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Berlin Brandenburg

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  • 1
    In: Obstetrics & Gynecology, 2018, Vol.131 Suppl 1, pp.87S-88S
    Description: INTRODUCTION:: Pathologists routinely use fetal foot length (FFL) to estimate the gestational ages (GA) of aborted fetuses. However, there is no standard formula. We aimed to develop an updated FFL-to-GA reference range from patient reported last menstrual period (LMP), ultrasound estimate, and best estimate for GA based on American College of Obstetricians and Gynecologists’ criteria in our patient population. After determining a reference range, we compared our measurements to those of previously published, commonly referenced FFL tables, which may not represent the ethnic diversity, or increasing BMI of current patient populations. METHODS:: Retrospective chart review of 628 dilation and evacuation (D&E) clinical records and procedure pathology reports from October 2012 to December 2014 in Honolulu, HI. RESULTS:: A linear relationship exists between FFL and GA in our population. Linear regression analysis of three pregnancy dating methods demonstrated that ultrasound derived dating provided the best-fit regression formula: FFL (mm) =496*(GA in days)-34.53 with an R2 value of .916. Patient race/ethnicity and BMI did not affect these equations in regression analysis. Our mean FFL differed from historically referenced ranges by .36-3.92mm, dependent on GA. Our FFL by GA was similar to ranges more recently endorsed by the National Abortion Federation despite differences in population racial and ethnic backgrounds. CONCLUSION:: If post-abortion FFL measurement is utilized for GA estimation, then updated, modern ranges should be referenced to better reflect the diversity of abortion patients nationwide.
    ISSN: 0029-7844
    Source: Copyright © 2013 Lippincott Williams & Wilkins. All rights reserved.〈img src=http://exlibris-pub.s3.amazonaws.com/LWW%20logo.png style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: Women's Health Issues, January 2018, Vol.28(1), pp.51-58
    Description: Conflicting research findings on the association of obesity and pregnancy intention may be due to their collective definition of obesity at a body mass index of 30 kg/m or greater. However, obese women with a BMI of 40 kg/m or greater may be both behaviorally and clinically different from obese women with a lower BMI. This study reexamines this relationship, stratifying by class of obesity; the study also explores variations in contraceptive use by class of obesity given their potential contribution to the incidence of unintended or unwanted pregnancy. This study combined data from the 2006 through 2010 and 2011 through 2013 US National Survey of Family Growth. Pregnancy intention (intended, mistimed, unwanted) and current contraceptive use (no method, barrier, pill/patch/ring/injection, long-acting reversible contraceptive, sterilization) were compared across body mass index categories: normal (18.5–24.9 kg/m kg/m ), overweight (25.0–29.9), obese class 1 (30.0–34.9 kg/m ), class 2 (35.0–39.9 kg/m ), and class 3 (≥40 kg/m , severe obesity). Weighted multinomial logistic regressions were refined to determine independent associations of body mass index class and pregnancy intention, as well as contraceptive method, controlling for demographic, socioeconomic, and reproductive factors. Body mass index data were available for 9,848 nonpregnant, sexually active women who reported not wanting to become pregnant. Women with class 3 obesity had significantly greater odds of mistimed (adjusted odd ratio [aOR], 1.67; 95% confidence interval [CI], 1.02–2.75) or unwanted (aOR, 1.96; 95% CI, 1.15–3.32) pregnancy compared with normal weight women. Women with class 2 or 3 obesity were more likely to not be using contraception (aOR, 1.53–1.62; 95% CI, 1.04–2.29). Although women with class 2 obesity were more likely to be using long-acting reversible contraceptive methods and sterilization over short-acting hormonal methods (aOR, 1.67; 95% CI, 1.08–2.57; aOR, 2.05; 95% CI,1.44–2.91), this association was not observed among women with class 3 obesity. Women with class 3 obesity are at greater risk of unintended pregnancy and are less likely to be using contraception than normal weight women. Whether these findings are related to patient and/or provider barriers that are not as visible among women with class 1 and class 2 obesity warrants further investigation.
    Keywords: Medicine ; Public Health
    ISSN: 1049-3867
    E-ISSN: 1878-4321
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  • 3
    Language: English
    In: Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, November 2013, Vol.72(11), pp.380-5
    Description: Due to toxicities associated with their malignancies and treatments, adolescent and young adult survivors of childhood cancer (AYASCC) are at high risk for developing chronic diseases. This can be compounded by a greater prevalence of unhealthy behaviors relative to similarly aged non-cancer peers. Disparities in health behaviors have been noted for Black and Hispanic AYASCC, but data on Asian American (AA) or Native Hawaiian and Other Pacific Islander (NHOPI) minorities are lacking. The purpose of this study was to help bridge these information gaps by gathering data from Hawai'i AA and NHOPI AYSCC. Telephone surveys were used to collect health behavior data from survivors 13-24 years of age (N=64); 55% of the sample was female, 77% AA or NHOPI, 63% leukemia/lymphoma survivors, and 32% overweight/obese. These were compared to state/national survey data for similarly aged individuals (Youth Risk Behavior Surveillance System data for 13-17 year olds, and Behavioral Risk Factor Surveillance System data for 18-24 year olds). While Hawai'i AYASCC had significantly lower rates of tobacco/alcohol use, a higher proportion did not eat five fruits/vegetables a day (96%) compared to state (83%) and national (78%) samples (P 〈 .001). Although many met age-specific physical activity recommendations, 44% of 〈18 year olds and 29% of ≥18 year olds still failed to meet national guidelines. Low intake of fruits/vegetables and suboptimal levels of physical activity place these vulnerable, ethnic minority cancer survivors at higher risk for chronic disease. These findings underscore the need to assess and advise survivors about their diet and exercise habits as part of post-treatment care.
    Keywords: Asian and Native Hawaiian/Pacific Islander ; Childhood Cancer Survivors ; Nutrition ; Physical Activity ; Asian Continental Ancestry Group -- Statistics & Numerical Data ; Health Behavior -- Ethnology ; Neoplasms -- Psychology ; Oceanic Ancestry Group -- Statistics & Numerical Data ; Survivors -- Psychology
    E-ISSN: 2165-8242
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 4
    Language: English
    In: Journal of Pediatric and Adolescent Gynecology, April 2017, Vol.30(2), pp.290-290
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpag.2017.03.050 Byline: Jennifer Salcedo, Mary Tschann, Jennifer Elia Author Affiliation: Department of Obstetrics, Gynecology & Women's Health, University of Hawaii John A. Burns School of Medicine, Honolulu, HI Article Note: (miscellaneous) 33
    Keywords: Medicine
    ISSN: 1083-3188
    E-ISSN: 1873-4332
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  • 5
    Language: English
    In: Journal of Pediatric and Adolescent Gynecology, April 2017, Vol.30(2), pp.284-284
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpag.2017.03.037 Byline: Mary Tschann, Jennifer Elia, Jennifer Salcedo Author Affiliation: Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI Article Note: (miscellaneous) 20
    Keywords: Medicine
    ISSN: 1083-3188
    E-ISSN: 1873-4332
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  • 6
    Language: English
    In: Journal of Pediatric and Adolescent Gynecology, April 2017, Vol.30(2), pp.283-283
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpag.2017.03.036 Byline: Maryssa Shigesato, Jennifer Elia, Mary Tschann, Holly Bullock, Jennifer Salcedo Author Affiliation: Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii Article Note: (miscellaneous) 19
    Keywords: Medicine
    ISSN: 1083-3188
    E-ISSN: 1873-4332
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  • 7
    Language: English
    In: Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, July 2017, Vol.76(7), pp.178-182
    Description: Emergency contraceptive pills (ECPs) are medications used after unprotected intercourse, underprotected intercourse, or sexual assault to decrease the risk of pregnancy. Availability of ECPs in Hawai'i's retail pharmacies was last assessed in 2007, following over-the-counter access to levonorgestrel ECPs (LNG-ECP) for women age 18 years or older and prior to U.S. Food and Drug Administration (FDA) approval of prescription-only ulipristal acetate (UPA). We conducted a county-by-county subanalysis from a larger observational population-based study on statewide availability of ECPs in Hawai'i's pharmacies. In the original study, researchers called all 198 unique retail pharmacies in Hawai'i between December 2013 and June 2014. Only 3% of pharmacies had UPA immediately available on-site in the state, with UPA available on Kaua'i and O'ahu only. At least one form of LNG-ECPs was available in 82% of pharmacies in 2013-2014, roughly the same as 2007 (81%) (P=0.9) when Lana'i and Moloka'i lacked access. Currently, only Moloka'i lacks retail pharmacy access to ECPs. When controlling for general inflation, the 2013-2014 mean price for name brand LNG-ECP fell within the reported range of 2007 prices. Generic LNG-ECPs were substantially lower in price than name brand LNG-ECPs in 2007 and 2013-2014. Availability of UPA is limited and significantly lower compared to LNG-ECPs. Availability of LNG-ECPs statewide has remained stable and the arrival of generics has decreased prices.
    Keywords: Availability ; Emergency Contraception ; Hawai‘i ; Pharmacies ; Ulipristal Acetate ; United States ; Contraceptives, Postcoital -- Therapeutic Use ; Health Services Accessibility -- Standards ; Pharmacy -- Statistics & Numerical Data
    E-ISSN: 2165-8242
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 8
    Language: English
    In: Journal of Pediatric and Adolescent Gynecology, February 2017, Vol.30(1), pp.29-34
    Description: To assess the values and beliefs regarding sexual behavior, sexual decision-making, and reproductive health learning preferences among teens in Hawaii. Survey regarding teens' knowledge, attitudes, and beliefs about sexual behaviors and preferences for learning about reproductive health. University of Hawaii Department of Obstetrics and Gynecology clinics in Honolulu, Hawaii. Female patients and their male or female companions ages 14-19 years. A 30-question anonymous survey. The main outcome was to describe the norms, attitudes, beliefs, and preferences of teens in this setting with regard to sexual health and sexual health education. For this, we provide a description of response frequencies and a comparison of mean scores across demographic characteristics. We analyzed a total of 100 surveys. Teens endorsed more values and norms protective against sexually transmitted infection than those protective against pregnancy. Younger teens expressed more protective values as a result of the influence of perceived parental values, whereas older teens expressed less protective values on the basis of the influence of peers. Respondents expressed comfort talking with their clinician about sexual health, and also expressed a slight preference that their clinicians initiate these conversations. The influence of parental values and peer norms on sexual behavior must be taken into consideration when designing interventions to address adolescent sexual health. Additionally, teens' greater concern about the consequences of sexually transmitted infection could be leveraged by clinicians to initiate broader conversations about sexual health, and a variety of modalities, including online resources and in-person conversations, should be used to meet the diversity of preferences expressed by teens across demographic groups.
    Keywords: Adolescents ; Pregnancy ; Sexually Transmitted Infections ; Surveys ; Norms ; Attitudes ; Behaviors ; Prevention ; Medicine
    ISSN: 1083-3188
    E-ISSN: 1873-4332
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  • 9
    Language: English
    In: Gynecologic Oncology, October 2014, Vol.135(1), pp.34-37
    Description: To determine if an abnormal CA-125 level in a menopausal female without ovarian cancer is associated with an increase in mortality. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Randomized Controlled (PLCO) Trial is a large multicenter prospective trial conducted by the National Cancer Institute (NCI). Over 78,000 healthy women aged 55–74 were randomized to a screening arm versus a usual medical care arm to evaluate the efficacy of screening in reducing mortality due to ovarian cancer. Women in the screening arm underwent annual screening for ovarian cancer with transvaginal ultrasound and CA-125 levels. There were 38,818 patients without ovarian cancer that had at least one CA-125 level drawn; 1201 (3.09%) had at least one abnormal level. The current study compares mortality in patients that had one or more abnormal CA-125 levels without ovarian cancer versus those with all normal levels. Patients with one or more abnormal CA-125 levels, without ovarian cancer, had a significantly higher mortality than patients with all normal CA-125 levels in the PLCO screening trial ( 〈 0.0001). This increased risk extended throughout the follow-up period. Analysis of cause of death listed on the death certificate showed an excess mortality attributable to lung cancer, digestive disease, and endocrine, nutritional, and metabolic disease. Menopausal females with an elevated CA-125 and without ovarian cancer are exposed to an increased risk of premature mortality.
    Keywords: Ca-125 ; Plco ; Ovarian Cancer Screening ; Medicine
    ISSN: 0090-8258
    E-ISSN: 1095-6859
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  • 10
    In: Perspectives on Sexual and Reproductive Health, December 2015, Vol.47(4), pp.163-170
    Description: CONTEXT: Native Hawaiians experience the highest reported rate of unintended pregnancy of any ethnic group in Hawaii. Understanding the context in which they make decisions that influence pregnancy and pregnancy planning is essential to reducing this rate.METHODS: A qualitative study was carried out in partnership with a community health center serving a large Native Hawaiian population to explore how Native Hawaiians conceptualize pregnancy and pregnancy planning. Between August and October 2013, semistructured interviews were conducted with 10 diverse key informants from the Hawaiian community. Content analysis was used to identify themes and patterns that emerged from the interviews.RESULTS: Core Hawaiian values of children and family strongly affect how Native Hawaiians view pregnancy, pregnancy planning and unintended pregnancies. 'Ohana (families) are large and characterized by tremendous support, which is perceived to lessen the burden of an unintended pregnancy. Pregnancies, whether planned or not, are seen as blessings because children are highly valued. Because of these concepts, there is an expectation for women to continue unplanned pregnancies. Although Hawaiians ascribe value to planning pregnancies and hope that children are born under what they identify as ideal circumstances, they acknowledge that these circumstances are not necessary and often do not occur.CONCLUSION: The concepts of family and children serve as core values to Native Hawaiians and are linked to the ways in which they view pregnancy and pregnancy planning.
    Keywords: Medicine ; Sociology & Social History;
    ISSN: 1538-6341
    E-ISSN: 1931-2393
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