Particularités en imagerie du cancer du sein de la femme jeune de moins de 35 ans / Particularities of breast cancer imaging in young women under 35 years of age

Objectif: Le cancer du sein chez la femme jeune est rare etprésente des caractéristiques épidémiologiques, diagnostiques et pronostiques propres. L'objectif de notre étude est d'évaluerles caractéristiques radiologiques (mammographiques, échographiqueset par résonnancemagnétique IRM du cancer du sein chez la femme jeune Algérienne, de moins de 35 ans. Matériels etméthodes: Etude prospective, descriptiveau sein du service d'imagerie médicale du Centre Pierre et Marie Curie,d'Algerincluant 204patientes âgées de moins 35ans, étalée sur 3 ans allantentre janvier 2015et janvier 2017,chez lesquelles undiagnostic de cancer du sein a été porté,Elles ont toutes bénéficiésd'une mammographie numérique, d'une échographie et d'une IRM mammaireet d'unprélèvement percutané.Résultats:La fréquence du cancer du sein chez la femme jeune de moins de 35 ans était de 10,6%. L'âge moyen était de 30.9 ans. L'autopalpation d'un nodule était prédominante (87.2%). La densité mammaire était de type c et d dans 67.7%. Contrairement à l'idée établie, la mammographie avait permis souvent le diagnostic de ces tumeurs. A la mammographie, la répartition des cas selon le stade BI-RADS révèle que plus de la moitié (53.9%) était classée BI-RADS 5 ; 35.5 % des cas classés en BIRADS 4, 7.2% classés en BI-RADS 3 et un faible pourcentage (3.6 %) en BI-RADS 0. Pour l'échographie, la répartition des cas selon les stades BI-RADS révèle que plus de la moitié était classée ACR5, ce qui représente 64 %, 32.7 % classée en ACR4 et 3.3% en ACR3.A l'IRM, 71.1 % des cas ont été classés en ACR 5, 28.4% en ACR4 et 0.5 des cas en ACR 3. Le type histologique était de type carcinome canalaire infiltrant de grade III et II selon Scarff-Bloom et Richardson (SBR) dans 96.11% descas.Conclusion: L'expression radiologique est souvent non spécifique et évocatrice d'une lésion suspecte néanmoins nous avons constaté une plus grande fréquence de tumeurs d'allure bénigne en mammographie par rapport à l'échographie mammaire et à l'IRM mammaire. L'IRM mammaire reste donc utile dans la caractérisation lésionnelle et le bilan d'extension

Objective: Breast cancer in young women is rare and has its own epidemiological, diagnostic and prognostic features. The aim of our study was to evaluate the radiological (mammographic, ultrasonographic and MRI) characteristics of breast cancer iMaterials and methods: Prospective, descriptive study in the medical imaging department of the CPMC in Algiers, including 204 patients under 35 years of age, over a 3-year period from January 2017 to January 2020, diagnosed with breast cancer. They all underwent digital mammography, ultrasound and MRI of the breast and percutaneous sampling.Results: The incidence of breast cancer in young women under 35 was 10.6%. The mean age was 30.9 years. Autopalpation of a nodule was predominant (87.2%). Breast density was type c and d in 67.7%. Contrary to popular belief, these tumorswere often diagnosed by mammography. On mammography, the distribution of cases according to BIRADS stage revealed that over half (53.9%) were classified as BIRADS 5; 35.5% of cases classified as BIRADS 4, 7.2% classified as BIRADS 3 and a small percentage (3.6%) as BIRADS 0.On ultrasonography, the distribution of cases according to BIRADS staging revealed that over half were classified as ACR5, representing 64%, 32.7% as ACR4 and 3.3% as ACR3. On MRI, 71.1% of cases were classified as ACR 5, 28.4% as ACR4 and 0.5 of cases as ACR 3. Histological type was infiltrating ductal carcinoma grade III and II according to Scarff-Bloom and Richardson (SBR) in 96.11% of cases.Conclusion: Radiological expression is often non-specific and suggestive of a suspicious lesion. Nevertheless, we found a greater frequency of benign tumorsin mammography than in breast ultrasound and breast MRI. Breast MRI therefore remains useful for lesion characterization and extension assessmenn young Algerian women under 35 years of age.

Scanner cardiaque pédiatrique dans le diagnostic des cardiopathies congénitales: expérience abidjanaise / Pediatric cardiac computed tomography in the diagnosis of congenital heart disease: Abidjan experience

Objectif.Depuis 2008, la Haute Autorité Sanitaire recommande la réalisation du scanner cardiaque dans le diagnostic des cardiopathies congénitales. Celui-ci aide à confirmer et préciser les anomalies mal définies à l'échocardiographie. Dans les pays développés, le scanner cardiaque est un examende routine pour le diagnostic des cardiopathies congénitales. En Côte-d'Ivoire, sa pratique est récente.L'objectif de cette étude était de décrire les techniques et résultats des scanners cardiaques pédiatriques réalisés dans une structure privée à Abidjan.Matériels et méthodes.Il s'agissait d'une étude descriptive rétrospective sur une période de 2 mois qui a inclus tous les enfants reçus à la clinique la rosette pour la réalisation d'un scanner cardiaque indiqué pour l'évaluation d'une cardiopathie congénitale. Les examens ont été réalisés sous sédation légère pour les enfants de moins de 7 ans.Résultats.Vingt scanners cardiaques pédiatriques ont été réalisés. Les indications des scanners cardiaques pédiatriques étaient la tétralogie de Fallot (15 cas), l'atrésie pulmonaire à septum ouvert (APSO) (2 cas), la communication inter auriculaire (CIA) (1 cas), la CIA associée à une communication interventriculaire (CIV) (1 cas) et la sténose pulmonaire supra valvulaire (1 cas). Dans les cas de Tétralogie deFallot et d'APSO, les branches pulmonaires et les collatérales aorto-pulmonaires ont été visualisées et mesurées. Pour le bilan de , un retour veineux pulmonaire non visualisé à l'échocardiographie a été retrouvé au scanner cardiaque. Dans tous les cas, un bilan tomodensitométrique malformatif était réalisé : recherche d'anomalies coronaires et d'arcs aortiques.Après réalisation du scanner cardiaque, 5 enfants ont bénéficié d'une cure chirurgicale. On notait une concordance entre les diagnostics peropératoires et tomodensitométriques

Objective. Since 2008, the French National Authority for Health recommends the use of a cardiac scanner for the diagnosis of congenital heart disease. It helps to confirm and clarify abnormalities that are poorly defined on echocardiography. In developed countries,cardiac CT is a routine examination for the diagnosis of congenital heart disease. In Côte d'Ivoire, its practice is recent. Materials and Methods. This was a retrospective descriptive study over a period of 2 months which included all children received at the Rosette clinic for a cardiac scan indicated for the evaluation of congenital heart disease. The examinations were performed under light sedation for children under 7 years of age. Results. Twenty paediatric cardiac scans were performed. The indications for the paediatric cardiac scans were tetralogy of Fallot (15 cases), pulmonary atresia with ventricular septal defect (PAVSD) (2 cases), atrial septal defect (ASD) (1 case), ASD associated with ventricular septal defect (VSD) (1 case) and supravalvular pulmonary stenosis (1 case). In cases of Tetralogy of Fallot and APSO, pulmonary arteries and aorto-pulmonary collaterals were visualised and measured. For the assessment of ASD, an anomalous pulmonary venous return not visualised on echocardiography was found on cardiac computed tomography (CT). In all cases, a malformative CT scan was performed: search for coronary, aortic arch. After the cardiac, 5 children underwent surgical treatment. There was concordance between the intraoperative and CT diagnoses. Conclusion. In our experience, cardiac CT now represents, minimally invasive, complementary diagnostic tool for the evaluation of congenital heart disease.

Prevalencia de infección por Chlamydia trachomatis y relación con el perfil de conductas sexuales en adolescentes y mujeres jóvenes de la Provincia de Osorno, Chile

Introducción: La infección por Chlamydia trachomatis es la ITS bacteriana más frecuente del mundo. En el cervix se presenta mayormente de forma asintomática y afecta especialmente a mujeres jóvenes y adolescentes. Puede producir daño permanente en el tracto reproductor femenino, se asocia a parto prematuro, infecciones neonatales transmitidas vía vertical y mayor riesgo de adquirir otras ITS como VIH Y VPH. Por estos motivos se han establecido estrategias de tamizaje para detectar y tratar precozmente la infección asintomática por C. trachomatis en diferentes países. En nuestro país no contamos con un programa nacional de tamizaje. Objetivo: Determinar la prevalencia de infección asintomática por Chlamydia trachomatis en mujeres entre 12 y 21 años de la Provincia de Osorno, Región de Los Lagos, Chile. Pacientes y Métodos: Se desarrolló un estudio de diseño transversal con una cohorte única de mujeres adolescentes y jóvenes consultantes en el Policlínico de Alto Riesgo Obstétrico y de Ginecología Infantil y Adolescente, del Hospital Base de Osorno, entre enero de 2019 y enero 2020. Se determinó el estado de infección asintomática mediante RPC en tiempo real para C. trachomatis. Se realizó una encuesta a fin de determinar características demográficas, hábitos y conductas sexuales de las pacientes estudiadas. Resultados: Fueron reclutadas 124 mujeres entre 12 a 21 años de edad, de las cuales, 36 (29,3%) se encontraban embarazadas al momento del estudio. La prevalencia de infección asintomática por C. trachomatis fue de 14/124 (11,3%). En las mujeres gestantes se encontraron 6/36 (16,7%) casos positivos de infección por C. trachomatis y 8/88 (9,1%) en las no gestantes. Existe una mayor frecuencia de infección asintomática a menor edad de inicio de actividad sexual (33,3% en aquellas que inician entre 11-12 años vs. 16,2% en las que inician entre 1314 años, 7,4% entre 15-16 y 8% entre 17-21 años; p < 0,05). Esta tendencia no fue observada al comparar el estado de infección con el tiempo de vida sexual activa. Sólo 15,7% de las pacientes utilizó preservativo en todas sus relaciones sexuales. Discusión: La infección asintomática por C. trachomatis es frecuente en las mujeres adolescentes y jóvenes sexualmente activas. Las pacientes con inicio más temprano de la actividad sexual coital (bajo 13 años de edad) podrían estar en mayor riesgo. Se requiere con urgencia establecer la frecuencia nacional de infección para desarrollar una estrategia sanitaria para su pesquisa y manejo oportuno en nuestro país.

Background: Chlamydia trachomatis infection is the world most common bacterial STI. At uterine cervix it presents mostly asymptomatically and especially affects young women and adolescents. It can cause permanent damage to the female reproductive tract and is associated with premature birth, connatal infections and increased risk of acquiring other STIs such as HIV and HPV. For these reasons, other countries have established screening strategies to detect and treat asymptomatic C. trachomatis infection. Our country don't have a national screening program. Aim: To determine the prevalence of C. trachomatis asymptomatic infection in adolescent and young women in Osorno province, Los Lagos Region, Chile. Methods: A crosssectional study was performed in adolescent and young women who consult at Hospital Base Osorno in the MaternoFetal and PediatricAdolescent Gynecology ambulatory clinics, between January 2019 and January 2020. The status of asymptomatic infection was determined by PCR for C. trachomatis. A survey was carried out to determine the demographic characteristics, habits and sexual behaviors. Results: 124 women between 12 and 21 years of age were recruited, of which 36 (29,3%) were pregnant at the time of the study. The prevalence of asymptomatic infection by C. trachomatis was 11.3.%. In pregnant women, there were 6/36 (16.7%) positive cases for C. trachomatis and 8/88 (9.1%) in nonpregnant women. We found a higher frequency of asymptomatic infection at younger age of first sexual intercourse (33% in adolescents at 11-12 years old vs. 16.2% at 13-14, 7.4% at 15-16 and 8% at 17-21; p<0.05). Only 15.7% of the patients utilized condoms in all their intercourses. Discussion: Asymptomatic C. trachomatis infection is common in adolescent and young women, with a higher risk in those who onset sexual activity at an early age (less than 13 years old). It is urgently required to determine the national frequency of asymptomatic C. trachomatis infection to develop a national strategy for screening and timely treatment.

"Tô tranquila, estou com meus exames indetectáveis": as relações afetivo-sexuais de mulheres jovens vivendo com HIV com carga viral indetectável / "I'm calm, I have my undetectable exams": the affective-sexual relationships of young women living with HIV with an undetectable viral load / "Estoy tranquila, tengo mis exámenes de laboratorio indetectables": las relaciones afectivo-sexuales de mujeres jovenes viviendo con VIH con carga viral indetectable

Resumo Neste artigo, discutimos de que modo o discurso biomédico sobre carga viral indetectável (re)organiza as trajetórias afetivas e sexuais de mulheres jovens vivendo com HIV. Realizamos entrevistas semiestruturadas com cinco jovens vivendo com HIV/aids, com idade entre 18 e 30 anos, tanto pela internet, como em um serviço de saúde especializado (SAE) em Salvador-Ba, no período entre 2015 e 2017. As interações online aconteceram através do Whatsapp e Facebook. As jovens vivenciam a necessidade de negociar o prazer e a prevenção. Posicionam-se como sujeitos de "risco" e adotam a noção de carga viral indetectável como forma de sentirem-se seguras na prevenção. Os novos discursos biomédicos são incorporados em seus cotidianos, e os sentimentos de medo, rejeição e a "possibilidade" de "perigo" para o outro (soronegativo) contribuem para a reorganização de suas vidas e de seus relacionamentos.

Abstract In this article, we discuss how the biomedical discourse of undetectable viral load reorganises the affective and sexual trajectories of young women living with HIV. We conducted semi-structured interviews with five young women living with HIV/AIDS, aged between 18 and 30 yo, on the internet and at a specialized health service (SAE) in Salvador-Ba, between 2015 and 2017. The online interactions occurred through Whatsapp and Facebook. Young women experience the need to negotiate pleasure and prevention. They position herself as at "risk" subjects and adopt the notion of undetectable viral load as a way to feel safe in prevention. The new biomedical discourses are incorporated into their daily lives, and the fear, rejection and "possibility" of "danger" for another (seronegative) contributed to the reorganization of their lives and relationships.

Resumen En este artículo, discutimos cómo el discurso biomédico sobre la carga viral indetectable (re)organiza las trayectorias afectivas y sexuales de las mujeres jovens que viven con el VIH. Realizamos entrevistas semiestructuradas con cinco jovenes que viven con VIH/ SIDA, con edades entre 18 y 30 años, tanto en línea como en un servicio especializado de salud (SAE) en Salvador-Ba, entre 2015 y 2017. Las interacciones en línea ocorrieron través de Whatsapp y Facebook. Las mujeres jóvenes experimentan la necesidad de negociar el placer y la prevención. Se posicionan como sujetos de "riesgo" y adoptan la noción de una carga viral indetectable como forma de sentirse seguras en la prevención. Los nuevos discursos biomédicos se incorporan a su cotidianidad, y los sentimientos de miedo, rechazo y "posibilidad" de "peligro" para el otro (seronegativo) contribuyen a la reorganización de sus vidas y relaciones.

Reconsideration of fertility in young patients with breast cancer / 中华内分泌外科杂志

The pregnancy rate of young breast cancer patients is far lower than that of the general population, which is possibly related to many factors such as patients' concern about tumor recurrence, ovarian dysfunction caused by chemotherapy, long endocrine treatment cycle, lack of professional multidisciplinary cooperation team and so on. At present, there is limited data on fertility preservation before tumor treatment and successful pregnancy and delivery after treatment for young breast cancer patients. In order to successfully carry out the fertility preservation of young female breast cancer patients, strengthen their physical and mental health, promote the return of social roles and improve the health level of their offsprings, this article reviews the factors affecting fertility, the appropriate population for fertility preservation, and the impact on the prognosis of breast cancer, as well as the timing and methods of fertility preservation and recovery opportunities in young women with breast cancer.

Contraceptive acceptability and associated factors among young women (15-24) living with HIV/AIDS: a hospital-based study in Kampala, Uganda

introduction: In Uganda, over 43% of all pregnancies among young women (15-24 years) living with HIV are either unwanted or mistimed. Unintended pregnancies account for 21.3% of neonatal HIV infections. The objective was to determine acceptability of contraceptives and associated factors among young women living with HIV attending HIV clinics in Kampala. Methods: Between February and May 2019, 450 young women attending public HIV clinics (Kisenyi HC IV, Kiswa HC III and Komamboga HC III) in Kampala were systematically enrolled in a cross-sectional study and interviewed using structured questionnaires. We used modified Poisson regression to determine the factors associated with acceptability of contraceptive. Data were analyzed using STATA 13.0. Statistical significance was determined at a P values < 0.05. Results: Contraceptive acceptability was 40.7% (95% CI: 27.6%-53.6%). Older age group (20-24 years) (aPR; 2.42, 95%CI; 1.06-5.52, P = 0.035), age at sex debut ≥ 18 years (aPR;1.25,95%CI; 1.13-1.38, P<0.001), having friend on contraceptives (aPR; 1.90, 95%CI; 1.10 - 3.26; P =0.021) and being married (aPR; 1.20, 95%CI; 1.09 - 1.32, P<0.001) were significantly associated with acceptability of contraceptives. Conclusion: There is a low acceptability for contraceptives. Younger age group who are not yet married need to be targeted

Analysis of clinicopathological features and factors influencing the survival of young breast cancer patients / 肿瘤研究与临床

Objective:To explore the clinicopathological characteristics and factors influencing the survival of young breast cancer patients with diagnostic age below 35 years, and to provide the basis for the prevention and treatment of young breast cancer patients.Methods:Epidemiological and clinicopathological data of young female patients with newly diagnosed breast cancer from Shanxi Province Cancer Hospital between January 2015 and December 2016 were retrospectively analyzed. The data included age at diagnosis, reproductive history, history of abortion, menopausal status, and immunohistochemical results. Univariate and multivariate analysis were performed by using Cox regression model.Results:A total of 118 young breast cancer patients were collected, and the median age was 31 years old. Among them, the vast majority of 118 young breast cancer patients were invasive cancer (113 cases, accounting for 95.8%); there were 65 cases (55.1%) with tumor diameter ≤ 20 mm, 61 cases (51.7%) at N 0 stage, and 112 cases (94.9%) at M 0 stage. The positive rates of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) were 73.7% (87/118), 69.5% (82/118) and 28.8% (34/118), respectively. Luminal B breast cancer was the predominant molecular subtype, accounting for 55.1% (65/118). By the end of follow-up (median follow-up period of 60 months), the overall survival rate of young breast cancer patients was 78.8%. Multivariate analysis showed that TNM staging was an independent factor affecting overall survival in young breast cancer patients ( HR = 7.858, 95% CI 2.924-21.120, P < 0.001). Conclusions:Young breast cancer patients have unique clinicopathological features and TNM staging is an independent factor affecting the prognosis. Individualized treatment helps to improve the quality of life and prolong the survival time of patients.

Effects of a concurrent training protocol on body composition and phase angle in physically inactive young women: a quasi-experimental intervention study / Efectos de un protocolo de entrenamiento concurrente sobre la composición corporal y el ángulo de fase en mujeres jóvenes físicamente inactivas: un estudio de intervención cuasi-experimental

SUMMARY: To determine the effect of a concurrent training program on body composition and phase angle in young women. 38 women (19.26 ± 1.86 years) participated in the study, and were assigned according to convenience sampling into two groups: 11 into the control group (CG) and 27 into the intervention group (IG). The IG performed a 12-weeks concurrent training protocol. The frequency was five days a week, and the intensity was established in 40-60 % of a repetition maximum to strength exercise, and 40-65 % heart rate reserve to endurance exercise. Body composition and phase angle were evaluated by bioelectrical impedance before and after the intervention. The IG had a decrease in fat mass (pre = 24.66 ± 5.65 kg; post = 20.38 ± 4.20 kg; Cohen's d = .80; p< 0,001 [CI 95 % = 3.34,5.22]), and an increase in muscle mass (pre = 22.75 ± 3.23 kg; post: 23.50 ± 3.41 kg; Cohen's d = -0.86; p= <0,001[CI 95 % = -1.09,- 0.40]) and total phase angle (pre = 5.72º ±0.39; post: 6.24º ± 0.51; Cohen's d = -1.32; p=<0,001 [CI 95 % = -0.67,-0.36]), whereas the CG had not show significant variations in variables of body composition or total phase angle. The results suggest that a 12-weeks concurrent training program could modify positively the young women's body composition and phase angle. Hence, it is recommended using similar protocols to change variables related to young women's health.

RESUMEN: El objetivo fue determinar el efecto de un programa de entrenamiento concurrente sobre la composición corporal y el ángulo de fase en mujeres jóvenes. 38 mujeres (19.26 ± 1.86 años) participaron en el estudio, y fueron asignadas de acuerdo a un muestreo de conveniencia en dos grupos: 11 en el grupo control (CG) y 27 en el grupo de intervención (GI). El IG realizó un protocolo de entrenamiento concurrente de 12 semanas. La frecuencia fue de cinco días a la semana y la intensidad se estableció en 40-60 % una repetición máxima para el ejercicio de fuerza y 40-65 % de frecuencia cardíaca de reserva para ejercicio de resistencia. La composición corporal y el ángulo de fase se evaluaron mediante impedancia bioeléctrica antes y después de la intervención. El IG tuvo una disminución en la masa grasa (pre = 24.66 ± 5.65 kg; post = 20.38 ± 4.20 kg; d de Cohen = .80; p <0,001 [IC 95 % = 3.34,5.22]), y un aumento en la masa muscular (pre = 22,75 ± 3,23 kg; post: 23,50 ± 3,41 kg; d de Cohen = -0,86; p = <0,001 [IC 95 % = -1,09, -0,40]) y ángulo de fase total (pre = 5,72º ± 0,39; post: 6,24 º ± 0,51; d de Cohen = -1,32; p = <0,001 [IC 95 % = -0,67, -0,36]), mientras que el GC no mostró variaciones significativas en las variables de composición corporal o ángulo de fase total. Los resultados sugieren que un programa de entrenamiento concurrente de 12 semanas podría modificar positivamente la composición corporal y el ángulo de fase de mujeres jóvenes. Por lo tanto, se recomienda utilizar protocolos similares para mofificar variables relacionadas con la salud de mujeres jóvenes.

Educación superior chilena y violencia de género: demandas desde los feminismos universitarios / Chilean higher education and gender-based violence: demands from expressions of feminism in universities / Educação superior chileno e violência de gênero: demandas do feminismo universitário

Resumen (analítico) Se presenta una investigación sobre el ciclo de movilizaciones feministas universitarias de 2018, en la cual jóvenes estudiantes chilenas denunciaron violencia y acoso en instituciones de educación superior. Se visibiliza que la violencia contra las mujeres ha sido normalizada e invisibilizada, pues se encuentra arraigada en una cultura sexista. Así, se propone un objetivo doble: por un lado, identificar cuáles manifestaciones de la violencia de género fueron las principales catalizadoras de dichas movilizaciones; y, por otro, determinar cómo tales violencias se expresan en los contextos universitarios desde la voz de sus protagonistas. Este movimiento introdujo críticas profundas a la concepción de educación superior y acabó por revelarla como un campo de continua disputa política articulada con la genealogía del movimiento estudiantil chileno y con el resurgimiento de feminismos jóvenes en Latinoamérica.

Abstract (analytical) This research focuses on the 2018 cycle of feminist mobilizations at univiersities in which young female Chilean students denounced violence and harassment in higher education institutions, highlighting that violence against women has been normalized and made invisible as it is rooted in the dominant sexist culture. A double objective was proposed for the study: identify which manifestations of gender-based violence were the main catalyst for these mobilizations; and determine how this violence is expressed in university contexts based on the voices of the protagonists of the mobilizations. This movement involved strong criticism to the conception of higher education, revealing it as a field of continuous political dispute that is articulated with the genealogy of the Chilean student movement and the resurgence of expressions of feminism by young people in Latin America.

Resumo (analítico) É apresentada uma investigação sobre o ciclo 2018 de mobilizações feministas universitárias, em que jovens estudantes chilenas denunciaram violência e assédio em instituições de ensino superior; tornar visível que a violência contra a mulher foi normalizada e invisibilizada, por tanto, está enraizada em uma cultura sexista. Assim se propõe um duplo objetivo: por um lado, identificar quais as manifestações de violência de gênero foram os principais catalisadores dessas mobilizações; e, de outro, determinar como tal violência se expressa em contextos universitários a partir da voz de suas protagonistas. Este movimento introduz críticas profundas à concepção de ensino superior e acabou revelando-a como um campo de contínua disputa política articulada com a genealogia do movimento estudantil chileno e com o ressurgimento de jovens feminismos na América Latina.

Association between subjective sleep quality and blood pressure at rest and during exercise in free-living conditions in young women: A pilot study / 体力科学

Sleep disorders are risk factors for hypertension. This adverse effect is especially affected in women. Nevertheless, the impact of sleep habits on the cardiovascular response remains unclear in young women. This study aimed to determine whether sleep habits could affect blood pressure regulation at rest and during exercise in young women. Twenty-two young women participated in this study. The Pittsburgh Sleep Quality Index (PSQI), resting blood pressure (BP), and BP response to the 2-minute isometric handgrip exercise, which consists of 25% maximum force production using left hand, were measured. Beat-by-beat arterial BP changes during exercise was measured using the Finapres™ device, and it was averaged every 30 sec before and during exercise; BP reactivity was evaluated by the delta change from rest to exercise. The PSQI score was 5.2 ± 2.2. The resting systolic and diastolic BPs were 105 ± 7 mmHg and 62 ± 7 mmHg, respectively. BP reactivity to the exercise were Δ 4 ± 7 mmHg, Δ 4 ± 7 mmHg, Δ 6 ± 7 mmHg, and Δ 7 ± 9 mmHg, for each 30-sec interval. Poorer sleepers (PSQI > 4.5) showed a tendency toward lower resting systolic BP compared with better sleepers (PSQI < 4.5) (p = 0.069). Systolic BP reactivity to the last 30 sec of exercise was correlated with the PSQI score (r = 0.484, p = 0.022). In conclusion, sleep quality may affect the cardiovascular regulation at rest and during exercise in young women.

Clinic, pathologic and molecular landscapes in ultra-young women with breast cancer in the State of São Paulo: a real-world study

Introduction: Breast cancer (BC) centers are increasingly attending "ultra-young" women (UYW) patients (≤ 30 years), who usually present aggressive tumors and face specific problems. Objectives: We aimed to examine a multicentric casuistic view, addressing clinicopathological and molecular characteristics of BC, as well as therapeutic measures and oncological outcomes. Methods: A retrospective multicentric observational study of UYW with infiltrating BC was carried out. The patients were treated between the period from January 1991 to December 2019. Clinical, epidemiological, morphological, molecular, therapeutic and outcomes data were collected from the charts. Results: A total of 293 patients were followed for a average period of 34.5 months. Nulliparity was referred by 204 women (75.5%), of whom 81 (37.1%) were overweight or obese. Positive family history in first-degree relatives was verified in 25 patients (10.1%). Only 30 patients underwent genetic tests, which revealed inherited pathogenic mutations in 12 of them (37.5%). Thirty-two (32) cases were classified as T1 at diagnosis (10.9%), while "De novo" stage IV was found in 29 patients (9.8%). Mastectomy was performed in 175 women (70.2%), quadrantectomy in 46 women (18.4%), and mammary adenectomies in 28 women (11.2%), of which 149 cases were reported after neoadjuvant chemotherapy (56.0%). A total of 111 patients had at least one positive lymph node (47.4%). The rate of patients with estrogen receptor-negative was 32.7% and the rate of patients with Human Epidermal Growth Factor Receptor 2-positive (HER2-positive) was 25%. The frequency of Luminal A neoplasias was 16.6%, Luminal B/HER2- was 35.9%, Luminal B/HER2+ was 15.1%, HER2 overexpressed was 9.3%, and Basal was 22.9%. Taking into account the outcomes, 173 patients were alive without disease (65.7%); 23 patients were alive with any form of recurrence (8.7%); and 67 patients (25.4%) evolved to BC deaths. Conclusions: It was concluded that UYW with BC are commonly diagnosed at advanced stages, present adverse morphological and molecular parameters, and have unfavorable prognosis.

Expresión tumoral de BRCA1 y resultados clínicos en pacientes uruguayas diagnosticadas de cáncer de mama antes de los 40 años / BRCA1 tumor expression and clinical results in uruguayan patients diagnosed with breast cancer before the age of 40 years old / Expressão tumoral de BRCA1 e resultados clínicos em pacientes uruguaias com diagnóstico de câncer de mama antes dos 40 anos

Resumen: Las mutaciones de BRCA1 son raras en el cáncer de mama (CM) esporádico; sin embargo, su expresión a nivel tumoral se encuentra disminuida o ausente en 30%-50% de los casos. Objetivo: valorar la expresión tumoral de BRCA1 por inmunohistoquímica (IHQ) en mujeres uruguayas diagnosticadas de CM antes de los 40 años. Material y método: se incluyeron pacientes diagnosticadas de CM antes de los 40 años. Se utilizaron los anticuerpos monoclonales anti-BRCA1 MS110 contra el extremo N-terminal y GLK-2 contra el extremo C-terminal. Se calculó la sobrevida global (SVG) y la sobrevida libre de enfermedad (SVLE), para la construcción de las curvas se utilizó el método de Kaplan-Meier y la diferencia de sobrevida se evaluó mediante el test de log rank. Resultados: se incluyeron 40 pacientes, la SVG y la SVLE a cinco años fueron de 73% y 60% respectivamente. La expresión de BRCA1 mediante GLK-2 fue <10% en 16 de las 40 pacientes (40%). La SVG y la SVLE a cinco años para las pacientes con expresión <10% fue de 56% vs 85% para las pacientes con expresión >10% (p=0,015) y de 40% vs 72% (p=0,034) respectivamente. La expresión de BRCA1 mediante MS110 fue <10% en 11 de las 40 pacientes (27,5%). No se encontraron diferencias en la SVG ni en la SVLE a cinco años con este marcador. Conclusión: la pérdida de la expresión tumoral de BRCA1 determinada mediante GLK-2 se encontró en el 40% de las pacientes incluidas y se asoció a una menor SVG y SVLE, por lo que podría tener un valor pronóstico desfavorable en estas pacientes.

Summary: BRCA1 mutations are rare in sporadic breast cancer (CM), however their expression at the tumor level is diminished or absent in 30-50% of cases. Objective: to assess the tumor expression of BRCA1 using immunohistochemistry (IHC) in Uruguayan women diagnosed with BC before the age of 40 years. Material and methods: patients diagnosed with BC before the age of 40 between. The antibodies used were anti BRCA1 MS110 monoclonal antibodies against the N-terminal end and GLK-2 against the C-terminal. Overall survival (OS) and disease free survival (DFS) were calculated; the curves were developed using the Kaplan-Meier method and the difference in survival was evaluated through the log rank test. Results: the average age of the 40 patients included was 36 years. The 5-year OS and DFS were 73% and 60% respectively. The expression of BRCA1 with GLK-2 was <10% in 16 of the 40 patients included (40%). The 5-year OS and DFS for patients with <10% expression was 56% vs. 85% for patients with >10% (p=0.015) and 40% vs. 72% (p = 0.034) respectively. The expression of BRCA1 by MS110 was <10% in 11 of the 40 patients included (27.5%). No differences were found in the 5-year OS or DFS based on the expression of this marker. Conclusion: The loss of BRCA1 expression using GLK-2, which suggests the presence of a truncated protein, was associated with a statistically significantly lower OS and DFS, that the decrease in the BRCA1 protein as determined by GLK2 has an unfavorable prognostic value for young patients with BC.

Resumo: As mutações de BRCA1 são raras no câncer de mama (CM) esporádico; no entanto sua expressão no nível tumoral está diminuída ou ausente em 30-50% dos casos. Objetivo: avaliar a expressão tumoral de BRCA1 por imuno-histoquímica (IHQ) em mulheres uruguaias com diagnóstico de CM antes dos 40 anos. Material e métodos: foram incluídas pacientes com diagnóstico de CM antes dos 40 anos. Foram utilizados anticorpos monoclonais anti BRCA1 MS110 contra o extremo N-terminal e GLK-2 contra o extremo C-terminal. A sobrevida global (SVG) e a sobrevida livre de enfermidade (SVLE) foram calculadas; o método de Kaplan-Meier foi utilizado para a construção das curvas e a diferença de sobrevida foi avaliada usando o teste de log-rank. Resultados: foram incluídas 40 pacientes; a SVG e a SVLE aos 5 anos foram 73% e 60% respectivamente. A expressão de BRCA1 mediante GLK-2 foi <10% em 16 das 40 pacientes (40 %). A SVG e a SVLE aos 5 anos para as pacientes com expressão £10% foi 56% vs. 85% para as pacientes com expressão >10% (p=0,015) e 40% vs. 72% (p=0,034) respectivamente. A expressão de BRCA1 mediante MS110 foi =10% em 11 das 40 pacientes (27,5%). Não foram encontradas diferenças na SVG nem na SVLE aos 5 anos com este marcador. Conclusão: foi encontrada perda da expressão tumoral de BRCA1 determinada por GLK-2 em 40% das pacientes incluídas e foi associada a uma menor SVG e SVLE, o que poderia ter um valor prognóstico desfavorável nestas pacientes.

Factors associated with breast cancer occurrence before the age of 40 in Yaoundé

Background: In Cameroon, one third of breast cancers concern women less than 40 of age and young age appeared to be an independent predictor of adverse outcome. This study aimed to determine factors associated with the development of breast cancer before the age of 40 in Yaoundé.Methods: A case-control study was conducted for 7 months, from November 1st, 2016 to May 31st, 2017 at the General Hospital and the gyneco-obstetric and Paediatric Hospital of Yaoundé. Study compared the socio-demographic, clinical and lifestyle data of 50 women less than 40 of age with breast cancer (cases) with those of 200 women below 40 of age without breast cancer (controls). Descriptive statistics, bivariate and multivariate logistic regressions were performed to assess the socio-demographic, clinical and lifestyle data. Data were computed using the SPSS version 23.0 software. The significance threshold value was set at 0.05.Results: After multivariate analysis, the factors independently associated with the occurrence of breast cancer before the age of 40 were: age ≥ 30 (aOR = 2.05); family history of breast cancer (aOR = 8.65); parity ≥ 1 (aOR = 2.46); breastfeeding (aOR = 3.39); waist circumference ≥ 88 centimeters (cm) (aOR = 4.38); breast density ≥ 90                      (aOR = 2.89); physical activity ≤ 3 hours/week (aOR = 4.78). Conclusions: Breast cancer in women under 40 is associated with family history, reproductive life and women's lifestyles.  Breastfeeding more than 12 months, having a balanced diet, supplementary screening tests in women with dense breasts and practicing physical activity; would be  effective ways to prevent it in young women.

LOVE49 Activity in Gunma: Report and Prospects for The Future / 日本プライマリ・ケア連合学会誌

INTRODUCTION: To eradicate uterine cervix cancer, we report LOVE49 activity in Gunma prefecture and considered activities to be focused on in the future.METHODS: Activities included the creation of original goods and "Gunma-chan" costume, broadcast by local FM radio, plans for distribution, and distribution among college students.RESULTS: Original goods were distributed more efficiently to young women than in previous years. These activities led to an increased number of goods distributed, shortening of the time for distribution and reducing the burden on members.CONCLUSION: It is important that women themselves obtain correct knowledge and information to continuously improve the check-up rate. Health education for young people in particular is important.

Frecuencia de alteraciones citológicas cervicales y virus papiloma humano en una muestra de estudiantes universitarias en Temuco, Chile / Frequency of cervical cytological alterations and human papilloma virus in a sample of university students in Temuco, Chile

Resumen Introducción: El inicio precoz de actividad sexual puede favorecer el desarrollo de alteraciones cervicales y de infecciones de transmisión sexual, en especial del virus papiloma humano (VPH) muy frecuente en adolescentes y jóvenes. Objetivo: Analizar el estado del cuello uterino, presencia del VPH y conductas sexuales en mujeres menores de 25 años. Material y Métodos: Participaron 182 estudiantes universitarias de 18-24 años, sanas, sexualmente activas y no vacunadas para VPH. Se realizó Papanicolaou (Pap) y clasificación del VPH en alto y bajo riesgo (AR y BR) mediante reacción de polimerasa en cadena en tiempo real. Las conductas sexuales fueron consultadas privadamente. Resultados: El 46,9% de los Pap presentaron alteraciones citológicas (inflamación inespecífica/hemorrágico: 29,4% y frotis atípicos (FA):10,2%). La frecuencia de los VPH-AR fue 24,3%; de éstos, 67,4% presentó un Pap alterado. Hubo asociación entre alteraciones citológicas y presencia de VPH (p < 0,0001) y años de actividad sexual y FA o neoplasia intraepitelial grado I (NIE I) (p = 0,009). El 11,9% de las jóvenes estudiadas (21/177) presentó FA o NIE I, con 66,7% de casos VPH-AR. Conclusiones: Estos hallazgos alertan la vulnerabilidad de estas jóvenes que tendrían un riesgo potencial de persistencia viral, NIE y eventualmente cáncer. Es importante enfatizar consejería y prevención previo a la edad normada de ingreso al programa de cribado para cáncer cérvico uterino en Chile.

Background: The early onset of sexual activity can promote the development of cervical alterations and sexually transmitted infections, especially the human papillomavirus (HPV) very common in adolescents and young people. Aim: The condition of the cervix, HPV and sexual behavior in young women under 25 years of age were analyzed. Methods: 182 university students, healthy, sexually active, 18-24 years old, without vaccine for HPV participated. Papanicolaou (Pap) test and classification of high and low risk HPV (HR and LR) were performed by real time polymerase chain reaction. The sexual behaviors were consulted in private. Results: The 46.9% of Pap presented cytological alterations, non-specific inflammation/hemorrhagic (29.4%) and atypical smear (10.2%) being de most frequent. The overall frequency of HPV-HR was 24.3%, of these 67.4% presented an altered Pap. There was an association between cytological alterations and HPV (p < 0.0001) and years of sexual activity and atypical smear or cervical intraepithelial neoplasia grade I (CIN I) (p = 0.009). 11.9% of young women (21/177) presented atypical smear or CIN I, with 66.7% of cases HPV-HR. Conclusions: These findings alert the vulnerability of these young women who would have a potential risk of viral persistence, CIN and eventually cancer. It is important to emphasize counseling and prevention prior to the regular age of admission to the screening program for cervical cancer. This study was financed by the Universidad de La Frontera through Projects DI15-0047 and DI17-0123.

Effect of Module Exclusive Breastfeeding Knowledge, Attitude and Confidence in Young Women in Tarakan

Background: Knowledge, attitudes, and beliefs among young women to breast milk are still low. Aim: This study wanted to assess the effect of exclusive breastfeeding module on knowledge, attitudes, and beliefs of young women in the town of Tarakan. Method: Quantitative research with pre-posttest without control subjects were students of SMK Health Kaltara Tarakan with the number of samples (n=50) of respondents. Before the module manufacturing, the survey was conducted as drafting. Modules were in narrative form and were tested before correction by experts. Submission of exclusive breastfeeding module is done after pre-test for the measurement of knowledge, attitudes, and beliefs of young women against exclusive breastfeeding. The data were analyzed using the t-test. Results: Characteristics of respondents in general age was at 15-16 years (80%). The majority was among the first and second children (74%) and the number of siblings was between 2-3 years (54%.) Knowledge, attitudes, and beliefs after the intervention were 10.08 ± 0.85, the attitude was 29.64 ± 1.41, and confidence was 31.50 ± 1.31. It was statistically significant at p<0.05. Conclusions: Learning with exclusive breastfeeding module method can improve knowledge, attitudes, and beliefs of young women against exclusive breastfeeding in Tarakan.

Clinico-Epidemiological and Pathological Characteristics of Breast Cancer in Young Women (<40 Years)

Breast cancer in young women (BCYW) is showing an increasing trend in incidence among women of India and other Asian countries compared to western countries. Methods: A retrospective study was carried out on total 579 patients treated between January 2010 and December 2017 to evaluate the clinico-epidemiological and pathological characteristics in BCYW. Cases were divided into two groups i.e the younger (<40 years) and the older (≥40 years) age group. Data were analyzed by chi square test using IBM SPSS version 21 for windows. P value less than 0.05 was considered significant. Results: The breast cancer in younger women (<40 years) was found in 20.2% of cases and was found to have greater proportion of unmarried women (p=0.002), higher frequency of nulliparity (p=0.006), greater incidence of bilateral breast cancer (p=0.017), greater incidence of multifocal or multicentric tumour (p=0.033), higher grade tumours (p=0.007), advanced T stage (p=0.003), advanced N stage (p=0.012) and overall advanced TNM stage (p=0.011) at diagnosis, higher frequency of lymphovascular invasion (p=0.00013), higher frequency of estrogen and progesterone receptor negativity (p=0.0005 and 0.0001 respectively). HER-2 expression rate was not found different between the two groups, whereas its expression rate was found significantly lower among women of age >50 years at diagnosis (p=0.001). Higher frequency of triple negative breast cancer was found in the younger age group (33.3% vs. 19.3%, p=0.001). Conclusions: Advanced stage presentation of BCYW warrants inclusion of younger age women in breast cancer screening and encouraging for breast self-examination.

Chinese consensus guidelines for breast cancer in young women: clinical practice and fertility preservation / 中华肿瘤杂志

Breast cancer in young women is a relatively common disease in China. Its clinical, pathological and genetic characteristics make the disease special. The consequences of anticancer treatments including premature menopause and impaired fertility have far-reaching impact for these women both medically and psycho-socially. Thus, specific multimodality care is paramount. To standardize the diagnosis and treatment process of breast cancer and fertility management strategy in young patients, based on the literature and relevant international guidelines, the oncology specialists and experts on reproductive medicine discuss and propose this "Chinese Consensus Guidelines for Breast Cancer in Young Women: Clinical Practice and Fertility Preservation" .

Rapid increase of syphilis in Tokyo: an analysis of infectious disease surveillance data from 2007 to 2016

@#The objective of this study was to examine the trends of primary and secondary syphilis in Tokyo between 2007 and 2016 using national infectious disease surveillance data. We analysed all 3269 cases reported during these 10 years. A statistically significant increase in cases was observed after 2010 with a more rapid rate of increase after 2014 mainly in urban areas in Tokyo. The notification rates per 100 000 population in 2010, 2014 and 2016 were 0.9 (n = 113), 2.2 (n = 295) and 8.7 (n = 1190), respectively. Domestic syphilis transmission was suspected in 92.6–99.3% of cases during the period 2007–2016. Until 2013, the increase was mainly observed among men who have sex with men (MSM); however, heterosexual transmission became more dominant and eventually surpassed transmission among MSM in 2015. In 2016, the notified cases of infections through heterosexual contact were 22.3 and 40.4 times higher in men and women, respectively, compared to those in 2010. The median ages of affected heterosexual men and women were 37 (interquartile range: 28–46) and 26 (interquartile range: 22–32) years, respectively. Reports of oropharyngeal lesions have been increasing among both men and women with syphilis. The number of congenital syphilis cases reported in Tokyo was 0 to 3 cases per year during the study period. More information and further analysis are needed to explain the reason for this increase.