBC) in women of white and Asian ancestry, we analyzed data from four case-control studies conducted in the USA and Japan. The study population included 1,699 breast cancer cases and 2,422 controls, of whom 45% reported white (N = 1,849) and 40% Asian (N = 1,633) ancestry. To standardize mammographic density assessment, a single observer re-read all mammograms using one type of interactive thresholding software. Logistic regression was applied to estimate odds ratios (OR) while adjusting for confounders. Overall, 496 (12%) of participants reported a FHBC, which was significantly associated with breast cancer risk in the adjusted model (OR 1.51; 95% CI 1.23-1.84). There was a statistically significant interaction on a multiplicative scale between FHBC and continuous percent density (per 10 % density: p = 0.03). The OR per 10% increase in percent density was higher among women with a FHBC (OR 1.30; 95% CI 1.13-1.49) than among those without a FHBC (OR 1.14; 1.09-1.20). This pattern was apparent in whites and Asians. The respective ORs were 1.45 (95% CI 1.17-1.80) versus 1.22 (95% CI 1.14-1.32) in whites, whereas the values in Asians were only 1.24 (95% CI 0.97-1.58) versus 1.09 (95% CI 1.00-1.19). These findings support the hypothesis that women with a FHBC appear to have a higher risk of breast cancer associated with percent mammographic density than women without a FHBC.

Two years' observational study of racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population

Background: Breast cancer is the most common malignancy after non-melanoma skin cancers and second highest cause of cancer deaths (after lung cancer) in females. Objective: To assess racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population. Methods: Medical records of 119 Caucasians and 146 African American women with pathologically proven breast cancer who were admitted in a tertiary care hospital serving the indigent population from January 2004 to December 2006 were reviewed retrospectively. Analysis of Variance was performed for within and between group differences using SPSS 19. Results: Our study showed that mean age of cancer diagnosis was much earlier (47.6 years) in white women whose second degree relatives have breast cancer than those women whose first degree relatives have breast cancer (58.6 years). However, in the black women this differencewas not observed (p value for white is 0.002 but for black it was 0 .94). Conclusion: Family history of women with breast cancer in this study showed history of breast cancer in a second degree female relative increased the risk of breast cancer in white women; positive history was associated with earlier age of onset of the disease. We suggest future studies should look into genetic and biological markers in the second generation family members for increased risk of breast cancer. Health Renaissance, January-April 2013; Vol. 11 No.1; 102-106 DOI: http://dx.doi.org/10.3126/hren.v11i2.8215

Clinical Manifest X-Linked Recessive Adrenoleukodystrophy in a Female

Adrenoleukodystrophy (ALD) is a rare X-linked inherited leukodystrophy with a reduced capacity for degradation of very long chain fatty acids (VLCFAs). The intracellular accumulation of VLCFA leads to demyelination in the central nervous system (CNS) and cell destruction in the adrenal glands. ALD primarily affects males; however, females may develop milder symptoms that may be difficult to recognize. The present report describes a 35-year-old female who experienced a feeling of heaviness in the upper and lower limbs, pain in both knees, and difficulty climbing stairs, running, and jumping. Clinical examination revealed decreased sensitivity in the feet, particularly to touch. Deep tendon reflexes in the lower limbs were brisk, and Babinski's sign was present bilaterally. Multiple sclerosis (MS) was excluded, and all clinical and biochemical tests were normal. After two years of progressing symptoms, the patient was reevaluated and plasma levels of VLCFA were found to be elevated. Seven years prior to this finding, the patient had been found to be heterozygous for the missense mutation c.1679C> T, p.Pro560Leu on the ABCD1 gene (ATP-Binding Cassette subfamily D1). In conclusion, the patient's symptoms could be attributed to ALD. The present case underlines the importance of reevaluating family history in women presenting with vague neurological symptoms.

Ambulatory Blood Pressure and Family History of Hypertension in Healthy Men and Women

Family history of hypertension is a primary predictor of high blood pressure (BP). This study attempted to determine whether there is a gradual increase in BP between individuals with two hypertensive parents, one hypertensive parent, and normotensive parents and whether this increase is apparent with both ambulatory and casual BP assessments in men as well as in women. A total of 220 healthy men and women, aged 22 to 50 years, completed two 24-h ambulatory BP sessions (one work day and one off work day). Based on family history information obtained from parents, three groups were formed: subjects with two hypertensive parents, one hypertensive parent, and normotensive parents. Work and off work days did not differ; analyses were based on mean values of the 2 days. Men with two hypertensive parents had higher daytime and night-time ambulatory BP than men with normotensive parents. Those with one hypertensive parent had intermediate BP levels. Ambulatory BP was not associated with family history in women. Also, men with one or two hypertensive parents had higher ambulatory BP than women with hypertensive parents, whereas offspring of normotensive parents exhibited no sex differences in BP. Elevated systolic and diastolic BP throughout the day and night seems to characterize men with two hypertensive parents. In evaluating the relationship between family history of hypertension and BP, it is important to use ambulatory BP measures, differentiate between individuals with one and with two hypertensive parents, and focus on gender differences in BP.

Race and family history assessment for breast cancer

Studies have demonstrated disparities in breast cancer screening between racial and ethnic groups. Knowledge of a woman's family history of breast cancer is important for initiating early screening interventions. The purpose of this study was to determine whether differences exist in the collection of family history information based on patient race. Cross-sectional patient telephone interview and medical record review. Eleven primary care practices in the Greater Boston area, all associated with Harvard Medical School teaching hospitals. One thousand seven hundred fifty-nine women without a prior history of breast cancer who had been seen at least once by their primary care provider during the prior year. Data were collected on patients regarding self-reported race, family breast cancer history information, and breast cancer screening interventions. Twenty-six percent (462/1,759) of the sample had documentation within their medical record of a family history for breast cancer. On multivariate analysis, after adjusting for patient age, education, number of continuous years in the provider's practice, language, and presentation with a breast complaint, white women were more likely to be asked about a breast cancer family history when compared to nonwhite women (odds ratio, 1.68; 95% confidence interval, 1.21 to 2.35). The majority of women seen by primary care providers do not have documentation of a family breast cancer history assessment within their medical record. White women were more likely to have family breast cancer information documented than nonwhites.

Effect of family history, obesity and exercise on breast cancer risk among postmenopausal women.

We examined effects of obesity and lifetime exercise patterns on postmenopausal breast cancer risk according to family history in a large population-based case control study conducted in Los Angeles County, California, because we hypothesized that both factors would affect risk through similar mechanistic pathways, and that their effects would be stronger among women with a family history. We studied 1883 postmenopausal breast cancer case subjects and 1628 postmenopausal control subjects ranging in age from 55-72 years. Cases were diagnosed with incident breast cancer in the late 1980s and 1990s. Controls were individually matched to case subjects on age, ethnic origin and neighborhood. In-person interviews determined known breast cancer risk factors including: height, weight, lifetime exercise, and family history of breast and other cancers. Breast cancer risk was raised among women who had at least 1 first-degree relative with breast cancer (odds ratio [OR] = 1.68; 95% confidence interval [CI] = 1.36-2.08). Risk increased with increasing levels of body-mass index (wt-kg/ht-m(2)) (p-trend = 0.005). Breast cancer risk was reduced among women who maintained, on average, 17.6 metabolic equivalent of energy expenditure (MET)-hr of activity/week from menarche onward (OR = 0.66; 95% CI = 0.48-0.90). Body-mass index, adjusted for lifetime exercise, was strongly associated with breast cancer risk among women with a positive family history of breast cancer (p-trend < 0.0001), but only weakly associated among women with no family history (p-trend = 0.08; homogeneity of trends p = 0.0005). In contrast, the risk reduction associated with exercise activity, adjusting for body-mass index, was limited to women without a family history of breast cancer (p-trend = 0.001; homogeneity of trends p = 0.005). Body-mass index and exercise activity, both modifiable risk factors for breast cancer, seem to have differential effects depending on a woman's family history of breast cancer, and may impact risk through different biological mechanisms.

Obstetrical family histories of women with unexplained recurrent pregnancy loss.

Objective: To determine whether there is an increased incidence of pregnancy loss in the mothers of women with unexplained recurrent pregnancy loss (RPL). Design: Survey analysis of the family history in women with recurrent pregnancy loss compared to a control population. Materials/Methods: We examined the family obstetrical histories of a population of women with RPL (n = 380) which was defined as at least 2 losses in the absence of hormonal, anatomic or genetic abnormalities. Each completed a questionnaire which asked for both her own and her mother’s obstetrical history. A control group of 140 women who were attending a family practice clinic were asked to complete a family history questionnaire anonymously. Results: Table 1 below shows the number of losses in each group. The mothers of the women with RPL had no higher prevalence of pregnancy losses than mothers of an unselected group of women.Table 1Family history in women with recurrent pregnancy loss.History of lossRPL n = 380 (%)RPL mothers n = 380 (%)Control mothers n = 140 (%)At least 1 loss380 (100)135 (35.5)45 (32.1)1 Loss080 (21.1)28 (20.0)2 Losses96 (25.3)30 (7.9)9 (6.4)≥3 Losses284 (74.7)25 (6.6)8 (5.7) Open table in a new tab Conclusions: Based upon our review of the obstetrical histories of 520 women, there does not appear to be any familial pattern to recurrent pregnancy loss.

Transvaginal sonographic ovarian findings in a random sample of women 25-40 years old.

To investigate the occurrence rate of adnexal lesions in premenopausal women. A random sample of women 25-40 years old was invited to undergo a transvaginal ultrasound examination, and 335 women were examined. The criteria used to define an adnexal lesion were either a cystic lesion with its largest diameter of at least 25 mm within the pelvic region, or the appearance of solid parts in any lesion regardless of size. Adnexal lesions were found in 26/335 cases, (7.8%) (95% confidence interval (CI), +/- 2.9%). The occurrence rate of ovarian cysts was 22/335 (6.6%) (95% CI, +/- 2.7%). There were no differences between the women with or without ovarian cysts related to age, smoking habits, parity or body mass index. At follow-up 3 months later, 18 of the 22 (82%) cysts had disappeared (95% CI, +/- 16%). Women using progesterone contraception (either oral contraception or an intrauterine device with levonorgestrel) had a significantly higher relative risk of 2.7 (95% CI, 1.1-6.9) of functional cysts as compared to women with natural cycles. Polycystic ovaries were found in 10.2% (95% CI, +/- 4.2%) of the women not using any hormonal contraception. The mean volumes of the polycystic ovaries were significantly larger compared to those in natural cycles. Adnexal lesions are common in asymptomatic women in the age group 25-40 years, but four out of five ovarian cysts disappeared spontaneously after 3 months. The ultrasound appearance of the cyst, the woman's family history and her own feelings must be considered if a persisting cyst is to be surgically removed or followed by repeated transvaginal ultrasound.

Hereditary susceptibility to breast cancer: Significance of age of onset in family history and contribution of BRCA1 and BRCA2

revised): OBJECTIVE: To correlate mutations in BRCA1 and BRCA2 with family history of breast cancer in a first-degree relative for women diagnosed with breast cancer before age 45 who do not have a personal or family history of ovarian cancer. METHODS: Family history for women with breast cancer diagnosed before age 45 was provided by ordering physicians via a test requisition form designed for this purpose. Gene analysis was performed by dye primer sequencing for the entire coding regions of BRCA1 and BRCA2. Because a personal and family history of ovarian cancer are known to be significantly associated with mutations, women with either were excluded from analysis. RESULTS: Overall, deleterious mutations in BRCA1 or BRCA2 were identified in 85 of 440 women (19%) with breast cancer under 45. Mutations were identified in 73 of 276 women (26%) with a first degree family history of breast cancer compared to 12 of 164 without (7%) (P <.0001). When results were analyzed by the age of diagnosis in first degree relatives, mutations were identified in 56 of 185 women (30%) with at least one first degree relative with breast cancer diagnosed before age 50 compared with 17 of 91 women (19%), where the first degree family history of breast cancer was at or over age 50 (P = .042). CONCLUSION: Among women with breast cancer diagnosed before age 45, a first-degree relative diagnosed with the disease under age 50 is an indicator of a mutation in BRCAl or BRCA2 even in the absence of a family history of ovarian cancer. Therefore, women diagnosed with early-onset breast cancer should be asked about the age of onset in any first-degree relative diagnosed with the disease, as well as about any family history of ovarian cancer. Mutations in BRCA2 account for a substantial proportion of hereditary breast cancer. Therefore, studies that are limited to BRCA1 or that do not analyze by age of onset of breast cancer in relatives may underestimate the contribution of mutations in BRCAl and BRCA2 to women with early onset breast cancer.

Hereditary susceptibility to breast cancer: significance of age of onset in family history and contribution of BRCA1 and BRCA2.

OBJECTIVE: To correlate mutations in BRCA1 and BRCA2 with family history of breast cancer in a first-degree relative for women diagnosed with breast cancer before age 45 who do not have a personal or family history of ovarian cancer.METHODS: Family history for women with breast cancer diagnosed before age 45 was provided by ordering physicians via a test requisition form designed for this purpose. Gene analysis was performed by dye primer sequencing for the entire coding regions of BRCA1 and BRCA2. Because a personal and family history of ovarian cancer are known to be significantly associated with mutations, women with either were excluded from analysis.RESULTS: Overall, deleterious mutations in BRCA1 or BRCA2 were identified in 85 of 440 women (19%) with breast cancer under 45. Mutations were identified in 73 of 276 women (26%) with a first degree family history of breast cancer compared to 12 of 164 without (7%) (P <.0001). When results were analyzed by the age of diagnosis in first degree relatives, mutations were identified in 56 of 185 women (30%) with at least one first degree relative with breast cancer diagnosed before age 50 compared with 17 of 91 women (19%), where the first degree family history of breast cancer was at or over age 50 (P = .042).CONCLUSION: Among women with breast cancer diagnosed before age 45, a first-degree relative diagnosed with the disease under age 50 is an indicator of a mutation in BRCAl or BRCA2 even in the absence of a family history of ovarian cancer. Therefore, women diagnosed with early-onset breast cancer should be asked about the age of onset in any first-degree relative diagnosed with the disease, as well as about any family history of ovarian cancer. Mutations in BRCA2 account for a substantial proportion of hereditary breast cancer. Therefore, studies that are limited to BRCA1 or that do not analyze by age of onset of breast cancer in relatives may underestimate the contribution of mutations in BRCAl and BRCA2 to women with early onset breast cancer.

The calculation of breast cancer risk for women with a first degree family history of ovarian cancer.

Recent linkage analyses demonstrate the strength of the genetic association between breast and ovarian cancer in some families. These findings highlight the importance of considering a woman's family history of ovarian cancer in the calculation of her risk of breast cancer. In this study, data on breast and ovarian cancer from the Cancer and Steroid Hormone Study, a large, population-based, case-control study conducted by the Centers for Disease Control, are used to calculate age-specific and cumulative risks of developing breast cancer for a woman with a first degree family history of ovarian cancer. These risks are calculated using maximum likelihood estimates from an autosomal dominant genetic model fit previously to the observed age-specific recurrence data of breast cancer among first degree relatives of the breast cancer cases and controls in these data as well as from genotype-specific estimates of lifetime ovarian cancer risk derived from this model. Under this model, the lifetime risk of developing breast cancer for a woman with one or two first degree relatives affected with ovarian cancer is estimated to be approximately 13% and 31%, respectively. A woman with one first degree relative affected with ovarian cancer and one first degree relative affected with breast cancer has an estimated risk of 40 percent of developing breast cancer by age 79 years if the relative with breast cancer was diagnosed in her thirties. This risk decreases with increasing age of onset of the relative affected with breast cancer.

Relationship between risk factors for breast cancer and hormonal status.

A total of 512 breast cancer patients and 540 controls were compared to examine the risk factors for different categories of breast cancer as defined by age, menopausal status and estrogen receptor (ER) tumor status. Significant differences were found by menopausal status, for age at first birth and age at menarche for all women, and for age at first birth and family history for women between 45 and 54 years old. No significant differences were found with ER status alone; however there was a significant difference between ER status and body weight in premenopausal women; the above significant differences with menopausal status were not found when stratified by ER tumour status. These findings support the hypothesis for aetiological differences for pre- and postmenopausal breast cancer and suggest that ER tumour status may influence the risk associated with body weight.