Postmenopausal Female Patients Research Articles

Ispitivanje udruženosti polimorfizma Pro12Ala u genu PPARG sa pojavom gojaznosti i metaboličkog sindroma kod žena u postmenopauzi

Introduction: During menopause, the prevalence of metabolic disorders in women increases significantly. Postmenopausal women have increased waist circumference, high blood pressure, hypertriglyceridemia, hyperglycemia and low HDL cholesterol, which leads to an increased risk of cardiovascular events. Gamma gene PPAR-g belongs to the family of nuclear receptors and plays a significant role in lipid and glucose metabolism. Polymorphism Pro12Ala is present within the PPARG gene. The presence of the Ala allele leads to a 30 to 50% reduction in PPAR-g activity. Aim: The aim of the research is to determine the association between the genotype Pro12Ala polymorphism genotype in the PPAR-g gene and the metabolic syndrome, hypertension, as well as the biochemical parameters of obesity in postmenopausal women. Material and methods: Total of 98 female postmenopausal patients were included in the study. The analysis of Pro12Ala genotype of PPAR-g gene was done by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Results: In the examined group of patients, CC (Pro/Pro) genotype was found in 81 patients (82.7%), while the CG (Pro/Ala) genotype was present in 17 patients (17.3%). Analysis of the association of Pro12Ala genotypes with the occurrence of metabolic syndrome, hypertension and type II diabetes showed that women carriers of CC genotype were statistically significantly more likely to have hypertension than carriers of CG genotype (p = 0.030). Analysis of the association of Pro12Ala polymorphisms with biochemical parameters (total cholesterol, HDL, LDL, triglycerides and glycaemia) did not show statistical significance. Conclusion: The results of this study indicate a possible association of the Pro/Pro genotype of the Pro12Ala polymorphism with the risk of developing hypertension in postmenopausal women.

Comprehensive Analysis of the Correlation between Estrogen Levels, Homocysteine, and Lipid Profiles in Postmenopausal Women with Coronary Heart Disease

Objective: To investigate the correlation between estrogen levels, blood homocysteine, and blood lipids in postmenopausal female patients with coronary heart disease. Methods: This study selected 50 postmenopausal female patients with coronary heart disease from Northeast Normal University Hospital (observation group). The data collection period extended from June 2021 to June 2023. Simultaneously, 50 healthy patients with no history of coronary heart disease were selected during the same period as the control group. Physical examinations were conducted for all participants. Estrogen levels, blood homocysteine, and blood lipid levels were tested in both groups. Results: Compared to the control group, the observation group exhibited higher levels of follicle-stimulating hormone (FSH), total cholesterol (TC), and homocysteine (Hcy), and lower levels of high-density lipoprotein cholesterol (HDL-C; P < 0.05). Pearson correlation analysis revealed a negative correlation between estradiol (E2) levels and changes in Hcy, TC, and low density lipoprotein cholesterol (LDL-C) levels (P < 0.01). Multivariate analysis indicated that E2 serves as a protective factor against coronary heart disease in postmenopausal women. Decreased E2 levels, LDL-C, and Hcy were identified as independent risk factors for coronary heart disease in women (P < 0.05). Conclusion: A declining trend in estrogen levels among postmenopausal women has implications for their blood lipid levels and is closely associated with the development of chronic complications of menopause.

THU421 Utility Of Forearm DXA As A Tool For Identification Of Osteoporosis: A Cleveland Clinic Experience

Abstract Disclosure: A.F. Ishola: None. K. Alsibai: None. A. Iqbal: None. A. Elsherif: None. P. Rao: None. L.Z. Khan: None. Background: Osteoporosis is a preventable and treatable condition with a significant impact on the quality of life. According to the National Osteoporosis Foundation, 10.2 million Americans have osteoporosis. In addition, more than 2 million osteoporosis-related fractures occur annually in the US and >70% of these occur in women. Unfortunately, most individuals at risk do not undergo appropriate assessment or treatment. Clinically osteoporosis may be diagnosed if there is a fragility fracture, independent of bone mineral density (BMD) T-score value. Diagnosis based on BMD can also be made with a T-score of − 2.5 or below in the lumbar spine, femoral neck, total proximal femur, or distal 1/3 radius. Due to the limitations in interpreting BMD values in patients with degenerative joint disease (DJD), using the forearm (distal 33% radius) as an alternative skeletal site could serve as a more sensitive screening test. Our study primary aims were to assess the frequency at which females age ≥ 65 undergoing BMD testing had DJD of the spine, to determine the frequency at which BMD testing of the forearm was performed in patients with DJD of the spine, and to assess skeletal site-specific rates of osteoporosis. Methods: This is a large, single-center, retrospective, IRB- approved study conducted at Cleveland Clinic Foundation. Postmenopausal female patients above the age of 65 who underwent DXA scans between January 2018 and December 2019 were identified. Manual chart reviews were performed. Patients receiving osteoporosis treatment and those with hyperparathyroidism were excluded. Results: 195 patients were eligible for the study. The mean age was 73.4 ± 8.2 years. DJD of spine and osteoarthritis were present in 74.5% and 58.2% of patients respectively. Forearm BMD testing was only performed in 18.9% of patients with DJD of the spine. Osteoporosis was diagnosed in 39.1 % at the femoral neck, 35.4% of patients at the lumbar spine, 9.3 % at the distal 1/3 radius, and 6.8% at the total hip. Conclusion: DJD of the spine and hip osteoarthritis often lead to falsely elevated T-scores resulting in under-diagnosis and under-treatment of osteoporosis. Although there is a higher sensitivity of using forearm BMD values to diagnose osteoporosis in patients with DJD of spine and/or osteoporosis, our preliminary data show that the forearm DXA scan is an under-utilized clinical tool in cases of DJD of spine, osteoarthritis, and hip replacement. Presentation: Thursday, June 15, 2023

The Overview of Coronary Heart Disease Risk Factors in Perimenopausal and Postmenopausal Female Patients at Haji Adam Malik General Hospital in 2021

ABSTRACT Background: Cardiovascular diseases are taking an estimated 17, 9 million lives each year, 85% were caused by coronary heart disease. After menopause, there are physiological changes that occurs in women’s body that increase the risk of coronary heart disease. Risk factors associated with the incidence of coronary heart disease are, family history, age, hypertension, diabetes, dyslipidemia, obesity, and smoking. Objectives: To examine the risk factors associated with the incidence of coronary heart disease in perimenopausal and postmenopausal women at RSUP Haji Adam Malik in 2021. Methods: This study is a descriptive study with cross sectional design and retrospective approach, carried out at RSUP Haji Adam Malik. The data were taken from 1 January-31 December 2021. Results: The results showed that out of 75 perimenopausal and postmenopausal women who suffered from CHD, 61 patients (81,3%) were >50 years old, 3 patients (4%) had a family history of CHD, 53 patients (70,7%) had hypertension, 45 patients (60%) had diabetes, 58 patients (77,3%) with dyslipidemia, 10 patients (13,3%) were obese, and 14 patients (18,7%) had a history of smoking. Conclusion: Risk factors for CHD in perimenopausal and postmenopausal women, are having a family history of CHD, age, hypertension, diabetes, dyslipidemia, obesity, and smoking. Keywords: coronary heart disease, risk factors, perimenopausal women, postmenopausal women, women with CHD ABSTRAK Latar Belakang: Penyakit kardiovaskular menyebabkan kematian 17,9 juta penduduk dunia setiap tahunnya, dan 85% diantaranya disebabkan oleh penyakit jantung koroner. Pada wanita yang telah mengalami menopause, terjadi perubahan fisiologis pada tubuh wanita sehingga risiko penyakit jantung koroner meningkat. Faktor risiko yang meningkatkan kejadian penyakit jantung koroner antara lain, usia, riwayat keluarga, hipertensi, diabetes, dislipidemia, obesitas, dan merokok. Tujuan: Untuk mengetahui faktor risiko yang menyebabkan terjadinya penyakit jantung koroner pada pasien wanita perimenopause dan postmenopause di RSUP Haji Adam Malik Medan pada tahun 2021. Metode: Jenis penelitian yang dilakukan adalah penelitian deskriptif dengan desain penelitian cross sectional dengan pendekatan retrospektif, yang dilakukan di RSUP H. Adam Malik. Hasil: Hasil penelitian menunjukkan, dari 75 orang wanita perimenopause dan postmenopause yang menderita PJK, sebanyak 61 pasien (81,3%) berusia >50 tahun, 3 pasien (4%) memiliki riwayat keluarga dengan PJK, 53 pasien (70,7%) menderita hipertensi, 45 pasien (60%) menderita diabetes, 58 pasien (77,3%) mengalami dislipidemia, 10 pasien (13,3%) mengalami obesitas, dan 14 pasien (18,7%) memiliki riwayat merokok. Kesimpulan: Faktor risiko PJK pada wanita perimenopause dan postmenopause, meliputi riwayat keluarga, usia, hipertensi, diabetes, dislipidemia, obesitas, dan merokok. Kata Kunci: faktor risiko, penyakit jantung koroner, wanita dengan PJK, wanita perimenopause, wanita postmenopause

Role of hemogram parameters as predictive markers for propofol injection pain in reproductive and postmenopausal women: a prospective study

Aims: In clinical practice, propofol injection pain (PIP) is a frequent condition that clinicians could face every day. The aim of this prospective study was to investigate the correlation between PIP and hemogram parameters in reproductive and postmenopausal women.
 Methods: In this prospective study, 40 reproductive and 40 postmenopausal female patients who underwent elective surgery were enrolled. Baseline data including age, weight, height, hemogram parameters, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune inflammatory score (SII) were recorded preoperatively. The pain was classified as 0: no pain, 1: mild pain, 2: moderate pain, 3: severe pain. Patients were previously informed about the questioning of pain scores during propofol.
 Results: The proportion of patients experiencing PIP in postmenopausal (n=16;40%) group was significantly higher than those in the reproductive group (n=6;15%) (p=0.009). When reproductive and postmenopausal groups were compared according to the presence or absence of pain, no difference was found between the groups in terms of hemogram ratios and platelet indices (p>0.05). The NLR, PLR and SII ratios were not significant in predicting the presence of PIP. 
 Conclusion: The findings of our study showed that the occurrence of PIP in postmenopausal women was higher compared to women in reproductive age. Hemogram values, NLR platelet, PLR and SII ratios were not significantly associated with the presence of PIP.

Comparison of the effect of Dapagliflozin and Pioglitazone on the risk of osteoporosis in postmenopausal women with Type-2 diabetes.

Type 2 Diabetes mellitus (T2DM) and osteoporosis, which increase with age, are two common diseases with different complications. The risk of fractures due to osteoporosis is 2 to 6 times higher in patients with diabetes mellitus (DM). Medications used in the treatment of DM in addition to the disease itself are associated with the risk of osteoporosis and osteoporotic fractures. This study was planned to examine the effects of pioglitazone and dapagliflozin, used in the treatment of T2DM, on the development of osteoporosis in postmenopausal women. This single-centre comparative study was conducted at Endocrine and Metabolic Diseases Polyclinic of a Hospital between April 15, 2019 and April 15, 2020, with a total of 80 postmenopausal female patients with a diagnosis of T2DM and 20 in the control group, aged between 50 and 70. The participants were evaluated under four groups: "Control" without diabetes mellitus (n=20), "Pioglitazone" using (n=30), "Dapagliflozin" using (n=30), and "Other Oral Antidiabetic" using (n=20). The mean age of the participants was 61.32±6.27 years. There was no statistically significant difference between the groups in the hip and waist T-score values of participants with T2DM in the study (p>0.05). There was no significant difference in waist and hip t-score values between the intervention groups. Pioglitazone and dapagliflozin used in postmenopausal T2DM patients were determined not to make a significant difference in waist and hip bone mineral density values. Our study revealed that pioglitazone and dapagliflozin can be used in postmenopausal T2DM individuals without known osteoporosis and other osteoporosis risk factors.

Serum androgen level in association with dry eye in elderly male and postmenopausal female patients

Purpose The aim of this study was to assess the association between objective and subjective indicators of dry eye syndrome (DES) and androgen level in elderly patients. Patients and methods This is a comparative cross-sectional study that included 80 Egyptian patients with DES. They were divided into two groups: Group A which consisted of 40 postmenopausal females and elderly males, and Group B which included 40 males and females under the age of 40 years. Each patient provided a medical history. The dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, which inquired about the presence, intensity, and frequency of symptoms of DES. Additionally, the tear film break-up time (TBUT) and Schirmer’s test were conducted. Serum androgen levels were measured using the ELISA test. Results The serum androgen was significantly lower in group A (12.6±8.19 ng/dl) than in group B (24±4.44 ng/dl), (P<0.001). There was a strong significant negative correlation between androgen level and age (r=−0.60, P<0.001). In addition, there was a significant positive correlation between the TBUT and Schirmer’s test values and the amount of testosterone (T) (r=0.62, P<0.001 and r=1.0, P<0.001, respectively). The Schirmer’s test was significantly lower in postmenopausal female patients compared to male patients (mean=10.21±1.05 mm versus 12.46±1.13 mm, respectively, P<0.001). Conclusion The serum androgen level was significantly lower in postmenopausal females and elderly males with DES compared to males and females under the age of 40 years, with a significant negative correlation between androgen level and age. Moreover, the TBUT and Schirmer’s test showed a significant positive association with T level. The Schirmer’s test results were significantly lower in postmenopausal females compared to males.

Impact of Osteoporosis in Postmenopausal Women With Primary Knee Osteoarthritis.

Although knee osteoarthritis (OA) and osteoporosis (OP) are common age-related bone disorders, the association between the two conditions remains indefinable. The aim of the present study is to investigate a possible relationship between the two conditions in post-menopausal women. A cross-sectional study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia, after obtaining IRB approval. The study included all post-menopausal female patients above 50 years of age, who underwent dual-energy X-ray absorptiometry (DXA) scans between January 2019 and July 2021 and have clear radiological data regarding knee OA. For our study, 487 ladies satisfied our inclusion criteria with an age range of 50-94 years (mean 64.67 ±8.4). The severity of knee OA was determined according to theKellgren and Lawrence (KL) grading system. The mean age and weight of all patients showed a significant association withknee OA. There was no significant association between bone quality and all parameters of bone mineral density (BMD) and T-scorewith the presence of knee OA. The mean age, height, weight, and BMI have a significant relationship with OP. Grade 3 of the KL classification system for knee OA is the only grade that showed a significant relationship with the presence of OP. The status of bone quality, BMD, and T-score parameters have no significant relationship with the severity subgrouping of knee OA. The BMD and the T-score of the right femoral neck have a significant correlation with BMI, which is linked to the presence of knee OA. We didn't find a clear relationship between OP or BMD and the presence of knee OA. However, our findings demonstrated that BMD, T-score of the right femoral neck, and BMI can all be utilized as predictors for the development and progression of knee OA. We recommendconsidering the many potential confounding variations when describing a relationship between OP and OA.

Evaluation of the uric acid and hematological parameters in patients with nodal hand osteoarthritis

Objectives: To compare patients with symptomatic nodal hand osteoarthritis (OA) with a control group in respect of inflammation parameters, uric acid, and hematological parameters. Methods: The study included 50 post-menopausal female patients, aged 40-80 years, diagnosed with symptomatic nodal hand OA, and a control group of 50 post-menopausal females in the same age range with no hand OA. Patient data including age, monocyte, neutrophil, lymphocyte, and thrombocyte counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, uric acid level, and the Kellgren-Lawrence (KL) score obtained from evaluations of hand radiographs, were recorded retrospectively from the hospital information system. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) were calculated. The data were compared between the two groups. Results: The data of 100 females were compared, comprising a patient group of 50 patients with symptomatic nodal OA, and a control group of 50 females. Age, monocyte, neutrophil, lymphocyte, and thrombocyte counts, NLR, PLR, MLR, ESR, CRP, and uric acid level were compared. With the exception of MLR and ESR, no statistically significant difference was determined between the two groups. The MLR was determined to be statistically significantly higher in the control group than in the patient group (p = 0.024). The ESR was determined to be statistically significantly higher in the patient group than in the control group p < 0.001). When patients with a KL score of 2 and 3 were compared, with the exception of age, no other difference was determined. Patients with a KL score of 3 were seen to be significantly older (p = 0.032). Conclusions: ESR was determined to be significantly higher in patients with symptomatic nodal OA. Clarification of the relationship between inflammation, uric acid, and hand OA, which is a heterogeneous disease, will be useful in the follow-up and treatment of patients.

Association Analysis of Triglyceride Glucose-Body Mass Index and Bone Turnover Markers in Patients with Type 2 Diabetes Mellitus.

In view of the high prevalence of osteoporosis in diabetic patients, this study aimed to investigate the correlation between TyG-BMI, which represents insulin resistance, and bone loss markers, which represent bone metabolism, in an attempt to provide new ideas for the early prevention and diagnosis of osteoporosis in patients with T2DM. A total of 1148 T2DM were enrolled. The clinical data and laboratory indicators of the patients were collected. TyG-BMI was calculated based on fasting blood glucose (FBG), triglycerides (TG), and body mass index (BMI) levels. Patients were divided into Q1-Q4 groups according to TyG-BMI quartiles. According to gender, two groups were divided into men and postmenopausal women. Subgroup analysis was performed according to age, course of disease, BMI, TG level and 25(OH)D3 level. The correlation between TyG-BMI and BTMs was investigated by correlation analysis and multiple linear regression analysis using SPSS25.0 statistical software. 1. Compared with Q1 group, the proportion of OC, PINP and β-CTX in Q2, Q3 and Q4 groups decreased significantly. 2. Correlation analysis and multiple linear regression analysis showed that TYG-BMI was negatively correlated with OC, PINP and β-CTX in all patients and male patients. In postmenopausal women, TyG-BMI was negatively correlated with OC and β-CTX, but not with PINP. 3. Subgroup analysis of male patients and postmenopausal female patients according to age, course of disease, BMI, TG and 25(OH)D3 showed that TyG-BMI had a stronger negative correlation with BTMs in male patients with age < 65, disease duration < 10, BMI≥24, TG < 1.7, and 25(OH)D3≥20. This study was the first to show an inverse association between TyG-BMI and BTMs in T2DM patients, suggesting that high TyG-BMI may be associated with impaired bone turnover.

A STUDY OF CARTILAGE OLIGOMERIC MATRIX PROTEIN (COMP) &amp; TUMOR NECROSIS FACTOR - IN POST MENOPAUSAL KNEE OSTEOARTHRITIC FEMALE PATIENT.

Osteoarthritis is a type of arthritis that occurs when the flexible ends of tissues at the end of the bones wear down and it could be due to various causes affecting the daily life of the people. Women are the most important part of society and according to studies it was stated women are more affected than men. There are many biochemical markers involved in the diagnosis of osteoarthritis with other investigations like radiological, and clinical approaches. Here in this study the Cartilage oligomeric matrix protein (COMP) and Tumor necrosis factor – alpha (TNF-?) were determined in post-menopausal knee osteoarthritic female patients and normal healthy subjects taking into consideration of all the exclusion and inclusion criteria. The samples were collected and tests were performed by ELISA. The study suggested that raised levels of the serum COMP &amp; TNF-? in the study group were age-related changes with inflammation and infection at the knee joint which were suggestive of knee osteoarthritis.

Refracture after plate removal of midshaft clavicle fractures after bone union—incidence, risk factors, management and outcomes

IntroductionThere is a great debate on the routine use of open reduction and internal fixation (ORIF) for midshaft clavicle fractures, and one concern is the adverse events after ORIF, such as implant removal after bone union. In this retrospective study, we assessed the incidence, risk factors, management and outcomes of refracture after plate removal of midshaft clavicle fractures after bone union.Materials and methodsThree hundred fifty-two patients diagnosed with acute midshaft clavicle fractures who had complete medical records from primary fractures to refracture were recruited. Details of imaging materials and clinical characteristics were carefully reviewed and analysed.ResultsThe incidence rate of refracture was 6.5% (23/352), and the average interval from implant removal to refracture was 25.6 days. Multivariate analysis showed that the risk factors were Robinson type-2B2 and fair/poor reduction. Females were 2.4 times more likely to have refracture, although it was not significant in multivariate analysis (p = 0.134). Postmenopausal females with a short interval (≤ 12 months) from primary surgery to implant removal had a significant risk for refracture. Tobacco use and alcohol use during bone healing were potential risk factors for male patients, although they were not significant in multivariate analysis. Ten patients received reoperation with or without bone graft, and they had a higher rate of bone union than 13 patients who refused reoperation.ConclusionThe incidence of refracture following implant removal after bone union is underestimated, and severe comminute fractures and unsatisfactory reduction during primary surgery are risk factors. Implant removal for postmenopausal female patients is not recommended due to a high rate of refracture.

THE ROLE OF SERUM ESTROGEN AND NITRIC OXIDE (NO) IN POST-MENOPAUSAL KNEE OSTEOARTHRITIC FEMALE PATIENTS

As we are all aware the hormone estrogen is the most essential sex hormone of the female. It plays significant roles in all phases of the life of females. Osteoarthritis is the most debilitating bone disorder commonly seen in females more than males. Out of all the joints knee joint is most commonly affected as it is the weight-bearing joint. So here in this study, the main objective is to know the role of serum estrogen and Nitric oxide levels in post-menopausal knee osteoarthritic female patients. The samples were collected and the chemiluminescence and ELISA method performed the tests. Consequently, results showed decreased levels of serum Estrogen in the study group than in the control group and levels of serum nitric oxide was increased as it confirmed the inflammatory marker at the site of infection. This whole suggests that deficiency estrogen and raised nitric oxide are helpful in the diagnosis and treatment modalities of knee osteoarthritis in postmenopausal females.

Dysregulation of circRNA-0076906 and circRNA-0134944 is Correlated with Susceptibility to Osteoporosis and Osteoporotic Fracture in Postmenopausal Females from the Chinese Han Population.

Many circRNAs, such as circRNA-0076906 and circRNA-0134944, have been reported to participate in the pathogenesis of osteoporosis via sponging miRNAs in postmenopausal female patients. In this study, we aimed to study potential signaling pathways underlying the role of certain circRNAs, miRNAs and their target genes in the pathogenesis of osteoporotic fracture in postmenopausal females. Quantitative real-time PCR was performed to analyze the expression of circRNAs, miRNAs and their targets genes. Luciferase assays were carried out to explore the regulatory relationship between circ_0076906/miR-548i/OGN and circ_0134944/miR-630/TLR4. Osteoporosis and fracture were positively correlated to the expression of circ_0134944, miR-548i and TLR4, but negatively correlated to the expression of circ_0076906, miR-630 and OGN in the peripheral blood and bone tissue samples of postmenopausal women. Luciferase activities of wild-type circ_0076906 and OGN were inhibited by miR-548i, and the luciferase activities of wild-type circ_0134944 and TLR4 were suppressed by miR-630 in MG-63 and U-2 OS cells. Inhibition of circ_0076906 expression in MG-63 and U-2 OS cells activated the expression of miR-548i and inhibited the expression of OGN. Moreover, the overexpression of circ_0134944 in MG-63 and U-2 OS cells suppressed the expression of miR-630 and enhanced the expression of TLR4. This study implied that the dysregulation of circRNA-0076906 and circRNA-0134944 modulated their specific signaling and thus contributed to the severity of osteoporosis, increasing the risk of osteoporotic fracture.

Abstract OT2-08-02: SOLTI-1907 ATREZZO: Targeting hormonal receptor negative (HR-) or PAM50 non-luminal disease with atezolizumab in combination with trastuzumab and vinorelbine in HER2-positive metastatic breast cancer (MBC)

Abstract Background Today, there is no clear therapeutic algorithm for patients with metastatic HER2-positive (HER2+) breast cancer (BC) who have progressed to trastuzumab, pertuzumab, tyrosine kinase inhibitors and antibody-drug conjugates (ADC). Among the emerging strategies, the use of immune checkpoint inhibitors in combination therapy is showing promising clinical benefit in the advanced setting of HER2+ BC by overcoming immune resistance and enhancing antitumor cellular immunity. The intrinsic subtypes Basal-like and HER2-enriched (i.e PAM50 non-luminal tumors) represent approximately the 60% of HER2+ BC and are associated with higher expression of immune-related genes, tumor-infiltrating lymphocytes (TILs) presence and high tumor mutational burden (TMB), compared to luminal subtypes. Additionally, immune infiltration and TMB in HER2+ BC are associated with chemo/antiHER2 responsiveness and with potential benefit from anti-PD-1/PD-L1 inhibitors. We hypothesize that combining atezolizumab with trastuzumab and vinorelbine may improve outcomes in HR- or PAM50 non-luminal/HR-positive (HR+) disease within HER2+ MBC. Methods ATREZZO is an open-label, single-arm, Simon 2-stage, multicenter phase II study. The trial will include 55 pre- or post-menopausal female or male patients with unresectable locally advanced or metastatic HR- or PAM50 non-luminal/HR+ HER2+ BC and progressed to trastuzumab-based chemotherapy and anti-HER2 ADC. Prior pertuzumab is allowed, but not required. Treatment consists of atezolizumab IV 1200 mg every 3 weeks combined with trastuzumab and vinorelbine. Patients with stable, progressing, or untreated brain metastasis not requiring immediate local therapy are eligible. The primary objective is to evaluate the Overall Response Rate (ORR) according to RECIST v 1.1 and secondary endpoints include ORR in patients with PD-L1 positive breast cancer, clinical benefit rate, overall survival and progression-free survival. The final recruited population will contain no more than 60 % of patients with PD-L1 negative tumors. Tumor assessments will be performed every 9 weeks. Incidence, duration and severity of adverse events, and further correlative molecular analyses will be also evaluated. An interim analysis will be conducted when 19 patients are evaluable for ORR and if the number of responses is ≥ 3, 36 additional patients will be included. As of July 15th, 2022, 48 patients were screened and 15 were included in sixteen Spanish sites. This study was funded by Roche Farma SA. Trial identification: NCT04759248 Citation Format: Eva Ciruelos, Antonia Perelló, Santiago González-Santiago, Ana López, Francisco Javier Salvador Bofill, Cinta Albacar, Juan Miguel Cejalvo, Santiago Escrivá-de-Romani, Isabel Blancas, Sonia Pernas, Olga Martínez-Sáez, Josefina Cruz, Jose Ponce, Sonia Servitja, Maria-Eva Perez-Lopez, Juan A Guerra, Esther Sanfeliu, Cesar A Rodríguez, Guillermo Villacampa, Lorea Villanueva, Pablo Tolosa, Tomás Pascual, Aleix Prat. SOLTI-1907 ATREZZO: Targeting hormonal receptor negative (HR-) or PAM50 non-luminal disease with atezolizumab in combination with trastuzumab and vinorelbine in HER2-positive metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-08-02.

Progesterone levels associated with proteinuria in male diabetes mellitus patients: A cross-sectional retrospective study.

The relationship between progesterone (P) and diabetic nephropathy (DKD) is unclear. Herein, we investigated the relationship between progesterone and DKD in men and postmenopausal women with type 2 diabetes mellitus. MATERIALSANDMETHODS: We recruited 3,556 male and postmenopausal female patients and obtained the dominance ratio (OR) and corresponding 95% confidence intervals (CIs) associated with progesterone by logistic regression analysis after adjusting for potentially confounding variants. We found that progesterone levels were significantly lower in the massive proteinuria and microproteinuria groups compared with the non-DKD group for male patients. Also, microproteinuria and massive proteinuria prevalence were higher in the first (lowest) progesterone quartile than in the second to fourth quartiles. After adjusting for confounders, compared with the first (lowest) progesterone quartile group, the OR for the second to fourth quartiles in the male microproteinuria subgroup, were: Q2: 0.846 (95% CI: 0.581-1.233, P=0.385); Q3: 0.667 (95% CI: 0.45-0988, P=0.044); Q4: 0.597 (95% CI: 0.393-0.907, P=0.016). In the male massive proteinuria subgroup, the OR for the third quartile group was 0.418 (95% CI: 0.201-0.867, P=0.019). In contrast, no significant association was detected between progesterone and DKD prevalence in the female group. Progesterone levels were negatively associated with DKD incidence in hospitalized male patients with type 2 diabetes mellitus.

Mid-term symptomatic relief after platelet-rich plasma infiltration in vulvar lichen sclerosus

PurposeVulvar lichen sclerosus (LS) is a chronic, progressive, autoimmune dermatologic condition that causes cutaneous changes accompanied by pruritus and pain. There remains a small population with vulvar LS refractory to topical corticosteroids. Injection of platelet-rich plasma (PRP) has been reported to have positive effects on tissue repair. The aim of this pilot study was to evaluate changes in symptom scores during and after PRP vulvar infiltration.MethodsThree PRP infiltrations were administered to 28 female postmenopausal patients with biopsy-proved LS with unsatisfactory response to steroid therapy. Change in score according to the Clinical Scoring System for Vulvar Lichen Sclerosus (CSS) was measured on six occasions over the course of a year. We used growth curve modeling to measure change over the period of the study.ResultsWomen in our study experienced a statistically significant improvement in auto-assessed symptoms of vulvar lichen sclerosus, and this improvement appears to be maintained throughout the monitoring year.ConclusionPlatelet-rich plasma may have a role in symptom relief in certain cases of patients with LS that do not respond to first-line therapy.

Evaluation and Correlation of Vitamin D Levels and Jaw Bone Mineral Density in Premenopausal and Postmenopausal Female Patients Undergoing Implant Therapy: Protocol for a Cross-sectional Study

Introduction: Vitamin D deficiency is one of the most common nutritional deficiencies worldwide. The amount and quality of bone at the implant installation site have an impact on the implant’s prognosis however, the effects of menopause on jaw bone remain unknown. Few studies have looked at the prevalence of vitamin D deficiency in India’s general population, but none have looked at the link between vitamin D deficiency (osteoporosis) and postmenopausal women’s jaw Bone Mineral Density (BMD). This is the first study of its sort in India to look at postmenopausal women’s vitamin D levels and jaw BMD. Aim: To evaluate and correlate vitamin D levels and jaw BMD in pre and postmenopausal females undergoing implant therapy. Materials and Methods: This cross-sectional study will include 50 partially or completely premenopausal (n=25) and postmenopausal females (n=25) having edentulous anterior and posterior maxillary and mandibular jaws. Females will be tested to evaluate their vitamin D levels and jaw BMD with Cone Beam Computed Tomography (CBCT) and results will be recorded in Hounsfield Units (HU) using Planmeca romexis viewer software. Chi-square test and Students t-test will be used.

Hormonal and Reproductive Factors in Relation to Cardiovascular Events in Women with Early Rheumatoid Arthritis.

Hormonal and reproductive factors affect the risk for cardiovascular events (CVE) in the general population. Although the risk of CVE is increased in rheumatoid arthritis (RA), the knowledge about the impact of hormonal factors for CVE in RA is sparse. Female postmenopausal patients ≤80 years with early RA were consecutively included in this observational study (n = 803) between 1 January 1996 until 31 December 2017. Questionnaires regarding hormonal factors were distributed from the index date. Data regarding CVE were obtained from the Swedish National Health Register and Cause of Death Register. Associations between CVE and hormonal factors were analyzed using Cox proportional hazard regression. Of the postmenopausal women, 64 women had a CVE after RA onset. The time period from menopause to RA onset was significantly longer for CVE cases with higher proportion of postmenopausal women. In Cox proportional hazard regression models, years from last childbirth and multiparity were associated with higher CVE risk. Adjustments for traditional risk factors did not affect the results except for hypertension. RA onset after menopause and a longer duration from menopause until onset increased the CVE risk. Multiparity was associated with higher CVE risk whilst oral contraceptives decreased the risk. These results can contribute to identification of high-risk patients for CVE beyond traditional risk factors.

Assessment of carotid arteries in stroke patients by ultrasonography and color Doppler

Background: Prevalence and associated mortality and morbidity rates apprehend stroke as a major health concern worldwide. Atherosclerotic disease of carotid arteries is the most common source of stroke. Quick and effective diagnosis, management and treatment of stroke is essential. Conventional diagnostic imaging techniques lacks the efficacy to rapidly and accurately dragonize stroke. Current investigation is focused towards assessing carotid arteries in stroke patients by ultrasonography and color Doppler to study the locate and study the morphology of lesion in carotid artery and to grade severity and extent of stenosis.Methods: A prospective observational study was performed on stroke patients of more than 40 years of age. The study was conducted at the department of radio diagnosis in a tertiary care center for a period of 18 months. Varied color Doppler parameters were studied and optimized to assess the morphology and surface of plaques and to determine stenosisResults: Mean age of the patients with carotid lesion was observed to be 59.7±9.8 years and male patients outnumbered postmenopausal female patients. Hemiparesis was the most common clinical presentation. Majority of patients exhibited raised intimomedial thickness and single or multiple plaques commonly in carotid bulb. Plaques of type II with irregular surface were most commonly observed which exhibited mostly 50-69% stenosis.Conclusions: The carotid artery embolic occlusion stenosis is the primary cause of stroke. Doppler sonography provides a rapid, noninvasive, relatively inexpensive and accurate means of diagnosing carotid stenosis, to determine the degree of cervical carotid stenosis and plaque morphology.