BMC Women's Health最新文献

Background: Breast cancer treatment has many strategies, each with its own effects on survivors' quality of life (QoL). The current study evaluated factors influencing QoL in women who have undergone mastectomy and compared different treatments based on sociodemographic and clinical factors.

Methods: A retrospective cohort study was conducted utilizing the EORTC Quality of Life breast cancer specific tool and the FACT-B and FBSI questionnaires to measure functional and symptom scales impacting QoL. The questionnaire was administered to 318 Egyptian women post-mastectomy and at 6-month follow-up. Results were reported as median and interquartile range (IQR) or frequency and percentage. Fisher's exact and Kruskal-Wallis tests were used for statistical inferences. Generalized linear models were used to predict QoL measures (outcome) by sociodemographic and clinical variables (independent) with adjusting for potential confounders. Independent variables were selected by elastic net regression.

Results: The Global QoL score for this cohort was 42.0 (IQR 25.0-67.0). The functional scale most affected was role (62%), with the cognition having the lowest effect. The most distressing symptoms on the symptom scale were fatigue (65%), insomnia (61%), and pain (60%). FACT-B had a median score of 79.0 (IQR 63.0-95.0). Generalized linear regression indicated that higher cognitive functioning (22.45; p < 0.050) and BCS (6.026, p < 0.010) was positively correlated with women > 60 years old. Urban women correlated with a lower SWB (-2.679, p < 0.05) and higher degree of insomnia. A BMI > 30 correlated negatively with many of the QoL domains. SM or MRM with reconstruction correlated positively with TQOL (8.109 < p < 0.050). Women who received chemotherapy had lower social functioning (-12.41, p < 0.050), BCS (-3.473, p < 0.010), greater association with diarrhoea (8.865, p < 0.010) and financial difficulties (15.23, p < 0.050). In contrast, women who received hormonal therapy had higher role functioning (17.64, p < 0.010), with less complaints of diarrhoea (-10.38, p < 0.010), nausea (-8.668, p < 0.010) and pain (-8.265, p < 0.050).

Conclusion: These results indicate that sociodemographic and clinical factors affect QoL in Egyptian women post-mastectomy. The worst functioning was the role and emotional scales, and the most distressing on the symptom scale were fatigue, insomnia, and pain making an imperative case for a more multidisciplinary team approach to treatment.

Introduction: The conflict between work and family responsibilities has created many challenges for working women in Iran. This study aimed to examine the effect of work-family conflict (WFC), subjective socio-economic status (SSS), and physical activity (PA) and quality of working life (QWL) on the quality of life (QOL) of working women in Kermanshah, Iran.

Methods: This cross-sectional study was conducted with 392 working women in Kermanshah, the most populous city in western Iran. The data gathering tool was a six-part questionnaire, including demographic checklist, PA scale, a question on SSS, WFC scale, QWL questionnaire, and QOL questionnaire. Data were analyzed by SPSS and AMOS software.

Results: The majority of participants (69.4%) were inactive or had low levels of PA during their leisure times. The highest positive correlation was observed between QWL and QOL (r = 0.309, p-value < 0.001). The highest direct effect among the variables belonged to the SSS on QWL (β = 0.41, p-value = 0.001) and QOL (β = 0.20, p-value < 0.001). Furthermore, the analysis of indirect effects indicated that QWL played a mediating role between SSS and QOL (β = 0.092, p-value < 0.001).

Conclusion: The findings of this study revealed that variables such as SSS, PA, and QWL had significant direct effects on QOL. However, WFC had no significant effect on QOL. Moreover, QWL had a significant positive mediating role between SSS and QOL.

Background: Recently, increased awareness of early diagnosis and treatment options has led to an increase in the number of breast cancer survivors. Psychosocial interventions to increase the quality of life in this group are gaining importance. One of the most common psychological problems in breast cancer survivors is fear of cancer recurrence (FCR). It is essential to elucidate the mechanisms of FCR.

Aims: This study aimed to examine the mediating effect of intrusive rumination on the relationship between illness uncertainty and FCR in breast cancer survivors.

Methods: The study was designed to be cross-sectional, and 204 breast cancer survivors were included. Participants were given the Mishel Uncertainty in Illness Scale-Community form (MUIS-C), the severity subscale of the Fear of Cancer Recurrence Inventory, and the Event-Related Rumination Inventory-intrusive rumination subscale. Correlation analyses were conducted, and the structural equation method evaluated the mediation effect.

Results: Most participants (74%) reported some degree of FCR. A significant positive relationship was found between illness uncertainty and FCR (r = 0.325; p ≤ 0.001). The path analysis showed that intrusive rumination partially mediates this relationship.

Conclusions: This study's results shed light on the relationship between illness uncertainty, rumination, and FCR. Planning psychoeducation programs during follow-up to reduce illness uncertainty may positively affect FCR. In addition, metacognitive therapies that can functionalize the ruminative thinking style can also effectively intervene in FCR.

Introduction and hypothesis: Urinary incontinence (UI) is defined as any involuntary loss of urine and can be associated with urgency and/or physical exertion. Electrical stimulation (ES) has recently been identified as a proven therapeutic alternative for UI, with few side effects and low cost. This systematic review, registered on the Prospective Register of Systematic Reviews (RD42024528812), investigated whether home-based ES would be as viable as outpatient ES in the treatment of women with UI.

Methods: Study selection was conducted by two independent researchers across the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Web of Science, Scopus, and PEDro (search conducted on February 25, 2024). We also searched the reference lists of eligible articles. There were no restrictions on date and language. The RoB2 and GRADE tools were used to assess methodological quality and evidence recommendation.

Results: 723 articles were found, and four trials were eligible. Very low-quality evidence indicated statistically significant differences in cure rates or improvement of urinary symptoms in women treated with both outpatient and home-based ES. Low-quality evidence recommends home-based ES in maintaining improvement of urinary symptoms, and moderate-quality evidence indicates no severity of symptoms in the home-based group.

Conclusion: Home-based ES is shown to be as effective as outpatient ES in the treatment of UI in women. However, data analysis revealed low-quality evidence regarding the cure or improvement of the women's conditions.

Background: Menarche is an important period in a female's life; its time of onset may depend on various factors and could correlate with the development of diseases in adulthood. Our study aims to investigate the relationship between body mass index and age at onset of menarche; METHODS: We used a unique standardized national dataset on adolescent girls participating in the Italian Health Behaviour in School-aged Children Study. Two independent nationally representative survey datasets: one on 15-year-olds (n = 6505, year 2017/2018) and one on 11-year-olds (n = 6548, year 2013/2014) were analysed. The survey instrument was the self-report questionnaire. Median age at menarche and 95% confidence intervals were estimated through Kaplan-Meier analysis. Hierarchical models assessed the relationship between BMI and age at menarche; RESULTS: Region-level median age at menarche ranged between 12 years/5 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 6% and 24%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta=-0.81; 95% CI, -0.92 to -0.70). Individual-level and class-level measures of BMI accounted for 215.2% of the region-level variance in age at menarche; CONCLUSIONS: The results show that girls who were overweight during childhood went through early puberty. Further investigation needs to assess a possible cause-effect relationship.

Background: This study aimed to investigate the relationship of psychological empowerment and enjoyment of physical activity with changes in physical activity levels, sleep quality, and muscular endurance following a high-intensity interval training (HIIT) program in physically inactive young women.

Methods: A total of 61 physically inactive young women (age: 20.1 ± 2.7 y) were recruited to participate in a six-month HIIT intervention delivered via a smartphone app. Outcome measures included physical activity levels (MET-min/week), muscular endurance (plank test), and sleep quality through the Pittsburgh Sleep Quality Index (PSQI). The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ) and the Physical Activity Enjoyment Scale (PACES) were used to assess psychological empowerment and enjoyment, respectively. Repeated measures ANOVA and covariate analyses were performed to evaluate the impact of the intervention and the role of psychological empowerment and enjoyment.

Results: At 6 months, significant improvements in physical activity (p < 0.001; η_p²=0.336) and muscular endurance (p = 0.005; η_p²=0.085) were observed, with large and moderate effect sizes, respectively. The PACES showed a significant interaction with time for MET-min/week (F = 11.67, p = 0.001, η_p²=0.129), suggesting that enjoyment influenced the increase in physical activity. No significant differences in sleep quality were observed (p > 0.05).

Conclusion: Enjoyment plays a crucial role in the response to HIIT programs among physically inactive young women, particularly in improving weekly physical activity levels. Psychological training showed no significant relationship with the outcomes studied.

Background: Cuproptosis is a novel form of cell death, acting on the tricarboxylic acid cycle in mitochondrial respiration and mediated by protein lipoylation. Other cancer cell death processes, such as necroptosis, pyroptosis, and ferroptosis, have been shown to play crucial roles in the therapy and prognosis of ovarian cancer. However, the role of cuproptosis in ovarian cancer remains unclear.

Methods: The expression profiles of 10 cuproptosis-related genes were extracted from GSE140082. Kaplan-Meier survival and Cox proportional hazards regression were used to identify prognostic genes for constructing risk models. Following this, Least Absolute Shrinkage and Selection Operator regression was employed to construct a risk score model. Next, a nomogram was constructed to predict overall survival in ovarian cancer. Ultimately, our analysis compared the two groups across various dimensions, including clinical characteristics, tumor progression, metabolism-related pathways, immune landscape, and drug sensitivity.

Results: MTF1 and LIAS were identified as protective factors in ovarian cancer, with patients in the higher risk group being significantly associated with poorer survival. Furthermore, integrating the risk score with clinical characteristics in the nomogram demonstrated high specificity and sensitivity in predicting survival. A higher propotion of M2 macrophages, follicular helper T cells, and resting mast cells was observed in the high-risk group. Additionally, the IC50 values of Dasatinib, Bortezomib, Parthenolide, and Imatinib were significantly lower in the high-risk group.

Conclusions: The study highlights the prognostic significance of cuproptosis-related genes and provides new insights into developing pharmacological therapeutic strategies targeting cuproptosis for the prevention and treatment of ovarian cancer.

Background: Prenatal maternal smoking, lower birthweight, and shorter breastfeeding duration have all been associated with an earlier age at menopause in daughters. We estimated the extent to which birthweight-for-gestational-age z-score and breastfeeding duration mediate the effect of prenatal maternal smoking on time to natural menopause in daughters.

Methods: Using pooled data from two prospective birth cohort studies - the 1970 British Cohort Study (n = 3,878) followed-up to age 46 years and the 1958 National Child Development Study (n = 4,822) followed-up to age 50 years - we perform mediation analysis with inverse odds weighting implemented in Cox proportional-hazards models.

Results: Prenatal maternal smoking was associated with lower birthweight z-scores [β: -0.29; 95% CI -0.34, -0.24] and reduced breastfeeding duration [RRR_< 1month: 0.90; 95% CI 0.79, 1.02; RRR_{≥ 1 month}: 0.66; 95% CI 0.59, 0.73 relative to women who were never breastfed]. Greater z-score for birthweight [HR: 0.96; 95% CI 0.91, 1.01] and longer breastfeeding duration [HR_{≥ 1 month}: 0.84; 95% CI 0.74, 0.96] were associated with lower hazards for earlier age at natural menopause. The total effect of prenatal maternal smoking on the time to natural menopause in daughters was estimated as a HR of 1.13 [95% CI 1.02, 1.24]. Birthweight z-score and breastfeeding duration jointly explained an estimated 14% of the total effect [HR_NIE: 1.02; 95% CI 0.99, 1.05].

Conclusions: The consequences of smoking during pregnancy on the earlier experience of natural menopause in daughters may partly be offset by intrauterine growth and longer breastfeeding duration to the extent that they mediate the risk of earlier menopause. However, since the extent of mediation by birthweight z-score and breastfeeding duration is small, other factors, including the direct effect of maternal smoking in utero, may play a more important role.

Background: Ovarian cancer is a leading cause of mortality worldwide. The third most prevalent gynecological cancer globally, following cervical and uterine cancer, and the third leading cause of cancer-related mortality among women in Sub-Saharan Africa, including Ethiopia. The time ovarian cancer patients have to wait between diagnosis and initiation of treatment are the indicators of quality in cancer care and influence patient outcomes. Despite extensive studies in the field, little is known about the strength of the association between ovarian cancer survival and waiting time. So, the main purpose of this study is to assess the effect of waiting time on ovarian cancer survival in oncology centers in Addis Ababa, Ethiopia.

Methods: A facility-based retrospective cohort study was conducted with a total of 561 study participants included. The main outcome of interest for this study was death due to ovarian cancer. The authors compared the ovarian cancer patients with waiting times ≤ 10 weeks and waiting times > 10 weeks for overall survival rate using the log rank test. The incidence density rate of mortality was calculated for each group variable. The effect of waiting time on ovarian cancer mortality was estimated using the Cox proportional hazards model at the 5% level of significance.

Results: The incidence density rate of mortality among ovarian cancer patients for waiting time ≤ 10 weeks was found to be 10.85 (95%CI, 9.10-12.98) per 1,000 person years observation, while for waiting time > 10 weeks the mortality rate was found to be 18.05 (95%CI, 15.33-21.23) per 1,000 person years observation. In the Cox regression analysis after full adjustments for confounder variables, the mortality event risk was 36% higher among waiting time > 10 weeks women (AHR = 1.36; 95%CI = 1.05-1.75) as compared to waiting time ≤ 10 weeks.

Conclusions: We have found that the incidence density rate of mortality among ovarian cancer patients was significantly higher in waiting time > 10 weeks groups. Therefore, future policy and clinician programmers should consider the impact of waiting time from diagnosis until to get the first treatment more carefully.