Vulvar contact dermatitis

Contact dermatitis is a common problem in the world of dermatology as well as women’s health, where vulvar irritation is a frequent complaint among women. It occurs following exposure to exogenous irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis), and can present in acute, subacute, or chronic forms. While vulvar pruritus and pain can be seen in a number of different conditions, contact dermatitis is one of the most common causes encountered in clinical practice, and its effects on patient quality of life can be dramatic. With a thorough history and a complete physical exam, this prevalent condition can be diagnosed and addressed. Treatment is aimed at identifying and eliminating the underlying cause, restoring the damaged epithelial barrier, and calming the inflammation. Although numerous options are available for addressing the itch and pain, the only true ”cure” for contact dermatitis is to avoid the responsible exposures

La vida jaibera: the gendered work and migration experiences of female guestworkers in the rural southeast

Recruitment of female guestworkers by the U.S. seafood processing industry provides Mexican women with opportunities to support their families financially through legal, seasonal labor migration--but at the cost of family separation. Interviews with workers from two plants in the rural Southeast and two formers workers demonstrate that the separation of production and reproduction means that women must negotiate migration within gendered models of marriage and motherhood across borders. Their accounts indicate that family contexts interact with precarious legal status to shape women's migration experiences, possibilities for permanent settlement, and U.S. labor market opportunities. Despite classification as temporary nonimmigrants, I find that crab pickers, or jaiberas, use seasonal migration to the United States as a long-term strategy to support families in Mexico, and are held in temporary positions in both locations. Political and labor market contexts and family arrangements subject them systems of control that have important policy implications.Master of Art

Influence of infertility diagnosis on pregnancy outcome in ART

Abstract Objective: To determine the influence of the infertility diagnosis on gestational age (GA) and birth weight (BW) of children conceived using assisted reproductive technology (ART). Design: Retrospective cohort. Setting: University-affiliated infertility clinic. Patients: Women with a singleton live birth following their first fresh ART cycle with autologous oocytes. Interventions: Patients were stratified into groups based on infertility diagnosis. GA and BW of their infants were compared. Main Outcome Measures: GA and BW of children conceived using ART. Results: 397 women were included. Average GA in the cohort was 38.7±2.3 weeks and average BW was 3301.5±633.8 grams. Maternal age, BMI, and parity were significantly different between groups. After controlling for these factors and stratifying by infertility diagnosis, there was no difference in GA or BW in infants conceived with ART. Conclusions: Contrary to previously reported data, there was no difference in GA or BW in infants conceived with ART when stratified by infertility diagnosis. Our results were not different from the national population; however GA was one week longer in our cohort than in the national ART database. These data suggest a difference exists between our cohort and the ART population at large. We propose that the main difference is our institution’s focus on single embryo transfer

Constrained Choices: Latina Immigrants Negotiating Work, Family, and Legality in the New South

Undocumented people are often described as living and working “in the shadows.” This framing identifies the illegality of migrants as an individual characteristic. Yet federal, state, and local policies are structural features that shape the meaning and consequences of being unauthorized in the United States. Latinas have increasingly joined migration streams and now constitute 46 percent of unauthorized people in the United States. In this dissertation, I identify the constraints and opportunities for Latina immigrant workers in North Carolina, a new destination state. Drawing on in-depth interviews with 48 women, as well as a focus group with women from five North Carolina counties, I analyze women’s experiences with work, family, and migration across the life course. Women’s accounts revealed that workers’ identities were frequently formed through early labor force participation in their countries of origin. Once in the United States, women’s labor force participation was increasingly constrained by employment restrictions targeting the undocumented at the same time that they faced the pull of family demands as they married and had children. In response to these constraints, women turned to work in so-called “nonstandard” employment relationships such as subcontracted work and self-employment. In some cases, these arrangements represent a survival strategy associated with exploitation and poor job quality. In other cases, nonstandard employment suggests a “strategy of resistance” in which women create mobility pathways associated with improved job quality and the achievement of work-family balance. Findings contribute to understanding the macro- and micro-level forces shaping intersectional inequality for U.S. immigrant populations and hold policy implications at state and federal levels.Doctor of Philosoph

Utilizing ethnic-specific differences in minor allele frequency to recategorize reported pathogenic deafness variants

Q1Q1Artículo original445-453Ethnic-specific differences in minor allele frequency impact variant categorization for genetic screening of nonsyndromic hearing loss (NSHL) and other genetic disorders. We sought to evaluate all previously reported pathogenic NSHL variants in the context of a large number of controls from ethnically distinct populations sequenced with orthogonal massively parallel sequencing methods. We used HGMD, ClinVar, and dbSNP to generate a comprehensive list of reported pathogenic NSHL variants and re-evaluated these variants in the context of 8,595 individuals from 12 populations and 6 ethnically distinct major human evolutionary phylogenetic groups from three sources (Exome Variant Server, 1000 Genomes project, and a control set of individuals created for this study, the OtoDB). Of the 2,197 reported pathogenic deafness variants, 325 (14.8%) were present in at least one of the 8,595 controls, indicating a minor allele frequency (MAF) >0.00006. MAFs ranged as high as 0.72, a level incompatible with pathogenicity for a fully penetrant disease like NSHL. Based on these data, we established MAF thresholds of 0.005 for autosomal-recessive variants (excluding specific variants in GJB2) and 0.0005 for autosomal-dominant variants. Using these thresholds, we recategorized 93 (4.2%) of reported pathogenic variants as benign. Our data show that evaluation of reported pathogenic deafness variants using variant MAFs from multiple distinct ethnicities and sequenced by orthogonal methods provides a powerful filter for determining pathogenicity. The proposed MAF thresholds will facilitate clinical interpretation of variants identified in genetic testing for NSHL. All data are publicly available to facilitate interpretation of genetic variants causing deafness

Vulvodynia

Vulvodynia is a complex disorder reported by up to 16% of women in the general population. While most patients describe it as burning, stinging, irritation, or rawness, it is underreported and underrecognized by providers. Vulvodynia is costly both economically and psychologically due to its negative impact on quality of life. Vulvodynia is a diagnosis of exclusion with unknown etiology and may involve multiple sources of pain in the same woman. Thus, there are no clinical or histopathologic criteria for the diagnosis other than consideration and careful evaluation to exclude other causes of pain. Successful therapy often requires a multidisciplinary approach with more than one therapeutic intervention to address the physical, psychological, psychosexual, and relationship components