Treatment Of Women Research Articles

Lifestyle Interventions for Polycystic Ovary Syndrome: Cross-Sectional Survey to Assess Women's Treatment and Outcome Preferences.

BackgroundPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Diet and lifestyle programs improve health, but women’s preferences for these programs have not been formally explored.ObjectiveThe aim of our study was to examine diet and lifestyle program preferences among women with PCOS.MethodsWe conducted a cross-sectional online survey of women with PCOS.ResultsAt least half of the 197 respondents expressed strong interest in programs addressing energy level, anxiety, depression, weight, diabetes prevention, menstrual period regulation, and hirsutism. Similarly, at least half reported willingness to modify their sleep, stress, and physical activity; and slightly less than half reported willingness to adopt a very low-carbohydrate, paleo, or low–glycemic index diet. At least half reported interest in online or mobile programs and email-based mentoring. Younger age was associated with interest in help with acne and fertility; higher body mass index was associated with wanting help with weight loss, energy, and anxiety; and greater stress eating was associated with wanting help with depression, anxiety, and menstrual period regulation.ConclusionsTo our knowledge, this is the first study to examine attitudes and preferences of women with PCOS toward such programs. Future online and mobile diet and lifestyle programs may be able to capitalize on this information to better target this population’s expressed preferences.

Oral fluid intake during the first stage of labour: A randomised trial.

Obstetric anaesthesia has been associated with concern for the inhalation of gastric contents for many years, justifying fasting during labour. However, many anaesthesiologists and obstetricians now allow fluid intake during labour. We hypothesised that allowing oral fluid intake during labour is not associated with increased gastric contents. We used ultrasound assessment of gastric contents to evaluate this hypothesis. A randomised, single-blind and intention-to-treat noninferiority trial comparing antral area measured by ultrasound in fasting parturients and in those who were allowed to drink fluid for 90 min after randomisation. Tenon University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France. Pregnant women, aged from 18 to 40 years and from week 36 of an uncomplicated singleton gestation, were randomised into a fasting group and a fluid intake group after admission to the delivery room. Of the 184 patients screened, data from 125 were analysed: fasting group (62), fluid intake group (63). Women in the fluid intake group were allowed to drink up to 400 ml of apple juice for 90 min after randomisation. We compared the percentage of women with an 'empty stomach' between the two groups: empty stomach was defined as an antral cross-sectional area (CSA) less than 300 mm assessed in a semirecumbent position with a 45-degree head-up tilt. At full cervical dilatation an antral CSA less than 300 mm was measured in 76 and 79% of the parturients in the fasting group and the fluid intake groups respectively (P = 0.633). The current study reveals that the percentage of pregnant women with an 'empty stomach', defined by an antral CSA less than 300 mm in a semirecumbent position with a 45-degree head-up tilt, was comparable at full cervical dilation among those who remained nil by mouth and those allowed to drink up to 400 ml for 90 min after their randomisation. Clinicaltrials.gov identifier: NCT02362815.

Familial Influences on Treatment and Substance Use Among Mothers Engaged in Prostitution

ObjectivesThis study explores how the family system, which includes family members, romantic partners, and children, influences substance use treatment decisions and behaviors among women engaged in street‐level prostitution.BackgroundWomen engaged in street‐level prostitution can be involved in and benefit from substance use treatment; however, these women report worse treatment outcomes compared with other treatment‐seeking women. Little is known about systemic influences on women's substance use treatment, which may contribute to poor treatment outcomes.MethodsWomen (n = 15) between the ages of 20 and 53 years participated in qualitative interviews exploring their perceptions of how their family system influenced substance use treatment decisions and behaviors. Inductive content analysis was used to analyze data and identify themes within participant responses.ResultsWomen reported on multiple shared experiences of how family members, romantic partners, and children directly and indirectly influenced their substance use treatment decisions and behaviors.ConclusionsIntervention efforts that engage supportive family members and children in women's treatment or support women's positive interactions with family are likely to provide unique advantages compared with individual treatment.ImplicationsProviders serving these uniquely vulnerable women should consider their family systems' influence when conceptualizing and intervening, in an effort to promote better long‐term treatment outcomes.

Mobile-Based Lifestyle Intervention in Women with Glucose Intolerance after Gestational Diabetes Mellitus (MELINDA), A Multicenter Randomized Controlled Trial: Methodology and Design.

The aims of the ‘Mobile-based lifestyle intervention in women with glucose intolerance after gestational diabetes mellitus (GDM)’ study (MELINDA) are: (1) to evaluate the prevalence and risk factors of glucose intolerance after a recent history of GDM; and (2) to evaluate the efficacy and feasibility of a telephone- and mobile-based lifestyle intervention in women with glucose intolerance after GDM. This is a Belgian multicenter randomized controlled trial (RCT) in seven hospitals with the aim of recruiting 236 women. Women in the intervention group will receive a blended program, based on one face-to-face education session and further follow-up through a mobile application and monthly telephone advice. Women in the control group will receive follow-up as in normal routine with referral to primary care. Participants will receive an oral glucose tolerance test (OGTT) one year after baseline. Primary endpoint is the frequency of weight goal achievement (≥5% weight loss if pre-pregnancy BMI ≥ 25 Kg/m2 or return to pre-gravid weight if BMI < 25 Kg/m2). At each visit blood samples are collected, anthropometric measurements are obtained, and self-administered questionnaires are completed. Recruitment began in May 2019.

Interventions commonly available during pandemics for heavy menstrual bleeding: an overview of Cochrane Reviews.

Within the context of heavy menstrual bleeding, pandemics impact upon women's assessment and treatment by healthcare providers. To summarise the evidence from Cochrane Reviews evaluating interventions for heavy menstrual bleeding that are commonly available during pandemics. We sought published Cochrane Reviews, evaluating interventions that can continue during pandemics for women with heavy menstrual bleeding with no known underlying cause. We identified Cochrane Reviews by searching the Cochrane Database of Systematic Reviews in June 2020. The primary outcome was menstrual bleeding. Secondary outcomes included quality of life, patient satisfaction, side effects, and serious adverse events. We undertook the selection of systematic reviews, data extraction, and quality assessment in duplicate. We resolved any disagreements by discussion. We assessed review quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool, and the certainty of the evidence for each outcome using GRADE methods. We included four Cochrane Reviews, with 11 comparisons, data from 44 randomised controlled trials (RCTs), and 3196 women. We assessed all the reviews to be high quality. Non-steroidal anti-inflammatory drugs (NSAIDs) NSAIDs may be more effective in reducing heavy menstrual bleeding than placebo (mean difference (MD) -124 mL per cycle, 95% confidence interval (CI) -186 to -62 mL per cycle; 1 RCT, 11 women; low-certainty evidence). Mefenamic acid may be similar to naproxen (MD 21 mL per cycle, 95% CI -6 to 48 mL per cycle; 2 RCTs, 61 women; low-certainty evidence), and NSAIDs may be similar to combined hormonal contraceptives for heavy menstrual bleeding (MD 25 mL per cycle, 95% CI -22 to 73 mL per cycle; 1 RCT, 26 women; low-certainty evidence). NSAIDs may be be less effective in reducing menstrual bleeding than antifibrinolytics (relative risk (RR) 0.70, 95% CI 0.58 to 0.85; 2 RCTs, 161 women; low-certainty evidence). We are uncertain whether NSAIDs reduce menstrual blood loss more than short-cycle progestogens (RR 0.80, 95% CI 0.49 to 1.32; 1 RCT 32 women; very low-certainty evidence). Antifibrinolytics Antifibrinolytics appear to be more effective in reducing heavy menstrual bleeding than placebo (MD -53 mL per cycle, 95% CI -63 to -44 mL per cycle; 4 RCTs, 565 women; moderate-certainty evidence). Antifibrinolytics may be similar to placebo on the incidence of side effects (RR 1.05, 95% CI 0.93 to 1.18; 1 RCT, 297 women; low-certainty evidence), and they are probably similar on the incidence of serious adverse events (thrombotic events; RR 0.10, 95% CI 0.00 to 2.46; 2 RCT, 468 women; moderate-certainty evidence). Antifibrinolytics may be more effective in reducing heavy menstrual bleeding than short-cycle progestogen (MD -111 mL per cycle, 95% CI -178 mL to -44 mL per cycle; 1 RCT, 46 women; low-certainty evidence). We are uncertain whether antifibrinolytics are similar to short-cycle progestogens on quality of life (RR 1.67, 95% CI 0.76 to 3.64; 1 RCT, 44 women; very low-certainty evidence), patient satisfaction (RR 0.91, 95% CI 0.59 to 1.39; 1 RCT, 42 women; very low-certainty evidence), or side effects (RR 0.85, 95% CI 0.65 to 1.12; 3 RCTs, 211 women; very low-certainty evidence). We are uncertain whether antifibrinolytics are more effective in reducing heavy menstrual bleeding when compared with long-cycle progestogen (MD -9 points per cycle, 95% CI -30 to 12 points per cycle; 2 RCTs, 184 women; low-certainty evidence). Antifibrinolytics may increase self-reported improvement in menstrual bleeding when compared with long-cycle medroxyprogesterone acetate (RR 1.32, 95% CI 1.08 to 1.61; 1 RCT, 94 women; low-certainty evidence). Antifibrinolytics may be similar to long-cycle progestogens on quality of life (MD 5, 95% CI -2.49 to 12.49; 1 RCT, 90 women; low-certainty evidence). We are uncertain whether antifibrinolytics are similar to long-cycle progestogens on side effects (RR 0.58, 95% CI 0.33 to 1.00; 2 RCTs, 184 women; very low-certainty evidence). There were no trials comparing antifibrinolytics to combined hormonal contraceptives. Combined hormonal contraceptives Combined hormonal contraceptives appear to be more effective for heavy menstrual bleeding than placebo or no treatment (RR 13.25, 95% CI 2.94 to 59.64; 2 RCTs, 363 women; moderate-certainty evidence). Combined hormonal contraceptives are probably similar to placebo on the incidence of side effects (RR 1.53, 95% CI 0.90 to 2.60; 2 RCTs, 411 women; moderate-certainty evidence). Progestogens There were no trials comparing progestogens to placebo. Limitations in the evidence included risk of bias in the primary RCTs, inconsistency between the primary RCTs, and imprecision in effect estimates. There is moderate-certainty evidence that antifibrinolytics and combined hormonal contraceptives reduce heavy menstrual bleeding compared with placebo. There is low-certainty evidence that NSAIDs reduce heavy menstrual bleeding compared with placebo. There is low-certainty evidence that antifibrinolytics are more effective in reducing heavy menstrual bleeding when compared with NSAIDs and short-cycle progestogens, but we are unable to draw conclusions about the effects of antifibrinolytics compared to long-cycle progestogens, on low-certainty evidence.

Efficacy of a High-Iron Dietary Intervention in Women with Celiac Disease and Iron Deficiency without Anemia: A Clinical Trial.

Background and Aim. Iron deficiency without anemia (IDWA) is a common finding in celiac disease (CD) and can also persist in case of good compliance and clinical response to a strict gluten-free diet (GFD). This scenario usually presents in CD women of child-bearing age in whom the imbalance between menstrual iron loss and inadequate iron intake from their diet plays the major role. A recommended approach to this condition is yet to be established. This study aimed to compare, in this subset of patients, the efficacy of a dietary approach consisting of an iron-rich diet against the traditional pharmacological oral-replacement therapy. Material and Methods. Between February and December 2016, consecutive CD female patients of child-bearing age as referred to our outpatient center with evidence of IDWA (ferritin <15 ng/mL or 15–20 ng/L with transferrin saturation <15%) were enrolled. After the completion of a 7-day weighed food intake recording to assess the usual iron dietary intake, the patients were randomized in two arms to receive a 12-week iron-rich diet (iron intake >20 mg/die) versus oral iron supplementation with ferrous sulfate (FS) (105 mg/day). Blood tests and dietary assessments were repeated at the end of treatment. The degree of compliance and tolerability to the treatments were assessed every month by means of specific questionnaires and symptoms evaluation. Results. A total of 22 women were enrolled and divided in the diet group (n = 10, age 37 ± 8 years) and in the FS group (n = 12, age 38 ± 10 years). The food intake records demonstrated an inadequate daily intake of iron in all the enrolled subjects. At the end of the treatments, ferritin levels were higher in the FS group (8.5 (5) versus 34 (30.8), p = 0.002). Compliance and tolerability were similar in both treatment groups (89% versus 87%, p = ns). Conclusions. These findings did not support any equivalent efficacy of an iron-rich diet compared to a FS supplementation in non-anemic iron-deficient women affected by CD. However, the diet appeared a well-tolerated approach, and adequate dietary instructions could effectively increase the daily iron consumption, suggesting a role in the long-term management of IDWA, especially in patients who do not tolerate pharmacological supplementation.

Educational Interventions for Women based on the Behavioral model/theory concerning Cervical Cancer: A Systematic Review

&#x0D; &#x0D; &#x0D; &#x0D; Introduction: Cervical cancer is the second most prevalent cancer worldwide among women and is also the second primary cause of cancer-induced mortalities among women at a global scale. The most effective educational programs are based on theoretical approaches derived from behavior change models. The present systematic review aimed to explore and identify the body of research with educational interventions based on a particular behavioral or cognitive model of cervical cancer. Methods: A number of keywords were search in the following databases: PubMed, Web of Science, Science Direct, Google Scholar, Embase, Scopus, Biomedcentral, IranMedex, SID and Magiran. These keywords were: Cervix cancer, uterine cervical neoplasms, screening, prevention and control, Papaniocolaou Test, Pap test, Pap smear, education, intervention, cervical cancer, theory and model, behavior model. The search time span was restricted to 2005 to 2020. Results: From among all the published academic papers with educational interventions, finally 22 papers were selected based on a particular theory or model. Among these papers, those based on the health belief model outnumbered the rest concerning cervical cancer. The Transtheoretical Model (TTM) model was the second most prevalent model adopted in the theory-based educational interventions. Conclusions: Educational interventions based on the behavioral theory or model showed to be effective on the target group concerning screening (secondary behavior) for cervical cancer. To further increase the effectiveness of the educational interventions, there is a need for a combination of new methods and theory-laden education to enhance the primary preventive behaviors of cervical cancer.&#x0D; &#x0D; &#x0D; &#x0D;

Treatment Choices in a National Cohort of Canadian Women With Symptomatic Uterine Fibroids.

To describe treatment choices made at the time of enrollment in CAPTURE, a Canadian patient registry for women with symptomatic uterine fibroids (UFs), and to define demographic and clinical characteristics that independently predict these choices. Women arranging appointments for UF care were eligible to enrol. At the time of the enrollment visit, women's self-reported treatment histories were noted, along with their clinical characteristics. Tretment options were discussed and chosen during that visit. Patients could choose medical and/or surgical treatment, or they could opt for no active treatment (i.e., "watchful waiting"); treatment decisions were not binding. The most common medication proposed and chosen was ulipristal acetate (UPA), and the most common procedure was myomectomy. These treatments were also the most commonly identified in patients' histories. Medication alone and medication in combination with surgery were the most common treatment approaches chosen (46% and 26%, respectively). Surgery alone and watchful waiting were chosen by 14% and 13% of patients, respectively. Significant predictors of active treatment included patient pregnancy plans, overall symptom severity, and prior treatment history (medical and surgical). Other parameters, including patient age and history of specific UF symptoms, appear to influence the choice of medical therapies (UPA, gonadotropin-releasing hormone agonists, or other options) and procedures (myomectomy or hysterectomy). This real-world study documents the patient factors associated with the treatment decisions of women seeking care for symptomatic UFs in contemporary Canadian gynaecology practice. Subsequent analyses will follow the outcomes of these treatments over two years in this population.

Comparison of Saffron versus Fluoxetine in Treatment of Women with Premenstrual Syndrome: A Randomized Clinical Trial Study

Background: Premenstrual syndrome (PMS) is a set of physical and psychological symptoms such as mood disability, breast tenderness, food craving, fatigue, and depression. Fluoxetine and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) usually are being administered for these patients. This study aimed to evaluate the effect of saffron plant in terms of its anti-inflammatory and anti-depressant effects compared to fluoxetine. Materials and Method: This study was a three-blind clinical trial that was carried out on working women and their relatives. Firstly, 164 patients with the premenstrual syndrome were selected, and they were randomly divided into two 82-person groups, including those who received fluoxetine and those who received saffron. Next, both groups were treated for two months. The data were collected in two stages through a self-designed questionnaire (on day 5 of menstrual cycle) and validated questionnaires of PRISM and Beck at the end of the period. Results: It was indicated that similar to fluoxetine, the use of saffron in PMS reduced the symptoms such as abdominal bloating, depression, and mood swing, but the latter could better relieve the breast and abdominal pain than fluoxetine. Conclusion: It was concluded that the use of medicinal herbs such as saffron could be effective in reducing the symptoms and they might cause fewer side effects than chemical drugs.

Patient Characteristics and Treatments for Women With Moderately Severe Fecal Incontinence [36F

INTRODUCTION: Surgical treatments, such as sphincteroplasty or sacral neuromodulation, are available for fecal incontinence (FI). There has been increasing attention on the progress to surgical treatment for overactive bladder, but little is known about the progress towards this therapy for FI. METHODS: This was a retrospective chart review of all new patients presenting to an academic Urogynecology clinic with Wexner Incontinence Scale scores of 11-14 (equivalent to moderately severe FI). Demographics, prior treatments, and how long it took for patients to proceed to definitive treatment were collected. Our prior work described women with severe FI (Wexner score 15–20). With this study we sought to describe women with moderately severe FI and compare moderate to severe FI groups. RESULTS: From January 2014 to July 2017, 158 new patients with a Wexner score of 11-14 were seen in clinic. The mean age was 62.5 +/-12 years. The majority (n=117, 77%) had never had any treatment for FI. The most common treatment plan at the first visit was fiber and dietary modifications (n=59, 38%). Only 3 patients went on to surgical treatment. There were no significant differences between those with moderate versus severe FI in how many ultimate progressed to surgical therapy (3 versus 6) or the number of clinic visits until that decision was made (2 versus 3), all p&gt;.05. CONCLUSION: Very few patients progress to surgical treatment despite at least moderately severe FI. Further work is needed to facilitate timely delivery of definitive care for this patient population.

Understanding Women's Treatment Preferences for Pelvic Floor Disorders [40F

INTRODUCTION: One in four women 20-years and older have at least one pelvic floor disorder (PFD). Studies show there is a lack of awareness and incorrect perception of PFDs among women of all ages. These factors may affect how women treat PFDs. Therefore, this study assessed women of different ages and risk levels knowledge, attitudes, and behaviors around PFDs to understand treatment decisions. METHODS: Researchers sought and gained informed consent from women of varying ages, ethnicities, and risk levels to participate in qualitative one-on-one interviews (n=20) and a focus group (n=6). After data collection, the participants' data were split into four groups for thematic analysis: women under 50 without PFD (n=12), women under 50 with PFD (n=3), women 50 or over without PFD (n=2), and women 50 or over with PFD (n=9). RESULTS: Age and risk level were not variables in participants’ treatment decisions. The majority of participants were not aware PFDs are a medical issue; they were more likely to say that they wouldn’t seek treatment from physicians, instead saying they would just wear pads or do Kegels. Once participants were made aware of PFDs being a legitimate medical issue, factors like time, income, convenience/ease of use, and perceived efficacy were cited as prefaces to treatment. Generally, noninvasive measures were the first choice of women of each category. Four out of five women who had a PFD-related surgery regretted it. CONCLUSION: Women of all categories need to be better informed of PFDs by their gynecologists in order to make more informed treatment decisions.

Feasibility of Frailty Assessment and Implementation of Interventions in Women Over 70 With Epithelial Ovarian Cancer

Feasibility of Frailty Assessment and Implementation of Interventions in Women Over 70 With Epithelial Ovarian Cancer

LCCC1931:Post-treatment Intervention in Women With Breast Cancer (70y/o+)

LCCC1931:Post-treatment Intervention in Women With Breast Cancer (70y/o+)

Sexual and Reproductive Health Characteristics of Women in Substance Use Treatment in Michigan.

To evaluate the sexual and reproductive health characteristics of women in treatment for opioid use disorder in Michigan and explore services provided and desired. We conducted a cross-sectional study of female patients aged 18-50 years who accessed opioid use disorder treatment at 22 randomly selected facilities in Michigan from December 2015 to May 2017. Computer-assisted self-interviews were completed using online survey management software to assess prior substance use and use disorder treatment, sexual and reproductive health history, and sexual and reproductive health services received in the previous 12 months through a treatment program, and desire for and barriers to sexual and reproductive health services within substance use disorder treatment. Descriptive statistics were calculated. The final sample consisted of 260 participants. About half (51.5%) had ever had an abnormal Pap test result, and 57.3% had ever tested positive for a sexually transmitted infection. Unintended pregnancy was common (61.2%), as was substance use during pregnancy (74.2%). Nearly half (46.5%) were not currently using a method of contraception, and only 28.5% were using a highly effective method. Common barriers to accessing reproductive health services included fear of being treated poorly or judged because of substance use, fear of child protective services, and structural barriers such as cost and lack of transportation. Most participants (80.4%) indicated interest in receiving sexual and reproductive health services on site or by referral from their substance use disorder treatment programs. Women in treatment for opioid use disorder in Michigan have high rates of adverse sexual and reproductive health experiences and face barriers to accessing care.

Feasibility and Health Benefits of an Individualized Physical Activity Intervention in Women With Metastatic Breast Cancer: Intervention Study.

BackgroundThere is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer.ObjectiveThe Advanced stage Breast cancer and Lifestyle Exercise (ABLE) Trial aimed to assess the feasibility of a physical activity intervention in women with metastatic breast cancer and to explore the effects of physical activity on functional, psychological, and clinical parameters.MethodsThe ABLE Trial was a single-arm, 6-month intervention study with a home-based, unsupervised, and personalized walking program using an activity tracker. At baseline and 6 months, we assessed anthropometrics, functional fitness, physical activity level, sedentary behavior, quality of life, fatigue, and tumor progression. Paired proportions were compared using the McNemar test and changes of parameters during the intervention were analyzed using the Wilcoxon signed-rank test, the Mann-Whitney test, and Spearman rank correlations.ResultsOverall, 49 participants (mean age 55 years; recruitment rate 94%) were enrolled and 96% adhered to the exercise prescription (attrition rate 2%). Statistically significant improvements in the 6-minute walking distance test (+7%, P<.001) and isometric quadriceps strength (+22%, P<.001), as well as decreases in body mass index (-2.5%, P=.03) and hip circumference (-4.0%, P<.001) were observed at 6 months. Quality of life remained stable and a nonstatistically significant decrease (-16%, P=.07) in fatigue was observed.ConclusionsThe high recruitment and adherence rates suggest the willingness of patients with metastatic breast cancer to participate in a physical activity program. The beneficial outcomes regarding physical fitness and anthropometry of this unsupervised physical activity program may encourage these patients to maintain a physically active lifestyle. Future randomized controlled trials with larger sample sizes are warranted.Trial RegistrationClinicalTrials.gov NCT03148886; https://clinicaltrials.gov/ct2/show/NCT03148886

Peripheral CD56+CD16+ NK Cell Populations in the Early Follicular Phase Are Associated With Successful Clinical Outcomes of Intravenous Immunoglobulin Treatment in Women With Repeated Implantation Failure.

The percentage of peripheral CD56+CD16+ NK cells in the early follicular phase on days 2–3 of the menstrual cycle in repeated implantation failure (RIF) patients was used to evaluate the impact of intravenous immunoglobulin (IVIG) on ART cycles. A total 283 patients with RIF consisting of at least 3 ART failures and at least 2 high quality embryo transfers were recruited. A logistic regression analysis for the peripheral immunological profile was completed to predict implantation success and compare the implantation and pregnancy rates between groups with ≤10.6 and >10.6% of CD56+CD16+ NK cells in the early follicular phase. The logistic regression and receiving operating curve analyses showed that patients with ≤ 10.6% of peripheral CD56+CD16+ NK cells in the early follicular phase showed a lower pregnancy rate within the RIF group without IVIG. Patients with peripheral CD56+CD16+ NK cells ≤ 10.6% and without IVIG treatment showed significantly lower implantation and pregnancy rates (12.3 and 30.3%, respectively) when compared with the CD56+CD16+ NK cells >10.6% group (24.9 and 48.0%, respectively, p < 0.05). Furthermore, the patients with CD56+CD16+ NK cells ≤ 10.6% given IVIG starting before ET had significantly higher implantation, pregnancy, and live birth rates (27.5, 57.4, and 45.6%, respectively) when compared with the non-IVIG group (12.3, 30.3, and 22.7%, respectively, p < 0.05). Our results showed that a low percentage of peripheral CD56+CD16+ NK cells (≤10.6%) in the early follicular phase is a potential indicator of reduced pregnancy and implantation success rates in RIF patients, and IVIG treatment will likely benefit this patient subgroup.

The Impact of Traditional Medicine-Based Lifestyle and Diet on Infertility Treatment in Women Undergoing Assisted Reproduction: A Randomized Controlled Trial

The problem of infertility is growing rapidly in the world. Traditional medicine with thousands of years of history has claimed that it can treat some kinds of infertility using nutritional and lifestyle modifications and interventions. The purpose of this study was to evaluate the effect of a traditional medicine-oriented diet and lifestyle on infertility treatment. Based on a clinical trial study, 180 infertile women who were 20–40 years old and candidates for in vitro fertilization (IVF) were randomly assigned to 2 groups: an intervention group and a control group. The intervention group used diet and lifestyle recommendations based on Iranian traditional medicine for at least 3 months. The number of ova, mature ovum number, embryo number, embryo quality, and fertilization rate were significantly higher in the intervention group than in the control group (for all items; p < 0.05). Overall pregnancy rate was significantly higher in the intervention group (35.2 vs. 12.4%; odds ratio [OR], 3.8; 95% CI, 1.8–8.3). The intervention group had a higher rate of getting spontaneous pregnancy than the control group (20.9 vs. 2.2%; OR, 11.5; 95% CI, 2.6–50.9). Chemical pregnancy was significantly higher in the intervention group (64 vs. 27.5%; OR, 4.7; 95% CI, 1.9–11.6). Diet and lifestyle modifications based on traditional medicine can contribute greatly to the infertility treatment. Thus, many infertility cases can be treated without the need to use advanced methods. In case of using assisted reproductive techniques, traditional medicine can enhance the efficiency of these methods.

The Effectiveness of Psychological Treatments in Women with Breast Cancer: A Systematic Review and Meta-Analysis.

Breast cancer is the most prevalent oncological disease among women, and it represents the second oncological cause of death. Many studies have considered the quality of life in people with breast cancer because this condition has high comorbidity with mental distress, anxiety, affective disorders and depression. Psychological interventions can reduce the stressful consequences of both the diagnosis and the medical treatments of breast cancer. However, different methods (e.g., group or individual therapy) and focus (e.g., improving personal skills or increasing emotional well-being) do not help to identify which type of psychological therapy can be more effective in improving quality of life in patients with breast cancer. This study was aimed to systematically review and compare, by means of a meta-analysis, the efficacy of cognitive behavioural, supportive-expressive or psycho-educational treatments in women with breast cancer, focusing on anxiety, depression, mood and quality of life as outcomes. The PRISMA statement was adopted. MEDLINE, PsycINFO, PUBMED and PsycArticles databases were used, and reference lists were examined for additional publications. In the selection of the articles were included studies considering women between 18 and 65 years who were diagnosed with breast cancer at any stage and under any treatment, and who underwent psychological group interventions. At the end of the systematic review, 45 studies met all inclusion criteria and were analysed in the meta-analysis. The overall effect size was medium, especially considering cognitive behavioural therapy and psycho-educational treatments. However, the studies are characterised by high methodological heterogeneity. Despite some limitations, this review and meta-analysis partially confirm the efficiency of cognitive-behavioural and psycho-educational therapies in the improvement of well-being in women with breast cancer.

Dynamics of Changes in Isometric Strength and Muscle Imbalance in the Treatment of Women with Low back Pain.

The aim of the study was to evaluate the dynamics of isometric changes in strength and muscular lumbar-pelvic imbalances in the treatment of women with low back pain. Forty-one women, nineteen in the study group (A) and twenty-two in the control group (B), participated in the study. Magnetic resonance imaging (MRI) was performed to assess the degree of degenerative changes in the lumbar spine. The diagnosis of isometric muscle strength and their imbalances was performed with the Tergumed 700 device. After six weeks of therapy in the study group (A), there was a significant improvement in the strength of all the examined muscle groups. However, in the control group (B), significant improvement occurred only in the strength of the lumbar flexor muscles and the flexor muscles on the left side. Furthermore, there was a significant intensification of the imbalance of left flexor muscle strength compared to right flexor strength in group B. Significant differences in favour of the study group (A) concerned the strength of the rotator muscles to the left, the strength of the extensor muscles of the lumbar spine, the strength of the flexors of the lumbar spine to the right, and the balance of the strength of the lumbar spine flexors to the left compared to the strength of the flexor muscles to the right. Therapy with the Tergumed 700 system leads to an increase in the muscle strength of the lumbar and pelvic complex, compensating for its imbalance, bringing beneficial effects in the treatment of low back pain.

Effectiveness of Therapeutic Interventions for Women with Urinary Incontinence: A Systematic Review

Effectiveness of Therapeutic Interventions for Women with Urinary Incontinence: A Systematic Review