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Journal of Family Medicine and Primary... Jan 2024Contraceptive information and services are fundamental to the health and human rights of all individuals. Low contraceptive use is a major challenge faced in India. To...
BACKGROUND
Contraceptive information and services are fundamental to the health and human rights of all individuals. Low contraceptive use is a major challenge faced in India. To determine whether a lack of awareness of contraceptive methods was a factor, we assessed the perception of women on contraceptive methods, their safety and efficacy and further determined whether their demographic background played any role in their perception.
MATERIALS AND METHODS
Reproductive-aged women from both rural and urban backgrounds of Bangalore and Tumkur, Karnataka, were individually questioned in a community setting using both Google Forms and personal interviews from September 2022 to December 2022. The questions consisted of limited demographic information and specific questions related to the knowledge and beliefs of women on the efficacy and safety of contraceptive methods and assessed situational awareness.
RESULTS
Although awareness was more amongst urban women (99.1%) compared with rural women (79%), the practice was significantly higher amongst rural women (63.2%) compared with urban women (36.7%). Perception showed variations with respect to age, education, religion and parity. A major religion-wise disparity was observed. With regard to safety, oral contraceptive pills (60.9%) and condoms (51.8%) were unanimously perceived to be the most and least harmful to health. The most commonly perceived short-term complications were found to be body changes, and mood swings, tiredness and infertility with no data to support the claim were the most commonly chosen long-term complication.
CONCLUSION
From the study, we concluded that more educated women were not immune to misinformation. The efficacy rates of different methods were highly underestimated with methods with higher failure rates perceived to be more effective. Results demonstrate that women are ill-informed about the long-term complications of various methods.
PubMed: 38482281
DOI: 10.4103/jfmpc.jfmpc_599_23 -
Supportive Care in Cancer : Official... Nov 2023Adjuvant endocrine therapy (AET) is pivotal for hormone receptor-positive breast cancer patients, significantly enhancing survival rates. Yet, adherence to AET remains...
PURPOSE
Adjuvant endocrine therapy (AET) is pivotal for hormone receptor-positive breast cancer patients, significantly enhancing survival rates. Yet, adherence to AET remains challenging due to side effects. This study delves into the lived experience of breast cancer survivors concerning AET-induced side effects and examines differences in symptom profiles between Tamoxifen and aromatase inhibitors (AIs).
METHODS
We interviewed 35 breast cancer survivors on AET, conducting qualitative iterative analysis using grounded theory. A codebook was developed to aid data coding and interpretation. NVIVO software facilitated comprehensive transcript analysis.
RESULTS
Survivors reported a spectrum of side effects like hot flashes, sexual issues, joint pain, stiffness, mood swings, and fertility concerns. Symptom profiles differed based on AET type. Tamoxifen users experienced more frequent sexual side effects and mood swings, while AIs were linked to joint pain, stiffness, and bone health worries. Those on AET for over 6 months expressed heightened concerns about side effects.
CONCLUSION
Tailored patient education, aligned with AET type, empowers survivors to manage side effects using self-regulatory strategies. Acknowledging distinct symptom profiles enables informed decisions, improving adherence and quality of life.
IMPLICATIONS
This study underscores tailored survivorship support, equipping patients with tools to manage side effects, enhancing adherence, and long-term outcomes. The findings inform the integration of comprehensive survivorship programs, emphasizing individualized strategies for managing side effects and promoting better adherence and improved quality of life.
Topics: Humans; Female; Breast Neoplasms; Quality of Life; Medication Adherence; Chemotherapy, Adjuvant; Tamoxifen; Adaptation, Psychological; Arthralgia; Antineoplastic Agents, Hormonal
PubMed: 38008817
DOI: 10.1007/s00520-023-08170-y -
Clinical and Translational Allergy May 2024Asthma is the most common chronic disease among children and poses a significant threat to their health. This study aims to assess the relationship between various...
BACKGROUND
Asthma is the most common chronic disease among children and poses a significant threat to their health. This study aims to assess the relationship between various plasma proteins and childhood asthma, thereby identifying potential therapeutic targets.
METHODS
Based on publicly available genome-wide association study summary statistics, we employed a two-sample Mendelian randomization (MR) approach to elucidate the causal relationship between plasma proteins and asthma. Mediation analysis was then conducted to evaluate the indirect influence of plasma proteins on childhood asthma mediated through risk factors. Comprehensive analysis was also conducted to explore the association between plasma proteins and various phenotypes using the UK Biobank dataset.
RESULTS
MR analysis uncovered a causal relationship between 10 plasma proteins and childhood asthma. Elevated levels of seven proteins (TLR4, UBP25, CBR1, Rac GTPase-activating protein 1 [RGAP1], IL-21, MICB, and PDE4D) and decreased levels of three proteins (GSTO1, LIRB4 and PIGF) were associated with an increased risk of childhood asthma. Our findings further validated the connections between reported risk factors (body mass index, mood swings, hay fever or allergic rhinitis, and eczema or dermatitis) and childhood asthma. Mediation analysis revealed the influence of proteins on childhood asthma outcomes through risk factors. Furthermore, the MR analysis identified 73 plasma proteins that exhibited causal associations with at least one risk factor for childhood asthma. Among them, RGAP1 mediates a significant proportion (25.10%) of the risk of childhood asthma through eczema or dermatitis. Finally, a phenotype-wide association study based on these 10 proteins and 1403 diseases provided novel associations between these biomarkers and multiple phenotypes.
CONCLUSION
Our study comprehensively investigated the causal relationship between plasma proteins and childhood asthma, providing novel insights into potential therapeutic targets.
PubMed: 38730525
DOI: 10.1002/clt2.12357 -
Vascular and Endovascular Surgery Jul 2023Controversy persists regarding the optimal treatment for large abdominal aortic aneurysm (AAA), highlighted by the publication of the National Institute for Health and...
BACKGROUND
Controversy persists regarding the optimal treatment for large abdominal aortic aneurysm (AAA), highlighted by the publication of the National Institute for Health and Care Excellence (NICE) guideline (NG156) on March 2020. The pendulum of opinion swings once more from endovascular to open surgical treatment. We report our experience over the last 15 years in treating consecutive AAA by open surgery.
METHODS
A retrospective review of a prospectively collected vascular database of all patients undergoing infra-renal open abdominal aortic aneurysm repair (OR) repair from 2004 to 2019 at the largest aneurysm centre in the United Kingdom. OR for elective and emergency (ruptured and symptomatic) outcomes included early morbidity and 30-day mortality, and long-term survival.
RESULTS
1017 patients underwent OR between 2004-2019, on application of our inclusion-criteria 994 patients formed our cohort for analysis (81.2% male) with a mean age 73.6 ± 7.8 years treated by OR for AAA. In that group 672 were elective and 308 were emergency (for ruptured or symptomatic). Overall 30 day mortality was 11.3%, elective 30 day mortality was 2.5%, and emergency 30 day mortality was 29.9%. 30 day re-intervention rate was 9.5%, (elective 7.0%, emergency 15.9%). Survival at 1000 days for elective repair was 72 v 46.7% for emergency and at 2000 days was 43.4% for elective v 25% for emergency.
CONCLUSION
Our data confirm that open surgery for AAA can be performed in large volume centres quite safely. Elective and Emergency surgery does affect early 30 day mortality but does not influence long-term outcome.
Topics: Humans; Male; Aged; Aged, 80 and over; Female; Treatment Outcome; Vascular Surgical Procedures; Retrospective Studies; Aortic Aneurysm, Abdominal; Elective Surgical Procedures; Risk Factors; Endovascular Procedures
PubMed: 36714998
DOI: 10.1177/15385744221149585 -
Frontiers in Psychiatry 2024Previous studies have shown that lifestyle was associated with depression. Thus, the aim of this study was to examine the causality between multiple lifestyles and...
BACKGROUND
Previous studies have shown that lifestyle was associated with depression. Thus, the aim of this study was to examine the causality between multiple lifestyles and depression by Mendelian randomization (MR) analysis.
METHODS
The single-nucleotide polymorphisms (SNPs) of depression, alcoholic drinks per week, sleeplessness or insomnia, body mass index (BMI), mood swings, weekly usage of mobile phone in the last 3 months, beef intake, cooked vegetable intake, and "smoking status: never" were acquired from the Integrative Epidemiology Unit Open genome-wide association study database. Causal effects of eight exposure factors and depression were investigated using MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, and weighted mode, and results were primarily referred to IVW. Subsequently, univariable MR (UVMR) analysis was performed on eight exposure factors and depression, separately. In addition, sensitivity analysis, including heterogeneity test, horizontal pleiotropy, and leave-one-out (LOO) methods, was conducted to evaluate the stability of MR results. Furthermore, multivariable MR (MVMR) analysis was carried out.
RESULTS
UVMR analysis revealed that all eight exposure factors were causally associated with depression; alcoholic drinks per week, sleeplessness or insomnia, BMI, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake were risk factors, and beef intake and "smoking status: never" were protection factors. Heterogeneity tests revealed no heterogeneity for alcoholic drinks per week, sleeplessness or insomnia, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake. Meanwhile, there was no horizontal pleiotropy in UVMR, and LOO analysis verified that univariable analysis results were reliable. Moreover, MVMR analysis indicated that mood swings and weekly usage of mobile phone in the last 3 months were risk factors, and beef intake was a protection factor for depression when multiple factors occurred at the same time.
CONCLUSION
Alcoholic drinks per week, sleeplessness or insomnia, BMI, mood swings, weekly usage of mobile phone in the last 3 months, and cooked vegetable intake were risk factors, and beef intake and "smoking status: never" were protection factors. In addition, mood swings, weekly usage of mobile phone in the last 3 months, and beef intake had a direct effect on depression when multiple factors occurred simultaneously.
PubMed: 38487581
DOI: 10.3389/fpsyt.2024.1343132 -
Nutrients Jul 2023Male climacteric syndrome (MCS) is a medical condition that can affect middle-aged men whose testosterone levels begin to decline considerably. These symptoms may... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Unripe Black Raspberry Extract Supplementation on Male Climacteric Syndrome and Voiding Dysfunction: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial.
Male climacteric syndrome (MCS) is a medical condition that can affect middle-aged men whose testosterone levels begin to decline considerably. These symptoms may include fatigue, decreased libido, mood swings, and disturbed sleep. MCS can be managed with lifestyle modifications and testosterone replacement. However, testosterone therapy may cause number of side effects, including an increased risk of cardiovascular issues. This study aims to evaluate the efficacy and safety of unripe black raspberry extract (BRE) against MCS and voiding dysfunction in men with andropause symptoms. A total of 30 subjects were enrolled and randomly assigned to the BRE group (n = 15) or the placebo group (n = 15). Participants were supplemented with 4800 mg BRE or placebo twice daily for 12 weeks. The impact of BRE was assessed using the Aging Male's Symptoms (AMS scale), International Prostate Symptom Score (IPSS) and the IPSS quality of life index (IPSS-QoL). Additionally, male sex hormones, lipid profiles, and anthropometric indices were assessed 6 and 12 weeks after treatment. The AMS scores did not differ significantly between the two groups. In the BRE group, the total IPSS and IPSS-QoL scores decreased significantly after 12 weeks compared to baseline ( < 0.05), but there was no significant difference compared to the placebo group. However, a significant difference was observed in the IPSS voiding symptoms sub-score compared to the placebo group. Furthermore, LDL-C and TC levels were also significantly lower in the BRE group than in the placebo group ( < 0.05). Collectively, the study provides strong evidence supporting the safety of BRE as a functional food and its supplementation potentially enhances lipid metabolism and alleviates MCS and dysuria symptoms, limiting the development of BPH.
Topics: Middle Aged; Humans; Male; Prostatic Hyperplasia; Quality of Life; Rubus; Testosterone; Climacteric; Double-Blind Method; Treatment Outcome
PubMed: 37571251
DOI: 10.3390/nu15153313 -
PLOS Global Public Health 2023Priority setting workshops enable researchers to take the lead from people with relevant lived experience, and design research which authentically responds to community...
Priority setting workshops enable researchers to take the lead from people with relevant lived experience, and design research which authentically responds to community needs. Large-scale global priority setting exercises have previously identified key research questions related to paediatric and adolescent HIV treatment, prevention, and service delivery. However, priority setting workshops focused on the needs of young people living with HIV are lacking in southern Africa. Here, we report the outcome of a priority setting workshop organised in Cape Town, South Africa with 19 young people living with HIV and their parents and caregivers. Workshops were facilitated by trained research and clinical staff, who provided a plain-language introduction to research questions for the attendees. During the day-long workshop, attendees developed a list of research questions concerning HIV-related physical health, mental health, and psychosocial support and later voted on the order of importance for the questions which they had collectively identified. Facilitators did not prompt any questions or amend the phrasing of questions generated by the attendees. A cure for HIV was highlighted as the most important research priority for young people living with HIV. Other priorities for young people included the effects of antiretroviral therapy on the body, the brain, and their social relationships, causes of emotional issues such as depression and mood swings, and potential interventions to reduce HIV-related stigma in schools through positive education for teachers and students. Research priorities for parents and caregivers included improving antiretroviral adherence through long-acting injections, mental health impacts of HIV status disclosure without consent, and improving support provided by local community clinics. The research questions identified through this workshop may be used by researchers to develop future studies which truly benefit young people living with HIV in South Africa and beyond.
PubMed: 38079383
DOI: 10.1371/journal.pgph.0002605 -
Archives of Sexual Behavior Jan 2024Consensual nonmonogamy (CNM) is increasingly recognized as a relevant aspect of family and relational diversity in the USA, but CNM-parenting is still perceived as a...
Consensual nonmonogamy (CNM) is increasingly recognized as a relevant aspect of family and relational diversity in the USA, but CNM-parenting is still perceived as a taboo topic. Pioneering research has only started to emerge and reveals persisting notions of regulation, discrimination, and stigmatization of CNM-parents. CNM-stigmatization is less prevalent among emerging adults, but it is unclear whether young adults' increasing acceptance of CNM relationships extends to their views on parenting. To explore emerging adults' perspectives on CNM-parenting, we conducted a mixed-method study with a diverse sample of 107 US-American college students. Each participant read four relationship-vignettes (monogamy, CNM-polyamory, CNM-open relationship, CNM-swinging) in randomized order, provided ratings for the perceived parenting capabilities of the described partners and described reasons for those ratings in short essays. On average, participants perceived the monogamous partners as more capable of raising children than the CNM partners. LGBTQ + participants perceived CNM-parents, especially polyamorous and swinging partners, as more capable for parenthood than did heterosexual participants. There were no significant differences in response patterns between males and females. In their essays, participants discussed their views on how the different relationship structures might affect parenting and what they perceived as indicators and conditions for successful parenting. The results of this study were interpreted relative to life-course perspectives of identity development, and relative to politico-economic perspectives on parental investment and sexual strategy theories. Implications are derived for sexuality education, research, and practice.
Topics: Male; Female; Young Adult; Child; Humans; Sexual Partners; Parenting; Sexual Behavior; Heterosexuality; Marriage
PubMed: 37943473
DOI: 10.1007/s10508-023-02720-5 -
Pharmacoepidemiology and Drug Safety Sep 2023Studies on the detection of COVID-19 vaccine signals in South Korea are insufficient. Therefore, to investigate adverse events (AEs) that might be associated with...
PURPOSE
Studies on the detection of COVID-19 vaccine signals in South Korea are insufficient. Therefore, to investigate adverse events (AEs) that might be associated with COVID-19 vaccines, signals were detected using spontaneous reports from South Korea. We compared the signals with the vaccine insert lists of the regulators in the four countries.
METHODS
Spontaneous reports from 62 sites were collected by the National Medical Center between January 2013 and May 2022. A descriptive analysis of AEs associated with COVID-19 vaccines (Pfizer, Moderna, AstraZeneca, and Janssen) was performed, and the proportional reporting ratio, reporting odds ratio, and information component were calculated. We performed five analyses, with five cases and one control group.
RESULTS
During the study period, 68 355 cases were reported, of which 12 485 were COVID-19 vaccine AEs. Injection site pain (2198 cases, 17.6%), myalgia (1552 cases, 12.4%), headache (1145 cases, 9.2%), pyrexia (1003 cases, 8.0%), and fatigue (735 cases, 5.9%) were frequently reported. When comparing all COVID-19 vaccines with other viral vaccines, 20 signals were detected, of which cachexia, dyspepsia, abdominal discomfort, and mood swings were not listed on the vaccine inserts in all four countries. Overall, 20, 17, 29, and 9 signals were detected in vaccines developed by Pfizer, Moderna, AstraZeneca, and Janssen, respectively.
CONCLUSIONS
Based on a disproportionate analysis of COVID-19 vaccine AEs using spontaneous reports from South Korea, different signals were detected for each vaccine manufacturer.
Topics: Humans; Adverse Drug Reaction Reporting Systems; COVID-19; COVID-19 Vaccines; Republic of Korea; Vaccines
PubMed: 37019851
DOI: 10.1002/pds.5629 -
Recenti Progressi in Medicina Dec 2023During pregnancy, the need for thyroid hormone and its production increase: the presence of a concomitant thyroid disease, however, may prevent the maternal thyroid from...
During pregnancy, the need for thyroid hormone and its production increase: the presence of a concomitant thyroid disease, however, may prevent the maternal thyroid from meeting such increased demands for hormone production, which could lead to - or worsen - a state of hypothyroidism. Hypothyroidism in pregnancy could adversely affect the growth and development of the fetus as well as the course of the pregnancy itself. The present case report involves a 38-year-old woman with autoimmune hypothyroidism, who has been on levothyroxine replacement therapy since adolescence. The patient underwent the transfer of an embryo previously obtained by in vitro fertilization (Fivet), starting with pre-pregnancy TSH levels of 0.5 mU/L. Two weeks after the transfer, despite a preemptive increase in Euthyrox dosage once pregnancy was confirmed, TSH values rose to 7.6 mU/L, which is why the dose of levothyroxine was increased: after another two weeks, a new sampling showed the return of TSH to levels appropriate for pregnancy status (<2.5 mU/L). During the remainder of gestation, thyroid function was monitored regularly, with minor adjustments in levothyroxine dosage according to TSH values, with no further major swings in its levels until the end of pregnancy.
Topics: Adult; Female; Humans; Pregnancy; Hormone Replacement Therapy; Hypothyroidism; Pregnancy Complications; Thyrotropin; Thyroxine
PubMed: 38031866
DOI: 10.1701/4142.41402