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Objectives This study assesses the screen rate and prevalence of postpartum pelvic floor disorders and sexual dysfunction (PFDs/SD) within the first year of delivery. Methods This is a retrospective review of postpartum women seen in a university clinic who delivered at the associated hospital and had postpartum visits from June 1, 2020, to April 15, 2022. Charts were reviewed from delivery to one year postpartum. Demographic and clinical characteristics were compared between women with and without postpartum screening. Results Three hundred thirty-four women met inclusion criteria. Two hundred twenty (65.9%) were screened for PFDs/SD. Compared to women who were not screened, women who were screened were older (32.6 vs 31.3 years, p=0.02). Women with a cesarean delivery (73% vs. 58% vaginal, p=0.004), delivered by an attending or resident (70% vs 60% midwife, p=0.06), first postpartum visit at less than six weeks after delivery (76% vs. 43% 6-12 weeks, p<0.001), and three or more postpartum visits (80% vs. 65% two visits, 50% one visit, p<0.001) were more likely to be screened. In an adjusted model, only timing of the first postpartum visit remained significant. Urinary incontinence and fecal incontinence were the most common PFDs diagnosed. Of the 41 women who had PFDs and/or SD, 31 (75.6%) were referred to pelvic floor physical therapy (PFPT) and/or urogynecology. Discussion In this retrospective cohort study, we found a low rate of postpartum screening for PFDs/SDs. This deficiency highlights critical gaps in care for postpartum women.
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BACKGROUND: The antiproliferative and apoptotic effects of ellagic acid, a dietary polyphenol, were studied. MATERIALS AND METHODS: The neutral red cytotoxicity assay compared the sensitivities of gingival fibroblasts and HSC-2 oral carcinoma cells to ellagic acid. The ferrous ion oxidation xylenol orange assay and levels of intracellular reduced glutathione were used to assess pro-oxidant nature of ellagic acid. Antioxidant activity was demonstrated in cells co-treated with H2O2 and ellagic acid by 2',7'-dichlorodihydrofluorescein diacetate staining and in cells co-treated with gallic acid and ellagic acid by morphological analysis. Apoptosis was assessed by microscopy, flow cytometry, luminescence, and immunoblotting. RESULTS: Ellagic acid was cytotoxic to carcinoma cells, but not to normal cells. Its pro-oxidant nature was minimal, whereas its antioxidant property was biologically significant. Ellagic acid-treated cells demonstrated apoptotic morphology, induction of apoptosis (flow cytometry), increase in caspase 3/7 activities (luminescence), and activation of caspase 3 and cleavage of poly ADP ribose polymerase (immunoblot). CONCLUSION: Ellagic acid exhibited significant antioxidant, but not pro-oxidant, activity and was selectively cytotoxic to oral carcinoma cells.