BMC Women's Health最新文献

Background: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder, affecting 5-10% of women of reproductive age. Major complications of PCOS include infertility, obesity, endometrial hyperplasia, endometrial cancer, insulin resistance, hyperandrogenism, and cardiovascular issues. This study aims to investigate the polymorphism of the Insulin Resistin (RETN) gene at positions - 420 CG and + 299 AG in relation to the susceptibility to PCOS.

Methods: This case-control study included 198 participants (100 diagnosed with PCOS and 98 normal controls). Two single nucleotide polymorphisms of the RETN gene - 420(C/G) (rs1862513) and + 299(G/A) (rs3745367), were analyzed using the PCR-RFLP method. Genomic DNA was extracted from blood samples using a DNA extraction kit. The PCR product was digested with restriction enzymes BbsI and AluI, and the results were analyzed by electrophoresis on an agarose gel. Statistical analysis determined the association of the genotypic and allelic variations with PCOS.

Results: The findings indicate no significant association between the RETN gene polymorphism and PCOS.

Discussion: Our study found that RETN gene polymorphisms do not appear to play a significant role in PCOS susceptibility in the Iranian population. These results suggest that other genetic or environmental factors may contribute more significantly to the development of PCOS. Further research with larger sample sizes and additional genetic markers is necessary to understand the genetic basis of PCOS fully.

Background: In Italy, approximately 50% of women report experiencing episodes of psychological and/or physical violence. The Emergency Department (ED) is widely recognized as one of the health services to which victims of violence seek treatment for injuries and within which situations of domestic violence and abuse can be recognized. This work aims to estimate the phenomenon of violence in the population of the Health Protection Agency (ATS) of Milan using data from emergency room access and hospital admissions. A further goal of the survey is to provide evidence to launch audit processes in health units designed to foster improvement strategies for the management of the phenomenon and guarantee integration with anti-violence centers.

Methods: In the first phase of the project, an algorithm was designed to detect women subjected to violence intercepted in the five years 2019-2023 in the administrative healthcare data of emergency rooms and hospital admissions. To identify the cases, the specific diagnosis codes of the ICD-9 have been selected. Prevalence and time trends of the phenomenon were estimated, stratifying by different socioanagraphic characteristics and by types and attributes of access. In addition, the degree of integration between social and health services was analyzed. The areas researched concern intake by specialized services; specifically, data on female residents of the cohort were cross-referenced with data on access to the network of social health services in the ATS territory.

Results: A clearly increasing phenomenon emerges: from 2019 to 2023, admissions to the ED have risen by 17%. A total of 35.6 percent of admissions involve women between the ages of 18 and 34. Foreigners account for approximately 40.9 percent of the cohort while constituting 15 percent of women residing in the territory. The yellow (Urgency) triage code is assigned for 3 out of the 4 admissions. A total of 11.5% of women had multiple accesses.

Conclusions: Administrative healthcare data offer consistent data for studying the phenomenon of violence. This project aims to provide useful tools to better guide policies for intervention and integration between services in the area. Further reflection will focus on the possibility of integrating health and social services to support an integrated approach.

Objective: To investigate the application value of multimodal hysterosalpingo-contrast sonography (HyCoSy) combined with negative hysterography in assessing tubal patency and diagnosing uterine lesions.

Methods: A total of 310 infertility patients were selected and examined using multimodal HyCoSy and negative hysterography to evaluate tubal patency and uterine lesions. Based on the doctors' experience levels, they were divided into high seniority group (more than 5 years of experience in Contrast-enhanced ultrasound) and low seniority group (resident doctors). Various ultrasound modes, including two-dimensional contrast-enhanced ultrasound (2D), static three-dimensional contrast-enhanced ultrasound (3D), real-time three-dimensional contrast-enhanced ultrasound (4D), and transvaginal harmonic imaging (HI), were employed for diagnosis. The χ2 test was used to compare the success rates of tubal patency diagnosis across different mode combinations. The Wilcoxon rank-sum test was used to compare the diagnostic efficiency of tubal patency between high and low seniority groups under multimodal ultrasound.

Results: A total of 306 patients successfully completed the examinations, with 538 cases of tubal patency and 74 cases of obstruction identified. The combination of multiple modalities significantly improved diagnostic efficiency, with the 4D + 3D + 2D + HI mode demonstrating a significantly higher diagnostic success rate compared to single modes (P < 0.005). Negative hysterography showed high consistency with hysteroscopy in diagnosing uterine malformations, with 100% sensitivity and specificity. Additionally, it demonstrated good diagnostic ability for cesarean scar diverticulum, endometrial polyps, submucosal fibroids, and uterine adhesions.

Conclusion: The combination of multimodal HyCoSy and negative hysterography is a simple, rapid, and accurate examination method suitable for assessing tubal patency and diagnosing uterine lesions.

Background: Cervical cancer ranks as the fourth most prevalent cancer among women globally, particularly affecting socioeconomically disadvantaged populations such as those in Tanzania. Receiving a cervical cancer diagnosis induces considerable stress and elicits negative reactions. Coping mechanisms, ranging from adaptive to maladaptive, are employed to navigate this challenging condition and are influenced by factors such as race, socioeconomic status, and sociocultural background. Despite its significance, little is known about the coping strategies utilized by cervical cancer patients in Tanzania.

Methods: By employing purposeful sampling, a qualitative descriptive study was conducted at the Ocean Road Cancer Institute in Dar es Salaam from December 2022 to January 2023, aiming to explore coping strategies adopted by cervical cancer patients. Thematic analysis was employed to analyse the gathered data.

Findings: The key themes that emerged included problem-focused coping, emotion-focused coping, social support, religious coping, and escapism.

Conclusions: Cervical cancer patients employ a diverse array of coping strategies to manage their condition. While many strategies observed were adaptive, some proved to be maladaptive, underscoring the importance of ongoing assessments to bolster adaptive coping mechanisms among this population.

Background of the study: Menstrual waste management encompasses the practices involved in handling menstrual hygiene products from the onset to the conclusion of menstruation. Despite being a crucial public health issue, menstrual waste management remains under-researched, particularly in educational institutions in Nigeria. This study investigates menstrual waste management practices among female students residing in hostels constructed by the Niger Delta Development Commission (NDDC) in the Niger Delta region, focusing on their methods of disposal, associated challenges, and compliance with global standards.

Methods: The study targeted first-year undergraduate female students from three tertiary institutions, with a total population of 825. A systematic sampling technique was used to select a sample of 413 respondents. Data were collected using a structured questionnaire adapted from the World Bank's Menstrual Health and Hygiene Resource Package (2021) and validated instruments by Adekunle and Ajayi (Am Int J Social Sci Res 4(2):78--87, 2019), with a reliability coefficient of 0.8. Ethical clearance was obtained from Delta State University.

Result: Findings revealed that common menstrual waste materials included cotton wool, pads, and napkins, with many students facing challenges related to affordability and availability of preferred products. Improper disposal practices, such as discarding without wrapping and burying in pits or burning, were prevalent, posing significant health and environmental risks. These unsound practices were exacerbated by the lack of adequate disposal facilities in hostels, limited awareness of proper disposal methods, and non-compliance with global guidelines. Health consequences included an increased risk of infections, while environmental impacts ranged from contamination to prolonged degradation of non-biodegradable materials.

Conclusion: The study highlights the urgent need for infrastructural improvements, targeted education on sustainable menstrual hygiene practices, and stricter adherence to global standards. Recommendations include: University management should jointly implement stringent policies to eliminate unsustainable disposal methods, providing affordable and eco-friendly menstrual products, such as reusable pads, integrating menstrual health education into institutional policies, and enhancing waste management systems. These measures are vital for promoting sustainable menstrual hygiene and aligning with global health and environmental goals.

Background: Chronic low-grade inflammation has been recognized as an underlying event linking obesity to diabetes and cardiovascular disease (CVD). However, inflammatory alterations in individuals and specifically women who are overweight remain understudied. Providing relevant insights is of substantial interest for women's cardiovascular health.

Methods: We determined the levels of key circulating biomarkers of innate immune responses and inflammation, including lipopolysaccharide-binding protein (LBP), C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and adiponectin in adult female subjects who were lean (n = 20) or overweight (n = 20) and had high cholesterol and/or high blood pressure - two important conventional risk factors for CVD.

Results: Plasma levels of LBP were significantly higher in the overweight group compared with the lean group (P = 0.017). The levels of CRP were also significantly higher in overweight subjects (P = 0.023), as were IL-6 (P = 0.016) and leptin (P = 0.004), pro-inflammatory mediators associated with cardiovascular risk. Levels of adiponectin, an adipokine with anti-inflammatory and anti-atherogenic functions, were significantly lower in the overweight group (P = 0.006). The leptin/adiponectin ratio, a preferential atherogenic marker was significantly increased in women who are overweight (P = 0.0007). LBP, CRP, leptin, IL-6, leptin, and adiponectin levels significantly correlated with BMI, but not with age and there was a significant correlation between LBP and IL-6 levels and LBP and CRP levels.

Conclusions: These results reveal the presence of a pro-inflammatory state in overweight women and are of interest for further studies with the goal for improved understanding of cardiovascular health risks in women.

Ovarian cancer (OC) is the most lethal gynecological tumor. N4-acetylcytidine (ac4C) modification, catalyzed by the acetyltransferase NAT10, is involved in the occurrence and development of cancers. This study aimed to investigate the role of NAT10 in OC and the underlying molecular mechanisms. The expression of NAT10 and CAPRIN1 in OC cells lines were measured using quantitative real-time polymerase chain reaction and immunoblotting. Biological behaviors of OC cells were evaluated using EdU, Transwell, sphere formation, and immunoblotting assays. The molecular mechanism of NAT10 function was analyzed using bioinformatics, ac4C- RNA immunoprecipitation, and actinomycin D treatment assay. The effect of NAT10 on OC progression in vivo was evaluated using xenograft tumor model. The results indicated that NAT10 and CAPRIN1 were highly expressed in OC cells. NAT10 knockdown suppressed OC cell proliferation, migration, invasiveness, stemness, and epithelial-mesenchymal transition in vitro, and impeded tumor growth in vivo. Additionally, CAPRIN1 expression was found to be positively related to NAT10 expression in OC. Silencing of NAT10 inhibited ac4C levels of CAPRIN1 and reduced its RNA stability. Moreover, overexpression of CAPRIN1 reversed the suppression of migration, invasion, and stemness caused by NAT10 knockdown, while knockdown of CAPRIN1 alone inhibited these malignant behaviors of OC cells. In conclusion, NAT10 promotes OC progression by promoting cellular migration, invasion, and stemness via upregulating CAPRIN1 expression. Mechanistically, NAT10 stabilizes CAPRIN1 by promoting its ac4C modification. These findings suggest that NAT10 may be a promising therapy target for OC.

Objective: To systematically evaluate existing developed and validated predictive models for stress urinary incontinence after pelvic floor reconstruction.

Methods: Relevant literature in PubMed, Embase, Web of Science, Cochrane Library, OVID, China National Knowledge Infrastructure(CNKI), Wan Fang Database, VIP database and Chinese Biomedical Literature Service System (SinoMed) were search from inception to 1 March 2024. Literature screening and data extraction were performed independently by two researchers. The chosen study's statistics included study design, data sources, outcome definitions, sample size, predictors, model development, and performance. The Predictive Modelling Risk of Bias Assessment Tool (PROBAST) checklist was used to assess risk of bias and applicability.

Results: A total of 7 studies containing 9 predictive models were included. All studies had a high risk of bias, primarily due to retrospective design, small sample sizes, single-center trials, lack of blinding, and missing data reporting. The meta-analysis revealed moderate heterogeneity (I² = 68.8%). The pooled AUC value of the validated models was 0.72 (95% CI: 0.65, 0.79), indicating moderate predictive ability.

Conclusion: The prediction models evaluated demonstrated moderate discrimination, but significant bias and methodological flaws. The meta-analysis revealed moderate heterogeneity (I² = 68.8%) among the included studies, reflecting differences in study populations, predictors, and methods, which limits the generalizability of the findings. Despite these challenges, these models highlight the potential to identify high-risk patients for targeted interventions to improve surgical outcomes and reduce postoperative complications. The findings suggest that by integrating these models into clinical decision-making, clinicians can better tailor surgical plans and preoperative counseling, thereby improving patient satisfaction and reducing the incidence of postoperative stress urinary incontinence. Future research should follow TRIPOD and PROBAST principles, focus on addressing sources of heterogeneity, improve model development through robust designs, large sample sizes, comprehensive predictors, and novel modelling approaches, and validate tools that can be effectively integrated into clinical decision-making to manage stress urinary incontinence after pelvic floor reconstruction.

Background: Breast and cervical cancers are the commonest cancers among women. Secondary prevention of cancer through screening minimizes disease burden and improves survival outcomes. Optimizing screening strategies for breast and cervical cancers is a challenge in resource-limited settings with a high population density such as China. Therefore, we aimed at assessing the efficiency of different combined screening strategies for breast and cervical cancers under different budgets in China.

Methods: Markov cohort model was used to evaluate the cost-effectiveness of 36 strategy combinations for breast and cervical cancer screening with varying screening modality and intervals. The results were used as inputs in the Integer Programming (IP) model to determine the combination of the different screening options under different budgets.

Results: The optimal combination strategy was biennial breast ultrasonography (BUS) and mammography (MAM) in parallel screening and quinquennial human papillomavirus (HPV) for breast and cervical cancer screening under the threshold of the annual per capita social cost investment (PCSCI) (18.80 USD) in China. Using this strategy, the total investment cost for 100,000 females was 1,877,984.50 USD, and the incremental life-years compared with no screening was 3,122 life-years. The optimal combination strategy included annual clinical breast examination (CBE), BUS and MAM in series screening, and biennial thin-layer liquid-based cytology (TCT) and HPV in series screening with the annual PCSCI reaching 37.60 USD. Thereafter, as the cost input continued to increase, the optimal combination strategy remained unchanged, and the sum of incremental life-years and actual input costs did not increase.

Conclusions: From a social cost-benefit perspective, biennial BUS and MAM in parallel screening, and quinquennial HPV screening is the most efficient combination strategy with limited budget, while annual CBE, BUS and MAM in series screening and biennial TCT and HPV in series screening are the most efficient combination strategy with sufficient budget.