Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment

Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.

Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study

Objective: This study was intended to investigate the relationship between COVID-19 disease and ovarian function in reproductive-aged women.Methods: Female COVID-19 patients of reproductive age were recruited between January 28 and March 8, 2020 from Tongji Hospital in Wuhan. Their baseline and clinical characteristics, as well as menstrual conditions, were recorded. Differentials in ovarian reserve markers and sex hormones (including anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], the ratio of FSH to luteinizing hormone [LH], estradiol [E2], progesterone [P], testosterone [T], and prolactin [PRL] were compared to those of healthy women who were randomly selected and individually matched for age, region, and menstrual status. Uni- and multi-variable hierarchical linear regression analyses were performed to identify risk factors associated with ovarian function in COVID-19 women.Results: Seventy eight patients agreed to be tested for serum hormone, of whom 17 (21.79%) were diagnosed as the severe group and 39 (50%) were in the basal level group. Menstrual status (P = 0.55), menstrual volumes (P = 0.066), phase of menstrual cycle (P = 0.58), and dysmenorrhea history (P = 0.12) were similar without significant differences between non-severe and severe COVID-19 women. Significant lower serum AMH level/proportion (0.19/0.28 vs. 1.12 ng/ml, P = 0.003/0.027; AMH ≤ 1.1 ng/ml: 75/70.4 vs. 49.7%, P = 0.009/0.004), higher serum T (0.38/0.39 vs. 0.22 ng/ml, P &lt; 0.001/0.001) and PRL (25.43/24.10 vs. 12.12 ng/ml, P &lt; 0.001/0.001) levels were observed in basal level and the all-COVID-19 group compared with healthy age-matched control. When adjusted for age, menstrual status and parity variations in multivariate hierarchical linear regression analysis, COVID-19 disease was significantly associated with serum AMH (β = −0.191; 95% CI: −1.177–0.327; P = 0.001), T (β = 0.411; 95% CI: 11.154–22.709; P &lt; 0.001), and PRL (β = 0.497; 95% CI: 10.787–20.266; P &lt; 0.001), suggesting an independent risk factor for ovarian function, which accounted for 3.2% of the decline in AMH, 14.3% of the increase in T, and 20.7% of the increase in PRL.Conclusion: Ovarian injury, including declined ovarian reserve and reproductive endocrine disorder, can be observed in women with COVID-19. More attention should be paid to their ovarian function under this pandemic, especially regarding reproductive-aged women.Clinical Trial Number: ChiCTR2000030015.

Determinants of Anemia among Early Adolescent Girls in Kendari City

Background: Adolescent girls' anemia is a public health challenge. Anemia has an impact on cognitive abilities to reduce intelligence and results in adolescent achievement is down.Objective: The purpose of this study was to analyze the determinants of anemia in early adolescent girls in Kendari City.Methods: This study used a cross-sectional design with a sample of 97 students. Data on parental characteristics, breakfast habits, nutritional status, menstrual status, and history of infectious diseases were collected by interview using a questionnaire. Data on nutrient intake (iron, protein, vitamin C) obtained through the 2x24 hour recall method then compared to the Indonesian standard (AKG). Hemoglobin level was measured using the EasyTouch heamoglobin meter device. Data analysis was done by chi-square analysis and multiple logistic regression analysis.Results: The results showed 28.9% of adolescent girls had anemia. The results of chi-square analysis obtained that there was a relationship between the incidence of anemia on mother's education (p=0.010,), parental income (p=0.017), iron intake (p=0,000), protein intake (p=0,000), vitamin C intake (p=0.023), breakfast habits (p=0.006), menstrual status (p=0.007) and history of infection diseases (p=0,000). While the results of multiple logistic regression analysis obtained that there was a relationship between iron intake (p=0.005,OR=3.009), protein intake (p=0.007,OR=2.012), vitamin C intake (p=0.038,OR=1.167), menstrual status (p=0.002,OR=3.181) with anemia.Conclusion: The dominant determinant of anemia in early adolescent girls in Kendari City is menstrual status. It is recommended to intervene in risk factors (mother's education, parental income, iron intake, protein, vitamin C, breakfast habits, menstrual status and history of infectious disease) to reduce the prevalence of anemia among adolescent girls.

The Effect of Feeding Date Palm Fruit (Phoeix dactylifera L.) on Energy, Macronutrient, and Fiber Intakes of a Convenient Sample of Females

Background : Female menstrual changes in hormone concentration influence appetite and eating behavior. As well, eating pattern has some influences on menstrual hormonal status. Feeding date palm fruit has been found in our previous report to affect menstrual hormones and some menstrual parameters. Objective: The aim of this research is to study the effect of feeding dates on energy, macronutrient, and fiber intakes, body weight, and body fat%. Additionally, this study aims to find any correlation between menstrual hormone concentration and the above-mentioned parameters. Methods: A convenient sample (n=37) of not-sexually active females aged 20-30 were divided into two groups; one group (dates group) was fed 7 dates and the other served as a control group. The participants of the control group were exposed to the same experimental conditions except for eating dates. Throughout the feeding trial, the volunteers filled a 3-day food record; one menses day and two non-menses days. Results: There was a significant effect of the menstrual status-feeding duration interaction in terms of protein and fat intakes. Additionally, menstrual status, as well as feeding duration, affected energy and macronutrient intakes significantly. Furthermore, feeding duration affected fiber intake significantly. Despite the above-mentioned differences in energy and macronutrient intakes, these effects didn’t affect the body weight and body mass index of the study participants, neither their body fat%. Moreover, we have found significant correlations between nutrient intakes and menstrual hormone concentration. Conclusion : Feeding dates affected energy, macronutrient, and fiber intakes significantly. These effects were related to the changes in menstrual hormone concentration.

Potential Influence of Menstrual Status and Sex Hormones on Female Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Cross-sectional Multicenter Study in Wuhan, China

Background Recent studies have indicated that females with coronavirus disease 2019 (COVID-19) have a lower morbidity, severe case rate, and mortality and better outcome than those of male individuals. However, the reasons remained to be addressed. Methods To find the factors that potentially protect females from COVID-19, we recruited all confirmed patients hospitalized at 3 branches of Tongji Hospital (N = 1902), and analyzed the correlation between menstrual status (n = 509, including 68 from Mobile Cabin Hospital), female hormones (n = 78), and cytokines related to immunity and inflammation (n = 263), and the severity/clinical outcomes in female patients &lt;60 years of age. Results Nonmenopausal female patients had milder severity and better outcome compared with age-matched men (P &lt; .01 for both). Menopausal patients had longer hospitalization times than nonmenopausal patients (hazard ratio [HR], 1.91 [95% confidence interval {CI}, 1.06–3.46]; P = .033). Both anti-Müllerian hormone (AMH) and estradiol (E2) showed a negative correlation with severity of infection (adjusted HR, 0.146 [95% CI, .026–.824], P = .029 and 0.304 [95% CI, .092–1.001], P = .05, respectively). E2 levels were negatively correlated with interleukin (IL) 2R, IL-6, IL-8, and tumor necrosis factor alpha in the luteal phase (P = .033, P = .048, P = .054, and P = .023) and C3 in the follicular phase (P = .030). Conclusions Menopause is an independent risk factor for female COVID-19 patients. AMH and E2 are potential protective factors, negatively correlated with COVID-19 severity, among which E2 is attributed to its regulation of cytokines related to immunity and inflammation.

Influence of menstrual status and pathological type on the apparent diffusion coefficient in cervical cancer: a primary study

Background Apparent diffusion coefficient (ADC) value is an important quantitative parameter in the research of cervical cancer, affected by some factors. Purpose To investigate the effect of pathological type and menstrual status on the ADC value of cervical cancer. Material and Methods A total of 352 individuals with pathologically confirmed cervical cancer between January 2015 to December 2017 were retrospectively enrolled in this study, including 317 cases with squamous cell carcinomas (SCC) and 35 cases with adenocarcinomas (AC); 177 patients were non-menopausal and 175 were menopausal. All patients underwent a routine 3.0-T magnetic resonance imaging (MRI) scan and diffusion-weighted imaging (DWI) examination using b-values of 0, 800, and 1000 s/mm2. Three parameters including mean ADC (ADCmean), maximum ADC (ADCmax), and minimum ADC (ADCmin) of cervical cancer lesions were measured and retrospectively analyzed. Independent samples t-test was used to compare the difference of ADC values in different menstrual status and pathological types. Results In all menopausal and non-menopausal patients, the ADCmean and ADCmin values of SCC were lower than those of AC ( P<0.05), the ADCmax of two pathological types showed no statistical difference ( P > 0.05). In menopausal patients, the ADCmean, ADCmax, and ADCmin values of SCC were not statistically different compared with those of AC ( P > 0.05). The ADCmean, ADCmax, and ADCmin values of different pathological types cervical cancers in non-menopausal patients were all higher than those in menopausal patients ( P<0.05). Conclusion The ADC values of the cervical cancers were different in different pathological types and were also affected by menstrual status.