BackgroundSomali women are infrequently screened for breast or cervical cancer, and there is a paucity of evidence-based interventions to increase cancer screening in this community. In order to create a culturally relevant intervention for Somali women living in Minnesota, we sought to understand what Somali immigrant women know about breast and cervical cancer, what are the attitudes toward screening and what cultural barriers are there to screen as well as cultural factors that would facilitate screening.MethodsIn partnership with a community-based organization, New American Community Services (NACS), focus groups were conducted to explore the issues described above. Two focus groups were held with younger women age 20 to 35 and two were held with women age 36 to 65.ResultsTwenty-nine women participated in the four focus groups. The women identified 1) differences in health care seeking behavior in Somalia verses the United States; 2) cultural understanding of cancer and disease; 3) barriers to mammogram or Pap screening; 4) facilitators to seeking preventive cancer screening; and 5) risk factors for developing cancer.ConclusionsCultural misperceptions and attitudes need to be addressed in developing culturally-appropriate interventions to improve screening uptake for Somali women. A nuanced response is required to address barriers specific to younger and older groups. Culturally informed beliefs can be integrated into intervention development, preventive care and screening promotion.

Several demographics and smoking-related symptomatology were significantly different between pregnant quitters and pregnant smokers. In addition, multiple factors predicting postpartum relapse were identified. This information can inform personalized interventions for high risk pregnant smokers and pregnant quitters at risk for postpartum relapse.

A term neonate was admitted to the Neonatal Intensive Care Unit for respiratory distress, hypotonia and atypical genitalia. Significant findings included a small phallic structure, labial folds, no palpable gonads and two perineal openings. Pelvic ultrasound showed uterine didelphys and a gonad in the right inguinal canal. The right gonad was removed during diagnostic laparoscopy with microscopic evaluation showing infantile testicular tissue and fluorescence in-situ hybridisation showed only XY signal suggesting that the removed gonad was a male-developed testis. Infant was 46,XY, SRY probe positive. The parents chose a female sex assignment prior to gonadectomy. The infant had respiratory insufficiency and central hypotonia that persisted on discharge. Whole exome sequencing showed a heterozygous pathogenic variant of the PBX1 gene. This variant encodes the pre-B-cell leukaemia homeobox PBX transcription factor and has been associated with malformations and severe hypoplasia or aplasia of multiple organs including lungs and gonads. Whole exome sequencing was crucial in providing a unifying diagnosis for this patient.

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INTRODUCTION: In pregnant women with hypertension, the presence of headache or visual symptoms may prompt early delivery due to concern for preeclampsia (PE) and eclampsia. We evaluated subjects with preeclampsia with severe features (PE-SF) to assess the impact of these symptoms on maternal and neonatal outcomes. METHODS: Retrospective cohort study of subjects with PE-SF, ≥23 weeks gestation at a single institution (October 2013-May 2017). Subjects were identified by ICD-9 and ICD-10 codes, with charts reviewed for diagnostic accuracy. Symptoms like headache and visual disturbances were determined by physician documentation. We compared outcomes in three groups: 1. No headache or visual disturbances; 2. Severe headache only; 3. Severe headache and visual disturbances. Significance determined by chi-square or t-test. RESULTS: Among 8,645 deliveries, 318 women (3.7%) delivered with PE-SF; 192 (60.4%) had no headache or visual disturbances, 68 (21.4%) severe headache only, and 39 (12.3%) both headache and visual disturbances. Maternal admission to the intensive care unit, pulmonary edema, kidney injury, or hemolysis, elevated liver enzymes, low platelet count syndrome, were no different between groups. However, those with both headache and visual disturbances had increased risk of eclampsia, p=0.016. Those with headache were delivered earlier (p<0.0001), more likely to have neonates born preterm (p=0.007) or admitted to the Neonatal Intensive Care Unit (NICU), p=0.02. CONCLUSION: We find that headache and visual disturbances contribute disproportionately to preterm delivery and NICU admission rates in PE-SF. However, the increased risk of eclampsia in this setting suggests that such action is justifiable.