Journal of Mid-life Health最新文献

Background: Stress urinary incontinence (SUI) is a significant health concern among peri-and postmenopausal women, often leading to diminished quality of life. Transcutaneous temperature-controlled radiofrequency (TTCRF) has emerged as a minimally invasive treatment option, but its efficacy may be limited in cases of severe tissue laxity. Platelet-rich plasma (PRP) offers a promising adjunct to enhance tissue remodeling and functional recovery when combined with TTCRF.

Objective: This study evaluates the safety, efficacy, and patient-reported outcomes of combining PRP with TTCRF for treating SUI in peri- and postmenopausal women, aiming to address gaps in current therapeutic strategies.

Materials and methods: A prospective, randomized controlled trial was conducted involving 80 peri- and postmenopausal women diagnosed with SUI. Participants were randomly assigned to two groups: PRP plus TTCRF (intervention group, n = 40) and TTCRF alone (control group, n = 40). Primary outcome measures included objective improvement assessed via urodynamic studies and subjective improvement evaluated using validated questionnaires (International Consultation on Incontinence Questionnaire - Short Form [ICIQ-SF] and Urogenital Distress Inventory). Secondary outcomes encompassed quality of life (Pelvic Floor Distress Inventory [PFDI-20]) and adverse event reporting. Statistical analyses were performed using SPSS version 27.0, with significance set at P < 0.05.

Results: At the 12-month follow-up, the intervention group demonstrated significantly superior outcomes compared to the control group. The mean reduction in ICIQ-SF scores was 9.8 points versus 6.6 points (P = 0.001), and urodynamic parameters improved by 32% more in the PRP plus TTCRF group (P = 0.003). Quality of life, as measured by PFDI-20, showed a 22% greater improvement in the intervention group (P = 0.002).

Conclusion: Combining PRP with TTCRF represents an innovative, minimally invasive approach that enhances tissue regeneration and functional recovery in peri- and post-menopausal women with SUI. These findings highlight the potential of PRP to augment the efficacy of TTCRF and warrant further investigation in larger, multicenter trials.

Background: The age at which menopause occurs varies widely among different populations around the world, and the severity of menopausal symptoms often increases with age. Although menopause is not classified as an illness, it is associated with higher rates of mortality and morbidity among women. Many women go through menopause without adequate knowledge of its health implications. It is essential for women to be informed about the symptoms and complications of menopause so they can manage it effectively and seek appropriate treatment. Without this knowledge and with negative attitudes towards menopause, women may face difficulties during the postmenopausal period.

Objectives: This study aims to assess the prevalence of menopausal symptoms and to evaluate the knowledge and attitudes of peri- and postmenopausal women toward menopause.

Materials and methods: This mixed-method study was conducted at a single center in a major tertiary care hospital located in Chengalpattu, Kanchipuram, Tamil Nadu, from February 2023 to October 2024. A total of 300 women experiencing perimenopausal and menopausal symptoms were included through convenience sampling. Ethical guidelines established by the institutional ethics committee were followed throughout the study. We utilized the Menopause Rating Scale (MRS), a self-reported and validated tool, to assess the severity of menopausal symptoms reported by the participants.

Results: The most common symptoms reported by perimenopausal women included sleep problems (53.4%), hot flashes (50%), anxiety (67.8%), irritability (65.6%), bladder issues (46.7%), and sexual discomfort (44.4%). In postmenopausal women, frequently reported symptoms were joint pain (56.2%), depressive mood (70%), physical and mental exhaustion (63.4%), vaginal dryness (64.8%), and sexual problems (58.1%). Overall, severe menopausal symptoms were more prevalent among postmenopausal women compared to those in the perimenopausal stage, with a statistically significant difference (P < 0.05). Binomial logistic regression analysis showed that age (adjusted odds ratio [AOR] - 1.78), parity (AOR - 2.49), and poor knowledge about menopause (AOR - 2.78) were significant risk factors associated with the severity of menopausal symptoms.

Conclusion: This mixed-method study found significant differences in menopausal symptoms, knowledge, and attitudes between peri- and postmenopausal women. In postmenopausal women, higher mean total MRS scores indicated severe somatic, psychological, and urogenital symptoms. We found that menopausal women need tailored education and culturally sensitive support to close knowledge gaps, promote positive attitudes, and meet complex needs.

A rare condition known as purple urine bag syndrome (PUBS) affects people who are catheterized, particularly elderly females with comorbidities. Urinary tract infections and alkaline urine are frequently linked to the purple staining of the urobag and urinary catheter. It is essential to monitor such patients closely and investigate the underlying cause of PUBS to ensure appropriate management and treatment. We report the case of a 66-year-old female who developed a stroke, became bedridden, and had a Foley catheter in situ for the past 6 months with complaints of purple staining of the urobag and tubing for 5 days.

Introduction: Breast cancer is a leading cause of cancer-related deaths among women worldwide. Prior to metastasis, carcinomas undergo epithelial-mesenchymal transition (EMT), a process wherein cancer cells acquire mobility, form tumor buds (TBs), and invade the stroma. The presence and number of TBs are directly proportional to tumor invasion and metastasis. By scoring TBs and using immunohistochemistry (IHC) to detect EMT process, we can identify patients with poor prognosis after surgical resection. This enables early recognition of patients requiring aggressive treatment and follow-up.

Aim: The aim of this study was to propose an algorithm for measuring TB and to establish the correlation between TB with EMT markers expression and main clinical parameters.

Materials and methods: A retrospective analytical study in an urban tertiary health care center involving 47 cases of invasive breast carcinomas. TB was assessed in Haematoxylin & Eosin stained tissue sections followed by IHC with EMT markers. Association between TB, EMT markers, and main clinical parameters was statistically analyzed using the Chi-square test.

Results: Among 47 cases, 30 had mean-low TB score (≤4/ 10HPF) and 17 had mean-high TB score (>4/10 HPF). Tumors with high TB scoring showed strong SNAIL, TWIST, and N-cadherin expression. Tumors with low TB scores showed high E-cadherin expression and low SNAIL, TWIST, and N-cadherin expression.

Conclusion: The study established a positive correlation between TB and EMT markers. High TB scores are significantly associated with lymphovascular invasion, lymph node metastasis, and higher tumor grading. Using TB score and EMT markers in breast cancer management can facilitate patient-centered approach.

Background: Sarcopenia, characterized by loss of muscle mass and function, is a significant health concern in aging populations. While its physical consequences are well-documented, the relationship between sarcopenia and mental health remains understudied. This study aimed to investigate the prevalence of sarcopenia and its association with mental health status, including depression, cognitive function, anxiety, and loneliness, among elderly patients.

Methodology: A comparative cross-sectional study was conducted on 407 participants aged ≥65. Sarcopenia was diagnosed using the modified Asian Working Group for Sarcopenia criteria. Mental health was assessed using validated scales: the 15-item Geriatric Depression Scale, the Mini-Mental State Examination, the 7-item Generalized Anxiety Disorder Scale, and the 3-item UCLA Loneliness Scale (UCLA-3). Logistic regression models were used to examine associations between sarcopenia and mental health outcomes.

Results: The prevalence of sarcopenia was 49.9% (95% confidence interval [CI]: 45.0%-54.8%), with higher rates in older age groups and women. After adjusting for confounders, sarcopenia was significantly associated with depression (odds ratio [OR]: 2.28, 95% CI: 1.51-3.44, P < 0.001) and cognitive impairment (OR: 1.86, 95% CI: 1.17-2.96, P = 0.009). Associations with anxiety (OR: 1.49, 95% CI: 0.93-2.38, P = 0.095) and loneliness (OR: 1.52, 95% CI: 1.00-2.31, P = 0.049) were observed but did not reach statistical significance.

Conclusion: Sarcopenia is highly prevalent among elderly patients and is independently associated with adverse mental health outcomes, particularly depression and cognitive impairment. These findings underscore the importance of integrated physical and mental health interventions in the care of older adults with sarcopenia.

Background: Endometrial cancer is the third most common cancer affecting the lower genital tract of women. Studies have shown modifiable and nonmodifiable risk factors for the same, which include genetic factors and microbes. Alteration in the microflora of the lower genital tract might be a triggering factor for many pathological and malignant conditions. Hence, we tried to explore the occurrence of Atopobium vaginae and Porphyromonas somerae in the lower genital tract of women with endometrial cancer and the factors associated with them.

Materials and methods: The study enrolled 64 patients aged between 40 and 80 years, of which 32 cases were cases of endometrial cancer and 32 cases had benign gynecological diseases. After taking the history and demographic profile of the patients, three swabs from the cervix and vagina were sent for gram staining, culture with blood and MacConkey agar, and antibiotic susceptibility tests. A real-time polymerase chain reaction was also done for molecular identification of organisms.

Results: Around 50% of women with endometrial cancer had isolated colonization with A. vaginae and P. somerae, with 25% showing the coexistence of both the organisms, whereas the benign gynecological disease group displayed absence of any organisms in 56% of women.

Conclusion: Coexistence of A. vaginae and P. somerae in the lower genital tract showed a significantly higher occurrence of endometrial cancer in comparison to those having either only one.

Background: Pulmonary and physical functions are associated with menopausal status. The exercise recommendations have been described, however, there is a dearth of literature proposing the benefit of these exercises for improving pulmonary and physical function among postmenopausal women.

Objective: The study aimed to explore the effect of multimodal exercises on functional capacity, hand grip strength (HGS), and pulmonary function among middle-aged postmenopausal women.

Materials and methods: Twelve postmenopausal women with a median age of 52.50 years were recruited by purposive sampling for this single group pretest-posttest quasi-experimental preliminary study. The outcomes were assessed at baseline and after 8 weeks and included 6-min walk test (6MWT), HGS, and pulmonary function measures: forced expiratory volume in 1^st s (FEV1) and maximum voluntary ventilation (MVV). The multimodal exercise intervention was given for 8 weeks at a frequency of three times a week.

Results: The Wilcoxon Signed-rank test showed that 6MWT (P = 0.002), dominant HGS (P = 0.002), nondominant HGS (P = 0.003), FEV₁ (P = 0.004), and MVV (0.002) showed statistically significant improvement with multimodal exercise protocol. The P < 0.05 was considered as statistically significant.

Conclusion: The multimodal exercise protocol has significant benefits in improving the functional capacity, HGS, and pulmonary function among postmenopausal women, however, larger experimental trials are warranted.

Objective: The deficiency of estrogen becomes clinically more overt over time and correlated with amounts of genitourinary syndromes of menopause (GSM). Our study aimed at examining the clinical effect of Hibiscus taiwanensis compound extract (HERCET®-w gel) on women with GSM.

Subjects and methods: This study included 31 patients with GSM symptoms. The treatment administered to patients included in this study was the daily use of vaginal treatment of HERCET®-w gel. Before, 3 months, and 6 months after HERCET®-w gel treatment, each patient's baseline characteristic data were collected.

Results: Our data showed that HERCET®-w gel could significantly improve some index or questionnaire in urinary symptoms including the Urogenital Distress Inventory 6, the Vaginal Health Index, or pH value. It also showed a significant increase in sexual function after 6 months treatment of HERCET®-w.

Conclusion: HERCET®-w on the women with GSM after 6 months could significantly improve GSM. It also showed an obvious progress of patients' sexual function in the Female Sexual Function Index score in the 6-month follow-up.

The use of hormone replacement therapy (HRT) was quite liberal in the 19^th century. The controversial reports given by the World Health Initiative and million women study restricted its use in certain medical conditions. This article has been written to revisit the use of HRT in certain medical conditions where it was earlier contraindicated. In the era of modern medicine, benefits and risks of HRT should be carefully thought of and a holistic treatment approach should be used to provide women the best quality of life she can have in her circumstance. Contraindications to HRT should be reconsidered as the estrogen deficient state might itself give the woman symptoms that could make her overall health even worse. HRT can be safely given in minimum doses, for a restricted period of time in conditions such as breast cancer, genital malignancy, cardiovascular disorders, Alzheimer's disease and thromboembolism and many more medical conditions. Another breakthrough in the past has been the use of HRT in hormone deficient states such as Turner syndrome (TS) and primary ovarian insufficiency (POI). HRT when timely given with growth hormone can prove to be beneficial in cases of both TS and POI.