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PubMedDate not supplied

Complementary and alternative medicine in women's health. Developing a research agenda.

Complementary and alternative medicine is becoming an established intervention modality within the contemporary health care system. Various forms of complementary and alternative medicine are used by patients and practitioners alike, including chiropractic, massage, botanical medicine, homeopathy, and energy therapies. The National Center for Complementary and Alternative Medicine was established within the National Institutes of Health to facilitate evaluation of these alternative therapies, establish an information clearinghouse, and promote research in the field. This article discusses several aspects of complementary and alternative medicine, relates them to women's health, and describes the need for a research agenda to evaluate the impact of the complementary and alternative medicine modalities used for important conditions affecting women.

Complementary Therapies↗
PubMed1987

The role of childhood sexual abuse in the development of alcoholism in women.

The effects of childhood sexual abuse on the development of alcoholism in women were examined by comparing a sample of 45 alcoholic women selected from local treatment agencies and Alcoholics Anonymous groups with a group of 40 nonalcoholic women selected randomly from a household population. Face-to-face interview schedules were administered to both samples. Sexual abuse was defined as any unwanted sexual contact with a person at least five years older than the respondent, or with any family relative, regardless of age difference. Types of sexual contact included both nonphysical contact (e.g., invitations, exposure) and physical contact (e.g., fondling, intercourse). Results showed that alcoholic women were more likely to have experienced sexual abuse, had a greater number of different types of sexual abuse experiences, and endured sexual abuse over a longer period than the comparison group. The presence of any childhood sexual abuse experience was sufficient to discriminate between the alcoholic women and the comparison group, even controlling for demographic variables and the presence of a parent with alcohol-related problems. Although alcoholic women were more likely to report that a parent had alcohol-related problems, relatively few of the sexual abuse incidents were perpetrated by a parent. The data suggest that vulnerabilities to sexual abuse were attributable to environmental or psychological factors in homes in which a parent was reported as having alcohol-related problems.

Adolescent↗
PubMed1994

Women and the development of drugs: why can't a woman be more like a man?

Most health providers and researchers would agree that the FDA provides the finest and safest methods to ensure safety and efficacy for the consumer. All proposed regulations or changes are published in the Federal Register (Title 21 Code of Federal Regulations). The 70 kg white male is no longer considered the norm. Any differences in race, gender, and ethnic composition need to be identified. Accessibility of clinical trial subjects has been a key factor in the inclusion of patients in studies as exemplified by the use of male medical students, male prison subjects, and male Veterans' Administration patients. This is no longer satisfactory; efforts now must be made to encourage and include representative women in each study. Woman scientists must now accept this challenge in education and leadership roles to ensure the proper representation of women in clinical studies.

Clinical Trials as Topic↗
PubMed2003

Improving access to and consumption of animal source foods in rural households: the experiences of a women-focused goat development program in the highlands of Ethiopia.

Ethiopia is one of the poorest countries in Africa and its population experiences low and falling life expectancy rates, high infant, child and maternal mortality and high rates of child malnutrition. This is exacerbated by the fact that Ethiopia is not self-sufficient in animal products and is a net importer of food. For the majority of the population, most food energy (93%) is derived from vegetable products with 7% coming from animal source foods (ASF). FARM-Africa hypothesizes that the inadequate nutritional status of the population, which contributes to the high mortality rates in the country, is related to the population's low consumption of ASF, such as milk and meat. This article presents the findings of the Dairy Goat Project, the objectives of which included the improvement of family welfare through the generation of increased income and milk consumption. The project adopted an integrated approach and increased the productivity of local goats managed by women through a combination of better management techniques, genetic improvements and information exchange. Through pre- and post-intervention analysis of data of those households within the project area, FARM-Africa demonstrated a considerable improvement in the nutritional status and family welfare of project participants. There was increased appearance of milk and meat products in local diets, and the addition of other foods, such as eggs and fresh vegetables, as a result of complementary activities established with funds generated through the principal activities of the Dairy Goat Project.

Animals↗
PubMed1990

[Echographic dynamic control of the urinary system and fetal development in pregnant women with acute pyelonephritis].

Ultrasonography in 52 pregnant women with acute pyelonephritis has been found to be a useful marker of efficacy of aggressive care. Reversal of inflammation in acute pyelonephritis without an associated disease reduced the kidney size and restored urine flow by the end of the 7-9th day of therapy. In pyelonephritis coexisting with nephrolithiasis, reversal of inflammation did not completely restore urine flow until a stone in the urinary tract was passed or surgically removed. The clinical patterns of pyelonephritis were elucidated in congenital renal malformations. The urine flow was completely restored and kidney sizes were maximally contracted postpartum. With an early therapy, the fetal development was appropriate for gestational age. Frequently relapsing pyelonephritis concomitant with toxemia or severe congenital renal disease led to intrauterine growth retardation.

Acute Disease↗
PubMed1984

[Pregnancy and fetal development in epileptic women].

Epilepsy affects almost 1% of all pregnant women. Epileptic women marry more often than epileptic men. Married epileptic women have a lower socio-economic status and are more severely ill than married male epileptics.--Several reasons are discussed--poor compliance being probably the most essential one--for an explanation of an occasional increase in the rate of attacks and a frequently observed tendency to a drop in plasma concentrations of anti-epileptics during pregnancy. Pregnancy and parturition are not more complicated in epileptic women than in non-epileptics women. Nevertheless, abortions are performed, and delivery by surgery is initiated, more often with epileptics, although there are no convincing arguments in favour of such procedures. For unknown reasons, perinatal lethality is up to twice as high than with controls.--Children of mothers treated with anti-epileptics have a tendency to intrauterine dystrophia, which is manifested mainly by a reduced size of the head which is not made up completely during the first few years of life, contrary to other body dimensions. We do not know as yet whether there are any links between dystrophia of the body, malformations and inhibited psychomotoric development.--Depending on the type of anti-epileptics given to the mothers who are breast-feeding their children, and on the concentration of these drugs in the plasma or in the mother's milk, breast-fed children may display signs of withdrawal or sedation. This must not be overlooked when considering the problem of breast-feeding.--The slightly enhanced risk of malformations appears to be less intimately connected, with intrauterine exposition of anti-epileptics than with the underlying disease itself.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Drug-Induced↗
PubMed2001

Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence.

BACKGROUND: Recent research suggests that a proportion of women may develop posttraumatic stress disorder after birth. Research has not yet addressed the possibility that postpartum symptoms could be a continuation of the disorder in pregnancy. This study aimed to test the idea that some women develop posttraumatic stress disorder as a result of childbirth, and to provide an estimate of the incidence using a prospective design, which controls for the disorder in pregnancy. METHOD: This prospective study assessed 289 women at three time points: 36 weeks gestation and 6 weeks and 6 months postpartum. The prevalence of posttraumatic stress disorder was assessed by questionnaire at each time point, and the incidence was examined after removing women who had severe symptoms of posttraumatic stress disorder or clinical depression in pregnancy. RESULTS: After removing women at the first time point, 2.8 percent of women fulfilled criteria for the disorder at 6 weeks postpartum and this decreased to 1.5 percent at 6 months postpartum. CONCLUSIONS: The results suggest that at least 1.5 percent of women may develop chronic posttraumatic stress disorder as a result of childbirth. It is important to increase awareness about the disorder and to give health professionals access to simple screening tools. Intervention is possible at several levels, but further research is needed to guide this intervention.

Adolescent↗
PubMedDate not supplied

Development of new-onset seizures in the peripartum period. Should human immunodeficiency virus infection be considered a cause?

The case histories of two women who developed new-onset seizures in the peripartum period of their pregnancies are presented. These two women had divergent medical histories and prenatal courses. Both women developed grand mal seizures that could be attributed to several established etiologies, yet no specific diagnoses were made. Although their risk factors for developing human immunodeficiency virus (HIV) infection were quite different, both women subsequently were confirmed as HIV positive. Since new-onset seizures have been described as a presenting symptom of HIV infection in other studies, the seizures experienced by these two women could be the presenting symptom of their HIV infection. The authors suggest that HIV testing should be considered for any pregnant woman who develops new-onset seizures during the course of her pregnancy, regardless of her risk factor assessment for HIV infection.

Adult↗
PubMed1999

[Maternal nutrition effect on fetus development and pregnant women's health].

A review is made of the main prenatal growth stages and the way they are influenced by social and biological factors pointing out the role of maternal nutrition before and during pregnancy. It is discussed the available evidence on the relation of maternal nutrition and fetal growth through clinical and epidemiological studies performed in animal and humans, analyzing the causal mechanisms of this association, including the role of placenta. Some clinical useful indicators that allow to evaluate maternal nutrition throughout gestation are presented. Emphasis is made on the impact of protein-energy malnutrition as well as on some specific deficiencies, particularly iron and folic acid. At last, the synergic effect of infection and malnutrition on low birth weight and prematurity is analyzed.

Anemia↗
PubMedDate not supplied

Candida sepsis in pregnancy and the postpartum period.

Colonization of the vagina by Candida is common during pregnancy, while candida sepsis in pregnancy is rare. A case of candida sepsis complicating an abortion prompted us to review seven additional cases that occurred during pregnancy or the postpartum period. In four women candidemia developed during pregnancy or following abortion, while in the other four it developed postpartum. Seven women had an apparent predisposing factor, such as antibiotic treatment or an intrauterine device. The clinical course was difficult in four patients and ended in death in three instances. Both amphotericin B and 5-fluorocytosine proved effective for treatment.

Abortion, Septic↗
PubMed2006

Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD.

UNLABELLED: The potential for brief periods of low-magnitude, high-frequency mechanical signals to enhance the musculoskeletal system was evaluated in young women with low BMD. Twelve months of this noninvasive signal, induced as whole body vibration for at least 2 minutes each day, increased bone and muscle mass in the axial skeleton and lower extremities compared with controls. INTRODUCTION: The incidence of osteoporosis, a disease that manifests in the elderly, may be reduced by increasing peak bone mass in the young. Preliminary data indicate that extremely low-level mechanical signals are anabolic to bone tissue, and their ability to enhance bone and muscle mass in young women was investigated in this study. MATERIALS AND METHODS: A 12-month trial was conducted in 48 young women (15-20 years) with low BMD and a history of at least one skeletal fracture. One half of the subjects underwent brief (10 minutes requested), daily, low-level whole body vibration (30 Hz, 0.3g); the remaining women served as controls. Quantitative CT performed at baseline and at the end of study was used to establish changes in muscle and bone mass in the weight-bearing skeleton. RESULTS: Using an intention-to-treat (ITT) analysis, cancellous bone in the lumbar vertebrae and cortical bone in the femoral midshaft of the experimental group increased by 2.1% (p = 0.025) and 3.4% (p < 0.001), respectively, compared with 0.1% (p = 0.74) and 1.1% (p = 0.14), in controls. Increases in cancellous and cortical bone were 2.0% (p = 0.06) and 2.3% (p = 0.04) greater, respectively, in the experimental group compared with controls. Cross-sectional area of paraspinous musculature was 4.9% greater (p = 0.002) in the experimental group versus controls. When a per protocol analysis was considered, gains in both muscle and bone were strongly correlated to a threshold in compliance, where the benefit of the mechanical intervention compared with controls was realized once subjects used the device for at least 2 minute/day (n = 18), as reflected by a 3.9% increase in cancellous bone of the spine (p = 0.007), 2.9% increase in cortical bone of the femur (p = 0.009), and 7.2% increase in musculature of the spine (p = 0.001) compared with controls and low compliers (n = 30). CONCLUSIONS: Short bouts of extremely low-level mechanical signals, several orders of magnitude below that associated with vigorous exercise, increased bone and muscle mass in the weight-bearing skeleton of young adult females with low BMD. Should these musculoskeletal enhancements be preserved through adulthood, this intervention may prove to be a deterrent to osteoporosis in the elderly.

Adolescent↗
PubMed2000

Life optimism, substance use, and AIDS-specific attitudes associated with HIV risk behavior among disadvantaged innercity women.

The development of more effective human immunodeficiency virus (HIV) prevention programs for disadvantaged women requires identification of factors associated with risk. In the present study, 158 women - all of whom met criteria indicative of HIV risk - were recruited in innercity primary healthcare clinics and administered measurements that assessed variables in three domains believed pertinent to HIV sexual risk behavior: (1) substance use in the past 3 months, (2) acquired immunodeficiency syndrome (AIDS)-specific cognitive and attitudinal factors, including AIDS risk knowledge, condom attitudes, perceived risk for AIDS, behavior change intentions, and perceived self-efficacy, and (3) life context variables, including self-esteem, fatalism, personal optimism toward the future, and current life satisfaction. When women were categorized into highest and lower groups based on their recent risk behavior, AIDS-specific cognitive and attitudinal factors, as expected, differentiated the groups. However, women at highest risk for HIV also most often used a variety of substances and scored lower in self-esteem, held views more characterized by personal fatalism and low optimism concerning the future, and had greater life dissatisfaction than women at lower risk. HIV prevention programs for disadvantaged women require attention not only to AIDS-specific knowledge, attitudes, and skills development but also to broader issues of life context that, if unaddressed, may limit women's ability and motivation to reduce risk for HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Parental intrusiveness in adolescence recalled by women with a history of bulimia nervosa and comparison women.

OBJECTIVE: To learn if women with a lifetime history of bulimia nervosa (BN) report more intrusive parental behavior during adolescence than their nonclinical peers, and to provide further validation of the Parental Intrusiveness Rating Scale (PIRS). METHOD: We administered the PIRS to 86 women with a lifetime history of BN and 573 comparison subjects and examined between-group differences. RESULTS: Relative to the comparison group, lifetime BN subjects reported higher levels of parental intrusiveness, specifically maternal invasion of privacy, maternal jealousy and competition, paternal seductiveness, and maternal and paternal overconcern with the daughter's eating, weight, and shape. There were no between-group differences in paternal invasion of privacy. In exploratory analyses with the comparison sample, Caucasian women reported greater maternal jealousy and competition than Asian American/Pacific Islander women, but there were no other differences. CONCLUSION: These results support clinical observations of high levels of parental intrusiveness in the adolescent experiences of women who develop BN. Nonclinical women of diverse ethnic backgrounds report largely equivalent experiences.

Adolescent↗
PubMed1996

Impact of deprenyl and tocopherol treatment on Parkinson's disease in DATATOP patients requiring levodopa. Parkinson Study Group.

The Deprenyl and Tocopherol Antioxidant Therapy of Parkinsonism (DATATOP) trial was designed to test outcomes from treatment with 10 mg of deprenyl and/or 2,000 mg of tocopherol/day in 800 untreated patients with Parkinson's disease. The need of subjects for symptomatic treatment with levodopa and the conversion of all subjects to open-label deprenyl made it possible to study the long-term effect of early deprenyl and tocopherol treatment on the later development of levodopa-associated side effects. The rate of developing these side effects did not differ among the original treatment groups (early versus late deprenyl and tocopherol versus nontocopherol). About 50% of subjects developed "wearing off," 30% dyskinesias, and 25% "freezing" in each group. At the end of the study, the groups were similarly disabled on the Hoehn-Yahr, Schwab-England, and Unified Parkinson's Disease Rating scales and took similar amounts of levodopa. Young subjects were more likely to develop wearing off, women to develop dyskinesias, and older subjects with rapidly progressive disease to develop freezing. We conclude that prior treatment with deprenyl or tocopherol did not reduce the occurrence of subsequent levodopa-associated adverse effects in this population.

Aged↗
PubMed1992

Is it worth weighing pregnant women in a developing country?

In order to find out which criteria could be useful for pregnancy screening and referral, the maternal weight gain curves of 251 patients have been reviewed. Three alarm signs (gain greater than 1.0 kg/w; no gain for 4 weeks and weight loss) have been assessed and correlated with the occurrence of macrosomia, twin pregnancy, fetal intrauterine growth retardation and intrauterine death. Although excessive weight gain appears statistically linked to preeclampsia, macrosomia and twin pregnancy the sensitivity and specificity of a system using these criteria are unacceptably low.

Birth Weight↗