Search Results (305)

Background/Objectives: This study pioneers the application of the ViPLUS module, utilizing plane-wave ultrasound to measure breast tissue viscosity and elasticity. The primary goal was to establish normal reference values for viscosity in healthy women. Secondary objectives included exploring correlations between breast tissue viscosity and breast density categories, hormonal influences, and menstrual cycle phases. Methods: A prospective study was conducted on 245 asymptomatic women. Viscosity and elasticity measurements were obtained using the ViPLUS module, ensuring high reliability with stringent quality control measures. Data were statistically analyzed to evaluate correlations and group differences. Results: The median viscosity value for normal breast parenchyma was 1.7 Pa.s, with no significant variations based on breast density, menopausal status, or menstrual cycle phase. A strong correlation (rho = 0.866, p < 0.001) was observed between elasticity and viscosity values. Conclusions: The findings suggest that breast viscosity is consistent across diverse physiological states, indicating its potential as an independent diagnostic marker. This parameter could be pivotal in future breast cancer screening strategies, especially for younger women and those with dense breasts. Full article

Purpose: To differentiate inflammatory breast cancer (IBC) from mastitis in Asian women presenting with symptoms of inflammation. Methods: Between January 2012 and June 2024, 101 Asian women with symptoms of inflammation underwent breast ultrasound (US). Clinical and demographic data were extracted from patients’ medical records. US analysis assessed lesion bilaterality, location, type, size, internal changes, and lymph node status. Patients with suspicious findings had US-guided biopsies, and pathology reports were reviewed for tumor histology and immunohistochemical markers. Logistic regression was used to determine odds ratios. Results: Of the 101 participants, 14 (13.9%) were diagnosed with IBC and 87 (86.1%) were diagnosed with mastitis. Patients with IBC were significantly older (46.4 vs. 38.4 years, p = 0.020) and showed a higher prevalence of postmenopausal status (57.1% vs. 12.6%, p < 0.0001). These patients experienced a longer symptom onset duration (37.7 vs. 12.7 days, p = 0.002) and more frequent localized symptoms like swelling (50.0% vs. 13.8%, p = 0.004). US findings showed that 21.4% of IBC lesions involved the entire breast, compared to only 1.1% in patients with mastitis (p = 0.001). Biopsy results revealed that invasive ductal carcinoma was the most common malignancy (78.6%). Logistic regression identified symptom onset duration (adjusted odds ratio (OR) 1.07, p = 0.014) and swelling (adjusted OR 15.24, p = 0.016) as significant predictors of IBC. Conclusion: In Asian women, age, menopausal status, symptom onset duration, and swelling are effective in differentiating IBC from mastitis. Logistic regression confirmed that symptom onset duration and swelling are significant predictors of IBC, with US findings indicating larger lesion sizes and more frequent whole-breast involvement. Full article

Background: Contrast-enhanced mammography (CEM) has recently gained recognition as an effective alternative to breast magnetic resonance imaging (MRI) for assessing breast lesions, offering both morphological and functional imaging capabilities. However, the phenomenon of background parenchymal enhancement (BPE) remains a critical consideration, as it can affect the interpretation of images by obscuring or mimicking lesions. While the impact of BPE has been well-documented in MRI, limited data are available regarding the factors influencing BPE in CEM and its relationship with breast cancer (BC) characteristics. Materials: This retrospective study included 116 patients with confirmed invasive BC who underwent CEM prior to biopsy and surgery. Data collected included patient age, breast density, receptor status, tumor grading, and the Ki-67 proliferation index. BPE was evaluated by two radiologists using the 2022 ACR BI-RADS lexicon for CEM. Statistical analyses were conducted to assess the relationship between BPE, patient demographics, and tumor characteristics. Results: The study found a significant association between higher levels of BPE and specific patient characteristics. In particular, increased BPE was more commonly observed in patients with higher breast density (p < 0.001) and those who were pre-menopausal (p = 0.029). Among patients categorized under density level B, the majority exhibited minimal BPE, while those in categories C and D showed progressively higher levels of BPE, indicating a clear trend correlating higher breast density with increased enhancement. Additionally, pre-menopausal patients demonstrated a higher likelihood of moderate to marked BPE compared to post-menopausal patients. Despite these significant associations, the analysis did not reveal a meaningful correlation between BPE intensity and tumor subtypes (p = 0.77) or tumor grade (p = 0.73). The inter-reader agreement for BPE assessment was substantial, as indicated by a weighted kappa of 0.78 (95% CI: 0.68–0.89), demonstrating consistent evaluation between radiologists. Conclusions: These findings suggest that BPE in CEM is influenced by factors like breast density and age, aligning with patterns observed in MRI studies. However, BPE intensity was not associated with tumor subtypes or grades, indicating a poorer prognosis. These insights highlight the potential of BPE as a risk biomarker in preventive follow-up, particularly for patients with high breast density and pre-menopausal status. Further multicentric and prospective studies are needed to validate these results and deepen the understanding of BPE’s role in CEM diagnostics. Full article

Background/Objectives: Hand grip strength (HGS) reflects muscle strength and is an important indicator of sarcopenia. There is a gap in the research regarding the determinants of relative HGS that take sex differences into account. Therefore, this study aimed to evaluate the association between relative HGS and physical, behavioral, and psychological factors in menopausal women from South Korea. Methods: This study used data obtained from the 7th National Health and Nutrition Examination Survey (2016–2018), which had a complex, stratified, and multistage sample design. A total of 2129 menopausal women aged between 40 and 64 were included in this cross-sectional study. To evaluate physical, behavioral, and psychological factors associated with relative HGS, a multiple regression analysis was used. Results: In this study, the sociodemographic factors that influenced relative HGS were education (high school: B = 0.03, p = 0.001; college: B = 0.04, p = 0.003) and marital status (live with: B = 0.04, p = 0.004). Among the physical factors, abdominal obesity (B = −0.16, p < 0.001) and comorbidities (B = −0.03, p = 0.026) were associated with a significantly lower relative HGS. Regarding behavioral factors, relative HGS was significantly lower for those who slept more than 8 h (B = −0.03, p = 0.041) than for those who slept 6–8 h. Regarding psychological factors, relative HGS was significantly higher for those with fair (B = 0.04, p = 0.001) and good (B = 0.06, p < 0.001) self-rated health. Conclusions: Relative HGS is associated with physical, behavioral, and psychological factors in menopausal women. These findings can inform research and guidelines for sarcopenia prevention using relative HGS as an indicator of health status. Full article

Background: Ovarian cancer is one of the most common cancers in women. Markers associated with ovarian cancer are still being sought. The aim of this study was to evaluate the expression of BRIP-1 (FANCJ) and FANCI proteins in ovarian cancer tissue and to assess these expressions in differentiating the described clinical features. Methods: The study enrolled 68 patients with ovarian cancer. The cohort was divided into a HGSOC (high-grade serous ovarian cancer) group and a non-HGSOC group, which represented ovarian cancer other than HGSOC. Immunohistochemical evaluation of FANCI and BRIP-1 (FANCJ) protein expression in ovarian cancer tissue samples was performed. All statistical analyses were performed using StatView software (Carry, NC, USA). Results: The FANCI protein mostly showed moderate positive and strong positive expression, while BRIP-1 protein mostly showed no expression or positive expression. Patients with lower expression of FANCI and BRIP-1 showed differences in the clinical stage of HGSOC, which was not observed in patients with higher expression of these proteins. In addition, patients with lower BRIP-1 expression showed differences in menopausal status, which was not observed in patients with higher expression of this protein. Conclusions: This study shows that FANCI protein is a marker associated with lower FIGO stage and histologically high-grade cancer in a group of all ovarian cancers and in non-HGSOC. Full article

Objectives: Uncomplicated cystitis is a leading form of bacterial UTI; the most common causative bacterium worldwide is Escherichia coli. This internet-based, prospective, multicenter, and national observational study aimed to report the antimicrobial resistance of E. coli in patients with uncomplicated cystitis through the use of the Korean Antimicrobial Resistance Monitoring System (KARMS) in 2023. Results: Data for a total of 654 patients were retrieved from the KARMS database. The mean (standard deviation) patient age was 55.9 (18.3) years. The numbers of postmenopausal women and patients with recurrent cystitis were 381 (59.4%) and 78 (11.9%), respectively. Regarding antimicrobial susceptibility, 96.8% were susceptible to fosfomycin, 98.9% to nitrofurantoin, 50.9% to ciprofloxacin, and 82.4% to cefotaxime. Extended-spectrum beta-lactamase positivity was 14.4% (89/616), and was significantly higher in tertiary hospitals (24.6%, p < 0.001) and recurrent cystitis (27.6%, p < 0.001). Fluoroquinolone resistance was significantly higher in tertiary hospitals (57.8%, p < 0.001), postmenopausal women (54.2%, p < 0.001), and recurrent cystitis (70.3%, p < 0.001). In addition, postmenopausal status (95% confidence interval [CI]: 1.44–3.17, odds ratio [OR] 2.13, p < 0.001), recurrent cystitis (95% CI: 1.40–4.66, OR 2.56, p = 0.002) and tertiary hospitals (95% CI: 1.00–2.93, OR 1.71, p = 0.049) were associated with significantly increased fluoroquinolone resistance. Methods: Any female patient diagnosed with clinical uncomplicated cystitis and microbiologically proven E. coli infection in 2023 was eligible for this study. Patient data were obtained from the web-based KARMS database. The antimicrobial susceptibility of E. coli was analyzed according to clinical factors, including hospital region, hospital type, menopause status, and recurrence status. Conclusions: The antimicrobial resistance of E. coli in patients with uncomplicated cystitis in the Republic of Korea has reached a serious level, especially in fluoroquinolone resistance. Therefore, major efforts should be made to reduce antimicrobial resistance. Full article

The oral mycobiome plays a critical role in maintaining oral and systemic health, with its composition and function influenced by various physiological and environmental factors. This descriptive review explores the changes in the oral mycobiome among postmenopausal women, examining how aging and associated inflammatory processes contribute to these alterations. These changes are linked to an increased prevalence of xerostomia, oral dysbiosis, and inflammation, which can negatively impact both oral and systemic health. We discuss the impact of hormonal fluctuations and immune senescence on fungal diversity and abundance, highlighting key species implicated in oral and systemic diseases. The review also examines the role of systemic conditions and medications, which are common in postmenopausal women, in further exacerbating oral mycobiome alterations. Lastly, it highlights the need for future research to better understand these interactions and develop targeted therapeutic strategies. The current literature indicates a significant association between menopausal status, age-related mycobiome shifts, and increased inflammatory responses, suggesting potential pathways for intervention. Full article

The rising global incidence of uterine cancer has been linked to the escalating prevalence of obesity. Obesity results in insulin resistance which alters the IGF system, thereby driving cancer progression via increased cell proliferation and the inhibition of apoptosis, although the precise mechanisms remain unclear. In a previous study, we compared the levels of IGF1 and IGF2 between fifty endometrial cancer patients (study group) and fifty age-matched non-cancer patients with benign gynaecological conditions (control group), identifying a correlation with menopause. Building on these data, we now report that IGF levels in pre-menopausal women were significantly lower in the study group compared to the control group, a pattern not observed in post-menopausal women. We undertook the receiver operating characteristic (ROC) curve analysis for calculating the potential of IGF1 and IGF2 to effectively distinguish pre-menopausal women with endometrial cancer from those without it. For pre-menopausal women, the area under ROC curve values were 0.966 for IGF1 and 0.955 for IGF2, both with significant p-values, indicating that IGF1 and IGF2 levels have the potential to be diagnostic biomarkers for distinguishing pre-menopausal women with endometrial cancer from those without it. In summary, our findings emphasise the importance of considering menopausal status in the context of IGF level assessments and suggest that IGF1 and IGF2 could play a crucial role in the early diagnosis of endometrial cancer in pre-menopausal women. Full article

The extent to which estradiol, progesterone, and testosterone influence mating behavior across the menstrual cycle is unclear. The Proactive and Responsive Mating Strategies Scales (PARMSS) were developed to separately examine two specific components of sexuality and were used here to test divergent hormonal associations. Preliminary psychometric data (N = 364 females) suggest that both scales consist of one factor and demonstrate strong psychometric properties (internal consistency, test–retest reliability, and construct and convergent validity). The PARMSS were used in a repeated-measures observational study to examine the relationships between changes in endogenous hormone levels and both proactive and responsive mating intentions with potential new short-term or long-term partners in healthy pre-menopausal participants (N = 38). At two points in their cycle, participants provided salivary hormone samples in the laboratory and reported the likelihood of engaging in proactive and responsive behaviors with men in photos and vignettes. Participants reported greater responsive than proactive intentions. Increases in estradiol and testosterone across the cycle were associated with increases in short-term mating intentions, particularly responsivity to potential short-term relationship partners. No associations were found for intentions that were proactive or that involved potential long-term partners or for progesterone. Changes in the three hormones explained changes in short-term responsive mating intentions (22% of the variance). The results suggest (a) cyclical changes in estradiol and testosterone are differentially associated with changes in responsive vs. proactive mating intentions and (b) context-dependent changes (i.e., short-term vs. long-term mating intentions and possibly relationship status). The findings require replication with larger and diverse samples. Full article

Background: The aim of this study is to evaluate the correlation between background parenchymal enhancement (BPE) and various patient-related and technical factors in recombined contrast-enhanced spectral mammography (CESM) images. Material and Methods: We assessed CESM images from 62 female patients who underwent CESM between May 2017 and October 2019, focusing on factors influencing BPE. A total of 235 images, all acquired using the same mammography machine, were analyzed. A region of interest (ROI) with a standard size of 0.75 to 1 cm² was used to evaluate the minimal, maximal, and average pixel intensity enhancement. Additionally, the images were qualitatively assessed on a scale from 1 (minimal BPE) to 4 (marked BPE). We examined correlations with body mass index (BMI), age, hematocrit, hemoglobin levels, cardiovascular conditions, and the amount of pressure applied during the examination. Results: Our study identified a significant correlation between the amount of pressure applied during the examination and the BPE (Spearman’s ρ = 0.546). Additionally, a significant but weak correlation was observed between BPE and BMI (Spearman’s ρ = 0.421). No significant associations were found between BPE and menopausal status, cardiovascular preconditions, hematocrit, hemoglobin levels, breast density, or age. Conclusions: Patient-related and procedural factors significantly influence BPE in CESM images. Specifically, increased applied pressure and BMI are associated with higher BPE. Full article

The routine use of granulocyte colony-stimulating factor (GCSF) is not recommended for the prevention or treatment of chemotherapy-induced neutropenia or febrile neutropenia because risks associated with certain types of cancers, distant organ metastases, and primary tumor growth cannot be excluded. We examined the association between GCSF use and the incidence of brain metastasis (BM), as well as BM-free survival (BMFS). This retrospective cohort study included 121 stage IV breast cancer patients without confirmed BM at the time of diagnosis and who received at least one course of systematic chemotherapy or target therapy at a tertiary teaching hospital between 1 January 2014 and 31 December 2022. The effect of GCSF use on BM was assessed with other confounding factors in Cox regression analyses. In this retrospective cohort, patients who received GCSF treatment had a significantly higher incidence of BM than those who did not (34.9% vs. 13.8%, p = 0.011). Univariate Cox regression analysis showed that GCSF use, menopause status, hormone treatment, HER2 treatment, cumulative dosage, dosage density, and neutropenia were independent risk factors for BMFS (p < 0.05). GCSF users had a higher risk of BM (adjusted HR: 2.538; 95% CI: 1.127–5.716, p = 0.025) than nonusers. BM risk was significantly associated with those with neutropenia (RR: 1.84, 95% CI: 1.21, 2.80) but not with those without neutropenia (RR: 0.59, 95% CI: 0.41–0.84, Interaction p-value < 0.05). The higher the dose density of GCSF, the higher the risk compared with those who do not use GCSF (p for trend < 0.01). These preliminary results suggest that GCSF is associated with BM in patients with stage IV breast cancer who did not have BM at initial diagnosis. Further comprehensively designed large-scale observational studies are needed to confirm our preliminary results. Full article

This study of the features of the biochemical composition of biological fluids in patients with breast cancer, including saliva, allows us to identify some indicators as metabolic predictors of the presence of the disease. Objectives: to study the influence of the menopause factor and body mass index (BMI) on the biochemical composition of saliva and to evaluate the applicability of metabolic markers of saliva for the diagnosis of breast cancer. Methods: The case–control study involved 1438 people (breast cancer, n = 543; fibroadenomas, n = 597; control, n = 298). A comprehensive study of the biochemical composition of saliva was carried out using 36 parameters. Results: When comparing the salivary biochemical composition in breast cancer, fibroadenomas, and controls, it is necessary to take into account the menopausal status, as well as BMI (less than 25 or more) for the group of patients with preserved menstrual function. A complex of biochemical parameters has been identified that change in saliva during breast cancer, regardless of menopause and BMI (total protein, urea, uric acid, NO, α-amino acids, GGT), as well as specific parameters that must be taken into account when analyzing individual subgroups (imidazole compounds, LDH, catalase, α-amylase). During the study of a separate group of patients with leaf-shaped (phyllodes) tumors, we found similarities with breast cancer in the changes in some biochemical parameters that can be attributed to metabolites of malignant growth (protein, α-amino acids, calcium, NO, pyruvate, peroxidase, α-amylase). Conclusions: We demonstrated changes in a wide range of salivary biochemical parameters depending on the presence of fibroadenomas and breast cancer. From the point of view of clinical practice, this may be useful information for monitoring the condition of patients with fibroadenomas, which are difficult to unambiguously classify based on instrumental diagnostics alone. Full article

Background and Objectives: This study aimed to investigate the association between insulin resistance, as measured by the triglyceride–glucose index (TyG index), and hearing impairment in middle-aged women in Korea. Materials and Methods: This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), specifically from the period after July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). This study was conducted on 5416 women aged 40 to 69 who had completed both the health examination survey and audiometric tests, excluding those with missing data on menopausal status and the use of hormone replacement therapy. Results: In the study group, the prevalence of high-frequency hearing loss according to the TyG index was significantly higher in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p < 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002). Conversely, the prevalence of low-frequency hearing loss did not show a significant difference in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199) Conclusions: Since diabetes can induce hearing impairment in women, it is recommended that women with a high TyG index undergo early hearing tests Full article

Introduction: Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC). Methods: A thorough search of the literature was performed across PubMed, Medline, Scopus, and Google Scholar, focussing on studies published between 2000 and 2024. Inclusion criteria entailed original research, reviews, and meta-analyses addressing bone mineral density (BMD), fracture incidence, and related risk factors in post-menopausal WLHIV. Results: The review identified 223 relevant studies. Post-menopausal WLHIV exhibit significantly lower BMD and higher fracture rates compared to both HIV-negative post-menopausal women and pre-menopausal WLHIV. cART, particularly tenofovir disoproxil fumarate (TDF), contributes to reduced BMD. Menopausal status exacerbates this risk through decreased oestrogen levels, leading to increased bone resorption. Moreover, lifestyle choices such as smoking, alcohol consumption, and low physical activity are more prevalent in PWHIV, which further elevates fracture risk. Different psychosocial factors may make WLWHIV more vulnerable at this stage of their life, such as depression, isolation, stigma, and housing and nutritional issues. Women living in LICs face a variety of challenges in accessing HIV care. There are gaps in research related to the prevalence of osteoporosis and bone loss in post-menopausal WLHIV in LICs. Conclusion: Post-menopausal women living with HIV face a significantly higher risk of bone loss and fractures due to the combined effects of HIV and menopause. Antiretroviral therapy (particularly TDF), lifestyle factors, and psychosocial challenges exacerbate this risk. There is a need for careful selection of cART, hormone replacement therapy (HRT), and emerging treatments such as Abaloparatide. A holistic approach including lifestyle changes and psychosocial support is crucial to reduce fracture risk in WLHIV, especially in low-income countries. Full article

Background/Objectives: Hysteroscopy has been used as both a diagnostic and therapeutic tool for intrauterine pathologies under direct visualization. However, this procedure may be associated with an increased risk of complications during entry, which can be reduced by cervical ripening before the operation. The efficacy of misoprostol in this context is influenced by factors such as estrogen levels, parity, and the mode of previous deliveries. This study aimed to assess the efficacy and safety of misoprostol in women with a challenging cervix while mitigating the influence of confounding variables. Methods: Three electronic databases, namely PubMed, Scopus, and ISI Web of Science, were searched until 14 May 2024. Randomized controlled trials focusing on postmenopausal patients, nulliparous women, and multiparous women with no prior history of vaginal delivery, undergoing hysteroscopy were included. The cervical width, time needed for cervical dilation, and the need for additional dilatation alongside the complications and adverse effects from all included studies were collected and analyzed using R (version 4.2.3). Results: Seven studies on premenopausal women and three on postmenopausal women were included. In premenopausal women, misoprostol significantly increased cervical width compared to placebo (SMD = 2.2, 95% CI 0.9 to 3.4) and reduced the need for additional cervical dilatation (OR = 0.36, 95% CI 0.17 to 0.74). No significant difference was found in the time required for cervical dilation between misoprostol and placebo groups. In postmenopausal women, misoprostol did not significantly affect cervical width compared to placebo (SMD = −0.55, 95% CI −1.3 to 0.21). Conclusions: Misoprostol is beneficial for cervical dilation in premenopausal women without a prior history of vaginal delivery but less effective in postmenopausal patients. While associated with postoperative risks, it reduces hysteroscopy-related complications. Future research should address discrepancies by controlling the confounding variables like menopausal status, parity, and mode of delivery to enhance the understanding of misoprostol’s effects and pinpoint the specific patient populations that would derive the greatest benefits from its use. Full article