Current Women s Health Reviews (Curr Wom Health Rev)

Publications in this journal

• Article: An Update on Developments in Female Hormonal Contraception

  Deborah A. Garside, Ayman Gebril, Natalie Nimmo, Manal Alsaadi, Alexander B. Mullen, Valerie A. Ferro
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  ABSTRACT: The human population continues to grow in some parts of the world, which has severe impact on resources, health and the environment. Individually, contraception enables women to choose their optimal family size and birth spacing, while in resource-poor countries it can help lift families out of poverty. While the oral contraceptive pill revolutionised female contraceptive options, there was a price to pay in terms of increased health risks. Today, improved formulations have been developed, together with non-oral hormonal technologies. This review will examine the history of female contraceptive research and provide an update on the status and future direction of new products.
  Current Women s Health Reviews 11/2012; 8(4):276.
• Article: Lynch Syndrome: Awareness among Medical Students at a United States Medical School.

  Melissa K Frey, Mollie A Biewald, Michael J Worley, Jolyn S Taylor, Stephanie N Lin, Kevin Holcomb
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  ABSTRACT: INTRODUCTION: Lynch syndrome was first described in the 1950s however until recently it was rarely included in medical school curricula. As a result, many practicing physicians have limited exposure, potentially contributing to significant under diagnosis. As identification of Lynch syndrome prior to malignancy allows for intensified screening, prophylactic surgery and improved patient outcomes, all physicians should be aware of the characteristics of affected families. We aim to determine the overall level of awareness of Lynch syndrome among medical students at an American medical school. METHODS: A voluntary and anonymous questionnaire was delivered to students at an American medical school. The survey instrument assessed the respondent's perceived knowledge regarding the genetics and recommended screening for carriers of Lynch syndrome mutations. RESULTS: The questionnaire was distributed to the entire student body (405 students) with a response rate of 50%. Fifty-nine percent of students reported that they had learned about Lynch syndrome; 27% of first year students, 44% of second year students; 90% of third year students and 100% of fourth year students. Of the students familiar with Lynch syndrome, the reported knowledge of the underlying genetics was 46%, available genetic screening, 18%, criteria used to screen for the syndrome, 24%, recommendations for colon screening, 31% and recommendations for endometrial cancer screening, 17%. CONCLUSION: The majority of medical students surveyed had been exposed to Lynch syndrome and awareness increased over each year of education. Significantly more students were aware of recommendations for colon cancer screening than endometrial cancer screening (32% versus 17%, p = 0.01). Studies of the natural history of Lynch syndrome indicate that affected women are more likely to present with endometrial cancer than colon cancer and while there are no prospective data proving the efficacy of endometrial cancer screening in this high-risk population, the endometrium is easily accessible and can be sampled using simple office techniques. In addition, prophylactic hysterectomy and bilateral salpingo-oophorectomy are reasonable risk reducing interventions for the prevention of both uterine and ovarian cancer. Our findings suggest that increased emphasis must be placed on teaching the gynecologic manifestations of Lynch Syndrome in order to avoid the misconception that it is simply a colon cancer syndrome.
  Current Women s Health Reviews 08/2012; 8(3):242-247.
• Article: Breast Cancer: Not Only a “Woman’s” Disease

  Piera Rizzolo, Valentina Silvestri, Mario Falchetti, Matteo Gulino, Laura Ottini
  Current Women s Health Reviews 01/2012; 8(1):55-64.
• Article: Evidence-Based Review of Physiologic Effects of Kangaroo Care

  Susan M. Ludington-Hoe
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  ABSTRACT: A comprehensive review of the evidence documenting preterm infant physiologic responses to Kangaroo Care (KC - intermittent skin-to-skin contact) and Kangaroo Mother Care (KMC - 24/7 skin-to-skin contact) has been conducted. Kangaroo Care's effects on preterm infant heart rate, bradycardia, respiratory rate, apnea, oxygen saturation, cerebral oxygenation, supplemental oxygen needs, oxygen consumption, desaturation episodes, temperature, rewarming, blood glucose, serum bilirubin, cholecystokinin, gastrin, somatostatin, weight gain or change, sleep and crying, brain maturation and complexity, infection, stress, and pain are reviewed, as are KC's effects with congenital heart defect infants. Documented effects of KC on prevention and amelioration of maternal depression, swifter delivery of the placenta and involution, and decreased likelihood of postpartal anemia are presented. Guidelines based on dosage (duration and frequency) of KC are provided, as is a summary of actual and potential benefits of KC, including use at end-of-life. Kangaroo Care's role in moving to the new paradigms of non-separation of the infant and mother during hospitalization and parents as primary providers of neonatal care concludes the manuscript.
  Current Women s Health Reviews 07/2011; 7(3):243-253.
• Article: The Hellp Syndrome: A Review

  Jack Moodley, Shaum Khedun
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  ABSTRACT: The HELLP syndrome (haemolysis, elevated liver enzymes, low platelet count) is a variant of the pre-eclampsia/eclampsia syndrome occurring in 10-20% of patients whose diseases are labelled as severe. Although the majority of cases of HELLP syndrome occur antepartum, the disease can present in the postpartum period, usually within 48 hours of delivery. Hypertension and proteinuria may not be detected in 10-20% of cases. As the HELLP syndrome and concurrent eclampsia have been implicated in as many as 5-6 of every 10 maternal deaths it is apparent that such patients require the expertise of a multidisciplinary team (e.g haematologist, maternal fetal medicine experts, and critical care specialists). There is no conclusive evidence supporting the use of high dose corticosteroids in the treatment of HELLP syndrome. Steroids for the use of accelerating fetal lung maturity and decreasing the high perinatal mortality associated with severe pre-eclampsia and the HELLP syndrome is however of proven benefit. The aetiology of pre-eclampsia complicated by the HELLP syndrome is unknown, but data from animal models suggest roles for circulating anti angiogenic proteins. The consensus is that delivery is followed by rapid return of the haematological system to normal. Pregnancies between 24-34 gestational weeks usually should, if possible, receive a standard corticosteroid course, followed by delivery. In pregnancies >35 weeks, rapid delivery alone suffices. Most clinicians would not attempt expectant management in gestations <24 weeks.
  Current Women s Health Reviews 04/2011; 7(2):125-135.
• Article: Antidepressant Use During Breastfeeding.

  Jan Øystein Berle, Olav Spigset
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  ABSTRACT: BACKGROUND: The treatment of breastfeeding mothers with depression raises several dilemmas, including the possible risk of drug exposure through breast milk for the infant. This article provides background information and presents practical advice and recommendations for the clinician dealing with the treatment of depression and related disorders in the postpartum period. METHODS: An electronic search for relevant articles was performed. As the use of tricyclic antidepressants has considerably decreased during the last decade and no new information on breastfeeding has emerged for the tricyclics in this period, this review exclusively focuses on the newer, non-tricyclic compounds. RESULTS: Most newer antidepressants produce very low or undetectable plasma concentrations in nursing infants. The highest infant plasma levels have been reported for fluoxetine, citalopram and venlafaxine. Suspected adverse effects have been reported in a few infants, particularly for fluoxetine and citalopram. CONCLUSIONS: Infant exposure of antidepressants through breast milk is generally low to very low. We consider that when antidepressant treatment is indicated in women with postpartum depression, they should not be advised to discontinue breastfeeding. Paroxetine and sertraline are most likely suitable first-line agents. Although some concern has been expressed for fluoxetine, citalopram and venlafaxine, we nevertheless consider that if the mother has been treated with one of these drugs during pregnancy, breast-feeding could also be allowed during continued treatment with these drugs in the postpartum period. However, an individual risk-benefit assessment should always be performed.
  Current Women s Health Reviews 02/2011; 7(1):28-34.
• Article: Challenges of early onset breast cancer in Sudan: the example of an African context

  Khalid Dafaallah Awadelkarim, Ahmed Elhaj, Renato Mariani-Costantini, Elgaylani Abdalla Eltayeb
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  ABSTRACT: Little is known about breast cancer in Africa. This review focuses mainly on early onset breast cancer in Central Sudan, as example of an African context. In Sudan, as in other parts of Africa, the incidence of the breast cancer is estimated to be lower than that in developed countries, yet, as a result of several factors, among which demographic structures, lifestyle, reproductive, environmental and socio-economic factors, including traditional beliefs, and access to diagnostic facilities and medical care, the majority of the patients present with locally advanced and metastatic disease and early onset breast cancer is frequent in institutional cancer series. Based on available data, no major differences in breast cancer subtypes emerge between Sudanese and Italian breast cancer cases. Pilot studies suggest that genetic/ethnic variables, among which mutations in the BRCA1/2 cancer-predisposing genes, may contribute to early onset disease in Central Sudan.
  Current Women s Health Reviews 01/2011; 7.
• Article: Psychosocial Predictors of Infertility Related Stress: A Review

  Kleanthi Gourounti, Fotios Anagnostopoulos, Grigorios Vaslamatzis
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  ABSTRACT: Objective: The objective of the present study was to review studies describing specifically the impact of certain personality traits, cognitive appraisals, coping strategies and social support on infertility related stress. Furthermore, the aim was to examine the interrelationships among these psychosocial potential predictors in order to develop a predictive psychosocial path-model of infertility related stress. The clinical application of the predictive model of infertility related stress would help the medical staff of fertility centers to identify infertile women who are at greater risk for infertility related stress and for adjustment difficulties and to foster the implementation of preventative and therapeutic interventions. Methods: A systematic search of the psychological and medical electronic databases (Medline, PsycINFO, CINAHL, EMBASE and Scopus) was performed. This review considered only quantitative, primary studies that were relevant to the objective of the review. Population of interest was considered to be infertile women undergoing fertility treatment. Independent variables were considered to be psychosocial predictors of infertility related stress. Outcomes (dependent variables) were considered to be anxiety, depression, and negative mood states. The development of the psychosocial path-model of infertility related stress was based on the principles of stress, appraisal and coping theories. Results: Nineteen studies met the inclusion criteria and finally included in the review. According to the review findings, psychosocial predictors of infertility related stress are: a) personality characteristics, such as neuroticism, pessimism and introversion, b) viewing infertility as a threat or a loss, c) low perceived control over the infertility condition and fertility treatment outcome, d) frequent use of avoidant/escape coping strategies, e) marital dissatisfaction and poor marital communication and f) impoverished social network. Based on the review findings, a predictive path-model of infertility related stress which diagrammatically represents the interrelationships among the independent variables and the interrelationships between the independent and dependent variables was developed. The produced diagrammatical-model shows that: a) the relationship between personality dispositions and fertility related stress is either direct or mediated by appraisal cognitions and coping strategies, b) the relationship between appraisal cognitions and fertility related distress is mediated by coping strategies and c) social support is associated with distress both directly and indirectly either through appraisal cognitions or through coping strategies. Conclusion: Although no single pattern of adjustment to infertility appears common, this review has identified several psychosocial factors that might make particular infertile individuals more vulnerable to stress. It is often a combination of factors which makes stress overwhelming. However, it is important to keep in mind that the risk posed by some factors may by mitigated by the presence of buffers. An insight into such risk and protective factors would facilitate the identification of women at risk of experiencing high infertility related stress and foster the implementation of tailored support, and therapeutic interventions.
  Current Women s Health Reviews 10/2010; 6(4):318-331.
• Article: Coasting: What is the Cost?

  Mohamed Aboulghar
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  ABSTRACT: The objective of this article is to review the current literature on the value of coasting for the prevention of ovarian hyperstimulation syndrome (OHSS). Coasting is a common procedure that is performed in ovarian stimulation cycles at risk of OHSS. Coasting is done by stopping FSH injections and monitoring E2 daily until it drops below 3000 pg/mL then hCG is given. Depriving granulosa cells of the FSH stimulus results in their apoptosis, thus reducing levels of E2 and vascular endothelial growth factor (VEGF linked to the pathogenesis of OHSS). Meanwhile, the small follicles that are dependent on FSH will undergo atresia, while large follicles will not be affected. Coasting is effective in reducing the OHSS rate, but complete prevention is not possible. Prolonged coasting is associated with a significantly lower pregnancy rate.
  Current Women s Health Reviews 07/2010; 6(3):239-244.
• Article: Emerging Technologies for Fertility Preservation in Female Patients

  Ahmed Nasr, Mohamed Ali Bedaiwy
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  ABSTRACT: A wide variety of fertility preservation options in women is available; however, most of the currently available strategies are still experimental and do not guarantee subsequent fertility. The only established method is in vitro fertilization with embryo cryopreservation prior to cancer therapy. Other proposed strategies to preserve fertility in women with cancer include: storage of frozen ovarian tissue or the whole ovary for future transplantation, storage isolated follicles for in vitro growth and maturation and ovarian transposition before radiotherapy. The effectiveness of ovarian protection during chemotherapy with GnRH analogs is yet to be shown.
  Current Women s Health Reviews 07/2010; 6(3):276-286.
• Article: PGD and Prenatal Diagnosis: Comparison and Review in Different Genetic Disorders

  Ling Sun, Lian Liu, Man Li, Nikoo Afifiyan, Ali Ahmady
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  ABSTRACT: Pre-implantation and prenatal testing provide genetic information and detect birth defects or abnormalities in an embryo/fetus before implantation/born. In this review, the process and details of the two testing are discussed.
  Current Women s Health Reviews 07/2010; 6(3):245-249.
• Article: Options to Prevent Multiple Pregnancies with ART

  James M. Goldfarb, Nina Desai
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  ABSTRACT: Multiple pregnancies have been and remain the most common and serious complication of assisted reproductive technologies (ART). Prematurity is the major complication of multiple pregnancies although there are other problems affecting the children and parents also increase significantly. The scope of the problem of ART and multiple pregnancies is discussed as well as the specific issues involving children and parents. Progress in decreasing ART multiple pregnancies and suggested steps to further decrease ART multiple pregnancies are also discussed.
  Current Women s Health Reviews 07/2010; 6(3):250-253.