35 results on '"Suneela Vegunta"'
Search Results
2. Human Trafficking Education: A Pilot Study of Integration into Medical School Curriculum
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Devika M Das, Jennifer MV Talbott, Jordan S Dutcher, Matthew Buras, Elisabeth Lim, Suneela Vegunta, Paru David, and Juliana M Kling
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Special aspects of education ,LC8-6691 ,Medicine (General) ,R5-920 - Abstract
OBJECTIVES Few medical schools incorporate formal education on human trafficking (HT) and sex trafficking (ST) into their curriculum. Our objective was to develop, implement, and evaluate education on HT and ST in the first-year medical student curriculum. METHODS The curriculum included a standardized patient (SP) experience and lecture. As part of their mandatory sexual health course, students interviewed an SP who presented with red flags for ST and then participated in a discussion led by a physician-facilitator in an observed small group setting. A multiple-choice survey to assess knowledge about HT and ST was developed and administered to students before and after the SP interview. RESULTS Of the 50 first-year medical students, 29 (58%) participated in the survey. Compared with the students’ baseline scores (according to the percentage of correct responses), scores after the educational intervention showed a significant increase in percentage correct on questions related to trafficking definition and scope (elder care, P = .01; landscaping, P = .03); victim identification ( P
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- 2023
- Full Text
- View/download PDF
3. Prevalence, Impact, and Diagnostic Challenges of Benign Breast Disease: A Narrative Review
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Jessica L Fraker, Caroline G Clune, Sabrina K Sahni, Avani Yaganti, and Suneela Vegunta
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Oncology ,Maternity and Midwifery ,Obstetrics and Gynecology - Published
- 2023
4. Association Between Lifestyle Changes, Mammographic Breast Density, and Breast Cancer
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Sara P, Lester, Aparna S, Kaur, and Suneela, Vegunta
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Cancer Research ,Oncology ,Risk Factors ,Humans ,Breast Neoplasms ,Female ,Life Style ,Breast Density ,Mammography - Abstract
In screening for breast cancer (BC), mammographic breast density (MBD) is a powerful risk factor that increases breast carcinogenesis and synergistically reduces the sensitivity of mammography. It also reduces specificity of lesion identification, leading to recalls, additional testing, and delayed and later-stage diagnoses, which result in increased health care costs. These findings provide the foundation for dense breast notification laws and lead to the increase in patient and provider interest in MBD. However, unlike other risk factors for BC, MBD is dynamic through a woman’s lifetime and is modifiable. Although MBD is known to change as a result of factors such as reproductive history and hormonal status, few conclusions have been reached for lifestyle factors such as alcohol, diet, physical activity, smoking, body mass index (BMI), and some commonly used medications. Our review examines the emerging evidence for the association of modifiable factors on MBD and the influence of MBD on BC risk. There are clear associations between alcohol use and menopausal hormone therapy and increased MBD. Physical activity and the Mediterranean diet lower the risk of BC without significant effect on MBD. Although high BMI and smoking are known risk factors for BC, they have been found to decrease MBD. The influence of several other factors, including caffeine intake, nonhormonal medications, and vitamins, on MBD is unclear. We recommend counseling patients on these modifiable risk factors and using this knowledge to help with informed decision making for tailored BC prevention strategies.
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- 2022
5. Latent HPV Infection: Does HPV Last Forever in Some Women?
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Patress Persons, Margaret Long, and Suneela Vegunta
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General Medicine - Published
- 2023
6. Abnormal Uterine Bleeding in Perimenopausal Women
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Michelle Y, Louie and Suneela, Vegunta
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Pregnancy ,Humans ,Female ,Hysteroscopy ,Uterine Hemorrhage ,General Medicine ,Perimenopause - Published
- 2022
7. Changing US trends in contraceptive choices
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Suneela Vegunta, Aakriti R. Carrubba, and Megan Wasson
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medicine.medical_specialty ,Obstetrics ,business.industry ,Medroxyprogesterone Acetate ,General Medicine ,United States ,Subdermal implant ,Safety profile ,Contraception ,Contraceptive Agents, Female ,medicine ,Humans ,Medroxyprogesterone acetate ,Female ,business ,Etonogestrel ,Intrauterine Devices ,medicine.drug - Abstract
Long-acting reversible contraceptives (ie, intrauterine devices and the etonogestrel subdermal implant) have become increasingly popular methods of contraception because of their convenience and safety profile. At the same time, the use of depot medroxyprogesterone acetate, one of the most prescribed contraceptives in the United States since its approval in 1992, is on the wane. The history and pros and cons of these contraceptive methods are reviewed.
- Published
- 2021
8. Identifying women with increased risk of breast cancer and implementing risk-reducing strategies and supplemental imaging
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Aparna S Kaur, Sandhya Pruthi, Sadia Choudhery, Suneela Vegunta, and Asha A Bhatt
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medicine.diagnostic_test ,business.industry ,Cancer ,General Medicine ,medicine.disease ,Lifestyle factors ,Increased risk ,Breast cancer ,Oncology ,Risk factors for breast cancer ,Environmental health ,Health care ,Medicine ,Breast MRI ,Pharmacology (medical) ,Radiology, Nuclear Medicine and imaging ,Lifetime risk ,business - Abstract
Breast cancer (BC) is the second most common cancer in women, affecting 1 in 8 women in the United States (12.5%) in their lifetime. However, some women have a higher lifetime risk of BC because of genetic and lifestyle factors, mammographic breast density, and reproductive and hormonal factors. Because BC risk is variable, screening and prevention strategies should be individualized after considering patient-specific risk factors. Thus, health care professionals need to be able to assess risk profiles, identify high-risk women, and individualize screening and prevention strategies through a shared decision-making process. In this article, we review the risk factors for BC, risk-assessment models that identify high-risk patients, and preventive medications and lifestyle modifications that may decrease risk. We also discuss the benefits and limitations of various supplemental screening methods.
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- 2021
9. Screening Women for Anal Cancers: Guidance for Health Care Professionals
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M. Helen Whited, Suneela Vegunta, Margaret E. Long, and Amit A. Shah
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Oncology ,medicine.medical_specialty ,education.field_of_study ,Hepatology ,business.industry ,Incidence (epidemiology) ,Mortality rate ,Population ,Gastroenterology ,MEDLINE ,Cancer ,Anus Neoplasms ,medicine.disease ,Risk Factors ,Internal medicine ,Health care ,Carcinoma, Squamous Cell ,medicine ,Carcinoma ,Humans ,Anal cancer ,Female ,business ,education ,Early Detection of Cancer - Abstract
Anal cancer is rare in the general population but is steadily increasing in incidence over the past decade especially in women. Identification and screening of women with high risk facilitates detection of anal precancer and early-stage cancer, improves survival, and potentially uses less invasive therapies compared with the conventional chemoradiation treatments used for advanced cancers. No recently published guidelines currently describe details about screening women for anal squamous cell cancer (ASCC). The available evidence supports the existence of groups of women with higher prevalence of ASCC (e.g., women with human immunodeficiency virus, immune suppression, or previous lower-genital high-grade lesion or cancer) who would likely benefit from screening with some combination of anal cytology and human papillomavirus testing. Additional research is needed to establish the cost-effectiveness and the influence of screening on ASCC mortality rates.
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- 2021
10. Should women with HPV-related noncervical cancers be considered at high risk for cervical cancer?
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Suneela Vegunta and Margaret E. Long
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Adult ,Oncology ,Cervical cancer ,medicine.medical_specialty ,Genotype ,Genital Neoplasms, Female ,business.industry ,Papillomavirus Infections ,MEDLINE ,Uterine Cervical Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,Risk Assessment ,Text mining ,Internal medicine ,Practice Guidelines as Topic ,Humans ,Women's Health ,Medicine ,Female ,business ,Papillomaviridae ,Early Detection of Cancer - Published
- 2020
11. Acute Liver Failure: Biomarkers Evaluated by the Acute Liver Failure Study Group
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Jorge L. Rakela, Constantine J. Karvellas, David G. Koch, Suneela Vegunta, and William M. Lee
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Gastroenterology - Published
- 2023
12. Influence of Menopausal Hormone Therapy on the Breast: Counseling Your Patients Before You Prescribe
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Sara P. Lester and Suneela Vegunta
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Oncology ,Counseling ,medicine.medical_specialty ,business.industry ,Hormone Replacement Therapy ,medicine.medical_treatment ,Estrogen Replacement Therapy ,Breast Neoplasms ,General Medicine ,medicine.disease ,Menopause ,Quality of life ,Low estrogen levels ,Internal medicine ,Quality of Life ,Medicine ,Humans ,Female ,Hormone therapy ,Menopausal hormone therapy ,business ,Mammography - Abstract
Menopausal hormone therapy (HT) aims to improve a woman's quality of life by treating bothersome menopausal symptoms associated with low estrogen levels. Although HT is prescribed to millions of women worldwide, its breast-related adverse effects have always been a concern. Some of the common adverse effects of HT are breast fullness, increased breast density, and increased breast cancer (BC) risk. Health care professionals need to be aware of the influence of HT on breast tissue to provide appropriate counseling as part of informed decision making. Our review summarizes the influence of HT on breast symptoms, breast density, mammograms, and BC risk.
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- 2021
13. Baseline Mammography: What Is It and Why Is It Important? A Cross-Sectional Survey of Women Undergoing Screening Mammography
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Juliana M. Kling, Roxanne Lorans, Robert K. Horsley, H’hamed Temkit, Suneela Vegunta, and Bhavika K. Patel
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Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Screening mammogram ,Cross-sectional study ,Primary care ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Breast cancer screening ,0302 clinical medicine ,Surveys and Questionnaires ,Health care ,medicine ,Humans ,Mass Screening ,Mammography ,False Positive Reactions ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,skin and connective tissue diseases ,Baseline (configuration management) ,Early Detection of Cancer ,health care economics and organizations ,Aged ,medicine.diagnostic_test ,Screening mammography ,business.industry ,Middle Aged ,United States ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Family medicine ,Educational Status ,Female ,business - Abstract
Objectives Studies have shown that having a baseline mammogram, the first screening mammogram, available for comparison at the time of interpreting a subsequent mammogram significantly decreases the potential of a false-positive examination. Our aim was to evaluate knowledge of and perception about the significance of baseline mammograms in those women undergoing screening mammography. Materials and Methods A cross-sectional prospective survey study was conducted in women without a history of breast cancer presenting for their screening mammogram. Respondents were surveyed anonymously between March and April 2017. The questionnaire was developed by primary care providers and radiologists and pretested for readability and clarity. Results In all, 401 women (87% white, 93% educated beyond high school) completed surveys in which 77% of women reported having yearly mammograms, 31% reported having a history of an abnormal mammogram, and 45% had not heard the term baseline mammogram. Of those who had heard the term, the most commonly reported source was their primary care provider (31%). Although 74% chose the correct definition of a baseline mammogram, 67% did not think that a baseline mammogram was important for decreasing associated cost, time, and discomfort due to the number of mammograms incorrectly read as abnormal. Conclusion In a group of educated women who routinely get mammograms, almost one-half had not heard the term baseline mammogram. Furthermore, most women did not think baseline mammography was important for decreasing associated cost, time, and discomfort due to mammograms incorrectly read as abnormal. This study suggests that efforts to improve women’s understanding of baseline mammograms and their importance are warranted, with greatest opportunity for health care providers and radiologists.
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- 2019
14. Effects of major lifestyle factors on breast cancer risk: impact of weight, nutrition, physical activity, alcohol and tobacco
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Dawn M. Mussallem, Sandhya Pruthi, Suneela Vegunta, and Sara P. Lester
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Risk impact ,business.industry ,Physical activity ,Alcohol ,medicine.disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Lifestyle factors ,Breast cancer ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Environmental health ,medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,business - Abstract
Breast cancer (BC) is the most commonly diagnosed cancer and second most common cause of cancer death in US women. Family history and genetics are well-known BC risk factors, but they only account for 15–20% of BC cases. Therefore, in addition to family history, healthcare providers must consider a woman’s modifiable and nonmodifiable personal risk factors that are associated with an increase in BC risk. The World Cancer Research Fund/American Institute for Cancer Research estimate that 30% of BC cases in the US are preventable. Lifestyle education is imperative given the magnitude of BC occurrence. Evidence supports prevention as an effective, long-term strategy for reducing risk. Healthcare providers are key stakeholders in empowering patients to adopt a healthy lifestyle for primary BC prevention. In this paper, we review the available evidence on modifiable BC risk including weight management, nutrition, physical activity, alcohol and tobacco use and provide strategies to counsel patients on lifestyle modifications.
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- 2020
15. Response to Albuquerque et al
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Amit A. Shah, Suneela Vegunta, Margaret E. Long, and M. Helen Whited
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Hepatology ,business.industry ,Gastroenterology ,Medicine ,business ,Humanities - Published
- 2021
16. Identifying women with increased risk of breast cancer and implementing risk-reducing strategies and supplemental imaging
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Suneela, Vegunta, Asha A, Bhatt, Sadia A, Choudhery, Sandhya, Pruthi, and Aparna S, Kaur
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Diagnostic Imaging ,Menarche ,Breast Neoplasms ,Genetic Counseling ,Risk Assessment ,Primary Prevention ,Risk Factors ,Practice Guidelines as Topic ,Humans ,Female ,Genetic Predisposition to Disease ,Menopause ,Life Style ,Early Detection of Cancer ,Breast Density ,Mammography - Abstract
Breast cancer (BC) is the second most common cancer in women, affecting 1 in 8 women in the United States (12.5%) in their lifetime. However, some women have a higher lifetime risk of BC because of genetic and lifestyle factors, mammographic breast density, and reproductive and hormonal factors. Because BC risk is variable, screening and prevention strategies should be individualized after considering patient-specific risk factors. Thus, health care professionals need to be able to assess risk profiles, identify high-risk women, and individualize screening and prevention strategies through a shared decision-making process. In this article, we review the risk factors for BC, risk-assessment models that identify high-risk patients, and preventive medications and lifestyle modifications that may decrease risk. We also discuss the benefits and limitations of various supplemental screening methods.
- Published
- 2020
17. Can't See the Forest for the Trees: Cancer Screening in Dense Breasts
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Suneela Vegunta, Juliana M. Kling, and Bhavika K. Patel
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medicine.medical_specialty ,Obstetrics ,business.industry ,Cancer screening ,medicine ,Humans ,Breast Neoplasms ,General Medicine ,business ,Early Detection of Cancer ,Breast Density ,Mammography - Published
- 2020
18. Supplemental Cancer Screening for Women With Dense Breasts: Guidance for Health Care Professionals
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Juliana M. Kling, Bhavika K. Patel, and Suneela Vegunta
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medicine.medical_specialty ,medicine.diagnostic_test ,Screening test ,business.industry ,education ,MEDLINE ,Breast Neoplasms ,General Medicine ,medicine.disease ,Risk Assessment ,Breast cancer screening ,Mammographic breast density ,Breast cancer ,Family medicine ,Cancer screening ,Health care ,Medicine ,Mammography ,Humans ,Female ,skin and connective tissue diseases ,business ,Early Detection of Cancer ,Breast Density - Abstract
Mammography is the standard for breast cancer screening. The sensitivity of mammography in identifying breast cancer, however, is reduced for women with dense breasts. Thirty-eight states have passed laws requiring that all women be notified of breast tissue density results in their mammogram report. The notification includes a statement that differs by state, encouraging women to discuss supplemental screening options with their health care professionals (HCPs). Several supplemental screening tests are available for women with dense breast tissue, but no established guidelines exist to direct HCPs in their recommendation of preferred supplemental screening test. Tailored screening, which takes into consideration the patient's mammographic breast density and lifetime breast cancer risk, can guide breast cancer screening strategies that are more comprehensive. This review describes the benefits and limitations of the various available supplemental screening tests to guide HCPs and patients in choosing the appropriate breast cancer screening.
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- 2020
19. Vasomotor symptoms in women over 60: results from the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS)
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Karla S. Frohmader Hilsaca, Ekta Kapoor, Juliana M. Kling, Suneela Vegunta, Kristin C. Mara, Darrell R. Schroeder, Paru S. David, Carol L. Kuhle, and Stephanie S. Faubion
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Gerontology ,Drug-Related Side Effects and Adverse Reactions ,Hormone Replacement Therapy ,Cross-sectional study ,General Mathematics ,medicine.medical_treatment ,Sweating ,Anxiety ,Hysterectomy ,Cohort Studies ,Healthy Aging ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Risk Factors ,Hot flash ,Caffeine ,Surveys and Questionnaires ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Aged ,030219 obstetrics & reproductive medicine ,Marital Status ,integumentary system ,Vasomotor ,business.industry ,Applied Mathematics ,Obstetrics and Gynecology ,Hormone replacement therapy (menopause) ,Middle Aged ,medicine.disease ,Vasomotor System ,Menopause ,Cross-Sectional Studies ,Logistic Models ,Hot Flashes ,Multivariate Analysis ,Quality of Life ,cardiovascular system ,Marital status ,Female ,medicine.symptom ,business ,circulatory and respiratory physiology ,Cohort study - Abstract
Frequency of vasomotor symptoms (VMS) in older women and the contributing factors are largely undefined. We measured the frequency of moderate-to-severe vasomotor symptoms (msVMS) in women ≥60 years of age and examined their characteristics to determine factors that may associate with VMS in older women.A cross-sectional survey was completed using the Menopause Health Questionnaire from the Data Registry on Experiences of Aging, Menopause, and Sexuality. Data were collected from women presenting for menopause consultation to Mayo Clinic, Rochester, MN, from January 1, 2006 to October 7, 2014. We created a binary variable where women were classified as having msVMS bother if they reported "quite a bit" or "extremely" compared with women reporting "not at all" or "a little bit." Women with and without msVMS were evaluated by menopause type, self-rated heath, current tobacco, caffeine, and alcohol use, as well as pertinent medication use. Associations between participant characteristics and msVMS were evaluated using logistic regression and a multivariable model with age as a covariate. Interactions between participant characteristics and age were also assessed.Of the 4,956 women presenting for menopause consultation, 921 (18%) were ≥60 years old. Of these, 379 (41.2%) reported msVMS bother. Women with msVMS were more likely to have a history of nonspontaneous menopause and report their health as fair, versus good or excellent. Women reporting current use of hormone therapy (HT) (21%) were less likely to report msVMS compared with those not taking HT (P 0.001).A substantial number of women seen in a specialty menopause clinic were over age 60 years and reported msVMS, highlighting that VMS may be disruptive in women over a decade past the natural age of menopause.
- Published
- 2018
20. Androgen Therapy in Women
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Juliana M. Kling, Ekta Kapoor, and Suneela Vegunta
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Pediatrics ,medicine.medical_specialty ,Hormone Replacement Therapy ,medicine.medical_treatment ,Sexual arousal ,Libido ,030209 endocrinology & metabolism ,Corrections ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Testosterone ,030212 general & internal medicine ,Sexual Dysfunctions, Psychological ,business.industry ,Hypoactive sexual desire disorder ,Hormone replacement therapy (menopause) ,Testosterone (patch) ,General Medicine ,Dehydroepiandrosterone ,medicine.disease ,Postmenopause ,Sexual dysfunction ,Androgen Therapy ,Androgens ,Female ,medicine.symptom ,business ,Sexual function - Abstract
Androgens are believed to have an important biologic role in women, particularly in regulation of libido and sexual arousal, although much about their function on other systems in women is unknown. Testosterone, the primary ovarian androgen, has been used to treat carefully selected postmenopausal women with hypoactive sexual desire disorder (HSDD). However, testosterone use in women has not been approved by the United States Food and Drug Administration (FDA) because of uncertainties regarding the effectiveness and long-term safety of this strategy. An intravaginal form of the adrenal androgen, dehydroepiandrosterone (DHEA) has been approved by the FDA to treat genitourinary syndrome of menopause. In this article, we review the current knowledge regarding the role of androgens and their clinical use in women. We conducted a systematic search of PubMed for publications describing the role and clinical use of androgens in women. We used the search terms "HSDD," "DHEA in women," "testosterone in women," and "androgens in women," and reviewed most references from all relevant articles. Most randomized placebo-controlled trials show an improvement in sexual function with low-dose testosterone therapy in select postmenopausal women with HSDD. Although this strategy appears to be safe in the short term and no major safety concerns have emerged thus far, long-term effects on cardiovascular risk and breast cancer incidence are not known. A trial of low-dose testosterone therapy may be considered for carefully selected postmenopausal women with HSDD, as long as other contributors to sexual dysfunction have been adequately addressed. However, patients need careful counseling regarding the lack of long-term safety data, and close clinical and laboratory monitoring of these women is recommended to avoid supraphysiologic dosing.
- Published
- 2019
21. Newer Name, Newer Treatments: The Genitourinary Syndrome of Menopause
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Juliana M. Kling, Julia A. Files, and Suneela Vegunta
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medicine.medical_specialty ,business.industry ,Genitourinary system ,General surgery ,Estrogens ,Dehydroepiandrosterone ,General Medicine ,medicine.disease ,Female Urogenital Diseases ,Vulva ,Menopause ,Administration, Intravaginal ,Tamoxifen ,Adjuvants, Immunologic ,Vagina ,Humans ,Medicine ,Female ,Atrophy ,business ,Lubricants - Published
- 2019
22. S7 Pancreatic Cancer Continuing Education (PaC-CE) Project: Survey of Primary Care Providers (PCPs) on Diagnosis and Management of Patients With Pancreatic Cancer (PaC)
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Shradha Gupta, Rahul Pannala, Shannon Coombs, and Suneela Vegunta
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medicine.medical_specialty ,Hepatology ,business.industry ,Family medicine ,Pancreatic cancer ,Gastroenterology ,medicine ,Continuing education ,Primary care ,medicine.disease ,business - Published
- 2021
23. Screening Women at High Risk for Cervical Cancer: Special Groups of Women Who Require More Frequent Screening
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Julia A. Files, Megan Wasson, and Suneela Vegunta
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medicine.medical_specialty ,Time Factors ,MEDLINE ,Human immunodeficiency virus (HIV) ,Transplants ,Uterine Cervical Neoplasms ,HIV Infections ,Cervical intraepithelial neoplasia ,Cervical cancer screening ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Mass Screening ,Early Detection of Cancer ,Mass screening ,Vaginal Smears ,Gynecology ,Cervical cancer ,Average risk ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Papillomavirus Infections ,General Medicine ,medicine.disease ,Antiretroviral therapy ,030220 oncology & carcinogenesis ,Female ,business - Abstract
The updated cervical cancer screening guidelines recommend that women at average risk who have negative screening results undergo cervical cytological testing every 3 to 5 years. These recommendations do not pertain to women at high risk for cervical cancer. This article reviews recommendations for cervical cancer screening in women at high risk.
- Published
- 2017
24. Managing Recurrent Urinary Tract Infections in Postmenopausal Women
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Preston H. Seaberg, Erum Jadoon-Khamash, and Suneela Vegunta
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Aged, 80 and over ,medicine.medical_specialty ,Postmenopausal women ,Estriol ,business.industry ,Urinary system ,General Medicine ,Postmenopause ,Administration, Intravaginal ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,Urinary Tract Infections ,Vagina ,medicine ,Humans ,Female ,030212 general & internal medicine ,business ,030217 neurology & neurosurgery - Published
- 2018
25. Association between menopausal symptoms and relationship distress
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Megan Kelly, Kristin C. Mara, Ekta Kapoor, Carol L. Kuhle, Jordan E. Rullo, Suneela Vegunta, Juliana M. Kling, and Stephanie S. Faubion
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General Biochemistry, Genetics and Molecular Biology ,Relationship distress ,03 medical and health sciences ,0302 clinical medicine ,Rating scale ,Surveys and Questionnaires ,medicine ,Humans ,Interpersonal Relations ,030212 general & internal medicine ,Association (psychology) ,Reproductive health ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Confounding ,Outcome measures ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Menopause ,Cross-Sectional Studies ,Marital satisfaction ,Female ,Symptom Assessment ,business ,Demography - Abstract
To determine the association between relationship distress and menopausal symptoms.A retrospective analysis was conducted of questionnaires completed by women 40-65 years of age seeking menopause or sexual health consultation between May, 2015 and May, 2017.Associations between menopausal symptoms assessed using the Menopause Rating Scale (MRS) and relationship distress measured on the Kansas Marital Satisfaction Scale (KMSS) were evaluated with two-sample t-tests. Linear regression was used to assess associations after adjusting for potential confounders.The sample of 1884 women averaged 53 years of age (SD = 6.1); most were white (95%), employed (66%), married (90%), and well-educated (≥ college graduate, 64%). Women reporting no relationship distress (KMSS ≥ 17) had less severe menopausal symptoms overall compared with women reporting relationship distress (total MRS score 13.1 vs 16.0, P 0.001), with similar findings in each MRS domain. In multivariable analyses, this relationship persisted for total MRS scores and for psychological symptoms among women with no relationship distress, who scored an estimated 1.15 points (95% CI 0.52-1.78) lower on the total MRS and 0.82 points (95% CI 0.53-1.10) lower in the psychological symptom.The absence of relationship distress was associated with less severe menopausal symptoms, particularly in the psychological domain, in women presenting to a women's health clinic. Given the cross = sectional design, the direction of the relationship is unknown.
- Published
- 2019
26. Sexual Health Matters: Management of Female Sexual Dysfunction
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Suneela Vegunta, Stephanie S. Faubion, and Juliana M. Kling
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Selective Estrogen Receptor Modulators ,Aging ,Administration, Topical ,Female sexual dysfunction ,Physiology ,03 medical and health sciences ,0302 clinical medicine ,Laser therapy ,Humans ,Medicine ,Testosterone ,030212 general & internal medicine ,Estrogen replacement therapy ,Physical Therapy Modalities ,Reproductive health ,030219 obstetrics & reproductive medicine ,Pelvic floor ,business.industry ,Estrogen Replacement Therapy ,Estrogens ,Testosterone (patch) ,Off-Label Use ,Pelvic Floor ,General Medicine ,medicine.disease ,Postmenopause ,Administration, Intravaginal ,Sexual Dysfunction, Physiological ,Tamoxifen ,medicine.anatomical_structure ,Selective estrogen receptor modulator ,Androgens ,Benzimidazoles ,Female ,Laser Therapy ,business ,medicine.drug - Published
- 2016
27. Reproductive planning for women after solid-organ transplant
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Suneela Vegunta, Mina Al-Badri, and Juliana M. Kling
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medicine.medical_specialty ,Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,MEDLINE ,food and beverages ,General Medicine ,Organ Transplantation ,medicine.disease ,Organ transplantation ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,Contraception counseling ,Family Planning Services ,embryonic structures ,medicine ,Humans ,Female ,030212 general & internal medicine ,business ,Intensive care medicine ,Solid organ transplantation ,Immunosuppressive Agents - Abstract
Women who receive transplants require contraception counseling because of the teratogenicity of immunosuppressant medications and the risks posed by pregnancy after transplant. Fortunately, pregnancy can succeed with careful planning and monitoring.
- Published
- 2017
28. Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias
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Michael J. Bryan, Melissa A. Lyle, Marcia G. Ko, Christopher M. Wittich, Trevor Duston, Yu Hui H. Chang, Ryan Melikian, Julia A. Files, Marjorie R. Jenkins, Sharonne N. Hayes, Suneela Vegunta, Anita P. Mayer, and Patricia Friedrich
- Subjects
medicine.medical_specialty ,Faculty, Medical ,media_common.quotation_subject ,Minnesota ,Sexism ,Stereotype ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Internal medicine ,medicine ,Gender bias ,Humans ,030212 general & internal medicine ,0101 mathematics ,Academic medicine ,Gender disparity ,media_common ,Language ,Stereotyping ,010102 general mathematics ,Arizona ,General Medicine ,Unconscious bias ,Formality ,Teaching Rounds ,Female ,Psychology - Abstract
Gender bias has been identified as one of the drivers of gender disparity in academic medicine. Bias may be reinforced by gender subordinating language or differential use of formality in forms of address. Professional titles may influence the perceived expertise and authority of the referenced individual. The objective of this study is to examine how professional titles were used in the same and mixed-gender speaker introductions at Internal Medicine Grand Rounds (IMGR).A retrospective observational study of video-archived speaker introductions at consecutive IMGR was conducted at two different locations (Arizona, Minnesota) of an academic medical center. Introducers and speakers at IMGR were physician and scientist peers holding MD, PhD, or MD/PhD degrees. The primary outcome was whether or not a speaker's professional title was used during the first form of address during speaker introductions at IMGR. As secondary outcomes, we evaluated whether or not the speakers professional title was used in any form of address during the introduction.Three hundred twenty-one forms of address were analyzed. Female introducers were more likely to use professional titles when introducing any speaker during the first form of address compared with male introducers (96.2% [102/106] vs. 65.6% [141/215]; p 0.001). Female dyads utilized formal titles during the first form of address 97.8% (45/46) compared with male dyads who utilized a formal title 72.4% (110/152) of the time (p = 0.007). In mixed-gender dyads, where the introducer was female and speaker male, formal titles were used 95.0% (57/60) of the time. Male introducers of female speakers utilized professional titles 49.2% (31/63) of the time (p 0.001).In this study, women introduced by men at IMGR were less likely to be addressed by professional title than were men introduced by men. Differential formality in speaker introductions may amplify isolation, marginalization, and professional discomfiture expressed by women faculty in academic medicine.
- Published
- 2017
29. Routine pelvic examinations: A descriptive cross-sectional survey of women's attitudes and beliefs after new guidelines
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Barbara E. Ruddy, Michael J. Bryan, Amit A. Shah, Mina Al-Badri, M'hamed Temkit, Mark R. Wallace, Stephanie S. Faubion, Heather Fields, Suneela Vegunta, Kathy L. MacLaughlin, and Juliana M. Kling
- Subjects
Adult ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Epidemiology ,Cross-sectional study ,Sexually Transmitted Diseases ,Sti screening ,Uterine Cervical Neoplasms ,Guidelines as Topic ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Outpatient clinic ,Humans ,Mass Screening ,Medical history ,030212 general & internal medicine ,Pelvic examination ,Gynecology ,Ovarian Neoplasms ,Pap smears ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Public Health, Environmental and Occupational Health ,Guideline ,Middle Aged ,United States ,Contraception ,Cross-Sectional Studies ,Family medicine ,Women's Health ,Female ,Gynecological Examination ,business ,Patient education - Abstract
Routine pelvic examinations have been a fundamental part of the annual female examination. The 2014 American College of Physicians (ACP) guideline recommends against routine pelvic examinations in asymptomatic, nonpregnant, average-risk women. Our aim was to evaluate women's attitudes and beliefs about pelvic examinations and how knowledge of the new guidelines contributes to attitudes and beliefs. A descriptive cross-sectional study was performed using a self-administered written survey developed through literature review and pretested and revised on the basis of staff suggestions. Nonpregnant women age≥21years presenting to outpatient clinics at Mayo Clinic in Arizona or Mayo Clinic in Rochester, Minnesota, received the survey. After being asked about pelvic examination practices and beliefs, participants were informed of the ACP guideline, to determine effect on attitudes and beliefs. Demographic characteristics and pertinent medical history questions were collected from participants. In total, 671 women who were predominantly white, married, and educated completed surveys. Participants described pelvic examinations as reassuring, and a majority believed the examinations were useful in detecting ovarian cancer (74.6%), necessary for screening for sexually transmitted infections (STIs) (71.0%), or necessary before initiating contraception (67.0%). After reading the 2014 ACP guideline, significantly fewer women planned to continue yearly pelvic examinations (P
- Published
- 2016
30. The association between recent abuse and menopausal symptom bother: results from the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS)
- Author
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Richa Sood, Darrell R. Schroeder, Suneela Vegunta, Jacqueline M. Thielen, Ekta Kapoor, Juliana M. Kling, Carol S. Kuhle, Julia A. Files, Aminah Jatoi, Paru S. David, Jordan E. Rullo, and Stephanie S. Faubion
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Cross-sectional study ,MEDLINE ,Human sexuality ,03 medical and health sciences ,Diagnostic Self Evaluation ,0302 clinical medicine ,medicine ,Menopausal Symptom ,Humans ,030212 general & internal medicine ,Registries ,Association (psychology) ,Self report ,Psychiatry ,Aged ,Aged, 80 and over ,Analysis of Variance ,030219 obstetrics & reproductive medicine ,business.industry ,Battered Women ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,United States ,Menopause ,Cross-Sectional Studies ,Domestic violence ,Female ,Self Report ,business - Abstract
The aim of the study was to determine whether there is an association between current menopausal symptom bother and a history of abuse (physical, sexual, or emotional/verbal) in the last year.A cross-sectional survey was completed using the Data Registry on Experiences of Aging, Menopause, and Sexuality and the Menopause Health Questionnaire. Data from the Menopause Health Questionnaire were collected from 4,956 women seen consecutively for menopause consultation in the Women's Health Clinic at Mayo Clinic (Rochester, MN) from January 1, 2006 through October 7, 2014. Data from 3,740 women were included in the analysis. Menopausal symptom ratings were compared between women reporting a history of abuse (physical, sexual, or emotional/verbal) in the last year and those not using a two-sample t test. Analysis of covariance was used to assess whether abuse was associated with menopausal symptom bother after adjusting for baseline participant characteristics.Of the 3,740 women, 253 (6.8%) reported experiencing one or more forms of abuse in the last year, the majority (96%) of which was verbal/emotional abuse. Those reporting abuse in the last year had higher (P 0.001) mean total menopausal symptom bother scores. Consistent findings were obtained from multivariable analyses adjusting for all demographic and substance use characteristics.In the present study from the Data Registry on Experiences of Aging, Menopause, and Sexuality, menopausal symptom bother scores were directly associated with recent self-reported abuse.
- Published
- 2016
31. Reproductive Life Planning: A Cross-Sectional Study of What College Students Know and Believe
- Author
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Allan Markus, Lisa N. Kransdorf, Yu Hui H. Chang, Anita P. Mayer, T. S. Raghu, Jo Knatz, Suneela Vegunta, Juliana M. Kling, Julia A. Files, Keith A. Frey, and Paru S. David
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Adolescent ,Universities ,Epidemiology ,Reproductive life plan ,Cross-sectional study ,Health Behavior ,Health literacy ,Preconception Care ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Students ,Contraception Behavior ,Reproductive health ,030219 obstetrics & reproductive medicine ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Obstetrics and Gynecology ,United States ,Health Literacy ,Cross-Sectional Studies ,Family planning ,Family medicine ,Family Planning Services ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,business - Abstract
Objectives The Centers for Disease Control and Prevention recommends a reproductive life plan (RLP) to promote individual responsibility for preconception health. The objectives of this study were to determine existing awareness of RLPs in a cohort of reproductive-age adults and to evaluate their knowledge level and beliefs about reproductive life planning. Methods We performed a cross-sectional survey study of adults ages 18-40 years old seeking care at the student health center of a large public university. Participation was voluntary. Survey responses were analyzed by age and gender. Results A total of 559 surveys were collected and analyzed. Only 24 % of participants had heard of an RLP although a majority (62.9 %) agreed that it is important to develop an RLP. Most respondents (85.4 %) preferred to receive information about reproductive life planning from a primary care provider or obstetrician-gynecologist, while only 4.2 % of patients surveyed reported ever being actually asked about an RLP by their healthcare provider. Among those who agreed that an RLP was important, knowledge of specific aspects of an RLP was lacking. Conclusions In our cohort of reproductive-age adults, general health literacy regarding RLPs was poor. Most of the young adults who responded to our survey did not know what an RLP was and even fewer had ever discussed one with their health provider.
- Published
- 2015
32. To screen or not to screen: is the pelvic examination the answer?
- Author
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Kathy L. MacLaughlin, Suneela Vegunta, and Stephanie S. Faubion
- Subjects
Sexual partner ,Gynecology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Obstetrics ,General Medicine ,medicine.disease ,Gynecological Examination ,Asymptomatic ,Pelvic Floor Disorders ,Pill ,Medicine ,Humans ,Mass Screening ,Female ,Family history ,medicine.symptom ,Medical prescription ,business ,Ovarian cancer ,Pelvic examination - Abstract
36-year-old woman, gravida 2, para 2, using a combined hormonal pill for contraception presents for an annual examination. She reports one new sexual partner since her last visit but denies any gynecologic, urinary, or gastrointestinal symptoms. She has no chronic disease. Her family history includes a maternal great aunt with ovarian cancer but is otherwise negative for malignancy. She had a negative cervical cytology and human papilloma virus (HPV) co-test 3 years ago for screening and denies any past abnormal results. She has recently read in a women’s health magazine that a pelvic examination may not be necessary and asks for your opinion on whether or not she needs an examination at this visit. Based on current evidence, you advise: A. To receive a refill of the combined hormonal contraceptive pill prescription, she needs to have a pelvic examination. B. A pelvic examination should be performed to screen for ovarian cancer, especially given her family history. C. As she is up to date on cervical cancer screening and is asymptomatic, a pelvic examination is not needed, but sexually transmitted infection screening is advised given her history. D. Because she has a new sexual partner, a pelvic examination must be performed to collect a specimen for sexually transmitted infection screening.
- Published
- 2015
33. Everything in Moderation: What the Female Athlete Triad Teaches Us About Energy Balance
- Author
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Lisa N. Kransdorf, Suneela Vegunta, and Julia A. Files
- Subjects
Adult ,Female athlete triad ,Female Athlete Triad Syndrome ,General Medicine ,medicine.disease ,Moderation ,Developmental psychology ,Bone Density ,medicine ,Humans ,Female ,Energy Intake ,Energy Metabolism ,Medical History Taking ,Psychology ,Social psychology - Published
- 2013
34. Why More is Not Always Better: New Pap Smear Guidelines
- Author
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Anita P. Mayer, Lisa N. Kransdorf, and Suneela Vegunta
- Subjects
Vaginal Smears ,medicine.medical_specialty ,Text mining ,business.industry ,Family medicine ,Practice Guidelines as Topic ,medicine ,Humans ,Uterine Cervical Neoplasms ,Female ,General Medicine ,business ,Papanicolaou Test - Published
- 2014
35. Human Papillomavirus Vaccine for Women over Forty: It's Not Just For Kids
- Author
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Anita P. Mayer, Suneela Vegunta, and Julia A. Files
- Subjects
Adult ,medicine.medical_specialty ,business.industry ,Sexual Behavior ,Papillomavirus Infections ,Vaccination ,Age Factors ,General Medicine ,Human papillomavirus vaccine ,Family medicine ,medicine ,Humans ,Female ,Papillomavirus Vaccines ,business - Published
- 2012
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