Oral Contraceptive Use Research Articles

Association between venous thromboembolism-associated genetic variants, coagulation factor levels, and thrombin generation potential.

Recently three large meta-analyses of genome-wide association studies for venous thromboembolism (VTE) identified over 130 genetic variants. However, mechanisms by which newly identified and therefore underexplored VTE-associated genetic variants influence VTE remain unclear. To elucidate the mechanism, we investigated the association between 61 newly identified VTE-associated genetic variants and the levels of coagulation factor (F) VIII, FIX, FXI, and fibrinogen as well as thrombin generation parameters (lag time, peak, endogenous thrombin potential, time-to-peak, and velocity), which are well-known biological traits associated with VTE. This study was conducted on 5341 participants of the Netherlands Epidemiology of Obesity study. The associations between VTE-associated genetic variants and coagulation factor levels and thrombin generation parameters were examined using linear regression analyses, adjusted for age, sex, body mass index, oral contraceptive use, hormone replacement therapy, and menopausal status. Of 61 genetic variants, 33 were associated with one or more of the coagulation factor levels and thrombin generation parameters. Following multiple testing corrections, five genetic variants remained significant, of which MAP1A rs55707100 exhibited the most robust association with thrombin generation parameters and FXI levels (β=-5.33%, 95% confidence interval: -8.44, -2.22). Our findings shed light on the underlying mechanisms by which these genetic variants influence the risk of VTE.

Knowledge, attitude, and practices about breast cancer among women in a high-altitude sub-Himalayan region: Are we reaching the unreached?

Breast cancer awareness and early detection are critical for reducing the global burden of the disease. This study assessed breast cancer awareness among women in a high-altitude sub-Himalayan region of North India. A cross-sectional survey was conducted among women attending the gynecology outpatient clinic in a district hospital. A structured questionnaire was used to collect data on breast cancer knowledge, attitudes, and practices. Participants received posttest health education and counseling on breast cancer prevention strategies. The study included 188 participants with a mean age of 31.0 ± 8.8 years. The findings revealed inadequate knowledge about breast cancer among a significant portion of the cohort. Misconceptions about risk factors, such as breastfeeding, oral contraceptive use, and past wrongdoings, were observed. Only half of the participants believed early-stage breast cancer could be effectively treated. Limited awareness of screening methods, including self-breast examination and mammography, was noted. Barriers to breast self-examination (BSE) included considering it unnecessary and lacking knowledge about its execution. This study highlights insufficient breast cancer awareness in the high-altitude sub-Himalayan region. Targeted interventions, including health campaigns and electronic media, should be prioritized to improve knowledge and promote early detection practices.

Prevalence and predictors of risk factors for cardiovascular diseases among women aged 15–49 years across urban and rural India: findings from a nationwide survey

BackgroundWomen’s health is usually looked upon in terms of their reproductive health. However, cardio-vascular diseases are one of the leading causes of death and disability among women, globally as well as in India. Risk factors of today can be disease of tomorrow. Gradience in level of epidemiological transition is observed across different states. The study aims to estimate the national and regional prevalence, and sociodemographic determinants of biological and behavioural risk factors for cardiovascular diseases.Materials and methodsThe present study was conducted among women in the age group of 15 to 49 years using nationally representative sample from fifth round National Family Health Survey in India. The data analysis in the current study included 7,24,115 women in the age group of 15 to 49 years. SPSS version 20 was used for the purpose of analysis. Weighted prevalence was computed for the studied behavioral and biological (dependent variable) risk factors using women specific weights as provided in the dataset. Binary logistic regression model was employed to calculate the adjusted odds ratio (OR) with the corresponding 95% confidence interval (CI) to study the sociodemographic determinants (independent variables) of these risk factors.ResultsHighest prevalent risk factor for cardiovascular diseases was reported to be central obesity (78.2%), followed by overweight/obesity (23.9%), oral contraceptive use (13.4%), raised blood pressure (11.8%), raised blood sugar (8.6%), tobacco use (4.0%), and alcohol use (0.7%). Higher odds of all the studied risk factors were reported with increasing age. All of the studied risk factors, except for alcohol consumption [OR (95%CI): 0.9 (0.8–0.96)], had higher odds in rural areas compared to urban areas. Compared to other castes, the odds of tobacco [OR (95% CI): 2.01 (1.91–2.08)] and alcohol consumption [OR (95% CI): 5.76 (5.12–6.28)], and raised blood pressure [OR (95% CI): 1.07(1.04–1.11)] was significantly higher among the people belonging to schedule tribe.Conclusion and recommendationThe present study highlights the state-wise disparities in the burden and predictors of risk factors for cardio-vascular diseases among women of reproductive age. The study provides insights to these disparities, and focuses on the need of tailoring the disease prevention and control measures suiting to the local needs.

Recurrent stroke in a reproductive age women with patent foramen ovale

BackgroundPatent foramen ovale (PFO) is a known cause of ischemic stroke in young adults and combined oral contraceptives (COCs) are widely used by women of reproductive age. If young women with PFO are taking COCs, they may be subjected to a synergistic increase in the occurrence of stroke, though reports of ischemic stroke in this population are rare. We report a woman of reproductive age who was taking COC suffered repetitive ischemic strokes before a patent foramen ovale (PFO) was detected and closed, which may raise concerns in this field.Case presentationA 31-year-old woman presented to the emergency department with sudden-onset right upper- and lower-limb weakness and dysarthria for 1 hour, whose only risk factor of stroke was oral contraceptive use. On admission, she was alert with left gaze deviation, dysarthria, and right-sided hemiplegia. Her symptoms improved after receiving the revascularization therapy. About 24 hours later, her left eye experienced sudden painless vision loss. Then the PFO with a substantial right-to-left shunt was detected and then she received a trans-catheter closure of the defect. Over 3 months of follow-up, there were no signs of stroke, but visual loss persisted.ConclusionThis case of disabling stroke raises concerns regarding optimal management in primary and secondary prevention of stroke in young women on COCs with additional risk factors of stroke.

THE SYSTEMATIC REVIEW OF GLAUCOMA AND ITS ASSOCIATIONS WITH FEMALE REPRODUCTIVE FACTORS

Background: Estrogen may have a neuroprotective role in glaucoma, and estrogen insufficiency is thought to contribute to glaucomatous damage through both mechanical and vascular processes. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed and SCIENCE DIRECT, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 93 articles, whereas the results of our search on SCIENCE DIRECT brought up 76 articles. The results of the search conducted for the last year of 2014 yielded a total 41 articles for PubMed and 26 articles for SCIENCE DIRECT. In the end, we compiled a total of 6 papers, 4 of which came from PubMed and 2 of which came from SCIENCE DIRECT. We included six research that met the criteria. Conclusion: In summary, a longer duration of OC usage may be related with a higher risk of OAG; however, it is unclear if OC use in general raises the risk of OAG or whether this potential association is mediated by IOP. An earlier age at natural menopause may increase the incidence of OAG. Most significantly, PMH use may be related with a lower IOP, and the estrogen-only kind of PMH may be associated with a lower risk of OAG.

Implementation of cervical cancer prevention and screening across five tertiary hospitals in Nepal and its policy implications: A mixed-methods study.

In Nepal, cervical cancer is the most common cancer among women despite the existing policies. This study intends to assess the implementation of cervical cancer prevention and screening through service utilization by women, knowledge and attitude among health professionals, and the perceptions of stakeholders in Nepal. This mixed-methods study was conducted in 2022 across five tertiary hospitals in Kathmandu, Nepal. The quantitative study comprised the health professionals and women attending gynecology outpatient clinics from the selected hospitals. The qualitative study comprised stakeholders including service providers and experts on cervical cancer from selected hospitals, civil societies, and the Ministry of Health and Population. The utilization of screening through pap smear among 657 women across five hospitals was 22.2% and HPV vaccination was 1.5%. The utilization of cervical cancer screening was associated with older age [adjusted odds ratio (AOR) = 1.09, CI: 1.07, 8.19], married (AOR = 3.024, CI: 1.12, 8.19), higher education (AOR = 3.024, CI:1.12, 8.42), oral contraceptives use (AOR = 2.49, CI: 1.36, 4.39), and ever heard of cervical cancer screening (AOR = 13.28, CI: 6.85, 25.73). Among 254 health professionals, the knowledge score was positively associated with them ever having a training [Standardized Beta (β) = 0.20, CI: 0.44, 2.43)] and having outreach activities in their hospital (β = 0.19 CI: 0.89, 9.53) regarding cervical cancer screening. The female as compared to male health professionals (β = 0.16, CI: 0.41, 8.16, P = 0.03) and having a cervical cancer screening guideline as compared to none (β = 0.19 CI: 0.89, 9.53, P = 0.026) were more likely to have a better attitude for screening. The qualitative findings among 23 stakeholders reflected implementation challenges in policy, supply, service delivery, providers, and community. This study showed low utilization of prevention and services by women and implementation gaps on cervical cancer prevention and screening services across five tertiary hospitals in Kathmandu, Nepal. The findings could help designing more focused interventions.

Margin status impact on recurrence of phyllodes tumors in high-risk groups: a retrospective observational study

BackgroundPhyllodes tumor (PT) is an fibroepithelial tumor with potential for local recurrence. The optimal margin for surgical resection of PT is still debated, particularly in cases of positive margins. This study aimed to identify the risk factors for phyllodes tumor recurrence and the effect of a free margin on tumor recurrence by considering these risk factors.Materials and methodsThis is a retrospective observational study of patients diagnosed with PT who had undergone surgical management. The data were collected from medical records from 2001 to 2020 in the breast clinic of Shahid Motahhari Clinic of Shiraz. Patients were followed up for at least 3 years after the operation to be checked for local recurrence or distant metastasis at regular intervals.ResultsThis retrospective study included 319 patients with PT who underwent surgical management. Of these patients, 83.9% (n = 267), 7.6% (n = 24), and 8.5% (n = 27) were classified as benign, borderline, and malignant, respectively. 8.8% of all patients and 7.6% of non-malignant cases experienced local recurrence, and risk factors for recurrence included oral contraceptive use, smoking, size > 4 cm, stromal overgrowth, and stromal cell atypia. A negative surgical margin decreased the prevalence of recurrence in tumors > 4 cm and with stromal overgrowth significantly.ConclusionThe study found that a negative margin in all patients did not reduce the recurrence rate in benign and borderline phyllodes tumors, suggesting close follow up as a reasonable alternative. However, a negative margin may be effective in reducing recurrence in certain high-risk groups.

High alpha-2-macroglobulin levels are a risk factor for cardiovascular disease events: A Moli-sani cohort study

Backgroundα2-macroglobulin (α2M) is a versatile endopeptidase inhibitor that plays a role in cell growth, inflammation and coagulation. α2M is an inhibitor of key coagulation enzyme thrombin. Hypercoagulability due to an excess of thrombin production can cause thrombotic events. Therefore, we investigated the association of α2M levels and cardiovascular events in a subset of the general Italian population. MethodsWe determined α2M levels in the baseline samples of a prospective cohort (n = 19,688; age: 55 ± 12 years; 47.8 % men) of the Moli-sani study and investigated the association with the cardiovascular events (n = 432, 2.2 %) in the median follow-up period of 4.3 years. Hazard ratios (HR) with 95 % confidence intervals (CI) were calculated by multivariable Cox regression and adjusted for a large panel of confounding factors. Resultsα2M levels above the 90th percentile were significantly associated with cardiovascular disease (CVD) events after full adjustment for age, sex, current smoking, BMI, oral contraceptive use, cardiovascular diseases, hypertension, hypercholesterolemia, diabetes and history of cancer (HR: 1.36; CI: 1.06–1.74). Moreover, high α2M was associated with coronary heart disease (CHD; HR: 1.47; CI: 1.12–1.91), but not stroke. Stratification for CVD at baseline showed that high α2M levels are associated with CHD events in subjects without CVD at baseline (HR: 1.40; CI: 1.00–1.95) and subjects with CVD at baseline (HR: 1.58; CI: 1.02–2.44). ConclusionWe show in a prospective cohort that high levels of α2M could be a risk factor for cardiovascular events, especially coronary heart disease events.

Association between age at first oral contraceptive use and breast cancer in women-Nouakchott, Mauritania, May - October 2021

Introduction: In Mauritania, breast cancer affects 44.9 women per 100,000 inhabitants in 2020 and is the most common cancer. In a context where two- thirds of women use oral contraceptives and nearly one-third of marriages are early, this study examines the association between the age of first use of oral contraceptives and breast cancer among women in Mauritania. Methods: A case-control study (192 cases for 192 controls) was conducted at the Nouakchott Oncology Center from 01 May 2021 to 31 October 2021. A case was defined and so was a witness. A logistic regression was performed with SAS® 9.4 software to estimate the odds ratio of breast cancer associated with age of first oral contraceptive use independent of other characteristics. Results: Half of the patients were from Nouakchott (50.5%), 41.7%, 57.8% and 85.4% were married, uneducated and housewives, respectively. The median age was similar in cases and controls. About 11% of cases and 18.7% of controls used oral contraceptives for the first time before the age of 24, and more than 64% had never used oral contraceptives. After adjusting for possible confounders, age at first oral contraceptive use (<24 years) was significantly associated with breast cancer (adjusted OR = 3.07, 95% CI 1.09-8.82; p = 0.0372) independently of other characteristics. Conclusions: The study shows that the age of first use of oral contraceptives, less than 24 years, is a risk factor for breast cancer in women followed at the Nouakchott Oncology Center. Sensitization of women on alternative contraceptive methods and early marriage is recommended.

Cumulative exposure to estrogen may increase the risk of migraine in women.

Migraine is a common disorder, particularly affecting women during their reproductive years. This female preponderance has been linked to exposure to female sex hormones. We used self-reported data from women born in 1943-1965 enrolled in the Norwegian Women and Cancer Study to examine the differences between women with migraine and women without migraine in a prospective design with respect to both endogenous and exogenous female sex hormone exposure. In total, 62,959 women were included in the study, of whom 24.8% reported previous migraine (n = 15,635). Using a Cox proportional hazards model, we found that higher age at menarche reduced the risk of migraine (hazards ratio (HR) = 0.96, 95% confidence interval (CI) = 0.95-0.98) and that oral contraceptive use and parity increased the risk of migraine (HR = 1.12, 95% CI = 1.06-1.18 and HR = 1.37, 95% CI = 1.29-1.46, respectively). Older age at menarche appears to reduce migraine risk, whereas oral contraceptive use and having children appear to increase the risk. Further research is required to investigate the causality of these associations.

Ab. No. 74 Women-Focused Cardiac Rehabilitation in India - An Urgent Need

Introduction: To review and highlight the current scenario of Cardiovascular disease (CVD) and Cardiac Rehabilitation (CR) offered to women in India and globally. CVD in women resulted in a 35% mortality rate among the total deaths worldwide in 2019. Women’s cardiovascular health needs additional attention because of increased CVD risk factors like diabetes, use of oral contraceptives, menopausal and postpartum issues, and low socioeconomic position. Globally, the rate of women screened, diagnosed, treated for CVD, and enrolled in rehabilitation is way more than in India. Method: Comprehensive literature search was done on search engines, PubMed and Google Scholar. Articles were selected based on the inclusion/exclusion criteria. 25 articles were screened and 16 were included and reviewed. A descriptive analysis was done. Result: The paper summarizes the increasing need and existing shortage of women-focused cardiac care in India. The male-female ratio of cardiac care utilization under Indian government policy was 70:30. Indian women’s low participation is due to financial dependency, lack of knowledge, and poor accessibility. There exists a lack of skilled professionals, dedicated CR centres pan India, and policies to advocate Women-focused CR (WFCR). Globally, 40.9% of countries have CR with 32.1% centres offering WFCR. These programs encompass community classes, home-based/online delivery models, women support groups, buddy programs, flexible scheduling, and comprehensive delivery of educational programs. Conclusion: The way forward for CR in India is to explore possibilities to reduce the barriers faced by women to avail of CR services. Policies need to be formulated to draw women’s attention to healthcare. Training programs should be introduced to upskill our nation’s young physiotherapy professionals. Implication: A bridge between CVD and CR must be formed and more women-centric CR programs should be designed for holistic cardiac health.

HPV Positive Women and Risk Factors in Development Cervical Intraepithelial Lesions

Background: Human papillomavirus is a risk factor in the development of cervical cancer. Other risk factors are frequent vaginal infections, cigarette smoking, use of oral contraceptives, but also lack of lacrobacillus in women with HPV infection. Objective: The objective of our study was to determine the risk factors for the development of cervical intraepithelial lesions in women with normal and pathological Pap test results. Methods: The research is a prospective study conducted in the Gynecology Center "Dr. Mahira Jahić" Tuzla and Dom Zdravlja Tešanj since February. 2023 to March 2024. The research included 200 respondents aged 25 to 50. Tested group: 100 subjects with pathological Pap smear findings (ASCUS, LSIL and HSIL) and a control group of 100 subjects with normal Pap smear findings. Sociodemographic data were obtained from the subjects during interviews and examinations: age, cigarette consumption and frequency of previous vaginal infections and the presence of lactobacilli. The obtained results were processed using the methods of descriptive statistics, student's t test and X2 test. A difference for a value of p<0.5 was considered statistically significant. Results: The mean age of the dpbo examined group was 38.1±1.7, while in the control group it was 39.6±1.9 years. Cigarettes were consumed by 62 (31%), 38 (19%) of the examined group, and 24 (12%) of the control group with a statistically significant difference of p<0.05. Out of a total of 100 in the examined group, 60 subjects had LSIL, 9 subjects had HSIL (CIN 2 two subjects and CIN 3 had 7), and ASCUS 29 and ASC-H 2 subjects. Subjects with pathological findings had significantly more vaginal infections during one year (p<0.05). HPV was positive in 65 (65%) subjects with a pathological Pap smear test, and negative HPV in 35 (35%). HPV 16,18 was present in 19 (19%) test subjects in combined form, and mono-isolate HPV 16 in 14 (14%) and HPV 18 in one case. In the combined form of several HPVs, HPV 16 and HPV 31, 33, 35, 45, 56 were found in 5 (5%), and HPV 18 in 4 (4%) with HPV 36, 59, 68. The most frequently isolated HPV 16 in 38 (38%) as monoisolate and in combined form. Lactobacilli were present in 26 (13%) subjects in the test group and in 60 (30%) subjects in the control group, with a statistically significant difference (p<0.05). The presence of Lactobacillus in subjects with a regular Pap test is significantly more frequent compared to women with cervical intraepithelial lesions (ASCUS, LSIL, ASC-H and HSIL) ) in the finding of the Pap test. Conclusion: Altered microflora of the vagina, lack of lactobacilli, frequent vaginal infections and smoking are risk factors for the development of CIN lesions in women positive for high-risk HPV.

The impact of elevated lipoprotein a levels on retinal vein occlusion in young individual: Case report with 7 months follow‐up

Aims/Purpose: Branch retinal vein occlusion (BRVO) occurs when a branch of the retinal vein becomes obstructed. The aim of this study case was to provide insights into the potential role of Lipoprotein (Lp) (a) in the pathogenesis of BRVO.Methods: Case of a 47‐year‐old woman with no significant ophthalmological or general medical history, except the use of oral contraception and smoking habits. Presented to the emergency care after 5 days of experiencing a sudden vision loss in her right eye.Results: The ophthalmological examination revealed a visual acuity of 10/10 on the left (OS) and VBLM/10 on the right eye (OD). Slit lamp and Fundus examination showed on OD a relative afferent pupillary defect and the classic features of acute retinal branch vein occlusion, including tortuous veins, capillary occlusion, papillary and macular oedema and haemorrhages. While all was normal in OS. A comprehensive ophthalmic examination was conducted, including fluorescein angiography and optical coherent tomography that showed no abnormal vessel growth at this stage. Then, the indication for a dexamethasone intravitreal implant has been made along with panretinal photocoagulation (PRP) in the ischaemic areas. More, discontinuing oral contraception, the serum concentrations of specific antibodies, as anticardiolipin and antiphospholipids, as well as homocysteine and Lp (a) levels. The blood tests yielded negative results except for the abnormal plasma level of lipoprotein (a), which was measured at 900 mg/L. After 2 months of follow‐up. The visual acuity in OD was measured at 9/10. Moreover, the restoration of normal macular thickness after 4 months. However, at 6 months follow‐up, the appearance of a neovascularization adjacent to the previously laser‐treated area. As a result, a series of closely spaced PRP was performed along with an intravitreal anti‐vascular endothelial growth factor. After 1 month, a complete disappearance of the neovascularization was observed.Conclusions: Identification of independent and highly predictive risk factors for BRVO is still a big challenge. The main goals are the preservation of visual acuity and the prevention of relapses. This case report emphasizes the importance of incorporating a systematic Lp (a) testing into clinical practice, even in young individual.

Fibroid uterus: A case study

Fibroid uterus, also known as Uterine leiomyoma, represents a common gynecological disorder affecting women, particularly those in their reproductive years. This paper presents a case study focusing on the clinical manifestation, diagnosis, management, and nursing care of a 43-year-old woman with fibroid uterus. Fibroids, benign neoplasms of the uterine wall, are classified based on their location within the uterus. Risk factors for fibroid development include early puberty, obesity, genetic predisposition, and oral contraceptive use. Diagnosis often involves ultrasound imaging, revealing characteristic features such as heterogeneous hypoechoic lesions. Management options range from medical to surgical interventions, with considerations for patient age, fertility preservation, and symptom severity. Surgical procedures like myomectomy and hysterectomy may be necessary, while non-surgical alternatives such as uterine artery embolism and myolysis offer alternatives. Nursing care focuses on pain management, nutritional support, infection prevention, and patient education. Early detection and appropriate management are essential to mitigate the risk of complications and preserve fertility in affected women.

Letter to the Editor in Response to 'Population-based cohort study of oral contraceptive use and risk of depression'.

Letter to the Editor in Response to 'Population-based cohort study of oral contraceptive use and risk of depression'.

Prediction of aneurysmal subarachnoid hemorrhage in comparison with other stroke types using routine care data.

Aneurysmal subarachnoid hemorrhage (aSAH) can be prevented by early detection and treatment of intracranial aneurysms in high-risk individuals. We investigated whether individuals at high risk of aSAH in the general population can be identified by developing an aSAH prediction model with electronic health records (EHR) data. To assess the aSAH model's relative performance, we additionally developed prediction models for acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) and compared the discriminative performance of the models. We included individuals aged ≥35 years without history of stroke from a Dutch routine care database (years 2007-2020) and defined outcomes aSAH, AIS and ICH using International Classification of Diseases (ICD) codes. Potential predictors included sociodemographic data, diagnoses, medications, and blood measurements. We cross-validated a Cox proportional hazards model with an elastic net penalty on derivation cohorts and reported the c-statistic and 10-year calibration on validation cohorts. We examined 1,040,855 individuals (mean age 54.6 years, 50.9% women) for a total of 10,173,170 person-years (median 11 years). 17,465 stroke events occurred during follow-up: 723 aSAH, 14,659 AIS, and 2,083 ICH. The aSAH model's c-statistic was 0.61 (95%CI 0.57-0.65), which was lower than the c-statistic of the AIS (0.77, 95%CI 0.77-0.78) and ICH models (0.77, 95%CI 0.75-0.78). All models were well-calibrated. The aSAH model identified 19 predictors, of which the 10 strongest included age, female sex, population density, socioeconomic status, oral contraceptive use, gastroenterological complaints, obstructive airway medication, epilepsy, childbirth complications, and smoking. Discriminative performance of the aSAH prediction model was moderate, while it was good for the AIS and ICH models. We conclude that it is currently not feasible to accurately identify individuals at increased risk for aSAH using EHR data.

Exploring Breast Cancer Dynamics: Understanding Risk Factors, Health Behaviors, and Treatment Trends among Women in Derna, Libya

Breast cancer poses a significant global health challenge, being the second most common cancer among women and a leading cause of cancer-related deaths. This research aims to investigate the multifaceted dimensions of breast cancer, from risk factors to diagnostic methods and treatments. A comprehensive analysis of 109 Libyan females who lived in Derna, utilizing an online questionnaire disseminated through social media platforms. In this study, 23% were diagnosed with breast cancer, while 77% were controls. Higher breast cancer incidence was observed among younger individuals (26-34 years) and those who were overweight. Most cases were from central Derna, were university graduates, employed, married, and had high incomes. Key risk factors included positive family history (20%), oral contraceptive use (4%), and hormone replacement therapy (8%). Higher rates of gynecologist visits, clinical breast examinations, and breast cancer screening were noted in the case group. The majority of cases were diagnosed at Stage III, primarily through tissue biopsy, with many opting for combined surgery and radiotherapy. In conclusion, bridging the gaps in knowledge about breast cancer risk factors, early detection methods, and treatments is crucial for advancing comprehensive cancer management and improving patient outcomes. Continued research and personalized treatment approaches are essential for the evolving landscape of breast cancer care.

Management of Premenstrual Dysphoric Disorder: A Scoping Review.

Premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) refer to physical, cognitive, or affective symptoms that arise in the late luteal phase and remit with menses. The present work is a clinically focused scoping review of the last twenty years of research on treatment for these disorders. A search of key terms using the PubMed/Medline, the Cochrane Library, Embase, and Web of Science databases was performed, and 194 studies of adult women met initial inclusion criteria for review. Research studies concerning medications, pharmacological and non-pharmacological complementary and alternative medicine treatments, and surgical interventions with the most available evidence were appraised and summarized. The most high-quality evidence can be found for the use of selective serotonin reuptake inhibitors (SSRIs) and combined oral contraceptives (COCs), with gonadotropin releasing hormone (GnRH) agonists and surgical interventions showing efficacy for refractory cases. While there is some evidence of the efficacy of alternative and complementary medicine treatments such as nutraceuticals, acupuncture, and yoga, variability in quality and methods of studies must be taken into account. Reprinted from Int J Womens Health 2022; 14:1783-1801, with permission from Dove Medical Press Ltd. Copyright © 2022.

Connections between reproductive health and cognitive aging among women enrolled in the HCHS/SOL and SOL-INCA.

Reproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women. Participants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence). Younger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence. Several aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.

Clinical Profile and Risk Factors of Adult Patients with Deep Vein Thrombosis in a Tertiary Hospital

Background: Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is a pressing problem in developing countries like the Philippines. There is a need to investigate the clinical profile of DVT patients to recognize those requiring considerate attention to prevent complications. Objectives: To determine the Clinical Profile of Adult Patients with Deep Vein Thrombosis in University of Santo Tomas Hospital from October 2015- June 2017. Methods: Retrospective cross sectional study was done. All adult patients who underwent venous duplex ultrasonography in the University of Santo Tomas Hospital from October 2015- June 2017 were identified and their data retrieved using the Heart Station computer database. Results: Out of the 290 patients, 45 (15.5%; 95%CI: 11.5 – 20.2%) were positive for DVT. Age (p=0.694) and gender (p=0.494) did not differ among those with and without DVT. The highest incidence is among those in the age range of 61-80 years old. The trend increased according to age up to 80 years old, beyond which there is a noted decline. The following were identified as significant risk factors in DVT: history of DVT (p<0.001), malignancy (p<0.001), recent surgery (p 0.02), oral contraceptive use (p 0.018) and bedridden state (p<0.001). Edema was the most common presentation. Conclusion: Among those who underwent venous duplex ultrasound of the lower extremities, 15% of the population had findings consistent with DVT, the mean age is 62.6 years old. In this study, we concluded that the most significant risk factors include malignancy, bedridden state, OCP use and recent surgery.