Screening for Gynecologic Conditions With Pelvic Examination US Preventive Services Task Force Recommendation Statement

IMPORTANCE Many conditions that can affect women\u27s health are often evaluated through pelvic examination. Although the pelvic examination is a common part of the physical examination, it is unclear whether performing screening pelvic examinations in asymptomatic women has a significant effect on disease morbidity and mortality. OBJECTIVE To issue a new US Preventive Services Task Force(USPSTF) recommendation on screening for gynecologic conditions with pelvic examination for conditions other than cervical cancer, gonorrhea, and chlamydia, for which the USPSTF has already made specific recommendations. EVIDENCE REVIEW The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women 18 years and older who are not at increased risk for any specific gynecologic condition. FINDINGS Overall, the USPSTF found inadequate evidence on screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions in asymptomatic, nonpregnant adult women. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women. (I statement) This statement does not apply to specific disorders for which the USPSTF already recommends screening (ie, screening for cervical cancer with a Papanicolaou smear, screening for gonorrhea and chlamydia)

A 14-year longitudinal study of the impact of clean indoor air legislation on state smoking prevalence, USA, 1997-2010

While clean indoor air legislation at the state level is an evidence-based recommendation, only limited evidence exists regarding the impact of clean indoor air policies on state smoking prevalence. Using state smoking prevalence data from 1997 to 2010, a repeated measures observational analysis assessed the association between clean indoor air policies (i.e., workplace, restaurant, and bar) and state smoking prevalence while controlling for state cigarette taxes and year. The impacts from the number of previous years with any clean indoor air policy, the number of policies newly in effect during the current year, and the number of policies in effect the previous year were analyzed. Findings indicate a smoking prevalence predicted decrease of 0.13 percentage points (p = 0.03) for each additional year one or more clean indoor air policies were in effect, a predicted decrease of 0.12 percentage points (p = 0.09) for each policy newly in effect in the current year, and a predicted decrease of 0.22 percentage points (p = 0.01) for each policy in effect in the previous year on the subsequent year. Clean indoor air policies show measurable associations with reductions in smoking prevalence within a year of implementation above and beyond taxes and time trends. Further efforts are needed to diffuse clean indoor air policies across states and provinces that have not yet adopted such policies.ECU Open Access Fun

Prevalence of Obesity and Its Association with Cardiovascular Disease Risk Factors in Adolescent Girls from a College in Central Taiwan

Although obesity is associated with important hemodynamic disturbances, little data exists on population-wide cardiovascular risk factors in obese adolescent girls in Taiwan. This study measured the prevalence of overweight/obesity and related cardiovascular disease risk factors in adolescent females. This was a school-based survey of a representative sample of 291 females aged 15 and 18 years in a public college in Central Taiwan. The main measures were height, body weight, systolic (SBP) and diastolic blood pressure (DBP), uric acid, cholesterol, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). Obese (body mass index [BMI]≥25.3) and overweight (22.7≤BMI≤25.2) individuals were combined and labeled as overweight (BMI ≥22.7) to make communication of results clearer. Data gleaned from freshmen's health examinations were analyzed. The prevalence of obesity (BMI≥25.3) was 9.28% and of overweight (BMI≥22.7) was 21.31%. Being overweight was associated with higher SBP, DBP, uric acid and TG, and lower levels of HDL-C, but was not associated with cholesterol. The 15-year-old group showed higher mean levels of uric acid, total cholesterol, TG and HDL-C than the 18-year-old group (p < 0.05). All told, 3.1%, 15.12% and 2.1% of the girls showed abnormally elevated levels of uric acid, cholesterol and TG, respectively. In addition, 5.84% had abnormally lower HDL-C levels, indicating that interventions should focus on reducing obesity and encouraging proper dietary habits and sufficient exercise, especially in subjects with lower HDL-C levels and higher levels of cholesterol, TG and uric acid