闭经

闭经指育龄期妇女月经未来潮。导致闭经的病因很多,有病理性和生理性两类。病理性原因导致的闭经多见于原发性闭经,解剖原因所致的闭经少见但也很重要。妊娠和哺乳期闭经属生理性闭经。闭经通常分为原发性和继发性闭经两种。原发性闭经指16岁时仍无月经来潮,而继发性闭经是指≥6个月无月经来潮。导致闭经原因常常多个混杂,所以区别两者的实际意义不大。导致闭经的内分泌因素包括:多囊卵巢综合征、紧张和劳累、体重相关、高泌乳素血症、心理性疾病、全身性疾病如:肾功能衰竭、药物因素、卵巢早衰、垂体缺血性坏死、原发性下丘脑-垂体-卵巢(H…     

The health insurance status of US Latino women: A profile from the 1982-1984 HHANES.

OBJECTIVES: This research studied the correlates of health insurance status among three major subpopulations (Mexican, Puerto Rican, and Cuban) of adult (ages of 20 to 64) Latino women. METHODS: Data from the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984, were examined to determine the percentages of health insurance coverage among the sample populations and to assess the relationship between access to coverage and selected sociodemographic employment/income, ancestry, and acculturation variables. RESULTS: Variations in health insurance coverage existed by Latina subpopulation. While Puerto Rican women had the highest percentage of any health insurance coverage, Mexican-origin women (particularly those 50 to 64 years old) had the lowest. For all three Latina groups, health insurance coverage was greater among those who reported a family income above the poverty level than among those whose income fell below the poverty level; employment location, acculturation variables, and ancestry were also related to coverage. CONCLUSIONS: Eligibility requirements, particularly for Mexican-and Cuban-origin women, need to be streamlined, and innovative health insurance programs need to be developed to increase access of Latinas to health insurance.     

Chy-3 mice are Vegfc haploinsufficient and exhibit defective dermal superficial to deep lymphatic transition and dermal lymphatic hypoplasia.

Recent advances in molecular lymphology and lymphatic phenotyping techniques in small animals offer new opportunities to delineate mutant mouse models. Chy-3 mutant mice were originally named for their chylous ascites, but the underlying lymphatic disorder was not defined. We now re-examined these mice and applied advanced genotyping and lymphatic phenotyping techniques to pinpoint the specific lymphatic defect in this mouse model. We demonstrated that Chy-3 mice carry a large chromosomal deletion that includes Vegfc and narrowed this region by monitoring the heterozygosity of genetic markers. We found that Chy-3 mice not only exhibited chylous ascites but also lymphedema of the hind paws and, in approximately half of the males, lymphedema of the penis. Visual lymphangiography and immunofluorescence staining showed a hypoplastic dermal lymphatic network, whereas the blood vasculature appeared unaffected. This hypoplastic lymphatic network was functional, and all adult Chy-3 mice exhibited a lateral lymphatic pathway directly connecting the inguinal to the axillary lymph node. The dermal superficial to deep lymphatic connections in upper limbs and in all cervical regions were intact and functionally drained the upper body. Lymphatic tracer was not transported from the dermal to the deep truncal lymphatic system in the lower limbs, even though the deep lymphatic vessels and nodes were present and patent. These findings further delineate the lymphatic phenotype of Chy-3 mice, identify a collateral lymph drainage pathway previously undescribed in other genetic models of lymphedema, and demonstrate a predilection for lymphatic abnormalities of the lower limbs.     

Pseudoinvasion with high-grade dysplasia in a colonic adenoma. Distinction from adenocarcinoma

High-grade dysplasia was found to extend to an area of pseudoinvasion in the submucosa of a colonic adenoma mimicking invasive carcinoma. The presence of both benign and cytologically malignant epithelium and residual foci of lamina propria among the submucosal glands distinguishes this entity from adenocarcinoma arising in an adenomatous polyp.     

Orphans as a window on the AIDS epidemic in Sub-Saharan Africa: initial results and implications of a study in Uganda

Provisional estimates from a Save the Children Fund enumeration study in four Ugandan districts indicate that the total number of orphans (one or both parents missing) ranges between 620,000 and 1,200,000. Needs assessments with guardians and local administrators show that although extended family networks are absorbing these children according to traditional rules, they may be vulnerable to increased mortality due to economic and health stresses on their caretakers, many of whom are elderly persons. The orphan burden will increase in Uganda and other Sub-Saharan African countries over the next few years. Allocation of additional national and international resources must be considered to avert breakdowns in community and familial support systems and consequent increases in under 5 mortality. The orphan burden is a window on the potential for massive social breakdown and dislocation in Sub-Saharan Africa resulting from high AIDS-related mortality. Methodologies for data collection and planning that use indigenous political systems must be built quickly to avert disaster.     

Cardiac abnormalities in the fragile X syndrome.

Twenty three patients with fragile X syndrome underwent cardiovascular assessment. Echocardiography showed dilatation of the aortic root in 12 (52%) and mitral valve prolapse in five (22%), four of whom had an apical mid-systolic click on auscultation. Patients with fragile X syndrome have cardiac defects similar to those seen in other disorders of connective tissue such as Marfan's syndrome and Ehlers-Danlos syndrome. These, and other somatic features, suggest an underlying connective tissue dysplasia.