ABSTRACT
A review is presented of the scientific evidence on preventive activities in women's care in relation to pregnancy follow-up, preventive activities in the planning and follow-up of contraceptive methods, preventive activities in menopause, and the prevention of osteoporotic fractures.
Subject(s)
Contraception , Women's Health , Female , Humans , PregnancyABSTRACT
BACKGROUND: The incidence of breast cancer has increased since the 1970s. Despite favorable trends in prognosis, the role of changes in clinical practice and the introduction of screening remain controversial. We examined breast cancer trends to shed light on their determinants. METHODS: Data were obtained for 8502 new cases of breast cancer in women between 1985 and 2012 from a population-based cancer registry in Granada (southern Spain), and for 2470 breast cancer deaths registered by the Andalusian Institute of Statistics. Joinpoint regression analyses of incidence and mortality rates were obtained. Observed and net survival rates were calculated for 1, 3 and 5 years. The results are reported here for overall survival and survival stratified by age group and tumor stage. RESULTS: Overall, age-adjusted (European Standard Population) incidence rates increased from 48.0 cases × 100,000 women in 1985-1989 to 83.4 in 2008-2012, with an annual percentage change (APC) of 2.5% (95%CI, 2.1-2.9) for 1985-2012. The greatest increase was in women younger than 40 years (APC 3.5, 95%CI, 2.4-4.8). For 2000-2012 the incidence trend increased only for stage I tumors (APC 3.8, 95%CI, 1.9-5.8). Overall age-adjusted breast cancer mortality decreased (APC - 1, 95%CI, - 1.4 - - 0.5), as did mortality in the 50-69 year age group (APC - 1.3, 95%CI, - 2.2 - - 0.4). Age-standardized net survival increased from 67.5% at 5 years in 1985-1989 to 83.7% in 2010-2012. All age groups younger than 70 years showed a similar evolution. Five-year net survival rates were 96.6% for patients with tumors diagnosed in stage I, 88.2% for stage II, 62.5% for stage III and 23.3% for stage IV. CONCLUSIONS: Breast cancer incidence is increasing - a reflection of the evolution of risk factors and increasing diagnostic pressure. After screening was introduced, the incidence of stage I tumors increased, with no decrease in the incidence of more advanced stages. Reductions were seen for overall mortality and mortality in the 50-69 year age group, but no changes were found after screening implementation. Survival trends have evolved favorably except for the 70-84 year age group and for metastatic tumors.
Subject(s)
Breast Neoplasms/epidemiology , Breast Neoplasms/mortality , Adult , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Incidence , Middle Aged , Registries , Spain/epidemiology , Survival AnalysisABSTRACT
No disponible
Subject(s)
Humans , Female , Pregnancy , Health Promotion , Women's Health Services , SpainABSTRACT
No disponible
Subject(s)
Humans , Female , Pregnancy Complications/prevention & control , Perinatal Death/prevention & control , Diabetes, Gestational/prevention & control , Chagas Disease/prevention & control , Toxoplasmosis, Congenital/prevention & control , Women's Health , Primary Health Care/organization & administration , Practice Patterns, Physicians' , Infectious Disease Transmission, Vertical/prevention & controlABSTRACT
No disponible
Subject(s)
Humans , Female , Women's Health , Pregnancy Complications/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Chagas Disease/prevention & control , Toxoplasmosis/prevention & control , Primary Prevention/organization & administration , Health Promotion/organization & administration , Primary Health Care/organization & administrationABSTRACT
La infección por Streptococcus agalactiae, estreptococo grupo B (EGB), continúa siendo la causa más frecuente de sepsis neonatal de etiología bacteriana. En 2003, las Sociedades Españolas de Ginecología y Obstetricia, Neonatología, Enfermedades Infecciosas y Microbiología Clínica, Quimioterapia y Medicina Familiar y Comunitaria publicaron recomendaciones actualizadas para la prevención de la infección neonatal precoz por EGB. En ellas se recomendaba la identificación de gestantes portadoras de EGB mediante cultivo de muestra de exudado vaginorrectal realizado en las 35-37 semanas de gestación y la administración de profilaxis antibiótica intraparto (PAI) a todas las gestantes colonizadas. En estas nuevas recomendaciones se actualizan los métodos microbiológicos para realizar la identificación de portadoras de EGB y la técnica de sensibilidad a antibióticos; se revisan los antibióticos de primera línea que pueden usarse para PAI (penicilina, ampicilina, cefazolina) y sus alternativas (clindamicina y vancomicina); se clarifica el significado de la presencia de EGB en orina, incluyendo criterios para el diagnóstico de infección urinaria y bacteriuria asintomática por EGB en la embarazada; se define el uso de PAI en la amenaza de parto prematuro y rotura prematura de membranas, y se revisa el manejo del recién nacido en relación con el estado de portadora de EGB de la madre. Estas recomendaciones solo son válidas para la prevención de la infección neonatal precoz por EGB, y no son efectivas frente a la infección neonatal tardía. Tras la aplicación generalizada de la PAI, la incidencia de la sepsis neonatal precoz por EGB ha disminuido (..) (AU)
Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including (..) (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Streptococcal Infections/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Streptococcus agalactiae/pathogenicity , Practice Patterns, Physicians' , Antibiotic Prophylaxis , Carrier State/diagnosis , Early DiagnosisABSTRACT
Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.
Subject(s)
Streptococcal Infections/prevention & control , Streptococcus agalactiae , Antibiotic Prophylaxis , Decision Trees , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Spain , Streptococcal Infections/diagnosis , Streptococcal Infections/therapySubject(s)
Humans , Female , Pregnancy Tests/ethics , Pregnancy Tests/methods , Hot Flashes/diagnosis , Hot Flashes/pathology , Epidemiological Monitoring/trends , Women's Health/ethics , Women's Health/statistics & numerical data , Women's Health/trends , Pregnancy Tests/statistics & numerical data , Pregnancy Tests/standards , Pregnancy Tests/trends , Menopause/psychology , Hot Flashes/etiology , Women's Health Services/organization & administration , Women's Health Services/supply & distribution , Women's Health Services/statistics & numerical data , Women's Health Services/standardsABSTRACT
It has been a significant reduction in neonatal group B streptococcus (GBS) infection in Spain following the widespread application of intrapartum antibiotic prophylaxis. In 2010, new recommendations have been published by the CDC and this fact, together with the new knowledge and experience available, has driven to the participating scientific societies publishing these new recommendations. In these recommendations is advised to study all pregnant women at 35-37 gestation weeks` to determine if they are colonized by GBS and to administer intrapartum antibiotic prophylaxis (IAP) to all colonized mothers. Microbiological methods to identify pregnant GBS carriers are updated and intrapartrum antibiotic prophylaxis in preterm labour and premature rupture of membranes and the management of the newborn in relation to GBS carrier status of the mother are also revised.
Subject(s)
Pregnancy Complications, Infectious/prevention & control , Streptococcal Infections/prevention & control , Streptococcus agalactiae , Adult , Carrier State/microbiology , Carrier State/prevention & control , Female , Humans , Infant, Newborn , Infant, Premature , Obstetric Labor, Premature , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/microbiology , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiologyABSTRACT
Como consecuencia aplicación de la profilaxis antibiótica intraparto ha ocurrido una importante reducción de la infección neonatal por estreptococo grupo B en nuestro país. En 2010 se han publicado nuevas recomendaciones por los CDC y este hecho, junto con los nuevos conocimientos disponibles, ha llevado a las sociedades participantes a publicar estas nuevas recomendaciones. En ellas se mantiene el criterio de administrar profilaxis intraparto a todas las embarazadas colonizadas por EGB, se actualizan las técnicas de diagnostico de portadoras y se clarifica la actuación frente al parto prematuro y a los recién nacidos a riesgo de infectarse(AU)
It has been a significant reduction in neonatal group B streptococcus (GBS) infection in Spain following the widespread application of intrapartum antibiotic prophylaxis. In 2010, new recommendations have been published by the CDC and this fact, together with the new knowledge and experience available, has driven to the participating scientific societies publishing these new recommendations. In these recommendations is advised to study all pregnant women at 35-37 gestation weeks` to determine if they are colonized by GBS and to administer intrapartum antibiotic prophylaxis (IAP) to all colonized mothers. Microbiological methods to identify pregnant GBS carriers are updated and intrapartrum antibiotic prophylaxis in preterm labour and premature rupture of membranes and the management of the newborn in relation to GBS carrier status of the mother are also revised(AU)
Subject(s)
Humans , Male , Female , Perinatal Care/methods , Perinatal Care/organization & administration , Societies, Medical/organization & administration , Societies, Medical/standards , Chorioamnionitis/epidemiology , Antibiotic Prophylaxis/methods , Antibiotic Prophylaxis , Antibiotic Prophylaxis/trends , Mass Screening/methodsABSTRACT
No disponible
Subject(s)
Humans , Female , Contraception/methods , Emergency Medical Services/methods , Emergency Medicine/methods , Emergency Medicine/trends , Emergency Treatment/methods , Emergency Treatment/trends , Family Development PlanningSubject(s)
Contraception, Postcoital , Adolescent , Adult , Contraception, Postcoital/statistics & numerical data , Female , Humans , Young AdultABSTRACT
BACKGROUND: User profile, continuation rate, reasons for discontinuation, problems during insertion and removal, and effectiveness of an etonogestrel subdermal contraceptive implant (ESCI) were assessed. STUDY DESIGN: A follow-up of 372 women 3 years after insertion of an ESCI performed by family physicians in Granada, Spain, by means of consultations, examination of medical records and telephone interviews. RESULTS: Data were available for 356 (95.7%) women. The average age was 27.2 years, and 159 (42.7%) were nulliparous. Continuation rates were 91.0% at 1 year, 74.7% at 2 years and 65.1% at 2 years and 9 months. The main reasons for discontinuation were excessive bleeding (44, 12.4%), wish to become pregnant (44, 12.4%) and side effects not related to menstruation (21, 5.9%). However, 141 (39.6%) received a second implant when the first one expired. No pregnancy occurred in 893.4 women-years. CONCLUSIONS: Family physicians can achieve excellent results with the ESCI. It should be included in the range of contraceptives offered by primary care physicians.
Subject(s)
Contraception Behavior/statistics & numerical data , Contraceptive Agents, Female/administration & dosage , Desogestrel/administration & dosage , Family Practice/statistics & numerical data , Adolescent , Adult , Contraceptive Agents, Female/adverse effects , Desogestrel/adverse effects , Drug Implants , Female , Follow-Up Studies , Humans , Menstruation Disturbances/chemically induced , Middle Aged , Spain , Treatment Outcome , Young AdultABSTRACT
No disponible
