Illness In Women Research Articles

Postpartum Mood Disorders: Sometimes More than "Baby Blues."

Postpartum mood disorders are a significant clinical and public health concern. While pregnancy is an immensesource of happiness and pleasure for a woman, it is also a stressful time. During pregnancy, there is a significantincrease in the level of steroidal hormones. Women become vulnerable to numerous mood disorders when thesechildbirth hormones are suddenly withdrawn. These mood disorders range in severity from mild postpartum blues tomore serious mood disorders such as postpartum depression and psychosis. Approximately 50% to 80% of newmothers experience postpartum blues within the first few days of their child's birth.Postpartum depression, while less prevalent (occurring in 10-15% of deliveries), has a profound impact on the healthof both the mother and the baby. Unfortunately, these forms of mental illnesses in women are usually undiagnosed,untreated, and underestimated. Postpartum psychosis is exceedingly rare, involving about 1-2 mothers out of every1000 live births, but it is a true psychiatric emergency. This article reviews postpartum mood disorders, their riskfactors, signs and symptoms, complications, screening, treatment, and nursing care for these mothers.
 Bangabandhu Sheikh Mujib Med. Coll. J. 2022; 1(1):46-48

Extracellular Vesicle-Derived Cord Blood Plasma and Photobiomodulation Therapy Down-Regulated Caspase 3, LC3 and Beclin 1 Markers in the PCOS Oocyte: An In Vitro Study.

Introduction: Polycystic ovary syndrome (PCOS) is the communal endocrine illness in women and the most common cause of infertility due to lack of ovulation. The exact cause of PCOS is still unknown. Affected women may have difficulty getting pregnant due to ovulation problems. Various methods have not been effective in the treatment of PCOS due to the positive role of photobiomodulation therapy (PBMT) and extracellular vesicles (ECV) obtained from cord blood plasma in the treatment of various diseases. The aim of this study was to study the role of ECV and PBMT in maturation and improvement of infertility in women with PCOS. Methods: In this research, a number of oocytes were obtained after ovarian stimulation from women who had been referred to the hospital for infertility treatment after obtaining personal consent, and they were divided into three groups: control, ECV and PBMT. Subsequently, in vitro maturation (IVM) was assessed, then some oocytes were cultured with a routine medium and others were treated with ECV and PBMT. Real-time PCR was used to evaluate BCL-2, BAX, caspase-3, and autophagy gene (ATG5, LC3, Beclin 1). Oocyte glutathione (GSH), oxidised gluathione (GSSG), and reactive oxygen species (ROS) were measured. Results: The metaphase II (MII) oocyte ratio formation significantly increased in the ECV and PBMT groups (P<0.05). The expression of the BCL-2 gene was significantly up-regulated in the ECV and PBMT groups, but the expression of BAX and caspase-3 significantly decreased (P<0.05). The expression of the ATG5, LC3, BECLIN-2 genes significantly decreased in the ECV and PBMT groups (P<0.05). ROS, GSSG decreased in ECV and PBMT groups but GSH increased (P<0.05). Conclusion: The use of ECV and PBMT can increase the rate of fertilization and maturation of an oocyte and cause a decrease in apoptosis, autophagy, and ROS in a PCOS oocyte.

Intersections of informal work status, gender and tuberculosis diagnosis: Insights from a qualitative study from an Indian setting.

There is evidence that more than one third of tuberculosis (TB) cases in India go undiagnosed each year and it is more pronounced among female patients. While there are studies available on the socioeconomic, cultural and gender-related dimensions of TB diagnosis delays among female patients in India, intersections of gender, informal work and diagnosis delays are not sufficiently studied. The present study aims to fill this gap by examining the TB diagnosis delay that are linked to the contingencies of working in informal arrangements for women from lower socio economic background. The study draws on 80 qualitative in-depth interviews conducted among female patients from lower socio-economic background, who were working or recently stopped working in informal arrangements and undergoing Directly Observed Therapy, Short-course (DOTS) treatment in Bengaluru (India) city and 60 willing significant others of the patients. The participants were identified through a scoping survey that covered 188 female patients from 18 DOTS centres in the city. Other than the already known reasons for the delay in TB diagnosis for women such as normalisation of symptoms, stigma and the gender-related discrimination leading to low prioritisation of women's illness, the present study identifies reasons related to work informality. These are normalisation of symptoms as workplace health problems; work related concerns that restricted formal help seeking; non TB specific narratives of symptoms, often incorrectly assumed to be work related health issues or comorbidities and thus confounding the early accurate diagnosis by the medical personnel and shifting between formal and informal systems of help-seeking. Further, the study found that mere knowledge of TB symptoms did not always translate to early diagnosis for patients from the lower socioeconomic groups working in informal arrangements due to the fear of losing work and wages owing to hospital visits. The workplace focus, especially the informal sector where a huge majority of India's workforce is employed, is notably absent in the TB elimination programme. The study indicates the need to adopt a comprehensive approach in the ongoing TB elimination programme in India in which family, living environment and workplace should be integral parts.

Effect of Resistance Exercise in Postmastectomy Breast Cancer Survivors: A Systematic Review

Background: Breast cancer (BC) impacts over 1.2 million individuals every year worldwide and is the most frequently diagnosed illness in women. Medical treatment options have increased chances of survival, but these procedures frequently have side effects that can negatively impact health status and quality of life (QoL) over the long term QoL. Given that resistance exercise has a special anabolic effect; it may be useful for addressing the effects of BC and its therapy. Materials and Methods: This is an integrative literature review study that includes data search from PubMed, MEDLINE, Scopus, Google Scholar, and the physiotherapy evidence database databases for articles and also crossing English descriptors indexed in the medical subject headings and health sciences descriptors, respectively. The present review is based on the Whittemore and Knafl methodology. Results: A total of 842 patients from 13 studies were included. There was no aggravation subjectively reported or objectively evaluated lymphedema symptoms. Adverse effects were uncommon, mostly of a musculoskeletal in nature, and were successfully handled using conservative methods. The studies we looked at indicate that women who had BC surgically treated can benefit from resistance exercise in terms of their clinical and health outcomes. Results demonstrate that in cancer survivors, pain, physical and emotional functioning, fatigue, depression, and aerobic capacity have improved. Conclusion: It is necessary to conduct rigorously constructed randomized controlled trials (RCTs) that recommend targeted resistance exercise regimens at various stages of BC treatment. To demonstrate the effectiveness of this intervention for the posttreatment care of BC patients and survivors as a method of enhancing health status and QoL, RCTs with complete, standardized reporting of interventions, and adverse events are necessary.

The lived experiences of endometriosis in adolescence-A critical hermeneutic perspective.

Endometriosis is a condition that worldwide affects 10% of all women of childbearing age. Despite the large prevalence, it takes 4-11 years from the first onset of symptoms until the time of diagnosis, and the majority experience symptoms debut in adolescence. Endometriosis affects women's lives both physically, psychologically, socially and a lack of recognition from society causes the pain the women experience to be neglected, hidden and normalised. Preventative measures targeting endometriosis in adolescence are limited and there is a need to change the way these symptoms are viewed and affected by society at large. The aim of this qualitative study was to explore the lived experiences of endometriosis in adolescence and the social reactions impact on the illness experience and quality of life. With a critical hermeneutic approach, individual interviews were conducted with women diagnosed with endometriosis. The analysis and interpretation were conducted inspired by Pedersen and Dreyer's (2018) method which is based on Ricoeur's critical theory. The structural analysis shows that women experience a struggle for recognition of symptoms from their immediate surroundings including family, friends, schools and health professionals, as symptoms considered linked to menstruation are deemed to be normal for women to experience. The women's narratives are characterised into a before and after diagnosis. Therefore, the diagnosis is found to be important for the meaning that the women attach to their experiences in adolescence. Social experiences have a substantial impact on women's illness experience and quality of life and affect how women perceive themselves and their symptoms. Through interventions at the social level, it might be possible to change the existing societal discourses surrounding women's menstruation pain to raise the awareness of endometriosis.

The role of mental illness in women’s pathways to crime living in a U.S.-México border region

ABSTRACT Feminist criminological theories emphasize trauma and victimization as pathways to criminal behavior among women while gender-neutral theories suggest that mental illness has a weak relationship to criminal behavior. Unfortunately, research on pathways to criminal behavior for women from different ethnic and cultural backgrounds is scant. The present study used semi-structured interviews to qualitatively examine factors that paved the pathway to criminal behavior for 72 women living in the U.S.-México border region. Four undergraduate research assistants coded the interviews and demonstrated acceptable reliability (Kappa = 0.72). Women frequently reported that financial issues, substance use, and family problems were direct causes of their criminal behavior. Moreover, even though a Structured Clinical Interview (SCID-IV) revealed many women met criteria for a diagnosable mental disorder and/or had experienced trauma, mental illness and trauma were rarely reported as direct causal factors of criminal behavior. Findings suggest agencies may be more successful at reducing recidivism if they allocate resources to assist women residing in border regions with: (1) accessibility to substance abuse interventions, (2) developing skills to resolve familial conflict, and (3) having ample opportunities to become gainfully employed.

Causes of death, three delays, and factors associated with Delay 1 among maternal deaths in Myanmar: The maternal death surveillance in 2019

ObjectiveThe maternal mortality ratio (MMR) in Myanmar was the highest in Southeast Asia in 2017. The Three Delay Model is used to evaluate delays that contribute to maternal deaths. This study aims to identify MMR, causes of death, the three delays related to maternal deaths, and the factors associated with Delay 1, which is the time of delay in deciding to seek health care (from the start of the woman's illness to the time when the problem is recognized to be requiring care), in Myanmar. Study designA cross-sectional study. ParticipantThis study included 934 cases of maternal deaths reported from all states and regions throughout Myanmar in 2019 that were not caused by accidents and injuries. Materials and methodsSocio-demographic factors, obstetrical factors, information about deaths, and assessment of delays were obtained from the Maternal Death Surveillance and Response System, the database of maternal deaths. Distribution of maternal deaths by states and regions, causes of maternal death, and types of delay that contributed to maternal deaths were descriptively summarized. Logistic regression analysis was performed to identify factors associated with Delay 1 among 567 maternal deaths without any missing data and unknown information on delays. FindingsIn 2019, the MMR was 106 (95% confidence interval, 99–112) per 100,000 live births. Of the 934 maternal deaths, 80.5% of deaths had at least one delay, and Delay 1 was the major delay (72.9%). Eclampsia/pre-eclampsia (21.6%), postpartum hemorrhage (18.2%), and abortion-related complications (13.2%) were the major causes of maternal death. The husband's low education, low household income, unplanned pregnancy, and no antenatal care were associated with Delay 1. Key conclusions and implication for practiceThe MMR was lower in 2019 than that in 2017 but remained high. Moreover, we demonstrate that most maternal deaths had at least one delay, mostly Delay 1. To prevent maternal deaths caused by Delay 1, the family planning should be promoted to prevent unplanned pregnancies. Educational training for healthcare providers who deliver antenatal care should be strengthened. Furthermore, education on the danger signs of pregnancy and during childbirth should be provided not only to pregnant women and their husbands in communities at health facilities.

Prevalence and Risk Factors of Polycystic Ovarian Syndrome PCOS: Cross-sectional Study

Background: The most prevalent endocrine illness in women of reproductive age is polycystic ovarian disease. In this study, girls between the ages of 18 and 30 who were vesiting the maternity hospital refer in King Saud, Saudi Arabia, will be assessed for poly cystic ovaries prevalence and risk factors.&#x0D; Methods: There were 1080 participants in this study, representing all outpatient visits over the chosen period (Jul 2022 to Jan 2023). They were required to answer questions about their menstrual cycle and the symptoms of hyperandrogenism on a questionnaire. Weight, height, waist, and hip circumferences were measured anthropometrically. Blood pressure was measured. A girl who exhibits either hirsutism or irregular menstruation, or both, was considered a probable case. All of the likely instances were required to undergo thorough examinations, hormone estimations, and ovarian ultrasounds.&#x0D; Results: Among the 1080 girls, 191 (17.6%) had irregular menstrual cycles, and 75 (6.9%) had hirsutism. According to Rotterdam's criteria, the prevalence of polycystic ovaries was found to be 18.9% after hormonal testing and ultrasound. The non-vegetarian diet, socioeconomic level I and II, snacking, obesity, insufficient physical activity, prehypertension, hypertension, central obesity, and self-reported emotional health issues in girls, and poly cystic ovaries in the family, were found to be substantially linked with polycystic ovaries.&#x0D; Conclusion: To lessen poly cystic ovaries and associated problems in females, early lifestyle change and health education were necessary.

Similar Levels of Disease Severity Correspond to a Greater Burden of Illness in Women Compared with Men with Hidradenitis Suppurativa.

Abstract is missing (Short communication)

UPLC-Q-TOF/MS Based Plasma Metabolomics for Identification of Paeonol's Metabolic Target in Endometriosis.

Endometriosis is a common gynecological illness in women of reproductive age that significantly decreases life quality and fertility. Paeonol has been shown to play an important part in endometriosis treatments. Understanding the mechanism is critical for treating endometriosis. In this study, autologous transplantation combined with a 28 day ice water bath was used to create a rat model of endometriosis with cold clotting and blood stagnation. The levels of estradiol and progesterone in plasma were detected by ELISA, and the pathological changes of ectopic endometrial tissue were examined by H&E staining, which proved the efficacy of paeonol. For metabolomic analysis of plasma samples, UPLC-Q/TOF-MS was combined with multivariate statistical analysis to identify the influence of paeonol on small molecule metabolites relevant to endometriosis. Finally, the key targets were screened using a combination of network pharmacology and molecular docking approaches. The results showed that the pathological indexes of rats were improved and returned to normal levels after treatment with paeonol, which was the basis for confirming the efficacy of paeonol. Metabolomics results identified 13 potential biomarkers, and paeonol callbacks 7 of them, involving six metabolic pathways. Finally, four key genes were found for paeonol therapy of endometriosis, and the results of molecular docking revealed a significant interaction between paeonol and the four key genes. This study was successful in establishing a rat model of endometriosis with cold coagulation and blood stagnation. GCH1, RPL8, PKLR, and MAOA were the key targets of paeonol in the treatment of endometriosis. It is also demonstrated that metabolomic techniques give the potential and environment for comprehensively understanding drug onset processes.

Vulnerabilities to illnesses in women living on the border of the Guiana Shield mines.

To analyze the the vulnerabilities to illnesses in women living on the border of the Guiana Shield mines: Brazil, French Guiana, and Suriname. Descriptive, exploratory field study with a qualitative approach. Data collection took place with 19 women who were living in the mining context, in April 2018. The interviews were recorded and transcribed in full and subsequently analyzed in the light of the concept of vulnerability. Women aged between 30 and 39 years, predominantly black and brown, on a common-law marriage, multiparous, of low level of education, and with work activities related to mining. Three empirical categories emerged: Exposure to environmental and life conditions in the mines: vulnerabilities to illnesses in women; Sexual and reproductive health in the context of borders: the invisibility between legality and illegality; Gendered facets of violence in the mines on the border of the Guiana Shield. Vulnerability is marked in the three dimensions of the concept: in the difficult access to health services, in the discontinued treatment, and in the disparity in health policies within countries, which are important aspects of vulnerability and health conditions.

Vulnerabilities to illnesses in women living on the border of the Guiana Shield mines

RESUMO Objetivo: Analisar as vulnerabilidades para o adoecimento de mulheres em áreas de garimpos da fronteira do Escudo das Guianas: Brasil, Guiana Francesa e Suriname. Método: Pesquisa de campo, descritiva, exploratória, de abordagem qualitativa. A coleta de dados ocorreu com 19 mulheres que vivenciavam o contexto de garimpagem, em abril de 2018. As entrevistas foram gravadas e transcritas na íntegra e posteriormente analisadas à luz do conceito de vulnerabilidade. Resultados: Mulheres com idade entre 30 e 39 anos, predominantemente pretas e pardas, união estável, multíparas, baixa escolaridade e com atividades de trabalho relacionadas à garimpagem. Emergiram três categorias empíricas: Exposição às condições ambientais e de vida nos garimpos: vulnerabilidades para o adoecimento de mulheres; Saúde sexual e reprodutiva no contexto de fronteiras: a invisibilidade entre a legalidade e a ilegalidade; Facetas gendradas da violência nos garimpos da fronteira do escudo das Guianas. Conclusão: A vulnerabilidade é acentuada nas três dimensões do conceito, quais sejam: a dificuldade de acesso aos serviços de saúde, tratamento descontinuado e disparidade nas políticas de saúde entre os países, que são aspectos importantes à vulnerabilidade e condições de saúde.

Heatstroke: Most hazardous condition in summer

Beyond 40 degrees Celsius, the core body temperature can cause psychological anomalies like delirium and coma. Heatstroke, often called sunstroke or heatstroke, is the most severe form of hyperthermia or a sickness brought on by high heat. Death, organ failure, or brain damage can result from heat stroke. It's possible to think of heatstroke as a tropical form of neurodegeneration, especially among unfamiliar visitors to warm climates. Incidence rates for various heat illnesses in women ranged from 1.30 to 2.89 per 1000 persons per year and 0.98 to 1.98 per 1000 person-years, respectively, compared to men. By the year 2050, the annual baseline number of deaths from heat stroke is expected to have increased by nearly 2.5 times from its current level. Nearly 21.7% of elderly patients contacted emergency departments due to heat stroke. Wearing loose-fitting clothing, using wet towels, taking showers, avoiding engaging in excessive physical activity outside in hot and hazardous weather, and staying hydrated are a few ways to prevent heat stroke. From 2006 to 2010, there were 3332 deaths attributed to heat stroke.

Organization of health care of elderly people in the city of Skopje - conditions and needs

The main goal of the paper was to understand the attitudes of the elderly in the city of Skopje regarding health care, organization and functioning of the health system for ensuring healthy and active aging. Methods: A descriptive-analytical method was used to present the results of the study (cross-sectional study) conducted on the territory of the city of Skopje in the period March-April 2019. A total of 350 respondents aged 65+ were included. A questionnaire containing 53 questions was developed and was designed to suit the age and sex of the respondents. The questionnaire was divided into four parts: first part - general and demographic characteristics; second part - health care; third part - mobility of the elderly; fourth part - conditions and lifestyle. The statistical analysis was performed with Windows 7.0 and SPSS, version 14. A statistical significance was used for two-way tests with a significance level of p &lt;0.05. Results: Of the total of 350 respondents, 133 (38%) were male, and 217 (62%) were female, with a sex ratio of 0.61 : 1. According to the answers given by the respondents in our sample, 50 (37.9%) men and 124 (57.14%) women had chronic diseases. A total of 260 (75.6%) respondents stated that they were satisfied with the health information system "My Appointment" (“Moj Termin”). In terms of sex, 101 (78.9%) men and 159 (73.6%) women were satisfied with "My Appointment". A total of 84 (24.4%), 27 (21.1%) men and 57 (26.4%) women, stated that they were dissatisfied with this service. Forty-seven (47.5%) respondents said that discrimination in health care was done by a doctor, 43 (43.4%) said it was done by a nurse and according to 9 (9.1%) respondents, discrimination was done by both the doctor and the nurse. The results obtained showed that more often highly educated people recognized discrimination and abuse by the health personnel than people with lower level of education. Conclusion: The elderly exercise partially their rights to social and health care. The elderly would like to expand the opportunities for social and health benefits. In the self-assessment of the health condition, most of the elderly perceived their health status to be relatively good. The analysis showed a higher percentage of chronic illnesses in women than in men. Тhere is a correlation between active and healthy aging and socioeconomic conditions in which the elderly live.

Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis.

Introduction: Quality of life (QoL) improvement is one of the main outcomes in the management of pelvic organ prolapse as a chronic illness in women. This systematic review aimed to investigate the impact of surgical or pessary treatment for pelvic organ prolapse (POP) on quality of life. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. Electronic databases, including PubMed, Scopus, and Web of Science, were searched for original articles that evaluated the QoL before and after surgical interventions or pessary in pelvic organ prolapse from 1 January 2012 until 30 June 2022 with a combination of proper keywords. Included studies were categorized based on interventions, and they were tabulated to summarize the results. Results: Overall, 587 citations were retrieved. Of these, 76 articles were found eligible for final review. Overall, three categories of intervention were identified: vaginal surgeries (47 studies), abdominal surgeries (18 studies), and pessary intervention (11 studies). Almost all interventions were associated with improved quality of life. The results of the meta-analysis showed a significant association between the employment of surgical approach techniques (including vaginal and abdominal surgeries) and the quality of life (Pelvic Floor Distress Inventory (PFDI) (MD: −48.08, 95% CI: −62.34 to −33.77, p-value < 0.01), Pelvic Floor Impact Questionnaire (PFIQ) (MD: −33.41, 95% CI: −43.48 to −23.34, p < 0.01)) and sexual activity of patients with pelvic organ prolapse (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) (MD: 4.84, 95% CI: 1.75 to 7.92, p < 0.01)). Furthermore, narrative synthesis for studies investigating the effect of the pessary approach showed a positive association between the use of this instrument and improvement in the quality of life and sexual activity. Conclusions: The results of our study revealed a significant improvement in the women’s quality of life following abdominal and vaginal reconstructive surgery. The use of pessary was also associated with increased patient quality of life.

Estrogen – A key neurosteroid in the understanding and treatment of mental illness in women

The commentary is an invited brief about my contribution to Psychiatry Research. My work has built on the “estrogen hypothesis”, as stated by Hafner, Riecher-Rossler and Seeman in the 1990’s. This hypothesis was that estrogen provides ‘protection’ against the early onset of severe schizophrenia in women, and with decreasing brain estrogens at the menopause, mental ill health worsens in women. In this paper, results from clinical trials conducted over many decades, that involved administering exogenous estrogen in different types and doses, show an overall positive impact - with improved symptoms of schizophrenia in women. This led to the conduct of further successful clinical trials of gonadal hormone treatment in women with PMDD and menopausal depression, plus understanding more about depression caused by hormone contraceptives. The role of estrogens in stress vulnerability is reflected in the sex-dependent reaction to childhood trauma, which has led to our new work in the neurobiological effects of early life trauma in women.

Identities of women who have an autoimmune rheumatic disease [ARD] during pregnancy planning, pregnancy and early parenting: A qualitative study.

Women of reproductive age who have autoimmune rheumatic diseases [ARDs] have expressed a need to be better supported with making decisions about pregnancy. Women with ARDs want their motherhood identities and associated preferences to be taken into account in decisions about their healthcare. The aim of this study was to explore the interplay between illness and motherhood identities of women with ARDs during preconception decision making. Timeline-facilitated qualitative interviews with women diagnosed with an ARD [18-49 years old]. Participants were purposively sampled based on the following three criteria: thinking about getting pregnant, currently pregnant, or had young children. Interviews were thematically analysed. Twenty-two women were interviewed face-to-face [N = 6] or over the telephone [N = 16]. Interview length ranged from 20 minutes to 70 minutes, with a mean length of 48 minutes. Three main themes were identified: prioritisation, discrepancy, and trade-off. Difficulties in balancing multiple identities in healthcare encounters were reported. Women used 'self-guides' as a reference for priority setting in a dynamic process that shifted as their level of disease activity altered and as their motherhood identity became more or less of a focus at a given point in time. Women's illness and motherhood identities did not present in isolation but were intertwined. Findings highlight the need for holistic person-centred care that supports women with the complex and emotive decisions relating to preconception decision-making. In practice, health professionals need to consider women's multiple and sometimes conflicting identities, and include both their condition and family associated goals and values within healthcare communication.

Insulin Resistance in Polycystic Ovarian Syndrome.

Polycystic ovarian syndrome (PCOS) is one of the readily recognised endocrine gland illnesses in women, with an incidence range from 2.2% to 26% in India. Patients experiencing PCOS experience issues involving irregular menstrual periods, hirsutism, acne, being overweight, and impotence. Long-term, low-grade inflammation has emerged as a crucial factor leading to PCOS. A rise in glucose levels may stimulate oxidative stress and a troubling reaction from mononuclear cells (MNC) of females with PCOS, which normally do not rely on fat. This is required because MNC-derived macrophages are the major source of cytokine synthesis in big adipose tissue and similarly encourage adipocyte cytokine production. In summary, data reveal the substantial risks of insulin resistance in obese people who are suffering from PCOS. The findings of this specific lesson indicated that individuals with the conventional PCOS phenotype had obesity and higher insulin levels and insulin resistance, neglecting the absence of BMI differences from other phenotypes. These data show that insulin resistance is the most significant pathophysiological trait in people with PCOS.

Prevalence of Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants

It is unknown how often breast implant illness (BII) is the indication for revision in women with silicone breast implants. To examine how often women with silicone breast implants have their implants explanted or replaced because of BII compared with local postoperative complications. A legacy cohort study on breast implant revision surgery was conducted between April 1, 2015, and December 31, 2020, and a prospective cohort study on breast implantation and revision surgery was conducted between April 1, 2015, and December 31, 2019 (with follow-up until December 31, 2020). Data were obtained from the Dutch Breast Implant Registry. Data analysis was performed from September 2021 to August 2022. Silicone breast implant. Breast implant revision with the indication BII or local postoperative complications. All 12 882 cosmetic breast implants (6667 women; mean [SD] age, 50.6 [12.7] years) and 2945 reconstructive breast implants (2139 women, mean [SD] age, 57.9 [11.3] years) in the legacy cohort and all 47 564 cosmetic breast implants (24 120 women, mean [SD] age, 32.3 [9.7] years) and 5928 reconstructive breast implants (4688 women, mean [SD] age, 50.9 [11.5] years) in the prospective cohort were included for analysis. In the prospective cohort, 739 cosmetic breast implants (1.6%) were revised after a median (IQR) time to reoperation of 1.8 (0.9-3.1) years, and 697 reconstructive breast implants (11.8%) were revised after a median (IQR) time to reoperation of 1.1 (0.5-1.9) years. BII was registered as the reason for revision in 35 cosmetic revisions (4.7%) and 5 reconstructive revisions (0.7%) in the prospective cohort, corresponding to 0.1% of the inserted implants. In the legacy cohort, 536 cosmetic revisions (4.2%) and 80 reconstructive breast implant revisions (2.7%) were performed because of BII. In this cohort study of women with silicone breast implants, BII was an uncommon indication for revision compared with local complications, both in the short and long term. In contrast to the increasing public interest in BII, these results showed that local complications are a far more common reason for breast implant revision.

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

Special Report: Women’s Reproductive Mental Health—A Clinical Framework