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2.
Health Psychol ; 12(3): 209-14, 1993 May.
Artigo em Inglês | MEDLINE | ID: mdl-8500450

RESUMO

The motivational and cognitive processes of behavior change in the area of screening mammography were investigated. A total of 676 women, 40 to 79 years old, were recruited for telephone interview through random selection from designated census tracts and were asked questions that assessed mammography stage-of-adoption and decisional balance constructs from the trans-theoretical model of behavior change. Two definitions of stage of adoption were used. Analysis of covariance showed that a history of regular screening and an intention to continue having the exam were associated with a more favorable decisional balance. Results replicated a prior investigation and demonstrated the usefulness of stage of adoption and decisional balance as guides for designing stage-matched interventions to increase rates of mammography.


Assuntos
Neoplasias da Mama/diagnóstico , Adulto , Idoso , Neoplasias da Mama/prevenção & controle , Tomada de Decisões , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Mamografia , Pessoa de Meia-Idade
3.
J Public Health Policy ; 13(1): 52-65, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1629360

RESUMO

The Rhode Island Department of Health has undertaken a Breast Cancer Screening Program which incorporates assessment, policy development, and assurance functions, following the model proposed in the Institute of Medicine (IOM) report, The Future of Public Health. With the community's help, projects have been implemented to increase screening capacity with dedicated, state-of-the-art equipment, to increase screening accessibility, to publicize the need for mammography, and to minimize false test results. In the program's first 15 months, the proportion of women ages 40 and over who were screened with mammography according to current guidelines increased from 35 to 46 percent (from 38 to 49 percent among women ages 40-49; from 31 to 43 percent among women ages 50 and over), including 15 percent who received their first screening mammogram. Providers' recommendations and knowledge of screening guidelines were important in explaining first-time use. The Department plans to apply the IOM model in other program areas. Its adoption by others is urged.


Assuntos
Neoplasias da Mama/prevenção & controle , Mamografia/estatística & dados numéricos , Programas de Rastreamento/organização & administração , Administração em Saúde Pública , Adulto , Fatores Etários , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Mamografia/normas , Formulação de Políticas , Avaliação de Programas e Projetos de Saúde , Rhode Island , Estados Unidos
4.
Public Health Rep ; 106(4): 410-20, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1908592

RESUMO

In late 1987, a total of 852 Rhode Island women ages 40 and older were interviewed by telephone (78 percent response rate) to measure their use of breast cancer screening and to investigate potential predictors of use. Predictors included the women's socioeconomic status, use of medical care, a provider's reported recommendations for screening, and the women's health beliefs about breast cancer and mammography. The Health Belief Model guided the construction of the interview questions and data analysis. Logistic regression was used to identify leading independent predictors of breast cancer screening according to contemporary recommendations: reporting that a medical provider had ever recommended a screening mammogram (odds ratio [OR] = 18.77), having received gynecological care in the previous year (OR = 4.92), having a regular source of gynecological care (OR = 2.63), having ever had a diagnostic mammogram (OR = 2.32), and perceiving mammography as safe enough to have annually (OR = 1.93). The findings suggest that programs intended to increase the use of breast cancer screening should include "inreach" and "outreach" elements; inreach to patients with established patient-provider relationships, by assuring that physicians recommend screening to all eligible patients, and outreach to all eligible women, by helping them overcome barriers to effective primary care, and by promoting mammography, emphasizing its effectiveness and safety. The findings also suggest that socioeconomically disadvantaged women, who are less likely to be screened than other women, should become special targets of inreach and outreach interventions.


Assuntos
Neoplasias da Mama/prevenção & controle , Comportamentos Relacionados com a Saúde , Programas de Rastreamento/estatística & dados numéricos , Modelos Psicológicos , Adulto , Idoso , Coleta de Dados , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Entrevistas como Assunto , Funções Verossimilhança , Mamografia/psicologia , Mamografia/estatística & dados numéricos , Programas de Rastreamento/psicologia , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Avaliação de Programas e Projetos de Saúde , Rhode Island , Autoexame/psicologia , Autoexame/estatística & dados numéricos , Inquéritos e Questionários
5.
Clin Dysmorphol ; 1(4): 221-7, 1992 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-1342874

RESUMO

Two siblings with a previously undescribed syndrome are presented. They both have severe dwarfism, antenatal in origin, with generalized chondrodysplasia, severe microcephaly with cerebellar vermis hypoplasia, a hypoplastic iris and a papillous coloboma (Coloboma of the optic disc). The first sibling has a 46,XY karyotype despite normal female internal and external genitalia. She has moderate mental retardation. Gestation of the second sibling was interrupted after antenatal diagnosis. The fetus was 46,XX and very similar to the first case.


Assuntos
Anormalidades Múltiplas/genética , Transtornos do Desenvolvimento Sexual/genética , Genes Recessivos , Osteocondrodisplasias/genética , Sistema Nervoso Central/anormalidades , Anormalidades do Olho/genética , Feminino , Retardo do Crescimento Fetal/genética , Humanos , Recém-Nascido , Osteocondrodisplasias/congênito , Osteocondrodisplasias/diagnóstico por imagem , Radiografia , Síndrome
6.
Artigo em Francês | MEDLINE | ID: mdl-1328353

RESUMO

Multiple lutein cyst (MLC) and luteoma are two aspects of ovarian hyperplasia induced by high levels of human chorionic gonadotrophin (HCG). Using a case report of MLC, the authors compare it with luteoma (the anatomoclinical and pathogenic data). Luteoma are more frequent with multipara, whereas MLC are more often seen with paucipara. Maternal virilization can occur in both cases but MLC does not seem to be responsible for fetal virilization. The fetus could be protected by the placenta, thanks to increased aromatase activity and sex binding globulin production. MLC and luteoma are usually found by chance. The pathology must be known, because of their spontaneous regression after delivery. So, the attitude will be conservative under the control of biopsies.


Assuntos
Cistos Ovarianos/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações na Gravidez/diagnóstico , Tumor da Célula Tecal/diagnóstico , Adulto , Gonadotropina Coriônica/fisiologia , Diagnóstico Diferencial , Feminino , Humanos , Regressão Neoplásica Espontânea , Cistos Ovarianos/etiologia , Cistos Ovarianos/cirurgia , Paridade , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/cirurgia , Complicações Neoplásicas na Gravidez/etiologia , Complicações Neoplásicas na Gravidez/cirurgia , Tumor da Célula Tecal/etiologia , Tumor da Célula Tecal/cirurgia
7.
Artigo em Francês | MEDLINE | ID: mdl-7252085

RESUMO

The authors have used the cytological investigation of the liquid discharge from the breast to search systematically for cancerous states and, more usually, for borderline conditions in the breast. Using a simple technique it has been possible to obtain some discharge from the breast more or less easily. In 15 per 1000 cases cytological abnormalities have been found, which means that there were 39 pathological discharges in the 2490 women who were examined over five years. 27 of these were benign lesions and 12 of them were suspect. Of these latter three borderline conditions were found and one invasive cancer was found. All four were asymptomatic. It is therefore worth while examining discharges from the breast in screening for borderline conditions in young women.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/metabolismo , Adulto , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Lesões Pré-Cancerosas
8.
Artigo em Francês | MEDLINE | ID: mdl-8040572

RESUMO

The authors report a case of bilateral ovarian steroid cell tumour, not otherwise specified (as subclassified now by Scully). For two years a 46-year-old woman had androgenic manifestations. Only plasma testosterone level was increased. A hysterectomy with bilateral ovariectomy was performed. The first diagnosis was bilateral Leydig cell tumour, but no Reinke crystal was found. The final diagnosis was steroid cell tumour, not otherwise specified. No significant nuclear atypia or mitotic activity were found and two-year follow-up was favourable. The authors discuss the difficulty to class some ovarian tumours between Leydig cell tumour and steroid cell tumour, not otherwise specified as defined by Scully.


Assuntos
Neoplasias de Tecido Gonadal/patologia , Neoplasias Ovarianas/patologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Histerectomia , Pessoa de Meia-Idade , Neoplasias de Tecido Gonadal/sangue , Neoplasias de Tecido Gonadal/classificação , Neoplasias de Tecido Gonadal/complicações , Neoplasias de Tecido Gonadal/cirurgia , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/classificação , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/cirurgia , Ovariectomia , Testosterona/sangue , Virilismo/etiologia
9.
Artigo em Francês | MEDLINE | ID: mdl-7730573

RESUMO

A young woman became pregnant 36 months after a liver transplant following an episode of fulminant hepatitis A. At 38 weeks gestation, she delivered by cesarean section following an isolated and moderate elevation of her transaminase enzymes, indicating rejection of the graft. This was later confirmed by liver biopsy. Following augmentation of steroid therapy her postnatal progress was good. The infant progressed quite well. This case raises the question of the management of pregnant women following liver transplantation, with elevated transaminase levels.


Assuntos
Rejeição de Enxerto/enzimologia , Transplante de Fígado , Complicações na Gravidez/enzimologia , Transaminases/sangue , Corticosteroides/uso terapêutico , Adulto , Cesárea , Feminino , Rejeição de Enxerto/tratamento farmacológico , Humanos , Gravidez , Complicações na Gravidez/tratamento farmacológico
10.
Artigo em Francês | MEDLINE | ID: mdl-2071861

RESUMO

Fetal cystic hygroma (CH) are congenital malformation of the lymphatic system which are seen in antenatally ultrasonography from the end of the first trimester of pregnancy. From a 13 CH retrospective study, the authors discuss the ultrasound diagnosis, the prognosis and the management of CH. In our study, CH is associated with lymphedema (69%), hydrops (46%), diminution of amniotic fluid (69%) and other abnormality (31%). In all cases a diminution or an absence of fetal movement are found. In seven cases a cytogenetic analysis are performed on amniocentesis or fetal tissues: there are five 45XO, one 47XX + 13 and one 46XX. In six cases the chromosome culture failed: two male phenotypes and two histologic appearances of chromosomic anomaly. The prognosis depends on chromosome analysis, other ultrasound abnormality and the size of CH. It is usually fatal in utero. If chromosome anomaly are found, a genetic counsel is proposed.


Assuntos
Doenças Fetais/diagnóstico por imagem , Linfangioma/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Adulto , Feminino , Doenças Fetais/genética , Doenças Fetais/patologia , Humanos , Cariotipagem , Linfangioma/genética , Linfangioma/patologia , Doenças Linfáticas/genética , Doenças Linfáticas/patologia , Fenótipo , Gravidez , Prognóstico , Estudos Retrospectivos , Ultrassonografia Pré-Natal
11.
Artigo em Francês | MEDLINE | ID: mdl-1228217

RESUMO

We herewith report 400 cases of forceps delivery under local regional block anesthesia of the internal pudental nerves. They were carried out together with routine episiotomy. The indications were the purely classical ones and the results were good. There were very few fetal complications and these were in all instances mild. There were very few maternal complications. So long as some precautious are taken we have in our hands an excellent method for extracting a baby with instruments and it should not have come into disrepute as it has (in comparison with the vacuum extractor).


Assuntos
Anestesia por Condução/métodos , Anestesia Obstétrica/métodos , Extração Obstétrica/métodos , Adulto , Peso ao Nascer , Feminino , Feto , Humanos , Gravidez , Complicações na Gravidez
12.
Artigo em Francês | MEDLINE | ID: mdl-7217638

RESUMO

The authors report five cases of fertile women who have Karyotype XO. After a short review of the classification of Turner's syndrome and of the physiopathology of the defective gonads in these patients, 79 cases in the literature and these 5 cases were reviewed and they allow us: a precise description of the morphology of these patients, which is dominated by the high incidence of small growth and the presence of the various degrees of malformations often found in Turner's syndrome; to study the gonad structure and function of these patients who have spontaneous menstruation. And finally to analyse the prognosis of pregnancies that have occurred in 33 women with an XO clone. These women have not only a raised incidence of spontaneous abortions at 32% but also frequent fetal malformations and chromosome abnormalities in the products of conception. It is therefore vital to carry out early amniocentesis in these patients.


Assuntos
Complicações na Gravidez , Síndrome de Turner/genética , Anormalidades Múltiplas , Aborto Espontâneo/etiologia , Feminino , Fertilidade , Genitália Feminina/patologia , Humanos , Recém-Nascido , Cariotipagem , Masculino , Menstruação , Mosaicismo , Gravidez , Cromossomos Sexuais/análise
13.
Artigo em Francês | MEDLINE | ID: mdl-739123

RESUMO

The fraction of complement C3, the total complement activity and the levels of IgG, IgA and IgM immunoglobulins have been estimated in the third trimester of pregnancy in 70 control pregnant women and in 38 hypertensive pregnant women who presented either with "pure toxaemia" or with "superimposed toxaemia". The level of IgG is definitely but not significantly lowered in cases of "pure toxaemia". The other parameters that were studied showed no notable changes in comparison with control pregnant women.


Assuntos
Complemento C3/análise , Proteínas do Sistema Complemento/análise , Imunoglobulinas/análise , Pré-Eclâmpsia/imunologia , Gravidez , Feminino , Humanos , Imunoglobulina A/análise , Imunoglobulina G/análise , Imunoglobulina M/análise
14.
Artigo em Francês | MEDLINE | ID: mdl-1955666

RESUMO

RDS in adults is an unusual complication of pregnancy. We analysed a case of adult respiratory distress syndrome during pregnancy and assessed the haemodynamic data under controlled ventilation whilst a spontaneous delivery was carried out. The rapid drop in pulmonary artery pressure and in the QS-QT complex after the delivery suggests that there may be a placental shunt which gives a too high reading for exaggeration of the left to right intrapulmonary shunt figures obtained.


Assuntos
Parto Obstétrico/métodos , Hemodinâmica , Complicações na Gravidez/fisiopatologia , Respiração Artificial/métodos , Síndrome do Desconforto Respiratório/fisiopatologia , Adulto , Feminino , Humanos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Síndrome do Desconforto Respiratório/diagnóstico , Síndrome do Desconforto Respiratório/terapia
18.
Am J Public Health ; 80(2): 158-61, 1990 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2297057

RESUMO

Death certificates for residents of Nassau County, New York dying between 1980 and 1982 were examined for causes of death defined as Sentinel Health Events (Occupational) (SHE(O]. Of 16,193 deaths from all causes, 2,286 (14.1 percent) were identified as SHE(O) deaths; 142 (6.2 percent) of these were matched for occupational and/or industry, 13 (9.2 percent) of which required no further match [corrected] because the cause of death was inherently related to the occupation or industry. Malignant neoplasms of the trachea, bronchus, or lung were the most frequently occurring SHE(O), accounting for 60 percent of all SHE(O) deaths and 81 percent of matched SHE(O) deaths. The construction industry was associated with the vast majority of such deaths.


Assuntos
Causas de Morte , Atestado de Óbito , Doenças Profissionais/mortalidade , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , New York/epidemiologia , Doenças Profissionais/etiologia , Ocupações , Pneumoconiose/mortalidade , Fatores de Risco
19.
Rev Fr Gynecol Obstet ; 80(2): 79-86, 1985 Feb.
Artigo em Francês | MEDLINE | ID: mdl-3885369

RESUMO

We investigated by culture the presence of mycoplasmal infection in all reproductive abnormalities. 271 charts were studied, comprising problems of sterility with abnormal sperm, cystitis, urethritis, spontaneous abortions, fetal death in utero, premature deliveries and small for gestational age fetuses. Antimycoplasmal therapy lead to recovery in cases where this infection was the only cause, notably in sterility. Is Mycoplasma a risk factor or does it simply represent current infection?


Assuntos
Infertilidade/etiologia , Infecções por Mycoplasma/complicações , Complicações na Gravidez/etiologia , Aborto Habitual/etiologia , Técnicas Bacteriológicas , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Masculinos/etiologia , Humanos , Masculino , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Complicações do Trabalho de Parto/etiologia , Gravidez , Complicações na Gravidez/diagnóstico , Gravidez Ectópica/etiologia , Infecções Sexualmente Transmissíveis/etiologia
20.
Qual Assur Health Care ; 4(2): 105-13, 1992 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1511144

RESUMO

Although many reliability studies on cervical cytology have been carried out, measurements of sensitivity and specificity have rarely been made since biopsies are not often performed on patients with a negative smear result. This screening assessment was performed over 3 years, using a database of 230,167 smears from 177,051 women. It would seem that cervical cytology has a high specificity (over 99%) but a relatively low sensitivity (61%). Values for sensitivity (exceeding 95%) and specificity (exceeding 99%) for invasive carcinoma should be regarded as reasonably accurate as all incident cases of symptomatic cervical carcinoma are recorded in the Burgundy register. The sensitivity (57%) for pre-invasive lesions is underestimated while their prevalence is overestimated: the lack of organized screening leads to the loss of prevalent cases. The predictive value of a positive smear is 76% for moderate-severe dysplasia, 85% for in situ carcinoma and over 95% for invasive carcinoma.


Assuntos
Carcinoma in Situ/diagnóstico , Condiloma Acuminado/diagnóstico , Modelos Teóricos , Avaliação de Resultados em Cuidados de Saúde , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma in Situ/patologia , Criança , Condiloma Acuminado/patologia , Testes Diagnósticos de Rotina/normas , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia
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