Bone Mineral Density is a Prognostic Factor for Postmenopausal Caucasian Women with Breast Cancer

Numerous studies have convincingly shown that women with low bone mineral density have lower risk of breast cancer. As many risk factors for breast cancer are also prognostic factors, we hypothesized that women with breast cancer and low bone mineral density will have lower breast cancer recurrence rates than women with normal bone densities. A prospectively collected data base of breast cancer patients was used to identify postmenopausal Caucasian women. Their records were reviewed and 309 patients with complete follow‐up and bone density tests within 1 year of their surgery were identified. The outcome of patients with low bone density (t > ?1.0) was compared to the outcome for patients with normal bone density (t < ?1.1). Among the 193 patients with invasive breast cancers and low bone density, distant disease‐free survival at 5 years was 96% compared to 84% for 114 patients with invasive breast cancers and normal bone density (p = 0.0239). Local disease‐free survival was 94% for low bone density patients compared to 86% for patients with normal bone densities (p = 0.0794). Bone mineral density is a significant prognostic factor for postmenopausal Caucasian women with breast cancer. Low bone mineral density is associated with a lower local and distant rate of recurrence.     

Effect of risedronate on speed of sound in postmenopausal women with osteoporosis

AIM: To examine the effects of treatment with risedronate for 1 year on speed of sound (SOS) of the calcaneus and bone turnover markers in postmenopausal women with osteoporosis.METHODS: Thirty-eight postmenopausal women with osteoporosis who had been treated with risedronate for > 1 year were enrolled in the study. The SOS and bone turnover markers were monitored during treatment with risedronate for 1 year.RESULTS: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase were significantly decreased at 3 mo (-34.7%) and 12 mo (-21.2%), respectively, compared with the baseline values. The SOS increased modestly, but significantly by 0.65% at 12 mo compared with the baseline value. Treatment with risedronate elicited an increase in the SOS of the calcaneus exceeding the coefficient of variation in vivo (0.27%).CONCLUSION: The present study confirmed that risedronate suppressed bone turnover and elicited a clinically significant increase in the SOS of the calcaneus in postmenopausal women with osteoporosis.     

Association between periodontitis and systemic bone mineral density in Japanese community-dwelling postmenopausal women

Objective

The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.

Subjects and methods

Subjects were 347 women aged 55–74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2–L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.

Results

Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore ≥ 1 groups in the Z value in lumbar vertebrate (106.9 ± 18.7 vs. 102.3 ± 1.0, p < 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = −1.039 ± 0.379, p = 0.007), femoral neck BMD (B = −1.332 ± 0.627, p = 0.034), and proximal femoral BMD (B = −1.329 ± 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.

Conclusion

A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study.     

绝经后妇女桡骨远端骨折术后桡骨短缩与骨密度的相关性研究

目的分析绝经后妇女的骨密度与桡骨远端骨折术后出现桡骨短缩的相关性。方法回顾性分析自2012-01—2014-06行手术治疗的252例绝经妇女桡骨远端骨折,术后均达到解剖复位或基本达到解剖复位,获得1年完整随访。将术后3个月桡骨短缩距离4 mm的患者纳入观察组,其余的按年龄、骨折类型及绝经时间进行1∶1个体匹配,纳入与观察组同样数量的病例进入对照组(术后3个月桡骨短缩距离4 mm)。术前、术后3个月及术后6个月用双能X线骨密度仪对2组健侧桡骨进行骨密度测量。结果观察组骨密度值:术前(0.69±0.14)g/cm2,术后3个月(0.67±0.12)g/cm~2,术后6个月(0.62±0.10)g/cm~2。对照组骨密度值:术前(0.79±0.15)g/cm~2,术后3个月(0.76±0.13)g/cm~2,术后6个月(0.71±0.10)g/cm~2。2组骨密度值随时间增加而降低,且观察组术前(F=7.588,P=0.008)、术后3个月(F=8.520,P=0.005)、术后6个月(F=11.203,P=0.001)骨密度值均低于对照组,差异有统计学意义(P0.05)。结论对于桡骨远端骨折患者术后出现桡骨短缩的原因,骨密度降低是一个不容忽略的重要因素,在术后应重视对低骨密度的患者采取相应措施。     

Fatigue,anxiety and depression overrule the role of oncological treatment in predicting self-reported health complaints in women with breast cancer compared to healthy controls

BackgroundWomen with breast cancer often attribute their health problems as side effects caused by oncological treatments. The aim of the study was to examine and compare self-reported health complaints (SHC) in postmenopausal patients with breast cancer to healthy controls.MethodWomen with breast cancer (N = 196) filled in 5 questionnaires 1–2 years after surgery; SHC Inventory, Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES), Fatigue – Functional Assessment of Cancer Therapy-Fatigue subscale (FACIT-F), Fatigue Visual Analog Scale (Fatigue VAS), and Hospital Anxiety and Depression Scale (HADS). Controls comprised 101 blood donors who reported on the questionnaires except for HADS. Bonferroni adjustment and p < 0.0017 was considered statistically significant for SHC Inventory, p < 0.05 for the remaining questionnaires.ResultsThe patients, mean age 58.0 (SD 9.5), reported significantly more self-reported health complaints, whereof 6 of 29 complaints were significantly elevated compared to the controls, mean age 57.0 (SD 5.8) (p < 0.001). HADS scores in patients fell into normal range, mean 6.3 (SD 5.7). A subgroup of 48 patients experienced more frequent and severe symptoms in all the questionnaires compared to the remaining 148 patients, and the 101 controls. Among the patients, fatigue, anxiety and depression explained 49% of the total variance in self-reported health complaints (p ≤ 0.001).ConclusionMost women with breast cancer (76%) reported health complaints equal to the healthy controls. Fatigue, anxiety and depression, not oncological treatments, were significant predictors for the complaints.     

绝经后子宫内膜良恶性病变经阴道多普勒超声与病理检查的诊断对比分析

目的：评价经阴道多普勒超声诊断绝经后子宫内膜良恶性病变的价值。方法回顾性分析2014年6月至2015年6月在我院住院治疗的86例经手术病理证实的绝经后子宫内膜病变患者的临床诊治资料,比较良、恶性病变患者内膜的厚度、子宫动脉血流参数及内膜内动脉血流参数,观察良、恶性病变患者的血流显像的差异。结果经阴道多普勒超声诊断子宫内膜病变与病理检查结果的符合率为89.53%,灵敏度为80.00%,特异度为91.55%;恶性病变组的内膜厚度为(11.31±2.52) mm,大于良性病变组的(8.62±1.91) mm,差异有统计学意义(P<0.05);恶性病变组的子宫动脉收缩期峰值流速(PSV)及阻力指数(RI)分别为(22.36±1.76) cm/s、(0.76±0.19),良性病变组分别为(21.81±1.62) cm/s、(0.83±0.25),组间比较差异均无统计学意义(P>0.05);就子宫内膜内动脉血流参数来看,恶性病变组和良性病变组的内膜动脉收缩期峰值流速(PSVen)分别为(13.29±0.68) cm/s、(13.25±0.72) cm/s,组间比较无统计学意义(P>0.05),而恶性病变组和良性病变组的内膜动脉收缩期阻力指数(RIen)及血流显示率分别为(0.37±0.06)、86.67%和(0.46±0.11)、23.94%,两组比较差异均有统计学意义(P<0.05)。结论经阴道多普勒超声在诊断绝经后子宫内膜良恶性病变方面具有较高的诊断符合率,对子宫内膜恶性病变的准确诊断有一定的应用价值,值得临床上广泛应用。     

130例绝经后骨质疏松症中医证型分布规律

目的:探索绝经后骨质疏松症的中医证型分布特征,为临床辨证提供参考。方法:制定绝经后骨质疏松症的中医证型调查表,按照纳入标准调查130例绝经后骨质疏松症患者,根据辨证标准进行辨证分型,采用SPSS 13.0软件进行中医证型的聚类分析。结果:130例绝经后骨质疏松症患者脏腑辨证以肾虚证最为常见。结论:肾主骨生髓,绝经后骨质疏松症临床以肾虚证最为常见,肾中精气不足失于养骨是骨质疏松发病的关键。     

Reproductive characteristics and risk of kidney cancer: Iowa Women's Health Study

Objectives

Kidney (renal cell) cancer accounts for approximately 3–4% of all new cases of primary cancer diagnosed in the United States. A relationship between kidney cancer and female reproductive factors has been hypothesized but supporting evidence is inconsistent. Our objectives were to explore the relationship between female reproductive factors and kidney cancer and identify independent risk factors related to female reproductive history and its effects on development of kidney cancer.

Methods

We measured risk factors for kidney cancer and reproductive characteristics in a group of 37,440 postmenopausal women in Iowa. From 1986 to 2003, 165 cases of incident kidney cancer were identified through a statewide cancer registry.

Results

After adjustment for age and other risk factors, past use of estrogen showed an increased risk of renal cancer (RR 1.56; 95% CI 1.13–2.17) when compared to no use. Women with no live birth (RR 1.91, p = 0.02) and women with three to four live births (RR 1.62, p = 0.02) also had an increased risk of kidney cancer when compared with women who had one to two live births. There was also a lower risk of kidney cancer with greater lifetime duration of ovulation.

Conclusion

Although most reproductive variables were not significantly associated with kidney cancer, our study indicates that a greater exposure to estrogens may increase risk for kidney cancer.     

Exercise self-efficacy of postmenopausal women resident in the tropics

OBJECTIVES: Weight gain and the associated increased risk of coronary artery disease are associated with the postmenopausal period. However, moderate intensity physical activity may be cardioprotective in this period. Australian women remain predominately sedentary despite the health benefits of regular exercise. Self-efficacy is an important predictor of exercise behaviour influencing exercise adoption when faced with potential barriers. Determination of exercise self-efficacy levels and the most significant barriers to exercise is necessary for the success of intervention programs for this population. METHODS: Postmenopausal women (N=101) resident in tropical North Queensland were recruited via announcements in local media, service club newsletters and electronic bulletin boards. Following data collection, participants were categorised as exercisers (n=53) or non-exercisers (n=48) based on whether they had performed a minimum of 150 min of accumulated moderate intensity exercise in the past 7 days. Exercise self-efficacy was determined via questionnaire. RESULTS: Results indicated that exercisers had a higher level of exercise self-efficacy and felt significantly more confident to exercise when faced with barriers compared to non-exercisers (p<.001). Discriminant function analysis found that exercise self-efficacy provided the greatest discrimination between exercisers and non-exercisers. The barrier items of conflicting schedules, difficulty getting to an exercise location and the weather were the main contributors to discrimination between exercisers and non-exercisers. CONCLUSIONS: Findings suggest that future intervention programs should aim to increase exercise self-efficacy and address these barriers so that more postmenopausal women resident in North Queensland can obtain the health benefits of exercise.