The panel recommends that all patients with PCOS be screened for IGT with a 2-h oral glucose tolerance test. A few members of the AES board recommend alternatively screening women with PCOS for IGT and type 2 DM using an oral glucose tolerance test only in patients with a body mass index of 30 kg/m2 or greater or in lean patients with additional risk factors. Patients with normal glucose tolerance should be rescreened at least once every 2 yr, or more frequently if additional risk factors are identified. Those with IGT should be screened annually for development of type 2 DM. PCOS patients with IGT should be treated with intensive lifestyle modification and weight loss and considered for treatment with insulin-sensitizing agents.
Objectives-Bacterial vaginosis (BV) is the most common vaginal disorder worldwide. Certain lactobacilli produce H 2 0 2 and lactic acid, which normally suppress growth of anaerobes, but in BV, G. vaginalis and other anaerobes proliferate, and the number of lactobacilli decreases. Gardnerella vaginalis colonizes the vaginal epithelium as a biofilm, which likely plays a role in colonization and relapsing infection.Study Design-We developed an in vitro model for G. vaginalis biofilm formation, and compared susceptibilities of biofilms vs. planktonic cultures to H 2 O 2 and lactic acid. The structure and composition of the biofilm matrix were studied in order to design a method for biofilm dissolution.Results-Biofilms tolerated 5-fold and 4-8 fold higher concentrations of H 2 O 2 and lactic acid (respectively) than planktonic cultures. Proteolytic dissolution of biofilms reduced sensitivity to H 2 0 2 and lactic acid. Conclusions-Increased tolerance to H 2 O 2 and lactic acid suggests that biofilm formation contributes to survival of G. vaginalis in the presence of lactobacilli.
Background: It is well-documented that the mental health of pregnant and postpartum women is essential for maternal, child, and family well-being. Of major public health concern is the perinatal mental health impacts that may occur during the ongoing COVID-19 pandemic. It is essential to explore the symptom experience and predictors of mental health status, including the relationship between media use and mental health. Materials and Methods: The purpose of this study is to evaluate the experiences of pregnant and postpartum women (n = 524) in the United States in the early phase of the COVID-19 pandemic. This cross-sectional online observational study collected psychosocial quantitative and qualitative survey data in adult pregnant and postpartum (up to 6 months postdelivery) women in April-June 2020. Results: Multivariable linear regression models were used to evaluate predictors of depressive symptoms, anxiety, and post-traumatic stress disorder. The most common predictors were job insecurity, family concerns, eating comfort foods, resilience/adaptability score, sleep, and use of social and news media. Qualitative themes centered on pervasive uncertainty and anxiety; grief about losses; gratitude for shifting priorities; and use of self-care methods including changing media use.Conclusions: This study provides information to identify risk for anxiety, depression, and PTSD symptoms in perinatal women during acute public health situations. Women with family and job concerns and low resilience/adaptability scores seem to be at high risk of psychological sequelae. Although use of social media is thought to improve social connectedness, our results indicate that increased media consumption is related to increased anxiety symptoms.
Our results highlight factors associated with attendance of PPCVs in low income populations. The continued disparity in postpartum care utilization compels additional efforts to improve access to health services across socioeconomic and demographic boundaries.
Future research should focus on the mechanisms by which inattention and impulsivity affect daily functioning in pregnant women, in addition to investigating potential interventions. Health care professionals should assess for impulsivity and inattention among pregnant women.
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