ABSTRACT
OBJECTIVE: To evaluate the associations of caffeinated, alcoholic, and sweetened beverage intakes with antral follicle count (AFC), a well-accepted biomarker of ovarian reserve. DESIGN: Observational prospective cohort study. SETTING: Fertility center at an academic hospital. PATIENTS: This study includes 567 women seeking fertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study. INTERVENTION: None. Women self-reported consumption of caffeinated (coffee, tea, soda), alcoholic (wine, beer, liquor), sugar-sweetened, and artificially sweetened beverages using a validated food-frequency questionnaire. MAIN OUTCOME MEASURE: Antral follicle count was assessed using a transvaginal ultrasound performed on the 3rd day of an unstimulated menstrual cycle or on the 3rd day of a progesterone withdrawal bleed. RESULTS: Median (interquartile range) age and AFC were 35.0 (32.0-38.0) years and 13.0 (9.0-18.0), respectively. Median (range) intake of caffeinated, alcoholic, sugar-sweetened, and artificially sweetened beverages in servings/day were 1.08 (0-7.08), 0.35 (0-3.84), 0.04 (0-4.80), and 0.04 (0-7.50), respectively. All examined beverages were unrelated to AFC. The multivariable adjusted mean AFC (95% confidence interval) for women in the top and bottom quartiles of intake were 13.8 (13.0-14.7) and 13.8 (12.9-14.7) for caffeinated beverages; 13.8 (13.0-14.7) and 13.8 (13.0-14.6) for alcoholic beverages; 13.5 (12.6-14.4) and 13.3 (12.4-14.2) for sugar-sweetened beverages; and 13.2 (12.4-14.1) and 13.4 (12.6-14.3) for artificially sweetened beverages. CONCLUSION: Low-to-moderate intakes of caffeinated, alcoholic, sugar-sweetened, and artificially sweetened beverages were unrelated to ovarian reserve, as measured by AFC, in a cohort of women seeking fertility care.
Subject(s)
Ovarian Reserve , Beverages/adverse effects , Female , Humans , Prospective Studies , Sugars , Sweetening AgentsABSTRACT
OBJECTIVE: Current literature is insufficient to determine the acceptability of self-sampling as a primary method for cervical cancer screening among women from a regular screening population. The aim of this study was to determine the acceptability of self-sampling among women in the Region of Murcia as a primary screening tool. METHODS: We performed a cross-sectional study between April-May 2021, in a regional sample of 247 women ages 35-65 years. All participants were contacted and completed a survey by telephone which included sociodemographic characteristics, knowledge and attitudes towards cancer screening, and self-sampling assessment. We conducted weighted statistical analysis including descriptive, bivariate and a multivariate logistic regression model to examine the associations between women's characteristics and their preference for self-sampling compared to clinician sampling. RESULTS: A total of 89.4% of participants reported at least one previous cytology in the last 5 years, 88.7% with a frequency equal to or less than 3 years. Eighty-one percent of women preferred self-sampling over clinical sampling as a primary screening method. Basal characteristics were unrelated to women's preference for self-sampling (P-adjusted≥0.05). Feasibility and reliability were the main concerns perceived in relation to self-sampling (23.3% and 14.8%, respectively). CONCLUSIONS: Acceptability of self-sampling was high among women in the Region of Murcia. Self-sampling in conjunction with an adequate educational strategy could be a suitable approach to consider in the cervical cancer screening program.
OBJETIVO: Actualmente existe poca evidencia publicada sobre la aceptabilidad de la autotoma como prueba inicial de cribado del cáncer de cérvix en una población de mujeres que acuden a cribado regularmente. El objetivo del estudio fue determinar la aceptabilidad de la autotoma en mujeres de la Región de Murcia (RM) como prueba primaria de cribado. METODOS: Estudio transversal mediante encuesta telefónica a una muestra de 247 mujeres entre 35-65 años de la RM entre abril-mayo de 2021. Se recogieron las características sociodemográficas, los conocimientos, actitudes frente a los cribados de cáncer y valoración de la autotoma. Se realizó un análisis ponderado descriptivo, bivariante y regresión logística multivariante para determinar las características de las participantes relacionadas con su preferencia por la autotoma frente a la toma realizada por un profesional sanitario. RESULTADOS: El 89,4% de las mujeres refirieron realizarse alguna citología en los últimos 5 años, el 88,7% de ellas con una frecuencia ≤3 años. El 81% de las mujeres prefirieron la autotoma como prueba primaria de cribado para la detección del cáncer de cérvix. No se detectaron características relacionadas con la preferencia de la autotoma frente a la toma por un profesional sanitario (P-ajustado≥0,05). Los principales inconvenientes valorados de la autotoma fueron la factibilidad (23,3%) y fiabilidad de la prueba (14,8%). CONCLUSIONES: La aceptabilidad de la autotoma fue elevada entre las mujeres encuestadas de la RM. Sería conveniente valorar este método junto a una estrategia adecuada de educación a las mujeres dentro del programa de prevención del cáncer de cérvix.
Subject(s)
Papillomavirus Infections , Uterine Cervical Neoplasms , Adult , Aged , Cross-Sectional Studies , Early Detection of Cancer/methods , Female , Humans , Middle Aged , Papillomavirus Infections/diagnosis , Reproducibility of Results , Self Care/methods , Spain , Uterine Cervical Neoplasms/diagnosisABSTRACT
Fundamentos: Actualmente existe poca evidencia publicada sobre la aceptabilidad de la autotoma como prueba inicial de cribado del cáncer de cérvix en una población de mujeres que acuden a cribado regularmente. El objetivo del estudio fue determinar la aceptabilidad de la autotoma en mujeres de la Región de Murcia (RM) como prueba primaria de cribado. Métodos: Estudio transversal mediante encuesta telefónica a una muestra de 247 mujeres entre 35-65 años de la RM entre abril-mayo de 2021. Se recogieron las características sociodemográficas, los conocimientos, actitudes frente a los cribados de cáncer y valoración de la autotoma. Se realizó un análisis ponderado descriptivo, bivariante y regresión logística multivariante para determinar las características de las participantes relacionadas con su preferencia por la autotoma frente a la toma realizada por un profesional sanitario. Resultados: El 89,4% de las mujeres refirieron realizarse alguna citología en los últimos 5 años, el 88,7% de ellas con una frecuencia ≤3 años. El 81% de las mujeres prefirieron la autotoma como prueba primaria de cribado para la detección del cáncer de cérvix. No se detectaron características relacionadas con la preferencia de la autotoma frente a la toma por un profesional sanitario (P-ajustado≥0,05). Los principales inconvenientes valorados de la autotoma fueron la factibilidad (23,3%) y fiabilidad de la prueba (14,8%). Conclusiones: La aceptabilidad de la autotoma fue elevada entre las mujeres encuestadas de la RM. Sería conveniente valorar este método junto a una estrategia adecuada de educación a las mujeres dentro del programa de prevención del cáncer de cérvix.(AU)
Background: Current literature is insufficient to determine the acceptability of self-sampling as a primary method for cervical cancer screening among women from a regular screening population. The aim of this study was to determine the acceptability of selfsampling among women in the Region of Murcia as a primary screening tool. Methods: We performed a cross-sectional study between April-May 2021, in a regional sample of 247 women ages 35-65 years. All participants were contacted and completed a survey by telephone which included sociodemographic characteristics, knowledge and attitudes towards cancer screening, and self-sampling assessment. We conducted weighted statistical analysis including descriptive, bivariate and a multivariate logistic regression model to examine the associations between womens characteristics and their preference for selfsampling compared to clinician sampling. Results: A total of 89.4% of participants reported at least one previous cytology in the last 5 years, 88.7% with a frequency equal to or less than 3 years. Eighty-ne percent of women preferred self-sampling over clinical sampling as a primary screening method. Basal characteristics were unrelated to womens preference for self-sampling (P-adjusted≥0.05). Feasibility and reliability were the main concerns perceived in relation to self-sampling (23.3% and 14.8%, respectively). Conclusions: Acceptability of self-sampling was high among women in the Region of Murcia. Selfsampling in conjunction with an adequate educational strategy could be a suitable approach to consider in the cervical cancer screening program.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Mass Screening , Uterine Cervical Neoplasms , Early Detection of Cancer , Human Papillomavirus DNA Tests , Public Health , Spain , Gynecology , Surveys and Questionnaires , Cross-Sectional StudiesABSTRACT
BACKGROUND: Current evidence is insufficient to determine the contribution of stent grafts as treatment in partially thrombosed aneurysms or residual wall-adherent thrombi in arteriovenous fistulae (AVFs) for haemodialysis. The overall purpose of this study was to analyse patency rates of post-interventional covered stent deployment in those cases. We also assessed if patency rates differed when fistulas were punctured through the stent during dialysis sessions. METHODS: We conducted a retrospective study between 2006 and 2014 analysing post-intervention primary patency rates using the Kaplan-Meier log-rank test. Multivariate Cox proportional regression models were performed to determine if cannulation within the stent graft area was a potential risk factor for occlusion, by adjusted hazard ratio (HR). RESULTS: A total of 27 procedures were included in the study. Primary patency rates (%) after stent deployment at 3, 6, 12, 24, 36 and 72 months were, respectively: total 59, 32, 32, 21, 11 and 5; stent puncture 53, 21, 21, 16, 5 and 0; and no stent puncture 80, 80, 80, 40, 40 and 40. Cannulation through the stent graft was not significantly associated with increased risk of obstruction in multivariate analysis (HR = 3.01; P = 0.286). CONCLUSION: Stent graft treatment may be a feasible procedure in partially thrombosed aneurysms and residual thrombi in AVF. Although fistulas punctured through the stent presented lower patency rates, this practice was not associated with a higher risk of obstruction. Giving the impossibility of comparing with similar approaches, further studies are needed to confirm or refute the advantages of this procedure.
ABSTRACT
OBJECTIVE: To investigate the associations between dietary patterns and antral follicle count (AFC), a marker of ovarian reserve. DESIGN: Prospective cohort study. SETTING: Fertility center at an academic hospital. PATIENT(S): A total of 363 women seeking preconception evaluation and infertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study. INTERVENTION(S): None. At enrollment, women reported diet through a food frequency questionnaire, from which we computed three dietary pattern adherence scores: the Mediterranean diet, the Fertility diet, and the Profertility diet. MAIN OUTCOME MEASURE(S): The AFC was assessed with a transvaginal ultrasound performed on the third day of an unstimulated menstrual cycle or on the third day of a P withdrawal bleed. RESULT(S): Higher adherence to the three dietary patterns examined were unrelated to AFC. The multivariable adjusted AFC means and 95% confidence intervals for women in the highest compared with the lowest quartile of adherence score were 13.9 (13.0-14.9) and 13.5 (12.6-14.4) for the Mediterranean diet, 14.0 (13.2-14.9) and 13.5 (12.7-14.3) for the Fertility diet, and 12.5 (11.6-13.5) and 13.3 (12.5-14.2) for the Profertility diet. CONCLUSION(S): Dietary patterns were unrelated to AFC among a cohort of women presenting at a fertility center. Due to the limited and heterogeneous current evidence, it is important to evaluate this association in further studies, and in particular among women from the general population.
Subject(s)
Diet, Healthy , Diet, Mediterranean , Feeding Behavior , Infertility, Female/physiopathology , Ovarian Reserve , Adult , Diet Records , Female , Fertility Clinics , Humans , Infertility, Female/diagnosis , Infertility, Female/etiology , Nutritional Status , Nutritive Value , Prospective Studies , Risk Assessment , Risk FactorsABSTRACT
The aim of this study was to assess the associations of intake of different types of meat with semen parameters and reproductive hormones in healthy young men. This cross-sectional study included 206 men, 18-23 years, from Southern Spain. All men completed a validated FFQ, underwent a physical examination, and provided blood and semen samples. Multivariable linear regression was used to evaluate the associations between meat intake with semen quality parameters and reproductive hormones. Total meat intake was unrelated to semen quality or reproductive hormone levels. When subgroups of meat were separately considered, however, shellfish intake was positively related to progressive motility. The adjusted percentages of progressively motile spermatozoa for men in increasing quartiles of shellfish intake were 45·2, 42·0, 49·4 and 53·2 % with a significant linear trend across quartiles (P trend≤0·001). In contrast, men who consumed organ meats had significantly lower progressive sperm motility (51·5 v. 42·8 %; P = 0·001) and higher luteinising hormone levels (4·0 v. 4·6 IU/l; P = 0·03) compared with men who did not consume organ meats. Intake of shellfish and organ meats was low in this population, however. Given the scarcity of data on the relation between specific types of meat with semen quality and reproductive hormone levels, additional research is needed to confirm or refute these findings.
Subject(s)
Diet/statistics & numerical data , Meat/analysis , Semen Analysis/statistics & numerical data , Adolescent , Cross-Sectional Studies , Diet Surveys , Healthy Volunteers , Humans , Linear Models , Male , Spain , Sperm Motility , Young AdultABSTRACT
The purpose of this study was to analyze whether the anogenital distance (AGD) was associated with variability in semen parameters. Semen parameters analyzed following the WHO guidelines and sperm DNA fragmentation were evaluated in 160 semen samples obtained over a period of a year from 16 healthy male volunteers. Two types of AGD measurements from the anus to the rear base of the scrotum (AGDAS) and to the cephalic insertion of the penis (AGDAP) were taken in each individual. The association between AGDs and semen parameters were studied using three statistical tools: a) general coefficient of variation (CV) and intra-individual coefficient of variation (CVi), b) general linear models for repeated measures, and c) mixed model fixed effects panel data. Men with shortened AGDAP have significantly greater intra-individual variability in sperm concentration, total sperm count, and normal sperm morphology. Conversely, greater total sperm motility was observed in men with long AGDAS. Shortened AGDAS was associated with less intra-individual variability of total sperm motility (progressive and non-progressive). AGD measurements were associated with the variability in semen parameters. AGD may be useful to determine intra-individual variability in semen parameters. ABBREVIATIONS: AGD: anogenital distance; AGDAP: anogenital distance from the anus to the cephalic insertion of the penis; AGDAS: anogenital distance from the anus to the rear base of the scrotum; AIC: Akaike information criteria; BMI: body mass index; CV: general coefficient of variation; CVi: intra-individual coefficient of variation; GLM: generalized linear model; PR+NP: total sperm motility.
Subject(s)
Anal Canal/anatomy & histology , Penis/anatomy & histology , Scrotum/anatomy & histology , Spermatozoa/physiology , Adult , Biological Variation, Individual , DNA Fragmentation , Healthy Volunteers , Humans , Male , Prospective Studies , Sperm Count , Sperm Motility , Young AdultABSTRACT
An association between anogenital distance (AGD) and endometriosis has been reported, suggesting that AGD may be a useful clinical tool in endometriosis. The predictive ability of AGD of women in discriminating presence and type of endometriosis was examined. A case-control study was conducted at the University Hospital 'Virgen de la Arrixaca', Murcia, Spain, between 2014 and 2015. A total of 114 participants diagnosed with endometriosis using ultrasound findings and 105 controls were recruited. Two AGD measurements were obtained: one from the anterior clitoral surface to the upper verge of the anus (AGDAC), and another one from the posterior fourchette to the upper verge of the anus (AGDAF). Parametric and non-parametric tests andreceiver operator characterstic analyses were used to determine relationships between AGD and presence of endometriosis and subgroups (ovarian endometriomas or deep infiltrating endometriosis [DIE]). The AGDAF, but not AGDAC, was associated with presence of endometriomas, DIE (P-values, <0.001-0.02), or both. The highest area under curve (0.91; 95% CI 0.84 to 0.97) was obtained for the DIE subgroup with the AGDAF measurement, with a sensitivity and specificity of 84.4% and 91.4%, respectively. AGDAF can therefore efficiently discriminate the presence of DIE and may be a useful clinical tool.
Subject(s)
Anal Canal/anatomy & histology , Endometriosis/diagnosis , Genitalia, Female/anatomy & histology , Adult , Case-Control Studies , Endometriosis/pathology , Female , Humans , Predictive Value of Tests , ROC Curve , Sensitivity and Specificity , SpainABSTRACT
PURPOSE: The overall purpose of this study is to compare the accuracy of physical examination (PE) versus ultrasonography (US) in people with arteriovenous fistula (AVF). METHODS: This is a cross-sectional study with a total of 99 patients attended by the vascular radiology unit for AVF evaluation during January - March 2015. PE and ultrasonography were blinded performed by different radiologists. For complete and individual signs of PE, sensitivity, specificity, predictive positive (PPV) and negative (PNV) value, likelihood ratios (LR) and Cohen's κ value were measured. RESULTS: According to ultrasonography, the presence of stenosis was identified in 57 (58%) patients, and 61 (62%) by PE. The accuracy of PE for the diagnosis of AVF was sensitivity 82%, specificity 67%, PPV 77%, NPV 74%, LR 2.74 and 0.26. There was a moderate agreement beyond chance between PE and ultrasonography (κ = 0.5). CONCLUSIONS: PE has shown a moderate accuracy to detect stenosis. With non-ultrasonography availability Haemodialysis Units can get benefit to optimize VA survival and professionals should improve its basic skills.
Subject(s)
Arteriovenous Shunt, Surgical/adverse effects , Graft Occlusion, Vascular/diagnosis , Physical Examination , Renal Dialysis , Ultrasonography , Upper Extremity/blood supply , Aged , Aged, 80 and over , Constriction, Pathologic , Cross-Sectional Studies , Female , Graft Occlusion, Vascular/diagnostic imaging , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/physiopathology , Humans , Male , Middle Aged , Predictive Value of Tests , Regional Blood Flow , Vascular PatencyABSTRACT
BACKGROUND: Anogenital distance (AGD), the distance from the centre of the anus to the genitals, is a sexually dimorphic phenotype in mammals. Experimental studies have shown that AGD is a biomarker of prenatal androgen exposure during the masculinisation period of development. The aim of this study is to assess the relationship between anogenital distance (AGD), as an indirect marker of prenatal hormonal environment, and prostate cancer (PCa) severity. MATERIALS: We conducted a cross-sectional study with a total of 120 PCa patients with confirmed biopsy of the tumour from April 2007 to July 2015. Two variants of the anogenital distance were assessed, from the anus to the posterior base of the scrotum (AGDAS ) and to the cephalad insertion of the penis (AGDAP ). We compared differences in groups to evaluate the association between AGD measurements and severity of the preoperative biopsy and clinical scores. RESULTS: Longer AGDAS was significantly associated with the highest Gleason score (P = 0.015) and D'Amico nomogram (P = 0.048). In contrast, no statistical differences were found in the AGDAP and severity of the preoperative biopsy. CONCLUSIONS: These findings are consistent with the hypothesis that a higher prenatal androgen exposure is associated with higher severity of PCa. Prostate 77: 406-411, 2017. © 2016 Wiley Periodicals, Inc.
