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Biomedical subjects

Julia A Files

Publications and source records attributed to Julia A Files.

7 recordsLinked to original sources
PubMed2006

Preconception healthcare: what women know and believe.

OBJECTIVES: The objectives of this study were to determine if women realize the importance of optimizing their health prior to a pregnancy, whether the pregnancy is planned or not; and to evaluate their knowledge level and beliefs about preconception healthcare. Additionally, we sought to understand how and when women wanted to receive information on preconception health. METHODS: A survey study was performed using consecutive patients presenting to primary care practices for an annual well-woman exam. Patients were recruited based on appointment type and willingness to complete the survey at the time of their appointment, but prior to being seen by the physician. RESULTS: A total of 499 women completed the survey. Nearly all women (98.6%) realized the importance of optimizing their health prior to a pregnancy, and realized the best time to receive information about preconception health is before conception. The vast majority of patients surveyed (95.3%) preferred to receive information about preconception health from their primary care physician. Only 39% of women could recall their physician ever discussing this topic. The population studied revealed some significant knowledge deficiencies about factors that may threaten the health of mother or fetus. CONCLUSIONS: A majority of women do understand the importance of optimizing their health prior to conception, and look to their Primary care physician as their preferred source for such information. Study participants demonstrated deficiencies in their knowledge of risk factors that impact maternal and fetal health suggesting that physicians are not addressing preconception healthcare during routine care.

Adolescent↗
PubMed2006

Hormonal contraception update.

Unintended pregnancy continues to be a serious public health issue in the United States. Of the 3 million unplanned pregnancies per year, 60% occur in women using some form of contraception. Educating and helping women choose a contraceptive agent that best suits their needs will improve compliance and contraceptive efficacy. A multitude of new contraceptive agents are now available. We review new hormonal contraceptive options and discuss newer oral agents, extended-cycle contraception, and innovative delivery methods.

Contraception↗
PubMed2006

Prevention of migraine in women throughout the life span.

Migraine is a common disorder in women. The 1-year prevalence of migraine is 18% in women compared with 6% in men. Migraine most commonly occurs during the reproductive years, affecting 27% of women 30 to 49 years of age. The predominance of this disorder and its social, functional, and economic consequences make migraine an important issue in women's health. The hormonal milieu has a substantial effect on migraine in women. An understanding of these hormonal influences in the various stages of life in females is essential to the management and prevention of migraines. This article reviews migraine prevention strategies with an emphasis on specific therapies for each stage of a woman's life.

Disease Progression↗
PubMed2005

The use of triptans in the management of menstrual migraine.

Many women experience headaches, including migraine, in association with their menstrual cycles. Although definitions vary, menstrual migraine generally refers to migraine without aura that occurs within several days prior to and several days after the onset of menses. Although menstrual migraine has been reported to be more difficult to treat than other types of migraines, there is no evidence from controlled clinical trials to support this assertion. Thus, the pharmacological treatment of menstrual migraine should be similar to that of other types of migraines, except with respect to the use of hormonal manipulations to treat menstrual migraine. Serotonin 5-HT(1B/1D) receptor agonists (triptans) are effective for the acute treatment of both menstrual and non-menstrual migraines. When used as acute therapy, a triptan should be administered early, when the headache is still mild in severity. Ideally, an acute therapy will provide rapid and complete pain relief with no disability. Some patients may require preventive therapy for menstrual migraine based on suboptimal response to an adequate trial of acute therapy. Patient diaries that record headache onset, relationship to the menstrual cycle and treatment response through three complete cycles will allow accurate prediction of the onset of menstrual migraine; this information is also needed to make decisions about timing of intermittent preventive therapy. The goals of intermittent preventive therapy are to reduce the frequency, duration and intensity of menstrual migraine attacks. Clinical studies show that triptans are effective when used as either acute therapy or as intermittent preventive therapy for menstrual migraine. Sumatriptan and zolmitriptan have been evaluated in prospective, randomised, controlled trials for acute treatment. Retrospective analyses and open-label studies also support the use of other triptans as acute therapy. In addition, sumatriptan, frovatriptan, naratriptan and zolmitriptan have been evaluated as intermittent preventive therapy in prospective studies. Thus, data from clinical studies indicate that triptans are effective for the treatment of menstrual migraine.

Clinical Trials as Topic↗
PubMed2005

Health care maintenance in female adolescents.

The assessment and care of female adolescents by primary care physicians can be facilitated with increased knowledge about this stage of development, the health care risks faced by these patients, and the resources available to aid in their care. With a focus on preventive health maintenance, this concise review addresses these areas as well as how to build relationships with female adolescent patients, conduct age-appropriate interviews and tests, and maintain patient confidentiality.

Adolescent↗
PubMed2003

In search of balance: medicine, motherhood, and madness.

Women physicians have made great strides not only in gaining acceptance but also in excelling in the medical profession. A large minority of physicians today are women. Success in the dual roles of mother and physician really is possible, and the experience offers a uniquely rich and complex life. Our hope is that the practical suggestions offered here will prove useful to the next generation of women physicians and that each subsequent generation will become ever more successful in filling these roles.

Activities of Daily Living↗