The ongoing COVID-19 pandemic is raising great concern all over the world. The recent introduction of vaccines has offered reason for optimism, however, new issues have arisen, such as vaccine reluctance. The safety of vaccines for pregnant women is one of the most serious of these concerns. The purpose of this review article is to provide updated international vaccine recommendations, results of ongoing studies and clinical trials, and the role of gynecologists in counseling the women to understand the risks versus benefits as well as form an informed decision towards vaccine acceptance for COVID-19.Although COVID-19 infection increases the risk of severe morbidity and mortality in pregnant women, pregnant women were not included in the initial vaccine trials. As a result, safety information is scarce. Nations have differing recommendations, though many have recently approved the COVID-19 immunization in pregnancy following a risk-benefit analysis. The Joint Committee on Vaccination and Immunization (JCVI) of the United Kingdom recently approved an mRNA vaccination for pregnant women. Vaccination is recommended by the CDC, ACOG, ARFM, and WHO. India recently took a stand, with the ICMR and the Ministry of Health and Family Welfare recommending vaccination during pregnancy and lactation. 相似文献
Objective. To describe factors related to compliance diagnostic follow‐up among minority women of low socioeconomic status with abnormal screening mammograms.
Methods. A retrospective cross‐sectional survey using a structured telephone interview. Three cancer screening clinics at an urban inner‐city public hospital. All women with abnormal screening mammograms between September 1990 and January 1992 were eligible; women were interviewed in August 1992. Abnormal mammograms were those requiring specific, non‐routine clinical follow‐up; non‐compliance was defined as delayed follow‐up (four to six months after the date of the mammogram), or no follow‐up at the time of interview (more than 6 months after abnormal).
Results. Sixty‐two of 442 screened women had abnormal results; the overall rate of non‐compliance with follow‐up was 50%. Among the 42 (68%) women who agreed to be interviewed, non‐compliers were less likely to state that they had been told to receive follow‐up than compilers (65% versus 100%; p = 0.008). Non‐compliant women were less likely to have suspicious mammography interpretations (p = 0.05), and more likely to report barriers to follow‐up, such as cost of lost wages and medical care, system barriers, or fears, than compliant women (61.9% versus 9%, p = 0.01). There were no differences between the two groups for age, education, insurance, source of care, family history, knowledge or attitudes.
Conclusions. These preliminary results suggest that follow‐up of low income, minority women with abnormal screening mammograms could be enhanced by improved communication of results. Future studies should extend these findings with larger samples and in other settings and populations. 相似文献
Summary The origin of the extracellular -amyloid protein (/A4) found in senile plaques and the cellular mechanisms responsible for its deposition in cerebral tissues are still an unresolved issue in Alzheimer's disease. In this study we analyzed in detail the distribution of various epitopes of /A4 in relation to local cellular elements in diffuse plaques of the hippocampal region. We also correlated our findings with the presence and distribution of non-/A4 epitopes of the amyloid precursor protein (APP) and with synaptophysin immunoreactivity in the cortical neuropil. Discontinuous /A4-immunoreactive deposits were found along dendrites, and around the soma of neurons included in the plaques. Furthermore, increased synaptophysin reactivity with slightly dilated synaptophysin-immunolabeled presynaptic terminals were found in diffuse plaques. APP epitopes could not be found in diffuse plaques. However, some of the APP antibodies, mainly those to the C-terminal portion of APP, and antibodies to /A4 recognized clusters of flat vesicular profiles (0.6–1.4 m in width and 2–3 m in length) in the neuropil of cortical areas where plaques had developed. Our findings are compatible with a neuronal origin of /A4 in diffuse plaques and with a primary release of /A4 at synaptic sites along the immunostained neurites. They also suggest that diffuse plaques might be preceded by minute lesions of the neuropil where /A4 is not yet released from the precursor molecule. 相似文献