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1.
Menopause ; 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39042017

RESUMO

OBJECTIVE: The aim of this study was to compare the efficacy of a non-hormone alternative, vaginal hyaluronic acid (HLA), to a standard-of-care therapy, vaginal estrogen, for the treatment of genitourinary syndrome of menopause (GSM). METHODS: This was a randomized, parallel arm pilot trial. Women with GSM were randomized to an HLA vaginal suppository or vaginal estrogen cream for 12 wk to compare the primary outcome, the vulvovaginal symptom questionnaire (VSQ) score. Secondary outcomes included the following: the female sexual function index (FSFI), the vaginal symptom index (VSI), visual analog scale (VAS) for dyspareunia, vaginal itching, and vaginal dryness, patient global impression of improvement (PGI-I) at follow-up, vaginal maturation index, and vaginal pH. Differences between treatment groups were estimated using the two-sided, two-sample t-test and 95% confidence intervals. RESULTS: Forty-nine women were randomized and 45 participants (vaginal estrogen = 23, vaginal HLA = 22) provided data at week 12. Baseline characteristics were similar in both groups. On the VSQ, there was no observed difference in overall scores between the HLA and vaginal estrogen groups at 12 wk (P = 0.81). Improvement was seen within both treatment groups on the VSQ after 12 wk. The VAS score, total VSI score, total FSFI score, and vaginal pH improved over time; however, improvement did not differ between study arms. Over 90% participants noted improvement on the PGI-I in both groups (P = 0.61). No treatment-related serious adverse events occurred. CONCLUSIONS: There were no clinically meaningful differences between vaginal HLA and vaginal estrogen for the treatment of GSM after 12 wk. Vaginal HLA may be a promising non-hormone therapy for GSM.

2.
Urogynecology (Phila) ; 30(3): 352-362, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38484253

RESUMO

IMPORTANCE: Urinary incontinence (UI) is a common and treatable medical condition among women, but only approximately one third of women seek care. OBJECTIVE: The objective of this study was to determine factors associated with care-seeking behavior in women with UI. STUDY DESIGN: This was a cross-sectional study using patient-reported survey data collected by the National Association for Continence from November 2018 to January 2019. This survey included 60 questions and was conducted using SurveyMonkey. Descriptive statistics were used for baseline characteristics, the χ2 test was used for categorical variables, and multivariate logistic regression was used to determine predictors of care-seeking behavior. RESULTS: Four hundred eighty-five women completed the survey, 30.7% were not care seeking, and 69.3% were care seeking for UI. Most women were 55 years or older and had UI for more than 4 years. Care-seeking women had more overactive bladder symptoms. Women who sought care were more likely to report feelings of anger, depression, hopelessness, isolation, and report greater social effects from UI than non-care-seeking women. Less than 10% of women who sought care were asked about their UI by a medical professional. In the multivariate logistic regression expenditure of $5 or more on monthly incontinence maintenance, daily UI and older age were associated with seeking care. CONCLUSIONS: Most women in our study population sought care for UI. Factors associated with seeking care were expenditure greater than $5 per month on incontinence, daily UI, and age. This information demonstrates the need for effective implementation of screening interventions to increase treatment access.


Assuntos
Bexiga Urinária Hiperativa , Incontinência Urinária , Humanos , Feminino , Estudos Transversais , Incontinência Urinária/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Bexiga Urinária Hiperativa/epidemiologia , Inquéritos e Questionários
3.
J Minim Invasive Gynecol ; 29(6): 738-742, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35085836

RESUMO

STUDY OBJECTIVE: To determine the feasibility of  intravenous indocyanine green (ICG) dye use in patients with adnexal torsion to intraoperatively evaluate ovarian perfusion after detorsion. DESIGN: A prospective multicenter single-arm feasibility study. SETTING: A teaching hospital. PATIENTS: A total of 12 nonpregnant patients, 18 to 45 years old with surgically confirmed adnexal torsion. INTERVENTIONS: Torsion was surgically confirmed, the involved adnexa were untwisted laparoscopically, and ICG dye was injected intravenously. The absence or presence of ICG perfusion was documented, and the clinical decision for ovarian conservation or removal was determined by the surgeon. MEASUREMENTS AND MAIN RESULTS: The primary outcome was feasibility of using ICG dye including measures such as time to visualized perfusion and operative time. Secondary outcomes included presence or absence of ovarian preservation and postoperative follow-up measures. Intraoperative visualization of ICG perfusion to the detorsed adnexa was achieved in 10 patients (83%) in a median time of 1 minute (0, 2), resulting in entire (n = 9) or partial (n = 1) ovarian conservation. Perfusion was absent in 2 cases, and postoophorectomy histologic necrosis was confirmed in one case. Median operative time was 74 minutes (48, 94). There were no adverse events related to ICG dye use. CONCLUSION: Intraoperative ICG dye use in this study was logistically feasible and conservation of the entire or partial ovary was observed in 83% of patients, including one case where preoperative Doppler flow was absent.


Assuntos
Verde de Indocianina , Torção Ovariana , Anexos Uterinos , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
4.
Electrophoresis ; 31(9): 1583-5, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20358539

RESUMO

The peak parking method was used to determine the obstruction factor of lauryl acrylate porous polymer monoliths. Polymers were prepared in situ in fused-silica capillaries using thermally initiated polymerization. These columns have been used for CEC of neutral analytes. Thiourea, which is unretained, was used as the test analyte for the obstruction factor measurement. The obstruction factor was determined to be 0.72 with a SD of (+/-0.01), which is consistent with the concept that organic porous polymer monoliths are more permeable than traditional LC stationary phases.


Assuntos
Acrilatos/química , Eletrocromatografia Capilar/métodos , Difusão , Modelos Lineares , Modelos Químicos , Polímeros/química , Tioureia/química
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