Evaluation of the Heart Failure in Internet Patient Information: Descriptive Survey Study.

Patients with heart failure (HF) may not receive enough HF education from their clinicians throughout the course of the illness. Given that information is readily accessible on the Internet, patients with HF may seek HF information online. However, the relevance of online information for patients, the health literacy demand, and quality of the information is unknown. The purpose of this study was to compare the HF topics available online with topics HF patients perceived to be important and to evaluate the health literacy demand and quality of online HF information. The most popular search engines and a website that ranks the popularity of the websites were searched to identify websites with HF information. The health literacy demand and quality of the information were evaluated using the Patient Education Material Evaluation Tool for Print Materials and the DISCERN tool, respectively. First, the HF Patients' Learning Needs Inventory (HFPLNI) was used to determine whether the websites included the 46 topics identified in this inventory. Patients with HF (n = 126) then completed the HFPLNI to rate the perceived importance on each topic. A chi-square test was used to compare the differences between the topics on the websites and those patients perceived to be important. Of the 46 topics, 39 were less likely to be included on the websites even though patients perceived that they were important topics. Information on the websites (n = 99) was not written could not be easily understood by patients and did not meet the overall health literacy demands of 58.0% and 19.8% of the patients, respectively. Only one-fifth of the websites were rated as fair to good quality. Online HF information had high health literacy demand and was poor quality with mostly generic HF information, which did not meet patients' information needs. Websites need to be developed reflecting patients' learning needs with low health literacy demand and good quality.

Transient Occlusion of Uterine Arteries in Procedures with High Risk of Uterine Bleeding.

INTRODUCTION: Uterine-conservative surgery via laparoscopy is a challengeable and high risk because of heavy intra-operative bleeding events in reproductive women with highly vascular uterine benign disease. There are three reported cases of women with highly vascular uterine benign diseases and high risk of intra-operative heavy bleeding, but were treated successfully to control intra-operative heavy bleeding risk by transient occlusion of the uterine artery (TOUA) through laparoscopy and resulted in safe conservation of the uterus. CASE PRESENTATION: The cases of women with high risk of heavy bleeding during therapeutic procedure included cesarean scar pregnancy, hydatid form mole on cesarean scar, and cervical pregnancy. All these women had the strong desire to presere their fertility and uterus. In all the three cases, we used the method of TOUA and performed therapeutic surgeries successfully, with less bleeding and safe conservation of the uterus through laparoscopy. CONCLUSION: Laparoscopic TOUA could be a therapeutic option to manage heavy intra-operative bleeding during conservative uterine surgeries associated with the risk of heavy bleeding.

Increased expression of nuclear factor kappa-B p65 subunit in adenomyosis.

OBJECTIVE: Nuclear factor kappa-B (NF-κB) is a critical proinflammatory regulator that has been suggested to play a pivotal role in the pathogenesis and pathophysiology of endometriosis. In the present study, we aimed to evaluate whether the expression of NF-κB p65 subunit is increased in the eutopic endometrium and/or in the adenomyosis nodule of women with adenomyosis. METHODS: Thirty-three women with histologically confirmed adenomyosis after laparoscopic or transabdominal hysterectomy were recruited. Women with carcinoma in situ of uterine cervix without evidence of adenomyosis or endometriosis (n=32) served as controls. Formalin-fixed, paraffin-embedded archival tissues were sectioned and immunostained utilizing a monoclonal anti-human NF-κB p65 subunit antibody, and the immunoreactivity of NF-κB p65 subunit was compared between women with and without adenomyosis. RESULTS: The immunoreactivities of both the nuclear and the cytoplasmic NF-κB p65 subunit were significantly increased in the stromal cells in the eutopic endometrium as well as in the adenomyosis nodule of women with adenomyosis compared with controls, respectively. The nuclear expression of NF-κB p65 subunit was significantly higher in the glandular cells in the eutopic endometrium as well as the adenomyosis nodule of women with adenomyosis compared with controls, respectively. CONCLUSION: The expression of NF-κB p65 is increased in the eutopic endometrium and adenomyosis nodule of women with adenomyosis, which strongly suggest that NF-κB plays a critical role in the pathogenesis and/or pathophysiology of adenomyosis.

Awareness and experience of menopausal symptom and hormone therapy in korean postmenopausal women.

OBJECTIVES: To investigate awareness and experience of menopausal symptom and hormone therapy in Korean postmenopausal women. METHODS: A total of 570 postmenopausal women were accepted our survey. The women filled out the questionnaires composed of medical and surgical history, menopausal age and symptom, demand of treatment on menopausal symptom, and personal method for overcoming the symptom. Also, we make inquiries about experience of hormone therapy, concern about hormone therapy, improvement of menopausal symptom after therapy, adverse effect, and cause of cease the therapy. RESULTS: According to the survey, 80% (456/570) of the women experienced menopausal symptom. When they felt the symptom at first, 47% (213/570) of women was 46-50 years old. The most common menopausal symptom was hot flushes (141/570). A number of Korean women regarded that menopause was a natural process of ageing (69%). Eighty two % of women thought to need to have treatment on menopausal symptom. However, only half (43%) visited doctor. The most concerned disease after menopause they had answered was osteoporosis (60%) but only 22% of women were taken regular check-up of bone mineral density. The common causes were unwilling to do treatment were concern about adverse effect (51%) and indefinite fear of cancer (32%). Moreover, many women got diverse information about menopause from the mass media than professional advice. CONCLUSION: Only a minority of Korean postmenopausal women with menopausal symptoms had taken a hormone therapy. We should provide appropriate education and counsel to Korean peri-menopause women.