Subgroup Analysis Of Women Research Articles

Use of the levonorgestrel-releasing intrauterine system in breast cancer patients

To study the recurrence of breast cancer among patients who were using the levonorgestrel-releasing intrauterine system (LNG IUS). A retrospective, controlled cohort analysis. Six Belgian hospitals. We identified 79 breast cancer patients who used the LNG IUS, and we selected a control group of 120 patients with no history of LNG IUS use and who were closely matched for age at diagnosis, tumor stage, tumor grade, and treatment modalities. Two subgroups were identified: [1] breast cancer patients who continued using the LNG IUS after diagnosis and [2] breast cancer patients who began using an LNG IUS after treatment for breast cancer. Patient's data were collected and survival analysis was performed. Breast cancer recurrence rate. There was a recurrence rate of 21.5% (17/79) among LNG IUS users and of 16.6% (20/120) among the control group (adjusted hazard ratio, 1.86; 95% confidence interval, 0.86-4.00; no statistically significant difference). Subgroup analysis showed that women using the LNG IUS (n = 38) at the time of breast cancer diagnosis (and who continued its use) had a statistically significantly increased risk of recurrence (adjusted hazard ratio, 3.39; 95% confidence interval, 1.01-11.35) compared with patients in the control group. There was 47.4% (18/38) nodal involvement in this subgroup, and all patients who recurred had metastatic disease. Overall, we did not find an increased risk of breast cancer recurrence associated with use of the LNG-IUS. However, in a subgroup analysis of women who developed breast cancer while using an LNG IUS and who continued to use the LNG IUS, we found a higher risk of recurrence of borderline statistical significance. Additional research is needed to confirm or refute these findings.

Risk Factors For Posterior Vitreous Detachment: A Case-Control Study

To identify possible risk factors for the development of posterior vitreous detachment (PVD). Retrospective case-control study. A total of 138 cases with PVD and 114 age-matched controls were accrued from two different sites. Demographic, medical, ocular, and lifestyle data were obtained through chart review, questionnaires, and clinical examination. A 108-item semiquantitative food frequency questionnaire was also used to estimate macro- and micronutrient intake. Univariate and multivariate regression analyses were employed to identify variables significantly associated with the main outcome measure of PVD. Subgroup analysis of gender-specific variables was performed. Among all patients, multivariate regression analysis demonstrated female gender (odds ratio [OR] = 2.01, P = .016), myopic refraction (OR = 4.32, P < .0005), and higher intake of vitamin B6 (OR = 2.61, P = .001) to be associated with PVD after controlling for age. In the subgroup analysis of women, menopause (OR = 18.2, P < .0005), myopic refraction (OR = 3.42, P = .01), and higher intake of vitamin B6 (OR = 3.92, P = .005) were associated with PVD. Specifically, there was a significant association between vitamin B6 and PVD amongst premenopausal women but not amongst postmenopausal women. An association between PVD and menopause has not been documented previously. We suspect that high estrogen levels seen in premenopausal women may be protective against PVD and that hormonal changes associated with menopause may lead to changes in the vitreous, predisposing to PVD. Higher levels of intake of vitamin B6 were also associated with the development of PVD in premenopausal women possibly through an anti-estrogen effect. These findings should be investigated further with prospective studies.

Do male partners of breast cancer patients perceive the quality of life of their mates?

18502 Background: Scant scientific data exists regarding the quality of life (QOL) of female breast cancer patients as perceived by their male partners. Methods: We evaluated the QOL of 73 breast cancer patients and their partners perception using the abbreviated and Portuguese (from Brazil) validated questionnaires forms of the World Health Organization Quality of life (WHOQOL-bref) and WHOQOL-bref adapted for the third person, respectively. The breast cancer patients were also evaluated by the Beck Depression Scale (BDS) and were considered depressed if they had a score equal or greater than 10. The inclusion criteria for this study were: female breast cancer patients with stage I to III, cohabitation with a male partner for at least one year, age from 18 to 65 years old, being able to understand the questionnaires and sign an informed consent term. In order to compare the the scores of the WHOQOL-bref of breast cancer patients and the scores of the adapted WHOQOL-bref of their partners, we used the Pearson correlation index, Student’s t test and variation analysis. All statistical tests were two-sided, and P &lt; .05 was used to indicate statistical significance. Results: In the analysis of all 73 patients, we found no difference between the perceptions of QOL and its domains between the breast cancer patients and their partners (see table ). However, in the subgroups of patients who had a mastectomy (n = 32) or were depressed (n = 35) as measured by the BDS scale, we found differences as their partners rated them higher on the physical domain and psychological domain (P = 0.003 and P = 0.009), respectively. Conclusions: Male partners of breast cancer patients have an accurate perception of their mates’ QOL. The only exceptions we found were in subgroup analysis of women who had a mastectomy and/or were depressed. Our findings suggest that the male partners of breast cancer patients can be seen as reliable surrogates of their QOL. [Table: see text] No significant financial relationships to disclose.

Maternal IVS1-401 T allele of the estrogen receptor α is an independent predictor of late fetal loss

To investigate whether sequence variants in the gene encoding for estrogen receptor alpha (ER-alpha) are risk determinants for fetal loss. Case-control study. University medical center. One hundred four women with a history of fetal loss and 277 healthy women with at least one previous pregnancy and no previous fetal loss. None. The IVS1-401C/T polymorphism of the human ER-alpha, the G1691A mutation of the factor V gene (factor V Leiden), the G20210A mutation of the prothrombin gene, and the C677T polymorphism of the methylenetetrahydrofolate-reductase (MTHFR) gene were determined by polymerase chain reaction. In the subgroup analysis of women with at least one late miscarriage (n = 70), the prevalences of the ER-alpha IVS1-401 T allele (T/T vs. C/C, odds ratio [OR]: 2.85, P=.018; T/T + C/T vs. C/C, OR: 2.28, P=.043) and of heterozygous factor V Leiden (OR, 3.2; P=.002) were significantly higher among women with late fetal loss than among healthy women. Carriers of both risk determinants have an at-least additive increase in risk for late abortions (OR, 7.0; P=.0004). The population of all late abortions that would be attributable to the genetic variants (population attributable risk) was 13.9% for factor V Leiden and 49.2% for the ER-alpha IVS1-401 T allele. Women with the IVS1-401 T allele of the ER-alpha and/or factor V Leiden are at increased risk for late fetal loss.

Major Progress for a Less Common Cancer

Major Progress for a Less Common Cancer

The polymorphism of platelet membrane integrin α2β1 (α2807TT) is associated with premature onset of fetal loss

Inherited thrombophilia could increase susceptibility to adverse pregnancy outcomes such as fetal loss. We determined the G1691A mutation of the factorV gene (FVL), the G20210A mutation of the prothrombin gene, the C677T polymorphism of the methylenetetrahydrofolate-reductase (MTHFR) gene, the HPA-1 polymorphism of the beta3 subunit of the platelet integrin alphaIIbbeta3 and the C807T polymorphism of the alpha2 subunit of integrin alpha2beta1 in 104 women with fetal loss and 277 normal women. In a subgroup analysis of women with recurrent early fetal loss (n=34), the prevalence of the genetic markers did not differ significantly between the women with early fetal loss and the normal women. However, in this subgroup of patients the onset of fetal loss was significantly earlier in women with the alpha2807TT genotype (7.1 +/- 1.9 vs. 8.8 +/- 1.5 weeks, p=0.001). No such significant difference was observed in carriers of the other genetic markers. In the subgroup analysis of women with late fetal loss (n=70), only the prevalence of heterozygous FVL was significantly associated with late fetal loss (odds ratio 3.2, p=0.002). There was no significant association of any genetic risk factor with premature fetal loss in the subgroup analysis of women with at least one late miscarriage. This study demonstrates a significant association of the alpha2807TT genotype of the platelet membrane integrin alpha2beta1 with premature onset of early fetal loss. It appears that this risk factor does not induce the pathomechanism, but modulates the course of fetal loss. Furthermore, our study confirms the association of FVL with late fetal loss.

The Polymorphism of Platelet Membrane Integrin α2 β1(α2807TT) Is Associated with Premature Onset of Fetal Loss.

Inherited thrombophilia could increase susceptibility to adverse pregnancy outcomes such as fetal loss. We determined the G1691A mutation of the factor V gene (FVL), the G20210A mutation of the prothrombin gene, the C677T polymorphism of the methylentetrahydrofolate-reductase (MTHFR) gene, the HPA-1 polymorphism of the b subunit of the platelet integrin αIIbβ3 and the C807T polymorphism of the α subunit of integrin α2β1 in 104 women with fetal loss and 277 normal women. In a subgroup analysis of women with recurrent early fetal loss (n=34), the prevalence of the genetic markers did not differ significantly between the women with early fetal loss and the normal women. However, in this subgroup of patients, the onset of fetal loss was significantly earlier in women with the α2807TT genotype (7.1 ± 1.9 vs. 8.8 ± 1.5 weeks, p=0.001). No such significant difference was observed in carriers of the other genetic markers. In the subgroup analysis of women with late fetal loss (n=70), only the prevalence of heterozygous FVL was significantly associated with late fetal loss (odds ratio 3.2, p=0.002). There was no significant association of any genetic risk factor with premature fetal loss in the subgroup analysis of women with at least one late miscarriage. This study demonstrates a significant association of the α2807TT genotype of the platelet membrane integrin α2β1 with premature onset of early fetal loss. Based on our results it appears that this risk factor does not induce the pathomechanism but modulates the course of fetal loss. Furthermore, our study confirms the association of FVL with late fetal loss.

Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women.

Sarcopenia refers to the loss of skeletal muscle mass with age. The objective of this study was to determine the prevalence of sarcopenia in a population of older, community-dwelling research volunteers. Appendicular skeletal muscle mass was measured by dual x-ray absorptiometry in 195 women aged 64 to 93 years and 142 men aged 64 to 92 years. We defined sarcopenia as appendicular skeletal muscle mass/height(2) (square meters) less than 2 standard deviations below the mean for young, healthy reference populations. We used two different reference populations and compared prevalence in our population to that reported in previous studies. Body mass index (BMI) was calculated and physical activity and performance were measured with the Physical Activity Scale for the Elderly, the Short Physical Performance Battery, and the Physical Performance Test. We measured health-related quality of life by using the SF-36 general health survey. Serum estrone, estradiol, sex hormone-binding globulin, parathyroid hormone, and 25-hydroxy vitamin D were measured in all participants and bioavailable testosterone was measured only in men. Leg press strength and leg press power were determined in men. The prevalence of sarcopenia in our cohort was 22.6% in women and 26.8% in men. A subgroup analysis of women and men 80 years or older revealed prevalence rates of 31.0% and 52.9%, respectively. In women, skeletal muscle mass correlated significantly with BMI and levels of serum estrone, estradiol, and 25-hydroxy vitamin D; in men, it correlated significantly with BMI, single leg stance time, leg press strength, leg press power, SF-36 general health score, Physical Performance Test total score, and bioavailable testosterone levels. With the use of linear regression analysis, BMI was the only predictor of appendicular skeletal muscle mass in women, accounting for 47.9% of the variance (p <.05). In men, BMI accounted for 50.1%, mean strength accounted for 10.3%, mean power accounted for 4.1%, and bioavailable testosterone accounted for 2.6% of the variance in appendicular skeletal muscle mass (p <.05). Sarcopenia is common in adults over the age of 65 years and increases with age. BMI is a strong predictor of skeletal muscle mass in women and men. Strength, power, and bioavailable testosterone are further contributors in men. These data suggest that interventions to target nutrition, strength training, and testosterone replacement therapy should be further investigated for their role in preventing muscle loss with age.

Polycystic Ovaries and Associated Clinical and Biochemical Features in Young Women

OBJECTIVE To determine the prevalence of polycystic ovaries as identified by ultrasound in a group of young, postmenarcheal women in the normal population, and to investigate how polycystic ovaries are related to the spectrum of clinical and biochemical symptoms associated with the polycystic ovary syndrome (PCOS). DESIGN Cross-sectional observational study. SUBJECTS AND METHODS Volunteers were recruited from two universities and two general practice surgeries in Oxford. 230 women aged 18–25 years participated. Information collected and measurements performed included: a menstrual history, anthropometric measurements, clinical observation of acne and hirsutism, transabdominal pelvic ultrasound, and biochemical analysis of a fasting blood sample. MAIN OUTCOME MEASURES Prevalence of polycystic ovaries and their association with symptoms of the polycystic ovary syndrome. RESULTS Polycystic ovarian morphology was identified in 74 (33%, 95% CI = 27–39%) of the 224 women who attended for an ultrasound scan. In the non-users of hormonal contraception, irregular menstrual cycles were 20% more common in women with polycystic ovaries than in women with normal ovaries (P = 0.07). There were no significant differences in acne, hirsutism, body mass index or body fat percentage between women with polycystic and normal ovaries. Analysis of biochemical data showed that women with polycystic ovaries had higher total serum testosterone concentrations (P = 0.03). The prevalence of PCOS in this age group was as low as 8% or as high as 26% depending on which criteria were applied to define the syndrome. Sub-group analyses of women according to ovarian morphology and features of PCOS revealed greater mean BMI in women with PCOS, and also indicated lower fasting insulin concentrations and greater insulin sensitivity in polycystic ovary and PCOS groups when compared to women with normal ovaries. CONCLUSIONS Polycystic ovaries are very common in this age group but are not necessarily associated with other symptomatology. The prevalence of polycystic ovary syndrome varies widely according to the definition applied. Sub-group analysis of women with polycystic ovaries according to the presence or absence of features of polycystic ovary syndrome does not reveal an increasing trend for progression of endocrine abnormalities usually associated with polycystic ovary syndrome.

Polycystic ovaries and associated clinical and biochemical features in young women.

To determine the prevalence of polycystic ovaries as identified by ultrasound in a group of young, postmenarcheal women in the normal population, and to investigate how polycystic ovaries are related to the spectrum of clinical and biochemical symptoms associated with the polycystic ovary syndrome (PCOS). Cross-sectional observational study. Volunteers were recruited from two universities and two general practice surgeries in Oxford. 230 women aged 18-25 years participated. Information collected and measurements performed included: a menstrual history, anthropometric measurements, clinical observation of acne and hirsutism, transabdominal pelvic ultrasound, and biochemical analysis of a fasting blood sample. Prevalence of polycystic ovaries and their association with symptoms of the polycystic ovary syndrome. Polycystic ovarian morphology was identified in 74 (33%, 95% CI = 27-39%) of the 224 women who attended for an ultrasound scan. In the non-users of hormonal contraception, irregular menstrual cycles were 20% more common in women with polycystic ovaries than in women with normal ovaries (P = 0.07). There were no significant differences in acne, hirsutism, body mass index or body fat percentage between women with polycystic and normal ovaries. Analysis of biochemical data showed that women with polycystic ovaries had higher total serum testosterone concentrations (P = 0.03). The prevalence of PCOS in this age group was as low as 8% or as high as 26% depending on which criteria were applied to define the syndrome. Sub-group analyses of women according to ovarian morphology and features of PCOS revealed greater mean BMI in women with PCOS, and also indicated lower fasting insulin concentrations and greater insulin sensitivity in polycystic ovary and PCOS groups when compared to women with normal ovaries. Polycystic ovaries are very common in this age group but are not necessarily associated with other symptomatology. The prevalence of polycystic ovary syndrome varies widely according to the definition applied. Sub-group analysis of women with polycystic ovaries according to the presence or absence of features of polycystic ovary syndrome does not reveal an increasing trend for progression of endocrine abnormalities usually associated with polycystic ovary syndrome.

CLINICAL AND BIOCHEMICAL STUDY OF POLYCYSTIC OVARIES SYNDROME IN YOUNG FEMALE POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN.

BACKGROUND: Polycystic ovaries syndrome (PCOS) is one of the commonest endocrine disorder inwomen. It is associated with characteristic metabolic disturbance, clinically manifested in the form ofamenorrhea, oligomenorrhoea. The present study was conducted on young females of district Peshawarand Mardan to investigate PCOS on the basis of clinical and biochemical findings.OBJECTIVE: To study clinical and biochemical feature regarding polycystic ovaries syndromes inyoung females of districts Peshawar and Mardan, Khyber Pkhutunkhwkha Pakistan.PATIENTS &amp; METHOD: It was a cross sectional study of university going female students with agegroup of 20 to 25 years. A pre-designed, pre-tested questionnaire was used for the collection of data.Total T, SHBG, LH, were measured, each hormone in a single assay, using an automatedimmunochemiluminescence method (Immulite, Diagnostic Products, Los Angeles, CA). 17-OHP wasmeasured by direct Enzyme-linked immunosorbent Assay (ELISA) method.RESULTS: A total nine hundred&amp; twenty six (n=926) females were randomly selected. General andclinical features include age, amenorrhea, oligomenorrhoea, acne, hirsutism, obesity and transabdominal ultrasound. The biochemical characteristics like hyper LH secretion of the 49.13% (n=455)subject were in a moderate range. In addition to 58.63% (n=543), 37.25% (n=345), 4.10% (n=38) of thewomen diagnosed with ACTH were in normal, low and high ranges respectively. Four eighty nine(n=489) women (52.80%) showed acyclic estrogen production in normal ranges while 23.97% (n=222)have in low ranges score and 23.21% (n=215) have high ranges of acyclic estrogen production.CONCLUSIONS: Polycystic ovaries are very common in this age group but are not necessarilyassociated with other signs and symptoms. The prevalence of polycystic ovary syndrome varies widelyaccording to the definition applied. Sub-group analysis of women with polycystic ovaries according tothe presence or absence of features of polycystic ovary syndrome does not reveal an increasing trend forprogression of endocrine abnormalities usually associated with polycystic ovary syndrome.KEYWORDS: Polycystic Ovaries Syndrome (PCOS), Peshawar, Mardan, KPK