BMC Women's Health最新文献

Objective: This study systematically evaluated the effect of aerobic exercise on sleep disorders in menopausal women and proposed a practical program from the perspective of "what to practice," "how much to practice," and "how to practice." We proposed the program from the standpoint of training science.

Methods: Up to March 20, 2023, a total of 16 articles and 19 RCT studies were retrieved from Web of Science, PubMed, Springer, Science Direct, China Knowledge Network, Wanfang, and VIP. The Cochrane Risk of Bias Assessment Tool was used to assess the quality of the literature, and We used RevMan5.3and STATA 16.0 software to provide a systematic review of included studies.

Results: The overall effect of low- and moderate-intensity aerobic exercise interventions for sleep disorders in menopausal women had a moderate effect size (SMD = -0.52, P < 0.001), and the effect values between different intervention frequencies (I² = 60%), intervention duration (I² = 60), intervention periods (I² = 70), exercise forms (I² = 70), and practice methods (I² = 70) had moderate heterogeneity. The most significant effect sizes were found for intervention frequency of 3 times/week (SMD = -0.57, P < 0.001); intervention duration of 70-90 min/session (SMD = -0.64, P = 0.004); intervention period of 8-10 weeks (SMD = -0.59, P = 0.35); and exercise form of static exercise ( SMD = -0.55, P = 0.003); and the practice mode was an individual exercise with the most significant effect size (SMD = -0.66, P < 0.01).

Conclusion: Low- and medium-intensity aerobic exercise intervention for sleep disorders in menopausal women has a good effect, but it is affected by training factors such as intervention frequency, intervention time, intervention period, exercise form, and practice mode; the best effect is achieved by adopting the dosage of 3 times/week, 70-90 min/times, and lasting for 8-10 weeks; aerobic intervention in the form of static exercise is the most effective; the best intervention effect is achieved by adopting the mode of individual exercise; but a group exercise approach improved exercise persistence in menopausal women.

Background: Latinas constitute nearly 20% of midlife women in the United States (U.S.), but remain underrepresented in menopause research. Many midlife Latinas are disadvantaged by limited English proficiency, less formal education, living below the federal poverty level, lack of health insurance, and social isolation and discrimination - factors that negatively affect menopause-related symptoms and health outcomes. This study aimed to understand knowledge, attitudes, and experiences of the menopause transition among midlife Latinas.

Methods: We conducted a qualitative descriptive study using five focus groups with 29 Hispanic/Latina midlife women. An emergent content analysis was performed by four bilingual coders. Data on socio-demographics, menopausal symptoms, menopause knowledge, and attitudes toward menopause and hormone therapy were collected over the phone. Descriptive statistics were performed to characterize study participants.

Results: Participants were aged 50.3 ± 6.3 years, 45% postmenopausal, 79% viewed menopause positively, and 55% reported having "little knowledge" about menopause. Seven themes emerged: 1) menopause is a stage of life (una etapa de vida); 2) not wanting to become an old lady (no quererme hacer viejita); 3) in our culture, we do not ask [about menopause]; 4) family dynamics; 5) each body is different (todo cuerpo es diferente); 6) menopause self-management and treatment options; 7) information is power (información es poder).

Conclusions: Although Latinas reported having a positive view of menopause, we found a need for culturally-tailored comprehensive menopause education. The importance of involving family members in menopause education was also revealed. Our next steps are to determine the best menopause messaging strategies and educational formats for midlife Latinas.

Background: Domestic Violence is a threatening worldwide problem. Its consequences against women can be dramatic, as it negatively affects women's quality of life reflected in their general wellbeing including physical, mental, emotional and sexual health, in addition to the economic cost. Both domestic violence and its cost are multidimensional constructs that cannot be directly measured.

Methodology: In this study, a latent trait model is used by applying item response theory to measure both domestic violence and its consequent cost via thirty-five observed variables. Accordingly, the study fills a gap in the literature since it is the first attempt to examine the relationship between domestic violence and its consequent cost in Egypt using latent variable modelling rather than simple descriptive statistics. Each construct is considered as a multidimensional latent variable. The overall latent trait model also estimates the relationship between domestic violence and its consequent cost. The effect of a number of socioeconomic covariates on domestic violence is examined within the model. The proposed model is fitted to data from the 2015 Egypt Economic Cost of Gender-Based Violence Survey (ECGBVS) using Mplus software.

Results: The study shows that psychological violence is equally important in measuring domestic violence, as physical violence. The cost resulting from domestic violence relies in its measurement both on the reduced quality of life and the monetary cost endured by the violated woman and children. For socioeconomic covariates, it is shown that domestic violence is affected by women's and husband's age, educational level, and husband's occupational status.

Conclusion: Domestic violence is measured by summarizing four forms of violence: physical, psychological, sexual and economic violence, in a single continuous latent variable measuring "Domestic Violence". Similarly, Cost is measured by summarizing three forms of consequent cost of violence: economic cost, cost on children and cost on women's quality of life, in another a single continuous latent variable "Cost". Each of these dimensions is measured by a number of aspects, reflecting the multidimensional nature of the variables. The fitted latent trait model ensured the positive relationship between Domestic Violence and its consequent multidimensional cost.

Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy.

Methods: The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups.

Results: The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P < 0.001) but increased intraoperative blood loss by about 41.82 mL (95% CI: 25.81, 57.82, P < 0.001).

Conclusion: By combining laparoscopy with traditional vaginal surgery, vNOTES offers advantages such as shorter surgery times, faster postoperative recovery, reduced hospital stays, greater minimal invasiveness, and improved cosmetic outcomes. However, it is essential for surgeons to continually enhance and standardize preoperative assessments and surgical techniques to minimize conversion rates and reduce intraoperative blood loss.

Trial registry number: ChiCTR2200059282, China Clinical Trials Registry, April 28, 2022.

Background: Neoadjuvant chemotherapy (NAC) with anthracycline sequential paclitaxel is the standard regimen for triple negative breast cancer (TNBC), while TNBC with residual positive axillary lymph node after standard NAC indicates poor prognosis. There is no evidence that vinorelbine alone can be used as an adjuvant intensive therapy for such patients at present.

Methods: We recruited TNBC patients with clinical stage of T1-4/N1-3/M0, who received NAC with 8 cycles of anthracycline sequential paclitaxel and had residual tumor in axillary lymph node after surgery. The patients were randomly divided into adjuvant intensive treatment group (Group A) and control group (Group B). The patients in group A received vinorelbine at a dose of 25 mg/m² on days 1/8 of a 21-day cycle with four planned cycles, while the control group received no therapy. Stratified according to the Miller-Payne system of the primary lesion (G1-2/G3-5). The endpoints included distant disease-free survival (DDFS), recurrence-free survival (RFS), overall survival (OS), and safety.

Results: A total of 22 eligible patients were enrolled in this study, the 3-year DDFS and RFS rates in the group A were significantly higher than those in group B (90.0% vs. 42.4%, p = 0.022, both) at a median follow-up of 36 months. All patients in the group A completed the scheme in full dose, and no grade 3/4 adverse event occurred.

Conclusions: TNBC patients with residual positive axillary lymph nodes after NAC of anthracycline sequential paclitaxel could benefit from adjuvant intensive therapy of vinorelbine with a good safety.

Trail registration: The study was registered on the Clinical Trial registry website ( https://register.

Clinicaltrials: gov , NCT03270007) (Registration Date: 08/30/2017).

Background: Thyroid autoimmunity (TAI) is associated with infertility and complications during pregnancy. However, the prevalence of thyroid autoantibodies in women with infertility remains unclear due to variability in study designs, sample sizes, and populations. In this meta-analysis, we aimed to assess the prevalence of thyroid autoantibodies in women with infertility compared with that in healthy controls.

Methods: Systematic searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library from inception to February 5, 2024. The inclusion criteria were women with infertility and those with autoimmune thyroid antibodies. Studies in which relevant data could not be extracted, randomized control trial reports, studies with non-original or duplicate data, and non-English articles were excluded. The main outcome was prevalence rate.

Results: The worldwide pooled prevalence of thyroid autoantibody positivity was 20%. In contrast, a significantly higher TAI prevalence was noted in the population with infertility than in healthy controls (risk ratio [RR] = 1.51). Subgroup analyses indicated that TAI prevalence was higher in patients receiving both assisted reproductive technology (ART) and non-ART treatments than in healthy controls (RR = 1.37 and 3.06, respectively). TAI prevalence was also higher in the recurrent abortion and non-recurrent abortion groups of infertility than in healthy controls (RR = 1.80 and 1.39, respectively). Additionally, a higher TAI prevalence was found in the euthyroid and non-simple euthyroid groups than in the control group (RR = 2.77 and 1.43, respectively). The prevalence was significantly higher in cases of unexplained infertility, endometriosis, ovulation disorders, and fallopian tube factors among women with infertility than among the control group (RR = 1.53, 1.83, 1.42, and 2.00, respectively).

Conclusions: Thyroid autoantibodies are more prevalent in patients with infertility than in healthy controls. Given the presence of thyroid autoantibodies, screening patients with infertility is clinically important.

Background: This study has employed network analysis while investigating the interrelationships among stress and stigma symptoms and their associations with quality of life among Chinese female infertility patients.

Methods: In this cross-sectional study, 428 female patients who visited the Department of Reproductive Center of Dalian Women and Children's Medical Group with chief complaints of infertility symptoms were recruited using convenience sampling from November 2022 to December 2023. Fertility-related stress and stigma status were examined by the Fertility Problem Inventory (FPI) and Infertility Stigma Scale (ISS), respectively. Quality of life was examined by the Fertility Quality of Life (FertiQoL). Network analysis was conducted to estimate the network of stress and stigma symptoms. The flow network approach was used to identify specific stigma and stress symptoms related to quality of life. Expected influence (EI) and bridge expected influence (bEI) were used to quantify central and bridge symptoms in the network, respectively. The bootstrapping method evaluated the accuracy and robustness of the network estimates.

Results: The average predictability of FPI and ISS symptoms was 0.67. The "relationship concern" was the most central symptom across all centrality indices, followed by "public stigma" and "social concern". The main symptoms bridging the FPI and ISS clusters were "self-devaluation", "social concern", and "relationship concern". The network demonstrated robustness in stability and accuracy tests. In the flow network, "social withdrawal" and "self-devaluation" showed strong negative associations with FertiQoL.

Conclusions: "Relationship concern," "public stigma," "social concern," and "self-devaluation" have been identified as the main central and bridge symptoms in the stress and stigma network in this study. Notably, stigma symptoms, particularly "social withdrawal" and "self-devaluation", showed stronger associations with FertiQoL compared to stress symptoms, highlighting their importance in potential treatment strategies.

Background: Metaplastic breast carcinoma (MpBC) is a rare histological subtype of breast cancer, and its prognosis is relatively poor. The survival trend of MpBC with different hormone receptor statuses has remained unclear over the past two decades.

Methods: MpBC patient data were collected from the Surveillance, Epidemiology, and End Results database from 2000 to 2019. Patients were divided into two groups according to their hormone receptor status (negative and positive). The survival probabilities were calculated via Kaplan‒Meier curves. Logistic regression analysis was used to obtain odds ratios for treatment and demographic characteristics. Multivariate Cox regression was used to identify prognostic factors.

Results: A total of 3,076 patients were enrolled, and a significant improvement in survival was observed over the last 10 years. For HR-negative MpBC patients, both overall survival and breast cancer-specific survival improved, whereas no survival improvement was observed for HR-positive patients. Compared with those in the time period from 2000 to 2009, the proportion of negative nodes and the likelihood of receiving chemotherapy increased for HR-negative patients from 2010 to 2019. In the HR-negative subgroup, the survival of Whites improved significantly, whereas the survival of Blacks improved in the HR-positive subgroup.

Conclusions: The survival of HR-negative MpBC patients has improved significantly in the past 20 years, which may be related to early diagnosis, increased adjuvant therapy and medical development, but no trend towards improvement has been observed in HR-positive patients. Racial disparities in different HR statuses also need to be addressed.

Background: Cardiovascular disease is the leading cause of death among women, but sex-specific risk factors are incompletely understood. In this study, we aimed to assess the associations between the type of menopause, and age at natural menopause with the odds of cardiovascular disease (CVD), and coronary heart disease (CHD).

Methods: This cross-sectional study is a part of data from the Rafsanjan Cohort Study (RCS) which is a branch of the Prospective Epidemiological Research Studies in Iran (PERSIAN). A sample of 1767 postmenopausal women were included. The diagnosis for CVD and CHD was based on self-report questionnaires. Menopause age was categorized as < 40, 40-44, 45-49, and ≥ 50. Also, the menopause types were classified as natural and induced menopause (surgery or chemotherapy). The association was evaluated by logistic regressions.

Results: The menopause age < 40 years had higher odds of CVD compared to women with menopause age > 40 years (OR: 2.66; 95%CI 1.29-5.48). Women with induced menopause had higher odds of CVD compared to women with natural menopause (OR = 1.44, 95% CI 1.04-1.98). In terms of the odds of CHD, the results showed that the odds of CHD increased in menopause age < 40 years and induced menopause compared to reference groups (OR: 2.49, 95% CI 1.15-5.37, OR = 1.48; 95% CI 1.06-2.07, respectively).

Conclusion: Premature menopause and induced menopause should be considered as important risk factors for CVD, and CHD. Health policymakers should pay more attention to the type of menopause and the age of menopause in postmenopausal women to predict the risk of CVD and preventive strategies.