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ABSTRACT: OBJECTIVE: To evaluate the prevalence of pelvic organ prolapse (POP) among a diverse group of women and to determine if race/ethnicity and/or socioeconomic status (SES) are factors in treatment-seeking behavior. STUDY DESIGN: All data were collected from the National Institutes of Health-supported Boston Area Community Health (BACH) Survey. Socioeconomic status (SES) was calculated by a two-factor index that combined household income with years of education. Inferential statistics comprised one-way analysis of variance (ANOVA), with a post hoc Scheffé's test performed to evaluate whether there were differences between individual groups. A chi-squared test was used to evaluate whether distributions were equal among the various questions by race/ethnicity and SES category. RESULTS: A total of 3,205 women were included in the analysis. Hispanic ethnicity and younger age were associated with POP (p<0.002 and p<0.001, respectively) as well as with seeking treatment for prolapse (p=0.007 and p<0.001, respectively). These factors were also associated with subsequent surgical repair (p=0.027 and p=0.019, respectively). A regression model showed that women were 4.9% more likely to seek treatment for every year younger they were, across the range of age. Although women of a higher SES were more likely to have POP, SES was neither associated with a higher likelihood of seeking treatment nor with the surgical management of prolapse. CONCLUSIONS: Hispanic ethnicity and younger age were associated with seeking treatment for POP. Hispanics were more likely than Whites or Blacks to proceed with surgical management. There was no correlation of SES with any of the above factors.
American journal of obstetrics and gynecology 05/2013; · 3.28 Impact Factor
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ABSTRACT: This study analyzed associations between plasma vitamin D(3) (25OHD(3)) and bone mineral density (BMD) and whether the effects of conjugated equine estrogens (CEE) on BMD are modulated by 25OHD(3).
Fifty cynomolgus monkeys were fed a diet containing 25OHD(3) (providing a woman's equivalent of 1000 IU/day of 25OHD3). The monkeys underwent bilateral oophorectomy and were randomized to either CEE (equivalent of 0.45 mg/day) (n=25) or placebo (n=25) and continued receiving the same diet. 25OHD(3) and BMD were measured at randomization and after 6 months. BMD also was measured after 20 months (equivalent to 6 human years). Associations between 25OHD(3) and BMD were subsequently analyzed.
Baseline 25OHD(3) plasma concentrations varied from 26 to 95 ng/mL (mean±standard deviation [SD] 54 ± 15 ng/mL). Higher plasma concentrations of 25OHD(3) were associated with a significantly increased BMD. Monkeys on both CEE and placebo had increased BMD over 20 months; however, the increase was not significantly different (0.034 g/cm(2) vs. 0.020 g/cm(2), respectively; p=0.064). The 20-month BMD increased significantly with CEE treatment in those with higher vs. lower 25OHD(3) concentrations (p=0.027). The percent change in BMD over 20 months also increased significantly with CEE treatment in those with higher vs. lower 25OHD(3) concentrations (p=0.018). A higher 25OHD(3) concentration had no significant effect on BMD in those receiving placebo.
Monkeys fed a diet containing 1000 IU/day equivalent of 25OHD(3) have a wide range of plasma 25OHD(3) concentrations. Those receiving CEE with higher 25OHD(3) concentrations had higher BMDs, suggesting 25OHD(3) and CEE have synergistic effects on BMD.
Journal of Women s Health 06/2012; 21(8):858-64. · 1.57 Impact Factor
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ABSTRACT: The aim of this study was to analyze coronary artery vitamin D receptor (VDR) expression, the plasma concentrations of 25-hydroxyvitamin D3 (25OHD3), and their relationship with coronary artery atherosclerosis.
Premenopausal cynomolgus monkeys were fed atherogenic diets containing the equivalent of 1,000 IU/day of vitamin D3. Protein was derived from casein-lactalbumin (C/L, n = 10), soy protein isolate (soy, n = 10), or a combination (n = 19). After 32 months of consuming the diets, each monkey underwent surgical menopause. After 32 postmenopausal months, coronary atherosclerosis was measured in the left circumflex (LCX) artery and left anterior descending (LAD) artery. VDR expression was determined for the LAD, and 25OHD3 concentrations were assessed.
Both the cross-sectional area of atherosclerotic plaques (in square millimeters) and plaque thickness (in millimeters) in the LCX as well as the LAD arteries were analyzed in these monkeys. Those with higher plasma vitamin D3 concentrations and higher VDR were compared with those with higher plasma 25OHD3 concentrations and lower VDR. Significantly smaller plaque sizes were noted with higher plasma 25OHD3 concentrations and higher VDR. For the LCX artery, there was also a significantly lower plaque size (both plaque thickness and cross-sectional area) in those with higher quantities of VDR and lower 25OHD3 concentrations versus those with lower quantities of VDR and higher plasma concentrations of 25OHD3 (P = 0.009 and P = 0.040, respectively).
Cynomolgus monkeys with higher quantities of VDR have significantly less atherosclerosis than do those with lower quantities of VDR and higher plasma 25OHD3 concentrations. If these findings translate to human beings, it might explain why some individuals with higher plasma concentrations of 25OHD3 have more coronary artery atherosclerosis.
Menopause (New York, N.Y.) 05/2012; 19(9):967-73. · 3.08 Impact Factor
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ABSTRACT: The activated vitamin D receptor (VDR) may have an important role in vascular health. The objective of this study was to determine whether there is an association between the expression of VDRs in coronary arteries and the extent of diet-induced atherosclerosis.
Utilizing a cohort of 39 postmenopausal female cynomolgus monkeys with varying stages of atherosclerosis, histologic sections of the left anterior descending artery (LAD) were analyzed for plaque cross-sectional area, plaque thickness, and VDR quantity using immunohistochemical H-score analysis. The quantities of VDRs were analyzed as a continuous variable and were divided at the median intimal H-score into high vs. low groupings.
In the LAD, a significant negative correlation was observed between the quantity of VDR and plaque size (both cross-sectional area [p<0.001] and plaque thickness [p<0.001]). Monkeys in the low VDR group had a significantly greater cross-sectional plaque area (1.2mm(2)) and greater plaque thickness (0.3mm) than those in the high VDR group (0.4mm(2), p=0.005; 0.1mm, p=0.003, respectively).
Lower concentrations of VDRs in a main coronary artery were associated with greater atherosclerotic plaque size in postmenopausal female monkeys. Given that coronary artery atherosclerosis is a major cause of coronary heart disease in postmenopausal women, further research to ascertain the relationship between VDRs and atherosclerosis is warranted.
Maturitas 04/2012; 73(2):143-7. · 2.77 Impact Factor
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ABSTRACT: We sought to compare recovery of activity and pain control after robotic (ROB) vs abdominal (ABD) sacral colpopexy.
Women undergoing ROB and ABD sacral colpopexy wore accelerometers for 7 days preoperatively and the first 10 days postoperatively. They completed postoperative pain diaries and Short Form-36 questionnaires before and after surgery.
At 5 days postoperatively, none of the 14 subjects in the ABD group and 4 of 28 (14.3%) in the ROB group achieved 50% total baseline activity counts (P = .283). At 10 days, 5 of 14 (35.7%) in the ABD group and 8 of 26 (30.8%) in the ROB group (P = .972) achieved 50%. Postoperative pain was similar in both groups. Short Form-36 vitality scores were lower (P = .017) after surgery in the ABD group, but not in the ROB group.
Women undergoing ROB vs ABD sacral colpopexy do not recover physical activity faster, and pain control is not improved.
American journal of obstetrics and gynecology 02/2012; 206(5):438.e1-6. · 3.28 Impact Factor
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ABSTRACT: The relationships of Pelvic Organ Prolapse Quantification (POP-Q) items pb and Bp with defecatory dysfunction were evaluated with the hypothesis that increased values for both items would correlate with symptoms of stool trapping.
Pelvic Floor Distress Inventory (PFDI-20) results and POP-Q exams from 1,663 urogynecology patients were compiled in a database. Rectocele was defined as POP-Q point Bp > -0.5 and perineocele as pb >3. PFDI-20 questions were used to compare defecatory symptoms and bother in women with and without rectocele and perineocele.
While perineocele was not associated with symptoms or bother, women with isolated rectoceles had higher rates of splinting (p < 0.001) and incomplete evacuation (p = 0.001) and higher bother scores (p < 0.001) than those with neither rectocele nor perineocele.
The POP-Q Bp point, but not the pb measurement, correlates with symptoms of defecatory dysfunction.
International Urogynecology Journal 01/2012; 23(6):743-7. · 1.83 Impact Factor
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ABSTRACT: The objective of this study was to examine a cohort of women sent for dual-energy x-ray absorptiometry (DXA) screening to see whether they met the criteria for bone density testing. In addition, we sought to determine whether they were receiving appropriate interventions, based on published guidelines.
Between January 1, 2007, and March 1, 2009, inclusive, postmenopausal women (age >49 y) who were sent for DXA bone density screening were offered enrollment into the study. Risk factors for osteoporosis, demographic information, and current DXA results were recorded. The 2006 Osteoporosis Position Statement of The North American Menopause Society was used for screening and therapeutic intervention guidelines.
Among the 615 women with data, the mean (SD) age was 61.5 (8.3) years. Using the 2006 guidelines of The North American Menopause Society, 41.3% (253 of 612) of the women who had DXA testing did not meet the criteria for such screening. Of these women, 25.5% (157 of 615) were not taking calcium, 31.1% (191 of 614) were not taking vitamin D, and 59.8% (343 of 574) were not exercising at least half an hour per week. Of the women with any of the approved indications for treatment, 15.7% (16 of 102) were not taking calcium, 18.6% (19 of 102) were not taking vitamin D, 52.7% (49 of 93) were not exercising at least 2 hours per week, and 35.3% (36 of 102) were not receiving therapy. In contrast, of those women without an indication for treatment, 17.8% (83 of 467) were receiving bisphosphonate, raloxifene, or calcitonin therapy.
A large number of women are not properly screened or treated for osteoporosis. Inappropriate screening may also lead to improper management of osteoporosis and its associated complications.
Menopause (New York, N.Y.) 07/2011; 18(10):1072-8. · 3.08 Impact Factor
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ABSTRACT: This article aims to evaluate how constipation symptoms change after pelvic reconstructive surgery using the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM). Our primary hypothesis was that constipation would improve after surgery.
Ninety-four subjects completed the PAC-SYM before and 7 weeks after pelvic reconstructive surgery from 2007 through 2009 inclusive. PAC-SYM scores were compared for the cohort before and 7 weeks post-surgery and based on route of surgery: vaginal or abdominal.
Baseline PAC-SYM scores between those undergoing abdominal or vaginal reconstructive surgery were not significantly different (0.76 versus 0.83, respectively; p = 0.586). Subjects in the vaginal surgery group had a significant reduction in PAC-SYM scores, 0.83 to 0.62 (p = 0.049). After abdominal surgery, subjects had an increase in abdominal subscale scores, 0.69 to 1.03 (p = 0.012).
Women undergoing vaginal prolapse surgery may have a short-term improvement in constipation symptoms, while those undergoing abdominal surgery have worsening of abdominal constipation symptoms.
International Urogynecology Journal 07/2011; 22(11):1413-9. · 1.83 Impact Factor
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ABSTRACT: Experimental and clinical data demonstrate a close association between depression and coronary heart disease (CHD). Because no simple depression instrument for use by general practitioners has been shown to predict CHD, the objective of this study was to evaluate whether such a questionnaire could predict CHD.
The prevalence of CHD and CHD risk factors was assessed in women with depression, measured by a validated three-question depression screening instrument. Among 1,919 participants in the breast arterial calcification and CHD 5-year prospective study, 1,454 women (75.8%) completed a baseline depression inventory.
Among the 1,454 women, 72.2% were postmenopausal, and the mean (SD) age at the conclusion of a 5-year prospective study was 61.3 (12.1) years. Among the women with no CHD risk factors at baseline and with one or less positive depression responses compared with those with two or more, 1.6% versus 3.8%, respectively, had at least one CHD risk factor (P = 0.004) by the 5th year of the study. In addition, 2.3% versus 6.0%, respectively, developed CHD (P = 0.005) by the 5th year of the study. Among all women with no positive depression responses compared with those with any positive depression responses, 2.1% versus 5.6%, respectively, had developed CHD by the 5th year of the study (P = 0.002). Finally, more positive depression responses were associated with a greater prevalence of CHD.
In this prospective study, depression-detected by a validated three-item questionnaire-was able to predict those women more likely to develop CHD.
Menopause (New York, N.Y.) 06/2011; 18(10):1096-100. · 3.08 Impact Factor
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ABSTRACT: The aim of this study was to investigate the plasma concentrations of vitamin D and its association with plasma lipid profiles.
Plasma vitamin D3 and lipid concentrations were measured in 119 female cynomolgus monkeys (premenopausal, n = 49; ovariectomized, n = 70) consuming approximately 1,000 IU per day of vitamin D3. In a subset of the ovariectomized monkeys (n = 23), vitamin D3 was remeasured after 6 months. The concentrations of vitamin D3 were analyzed as a continuous variable and were divided at the median into high (≥48 ng/mL) versus low (<48 ng/mL) groupings.
Among the 119 monkeys, the range of vitamin D3 concentrations was 24.0 to 95.2 ng/mL (mean ± SD, 48.5 ± 12.7 ng/mL). Plasma vitamin D3 concentration was positively associated with high-density lipoprotein cholesterol (HDL-C; P = 0.003). Monkeys in the high vitamin D3 group had a significantly greater plasma HDL-C concentration (57.9 mg/dL) than did those in the low vitamin D3 group (47.1 mg/dL; P = 0.001). Although the difference was not significant (P = 0.120), the monkeys in the high vitamin D3 group had a decreased total plasma cholesterol-to-HDL-C ratio compared with those in the low vitamin D3 group (5.4 and 6.2, respectively), potentially putting them at lower risk of atherosclerosis development.
Given that the monkeys all consumed a diet replete in vitamin D3, it seems that individual differences in vitamin D absorption or metabolism may have determined whether the monkeys had high or low concentrations of vitamin D3. Lower vitamin D3 was associated with a more atherogenic lipid profile, a major risk factor for progressing to coronary artery atherosclerosis in monkeys and human beings.
Menopause (New York, N.Y.) 05/2011; 18(9):994-1000. · 3.08 Impact Factor
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Menopause (New York, N.Y.) 05/2011; 18(5):591. · 3.08 Impact Factor
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ABSTRACT: INTRODUCTION/HYPOTHESIS: To identify factors that influence nulliparous women to choose cesarean delivery on maternal request (CDMR).
Nulliparous women at > or = 34 weeks completed a 76-item survey about concerns during labor, delivery and postpartum.
Mean age of the 294 respondents was 28.4 years (+/- 6.13 years SD) and mean gestational age was 35.4 weeks (+/- 2.8 weeks). Sixteen patients (5.4%) would request CDMR if offered. Women who would request CDMR were more likely to plan breastfeeding (OR 5.1, P=0.02), have a mother who delivered by C-section (OR 5.1, P= 0.01), and be concerned about the number of family members present (OR 1.75, P=0.002). Pelvic muscle damage, urinary incontinence, fecal incontinence, or need for prolapse surgery were notcited by any patient as her top concern.
Few women in our sample desire CDMR. Concern for pelvic-floor problems was low.
Connecticut medicine 04/2011; 75(4):207-18.
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ABSTRACT: To determine whether metastatic mammary carcinoma can be detected on cervical cytology in patients with atypical glandular cells (AGCs).
This blinded study of AGC cases with a matched control group was approved by Hartford Hospital institutional review board. Between January 2002 and November 2008, inclusive, all Pap tests in our database with AGC were identified. The AGC cases from patients with breast disease, compared with the control group of AGC patients without breast disease, were reanalyzed independently by 2 pathologists.
Among the 40 women who had an AGC Pap test with breast disease, 21 cases were available for review (16 with invasive and 5 with in situ breast lesions). Seventeen cases of AGC in patients without breast disease served as the control group. The 2 pathologists agreed with the original Pap finding (AGC) in 84.2% to 89.5% of cases. There were no cases, either among those with breast disease or those without, where cells consistent with breast disease were seen, nor were "tamoxifen cells" identified, on Pap testing.
Studies have found that an association exists between patients with AGCs on cervical cytology and extrauterine malignancies, including breast disease. The results of this analysis would suggest that, at least for breast disease, the higher association of cancer or precancerous lesions in those with AGC is not related to the direct extension of disease or metastasis. Further research will be needed to help delineate the potential etiology of this association.
Journal of Lower Genital Tract Disease 03/2011; 15(3):189-94. · 1.07 Impact Factor
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ABSTRACT: Although transesophageal echocardiography is the definitive test for the detection of left atrial (LA) appendage thrombus, transthoracic echocardiography has yet to prove useful for the determination of increased risk for LA appendage thrombus formation. The authors hypothesized that higher LA volume and/or lower left ventricular ejection fraction (LVEF) might prove valuable as markers of increased risk for LA appendage thrombus formation and tested this hypothesis in a consecutive retrospective series of patients with atrial fibrillation undergoing both transthoracic and transesophageal echocardiography.
Three hundred thirty-four consecutive patients with atrial fibrillation undergoing transesophageal echocardiography for the detection of LA appendage thrombus were studied. Anticoagulation status, CHADS(2) scores, and echocardiographic parameters were catalogued. The relationship between the presence of LA appendage thrombus and covariates was analyzed using binary logistic regression.
LA appendage thrombus was detected in 52 patients (15.6%). A higher CHADS(2) score (odds ratio, 1.45; P < .004), increased LA volume index (odds ratio, 1.02; P = .018), and lower LVEF (odds ratio, 1.02; P = .05) were significant predictors of LA appendage thrombus formation. LA appendage thrombus was not seen in patients with CHADS(2) scores ≤ 1, LVEFs > 55%, and a LA volume indexes < 28 mL/m(2). A ratio of LVEF to LA volume index ≤ 1.5 produced 100% sensitivity for the presence of LA appendage thrombus.
The presence of LA appendage thrombus is related to both clinical and echocardiographic variables. Although no single echocardiographic variable discriminated between the presence and absence of LA thrombus, a normal LVEF and normal LA volume index were associated with the absence of LA appendage thrombus formation. For patients with atrial fibrillation with CHADS(2) scores ≤ 1, normal left ventricular systolic function and normal LA volume in combination may be a useful measure for the identification of patients at low risk for LA appendage thrombus formation.
Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 03/2011; 24(5):499-505. · 2.98 Impact Factor
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ABSTRACT: : To determine whether flatal incontinence (FI) adversely affects sexual function.
: A database of 1203 women presenting to a consultative urogynecology practice was queried. The Pelvic Floor Distress Inventory Short Form (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function (PISQ-12) questionnaires were administered on presentation to the practice. Flatal incontinence was identified by an answer of at least "somewhat" to question 11 of PFDI-20. Questions 9 and 10 were used to eliminate confounding effects of leakage of solid and liquid stool. Univariate analyses were performed using Student t and χ tests.
: Of the 1076 women who answered PFDI-20 question 11, 485 subjects (46.2%) were FI and 591 (54.9%) were not flatally incontinent (NFI). The PFDI-20 global and all 3 subscores were higher in the FI than in the NFI group. Sexual activity was reported in 47.8% of subjects with FI and in 60.2% of the NFI group (P < 0.001). Among those who were sexually active, PISQ-12 scores were significantly higher in the FI group (n = 219, 15.8 ± 6.4 vs n = 334, 14.4 ± 5.9, P = 0.006). After sexually active subjects with incontinence to stool were excluded, PFDI-20 and PISQ-12 scores were compared. Those with FI had significantly higher PFDI-20 global and subscores, but there was no significant difference in PISQ-12 scores (FI: 14.8 ± 6.2 vs NFI: 14.0 ± 5.7, P = 0.161).
: Flatal incontinence is associated with decreased sexual activity and impaired sexual function. Flatal incontinence not accompanied by incontinence to stool, however, may not worsen sexual function.
Journal of Pelvic Medicine and Surgery 03/2011; 17(2):70-3.
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ABSTRACT: To estimate whether mammography can be an early, valid tool for predicting the development of coronary heart disease (CHD) in women.
Women presenting for routine mammograms between June and August 2004 were recruited for the study. Baseline data collected included risk factors and family history of heart disease, as well as any cardiac events experienced by the patient. Similar follow-up data were collected during subsequent years, and these patient-completed surveys were correlated with the baseline mammograms screened for breast arterial calcifications.
Throughout the 5-year follow-up, CHD was present in 20.8% of women who screened positive for breast arterial calcification and in 5.4% of who screened negative for breast arterial calcification (P<.001). Among women who did not have CHD at baseline, breast arterial calcification-positive women were more likely to develop CHD or a stroke than those who were breast arterial calcification-negative (6.3% compared with 2.3%, P=.003; and 58.3% compared with 13.3%, P<.001), respectively. These results remained significant even when controlling for age.
The presence of breast arterial calcifications on mammograms indicates a significantly increased risk of developing CHD or a stroke. These results suggest that breast arterial calcifications should be routinely reported on mammograms and viewed as a marker for the development of CHD.
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Obstetrics and Gynecology 02/2011; 117(2 Pt 1):233-41. · 4.73 Impact Factor
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ABSTRACT: This study seeks to determine whether an association exists between atypical glandular cells (AGC) on cervical cytology and breast disease.
We analyzed 470,147 Papanicolaou test results from January 1, 2002, to November 17, 2008, inclusive. We studied all cases of AGC versus a control group with normal Papanicolaou test results. The database was then searched to determine which of these women had a history of breast disease. A comparison of the prevalence of breast disease between the two groups was performed.
Of the 470,147 total Papanicolaou tests, 1,087 cases of AGC (0.23%) were identified from 1,026 women. There were 1,064 women comprising the normal population. The mean ± SD age of these two groups was 44.9 ± 13.7 and 41.6 ± 14.4 years, respectively. Among the women with an AGC on Papanicolaou testing, 40 (3.9%) had breast disease compared with 21 (2.0%) among those without an AGC on Papanicolaou testing (P = 0.009). Among the 40 women with an AGC on their Papanicolaou test and breast disease, 7 (17.5%) also had a concerning gynecologic (Gyn) pathologic finding at the level of the cervix, endocervix, or uterus. In comparison, the women with normal Papanicolaou test results had no Gyn pathologic findings.
The prevalence of an abnormal Gyn pathologic finding in those with AGC is consistent with prior data. Women from this data set who have an AGC on Papanicolaou testing have a statistically higher likelihood of having concurrent breast disease. Further data are needed to elucidate the reason for this association.
Menopause (New York, N.Y.) 01/2011; 18(1):67-72. · 3.08 Impact Factor
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ABSTRACT: The objective of this study was to identify the prevalence of female sexual dysfunction (FSD) in a sample comprising women of mostly Hispanic descent and low socioeconomic status (SES).
Demographic data and symptoms related to sexuality were analyzed from 102 women who consecutively came to the Women's Life Center at Hartford Hospital (2004-2008). FSD was defined as decreased sexual desire, dyspareunia, or vaginal dryness; depression as one positive response to a validated three-question screening instrument; and anxiety as a positive response to whether the patient experiences anxiety sometimes or often.
The cohort was 52.9 ± 6.8 years of age (mean ± standard deviation [SD]) and 80.0% Hispanic, and 47.8% were unemployed. The majority (92.8%) earned < $25,000, and most (95.8%) did not have a college degree. The prevalence of FSD was 75.6%. The prevalence of depression was 80.9% vs. 52.8% (p = 0.01) and that of anxiety was 76.6% vs. 45.7% (p = 0.01) among women with vs. without a decrease in sexual desire. The prevalence of depression was 83.3% vs. 55.9% (p = 0.03) and that of anxiety was 76.7% vs. 52.9% (p = 0.07) among women who reported dyspareunia vs. those who did not. Problems sleeping was the only variable associated with a statistically higher likelihood of FSD (odds ratio [OR] 5.57, 95% confidence interval [CI] 1.22-25.33, p = 0.03). No significant differences were seen when comparing FSD between Hispanics and non-Hispanics.
This sample of predominantly Hispanic women of low SES had a high prevalence of FSD. These data also suggest that poor sleep is significantly associated with FSD and that women of low SES with FSD may have a significantly higher prevalence of depression and anxiety.
Journal of Women s Health 10/2010; 19(10):1843-9. · 1.57 Impact Factor
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ABSTRACT: The assessment of osteoporosis risk factors can help guide early intervention. The objective of this study was to analyze numerous potential risk factors to see which were associated with postmenopausal osteoporosis. Women aged 49 or greater presenting for dual-energy x-ray absorptiometry bone scans were recruited from radiology sites in the Hartford, Connecticut, area between January 2007 and March 2009, inclusive. Information was collected regarding primary and secondary risk factors for osteoporosis development, as well as family history and history of pregnancy and breast-feeding. Survey results were subsequently correlated with each woman's dual-energy x-ray absorptiometry scan results. In a sample of 619 women, history of fracture (odds ratio [OR], 12.49), weight less than 127 pounds (OR, 3.50), and use of anticoagulants (OR, 5.40) increased the chance of developing osteoporosis. In contrast, multiparity (OR, 0.45) and history of breast-feeding (OR, 0.38) decreased the development of osteoporosis in postmenopausal women. In women aged 49 to 54, breast-feeding was significantly protective, while low body mass index was most indicative of osteoporosis in women ages 55 to 64. Both previous fracture and low body mass index were associated with osteoporosis in women over age 64. The current results are consistent with other studies suggesting that previous fracture, low body weight, and use of anticoagulants increase the risk of osteoporosis. Our results also suggest that a history of pregnancy and breast-feeding protects against the development of postmenopausal osteoporosis, especially in women aged 49 to 54.
Obstetrical & gynecological survey 09/2010; 65(9):591-6. · 3.10 Impact Factor
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ABSTRACT: Some new urogynecology patients who are given the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) complete it despite stating that they are not sexually active. This study compared sexually active (SA) and non-sexually active (NSA) women who complete the PISQ-12, hypothesizing that these groups differ substantially.
New patients during the study period were given the PISQ-12 and two other validated questionnaires. Medical and demographic data were collected and analyzed for univariate differences between SA and NSA PISQ-12 completers. Logistical regression identified factors predicting PISQ-12 completion.
Of the 655 new patients during the study period, 399 completed the PISQ-12. Of these, 16.8% were NSA. These women were older, less likely married, and had higher BMI than their SA counterpart. Being sexually active, younger, and married are predictors of PISQ-12 completion.
Some NSA women complete the PISQ-12. Instructions should specify that only SA women complete this questionnaire.
International Urogynecology Journal 05/2010; 21(5):579-82. · 1.83 Impact Factor
