Przeglad Menopauzalny最新文献

Introduction: The thyroid gland has a significant impact on the morphofunctional state of the organs of the female reproductive system, the regulation of the ovarian-menstrual cycle, as well as the age-related decline of the generative and endocrine function of the ovaries.

Material and methods: The study involved 102 women aged 49-62 years, who were divided into 2 groups. Group I included 54 patients who suffered from manifestations of the menopausal syndrome, and the control group comprised 48 patients whose menopausal period proceeded physiologically. All patients underwent clinical, laboratory, and instrumental examinations in accordance with the requirements of modern protocols.

Results: A thyroid dysfunction has a significant impact on the course of menopause. In women who suffered from manifestations of pathological menopause, the thyroid dysfunction was detected in 64.81% of patients, with the most frequently diagnosed being hypothyroid state (61.11%). Among thyroid diseases, chronic autoimmune thyroiditis prevailed (37.04%), and diffuse focal and focal changes were observed in 24.07% of cases. In patients with uncomplicated menopause, thyroid pathology was diagnosed 3.9 times less frequently. No autoimmune thyropathies were identified among the patients in the control group; focal pathology (category TI-RADS1 and TI-RADS2) was detected in 14.58% of cases.

Conclusions: Thyroid dysfunction accompanied by hypothyroidism can be considered as a risk-stratification factor for the development of pathological menopause.

As can be seen from research, 44% of oncological problems disclose problems in relationships with a partner. About 80% of oncological patients report deterioration of the quality of their sexual life. Although the situation improves, a significant majority of ill persons do not obtain assistance in the scope of sexuality during oncological treatment. Intimacy is an important sphere of life and can support the process of recovery. Intimacy plays special role in the difficult period of the fight against disease. Independently of the applied method of oncological treatment, side effects of therapy can influence one's sexual life. This means that an increasing number of persons who are healed from cancerous disease are exposed to the long-term undesirable influence of treatment. The process of oncological treatment has an essential impact on the intimate life of those who suffer from oncological diseases. To a great extent, this process and the disease itself contribute to a decrease of the quality of life due to the appearance of symptoms caused by earlier menopause, they negatively influence the feeling desire and sexual performance. Unfortunately, despite the development of oncosexology, sexual problems of oncologically ill persons are not noticed, and sometimes they are played down or overlooked due to everyday problems.

Introduction: Cervical carcinoma is the second commonest malignancy among females worldwide. In India, about 365.71 million women aged over 15 years are more vulnerable to cervical carcinoma. Risk factors may include immunodeficiency diseases, herpes, smoking and oral contraceptives. Scientific literature has documented that type 2 diabetes mellitus (T2DM) could aggravate the risk of some malignancies (hepatic, pancreatic, endometrial). This study aimed to evaluate the potential association between cervical carcinoma and diabetes mellitus in women.

Material and methods: Patients with cervical carcinoma, with or without diabetes, were assigned to two groups based on attainment of menopause. SPSS version 11.5 was used for data analysis. Odds ratios were calculated, and the chi-square test was used. P-values ≤ 0.05 were considered statistically significant.

Results: It was observed that 29% of patients with cervical cancer were sixty to seventy years old, with a majority (40%) of them being multiparous. Though the association of body mass index as a risk factor for diabetic patients with cervical carcinoma was not significant in pre- and post-menopausal age groups, T2DM in cervical carcinoma is a useful prognostic indicator.

Conclusions: Diabetic females after attaining menopause have a higher risk of developing cervical carcinoma and therefore should mandatorily receive routine screening. Future research with a longer timeframe is needed in order to generalize the results.

Introduction: Menopausal symptoms in women are influenced by personality traits as well as physical and psychological characteristics. The effects of coronavirus disease 2019 (COVID-19) phobia on personality traits and menopausal symptoms in premenopausal and postmenopausal women were examined in this study.

Material and methods: The study was conducted in a cross-sectional and descriptive design with 410 women. The data were collected using a descriptive data form, the COVID-19 phobia scale, the menopause rating scale, and the Cervantes personality scale.

Results: In this study, 46.8% of the women were premenopausal and 53.2% were postmenopausal. The mean age was 42.9 ±1.97 years in premenopausal women and 50.9 ±2.94 years in postmenopausal women. The psychological, social, and total COVID-19 phobia scores were found to be higher in postmenopausal women than premenopausal women. Postmenopausal women showed more introverted personality traits than premenopausal women. COVID-19 phobia affected postmenopausal women more than premenopausal women in terms of psychological, social and all menopausal symptoms. As COVID-19 phobia increased, neurotic personality traits increased in premenopausal women, and introverted and neurotic personality traits increased in postmenopausal women (p < 0.05). Menopausal symptoms increased with neurotic personality traits in premenopausal women and with introverted personality traits in postmenopausal women (p < 0.001).

Conclusions: COVID-19 phobia affected both groups in terms of menopausal symptoms and personality traits. For the management of menopausal symptoms, it is recommended to consider neurotic personality traits in premenopausal women and introverted personality traits in postmenopausal women.

Introduction: The aim of the study is to assess changes in body mass index (BMI), functional fitness, satisfaction with and quality of life among women 60+ years after participating in a 9-month organised health training programme.

Material and methods: Research on a group of 74 women aged 60-83 years (M = 67.8; SD = 5.1) was conducted twice, at the beginning and after 9 months of the health training programme (90 minutes, twice a week). The following tools were used in the research: SECA model 764 device, Fullerton functional fitness test, the World Health Organization Quality of Life questionnaire, and the satisfaction with life scale. Calculations were performed using the Statistica 13.1 program, via Pearson's and Spearman's correlation coefficients as well as Student's t-test for dependent measurements and the Wilcoxon paired test. Interactive repeated measures analysis of variance was also used. The assumed level of significance was α = 0.05.

Results: Comparing the results before and after implementing the health training programme, it was found that the average BMI value decreased (p < 0.001), while the functional fitness indicators, including the tests: 30-second chair stand (p < 0.001), 30-second arm curl (p < 0.001), back scratch (p = 0.001) and two-minute step-in-place (p = 0.002), increased. Between the first and second measurement, differences in quality of life profiles were also demonstrated, with 3 aspects of quality of life intensifying (somatic, psychological, and environmental), the psychological aspect increasing the most.

Conclusions: The obtained results confirmed the positive impact of the 9-month health training programme on the BMI, functional fitness, and quality of life of women above the age of 60 years.

Uterine fibroids are the most common pelvic benign tumours occurring in women of reproductive age. Current treatment options include surgical procedures, pharmacological therapies, and minimally invasive procedures. The most commonly applied and accepted minimally invasive procedure used in the treatment of symptomatic uterine fibroid is uterine artery embolisation (UAE). Uterine artery embolisation is a minimally invasive procedure that can be used either as an auxiliary method or the main treatment method of symptomatic uterine fibroids. We would like to present the application of pre-operative UAE before hysterectomy in anaemic women with giant uterine fibroid (21.9 × 14.9 × 10.4 cm) and HIV-associated nephropathy. Among the possible treatment options for uterine fibroids in cases like the one presented in our manuscript, hysterectomy is the treatment of choice. However, surgical treatment in a patient with severe comorbid conditions and giant uterine fibroid carries serious risk of perioperative complications. Pre-operative UAE decreases such risk by reducing blood loss during hysterectomy and shortening operation/anaesthesia time. Although the benefits of pre-operative UAE before planned myomectomy or hysterectomy in high surgical risk patients with large fibroids has yet to be confirmed in a well-designed clinical trial, this procedure seems to be a promising tool to reduce the risk of perioperative complications in such patients.

Introduction: Endometrial cancer is currently the most common malignancy of the female reproductive system. The significance of the disease is determined by the search for additional biomarkers with the aim to optimize earlier diagnosis and to help for timely treatment. The objective of this study was to assess the serum levels of fibronectin (FN) in patients with malignant endometrial pathology and to compare them with patients with benign pathology and healthy women.

Material and methods: We analyzed serum FN levels in women with malignant and benign pathology of the endometrium. Blood serum samples were collected from 100 patients - 50 diagnosed with endometrial cancer and 50 with confirmed endometrial polyps. In addition, 50 control subjects were tested. Fibronectin levels were measured by enzyme-linked immunosorbent assay (ELISA) according to the protocol.

Results: Statistical analysis was performed and the results demonstrated statistical significances (p = 0.008) of FN levels in the group with endometrial cancer (mean 482.73, median 409.12 µg/ml) compared to the control group (mean 346.86, median 258.87 µg/ml), but no significant difference in FN levels was observed between the group with endometrial malignancy and the group with benign pathology of the endometrium. In addition, in the cancer group FN levels did not show any significant differences depending on the histologic type.

Conclusions: The serum FN concentration can be used as an additional tumor marker for gynecological malignancies and can be a potential diagnostic and prognostic marker for malignant endometrial pathology as well as for other gynecological malignancies.

Introduction: The research aimed to delineate and investigate the utilisation of antidiabetic drugs in type 2 diabetes patients with kidney failure at a hospital in Can Tho City, Vietnam.

Material and methods: The research analysed the use of antidiabetic drugs at various time points, determined the drug interaction rate, and evaluated the appropriate use of drugs and the relationship with the achievement of target blood glucose and HbA_1c levels. A two-tailed Student's t-test was employed to compare continuous variables, an ANOVA test was used to assess multiple values, and an χ² test was utilised to evaluate categorical variables.

Results: Insulin monotherapy was the predominant regimen for treating type 2 diabetes in patients with impaired kidney function. Metformin was the most prescribed oral medication. Approximately 85.78% of patients received safe and appropriate diabetes treatment. Statistical analysis revealed a significant relationship between achieving target blood glucose and HbA_1c after 3 months and factors such as safe drug use and minimal drug interactions (p < 0.05). Patients with chronic kidney disease demonstrated better blood glucose control compared to those with acute kidney disease.

Conclusions: The most common drug used for type 2 diabetes patients with impaired kidney function was insulin monotherapy, with usage increasing with the severity of chronic kidney disease. The chronic kidney disease group exhibited a higher rate of achieving target blood glucose and HbA_1c compared to the acute kidney disease group. Rational, safe, and interaction-free drug use significantly contributed to better blood sugar control compared to less prudent medication choices.

Leiomyomas are benign, well-circumscribed mesenchymal tumours. While uterine leiomyomas are common, vulval leiomyomas are rare. We report the challenging case of vulval leiomyoma in a multiparous woman, who also developed acute postoperative delirium. A 41-year-old multiparous woman presented with a mass in the perineum of one year duration and discomfort in a sitting position since a month ago. Her menstrual history, family history, and personal history were unremarkable. On examination of the vulva, there was a firm mass of size 10 x 8 cm on the left side, involving the labium majus and minus, which was distorting the introitus. The uterus and ovaries were normal. Preoperative ultrasound was suggestive of a vulval solid lobulated lesion, probably leiomyoma. Excision of the mass was performed. The patient developed postoperative delirium at 3 hours and was treated with an injection of haloperidol, antibiotics, and electrolyte correction. She recovered well and was discharged on the sixth postoperative day. Histopathology confirmed leiomyoma of the vulval mass, with areas of cystic degeneration. At 6-month follow-up the patient was asymptomatic and had no recurrence. To conclude, vulval leiomyoma is rare and treated by excision. The occurrence of postoperative delirium adds to the surgical morbidity, and gynaecologists should be aware of these conditions for optimal outcomes.