Menopausal Transition Symptoms in Midlife Women Living With Fibromyalgia and Chronic Fatigue

We aimed to determine how menopausal transition symptoms cluster across 216 midlife women with fibromyalgia, chronic fatigue syndromes (FMS/CFS), or both and subsequently to compare symptom factor severity scores by menopausal status among these women and compare symptom reporting with prior community-based samples of women without obvious illness. We designed a cross-sectional telephone survey of 216 women aged 35 to 55, diagnosed with FMS/CFS, symptomatic in the prior 6 months, and without hysterectomy. Thirty-six of 61 symptoms loaded on five factors: aroused/anxious mood, depressed mood/withdrawal, musculoskeletal, gastrointestinal (GI), and vasomotor. Peri- and postmenopausal women had higher symptom severity scores for musculoskeletal, GI, and vasomotor factors but not mood factors. Symptoms for the women we studied who had FMS/CFS clustered similar to those in previous community-based samples of midlife women without major illness; however, the number of women experiencing symptoms was much higher among our sample.     

Trinucleotide repeat polymorphisms in the androgen receptor gene and risk of ovarian cancer.

INTRODUCTION: Androgens may play a role in the development of ovarian cancers. Two trinucleotide repeat polymorphisms have been described in exon 1 of the androgen receptor (AR) gene that may affect its function. Previous studies of ovarian cancer and AR repeat polymorphisms have been inconsistent. METHODS: We analyzed CAG and GGC repeat length polymorphisms in the AR gene using data from a population-based case-control study of ovarian cancer that included 594 cases and 681 controls. Repeat lengths were determined by fluorescent DNA fragment analysis using ABI GeneScan software. Change point models were used to determine appropriate repeat length cutoff points by race (African American versus Caucasian) for both the shorter and longer CAG and GGC repeats. RESULTS: No relationship was observed between CAG repeat length and ovarian cancer among Caucasians. Among African Americans, having a short repeat length on either allele was associated with a 2-fold increase in ovarian cancer risk (age-adjusted odds ratio, 2.2; 95% confidence interval, 1.1-4.1). Having short CAG repeat lengths for both alleles was associated with a 5-fold increased risk for developing ovarian cancer (age-adjusted odds ratio, 5.4; 95% confidence interval, 1.4-1.7). No relationship with the GGC repeat length polymorphisms was observed. CONCLUSION: These results suggest that having a short CAG repeat length in AR increases ovarian cancer risk in African Americans. The failure to observe this relationship in Caucasians may be due to the rarity of such short CAG alleles in this population or could reflect racial differences in disease etiology.     

Women''s Preventive Screening in Rural Health Clinics

CONTEXT: Despite the strong interest in health care quality, little is known about the quality of preventive care among women in rural primary care settings. PURPOSE: We sought to assess the quality of screening practices in Rural Health Clinics (RHCs) as measured by the rates at which female patients received screening within national guidelines. METHODS: A cross-sectional, retrospective chart review of 480 charts of female patients in 12 randomly selected RHCs was conducted. Data were collected on screening activities documented in >3,800 patient visits. Chart data was extracted by trained, standardized chart auditors using the Women's Primary Care Screening Form for patient data and the Revised National Rural Health Clinic Survey for RHC background data. The rates of receipt of 5 preventive screenings received by female patients in RHCs were determined using a standardized and reproducible method, and patient and clinic characteristics associated with women's receipt of these screenings were identified. FINDINGS: Demographic characteristics of patients were similar to that of national rural comparisons. Screening rates for Pap tests (66%) and mammograms (55%) were lower than Healthy People 2010 estimates, but similar to other record audit data; screening rates for cholesterol with comorbidity (66%) were near the Healthy People 2010 estimate, and screening rates for cholesterol without comorbidity (61%) exceeded it; and rates of blood pressure screening (99%) exceeded Healthy People 2010 estimates of national rates. Screening rates for depression showed that 35% had received a formal or informal screening. CONCLUSIONS: Rates of screenings for insured and uninsured female RHC patients in this retrospective chart review were not significantly different. Methods to improve pap and mammogram screening rates are needed.     

Ovulation and ovarian cancer: a comparison of two methods for calculating lifetime ovulatory cycles (United States)

Objective: To compare two methods for calculating lifetime ovulatory cycles (LOC) to determine if more detailed menstrual cycle information results in stronger associations with ovarian cancer. Methods: Using data from 232 cases and 242 controls in a population-based study of ovarian cancer, we compared a standard method for calculating LOC with a second method that had more detailed information on menstrual characteristics. Odds ratios for ovarian cancer by number of LOC were estimated using unconditional logistic regression. Results: The average number of LOC was 29 fewer for the second method that had more detailed menstrual cycle information, as compared to the standard method (p < 0.0001). The difference was due primarily to the second method considering episodes of missed/irregular periods. Associations between LOC and ovarian cancer were weaker for the second method than the standard method. Further analyses suggested that a reduced number of ovulatory cycles due to menstrual irregularity was associated with increased ovarian cancer risk, in contrast to the protective effects observed for fewer ovulatory cycles due to pregnancy or oral contraceptive use. Conclusion: Obtaining additional details on menstrual factors that affect LOC, particularly missed or irregular cycles, provides important information on ovarian cancer risk. Our data suggest that episodes of anovulation due to menstrual disturbances should be evaluated separately from anovulation due to pregnancy or oral contraceptive use.     

An Experiment in Cooperative Child Care

ABSTRACT: Neither traditional day care nor a proprietary preschool, this parent-organized and operated day care center arose out of the needs of a group of parents and their children. The cost is less than traditional day care, and infants can be enrolled. The program is developed and carried out by parents. The results are that the children develop a sense of self and community, and they get experience in learning and relating to others, while their parents get free time to follow their own interests.