Diagnosing breast carcinoma in young women.

OBJECTIVE--To assess the individual and combined diagnostic accuracy of clinical examination, mammography, and fine needle aspiration biopsy in young women with breast cancer. DESIGN--Analysis based on case notes of patients presenting with breast cancer during 1971-89. SETTING--A combined breast clinic. PATIENTS--Consecutive series of 81 women aged less than 36 with histologically proved breast cancer presenting with a discrete mass over 19 years. MAIN OUTCOME MEASURES--Results of clinical examination, xeromammography or conventional mammography, fine needle aspiration biopsy, and examination of tissue removed by surgery. RESULTS--The clinical diagnosis was correct in 47 women and radiography in 35. Fine needle aspiration biopsy was correct in 47 of the 63 women in whom it was successfully performed. Fine needle aspiration was significantly more accurate than mammography (78% v 45%, p less than 0.01). Ten (16%) patients had negative results on clinical examination, mammography, and fine needle aspiration. CONCLUSION--Mammography alone seems inadequately sensitive to detect breast cancer in young patients. When all investigations give negative results excision biopsy is the only way of obtaining a definitive diagnosis.     

Contribution to the physique of women with manic-depressive disorder in Hungary

The purpose of this study was to get new data about the physique (somatotype) of manic-depressive patients. The somatotypes of manic-depressive females (n = 31, mean age: 30 year) investigated show a balanced mesomorphic-endomorphic predominance. The mean somatotype was 6.34, 5.27, 1.39. Previous Hungarian studies showed a meso-endomorphic somatotype in manic-depressive females. The physique of these patients determined by Kretschmer as pycnic did not show significant alteration due to environmental changes. Thus, according to the recent study, Kretschmer's statements (1921) are still valid in manic-depressive females. They are invariably characterized by a pycnic physique.     

Vaginal microbial flora in normal young women.

Vaginal swabs were taken from 1498 women attending a family planning clinic. The flora was assessed in the absence of any information about the women to whom the swabs related. Yeasts and fungi were present in 311 women (21%) and were no more prevalent among "pill" users than others. Candida albicans was significantly associated with vulval itching and with a vaginal discharge described as heavier than normal or curdy on clinical examination, though these abnormalities were present in only a minority of women with the organism. Trichomonas vaginalis was found in 14 women (1%) and was associated with abnormalities of vaginal discharge in all but one. Gram-negative anaerobic bacilli were significantly more common in women with a troublesome vaginal discharge and those who used an intrauterine device than others. No associations were found between fungi other than C albicans or the other bacteria sought and either symptoms or clinical abnormalities of vaginal discharge.     

Prediction of body density in young and middle-aged women.

The purpose of this investigation was to predict body density of young and middle-aged women and to determine if the use of a greater variety of variables, particularly those for fat in the bust and hip regions, increases the predictability of body density. Body density determined by the hydrostatic technique (dependent variable) was obtained from 83 volunteer young women and 60 middle-aged women ranging from 18 to 22 and 33 to 50 yr of age, respectively. Independent variables included 8 skinfold, 13 girth, and 7 diameter measures; age; height; weight; and bra and cup sizes. Mean body density for young women was 1.043 g/ml (SD plus or minus 0.014) and percent fat, 24.8 (SD plus or minus 6.4); 1.031 g/ml (SD plus or minus 0.015) and 29.8% (SD plus or minus 6.7) for middle aged subjects. Percent fat was calculated by the formula of Siri. Factor analysis was used to examine the dimensions measured by the independent variables as a function of age. A multiple regression model was used to develop predictions of body density from the independent variables. The best combination of four variables for predicting body density was skinfold thigh, skinfold suprailiac, cup size, skinfold suprailiac, girth waist, and skinfold thigh (R = 0.89) for middle-aged women. The data showed that the highest predictons were found by using combinations of skinfold, girth, and diameter variables; cup size also supported the need for different regression equations for different age groups.     

Fertility and physique in a malnourished population.

Theoretically, 3 types of selection may act on continuous variation in natural populations: 1) directional - 1 of the extremes is favored; 2) stabilizing - the average phenotype is favored over the extremes; and 3) disruptive - both extremes have a higher fitness than intermediates. In an effort to obtain some information on the relation of fertility (the number of surviving offspring) and body size in populations living under depressed environmental conditions, this relationship was examined in a South American community in which chronic malnutrition has been documented by its marked influence on the growth and development of children in this population. The sample consisted of 338 male and 366 female adult residents of a subsistence farming community in the Andes Mountains of Colombia. The data represent 403 families, about 30% of all households of the community. Body measurements were obtained on both parents in 318 families and on 1 parent in the remaining families. 13 body measurements were taken. 2 kinds of trends of body measurements were evident in this population. 1st, there is a positive association of fertility with soft tissue. Paralleling the positive association of fat and fertility in this malnourished population is a tendency for: 1) the wealthier to have larger families; 2) the wealthier to have heavier body builds; and 3) the fat-fertility association to diminish when both spouses' fat components are taken together. The above trend appears to be a result of socioeconomic factors. 2nd, there is a curvilinear relationship between fertility and bone measurements; the very small and the very large boned have reduced fertility.     

Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences

Background

A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group differentials in HIV prevalence trends among men and women aged 15–24 years in Zambia.

Design and Methods

We analysed ANC data for women aged 15–24 years from 22 sentinel sites consistently covered in the period 1994–2008, and HIV data for young men and women aged 15–24 years from the ZDHS 2001/2 and 2007. In addition, we systematically reviewed peer-reviewed articles that have reported findings on HIV prevalence and incidence among young people.

Findings

Overall trends of the ANC surveillance data indicated a substantial HIV prevalence decline among young women in both urban and rural areas. However, provincial declines differed substantially, i.e. between 10% and 68% among urban women, and from stability to 86% among rural women. Prevalence declines were steeper among those with the highest educational attainments than among the least educated. The ZDHS data indicated a significant reduction in prevalence between the two survey rounds among young women only. Provincial-level ZDHS changes were difficult to assess because the sample sizes were small. ANC-based trend patterns were consistent with those observed in PMTCT-based data (2002–2006), whereas population-based surveys in a selected urban community (1995–2003) suggested that the ANC-based data underestimated the prevalence declines in the general populations of both young both men and women.

Conclusion

The overall HIV prevalence declined substantially among young women in Zambia and this is interpreted as indicating a decline in HIV incidence. It is noteworthy that overall national trends masked substantial differences by place and by educational attainment, demonstrating critical limitations in the current focus on overall country-level trends in epidemiological reports.     

Gait patterns of young Japanese women.

Gait patterns of 440 young Japanese women walking along a sidewalk were observed in September. Walking speed, step length and cadence were significantly greater in single walking than in group walking. Time of day, walking direction and clothes did not influence the walking patterns. Step length in heeled shoes was shorter than that in sneakers and flat shoes.     

Low iron intakes among young women in Britain.

A large survey by the Ministry of Agriculture, Fisheries and Food of people aged 15 to 25 showed that the women, and especially the participants "on a diet" or "watching their weight," generally had iron intakes well below the recommended daily allowance. Reduced iron intake appeared to result from diets of reduced iron concentration as well as from energy restriction. Further research is needed to establish whether this population is compromised or whether the current recommended daily allowances are unnecessarily high.