Background Fecal testing can only reduce colorectal cancer mortality if patients with an abnormal test result receive a follow-up colonoscopy. As part of the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC) project, we examined factors associated with adherence to follow-up colonoscopy among patients with abnormal fecal test results. Methods As part of STOP CRC outreach, Virginia Garcia Memorial Health Center staff distributed 1,753 fecal immunochemical tests (FIT), of which 677 (39%) were completed, and 56 had an abnormal result (8%). Project staff used logistic regression analyses to examine factors associated with colonoscopy referral and completion. Results Of the 56 patients with abnormal FIT results; 45 (80%) had evidence of a referral for colonoscopy, 32 (57%) had evidence of a completed colonoscopy within 18 months, and 14 (25%) within 60 days of an abnormal fecal test result. In adjusted analysis, Hispanics had lower odds of completing follow-up colonoscopy within 60 days than non-Hispanic whites (adjusted OR = 0.20; 95% CI: 0.04, 0.92). Colonoscopy within 60 days trended lower for women than for men (adjusted OR = 0.25; 95% CI 0.06 – 1.04). Among the 24 patients lacking medical record evidence of a colonoscopy, 19 (79%) had a documented reason, including clinician did not pursue, patient refused, and colonoscopy not indicated. No reason was found for 21%. Conclusion Improvements are needed to increase rates of follow-up colonoscopy completion, especially among female and Hispanic patients.
This systematic review evaluates the efficacy and safety of l-arginine alone or in combination for the treatment of women with hypoactive sexual desire disorder (HSDD) or related conditions, such as female sexual interest/arousal disorder and female sexual arousal disorder. Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature were searched using keywords “arginine”, “Lady Prelox”, “ArginMax”, “Stronvivo”, “Ristela”, “hypoactive sexual desire disorder”, “female sexual interest arousal disorder”, “female sexual arousal disorder”, “sexual dysfunction”, “sexual behavior”, “dyspareunia”, “libido”, and permutations thereof. Relevant records were retained if they were primary literature, conducted in women with HSDD or related conditions, and published as full text in English. Five randomized controlled trials and two nonrandomized studies met eligibility criteria. Six of the seven studies reported either an increase in the total mean Female Sexual Function Index score or significant increases in multiple domains therein. One study assessed vaginal pulse amplitude and found a statistically significant increase in a combination treatment group compared to placebo. No significant side effects were reported. Four of seven studies had potential risk-of-bias concerns per Cochrane assessments. This systematic review found that combination products containing l-arginine in the form of ArginMax or Lady Prelox may be considered for the treatment of HSDD and related conditions in women regardless of age.
INTRODUCTION: Breastfeeding reduces the risk of breast cancer. Disparities exist in breastfeeding with about 59% of African-American infants ever being breastfed versus 75% of white infants. One possible explanation is that African-American women may not be discussing benefits of breastfeeding. Thus, this pilot study explores the use of social media to engage pregnant African-American women in education about breastfeeding and to test its impact on breastfeeding outcomes. METHODS: This study was a randomized intervention enrolling eligible African-American women in Buffalo over 18 months into one of two private Facebook groups. The intervention arm received breastfeeding plus breast cancer risk-reduction messaging while the control arm received messaging about breastfeeding alone. A subset of the intervention and control arms failed to join the assigned Facebook group thus creating “true controls” for the study. Participants completed pre- and post-birth assessments. RESULTS: 288 women (N=135 in intervention arm, N=153 in control arm) were randomized into the study. Pre-birth, 76.7% of true controls, 74.7% of breastfeeding-only, and 85.9% of the intervention-group were planning to breastfeed, but, respectively, only 24.6%, 34.6%, and 32.9% exclusively breastfeed post-birth. Breast cancer risk perceptions did not differ between pre-birth and post-birth for the intervention group. The percentage of controls who responded that their risk was “very low” or “somewhat low” significantly increased from 61.5% at pre-birth to 80.0% at post-birth. CONCLUSION: Exclusive breastfeeding is high among groups receiving social media messaging. Therefore, continued and improved efforts should be made to use social media to promote breastfeeding and its benefits.
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