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Archives of Gynecology and Obstetrics May 2024To evaluate clinical characteristics, quality of life (QoL) and effectiveness in patients with menstrual cycle disorders (MCDs) including abnormal uterine bleeding,...
PURPOSE
To evaluate clinical characteristics, quality of life (QoL) and effectiveness in patients with menstrual cycle disorders (MCDs) including abnormal uterine bleeding, dysmenorrhea and mastodynia/mastalgia related to premenstrual syndrome taking the Vitex agnus-castus (VAC) products Cyclodynon® or Mastodynon® in a real-world setting.
METHODS
A single-center retrospective longitudinal cohort study (3 ± 1 months), using data obtained from healthcare data archive and telephone interviews. The main study variables were changes in bleeding, menstrual pain, breast tenderness and patients' QoL.
RESULTS
Data from 1700 women with a mean age of 30.2 years (± 6.3) were analyzed. The most common MCDs were dysmenorrhea (43.8%) and mastodynia/mastalgia (21.1%). Three-month treatment with VAC extract substantially decreased the percentage of patients with irregular cycle (from 9.1% to 0.1%) and breast tenderness (from 39.9% to 0.8%). Improvement in bleeding intensity, frequency and menstrual pain was experienced by 83.4%, 79.2%, and 85.2% of the patients, respectively. When analyzed by disease category, these parameters improved in almost all dysmenorrhea patients, while they improved to a lesser extent in mastodynia/mastalgia patients. QoL improved in all aspects, but was reported by a higher proportion of dysmenorrhea patients compared to mastodynia/mastalgia patients. Treatment was overall well tolerated with a favorable safety profile.
CONCLUSION
These real-world data demonstrate the effectiveness of the VAC-containing products Cyclodynon® and Mastodynon® in the three-month treatment of MCDs, with a pronounced improvement in key disease symptoms and QoL. Intriguingly, while QoL was generally greatly improved, the response to VAC therapy varied depending on the type of underlying MCD.
Topics: Humans; Female; Adult; Mastodynia; Dysmenorrhea; Vitex; Quality of Life; Longitudinal Studies; Retrospective Studies; Menstruation Disturbances; Menstrual Cycle
PubMed: 38393671
DOI: 10.1007/s00404-023-07363-4 -
Journal of the American College of... Oct 2023Despite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT...
OBJECTIVE
Despite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT (Generative Pre-trained Transformer)-3.5 and GPT-4's (OpenAI, San Francisco, California) capacity for clinical decision support in radiology via the identification of appropriate imaging services for two important clinical presentations: breast cancer screening and breast pain.
METHODS
We compared ChatGPT's responses to the ACR Appropriateness Criteria for breast pain and breast cancer screening. Our prompt formats included an open-ended (OE) and a select all that apply (SATA) format. Scoring criteria evaluated whether proposed imaging modalities were in accordance with ACR guidelines. Three replicate entries were conducted for each prompt, and the average of these was used to determine final scores.
RESULTS
Both ChatGPT-3.5 and ChatGPT-4 achieved an average OE score of 1.830 (out of 2) for breast cancer screening prompts. ChatGPT-3.5 achieved a SATA average percentage correct of 88.9%, compared with ChatGPT-4's average percentage correct of 98.4% for breast cancer screening prompts. For breast pain, ChatGPT-3.5 achieved an average OE score of 1.125 (out of 2) and a SATA average percentage correct of 58.3%, as compared with an average OE score of 1.666 (out of 2) and a SATA average percentage correct of 77.7%.
DISCUSSION
Our results demonstrate the eventual feasibility of using large language models like ChatGPT for radiologic decision making, with the potential to improve clinical workflow and responsible use of radiology services. More use cases and greater accuracy are necessary to evaluate and implement such tools.
Topics: Humans; Female; Mastodynia; Radiology; Breast Neoplasms; Decision Making
PubMed: 37356806
DOI: 10.1016/j.jacr.2023.05.003 -
Cureus Apr 2024Breast cancer is the most frequent malignancy among women worldwide, including a wide range of histological subtypes, from typical expressions like invasive ductal...
Breast cancer is the most frequent malignancy among women worldwide, including a wide range of histological subtypes, from typical expressions like invasive ductal carcinoma to less common variations like apocrine breast carcinoma. This document discusses the case of a 65-year-old female with apocrine breast cancer, who presented with a chronic mastodynia. This case highlights the importance of being aware of apocrine breast cancer.
PubMed: 38721213
DOI: 10.7759/cureus.57789 -
Journal of Investigative Medicine High... 2024Breast pain is a common concern among women in primary care clinics. A rare cause of breast pain is Mondor's disease (MD), which can present as an acute, painful,... (Review)
Review
Breast pain is a common concern among women in primary care clinics. A rare cause of breast pain is Mondor's disease (MD), which can present as an acute, painful, erythematous, cord-like induration on the breast or anterior chest wall. The disorder is caused by sclerosing superficial thrombophlebitis of the anterolateral thoracoabdominal wall veins. There does not appear to be a racial or ethnic propensity for this condition; however, it is important to understand that it may be more difficult to see in darker skin types (Fitzpatrick skin types IV-VI) and requires close attention on physical exam. The cause of MD is poorly understood but may be related to direct trauma, strenuous exercise, or hormone changes. We review a case of a 54-year-old woman who presented with an anterior chest wall palpable cord, better visualized with adequate lighting and skin traction, ultimately diagnosed as MD based on clinical findings and imaging studies. Mondor's disease often resolves spontaneously with supportive care, as in this patient's case; however, clinicians should be aware of this rare cause of breast pain and its association with hypercoagulable state, vasculitis, and breast cancer.
Topics: Humans; Female; Middle Aged; Mastodynia; Breast; Thrombophlebitis; Breast Neoplasms; Thoracic Wall
PubMed: 38606534
DOI: 10.1177/23247096241246621 -
European Review For Medical and... Apr 2024The primary aim of this study was to explore the involvement of cervical discopathy in the development of non-cyclic mastalgia by employing cervical magnetic resonance...
OBJECTIVE
The primary aim of this study was to explore the involvement of cervical discopathy in the development of non-cyclic mastalgia by employing cervical magnetic resonance imaging (MRI).
PATIENTS AND METHODS
A total of 407 patients were included in the study. Individualized management plans were developed for each patient. Pathological findings in MRI results were assessed by specialists in physical therapy and neurosurgery, and appropriate treatment was administered. Visual assessments of patients were conducted. The Analog Scale (VAS) scoring system was used at the initial presentation, and patients were evaluated at 1 and 3 months following the treatment.
RESULTS
In the MRI examinations of the patients included in the study, simultaneous cervical disc protrusion was observed in 29% (n: 124) of those with annular bulging. Comparing the VAS scores of patients before treatment, at the 1st and at the 3rd month showed a significant decrease in mastalgia pain (p < 0.001).
CONCLUSIONS
The diagnosis of cervical discopathy holds significant importance in the treatment of mastalgia patients. Therefore, clinicians should keep the cervical spine in mind as a potential contributing factor to mastalgia.
Topics: Humans; Female; Magnetic Resonance Imaging; Cervical Vertebrae; Middle Aged; Male; Adult; Mastodynia; Pain Measurement; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Aged
PubMed: 38708461
DOI: 10.26355/eurrev_202404_36018 -
Women's Health (London, England) 2024Scarce evidence exists on barriers to physical activity in Mexican women. Despite evidence from other countries, no research has investigated the influence of the breast... (Observational Study)
Observational Study
BACKGROUND
Scarce evidence exists on barriers to physical activity in Mexican women. Despite evidence from other countries, no research has investigated the influence of the breast on PA in this population.
OBJECTIVE
To determine the association between the breast and physical activity in Mexican women.
DESIGN
Cross-sectional observational study.
METHODS
Volunteers were 279 Mexican women from Veracruz, Durango, and Baja California states, who completed a paper survey of their demographics, brassiere characteristics, breast pain, and frequency and amounts of weekly physical activity.
RESULTS
The first barrier to physical activity was time constraints, followed by breast-related issues. Breast pain was reported by 47.1% of women, and the breast as a barrier to physical activity participation was reported by 30.6%. Responses, such as "I am embarrassed by excessive breast movement" and "My breasts are too big" were the most frequently reported breast-related barriers to physical activity. Breast pain was associated with the menstrual cycle and exercise. Breast health knowledge and pain intensity were unrelated to moderate- and vigorous-intensity physical activity. The 36.4% and 6.7% of women did not meet weekly moderate- and vigorous-intensity physical activity guidelines, respectively. Weekly moderate- and vigorous-intensity physical activity was similar between women reporting breast pain and those who did not.
CONCLUSIONS
Because the breast was the second most significant barrier to physical activity, it is imperative to increase breast health knowledge in Mexican women to reduce impediments to physical activity.
Topics: Female; Humans; Cross-Sectional Studies; Mastodynia; Mexico; Breast; Exercise
PubMed: 38523351
DOI: 10.1177/17455057241231477 -
European Journal of Obstetrics,... May 2024The aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation.
OBJECTIVE
The aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation.
STUDY DESIGN
Between October 2021 and October 2022, a case-control studywas conducted in mother andchild centers and sexual health centers in the Paris, France area. The case group included pregnant women who did not have a scheduled gynecological consultation in the past two years. The control group included pregnant women who had a scheduled gynecological consultation in the past two years. Pregnant women were interviewed using a standardized questionnaire about a history of domestic and sexual violence, the date of their last gynecological consultation and the gynecological health.
RESULTS
A total of 405 pregnant women were included in the case group (n = 129) or in the control group (n = 276). After adjustment for age, couple, social security, supplementary health insurance, dyspareunia, abnormal vaginal discharge, dysmenorrhea, regular pelvic pain, mastodynia, vulvodynia and history of difficult delivery, a history of intimate partner violence was associated with the absence of a gynecological consultation in the past two years (OR 2.13; CI95% 1.21-3.73, p = 0.008). A history of sexual violence, regardless of age, was associated with the absence a gynecological consultation in the past two years (OR 1.92; CI95% 1.05-3.49, p = 0.03). The absence of a gynecological consultation was associated with dyspareunia and domestic or sexual violence (p < 0.0001 and p < 0.0001, respectively).
CONCLUSIONS
This study highlighted the association between domestic and sexual violence and the absence of gynecological consultations in the past two years. It underlines the importance of screening for domestic and sexual violence during gynecological consultations and its impacts on mental health, in particular psychotraumatic symptoms, and on gynecological health, in particular dyspareunia.
Topics: Female; Humans; Pregnancy; Domestic Violence; Case-Control Studies; Dyspareunia; Follow-Up Studies; Sex Offenses; Intimate Partner Violence; Prevalence
PubMed: 38471336
DOI: 10.1016/j.ejogrb.2024.02.055 -
Medical Science Monitor : International... Mar 2024BACKGROUND Breast pain, prevalent among women of reproductive age, varies during menstrual cycles and is influenced by sociodemographic and clinical factors. This study...
BACKGROUND Breast pain, prevalent among women of reproductive age, varies during menstrual cycles and is influenced by sociodemographic and clinical factors. This study aimed to assess these demographic and clinical variables in women with breast pain, considering the spatial distinctions between urban and rural locations. MATERIAL AND METHODS This retrospective study included 730 women presenting with mastalgia between 2010 and 2023. The study evaluated patient demographics, pain characteristics (eg, breast pain duration, site, quadrant-based localization, and radiation of breast pain), radiologic findings, and the presence of comorbid medical conditions. RESULTS There were 498 patients in the urban group and 232 patients in the rural group. Among the radiologic findings, the rate of mastitis was higher in the rural group (P<0.05). Regarding the localization of breast pain within the quadrants, left breast upper-inner (LUI) quadrant pain was more common in the rural group (P=0.014). Regarding comorbid medical conditions, the prevalence of gastrointestinal system disease was higher in the rural group (P=0.009). Using logistic regression analysis, gastrointestinal disease was determined to be a significant independent risk factor for increased LUI quadrant pain in the rural group (odds ratio [OR]: 3.132, P=0.014), while pre-existing thyroid disease (OR: 2.482, P=0.004), hypertension (OR: 2.534, P=0.006), and radiologic evidence of ductal ectasia (OR: 2.878, P=0.03) were independent risk factors in the urban group. CONCLUSIONS Patient outcomes may be improved by a tailored, population-based approach to mastalgia patients in rural and urban locations focused on their radiologic findings and comorbid medical conditions.
Topics: Humans; Female; Mastodynia; Retrospective Studies; Turkey; Breast; Breast Diseases
PubMed: 38525558
DOI: 10.12659/MSM.943448 -
BMC Public Health Nov 2023Mastalgia, or breast pain, is a prevalent and distressing condition experienced by women, impacting their daily lives and causing complications. It is common among women...
BACKGROUND
Mastalgia, or breast pain, is a prevalent and distressing condition experienced by women, impacting their daily lives and causing complications. It is common among women of reproductive age, with associations found with premenstrual syndrome, fibrocystic breast disease, psychological distress, and, in rare cases, breast cancer. While Western societies have high frequencies of Mastalgia, it is less diagnosed in Asian cultures including Bangladesh. This study aimed to investigate the prevalence and factors associated with Mastalgia among early reproductive-aged women in Bangladesh.
METHODS
A cross-sectional survey was conducted, and data were collected from different regions of the country. A convenience sampling method was used to take 1,214 participants for the study. A pre-tested semi-structured questionnaire was used to collect data. Bivariate and multivariate analyses were conducted to ascertain factors that were significantly associated with Mastalgia. The data were analyzed using the SPSS software 26 version.
RESULTS
All the participants were female (mean age: 22.87 ± 2.64 years; age ranges: 18-35 years). The prevalence of Mastalgia was found to be 35.5%. The study was conducted using a self-reported semi-structured questionnaire. Participants with a higher education level and higher income were more likely to experience Mastalgia. A family history of breast cancer and severe abdominal pain during menstruation were also identified as associated factors for Mastalgia (p < 0.05).
CONCLUSIONS
This study enhances our understanding of Mastalgia in Bangladesh, offering insights for healthcare and policy. Further research is required to uncover its root causes and develop effective interventions. The study highlights the prevalence of mastalgia and its related factors, emphasizing the necessity for increased awareness and support for affected women.
Topics: Adolescent; Adult; Female; Humans; Young Adult; Bangladesh; Breast Neoplasms; Cross-Sectional Studies; Mastodynia; Prevalence
PubMed: 37978504
DOI: 10.1186/s12889-023-17173-7