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Treatment-induced menopause symptoms among women with breast cancer undergoing chemotherapy in China: a comparison to age- and menopause status-matched controls. 中国接受化疗的乳腺癌妇女因治疗引起的更年期症状:与年龄和更年期状况匹配的对照组的比较。
Pub Date : 2023-12-12 DOI: 10.1097/gme.0000000000002296
Di Zhao, Qinghua Ma, Guopeng Li, Rui Qin, Yingtao Meng, Ping Li
Whether women with breast cancer experience more severe menopause symptoms than comparison women without a history of breast cancer diagnosis remains unclear. We aimed to investigate whether women with breast cancer undergoing chemotherapy experience more severe menopause symptoms than comparison women and explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy.
与没有乳腺癌诊断史的女性相比,乳腺癌女性是否会出现更严重的更年期症状,目前仍不清楚。我们的目的是调查接受化疗的乳腺癌妇女是否会比其他妇女经历更严重的更年期症状,并探讨影响接受化疗的乳腺癌妇女更年期症状的各种因素。
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引用次数: 0
Discontinuation of hormone therapy and bone mineral density: does physical activity modify that relationship? 停止激素治疗和骨密度:体育活动能改变这种关系吗?
Pub Date : 2023-10-31 DOI: 10.1097/gme.0000000000002272
Alyssa N. Sheedy, Jean Wactawski-Wende, Kathleen M. Hovey, Michael J. LaMonte
Abstract Objective Hormone therapy can positively impact bone mineral density after menopause. We explored bone mineral density change in postmenopausal women who discontinued hormone therapy after the Women's Health Initiative landmark 2002 trial results were published. We secondarily explored whether usual physical activity modified the results. Methods Postmenopausal women participating in the Buffalo OsteoPerio study with information on hip bone density, hormone therapy use, and self-reported physical activity at two time points (1997-2001; 2002-2007) were included (N = 961). Hormone therapy included three groups according to use at baseline and year 5 (non/non; current/non; current/current). Results At baseline (mean age, 65.9 years; SD, 6.7 years), 480 women were not using hormone therapy, while 481 were current users. Between the baseline and 5-year visits, 336 women using hormone therapy discontinued. Baseline total hip bone density was highest in current users. After 5 years, those who continued hormone therapy exhibited no bone loss; those who discontinued exhibited the greatest loss at the total hip of −0.021 gm/cm 2 . Women who never used hormone therapy exhibited some loss of −0.012 gm/cm 2 . Usual physical activity did not appreciably impact change in bone density in any group. Conclusions This prospective observational study explored the 5-year change in bone mineral density among older postmenopausal women after the landmark 2002 hormone therapy trial findings were released. We found bone density decreased in never-users and in women who discontinued use. Bone density was maintained in current users. Although usual physical activity did not mitigate bone loss, targeted physical activity regimens should be investigated.
【摘要】目的激素治疗对绝经后骨密度有积极影响。我们研究了在2002年妇女健康倡议里程碑式的试验结果发表后停止激素治疗的绝经后妇女的骨密度变化。其次,我们探讨了通常的体育活动是否会改变结果。方法:绝经后妇女参加Buffalo OsteoPerio研究,在两个时间点(1997-2001;(N = 961)。根据基线和第5年的使用情况,激素治疗分为三组(非/非;当前/非;电流/电流)。结果基线时(平均年龄65.9岁;SD(6.7岁),480名妇女未使用激素治疗,481名妇女正在使用激素治疗。在基线和5年随访期间,336名接受激素治疗的妇女停止了治疗。基线髋部总骨密度在当前使用者中最高。5年后,那些继续激素治疗的人没有骨质流失;停药组髋部损失最大,为- 0.021 gm/ cm2。从未使用激素治疗的妇女表现出- 0.012 gm/ cm2的损失。在任何一组中,通常的体育活动对骨密度的变化都没有明显的影响。结论:这项前瞻性观察性研究探讨了2002年具有里程碑意义的激素治疗试验结果发布后,老年绝经后妇女骨密度的5年变化。我们发现从不使用和停止使用的女性骨密度下降。现有使用者的骨密度保持不变。虽然通常的体力活动并不能减轻骨质流失,但应该研究有针对性的体力活动方案。
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引用次数: 0
Triage method for endometrial biopsy in postmenopausal women: a multicenter retrospective cohort study 绝经后妇女子宫内膜活检的分诊方法:一项多中心回顾性队列研究
Pub Date : 2023-10-31 DOI: 10.1097/gme.0000000000002271
Yufei Shen, Lucia Li, Hailong Wang, Yi Hu, Xi Deng, Xiaoling Lian, Yanlin Tan, Liling Liang, Yu Zhang, Wenqing Yang
Abstract Objective To identify the optimal triage procedure for endometrial biopsies in postmenopausal women. Methods The clinical information of 470 postmenopausal women with endometrial biopsy results and postmenopausal bleeding (PMB) and/or transvaginal ultrasonography (TVU) abnormalities were collected at the gynecology departments of four general hospitals from March 2021 to March 2022. In the validation cohort, 112 women with TVU abnormalities who underwent endometrial biopsy at Xiangya hospital between May 2022 and May 2023 were enrolled. The endpoint was the final diagnosis based on hysteroscopy reports and biopsy pathology results. The sensitivity, specificity, positive predictive value, and negative predictive value were compared among the three triage methods. A nomogram prediction model was developed and validated. Results Referring women with TVU abnormalities for endometrial biopsy identified 100% malignant/premalignant lesions despite low specificity (19.7%). Among women with measurable endometrial thickness (ET), we suggest that the ET cutoff value for biopsy referral should be ≥4 mm. The PMB (odds ratio [OR], 3.241; 95% confidence interval [CI], 1.073-9.789), diabetes (OR, 10.915; 95% CI, 3.389-35.156), and endometrial thickness (OR, 1.277; 95% CI, 1.156-1.409) were independent predictive factors for endometrial (pre)malignancy. A nomogram prediction model was constructed (area under curve [AUC] = 0.802, 95% CI: 0.715 to 0.889). The ideal cutoff point was 22.5, with a sensitivity of 100.0% and a specificity of 15.7%. The external validation achieved an AUC of 0.798 (95% CI, 0.685-0.911). Conclusions It was possible to refer all postmenopausal women with TVU abnormity (ET ≥ 4 mm or other abnormal findings) for endometrial biopsy. Among women with TVU abnormalities, a nomogram was constructed, and a score greater than 22.5 suggested the need for referral for endometrial biopsy, while a score less than 22.5 suggested that regular follow-up was required, further improving the triage procedure.
摘要目的探讨绝经后妇女子宫内膜活检的最佳分诊方法。方法收集2021年3月至2022年3月在4家综合医院妇科就诊的470例绝经后妇女子宫内膜活检结果、绝经后出血(PMB)和/或经阴道超声检查(TVU)异常的临床资料。在验证队列中,纳入了2022年5月至2023年5月期间在湘雅医院接受子宫内膜活检的112名TVU异常妇女。终点是基于宫腔镜报告和活检病理结果的最终诊断。比较三种分诊方法的敏感性、特异性、阳性预测值和阴性预测值。建立了nomogram预测模型并进行了验证。结果有TVU异常的女性进行子宫内膜活检,虽然特异性较低(19.7%),但发现100%的恶性/癌前病变。在可测量子宫内膜厚度(ET)的女性中,我们建议活检转诊的ET临界值应≥4 mm。PMB(优势比[OR], 3.241;95%可信区间[CI], 1.073-9.789),糖尿病(OR, 10.915;95% CI, 3.389-35.156)和子宫内膜厚度(OR, 1.277;95% CI(1.156-1.409)是子宫内膜(前)恶性肿瘤的独立预测因素。建立了nomogram预测模型(曲线下面积[AUC] = 0.802, 95% CI: 0.715 ~ 0.889)。理想截断点为22.5,敏感性为100.0%,特异性为15.7%。外部验证的AUC为0.798 (95% CI, 0.685-0.911)。结论有TVU异常(ET≥4 mm或其他异常表现)的绝经后妇女均可行子宫内膜活检。在有TVU异常的妇女中,构建了一个nomogram,分数大于22.5表明需要转诊子宫内膜活检,而分数小于22.5表明需要定期随访,进一步改善了分诊程序。
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引用次数: 0
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Menopause
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