Women and Development

Exposure to excessive amounts of lead over a long period of time (chronic exposure) increases the risk of developing certain diseases. The parts of the body which may be affected include the blood, nervous system, digestive system, reproductive system, and kidneys. These effects include anemia, muscular weakness, kidney damage, and reproductive effects, such as reduced fertiHty in both men and women, and damage to the fetus of exposed pregnant women. 

Clinicians have more recently become more aware of elevated rates of posttraumatic stress disorder (PTSD) in both men and women with opioid dependence (Hien et al. 2000). A lifetime prevalence of PTSD of 20% in women and 11% in men was found in one sample of methadone maintenance patients (Villagomez et al. 1995). Patients often deny a PTSD history during initial assessment. They should be reassessed after they have had the opportunity to develop trust in their treating clinicians. 

Post-traumatic stress disorder (PTSD) is a severe condition with a lifetime prevalence of about 12.5% in women and 6.2% in men (Pigott, 1999). About one in four individuals exposed to trauma develop the syndrome. Drug treatments are still being developed, mostly using antidepressants. Few systematic data are available on the pharmacoeconomics of the condition. 

Breast cancer is one of the most common forms of cancer affecting women and, in Western countries, the incidence is rising. The risk of breast cancer increases markedly with age, although a decrease in the rate occurs after the menopause, suggesting that development is hormone-dependent. To date, a number of hormone-related risk factors have been identified (Bingham et al, 1998). Countries such as Japan have relatively low rates of breast cancer, which have been associated with consumption of a diet high in soy foods. Currently, however, the data from epidemiological studies is inconclusive. 

The prevalence of hypertension differs based on age, sex, and ethnicity. As individuals become older, their risk of high blood pressure increases. Individuals 55 years of age who do not have hypertension are estimated to have a lifetime risk of 90% of eventually developing hypertension. The National Health and Nutrition Examination Survey from 1999 to 2000 indicated that hypertension is slightly more prevalent in men (30.1%) than women (27.1%). However, the prevalence increased by 5.6% in women and has remained unchanged in men from 1988 to 2000.5 Hypertension prevalence is highest in African-Americans when compared to non-Hispanic whites and Mexican-Americans.1... 

In 1990, Vatten et al.51 in Norway subsequently reviewed data on breast cancer risk from a cohort of 14,593 women with 152 cases of breast cancer during a follow up of 12 years on subjects who were between 35 and 51 years old at the beginning of the study and between 46 and 63 years at the end. They reported no overall statistically significant correlation between breast cancer and coffee consumption, but when body mass index was taken into account, lean women who consumed >5 cups per day had a lower risk than women who drank two cups or less. In obese women, however, there was a positive correlation between coffee intake and breast cancer. In a 1993 study, though, Folsom and associates52 failed to find an association between caffeine and postmenopausal breast cancer in 34,388 women in the Iowa Women s Health Study, with a median caffeine intake of 212 mg/day in women who developed breast cancer and 201 mg/day for women who did not and in Denmark, Ewertz53 studied... 

Participatory Approaches inclusive of all stakeholders—both before an activity is initiated and throughout (e.g., women in developing countries). 

The O Flaherty Model simulates the age-dependence of lead kinetics on such factors as absorption efficiency, excretion efficiency, uptake into bone and loss from bone, and partitioning between plasma and red blood cells. The model does not incorporate age, dose rate, or time dependence of lead accumulation in every organ (e g., kidney) because the complex patterns of lead accumulation in certain tissues are not known (O Flaherty 1991a) (see Section 2.4.1). However, the basic model structure allows for additional modules to be incorporated, depending on its intended use in risk assessment. For example, additional modules that are currently being developed are a pregnancy model and a model of net bone loss in older women and men. 

Patient age and hormonal status in women should be considered in the initial evaluation of patients with skin disorders. Older patients are predisposed to developing psoriasis, seborrhea, and other skin conditions. Atopic dermatitis is most likely to occur in children. Menopausal women tend to develop brown hyperpigmentation, or melasma. Pregnant women may develop hyperpigmentation of the areola and genitalia as well as melasma. 

Affairs of the American Medical Association recommends that women be informed about the small risk of interactions with antibiotics, and, if desired, appropriate additional nonhormonal contraceptive agents should be considered. Women who develop breakthrough bleeding during concomitant use of antibiotics and CHCs should be told to use an alternate method of contraception during the period of concomitant use. 

These patients are most commonly women and can be divided into two groups those with fewer than two or three episodes per year and those who develop more frequent infections. 

Based on this concept of correlation between high replication rate/high persistent mutation risk, Pike et al. (1983) formulated the hypothesis of breast tissue age and developed a mathematical model to predict the effects of exposure to ovarian hormones. This model incorporates reproductive and endocrine items related to breast cancer and is able to predict the relative risk of individual situations with results that are very close to those observed in clinical trials. According to this hypothesis, both the years of exposure and the circulating serum levels of estrogens are associated to short-term breast cancer risk in postmenopausal women (Toniolo et al. 1995). 

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