Size In Women Research Articles

Women's Political Representation in Nepal: An Experience from the 2008 Constituent Assembly

In Nepal, a constituent assembly was elected in 2008 to draft a new constitution for the nation. The assembly worked for four years but was dissolved without completing its task. Nonetheless, it had made decisions on most constitutional provisions apart from the provision of federal structures. Political forces agreed thereafter that the new assembly will create a constitution based on the constitutional provisions decided by the dissolved assembly. Women comprised almost 33 percent of the constituent assembly in 2008. However, to what extent did the presence of a ‘critical mass’ of women in the assembly contribute to progress towards gender equality? This article, reviews existing literature, with a view to query the effects of ‘critical mass,’ arguing that despite the sizeable presence of women in the assembly, they were unable to influence the culture of this male-dominated political institution. The alliance among women for advancing women's interests was far from possible. In this respect, the assembly was not very different from the parliaments of the past, which only had a nominal women's representation. The size of women's presence has no particular relationship with a ‘women-friendly’ policy in Nepal, no more than seen in the studies of western parliaments.

Does Polycystic Ovarian Syndrome Increase Insulin Resistance Above and Beyond Obesity?

Objective: Although obesity and insulin resistance are common in women with polycystic ovarian syndrome (PCOS), PCOS is generally believed to independently raise the risk of insulin resistance. However, only a few studies have used direct measures of insulin resistance, and they have included few subjects. The objective of this study was to compare the relationship between body mass index (BMI) and insulin resistance in a relatively large sample size of women, with and without PCOS, using a specific measure of insulin action. Methods: We compared 94 women with PCOS based on the 1990 NIH criteria with 72 controls with eumenorrhea less than 40 years old. Degree of insulin resistance was quantified using the insulin suppression test. Fasting glucose and lipid concentrations and blood pressure were also measured. Results: There was a significant and comparable relationship between BMI and insulin resistance in women with and without PCOS (r=0.55, p<0.001 in PCOS, r=0.53, p<0.001 in Control). In a linear model adjusted for age and BMI, PCOS was not significantly associated with insulin resistance. PCOS was significantly associated with systolic blood pressure (p=0.03) but not triglyceride, high-density lipoprotein cholesterol and fasting glucose concentration. Conclusion: Challenging previous studies, we find that PCOS is not independently associated with insulin resistance beyond obesity. PCOS, however, may independently increase systolic blood pressure.

Impact of breast cancer family history on tumor detection and tumor size in women newly-diagnosed with invasive breast cancer

This study evaluated the impact of family history (FH) on tumor detection, the patient's age and tumor size at diagnosis in breast cancer (BC). Furthermore, we investigated whether the impact of FH on these features was dependent on degree of relationship, number of relatives with a BC history, or the age of the affected relative at the time that her BC was diagnosed. Out of the entire cohort (n = 1,037), 244 patients (23.5%) had a positive FH; 159 (15.3%) had first-degree relatives affected with BC and 85 patients (8.2%) had second-degree affected relatives. Compared to women who had no BC-affected relatives, the tumors of women who had positive FH were more often found by radiological breast examination (RBE: 31.7%/27.2%, p = 0.008), and they were smaller (general tumor size: 21.8 mm/26.4 mm, p = 0.003; size of tumors found by breast self-examination (BSE): 26.1 mm/30.6 mm, p = 0.041). However, this positive effect of increased use of BC screening and smaller tumor sizes was only observed in patients whose first-degree relatives were affected (comparison with second-degree affected relatives: RBE: 43.8%/24.7%; odds ratio 2.38, p = 0.007; general tumor size: 19.3 mm/26.3 mm; mean difference (MD) -6.9, p = 0.025; tumor size found by BSE: 22.5 mm/31.0 mm; MD -8.5, p = 0.044). When more second-degree relatives or older relatives were diagnosed with BC, the tumors of these patients were similarly often detected by RBE (relationship: 24.7%/27.2%, p = 0.641; age: 33.7 %/27.2 %, p = 0.177) and had similar tumor sizes (general size: 26.3 mm/26.4 mm, p = 0.960; BSE: 31.0 mm/30.6 mm, p = 0.902) as those of women without a FH. Women with a positive FH generally use mammography screening more often and perceive changes in the breast earlier than women without such history. The increased awareness of BC risk decreases if the relationship is more distant.

Impact of gender-specific reference values of high-sensitivity troponin T on the prevalence and long-term outcome of acute myocardial infarction

Purpose: Recently, the 99th percentile of hs-cTn assays in healthy individuals was found to be significantly lower in women as compared to men, possibly at least in part related to the smaller size of women's hearts. These recent findings question current clinical practice to use identical cut-off values for the diagnosis of acute myocardial infarction (AMI) in men and women. In order to shed more light on this important topic we sought to examine the impact of gender-specific reference values on the prevalence, clinical characteristics and long-term outcome of AMI in a large multicenter cohort of consecutive patients presenting with acute chest pain to the Emergency Department (ED). Methods: We included n=2365 consecutive patients of our ongoing prospective international multicenterstudy. Patients with STEMI (n=79) have been excluded from analysis. The initial final diagnosis was adjudicated by two independent cardiologists usingall available clinical information and high-sensitivity cardiac Troponin T (hs-cTnT, Roche) witha 99th percentile cutoff value of 14 ng/l. We adjudicated a second final diagnosis using gender-specific cutoff reference values, e.g. 8.9 ng/l for women and 15.5 ng/l formen. We excluded female patients (n=5) with insufficient serial hs-cTnT values to assess the criteria. All patients received long-term follow-up. Results: There were n=725 women and n=1561 men in the cohort. Using the same cutoff value for both women and men, 14.6% (n=106) females and 19.6% (n=396) males received the final diagnosis of NSTEMI. 5.9% (n=43) females and 11.3% (n=176) males received the final the diagnosis of Unstable Angina (UA). Using gender-specific cutoffs, 2 women (5% of all women with UA) were shifted from the diagnosis of UA to NSTEMI. Using gender-specific cut-off values, no changes occurred in the diagnosis of men. The first reclassified woman was 74 years old, with known coronary heart disease. 65 days after presentation the patient died, presumably from cardiac causes. The second woman was 85 years old, also with known coronary heart disease. There was no further cardiac event documented during follow-up. Conclusions: In patients presenting with acute chest pain to the ED, using gender-specific reference values for hs-cTnT does reclassify only a very small proportion of patients. Still, the reclassification of women to NSTEMI seems appropriate. (Clinical trials.gov number, [NCT00470587][1]) [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00470587&atom=%2Fehj%2F34%2Fsuppl_1%2FP4042.atom

Psychosocial Outcomes of a Randomized Controlled Trial of Outpatient Cervical Priming for Induction of Labor

Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to "prime" or "ripen" the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). Of 1,004 eligible women, 85 percent consented (n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety.

Atherogenic changes in low-density lipoprotein particle profiles were not observed in non-obese women with polycystic ovary syndrome

Is a preponderance of small dense low-density lipoprotein-cholesterol (LDL-C) observed in non-obese women with polycystic ovary syndrome (PCOS)? Non-obese Korean women with PCOS have no quantitative or qualitative changes in LDL-C profiles. Small dense LDL particles (sd-LDL) are more atherogenic than large buoyant ones and are strongly associated with coronary artery disease independent of other risk factors. Many investigators have found an increased proportion of atherogenic sd-LDL or a decreased mean LDL particle size in women with PCOS, but all of these studies have been based primarily on obese or overweight women with PCOS. This was a case-control study evaluating complete lipid and lipoprotein profiles in 64 PCOS patients and 64 age- and BMI-matched controls. All women with PCOS in our study population were not obese. To determine the differences in the LDL particle profiles between PCOS phenotypes, the patients with PCOS were divided into two subgroups according to the presence of clinical or biochemical hyperandrogenism. Using the Rotterdam criteria, we recruited 64 women (18-40 years) with PCOS who were attending a tertiary university hospital. A total of 64 premenopausal control women were matched with patients based on exact age and BMI (± 1.0 kg/m(2)). All the participants fell within the non-obese range of the BMI (<25 kg/m(2)) according to the definition of obesity for Asians. The LDL subfraction was analyzed by 3% polyacrylamide gel tube electrophoresis. Seven LDL subclasses were quantified and LDL subclasses 3-7 were small LDL subfractions. LDL subfraction scores were calculated based on the following weighted scoring system developed by the manufacturer: scores of <5.5 were categorized as phenotype A (large, buoyant LDLs), and those >5.5 were categorized as non-A phenotype (sd-LDLs). The system also determined the mean LDL particle size diameter. There were no differences in the absolute level of LDL-C, mean LDL diameter or percentage of atherogenic sd-LDLs between PCOS patients and controls or between hyperandrogenic and non-hyperandrogenic PCOS subgroups. Also, none of the subjects showed a non-A LDL phenotype. The most notable finding of our study was the difference in the lipoprotein (a) levels and prevalence of its elevation in PCOS patients versus controls (P = 0.002 and P = 0.004, respectively), and between PCOS subgroups (P = 0.030 and P = 0.047, respectively). Inclusion of only non-obese subjects, small sample size and lack of information on other potential confounding factors, such as differences in diet and/or exercise patterns. Although our findings suggest that non-obese women with PCOS have no significant quantitative or qualitative changes in LDL-C profile, data on obese Korean women with PCOS could offer complementary findings about the possible relationship between the magnitude of obesity and LDL phenotype. Further investigations are needed to determine whether a change in lipoprotein (a) in non-obese women with PCOS is also found in other ethnic groups. No conflict of interest exists. This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A100624). N/A.

Development of woven stretch fabric for comfortably fitting sari blouses and analysis of fit

Six stretchable fabrics were woven using 50s and 60s cotton in warp with 40s, 50s and 60s cotton core spun lycra in weft for a sari blouse. Low-stress mechanical properties were measured and handle value calculated and their influence on fit analysed. The fit was analysed for women's sizes 12, 16 and 22, in total 18 blouses were constructed. 60s cotton warp/60s cotton core spun lycra weft received higher ratings in subjective wear trial expression and visual analysis of fit by judges. The ease measurement, number of wrinkles and seam line deviation of this fabric are closer to the rating value 5 and are excellent. The findings reveal that finer yarn count in warp and weft, lower thickness, higher extensibility, lower shear and bending rigidity value with superior hand value make the fabric stretch and drape well over the body contours, giving dimensional comfort to the wearer, with comfortable fit.

Ulipristal Acetate Versus Leuprolide Acetate for Uterine Fibroids

Current intervention strategies for management of uterine fibroids in women of reproductive age are primarily surgical or radiological. There are limited options for medical therapy. Two small placebo-controlled trials showed that ulipristal acetate, a selective progesterone-receptor modulator (SPRM), reduced fibroid and uterine sizes in women with symptomatic fibroids. The aim of this randomized, double-blind, controlled noninferiority trial was to determine whether ulipristal acetate was noninferior to leuprolide acetate in controlling bleeding before planned surgery in premenopausal women with symptomatic fibroids. Another aim was to compare the adverse effect profile of the 2 drugs. The participants, 307 patients with heavy uterine bleeding, were randomized to receive 3 months of daily therapy with oral ulipristal acetate (either 5 or 10 mg) or once-monthly intramuscular injections of leuprolide acetate (3.75 mg). The primary study outcome was the proportion of patients with controlled uterine bleeding at week 13. A prespecified noninferiority margin of −20% was used. Bleeding was controlled at 13 weeks in all 3 treatment groups; there was 90% control with the 5-mg dose of ulipristal acetate: 98% with the 10-mg dose versus 89% with the leuprolide acetate injection; the difference between ulipristal acetate and leuprolide acetate was 1.2 percentage points (95% confidence interval, −9.3 to 11.8) for the 5-mg dose and 8.8 percentage points (95% confidence interval, 0.4 to 18.3) for the 10-mg dose. Bleeding was attenuated more rapidly with ulipristal acetate than leuprolide acetate: median times to amenorrhea were 7 days in patients receiving 5 mg of ulipristal acetate and 5 days in those receiving 10 mg versus 21 days in those receiving leuprolide acetate. Moderate-to-severe hot flashes occurred less frequently in patients treated with ulipristal acetate than in those treated with leuprolide acetate: 11% with the 5-mg dose of ulipristal acetate and 10% with the 10-mg dose compared with 40% in those treated with leuprolide acetate (P < 0.001 for both comparisons). These findings show that daily doses of oral ulipristal acetate of both 5 and 10 mg were noninferior to once-monthly injections of leuprolide acetate in controlling bleeding in patients with fibroids and were less likely to cause hot flashes.

Reliability and validity of the figure-of-eight method of measuring hand size in patients with breast cancer-related lymphoedema

Breast cancer-related lymphoedema (BCRL) affects 24-42% of patients following treatment for breast cancer. The gold standard method of measuring hand swelling associated with BCRL is to use water displacement (volumeter). This is not always possible in the clinical setting and the figure-of-eight method, which involves wrapping a simple measuring tape around the hand in a specific way, may be an alternative. The aim of the study was to examine the reliability and validity of the figure-of-eight method of measuring hand size in women with BCRL. Twenty-four patients with hand swelling associated with BCRL participated. Two novice testers performed three 'blinded' figure-of-eight measurements and three volumetric measurements of each hand. In terms of intertester (between-tester) and intratester (within-tester) reliability, the intraclass correlation coefficients were all greater than 0.8 indicating high intra- and intertester reliability for the figure-of-eight method. For validity, a Pearson's moment correlation computed between the figure-of-eight and volumetric methods highlighted a statistically significant correlation of 0.7 between the methods for both testers. The figure-of-eight method was found to be a valid and reliable method of measuring hand swelling in this population.

Comparison the effect of stabilization and McKenzie exercises on pain, disability and lumbar multifidus muscle size in women with chronic non-specific low back pain

Introduction : Low back pain may cause clinical symptoms such as: reflex inhibition and atrophy of multifidus muscles, lumbar paraspinal muscles atrophy, dysfunction and disability. The atrophy of multifidus muscles could be a main cause of recurring back pain.. Therefore, present study compared the effect of stability and McKenzie exercises on pain, disability and multifidus size in women with chronic non-specific low back pain. Materials and Methods: 60 non-athletic women with chronic non-specific low back pain allocated in this research. They randomly and equally divided in to two experimental groups, 30 subjects (Mean ± SD age, 33.37 ± 7.92 year) in stabilization exercise group and 30 participants (Mean ± SD age, 37.00 ± 9.97 year) in McKenzie exercises group. Both groups performed exercise training for 6 weeks. The level of pain, disability, and the cross sectional area of lumbar multifidus muscle was respectively measured by visual analog scale (VAS), Ostwestry disability index and Ultrasonography imaging. These data were collected just before intervention, after 6 weeks of exercise intervention, and also at the end of 4 weeks follow-up period. Independent sample t-test was used to analyze the data and P 0.05). Conclusion: Stabilization and McKenzie exercises may improve pain and disability in patients with chronic non-specific low back pain, while stabilization exercise results in size improvement of lumbar multifidus muscles at L5 level. Therefore stabilization exercises may be more effective to prevent recurrent chronic low back pain. Keywords : Non-specific chronic low back pain, Stabilization exercises, McKenzie exercises, Lumbar multifidus muscle

Peripheral adiposity in relation to offspring birth size in women with and without gestational diabetes: Preliminary data

To document the relationship between maternal body composition parameters and offspring anthropometric measurements. A prospective sample of 48 pregnant women with either gestational diabetes (GDM, n=21) or normal glucose tolerance (NGT, n=27) was studied. Maternal weight, hip circumference and skinfold thicknesses were obtained at 32 weeks of gestation. Offspring length and weight, as well as cranial and thoracic perimeters were obtained at birth. Reported maternal pregravid BMI correlated with offspring thoracic perimeter (ρ=0.52, P<0.05) and tended to correlate with birth weight (ρ=0.41, P=0.07). There were significant correlations between hip circumference and pregravid BMI, and with biceps, triceps, subscapular, thigh and total sum of skinfold thicknesses (ρ=0.53-0.75, all P<0.01). Hip circumference also correlated with offspring length (ρ=0.61), weight (ρ=0.75) and thoracic perimeter (ρ=0.60, all P<0.05). Maternal hip circumference was an independent and significant predictor of offspring weight, explaining 14.1% of the observed variance (P<0.05). In a sample of women with and without GDM, maternal hip circumference was strongly related to other body composition estimates and was also predictive of offspring size measurements at birth.

Angiographically-assessed coronary artery disease associates with HDL particle size in women

It has been suggested that a reduced HDL particle size could be another feature of the atherogenic dyslipidemia found among viscerally obese subjects. ObjectiveTo investigate, in women, the relationship between HDL particle size and coronary artery disease (CAD). MethodsAverage HDL particle size was measured in a sample of 239 women on whom CAD was assessed by angiography. ResultsOverall, women who had CAD were characterized by a deteriorated fasting metabolic risk profile, which was accompanied by smaller HDL particles compared to women without CAD (80.4 ± 2.2 Å vs. 81.5 ± 2.7 Å, p < 0.01). In addition, a reduced HDL particle size was a significant correlate of several features of the atherogenic metabolic profile of abdominal obesity such as increased triglyceride and apolipoprotein B concentrations, decreased HDL cholesterol levels, an elevated cholesterol/HDL cholesterol ratio and hyperinsulinemia and was also associated with an increased waist circumference (0.13≤|r|≤0.21, p < 0.05). Odds ratio of being affected by CAD was increased by 2.5-fold (95% CI: 1.4–4.5; p < 0.01) among women with smaller HDL particles compared to women with larger HDL particles. Finally, women characterized by the presence of the NCEP-ATP III clinical criteria or by hypertriglyceridemic waist were characterized by smaller HDL particles compared to women without these clinical phenotypes (p < 0.05). ConclusionHDL particle size appears to be another relevant feature of a dysmetabolic state which is related to CAD risk in women.

Isolated in A Technologically Connected World?: Changes in the Core Professional Ties of Female Researchers in Ghana, Kenya, and Kerala, India

Using panel data gathered across two waves (2001 and 2005) from researchers in Ghana, Kenya, and Kerala, India, we examine three questions: (1) To what extent do gender differences exist in the core professional networks of scientists in low-income areas? (2) How do gender differences shift over time? (3) Does use of information and communication technologies (ICTs) mediate the relationship between gender and core network composition? Our results indicate that over a period marked by dramatic increases in access to and use of various ICTs, the composition and size of female researchers core professional ties have either not changed significantly or have changed in an unexpected direction. Indeed, the size of women's ties are retracting over time rather than expanding.

Heterogeneity of high‐grade cervical intraepithelial neoplasia related to HPV16: Implications for natural history and management

Factors associated with progression from cervical intraepithelial neoplasia (CIN) grades 2 and 3 to invasive cancer are not well understood; most CIN2 and CIN3 do not progress to cancer. Among carcinogenic human papillomavirus (HPV) types, infections with HPV16 have the highest risk of progressing to cancer. We evaluated the heterogeneity of risk factors, lesion size, colposcopic impression and colposcopic biopsy results in relation to HPV16 status among 627 women with CIN2 or CIN3 in women referred to colposcopy at the University of Oklahoma. Loop excision specimens were evaluated in 12 radial segments to estimate lesion size. The mean age at CIN3 was 27.7 years for HPV16-positive women (n = 225) and 33.6 years for HPV16-negative women (n = 104). The average lesion size did not differ by HPV16 status (p = 0.83). Among HPV16-positive women with CIN3, lesions were significantly larger in women 30 years and older (p = 0.03). Colposcopic impression was worse in women with HPV16 infections (p = 0.009), but the detection of CIN3 at the preceding biopsy was not improved in HPV16-positive women. CIN3 is detected at the same lesion size, but at much younger age in women with HPV16 infections, suggesting faster growth. CIN2 lesion size in women without HPV16 peaks below 30 years and then decreases, suggesting frequent regression, whereas HPV16-related CIN2 is more likely to persist. Lesion size seems to be an important determinant of colposcopy and biopsy performance. Genotyping for HPV16 in cervical cancer screening can improve risk stratification but may pose challenges to finding small lesions in colposcopy.

Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus

Women with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have fewer children on average than other women. We sought to determine the roles of infertility, pregnancy loss, and personal choice on family size in women with these diseases. A reproductive history questionnaire was completed by women with RA and SLE participating in a longitudinal observational study. Within each disease cohort, participants were divided into 3 groups: those interested in having children at symptom onset who had either fewer children than planned (group A) or the same number as planned (group B), and those no longer interested in having children at diagnosis (group C). Of the 578 RA and 114 SLE women surveyed, >60% were in group C. Of those interested in having children, 55% with RA and 64% with SLE had fewer children than originally planned. Among women with RA, group A had 1 less pregnancy, 1 less live birth, and an infertility rate 1.5 times higher than group B; the miscarriage rate was similar in both groups. Compared to SLE group B, SLE group A had a similar number of pregnancies, but a 3-fold higher rate of miscarriage and 1 less live birth. Concerns about child health and personal welfare were associated with a lower pregnancy rate. In this population, more than one-half of young women with RA or SLE had fewer biologic children than desired. While patient choice plays a role, infertility in RA patients and miscarriage in SLE patients are also important.

The evolved psychology of voice: evaluating interrelationships in listeners' assessments of the size, masculinity, and attractiveness of unseen speakers

A growing body of research has examined how voice characteristics advertise personal dimensions relevant in mate competition and mate choice. This work has centered on two key voice features, namely, fundamental frequency (F0) and formants (Fn), and has consistently found that speakers with low F0, low Fn, or both are rated as being larger, more masculine, and more attractive if men but less attractive if women. However, this consistency in listeners' perceptions is not matched by an equivalent consensus in how these mate-relevant dimensions are causally related or signaled by voice characteristics. Consequently, it is critical to test whether the strong correlations in listeners' perceptions reflect reliable causal relationships between these dimensions or, alternatively, whether they reflect some perceptual or cognitive nonindependence, for example, “what is large is masculine” and “what is small is feminine.” To test this latter possibility, we report detailed analyses of interdependence in listeners' ratings of perceived size, masculinity or femininity, and attractiveness of natural and manipulated voices of the opposite sex. We found strong correlations in listeners' ratings of all three dimensions, confirming past research. Principal component analysis corroborated these interrelationships but also revealed some independence in women's ratings of men's attractiveness and additional (but weaker) independence in men's ratings of women's size. We discuss possible implications for future research on the evolved psychology of voice and whether and how it reflects adaptive functional heuristics for discriminating mates.

식물추출물 팩의 여성가슴 탄력증진과 크기증대에 관한 연구

In this study, we purified the extracts from the seeds and the roots of various plant species, including Q. acutissima, C. lanceolata, P. mirifica, P. bambusoides, and S. repens, and then investigated the effects of these extracts on cell growth and fat accumulation in adipocytes. We found that the extracts purified from Q. acutissima, C. lanceolata, P. mirifica, P. bambusoides, and S. repens more effectively increased the cell growth, as well as promoting the fat accumulation in adipocytes to a greater extent, than other extracts in vitro. Therefore, we made breast packs containing these effective extracts, and then investigated whether they were effective in enhancing the elasticity and volume of women’s breasts. The measurements of breast elasticity and size revealed that the breast packs efficiently increased the elasticity and size of women’s breasts. Furthermore, evaluation of the questionnaires related to usage of the breast packs indicated great satisfaction in terms of the lift, firmness, and elasticity of breasts. In conclusion, extracts purified from Q. acutissima, C. lanceolata, P. mirifica, P. bambusoides, and S. repens leading to cell growth and fat accumulation in adipocytes can effectively contribute to improving the elasticity and size of women’s breasts.

Abstract 17605: Gender Differences in Predictors of Risk of Retroperitoneal Bleeding

Background: Retroperitoneal bleeding (RPB) can be a serious complication related to cardiac catheterization via femoral approach. Despite improvement in procedural safety, women undergoing cardiac catheterization remain at a two-fold higher risk of access site bleeding including RPB compared to men. We sought to compare clinical and angiographic predictors of RPB among men and women undergoing cardiac catheterization. METHODS: Case-control study design was used to identify cases with documented RPB and matched using age, procedure and gender to define controls. Detailed clinical and femoral angiographic data was collected and analyzed. Safe zone arteriotomy (SZA) was defined as access below inferior epigastric artery and above femoral artery (CFA) bifurcation. Univariate comparisons were made between cases and controls in both genders. Multivariate analysis was performed to identify independent predictors of RPB after adjusting for baseline differences. RESULTS: There were significant differences in clinical variables such as BMI and femoral artery anatomy among women with and without RPB (Table). On the other hand among men, BMI or size of CFA was not relevant but non-SZA (high stick) was more likely in men with RPB. On multivariate analysis, BMI trended to be only independent predictor of RPB among women (OR 0.83, 95% CI 0.68-1.0, p=0.05) whereas in men, SZA strongly predicted RPB (OR 0.30, 95 % CI 0.1- 0.3, P&lt; 0.01). Conclusion: There are significant gender differences in mediators of RPB risk. The presence of non-modifiable risk factors such as smaller BMI and CFA vessel size in women may explain the persistent increased risk of RPB and access site complications seen in women.

Body fat mass is a predictor of risk of osteoporotic fractures in women but not in men: a prospective population study

Obesity has generally been associated with higher bone density and lower fracture risk. However, weight-related indices of obesity may be related differently to health end-points, compared with fat-related indices (such as body fat distribution and fat mass), as they may capture different dimensions of obesity and the associated biological effects. The aim of this study was to examine the association between percentage body fat (%BF) and prospective risk of fracture. The European Prospective Investigation into Cancer (EPIC) in Norfolk was a population-based prospective study. A total of 14 789 participants (6470 men, aged 42-82 years at baseline) were included. The main outcome measures were quantitative ultrasound of the heel and incident hip and any osteoporotic fractures. A total of 556 participants suffered a fracture (184 hip fractures) during 8.7 ± 0.8 years of follow-up. Risk of hip fracture decreased linearly with increasing %BF amongst women but not men. After adjustment for age, history of fracture, height, smoking, alcohol intake and heel broadband ultrasound attenuation (BUA), the hazard ratio (95% CI) for a 10% higher %BF on risk of hip fracture was 0.56 (0.39-0.79) in women and 0.92 (0.39-2.21) in men. The effect size in women was approximately equivalent to a difference of 5 years in age or 1 standard deviation (17 dB MHz(-1) ) increased BUA. A nonlinear negative association was also observed between %BF and risk of 'any type of fracture' amongst women but not men. The %BF appears to predict hip fracture risk in women with an effect size comparable to that of bone density as measured by heel ultrasound. This effect was not observed in men. Understanding the differences in relationships between different indices of obesity as well as sex differences may help to elucidate the metabolic and other underlying mechanisms involved in bone health and fracture risk.

Measuring hand size in patients with breast cancer related lymphoedema (BCRL)

Breast cancer related lymphoedema (BCRL) affects 24–42% of patients after treatment for breast cancer. The gold standard method to measure the hand swelling associated with BCRL is to submerge the...