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The Pan African Medical Journal 2022the objective of this work was to establish the clinical profile of patients consulting in gyneco-obstetrical emergencies and identify the reasons for consultation and... (Observational Study)
Observational Study
INTRODUCTION
the objective of this work was to establish the clinical profile of patients consulting in gyneco-obstetrical emergencies and identify the reasons for consultation and the becoming of the consultants.
METHODS
a one-center retrospective descriptive observational study was performed including patients who consulted between January 1 and December 31, 2018. Obstetric emergencies after 36 weeks of amenorrhea were not included. We drew lots 4 months of the year 2018 (one month per season). Then we drew lots 2 weeks of each month. A data collection sheet was developed for the purposes of this work.
RESULTS
a total of 2007 patients were included in our study among 15,553 gynecological emergency room consultants during 2018. We found that the largest number of consultants was recorded at the start of the week and between 7 am and 7 pm. The most frequently obstetric reasons observed for consultation were pelvic pain (39.6%), bleeding (23.8%) and vomiting (8.7%). The most frequently gynecological reasons for consultation were pelvic pain (54.2%), then metrorrhagia (18.8%) and mastodynia (7.1%). Of the study participants, 66.82% received an ultrasound, 23% received a beta HCG test. The majority of emergency room consultants were referred to their home.
CONCLUSION
the majority of patients visiting the emergency room do not have any emergency-related pathologies.
Topics: Pregnancy; Female; Humans; Gynecology; Emergencies; Retrospective Studies; Consultants; Pelvic Pain
PubMed: 36578808
DOI: 10.11604/pamj.2022.43.53.32867 -
Revista Brasileira de Ginecologia E... Oct 2022Different drugs are used to treat mastalgia, such as danazol and bromocriptine, and both are associated with side effects, due to which most of women and healthcare... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Different drugs are used to treat mastalgia, such as danazol and bromocriptine, and both are associated with side effects, due to which most of women and healthcare providers are interested in herbal medicines. Therefore we aim to study the effectiveness of phytoestrogens on the severity of cyclic mastalgia.
METHODS
To carry out the present study, English electronic resources such as the Cochrane Library, ISI Web of Science, Scopus, and PubMed were used systematically and with no time limitation up to February 10, 2020.
RESULTS
In total, 20 studies were included in the present meta-analysis. The results of the meta-analysis showed that herbal medicines versus the control group (standard mean difference [SMD] = - 0.585; 95% confidence interval [CI]: - 0.728-- 0.44; heterogeneity; = 0.02; I2 = 42%), herbal medicines versus the B group (SMD = - 0.59; 95%CI: - 0.75-- 0.44; heterogeneity; = 0.03; I2 = 42%), and its subgroups, such as phytoestrogen (SMD = - 0.691; 95%CI: - 0.82-- 0.55; heterogeneity; = 0.669; I2 = 0%), Vitex-agnus-castus (SMD = - 0.642; 95%CI: - 0.84-- 0.44; < 0.001; = 203; I2 = 32%), flaxseed (SMD = - 0.63; 95%CI: - 0.901-- 0.367; = 0.871; I2 = 0%), and evening primrose (SMD= - 0.485; 95%CI:- 0.84-- 0.12; = 0.008; heterogeneity; = 0.06; I2 = 56%] may have effective and helpful effects on improving cyclic breast mastalgia. Also, chamomile, isoflavone, cinnamon, and nigella sativa significantly reduced mastalgia symptoms.
CONCLUSION
Herbal medicines and their subgroups may have effective and helpful effects on improving cyclic breast mastalgia. The findings of our meta-analysis must be done cautiously because low methodological quality in some evaluated studies of this systematic review.
Topics: Female; Humans; Mastodynia; Plants, Medicinal; Breast; Plant Extracts
PubMed: 36446563
DOI: 10.1055/s-0042-1755456 -
BMC Complementary Medicine and Therapies Nov 2022About 68% of women aged 18-44 years have experienced cyclic mastalgia (CM), which occurs during the luteal phase of the menstrual cycle when elevated hormone levels...
BACKGROUND
About 68% of women aged 18-44 years have experienced cyclic mastalgia (CM), which occurs during the luteal phase of the menstrual cycle when elevated hormone levels induce greater breast gland thickness. CM has a moderate-to-severe impact on a woman's quality of life. Prior research has suggested that acupuncture may be beneficial for breast pain relief. In this study, we investigate the effectiveness of manual acupuncture (MA) in the treatment of CM compared with that of sham acupuncture (SA).
METHODS
This is a multicenter, randomized, controlled trial. A total of 108 eligible CM patients will be randomly assigned to either MA (n = 54) or SA (n = 54) group using a 1:1 ratio and a stratified, blocked randomization. Acupuncture will be performed two weeks prior to menstruation and discontinued when menses begins. In both the MA and SA group, participants will be given acupuncture three times per week for 2 weeks per menstrual cycle for three consecutive menstrual cycles, encompassing a total of 18 sessions. The primary outcome will be the change in the average daily Breast Pain Visual Analog Scale (VAS-BP) over the first two weeks of menstruation from baseline to endpoints. The number of nominal days of breast pain (NDBP) two weeks before menstruation, World Health Organization Quality-of-Life Scale-Short Form scores, global patient assessment, breast glandular-section thickness, and breast-duct width three days before menstruation will also be measured as secondary outcomes.
DISCUSSION
This prospective randomized trial will help evaluate the efficacy of acupuncture in treating CM. The results of this study will provide evidence of the therapeutic effectiveness of acupuncture on CM.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05408377 , registered on June 7, 2022.
Topics: Humans; Female; Mastodynia; Quality of Life; Prospective Studies; Treatment Outcome; Acupuncture Therapy; Randomized Controlled Trials as Topic; Multicenter Studies as Topic
PubMed: 36401325
DOI: 10.1186/s12906-022-03779-8 -
JBI Evidence Implementation Dec 2022To assess compliance with recommendations to alleviate nipple pain and/or trauma (NPT) and to reduce the rate of breastfeeding abandonment for this reason.
OBJECTIVES
To assess compliance with recommendations to alleviate nipple pain and/or trauma (NPT) and to reduce the rate of breastfeeding abandonment for this reason.
INTRODUCTION
As a fundamental priority, health programmes encourage mothers to breastfeed exclusively for the first 6 months of the baby's life and to supplement breast milk with other foods up to the age of 2 years. However, the presence of NPT can reduce or prevent compliance with this recommendation.
METHODS
The project was designed and carried out using a framework based on the JBI Practical Application of Clinical Evidence System (JBI-PACES). Six audit criteria were used in preaudits and postaudits to observe any changes in compliance with the recommendations. Between audits, the Getting Research into Practice (GRiP) tool was used to identify stakeholders, barriers and facilitators of the project.
RESULTS
Two hundred and sixty-seven breastfeeding women were studied in the baseline phase and 275 during follow-up. Compliance in four criteria improved, and the rates of NPT decreased (pain: from 63.3 to 53.5%; P = 0.02; trauma: from 37.8 to 24.7%; P = 0.01). The proportion of women advised by qualified personnel increased from 63 to 88% whereas those who cited pain as the reason for abandoning exclusive breastfeeding decreased from 1.5 to 1.1%.
CONCLUSION
This evidence-based implementation project achieved significantly improved compliance rates in most of the evidence-based criteria considered. In consequence, the prevalence of NPT fell significantly. Nevertheless, there was no significant impact on the proportion of mothers abandoning breastfeeding for this reason.
Topics: Infant; Humans; Female; Child, Preschool; Breast Feeding; Spain; Nipples; Hospitals, University; Mastodynia
PubMed: 36378095
DOI: 10.1097/XEB.0000000000000340 -
Bratislavske Lekarske Listy 2022Medicinal plants exert therapeutic effects or have beneficial healing functions on the human or animal body. Medicinal plants are widely used in traditional medicine... (Review)
Review
Medicinal plants exert therapeutic effects or have beneficial healing functions on the human or animal body. Medicinal plants are widely used in traditional medicine as an interesting alternative and/or complementary to science-based medicine. Compared to chemical drugs, medicinal plants have a lower risk of side effects, are eco-friendly, and have cost-effective production. This encouraged researchers to extensively exploit them for their therapeutic use. One of the most well-known medicinal plants is Vitex agnus-castus L., which belongs to the Verbenaceae family. This shrub tree is mainly grown in tropical and sub-tropical regions. The parts of VAC, especially berries and leaves, contain essential oils, flavonoids, and diterpenes. Many medical benefits of VAC have already been reported, including mastalgia, regulating menstrual cycles and premenstrual complaints, and infertility. Respiratory and cardiovascular effects are also reported. In this review, we will analyze and characterize the known roles of VAC in mastalgia, as well as the mechanism of action reported in in vitro and/or in vivo studies, and show the potential for alternative therapeutic uses in mastalgia, also known as breast pain (Fig. 2, Ref. 40). Keywords: mastalgia, Vitex agnus-castus, therapy, traditional medicine.
Topics: Female; Animals; Humans; Vitex; Mastodynia; Plants, Medicinal; Plant Extracts; Plant Leaves
PubMed: 36342880
DOI: 10.4149/BLL_2022_147 -
The Surgical Clinics of North America Dec 2022Breast pain is a common symptom in most women during their lifetime, and many times is self-limited. Mastalgia is categorized into 3 main groups: cyclic, noncyclic and... (Review)
Review
Breast pain is a common symptom in most women during their lifetime, and many times is self-limited. Mastalgia is categorized into 3 main groups: cyclic, noncyclic and extramammary. A good history, examination and targeted imaging can help to delineate the underlying cause of mastalgia and therefore guide treatment options. Diet, medications, stress, hormonal fluctuations, and an ill-fitting bra can be contributing factors for physiologic causes of mastalgia. Breast cancer is rarely a cause but should be excluded. Reassurance, support, dietary changes, nonsteroidal anti-inflammatory drugs and occasionally hormonal medications are options to help with improving breast pain.
Topics: Female; Humans; Mastodynia; Breast Neoplasms; Anti-Inflammatory Agents, Non-Steroidal
PubMed: 36335929
DOI: 10.1016/j.suc.2022.06.001 -
Gynecological Endocrinology : the... Nov 2022Dysmenorrhea and mastodynia are the most common gynecologic pain causes in women of all ages and races during their reproductive life. The following study aimed to show...
INTRODUCTION
Dysmenorrhea and mastodynia are the most common gynecologic pain causes in women of all ages and races during their reproductive life. The following study aimed to show the influence of two POP´s in the development of dysmenorrhea and mastodynia after nine months of use.
MATERIAL AND METHODS
A total of 858 women with 6691 drospirenone (DRSP) cycles and 332 women with 2487 desogestrel (DSG) cycles were analyzed. Women included in this study were all child-bearing potentials, at risk of pregnancy, agreeing to use only the study medication for contraception for the duration of the study medication treatment, aged 18 to 45.
RESULTS
At screening, 168 (19.6%) of the 858 patients using DRSP and 64 (19,3%) of the DSG patients reported that they had suffered from dysmenorrhea within six cycles prior to the first visit before starting with the medication. 20,2% of the DRSP and 10,9% of the DSG group had a sever dysmenorrhea. After 9 cycles this was reduced to 0,6% and 3,1% respectively. In total, 96 women (11.2%) in the DRSP and 49 (14,8%) experienced mastodynia within six cycles before the screening. Of these 91.6% in the DRSP group and 91,8% in the DSG group had no or mild mastodynoa at follow-up.
DISCUSSION
The progestins 4 mg and desogestrel 0,075 mg showed a marked effect in the non-contraceptive aspects of dysmenorrhea and mastodynia so that new possibilities are opened for these two benign gynecological diseases. Future studies must reaffirm these first data.
Topics: Pregnancy; Female; Humans; Desogestrel; Progestins; Dysmenorrhea; Mastodynia; Progesterone Congeners; Ethinyl Estradiol; Contraceptives, Oral, Combined
PubMed: 36265507
DOI: 10.1080/09513590.2022.2134339 -
International Journal of Radiation... Mar 2023Evidence supports use of partial-breast irradiation (PBI) in the management of early breast cancer, but the optimal dose-fractionation remains unsettled.
PURPOSE
Evidence supports use of partial-breast irradiation (PBI) in the management of early breast cancer, but the optimal dose-fractionation remains unsettled.
METHODS AND MATERIALS
We conducted a phase 2 clinical trial (OPAL trial) to evaluate a novel PBI dosing schedule of 35 Gy in 10 daily fractions. Patients with close (<2 mm) margins also received a boost of 9 Gy in 3 fractions. Eligible patients underwent margin-negative lumpectomy for ductal carcinoma in situ or estrogen receptor-positive invasive breast cancer, up to 3 cm, pTis-T2 N0. The primary outcome was any grade ≥2 toxic effect occurring from the start of radiation through 6 months of follow-up. Secondary outcomes included patient-reported cosmesis, breast pain, and functional status, measured using the Breast Cancer Treatment Outcomes Scale, and physician-reported cosmesis, measured using the Radiation Therapy and Oncology Group scale. The Cochran-Armitage trend test and multivariable mixed-effects longitudinal growth curve models compared outcomes for the OPAL study population with those for a control group of similar patients treated with whole-breast irradiation (WBI) plus boost.
RESULTS
All 149 patients enrolled on the OPAL trial received the prescribed dose, and 17.4% received boost. The median age was 64 years; 83.2% were White, and 73.8% were overweight or obese. With median follow-up of 2.0 years, 1 patient (0.7%) experienced in-breast recurrence. Prevalence of the primary toxicity outcome was 17.4% (26 of 149 patients) in the OPAL trial compared with 72.7% (128 of 176 patients) in the control WBI-plus-boost cohort (P < .001). In longitudinal multivariable analysis, treatment on the OPAL trial was associated with improved patient-reported cosmesis (P < .001), functional status (P = .004), breast pain (P = .004), and physician-reported cosmesis (P < .001).
CONCLUSIONS
Treatment with daily PBI was associated with substantial reduction in early toxicity and improved patient- and physician-reported outcomes compared with WBI plus boost. Daily external-beam partial-breast irradiation with 13 or fewer fractions merits further prospective evaluation.
Topics: Humans; Middle Aged; Female; Treatment Outcome; Mastodynia; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Radiotherapy, Adjuvant; Mastectomy, Segmental
PubMed: 36216274
DOI: 10.1016/j.ijrobp.2022.09.083 -
PeerJ 2022Many potential factors associated with Inflammatory Conditions of the Lactating Breast (ICLB) have been reported in the literature, by lactating mothers and clinicians....
BACKGROUND
Many potential factors associated with Inflammatory Conditions of the Lactating Breast (ICLB) have been reported in the literature, by lactating mothers and clinicians. Clinicians, including general practitioners, lactation consultants and physiotherapists, require a clinical reasoning model that summarises associated or linked factors, to aid in the assessment, treatment, and prevention of ICLB. Thus, we aimed to adapt the existing Breastfeeding Pain Reasoning Model (BPRM), for use in the management of ICLB, using prior research and clinical audit data to guide adaptation. The existing BPRM categorises contributing factors for breastfeeding nipple pain, rather than ICLB.
METHODS
Factors linked with ICLB were identified from prior research and considered for inclusion into the existing model. Clinical data from a retrospective audit of ICLB patient notes at a private physiotherapy practice were also examined. Any factors identified from prior research that could not be identified in the clinical notes were not considered for inclusion into the existing model. Additional factors from the clinical notes that appeared repeatedly were considered for inclusion into the adaptation of the BPRM. A draft adapted model was created comprising all eligible factors, considering their counts and percentages as calculated from the clinical data. The research team iteratively examined all factors for appropriate categorisation and modification within the adapted model.
RESULTS
Prior research and data from 160 clinical notes were used to identify factors for inclusion in the adapted model. A total of 57 factors, 13 pre-existing in the BPRM and 44 extra identified from the prior research or clinical audit, comprised the draft adapted model. Factor consolidation and terminology modification resulted in a total of 34 factors in the final proposed adapted ICLB model. The three main categories, CNS modulation, External influences and Local stimulation, from the existing model were maintained, with one minor terminology change to the former Local stimulation category, resulting in 'Local influences' category. Terminology for five subcategories were modified to better reflect the types of factors for ICLB. The most common factors in the adapted model, calculated from the clinical audit population of mothers with ICLB, were employment (85%), high socioeconomic status (81%), antibiotic use during breastfeeding (61%), history of an ICLB (56%), any breast pump use (45%), multiparity (43%), birth interventions (35%), decreased milk transfer (33%), breastfeeding behaviour and practices (33%), nipple pain (30%) and fit and hold (attachment and positioning) difficulty (28%).
CONCLUSION
An ICLB-specific linked factors model is proposed in this paper. Clinicians treating mothers with ICLB can use this model to identify influencing and determining factors of ICLB clinical presentations and provide targeted education and effective treatment plans.
Topics: Female; Humans; Lactation; Retrospective Studies; Breast Feeding; Mothers; Mastodynia
PubMed: 35910773
DOI: 10.7717/peerj.13627 -
BMJ (Clinical Research Ed.) Jul 2022
Topics: Chest Pain; Humans; Male; Mastodynia
PubMed: 35798361
DOI: 10.1136/bmj-2022-070515