Preoperative anxiety in women

Preoperative anxiety and fear can have adverse effects on patients' perioperative experiences. This study emerged from a larger study in which the researcher examined the perioperative experiences of women. The purpose of this study was to further investigate and describe the nature of preoperative anxiety in female subjects. This article reviews the literature on this topic, discusses the results, and explores the implications of anxiety and fear on the perioperative experience. The author offers suggestions to improve nurses' assessment of preoperative fear and anxiety and ways to lessen such feelings in patients.     

Social physique anxiety in postmenopausal women

Social physique anxiety (SPA), the degree to which individuals become anxious when others observe their bodies, is an important concept for postmenopausal women because it may be directly related to their physical activity behavior. Women with high levels of social physique anxiety may not participate in health-enhancing physical activity. Therefore, the main purpose of this study was to examine SPA in postmenopausal women relative to leisure time physical activity (LTPA, activities such as exercise, recreation, and sports). Other factors, such as percent body fat, body fat distribution, age, and hormone replacement therapy status were also examined for their relationship to SPA. Women who expended < or = 500 kcal.wk-1 in LTPA had significantly higher SPA than women who expended > or = 2,000 kcal.wk-1, independent of percent body fat. Women with more than 37.5% body fat had significantly higher SPA than those with less than 37.5% body fat. Women with upper BFD (waist-to-hip ratio or WHR > 0.85) had higher SPA than women with lower BFD (WHR < 0.75). There were no differences in SPA relative to age or HRT status. It appears that a sedentary lifestyle, high percent body fat, and upper body fat distribution are associated with increased SPA in postmenopausal women, thus health promotion professionals should be aware of these concerns when developing physical activity interventions for postmenopausal women.     

Reduction of pain in childbirth by the alleviation of anxiety during pregnancy.

Used the Institute for Personality and Ability Testing (IPAT) Anxiety Scale and 3 anxiety-related scales from Schaefer and Manheimer's Pregnancy Research Questionnaire (PRQ) to measure fear and anxiety before and after courses in childbirth education and childcare for 42 primiparas (mean age = 26 yrs) in the 3rd trimester of pregnancy. A groups * trial analysis of variance indicated that both kinds of instruction significantly reduced 2 of 3 pregnancy-related anxieties, as determined by PRQ Fears for Baby and Irritability and Tension scores. Only the childbirth education course (Lamaze method) succeeded in reducing general anxiety level, as measured by the IPAT Anxiety Scale. Anxiety level was found to exert a significant effect on self-ratings of pain during the transition stage of labor. It is concluded that childbirth education can reduce fear and anxiety and that pain perception is enhanced by high anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial and sexual outcome in women with Turner syndrome

Results of an inquiry in adults patients (18-53 years of age) coming from three centers (1 in Rouen & 2 in Paris), 213 questionnaires were sent. 105 answers were received. Scholar achievement: only secondary cycle in 6%, Secondary cycle + professional course in 22% and tertiary cycle in 44%. No scholar ship in 2%, 26% were still ongoing studies. Professions: 18% are unemployed (24%), Secretary jobs: 10%, Health professions (altogether): 18%, Teachers: 8%, Clerks: 7%, Executive jobs: 8% and Miscellaneous jobs: 5%. 3% have an handicapped status. The small height was a career obstacle in 29%. Affective life. Age of first sexual intercourse was 19-22 years. 17 are or were married and 15% are living in couple. But 58% have not any sexual life whatsoever. These women are divided on the ways to cure the sterility. Few among the oldest have attempted adoption or medically assisted procreation, with each time low rate of success. 26% have psychological disturbances which were serious in 6% mainly due to depression.     

Predictors of long-term outcome in severe head injury

Potentiometric choline electrodes were developed on the basis of the mediator-free bioelectrocatalysis. The electrodes made of a composite carbon-polymer material contain choline oxidase and peroxidase coimmobilized on the surface of the electrode. The rate of the potential increase was shown to be proportional to the choline concentration within a broad range of variation. Coupling of choline-sensitive electrodes with butyrylcholinesterase makes possible both the direct detection of butyrylcholine and analysis of butyrylcholinesterase inhibitors.     

Self-efficacy expectancies, outcome expectancies, and the persistence of pain control in childbirth.

Examined A. Bandura's (see record 1977-25733-001) self-efficacy theory of mastery behavior, which distinguishes self-efficacy expectancies (SEEs) from outcome expectancies (OEs), by the relative roles of SEEs, OEs, and importance as predictors of persistence of pain control in medication-free childbirth. 52 primiparous women made self-efficacy judgments before and during labor and then reported in postdelivery interviews the timing and amount of medication use during labor and delivery. SEEs predicted persistence in pain control without medication better than OEs, importance, and 7 other alternative predictors. These results support several aspects of construct validation to the SEE construct. However, SEEs and OEs were highly correlated and largely redundant in their correlations with mastery. Three possible reasons and implications for this lack of differentiation are discussed. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in attachment anxiety is associated with improved depression among women with binge eating disorder.

The study examined if the relationship between change in attachment insecurity and target symptom outcomes was moderated by treatment type. Women (N = 66) with binge eating disorder (BED) were randomly assigned to two treatment types: group cognitive-behavioral therapy (GCBT) or group psychodynamic-interpersonal psychotherapy (GPIP). Results indicated significant positive pre- to posttreatment changes in all attachment insecurity scales, but no difference between GCBT and GPIP on these changes. Change in attachment anxiety was related to improved depression for women completing GPIP, but not for women completing GCBT. This indicated a moderating effect of treatment type in explaining the relationship between change in attachment anxiety and improved depression. Changes in attachment anxiety may be important for symptom outcomes related to psychodynamic-interpersonal therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical effects of childbirth with median episiotomy and anal sphincter injury on fecal incontinence of primiparous women

Obstetric damage of the anorectal continence organ can lead to impaired anal continence. To assess the effect of birth, either with or without direct injury of the anal sphincter, 123 primiparae were studied. 41 patients with a midline episiotomy and 82 patients with an additional injury of the anal sphincter were assessed at a median of 21 weeks postpartum and compared with 18 healthy volunteers. Anorectal manometry as well as a standardized questionnaire were employed. Patients with an additional injury of the anal sphincter reported persistent flatus incontinence significantly more often (p = 0.0069) than patients with a midline episiotomy only. Incontinence of solid or liquid stool occurred only transiently. Compared to nulliparae in all primiparae a significant shortening of anal canal and a decreased squeeze pressure were observed. In addition, a significantly reduced resting pressure was seen in patients with an anal sphincter injury. The rectoanal inhibitory reflex was absent significantly more often following anal sphincter tear (p = 0.0023). Vaginal delivery, both with and without anal sphincter injury, leads to early detectable changes in anorectal sphincter function.     

Anticipatory anxiety in women receiving chemotherapy for breast cancer.

Examined (1) the prevalence and course of anxiety before the 1st 6 infusions of cancer chemotherapy and (2) the contribution of trait anxiety, side effect expectations, and prior occurrence of posttreatment side effects to anxiety before infusions. 53 women receiving adjuvant chemotherapy for breast cancer participated. Anxiety was most prevalent and intense before the 1st infusion. Trait anxiety predicted anxiety before the 1st and subsequent infusions. Prior occurrence of posttreatment nervousness also predicted anxiety before subsequent infusions, even after accounting for trait anxiety and other posttreatment side effects. Results are discussed in terms of the role that anxiety proneness, response expectancy, and classical conditioning may play in the development of anxiety before repeated chemotherapy infusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and anxiety among women in an urban setting in Zimbabwe

There has been little investigation of the side-effects experienced by women receiving adjuvant carboplatin in the treatment of ovarian cancer. This study aimed to describe the range of problems experienced by patients and to estimate incidence and severity of side-effects over the treatment period. Eleven patients participated and completed a 75-item self-report questionnaire at each course of treatment. Severity of each side-effect was graded from 0 to 4. Patients also stated which had been the worst side effect at each course. The response rate was 94%. Seventy-two side-effects were reported. Fatigue emerged as both the most common and the most 'troublesome' side-effect. Nausea, difficulty sleeping, taste change, and constipation were also ranked highly. Although limited by a small sample size, this study suggests patients undergoing carboplatin experience a wide range of problems, many of which merit further investigation.     

Foetal outcome in women with inflammatory bowel disease treated during pregnancy with oral mesalazine microgranules

BACKGROUND: Little information is available about the safety of high doses of mesalazine during pregnancy. AIM: To study the fate of pregnancy and foetal outcome in women taking 1-4 g/day of mesalazine microgranules for inflammatory bowel disease. PATIENTS AND METHODS: Case reports were collected from the Pharmacovigilance Department of Ferring SA, France, from a survey conducted in three gastroenterology units, and from a teratology information service. The evolution of pregnancy and foetal outcome were assessed by questionnaire. RESULTS: The study covered a total of 123 pregnancies (126 foetuses). Ninety-six women took mesalazine during the first trimester, 85 during the second and 83 during the third. The mean daily dose was 2.1+/-0.8 g; 86 women received <3 g/day (low-dose group), 37 women received > or =3 g/day (high-dose group). The following abnormalities were observed in the low-dose and high-dose groups, respectively: ectopic pregnancy (1/0), spontaneous abortions (1/1), foetal death (0/1), premature deliveries (3/5, P < 0.05), congenital malformations (3/1) and one case of lethal oxalosis. Abnormalities were not considered to be related to mesalazine. CONCLUSIONS: The use of oral mesalazine microgranules during pregnancy is safe at doses < or =2 g/day, and probably also at a dose of 3 g/day.     

First-incidence anxiety in the Lundby Study: course and predictors of outcome

PURPOSE: In this study, we investigated the ultrastructure of the microvasculature in human renal cell carcinoma (RCC) specimens. MATERIALS AND METHODS: RCC specimens from 30 patients were studied by light microscopy after hematoxylin and eosin staining and alpha-smooth muscle actin staining, and by electron microscopy after uranyl acetate lead nitrate staining or periodic acid thiosemicarbazide gelatin methenamine silver staining. RESULTS: In the light microscopy, the capillaries located adjacent to the renal medullary tubules in normal renal tissue specimen were in an orderly manner, while capillaries in the RCC specimens were found to be densely or sparsely distributed unconventionally. The pericytes encircling the capillary endothelial cells were positive for alpha-smooth muscle actin and formed aggregates in many of the RCC specimens, but did not form aggregates in the normal tissue specimens. In the electron microscopy, capillary endothelial cells in the normal renal tissue specimens were found to form well-developed membranous structure such as characterized by fenestrations and tight junctions. However, few pericytes were detected. On the other hand, the capillary endothelial cells in RCC specimens were found to be immature with poorly developed junctional complexes. Capillary pericytes with numerous cytoplasmic processes were found in many of the RCC specimens. In addition, the basement membranes of the capillary walls were structurally abnormal in that it was being multilayered. Based on the results of analysis of a total of 324 capillaries observed in all RCC specimens, capillaries could be classified as type I capillaries, associated with well-developed pericytes with numerous processes, or type II capillaries, associated with few pericytes with few processes. Type I capillaries predominated in cases which an angiographically hypervascularity was detected. Whereas, type II capillaries predominated in cases in which angiographically hypovascular pattern were detected. CONCLUSION: The fine structure of the pericytes seems to reflect the qualitative difference in capillary structure between normal renal tissue and RCC specimens. Therefore, the present findings may contribute to the recognition of intratumoral hemodynamics.     

Changes in body image, depression, and anxiety levels among women with human papillomavirus infection

In the present study, we examined the expression of CD44 variant exons in human oral squamous cell carcinoma (OSCC). Of ten cell lines from OSCCs, two (KB and H357), as well as the HeLa cell line, failed to express CD44 variant exons. In surgical specimens, all normal mucosa expressed CD44v9 (both mRNA and protein). Of 40 primary OSCCs, 19 (47.5%) showed downregulation of CD44v9, which correlated with tumor cell differentiation, primary metastasis to lymph nodes and secondary metastasis to lymph nodes. The results suggest that the downregulation of CD44v9 may play a role in lymphatic metastasis of OSCC and changes in its expression may be a useful diagnostic tool to determine the metastatic potential of OSCC to lymph nodes. Moreover, three cell lines that failed to express CD44 variant exons might become a useful experimental model to study the role of variant exons in the progression of OSCC.     

Process and outcome in a hostel outreach program for homeless clients with severe mental illness

A longitudinal study followed 55 homeless and severely mentally ill clients of a hostel outreach program to assess outcomes and their relationship to program elements. Results at 18-month follow-up indicated that, despite chronic histories of transiency and shelter use, housing stability had been achieved, and that initial gains in social functioning and symptom reduction had been increased. Development of a strong working alliance proved a key program element in the findings.     

Influences of beliefs and personality disorders on treatment outcome in anxiety patients.

The present study investigated the effects of personality disorders (PDs) and specific PD-related beliefs on the results of (cognitive-)behavioral therapy for anxiety disorders in a sample of 398 outpatients. The authors used a prospective design in which relationships between PD variables before treatment and outcome measures at posttest and follow-up were evaluated with multilevel analyses. People with PDs and PD-related beliefs reported higher symptom levels at outcome. However, these effects were not as strong as might be expected on the basis of prevailing clinical thought in this area. Dropout rates were not influenced by the presence of 1 or more PDs or PD-related beliefs. Results indicate that treatment of anxiety disorders in patients with concomitant one or more PDs is appropriate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)