Objectives: D-Mannose is a promising nonantibiotic prophylaxis for recurrent urinary tract infection (rUTI). Recurrent UTI is common in postmenopausal women and may be especially prevalent in those with cystitis cystica (CC) lesions found on cystoscopy. Our objectives were to determine whether CC lesions are associated with a higher UTI incidence rate and whether D-mannose reduces this rate in women with CC.Methods: This is a retrospective cohort study of patients with rUTI who underwent cystoscopy at our institution (from which CC status was identified) and who were treated with D-mannose as a single agent for UTI prophylaxis. Participants were required to have at least 1 year of follow-up for UTIs both before and after D-mannose initiation to allow for a pre-post comparison.Results: Twenty-seven patients were included in the analysis (13 with CC, 14 without CC). Most patients (88.9%) were postmenopausal. Patients with CC had a higher UTI incidence rate than patients without CC (4.69 vs 2.93 UTIs/year before starting D-mannose prophylaxis, P = 0.021). After initiating D-mannose prophylaxis, the UTI incidence rate decreased significantly in patients with CC (rate decrease = 2.23 UTIs/year, P = 0.0028). This decrease was similar in magnitude to that observed in patients without CC (rate decrease = 1.64 UTIs/year, P = 0.0007; P interaction = 0.58).Conclusions: Patients with rUTI with CC had more frequent UTI episodes than patients without CC. Patients in both groups had fewer UTI episodes after beginning D-mannose prophylaxis. These findings add to the body of literature supporting D-mannose for the prevention of rUTI in women, including those with CC.
Objective Obstetric anal sphincter injuries (OASIs) are severe tears involving the external and internal anal sphincters. We aimed to document the incidence of OASIs within a racially and ethnically diverse institution to elucidate which maternal, fetal, and parturition factors may be associated with OASIs in minority subgroups. Methods This was a retrospective unmatched case-control study of reproductive aged women who delivered between January 1, 2014, and December 31, 2017, at our institution. Data for maternal, fetal, and parturition factors were gathered through chart review. We also investigated the expertise level of the surgeon performing repairs and complications that developed in the postpartum period. Logistic regression analysis was used to compare women with third- and fourth-degree lacerations against the control group of women with first-degree, second-degree, or no lacerations. Results Of the 23,362 deliveries between January 1, 2014, and December 31, 2017, the incidence of OASIs was 1%. Of our patients, 38% self-identified as Hispanic, 32% as Black, 13% as White, and 3.5% as Asian. Risk for OASIs was significantly increased in nulliparity, Pitocin use, operative deliveries, episiotomy, and prolonged second stage of labor. Black race and obesity were protective for OASIs. There was no significant difference in complication rates based on type of repair nor the provider level of training. Conclusions The incidence of OASIs at our institution is similar to current published literature. Our study population is unique in its overrepresentation of minority groups, offering insight into potentially distinctive risk and protective factors associated with OASIs.
INTRODUCTION: Exercise and lifestyle interventions may improve health metrics and quality of life in survivors of endometrial cancer. The purpose of this study was to evaluate the association between patient characteristics and self-efficacy as well as transtheoretical stage of change for diet or exercise in an ethnic/racially diverse population of women with endometrial cancer. METHODS: After IRB approval, 100 survivors of endometrial cancer completed a questionnaire including demographics, disease factors and co-morbidities. Transtheoretical Stage of Change and Self-Efficacy for Diet and Exercise were assessed using the Stages of Change Measure and Five Item Self Efficacy Measure. Associations were evaluated using Krusal Wallis and ANOVA testing, performed with Stata version 13.0. RESULTS: Mean age of 99 responders was 69 years and BMI was 34.1 kg/m2. There was a difference in BMI between stages of transtheoretical stage of change for exercise, maintenance vs contemplation (29.2 vs 38.0, p less than 0.01) and between stage of change for diet (38.6 vs 31.4, p=0.04) . Obesity (BMI greater than 30) was associated with the action stage of change when evaluated as a categorical variable (p less than 0.01). Self-efficacy for exercise as compared to transtheoretical stage of change was of borderline significance (p=0.08), however it was not significant for diet. CONCLUSION: In survivors of endometrial cancer, BMI was the only clinical/pathological factor associated with transtheoretical stage of change for exercise. Patient centered diet and exercise lifestyle intervention programs may consider patient BMI, and education as well as transtheoretical stage of change and self-efficacy to improve recruitment and retention.
1589 Background: BRCA testing has become an integral component of ovarian cancer management; however, low testing uptake remains an obstacle. This study evaluated the impact of an oncologist-led counseling and testing model on BRCA testing uptake. Methods: The ENGAGE study (NCT02406235) is a prospective study of an oncologist-led BRCA counseling and testing model in patients with epithelial ovarian, primary peritoneal and fallopian tube cancer (EOC). The United States lead accruing gynecologic oncology sites were Montefiore, an urban academic medical center; and Winthrop, a suburban teaching hospital. Oncologists were trained in BRCA counseling prior to site activation, and directly submitted patients’ samples for BRCA testing. Prior to the ENGAGE study, EOC patients were referred to genetics professionals for counseling and testing. We determined the number of BRCA tests performed, and simple descriptive statistics were used to summarize the data. Results: A combined total of 141 EOC patients underwent BRCA testing during the 20 consecutive months analyzed. In the 10 months pre-ENGAGE, 8 Montefiore patients had BRCA testing, all submitted through the genetics division. Nineteen Winthrop patients had BRCA testing, 16 from their oncologist’s office and 3 from an external genetics office. During the 10-month ENGAGE trial, 64 Montefiore patients and 50 Winthrop patients had BRCA testing. This represents a four-fold increase in BRCA testing uptake, with 114 patients tested during ENGAGE versus 27 patients tested pre-ENGAGE. Of these 114, 99 had BRCA counseling and testing through their oncologist’s office. Conclusions: Implementation of an oncologist-led genetic counseling and testing model was associated with increased BRCA testing among ovarian cancer patients in both the urban and suburban hospitals. Increased BRCA testing could be related to increased patient convenience and standardized training of the clinical team. These findings may guide other institutions as they implement streamlined genetic counseling and testing protocols.
Researchers, universities, and academic libraries develop a range of tools and platforms to make scholarship more accessible. What could these scholarly communications and open access projects learn from examples set by fandom and fan activists, for example, the fan works platform Archive of Our Own (AO3)? This conceptual paper, the result of a brainstorming session by scholars and librarians, proposes that a Fantasy Research Archive of Our Own should excel at making scholarly knowledge production into a visibly, enthusiastically collective endeavor that recognizes many kinds of contributions beyond the publication of traditional research papers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.