Women’s Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21699
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Browsing Women’s Health by Author "Keck, Erin"
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Item Association of Trauma on Chronic, Infectious, and Reproductive-related Disease Prevalence among Women in Substance Abuse Treatment(2017-03-14) Guardado, Annie; Dokpesi, Philip; Bakre, Sulaimon; Felini, Martha; Keck, ErinBackground: Previous literature demonstrates that individuals with co-occurring substance use disorders (SUDCs) often have comorbid conditions. Although SUDCs have been linked to higher use of medical management, there are few studies of the burden of disease types across and within high risk women in substance abuse treatment. The purpose of this cross-sectional study was to analyze the prevalence of chronic, infectious, and reproductive-related disease separately among women in substance abuse treatment and further explore whether prior trauma history was associated with disease prevalence. Methods: As part of a larger cancer prevention project conducted in Dallas from 2012-2016, 1076 women in treatment at the largest substance abuse treatment center in North Texas received education regarding cancer prevention, and were offered a well woman cancer screening exam. Data collected from a self-administered questionnaire included demographics, medical health history, reproductive history, substance use history, and trauma experience (physical, sexual, verbal/emotional) within the last 6 months. Participants were from 119 counties across Texas, including border counties. Descriptive and stratified analyses were performed to determine disease prevalence by trauma history. Results: Exposure to trauma was correlated with a higher prevalence of chronic disease (p Conclusions: Findings suggest comorbid disease and adverse reproductive outcomes are prevalent in this population. An exceptional window of opportunity exists to integrate preventive and preconception care interventions within treatment recovery centers, but the key challenge will be determining how it can be best delivered to women with significant trauma histories.Item Osteonecrosis Following Radiation and Osteoporosis(2017-03-14) Anderson, Ralph; Miroshnichenko, Gennady; Keck, Erin; Zimmerman, Leah; Mello, LeahObjective: This case report describes osteonecrosis of the pelvis, two and half years after receiving radiation therapy for a leiomyosarcoma of the vagina in a 40 year old female. Methods: The patient presented with a vaginal mass measuring 8 cm which on biopsy showed a leiomyosarcoma (20 mitotic figures / 10 high power fields). She had a resection of the tumor followed by radiotherapy to the pelvis and 6 months of Doxil chemotherapy finishing in March of 2013. Three years later she presented with pelvic pain and instability of walking. A combination of radiologic imaging including a CT scan of her pelvis, a bone scan and a MRI scan of her lumbosacral spine revealed necrotic lesions in the pelvic ischium and bilateral pelvic insufficiency fractures in the sacrum. Biopsy of the tissues showed necrotic tissue but no cancer. A DEXA scan was performed which showed diagnostic T scores as L spine -0.6, femoral neck -3.1, total hip -3.1, giving a WHO classification of osteoporosis. Results: Her treatment for osteonecrosis and osteoporosis includes calcium, vitamin E, oyster shell, weight bearing exercises and Fosamax 70 milligrams daily. Her pain has improved and she no longer requires utilizing a walker. Conclusions: In women who present with pelvic pain after pelvic radiotherapy, bony destruction and fractures can be indicative of a late radiation effect rather than osseous metastases. Patients with osteoporosis are at a much higher risk for developing post-radiotherapy osteonecrosis and fractures. Conservative treatment together with Fosamax have begun to show improvement in the clinical condition of the patient. Radiological imaging will be utilized as appropriate to determine improvement in the status of the pelvic bone.