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[Who needs more psychosocial oriented rehabilitation -- women after breast cancer or women after genital cancer? -- A sociopsychological study of 308 women (author's transl)].

A standardised questionnaire and personality test were used to study whether women after breast cancer treatment, or women treated for genital cancer need psychosocial counselling more frequently. The interview was given to 308 women during the author's tumor after-care consultations. 1. Repercussion on their marital lives were reported three times more often by women treated for genital cancer than by women after mastectomy (p less than 0.01). There was not significant difference with regard to their family status. 2. As epidemiologically expected -- mastectomy patients had born less children than women treated for genital cancer (p less than 0.05). 3. A reduced self-confidence was reported more often by patients treated for breast cancer than by the other patient group (p less than 0.01). 4. No decrease in working performance was observed by 50% of the women treated for genital cancers as against one third of the masectomy patients. 5. Work resumption was reported more often to be strenuous for masectomy patients than for women treated for genital cancer (p less than 0.05). 6. Woman after mastectomy experiences 50% less sexual repercussions than genital cancer patients (p less than 0.05).

Breast Neoplasms↗

Cardiovascular risk factors in middle-aged women and the association with use of hormone therapy: results from a population-based study of Swedish women. The Women's Health in the Lund Area (WHILA) Study.

OBJECTIVE: Cardiovascular diseases in women are multifactorial. Women carry different risk factors compared to men and these specific risk factors need to be delineated, particularly in relation to the hormonal situation, and effects of diet and lifestyle. METHODS: Out of the total cohort of 10,766 women born 1935-1945 living in the Lund area of southern Sweden, 6917 women completed a generic questionnaire and underwent a physical and laboratory assessment. According to hormonal status, 492 women were premenopausal (PM), 3600 were postmenopausal without hormone therapy (HT) (PM0) and 2816 were postmenopausal with ever-use of HT (PMT). Major cardiovascular risk factors as well as level of education, diet, and degree of physical activity were assessed in relation to hormonal status. RESULTS: Compared to the PM0 group, the women in the PMT group had a higher level of education, more often worked full time, more often had sedentary work and lived a more regular life. They also had a lower rate of cigarette consumption, lower waist-to-hip ratio and lower body mass index than women in the PM0 group. The PMT group had lower levels of serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglycerides than the PM0 group and also had lower systolic and diastolic blood pressures, a lower prevalence of type II diabetes mellitus, of deep venous thrombosis and of coronary artery disease. Low-risk factors for cardiovascular disease and high level of education were still associated with HT, after adjustment by multiple logistic regression. Major risk factors for coronary heart disease were similar between the PM and the PMT groups. CONCLUSION: Use of HT is accompanied by a lower risk profile for cardiovascular disease and also by several factors indicating a healthier lifestyle.

Aged↗

Status of climacteric symptoms among middle-aged to elderly Japanese women: comparison of general healthy women with women presenting at a menopausal clinic.

AIM: To examine the status and characteristics of climacteric symptoms reported by generally healthy middle-aged to elderly women in Japan, those living in Saitama Prefecture were surveyed . METHODS: The subjects comprised 398 women ranging in age from 40 to <60 years (mean age, 50.5 years). Climacteric symptoms were objectively assessed using the Keio questionnaire. The total scores obtained for the 40 symptoms were used to calculate symptom prevalence and severity. RESULTS: (i) The most frequent symptom was poor memory, reported by 88.7% of the women. (ii) Lumbar-sacral back pain was rated as a severe symptom by the highest percentage of women (15.3%). (iii) The prevalence and severity of poor memory and lumbar-sacral back pain did not differ with menopausal status. (iv) Hot flashes and sweats were slightly higher in peri- and early postmenopausal women than in premenopausal women. CONCLUSIONS: The present study showed that healthy women who do not consult physicians because of climacteric symptoms are primarily concerned with age-related symptoms, such as poor memory, loss of hair, and forgetfulness.

Adult↗

[Access to Danish health care by immigrant women. Access to hospital care among immigrant women with breast cancer compared with Danish women].

The study aim is to measure possible differences in access to health care among immigrant women with breast cancer compared with Danish women. We used tumour size at diagnosis as a proxy measure of access. The Danish Central Personal Register provided information from 1977-1996 on women between 20-75 years born in countries in which Islam is the dominating faith. These data were linked to the Danish Breast Cancer Cooperative Group, which registers data concerning tumour size. Sixty-five immigrant women with breast cancer were identified and matched with a control population of Danish women. The study showed larger tumours at diagnosis among women from ethnic minority groups compared to Danes. However, this tendency was not significant. Furthermore, mammographic screening had a significant effect on the tumour sizes of Danish women, but not on those of immigrants. The study indicates ethnic inequalities related to access to health services as measured by tumour size.

Adult↗

[Pregnant women's sick leave is behind the increased sick leave among women of fertile age. A study of pregnant women's sick leave 1978-1997].

Sick leave rates among pregnant women have been found to vary substantially over time. 8,884 woman delivered at Linköping and Värnamo Women's Clinics in 1978, 1986, 1988, 1992, 1995 and 1997 were studied. Sick leave nearly doubled between 1978 and 1986, and dropped back to the 1978 level in 1997. The somewhat paradoxical findings in our surveys indicate that attitudes, especially as observed in the youngest age groups, together with a sensible adaptation to the prevailing terms of the social security system, may well be the most plausible explanation. Studies on sick leave among women of fertile age should preferably also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a profound impact on sick leave statistics among all insured women of fertile age.

Adolescent↗

An estrogen receptor genetic polymorphism and a history of spontaneous abortion--correlation in women with estrogen receptor positive breast cancer but not in women with estrogen receptor negative breast cancer or in women without cancer.

We previously identified a polymorphism in the human estrogen receptor gene. In a preliminary study on women with estrogen receptor positive (ER+) breast tumors, we found that the presence of the rarer of the two alleles, the B' allele, is correlated with a history of spontaneous abortion. Because that study evaluated only women with estrogen receptor positive (ER+) breast cancer, it was unknown whether the observed correlation was restricted to the cancer group or was independent of breast cancer. We have now extended our analysis to include not only additional women with ER+ breast cancer, but also those with estrogen receptor negative (ER-) breast cancer and women without cancer. Results of the current study continue to show an association between the B' allele and a history of spontaneous abortion in the ER+ breast cancer group. There was no such correlation either in the ER- breast cancer group or in the group without cancer. Also, we continue to observe, in the ER+ breast cancer group, a significantly higher concentration of ER protein in tumors from homozygous wild type women (genotype BB), than in the tumors from women who are heterozygous for the rarer allele (genotype BB'). We conclude that the combination of spontaneous abortion and the BB' ER genotype may be a marker for breast cancer susceptibility.

Abortion, Spontaneous↗

Vitamin C status in elderly women: a comparison between women living in a nursing home and women living independently.

The vitamin C status in blood fractions in 135 elderly women aged 65 years and older was studied within the framework of the Dutch Nutrition Surveillance System. Mean (+/- standard deviation) vitamin C intake (mg/day) was lower among women living in a nursing home (54 +/- 27 mg/day) than among women living in service flats (97 +/- 55 mg/day) and women living independently (132 +/- 44 mg/day). (Service flats are apartments in which the rent includes housekeeping and, when ordered, meal service.) Marginal vitamin C values (< 23 mumol/L) in blood fractions and even levels as low as those found in clinical scurvy (< 11 mumol/L) were frequently observed. In the nursing home, 35% of the women had plasma vitamin C values below 11 mumol/L, and 23% had values between 11 and 23 mumol/L. Blood levels were not significantly affected by age, smoking status, or use of particular drugs but were strongly (r = .47 or, after logarithmic transformation, r = .64) associated with daily intake of vitamin C. Low intake of vitamin C resulted from an overall low food consumption and selective restriction of food products rich in vitamin C. Vitamin C losses caused by food preparation practices and distribution in the nursing home's catering system reduced actual vitamin C intake levels but these losses were not substantially greater than those that are assumed to occur as a result of preparation practices by women living independently.

Activities of Daily Living↗

Serum iron and transferrin saturation in women with special reference to women with low transferrin saturation. The population study of women in Göteborg 1968-1969.

Serum iron and total iron binding capacity (TIBC) were determined in a population sample of 1462 women in age strata between 38 and 60. Serum iron and TIBC values were similar in the various ages studied but with a slight trend towards higher serum iron and lower TIBC values in the upper ages. Transferrin saturation was used to divide the material arbitarily into women with and without iron deficiency. The dividing point chosen was 16%. The women thus defined as iron deficient had lower mean haemoglobin values than women in the total population sample and were more often anaemic. They had also lower MCV, MCH and MCHC indices than women in the total population sample. Of these indices, MCH seemed to discriminate the state of iron deficiency better than MCV and MCHC. Except for an increased mean menstrual blood loss no obvious cause of iron deficiency could be found in these women with low transferrin saturation.

Adult↗

[Induced abortion: women's free choice or impossibility of choice? Higher frequency of induced abortions among immigrant women in Sweden compared to native Swedish women].

During one year all women attending one of Sweden's largest clinics for induced abortion were interviewed. Out of 1,289 interviewed women 36 % (468) were born abroad, compared to 29% of women in corresponding ages in the local communities. The immigrant women had less experience of contraceptive methods, more born children and reported the partner relationship to be the reason for abortion more frequently than native Swedish women. Immigrant status was seen as independent risk factor for repeated induced abortion. In order to reduce the number of induced abortions it is necessary to increase family planning resources to immigrant women.

Abortion Applicants↗

Women are silver, women are diamonds: conflicting images of women in the Cambodian print media.

This paper examines 116 articles related to sexual and reproductive health translated into English from the Khmer press from April 1997 to February 2004. These excerpts were found in The Mirror, a publication of the non-governmental organisation Open Forum of Cambodia, which collates and reviews all issues of the Khmer press on a weekly basis. Five major themes were identified: the politics of women's health, government regulation and control, the sex industry in Cambodia, rape, and the HIV epidemic. Discourse analysis of these articles in the context of other sources and experience allows a gendered exploration of the reporting of sexual and reproductive health and rights issues in Cambodia by the Khmer print media. The reports explore the contested political empowerment of women in this strongly hierarchical society, and the mechanisms used to regulate and control sexual activity The expanding sex industry and associated sexual trafficking are reported, together with the corruption of legal structures designed to regulate health systems and protect women and children from sexual exploitation and rape. The growing problem of AIDS and successes in reducing HIV transmission through the collaboration of sex workers in the 100% condom use policy is documented, and the tensions implicit in a cultural representation of women that both protects and constrains women are explored.

Cambodia↗

Women clients in special women's demonstration drug abuse treatment programs compared with women entering selected co-sex programs.

A study comparing characteristics of women in special women's demonstration drug abuse treatment programs with those in selected co-sex programs. Black and White women in women's programs differ from those entering more traditional programs in their referral sources, types and degree of social and financial support, use of community resources, living arrangements, and patterns of criminal involvement and drug use. The need for women's programs, and treatment, policy, and research implications are discussed.

Adolescent↗

The prevalence of antiphospholipid antibodies in women with recurrent spontaneous abortion, women with successful pregnancies, and women who have never been pregnant.

Antibodies to negatively charged phospholipids are associated with a predisposition to both arterial and venous thrombosis, recurrent fetal wastage, and thrombocytopenia. These associations have been reported in patients who do not fulfill criteria for connective tissue diseases. In this study, we determined the prevalence of antiphospholipid antibodies in 81 women who had had recurrent spontaneous abortion (3 or more fetal losses), in 88 women whose pregnancies were successful, and in 64 women who had never been pregnant. Antiphospholipid antibodies were found in 16% of women with recurrent spontaneous abortion, and at a statistically greater prevalence than in women who had successful pregnancies (7%) as well as those who had never been pregnant (3%). A false-positive VDRL and IgG anticardiolipin antibodies were more specific for fetal wastage than was either the lupus anticoagulant or IgM anticardiolipin antibodies.

Abortion, Habitual↗

Are endometrial polyps from pre-menopausal women similar to post-menopausal women? An immunohistochemical comparison of endometrial polyps from pre- and post-menopausal women.

OBJECTIVE: Do endometrial polyps from pre- and post-menopausal women have similar immunohistochemical expression of oestrogen and progesterone receptors (ER, PR) and markers of cellular proliferation/apoptosis (Ki67 and Bcl-2). DESIGN: Prospective cohort study. Non-parametric statistical analysis was used. SETTING: Polyps recruited from women attending an out-patient hysteroscopy clinic in a UK district general hospital. PATIENTS: Fourteen pre-menopausal and 16 post-menopausal women who presented with abnormal bleeding with endometrial polyps. INTERVENTIONS: Immunohistochemical staining was performed on endometrial polyps. MAIN OUTCOME MEASURES: Significant differences or correlations between hormone receptor expression (oestrogen and progesterone) and cell growth indices (Ki67 and Bcl-2). RESULTS: Endometrial polyps from pre- and post-menopausal women had significant differences in their expression of hormone receptors and Ki67. However, polyps from both groups of women had similarly increased levels of Bcl-2, an inhibitor of apoptosis. CONCLUSIONS: Pre- and post-menopausal polyps exhibit differing hormone receptor and proliferation markers, presumably a result of their hormonal milieu. However, both groups appear to have lost the usual control mechanisms for apoptotic regulation, this appears to be responsible for their growth.

Adult↗

The childhood and family background of women with clinical eating disorders: a comparison with women with major depression and women without psychiatric disorder.

BACKGROUND: Childhood antecedents are often put forward as being of possible aetiological significance for both anorexia nervosa and bulimia nervosa. METHOD: Comparisons were made of groups of women with eating disorders with groups of women with major depression or without current psychiatric disorder, using the Childhood Experience of Care and Abuse interview (CECA). RESULTS: Women with bulimia nervosa (or mixed bulimia and anorexia nervosa) tended to report more troubled childhood experiences than did women from the non-morbid comparison group. In this respect, they resembled those with major depression. In contrast, those with anorexia nervosa resembled the non-morbid women rather than the other psychiatric groups. CONCLUSIONS: Adversity in childhood as measured by the CECA may play a part in the causation of bulimia nervosa but not of anorexia nervosa. It remains possible that more specific or subtle family influences may be relevant.

Adult↗

Subjective well-being of elderly women: conceptual differences between cancer patients, women suffering from chronic ailments and healthy women.

Studies have shown that the mean scores on global subjective well-being measures of cancer patients do not differ from the mean scores of other patient samples or samples of healthy individuals. These results give rise to speculations about the nature of the concept subjective well-being. Therefore, we compared the structure of the concept subjective well-being between three groups of elderly women (cancer patients, women suffering from chronic ailments and healthy women). This was done by examining the relationships between five dimensions of subjective well-being (perceived physical health, self-esteem, negative affect, optimism and loneliness) and two measures of global subjective well-being (affective well-being and life satisfaction) in each group of women. The results clearly demonstrate the differences in the relative importance of the five dimensions for the global evaluation of well-being between the three groups. The most notable finding was that perceived physical health appears to be more strongly related to global subjective well-being, when the objective health status is worse. The unequal relative importance of dimensions of subjective well-being should be taken into account when comparing the mean scores on subjective well-being measures between populations with different states of health.

Aged↗

Does the hormonal situation modify lipid effects by lifestyle factors in middle-aged women? Results from a population-based study of Swedish women: the women's health in the Lund area study.

The aim of the study was to outline whether the influence by lifestyle factors on serum lipids was modified by the hormonal situation in middle-aged women. Six thousand nine hundred eight women, aged 50 to 59 years, participated in a health assessment program, including a serum lipid profile evaluation. The women were grouped according to their hormonal status into premenopausal (PM) (n = 492), postmenopausal without hormone therapy (HT) (PM0) (n = 3600), and postmenopausal with HT (PMT) (n = 2816). From the PMT group, we analyzed oral (n = 901) and transdermal HT (n = 351) regimens, containing norethisterone acetate and 17beta-estradiol. Serum lipids and lipoproteins were determined by conventional methods. Lifestyle factors included smoking and physical activity at leisure time and at work. Multivariate linear regression analysis controlling for age, education, and dietary habits showed that current smoking was positively associated with triglycerides in the PM, PM0, PMT, and oral HT groups. In the PM0, PMT, and oral HT groups, current smoking was positively associated with total cholesterol and low-density lipoprotein and negatively associated with high-density lipoprotein (HDL). Low physical activity at leisure time was positively associated with triglycerides in the PM and PMT groups and negatively associated with HDL in the PM0 and PMT groups. High physical activity at work was positively associated with triglycerides in the PMT group and with total cholesterol in the PM0 group, but negatively associated with HDL in the PMT and transdermal groups. Body mass index was positively associated with triglycerides and negatively with HDL in all the groups regardless of the hormonal situation. The serum lipid profile as influenced by lifestyle factors was modified by the hormonal situation. Compared with the postmenopausal women without HT use, the use of HT contributes to fewer "negative" effects by lifestyle factors on serum lipids.

Aged↗