Aspectos clínicoepidemiológicos de pacientes con cáncer de mama del Policlínico 28 de septiembre / Clinical-Epidemiological Aspects of Patients with Breast Cancer and from the Policlínico 28 de Septiembre of Santiago de Cuba

Introducción: El cáncer de mama es considerado como un serio problema de salud pública por la alta prevalencia tanto en países desarrollados como en desarrollo. Son escasos los estudios clínico-epidemiológicos actualizados en el área de salud del Policlínico 28 de septiembre relacionados con dicha entidad clínica. Objetivo: Caracterizar desde el punto de vista clínico y epidemiológico a pacientes con cáncer de mama del área de salud perteneciente al Policlínico 28 de septiembre. Métodos: Estudio descriptivo en una serie de 35 mujeres mayores de 30 años con diagnóstico confirmado de cáncer de mama. Las variables estudiadas comprendieron edad, antecedentes familiares de cáncer de mama, factores de riesgo generales y hormonales, signos y síntomas clínicos, resultados de estudio ecográfico y diagnóstico histopatológico. Se utilizó el porcentaje como medida de resumen. Resultados: El 42,8 por ciento de la muestra objeto de estudio estuvo comprendido en el grupo de edad de 40-49 años. El 65,7 por ciento del total de mujeres tenía antecedentes familiares de cáncer de mama. La menarquía precoz (54,2 por ciento) y la nuliparidad (48,5 por ciento) representaron los factores de riesgo de mayor incidencia. El 57,1 por ciento de las lesiones diagnosticadas correspondieron a carcinomas en estadío I y IIa. Conclusiones: El cáncer de mama constituye un serio problema de salud en mujeres mayores de 30 años pertenecientes al Policlínico 28 de septiembre del municipio Santiago de Cuba(AU)

Introduction: Breast cancer is considered a serious public health concern due to its high prevalence in both developed and developing countries. There are few updated clinical-epidemiological studies carried out in the health area of the Policlínico Docente 28 de Septiembre related to this clinical entity. Objective: To characterize, from the clinical and epidemiological point of view, the patients with breast cancer and from the health area belonging to the Policlínico Docente 28 de Septiembre. Methods: A descriptive study was carried out with a series of 35 women aged more than 30 years and with a confirmed diagnosis of breast cancer. The variables studied included age, family history of breast cancer, general and hormonal risk factors, clinical signs and symptoms, ultrasound findings and histopathological diagnosis. Percentage was used as summary measure. Results: 42.8 percent of the study sample was in the age group 40-49 years old. Of the total number of women, 65.7 percent had a family history of breast cancer. Early menarche (54.2 percent) and nulliparity (48.5 percent) represented the risk factors with the highest incidence. 57.1 percent of the diagnosed lesions corresponded to stage I and IIA carcinomas. Conclusions: Breast cancer is a serious health problem in women older than 30 years and belonging to the Policlínico Docente 28 de Septiembre, of Santiago de Cuba Municipality(AU)

Menarquia en adolescentes de zona urbana y periurbana de encarnación y su asociación con estado nutricional y menarquia materna. Año 2022

Introducción: La menarquia es un indicador de maduración sexual que se produce entre los 10-15 años. Factores genéticos y ambientales intervienen en la edad de aparición de la menarquia. Objetivos: Determinar la edad de menarquia y su asociación con el estado nutricional y la menarquia materna en adolescentes del 6° grado de instituciones educativas seleccionadas de zona urbana y periurbana de Encarnación. Materiales y métodos: Estudio observacional, descriptivo con componente analítico en adolescentes sin patología endócrina de base, con consentimiento escrito. Se evaluó presencia de menarquia, edad de inicio, estado nutricional, circunferencia abdominal (CA), menarca materna. Resultados: Fueron incluidas 112 adolescentes (urbana 51, periurbana 61), edad promedio 12 años. El 77,7%(n=87) refirió menarca, más frecuente en zona urbana (90,2%, vs 67%c2 p=0,003). Edad promedio de menarquia fue 11,1±0,7 años (urbana 11,4±0,5 vs 10,7±0,8, p=0,0001) y fue menor que la materna con 12,8±1,4 años (p=0,0001). El 16,1% tenía obesidad (23% en zona periurbana versus 7,8% en urbana c2 p=0,002), el 0,9% tuvo desnutrición y un 30,4% sobrepeso. Las adolescentes con obesidad tuvieron menarca a los 10,6±0,9 años vs 11,1±0,7 años en el resto (T Student p=0,03). El 13,4%(n=15) tuvo CA aumentada, y en ellas la edad de menarca fue menor (10,6±0,7 años, p=0,03). Conclusión: Dos tercios de las adolescentes refirió menarquia, aquellas de zona periurbana, con obesidad o circunferencia abdominal aumentada mostraron menor promedio de edad de inicio.

Introduction: Menarche is an indicator of sexual maturation that occurs between 10-15 years of age. Genetic and environmental factors affect the age of onset of menarche. Objectives: To determine the age of menarche and its association with nutritional status and maternal menarche in 6th grade adolescents from selected educational institutions in urban and peri-urban areas of Encarnación. Materials and methods: This was an observational, descriptive study with an analytical component in adolescents without underlying endocrine pathology; written consent was obtained. The presence of menarche, age at onset, nutritional status, abdominal circumference (AC), and maternal menarche were evaluated. Results: 112 adolescents (51 urban, 61 peri-urban) were included, the average age 12 years. 77.7% (n=87) reported menarche, more frequently in urban areas (90.2%, vs 67%, p=0.003). Mean age at menarche was 11.1 ± 0.7 years (urban 11.4 ± 0.5 vs 10.7 ± 0.8, p = 0.0001) and was lower than the maternal age with 12.8 ± 1, 4 years (p=0.0001). 16.1% were obese (23% in peri-urban areas versus 7.8% in urban areas, p=0.002), 0.9% were undernourished and 30.4% were overweight. Adolescents with obesity had menarche at 10.6±0.9 years vs. 11.1±0.7 years in the rest (Student's T, p=0.03). 13.4% (n=15) had increased AC, and in these, the age of menarche was lower (10.6±0.7 years, p=0.03). Conclusion: Two thirds of the adolescents reported menarche, those from the peri-urban area, with obesity or increased abdominal circumference, showed a lower average age of onset.

Study on Menstrual Hygiene Management among Urban and Rural Adolescent Girls in Marathwada region of Maharashtra, India

Introduction: Adolescence is a significant period in the life of a woman. Menstruation is a naturally occurring physiological phenomenon in adolescent girls and premenopausal women. Menstrual hygiene and management is an insufficiently acknowledged issue and has not received adequate attention. The lack of menstrual hygiene among rural population is alarming, and there is a need for policy-making and awareness programs to be initiated. Aim: Hence the present study was aimed to compare the status of menstrual hygiene among rural and urban adolescent girls. Methods: A community-based cross-sectional study was carried out among 250 adolescent girls (rural & urban), aged between 13 to 19 years residing the in field practice area of IIMSR Medical College, Badnapur, Jalna. Data was analyzed by using MS Excel 2010. Results: Out of 250 participants, 48.8% girls from rural area and 51.2% from urban area. The mean age of the menarche was 12.3 ± 1.4 and 12.34 ± 1.43 in rural and urban girls, respectively. Knowledge of menstruation prior to menarche was found to be less in rural girls compared with urban girls. Regarding menstrual hygiene practices during menstruation, out of the total girls residing in rural area 49.18% girl and out of the total girls residing in urban area 62.5% girls were using sanitary pads. Restriction during menstruation was observed more in rural girls than in urban areas. Conclusion: More awareness regarding menarche and menstruation was among urban girls than. Hygienic practices observed by girls were also more satisfactory in the urban area as compared with rural ones.

Impacto da disseminação de informação sobre endometriose no autocuidado de adolescentes de escola pública / Impact of dissemination of information about endometriosis on self-care of public school adolescents

Objetivo: Averiguar o conhecimento das adolescentes sobre endometriose, que é uma doença estrogênio-dependente, podendo ser progressiva, e que se caracteriza pela presença do tecido endometrial fora do útero. Estima-se que a endometriose acometa cerca de 10% das mulheres em idade reprodutiva, sendo 4% a 17% das adolescentes. Métodos: A pesquisa foi desenvolvida com adolescentes estudantes do terceiro ano do ensino médio de escolas estaduais do município de Avaré (São Paulo) de forma descritiva, exploratória e quali-quantitativa, em três etapas: aplicação de questionário, realização de palestra e nova aplicação de questionário. Participaram quatro escolas, totalizando 80 adolescentes participantes na primeira fase e 48 adolescentes na terceira fase. Resultados: Houve aumento de 21,35 vezes no número de adolescentes que se beneficiaram dos conhecimentos gerados pelas palestras, além da replicação da informação para terceiros, possivelmente aumento no número de mulheres que tomaram conhecimento sobre o que é endometriose. Conclusão: Verificou-se que a aplicação de palestras informativas sobre sinais e sintomas de endometriose aumentou o grau de conhecimento de adolescentes entre 16 e 17 anos de escola pública.

Objective: To investigate the knowledge of adolescents about Endometriosis, which is a progressive, estrogen/dependent disease, which can be progressive and which is characterized by the presence of endometrial tissue outside the uterus. It is estimated that it affects about 10% of women of reproductive age, of which 2%-4% are postmenopausal, with or without hormonal treatment, and 4% to 17% of adolescents. Methods: The research was carried out with adolescent students in the 3rd year of high school from state schools in the city of Avaré (São Paulo) in a descriptive, exploratory and qualitative-quantitative manner in three stages: application of a questionnaire, holding a lecture and a new application of quiz. Four schools participated, totaling 80 adolescents participating in the first phase and 48 adolescents in the third phase. Results: There was a 21.35-fold increase in the number of adolescents who benefited from the knowledge generated by the lectures, in addition to the replication of information to third parties, possibly an increase in the number of women who learned about what endometriosis is. Conclusion: It was found that the application of informative lectures on signs and symptoms of endometriosis increased the level of knowledge of adolescents between 16 and 17 years of age in public school.

Prevalence of Anemia among Adolescent Girls in Rural Area of a District of Maharashtra

Introduction: Nutritional anemia is one of India’s major public health problems. Adolescence is a vulnerable period in the human life cycle for the development of nutritional anemia. Anemia in adolescent girls contributes to maternal and foetal mortality and morbidity in future. Aim and Objectives: To estimate the prevalence of anemia among adolescent girls and to study the sociodemographic factors associated with anemia. Method: It was a community based cross sectional study in 10 villages of a district. 420 adolescent girls were interviewed using a predesigned, pretested questionnaire, and their anemic status was assessed by hemoglobin estimation. Results were analyzed by using percentage, proportion and Chi-square test, with the help of Microsoft Excel 2007 and SPSS version 20.0 statistical software. Result: Mean age of the study sample was 14.01 ± 2.57 years. The majority (64.8%) of the girls were Hindu by religion and belonged to a nuclear family (53.6%). 45.2 % were educated up to high school level. Most of the girls belonged to socioeconomic class IV (46.0%). The prevalence of anemia in this study was found to be 65.7%. The prevalence of mild and moderate anemia among study participants was 32.6 and 29.8%, respectively. A statistically significant association was found between the prevalence of anemia with age group, educational status of both father and mother, and status of attainment of menarche (p<0.05). Conclusion and Recommendation: The prevalence of anemia among adolescent girls was very high; therefore, attempts must be made to sensitize adolescents and their parents through health and nutrition education, information, education, and communication (IEC), and appropriate behavioral change communication (BCC) activities.

Association of polycystic ovary syndrome with mammographic density in Turkish women: a population-based case-control study

SUMMARY OBJECTIVE: The objective of this study was to investigate the breast densities and Breast Imaging-Reporting and Data System scores of patients with polycystic ovary syndrome and normoovulatory women and to determine whether these patients constitute a high-risk population for breast cancer. METHODS: This retrospective case-control study was conducted at our institution between January 2022 and December 2022, involving patients diagnosed with polycystic ovary syndrome. Menstrual periods, hyperandrogenemic findings, and ultrasound reports of the patients were retrieved from our hospital's database. Patients who met at least two of the Rotterdam criteria were included in the polycystic ovary syndrome group. A total of 70 premenopausal patients over the age of 40 years, diagnosed with polycystic ovary syndrome, and 70 normoovulatory women, matched for age and body mass index, were included in the study. The two groups were compared regarding age at menarche, menstrual pattern, gravida, parity, levels of follicle-stimulating hormone, luteinizing hormone, and estradiol, endometrial thickness, breast density category, and Breast Imaging-Reporting and Data System classifications. RESULTS: Patients in the polycystic ovary syndrome group had a higher age at menarche (12.7 vs. 12.3, p=0.006). There was no difference between the gonadotropin levels in both groups. However, the estradiol level was higher in the polycystic ovary syndrome group (p<0.001). There was no statistically significant difference between the two groups in terms of breast density and Breast Imaging-Reporting and Data System scores (p=0.319 and p=0.650, respectively). CONCLUSION: Although we can conclude that the risk of breast malignancy is not increased in patients with polycystic ovary syndrome, the impact of the complex hormonal status of polycystic ovary syndrome on breast cancer remains unclear in the literature.

Sobrepeso e obesidade entre mulheres e associação com características demográficas e obstétricas entre usuárias de uma unidade de saúde especializada / Overweight and obesity between women and association with demographic and obstetric characteristics among users of a specialized health unit

Resumo Introdução O excesso de peso é um fator de risco para doenças crônicas. Objetivo Estimar a prevalência de sobrepeso e obesidade, e investigar sua associação com variáveis demográficas, socioeconômicas e reprodutivas e com comportamentos relacionados à saúde entre mulheres usuárias de unidade de atenção especializada. Método Estudo transversal com mulheres em atendimento por mastologista. O estado nutricional foi classificado por meio do índice de massa corporal. Foram utilizados modelos de regressão logística multinomial brutos e ajustados, com estimativa de razões de chance (RC) e intervalos de confiança de 95% (IC95%). A eutrofia foi considerada como categoria de referência. Resultados Participaram 182 mulheres com média de idade de 51 anos. A prevalência de sobrepeso foi de 34,1% (IC95% 27,1-41,0) e de obesidade foi de 31,8% (IC95% 25,0-38,7). Apresentaram maiores chances de obesidade as mulheres: com 60 anos ou mais, que exerciam atividade remunerada, que tiveram menarca antes dos 13 anos e com três ou mais gestações. Após análise ajustada, permaneceram associadas à maior chance de obesidade a menarca antes dos 13 anos (RC 4,40; IC95% 1,76-10,99) e três ou mais gestações (RC 8,50; IC95% 2,14-33,70). Conclusão Verificou-se elevada prevalência de sobrepeso e obesidade entre as participantes, associada às características reprodutivas.

Abstract Background Overweight is a risk factor for chronic diseases. Objective To estimate the prevalence of overweight and obesity and to investigate its association with demographic, socioeconomic, reproductive and health behaviors related among women users of specialized care units. Method Cross-sectional study with women in care by a mastologist. Nutritional status was classified by Body Mass Index (BMI). Gross and adjusted multinomial logistic regression models were used, to estimate an Odds Ratios (OR) and 95% Confidence Intervals (95% CI). Eutrophy was considered as a reference category. Results 182 women with a mean age of 51 years. The prevalence of overweight was 34.1% (CI 95% 27.1-41.0) and obesity was 31.8% (CI 95% 25.0-38.7). Women were more likely to be obese: 60 years of age or older, who were gainfully employed, who had menarche before age 13, and with three or more pregnancies. After adjusted analysis, they remained associated with a greater chance of the development of obesity to menarche before 13 years (OR 4.40 CI 95% 1.76-10.99) and three or more pregnancies (OR 8.50 CI 95% 2.14-33.70). Conclusion There was a high prevalence of overweight and obesity among the participants, associated with reproductive characteristics.

Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China / 北京大学学报(医学版)

OBJECTIVE@#To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province.@*METHODS@#Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression.@*RESULTS@#The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66).@*CONCLUSION@#The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.

Association between school bullying and the early age at menarche among girls / 中国学校卫生

Objective@#To analyze the correlation between school bullying and the age at menarche (AAM) in girls, so as to provide references for promoting the healthy growth of girls in puberty.@*Methods@#In April 2022, a total of 987 middle school girls with onset of menarche in Rongchang District of Chongqing were selected by using a stratified random cluster sampling method to carry out a questionnaire survey and physical examination. The t tests,variance analysis and Dunnett t tests were conducted to analyze the differences between individuals who experienced different types of school bullying and AAM. Multivariate Logistic regression analysis was conducted to analyze the association between school bullying and the early age at menarche.@*Results@#The average AAM of 987 girls was (12.13±1.03) years, and 22.90% of them had early AAM. The AAM of those who did not experience bullying events (12.18±0.96) varied significantly with those who experienced bullying events (11.86±1.44) ( t=3.71, P <0.01). The average AAM of individuals who experienced 1, 2, 3 or more school bullying events was (12.08±1.38, 11.74±1.07, 11.61± 1.63 ) years old, respectively. There was a statistically significant difference in AAM between girls who did not experience school bullying and those who experienced 1, 2, 3 or more types of school bullying ( F=6.99, P <0.01). Multivariate Logistic regression analysis found that after adjusting confounding factors, experiencing school bullying ( OR=2.71, 95%CI =2.04-4.27), being deliberately excluded from collective activities or being isolated ( OR=2.58, 95%CI =1.69-4.67), being kicked, pushed or locked in the house ( OR= 2.85 , 95%CI =1.39-4.92), being teased due to physical defects or appearance ( OR=2.74, 95%CI =1.77-5.02), experiencing one school bullying event ( OR=2.33, 95%CI =1.52-4.23), and experiencing two school bullying events ( OR=3.36, 95%CI = 1.82 -7.36), and experiencing three or more school bullying events ( OR=2.89, 95%CI =1.74-5.71) were associated with the early age at menarche ( P <0.05).@*Conclusion@#School bullying is related to the earlier AAM among girls. Strengthening school anti bullying education might be helpful for promoting girls healthy growth and development in adolescence.

Relationship of Cognitive Function With Menarche Age,Menopause Age, and Reproductive Period in Female Patients With Hypertension / 中国医学科学院学报

Objective To explore the relationship of menarche age,menopause age,and reproductive period with cognitive function in the female patients with hypertension.Methods Hypertension screening was carried out in Wuyuan county of Jiangxi province from July to August in 2018.Data were collected through a face-to-face questionnaire survey,physical measurement,and biochemical tests.The cognitive function was scored according to the mini-mental state examination(MMSE)scale.Multiple linear regression and Logistic regression were employed to analyze the effects of menarche age,menopause age,and reproductive period on cognitive function,and the penalized spline regression to fit the curves.Results A total of 4595 postmenopausal women with hypertension were included in the analysis,with the mean age of(65.1±8.4)years,mean menarche age of(16.6±2.2)years,mean menopause age of(48.2±5.0)years,mean reproductive period of(31.7±5.5)years,mean MMSE score of(19.0±6.3)points,and total cognitive impairment detection rate of 40.4%(1859/4595).The detection rates of cognitive impairment were 28.4%,39.1%,and 45.8% in the females with the menarche ages of <15,15-16,and ≥17 years,47.9%,39.7%,and 38.3% in the females with the menopausal ages of <45,45-49,and ≥50 years,and 56.0%,44.4%,40.6%,and 32.6% in the females with the reproductive periods of <25,25-29,30-34,and ≥35 years,respectively.Moreover,the detection rates of cognitive impairment among different age groups were statistically significant(all P<0.05).Compared with the group with the menarche age <15 years,the groups with the menarche ages of 15-16 years and ≥17 years showed increased detection rates of cognitive impairment(OR=1.45,95%CI=1.19-1.75,P<0.001;OR=1.65,95%CI=1.37-1.98,P<0.001).Compared with the group with the menopausal age <45 years,the groups with the menopausal ages of 45-49 years and ≥50 years showed decreased detection rates of cognitive impairment(OR=0.80,95%CI=0.66-0.95,P=0.013;OR=0.78,95%CI=0.65-0.93,P<0.001).Compared with the group with the reproductive period <25 years,the groups with the reproductive periods of 25-29,30-34,and ≥35 years showed decreased detection rates of cognitive impairment(OR=0.66,95%CI=0.52-0.84,P<0.001;OR=0.62,95%CI=0.50-0.76,P<0.001;OR=0.51,95%CI=0.41-0.63,P<0.001).Conclusion The detection rate of cognitive impairment had a positive correlation with menarche age and negative correlations with menopause age and reproductive period in the female patients with hypertension.

Corioangioma en paciente multípara. Caso clínico / Chorioangioma in multiparous aged. Clinical case

Resumen ANTECEDENTES: El corioangioma es un tumor vascular de origen placentario perteneciente al grupo de los hemangiomas vasculares. Es el tumor placentario primario no trofoblástico más frecuente de origen vascular. CASO CLÍNICO: Paciente de 37 años con antecedentes de: menarquia a los 12 años, inicio de la vida sexual activa a los 13 años, tres embarazos y dos partos. Del embarazo actual solo había tenido dos consultas prenatales. El ultrasonido reportó 35 semanas de embarazo con feto de 2250 g. La paciente tuvo dolor de origen obstétrico y trabajo de parto en fase latente. El parto fue eutócico, sin complicaciones. Se observó una tumoración placentaria. CONCLUSIONES: La valoración placentaria mediante ultrasonido-Doppler de control es importante para detectar tumoraciones y evitar que, cuando son pequeñas, pasen inadvertidas, como los corioangiomas.

Abstract BACKGROUND: Chorioangioma is a vascular tumor of placental origin belonging to the group of vascular hemangiomas. It is the most frequent non-trophoblastic primary placental tumor of vascular origin. CLINICAL CASE: 37-year-old patient with a history of: menarche at 12 years of age, beginning of active sexual life at 13 years of age, three pregnancies and two deliveries. She had only had two prenatal visits for the current pregnancy. The ultrasound reported 35 weeks of pregnancy with a 2250 g fetus. The patient had pain of obstetric origin and labor in the latent phase. The delivery was euthecological, without complications. A placental tumor was noted. CONCLUSIONS: Placental assessment by control ultrasound-Doppler is important to detect tumors and to avoid that, when they are small, they go unnoticed, such as chorangiomas.

A STUDY ON THE SELECTED MENSTRUAL CHARACTERISTICS OF THE COLLEGE GIRLS

Direct involvement of females in high-intensity exercise causes hormonal changes and also affects the menstrual cycle. The duration of the normal reproductive cycle in females is about 26-35 days and divided into different phases. In the absence of pregnancy, menstruation or vaginal bleeding occurs, about 8 days after ovulation which is followed by low estrogen and progesterone levels as well as endometrium deterioration. The purpose was to study the menstrual profile of college girls and compare them between the athletes and non-athletes. The subjects were 30 female college athletes with regular conditioning and 30 sedentary female college girls from West Bengal. The variables were Height, Weight, BMI, Menarche Age, Menstrual Age, Menstruation duration, and Flow rate history of the subjects which were measured by the self-made questionnaire validated by Professors and Doctors. The mean day of the menstrual cycle was 27.5 for athletes and 25.9 for non-athletes. The days of menstrual duration also show normal characteristics in the case of athletes and less than the nonathletes. In the case of flow rate also the athletes show less than their counterparts. The menarche ages are lying in the same age range of 12 to 15 years. More non-athletes (23) have crossed over the normal cycle of 25-28 days than the athletes (17). Athletes (27) have a more normal menstrual duration (3-5 days) than non-athletes (21). Non-athletes (8) suffer a long period of menstrual duration than athletes (1). The flow rate of the non-athletes is more than the athletes. A significant effect of exercise occurred on the menstrual profile of college girls. Significance differences were found in the case of menstrual duration and flow rate between athletes and non-athletes. No significant difference occurred in the case of menarche age between athletes and non-athletes.

Correlation of Body mass index with premenstrual syndrome and age at menarche in medical students

Background: The female reproductive cycle encompasses various physiological phenomenon and menstruation being one such is associated with various problems affecting the quality of life. Premenstrual syndrome (PMS) is one of them. Body mass index (BMI) is considered a modifiable risk factor for PMS and is also related to the age at menarche. Aim and Objectives: To determine the correlation of BMI with PMS and the age of onset of menarche among medical students. Materials and Methods: The cross-sectional study was conducted at a Medical College at Gangtok, among 100 consenting participants after obtaining due permission from the Institutional Ethics Committee. Apart from demographic details, height and weight were recorded along with age of onset of menarche. The presence or absence of PMS was evaluated using Calendar of Premenstrual experiences, a self-reported dairy measure of PMS developed by Mortola et al. Results: Mean age of participants was 20.7 years and at mean age of 12.5 years they attained menarche. Girls who had either low or high BMI attained menarche at a higher age, but the difference was not significant (P = 0.142). Association between PMS and BMI was poor (0.027, P = 0.869). The correlation analysis found a poor negative correlation (?0.052, P = 0.606) between BMI and age at menarche. The correlation between age at menarche and the presence of PMS was positive (0.182, P = 0.07). Conclusion: PMS was seen in 53% of the study population, but only 24% had a high BMI. Deviated BMI from normal had menarche at a higher age and there was a poor correlation between the BMI and PMS.

Reconstrucción cervical con conexión vaginal secundaria a agenesia cervical. Reporte de caso / Cervical reconstruction with vaginal conexion secundary to cervical agenesia. Case report

Resumen ANTECEDENTES: La agenesia cervical congénita es una anomalía poco común del sistema de Müller, que generalmente se reconoce durante la menarquia. Hasta hace poco, el tratamiento de primera elección era la histerectomía, debido a que no se consideraba una enfermedad compatible con la fertilidad. Hoy en día, gracias a las técnicas de reproducción asistida, se han desarrollado procedimientos quirúrgicos menos agresivos que sí preservan la fertilidad de las pacientes. OBJETIVO: Revisar un caso de agenesia cervical a partir de su tratamiento quirúrgico y seguimiento de la reconstrucción cervical con la conexión entre la vagina y el útero, revisar la bibliografía y cómo establecer el pronóstico a largo plazo. CASO CLÍNICO: Paciente de 12 años llevada a consulta ante la ausencia de menstruación. El procedimiento diagnóstico transcurrió sin que se encontraran alteraciones; sin embargo, en la laparoscopia diagnóstica operatoria efectuada a los 14 años, indicada por dolor pélvico cíclico, se advirtieron la ausencia del cuello del útero, un hematometra y endometriosis grado IV. En el segundo tiempo quirúrgico, practicado en conjunto con el cirujano pediatra, se practicó, por laparotomía, la comunicación entre el útero y la vagina. En la actualidad, la paciente tiene 19 años y sus menstruaciones son cíclicas, no dolorosas. En el último ultrasonido se visualizó la conexión entre el útero y la vagina. CONCLUSIONES: Hoy en día, la anastomosis útero vaginal es un procedimiento capaz de mantener la función del útero y permitir el embarazo, con los cuidados adecuados.

Abstract BACKGROUND: Congenital cervical agenesis is a rare anomaly of the Müllerian system, usually recognized during menarche. Until recently, the treatment of first choice was hysterectomy, because it was not considered a disease compatible with fertility. Today, thanks to assisted reproductive techniques, less aggressive surgical procedures have been developed that do preserve the fertility of patients. OBJECTIVE: To review a case of cervical agenesis from its surgical treatment and follow-up cervical reconstruction with the connection between the vagina and the uterus, review the literature and how to establish the long-term prognosis. CLINICAL CASE: A 12 years old female patient was brought for consultation due to absence of menstruation. The diagnostic procedure was carried out without finding any alterations; however, in the operative diagnostic laparoscopy performed at the age of 14, indicated by cyclic pelvic pain, the absence of the cervix, a hematometra and endometriosis grade IV were noticed. In the second surgery, performed in conjunction with the pediatric surgeon, the communication between the uterus and the vagina was performed by laparotomy. At present, the patient is 19 years old and her menses are cyclical, not painful. In the last ultrasound the connection between the uterus and the vagina was visualized. CONCLUSIONS: Today, utero-vaginal anastomosis is a procedure capable of maintaining the function of the uterus and allowing pregnancy, with proper care.

Relationship between age at menarche and screening positive myopia among girls / 中国学校卫生

Objective@#To assess screening method for myopia among Chinese school age children and adolescents, and to provide scientific evidence for an appropriate protocol for vision screening.@*Methods@#According to technical protocols of 2014 Chinese National Survey on Students Constitution and Health, a total of 1 725 primary and middle school girls aged 9 to 13 years old from Suzhou, Hefei and Chizhou of Anhui Province were selected. Basic information and menarche were collected by questionnaires. Distance visual acuity and subjective refraction were used for screening myopia. And multivariate Logistic regression analysis was used to analyze the relationship between menarche and screening myopia.@*Results@#The detection rate of screening positive myopia of girls aged 9-13 years in Anhui province was 62.5%(1 078). The ratio of screening myopia was significantly higher in urban girls (71.0%) compared with suburban girls(54.6%), and higher in girls with homework time >2 h compared (70.8%) with homework time 1-2 h and <1 h (68.4%, 54.9%) groups ( χ 2=49.50, 37.88, P <0.01). The detection rate of screening myopia between different menarche groups was only statistically significant among girls aged 9 and 13 years ( χ 2=4.75, 11.22, P <0.05). Multivariate Logistic regression analysis showed that menarche was significantly associated with screening myopia ( OR =2.06, 95% CI =1.68- 2.52 ). After controlling age and BMI, the association remained ( P <0.05). After further controlling family residence background and homework time, the association diminished ( P >0.05).@*Conclusion@#Menarche is closely associated with screening myopia among girls in selected age groups, future cohort studies are needed to focus on prevention and control of myopia during pubertal development.

Association between age at menarche and prehypertension in female college students / 中国学校卫生

Objective@#To explore the correlation of age at menarche and prehypertension in female college students.@*Methods@#Age at menarche of 558 female college students was collected, while blood pressure, height and weight were measured, and body mass index(BMI) was calculated.@*Results@#Average age at menarche was (12.48±0.95) years, prevalence of prehypertension was 17.56% (98/558). The age of menarche was 8-11, 12, 13, 14, 15-19, and the prevalence of hypertension was 30.95%, 10.00% , 17.31%, 10.81%, 31.58% respectively, U shape association was observed in the association between prehypertension with age at menarche, lowest when age at menarche was <12 years. There was no significant difference in prehypertension between age at menarche was 13, 14 years old with 12-year-old group, those age at menarche 8-11 or 15-19 had a significantly higher risk of developing prehypertension than those 12-year-old( OR =4.03, 4.15, P <0.05).@*Conclusion@#Early or late menarche is associated with high blood pressure, appropriate intervention for girls with early menarche and obesity may be beneficial in reducing their future hypertension.

Association between exposure to artificial light at night and the occurrence of menarche in Han girls / 中国学校卫生

Objective@#To analyze the association between the occurrence of menarche and the exposure to artificial light at night (ALAN) in female Han nationality girls aged 9-18 in China, so as to provide a reference for the research on the disturbance mechanism of ALAN on puberty, as well as provide a scientific evidence for controlling ALAN and making public sanitary policy.@*Methods@#A total of 74 483 Han girls aged 9-18 with complete records of menarche, height, and weight were included in the 2014 Chinese National Surveys on Students Constitution and Health. Pearson correlation was used to explore the correlation between the incidence of menarche and the exposure to artificial light at night in 11-year-old Han girls, and the third quantiles of the area covered by outdoor night lights (0.16, 0.60) and the third quantiles of the average night light intensity [0.97, 5.91 nw/(sr ·cm) 2] were used respectively to divide the study subjects into 3 groups, and the multifactor Logistic regression model was used to analyze the effect of artificial light at night exposure on menarche.@*Results@#In 2014, the median age of menarche of Chinese Han girls was 12.18 years old, and the incidence of menarche in the 11-year-old group was 26.31%. After controlling for body mass index, local population and the logarithmic values of per capita GDP, the incidence of menarche of 11-year-old Han girls was positively correlated with the local outdoor average night light coverage area ratio and the night average light intensity logarithmic adjustment value( r =0.29, 0.30, P <0.05).The higher the local outdoor night light coverage area ratio ( OR =1.28, 1.52) and the average night light intensity ( OR =1.47, 1.58), the higher the incidence of menarche in 11-year-old Han girls( P <0.05).@*Conclusion@#There is a positive correlation between artificial light at night exposure and the menarche rate of 11-year-old Han girls. Research on artificial light at night exposure may provide scientific evidence on puberty onset and its effects on population health.

Menstrual cycle among adolescents: girls' awareness and influence of age at menarche and overweight / Ciclo menstrual em adolescentes: percepção das adolescentes e influência da idade de menarca e excesso de peso

Abstract Objective: To characterize the menstrual cycle (regularity and menstrual flow length), the prevalence of dysmenorrhea and self-monitoring of the cycle in students from Lisbon region, and explore the effect of chronological age, age at menarche and body mass index (BMI) on menstrual disorders. Methods: This is a cross-sectional study with 848 girls aged 12-18 years. A questionnaire about the sociodemographic context and characteristics of the menstrual cycle, and weight and height measures were assessed. BMI was classified according to International Obesity Taskforce criteria. A descriptive analysis of the variables was made, and Odds Ratios (ORs) and 95% confidence intervals (95%CIs) were determined. Results: Mean age at menarche was 12.4 years and mean BMI was 22.0kg/m2. Among adolescents, 59% have regular menstrual cycle, 83% have menstrual flow length of ≤6 days. 88% suffered from dysmenorrhea, among which 8,7% declare absenteeism from school and 49% took pain medication, and 65% self-monitor their menstrual cycle. Higher maternal education was associated with a higher self-monitoring of menstrual cycle among the sample (OR 1.60; 95%CI 1.15-2.17). Girls with menarche <12 years-of-age are more likely to have menstrual flow length of >6 days (OR 1.73; 95%CI 1.19-2.51) and dysmenorrhea (OR 1.87; 95%CI 1.11-3.16) than those with menarche ≥12 years-of-age. No significant association between BMI and menstrual cycle variables was observed. Conclusions: The results suggest that menstrual disorders are frequent and may be associated with early menarche, but not with BMI. It is important to encourage self-monitoring of the menstrual cycle to detect menstrual disorders timely and promote health and well-being.

Resumo Objetivo: Caracterizar o ciclo menstrual (regularidade e duração da menstruação), prevalência de dismenorreia e automonitoramento do ciclo em estudantes da região de Lisboa, e explorar o efeito da idade cronológica, idade de menarca e índice de massa corpórea (IMC) nos distúrbios menstruais. Métodos: Este é um estudo transversal com 848 meninas entre 12 e 18 anos. Foi aplicado um questionário sobre contexto sociodemográfico e características menstruais e feita a medição do peso e altura. O IMC foi classificado pelos critérios da International Obesity Taskforce. Fez-se uma análise descritiva das variáveis e determinaram-se Odds Ratio (p<0,005; IC95%). Resultados: A média da idade de menarca foi 12.4 anos e do IMC foi de 22.0kg/m2. Entre as jovens, 59% afirmaram ter ciclo menstrual regular, 83% menstruação com duração ≤6 dias, 88% sofrem de dismenorreia, entre as quais 8,7% faltaram à escola e 49% consumiram analgésicos, e 65% automonitoram o ciclo menstrual. Uma educação materna elevada está associada a maior monitorização do ciclo menstrual entre as jovens (OR 1,60; IC95% 1,15-2,17). Meninas com idade de menarca <12 anos têm maior chance de ter menstruação com duração >6 dias (OR 1,73; IC95% 1,19-2,51) e dismenorreia (OR 1,87; IC95% 1,11-3,16) do que aquelas com menarca ≥12 anos. Não se observou associação entre o IMC e as características menstruais. Conclusões: Os resultados sugerem que os distúrbios menstruais são frequentes nas adolescentes e podem estar associados com a menarca precoce, mas não com o IMC. É importante incentivar a automonitoramento do ciclo menstrual para detectar adequadamente as perturbações menstruais e promover a saúde e bem-estar.

Fatores associados à idade da menopausa natural na coorte Elsa-Brasil / Factors associated with age at natural menopause in the Elsa-Brasil cohort

Introdução: No Brasil, a média etária da menopausa está entre 50 a 51,2 anos. Quando precoce, a menopausa se associa ao maior risco para doenças cardiovasculares, diabetes mellitus tipo 2 e osteoporose, entre outras doenças. Características sociodemográficas, hábitos de vida e fatores reprodutivos podem interferir na idade da menopausa natural, porém existem poucos estudos sobre essas relações no contexto brasileiro. Objetivo: Analisar os fatores associados à idade da menopausa natural em mulheres participantes do Estudo Longitudinal de Saúde do Adulto ELSA ­ Brasil, na primeira (2008 ­ 2010) e segunda visita (2012 ­ 2014). Metodologia: Estudo transversal, com dados da primeira (2008-2010) e segunda (2012-2014) visita do Elsa-Brasil. Foram elegíveis para participar deste estudo todas as 3.538 mulheres com relato de menopausa natural durante a 1ª ou 2ª visita ao ELSA. O desfecho do estudo foi a idade da menopausa natural (variável contínua). Variáveis explicativas: características sociodemográficas (idade, renda, escolaridade, raça/cor), reprodutivas (idade da menarca, histórico de gestação número de partos e abortos, duração do ciclo menstrual, uso de anticoncepcional), hábitos de vida (tabagismo, uso de álcool, consumo diário de frutas e verduras, atividade física), variáveis de saúde (obesidade, diabetes, hipertensão). A associação entre essas variáveis explicativas e o desfecho foi feita por regressão linear múltipla. Resultados: A média de idade da menopausa natural foi 49,07 anos. Encontramos que, quanto menor a escolaridade, menor a média da idade da menopausa (Fundamental incompleto versus Ensino Superior: ß -1.26; IC95%-1.93; -0.59; Fundamental versus Ensino Superior: ß-1.19; IC95%-1.79; -0.60; Ensino Médio versus Ensino Superior: ß-0.81; IC95%-1.16; -0.47). Adicionalmente, encontramos menores médias da idade da menopausa entre mulheres que reportaram raça/cor da pele parda (ß:-0.43; IC95%-0.80; -0.06) e indígena (ß:-1.71; IC95% -3.12; -0.30), quando comparadas às mulheres brancas. As tabagistas também apresentaram menor média de idade da menopausa (ß:-0.84; IC95%-1.29; - 0.39), em relação às que reportaram nunca ter fumado. Observamos também que mulheres com maior número de gestações apresentaram maior média de idade da menopausa quando comparadas às mulheres com nenhuma gestação (2 gestações ß:0.46; IC95% 0.01; 0.93, 3 gestações ß:1.01; 0.53;1.50, 4 ou mais ß:0.93; IC95% 0.45;1.41 em relação a nenhuma gestação). Por fim, também encontramos que, enquanto mulheres com ciclos menstruais curtos (<25 dias) foram associadas à menor idade da menopausa (ß -0.58; IC95% -1.15; -0.02), mulheres com ciclos menstruais longos (>35 dias) foram associadas à maior idade da menopausa (ß: 2.24; IC95% 1.43; 3.04), quando comparadas às mulheres com ciclos de 25-35 dias. Conclusão: Menor escolaridade, tabagismo, cor da pele parda e indígena e menor ciclo menstrual associaram-se a menores médias de idade da menopausa natural, enquanto o maior ciclo menstrual e o maior número de gestações associaram-se positivamente ao desfecho. Este estudo soma-se a outros estudos nacionais sobre o tema e tem potencial para auxiliar a compressão acerca de fatores relacionados à idade da menopausa e, consequentemente, ser fonte de evidências para formulação de políticas mais abrangentes na saúde da mulher, com a intenção de minimizar os impactos que podem ser gerados na idade da menopausa e, consequentemente, nas comorbidades advindas de uma menopausa precoce.

Introduction: In Brazil, the average age of menopause is between 50 and 51.2 years. When early, menopause is associated with a higher risk for cardiovascular diseases, type 2 diabetes mellitus and osteoporosis, among others. Sociodemographic characteristics, life habits and reproductive factors can interfere with the age of natural menopause, but there are few studies on these relationships in the Brazilian context. Objective: To analyze factors associated with age at natural menopause in women participating in the ELSA Adult Health Longitudinal Study ­ Brazil, at the first (2008 ­ 2010) and second visit (2012 ­ 2014). Methodology: Cross-sectional study, with data from the first (2008-2010) and second (2012-2014) visit in Elsa-Brasil. A total of 3,538 women were studied, considering the age of natural menopause as outcome. Explanatory variables: sociodemographic characteristics (age, income, education, race/color), reproductive characteristics (age at menarche, history of pregnancy - number of deliveries and abortions, duration of the menstrual cycle, use of contraceptives), life habits (smoking, use alcohol consumption, daily consumption of fruits and vegetables, physical activity), health variables (obesity, diabetes, hypertension, symptoms of depression). The association between these variables and the outcome was analyzed by multiple linear regression. Results: The mean age of natural menopause was 49.07 years. The following variables were associated with menopause age: low schooling (High school: ß-0.81; 95%CI-1.16;-0.47, Elementary school: ß-1.19; 95%CI-1.79;-0.60, Incomplete elementary school: ß -1.26;95%CI -1.93, -0.59) in relation to higher education; brown and indigenous skin color in relation to white skin color (ß: -0.43; 95%CI-0.80;-0.06 and ß:-1.71; 95%CI -3.12;-0.30); smoking (ß:-0.84;CI95%-1.29;- 0.39) in relation to never having smoked; number of pregnancies (2 pregnancies ß:0.46; 95%CI 0.01; 0.93, 3 pregnancies ß:1.01; 0.53;1.50, 4 or more ß:0.93; 95%CI 0.45;1.41); in relation to no pregnancy; and menstrual cycle <25 days and >35 days (ß -0.58; 95%CI -1.15; -0.02, ß: 2.24; 95%CI 1.43; 3.04), compared to 25-35 days. Conclusion: Lower schooling, smoking, brown and indigenous skin color and shorter menstrual cycle were associated with lower mean age at natural menopause, while longer menstrual cycle and higher number of pregnancies were positively associated with the outcome. This study adds to other national studies on the subject and is able to help in clinical practice when health professionals have access to quality data, in the discussion and formulation of more comprehensive women's health policies that work on associated factors with the intention of minimizing the impacts that can be generated in the age of menopause and consequently in the comorbidities arising from an early menopause.

Variantes de la pubertad precoz en las niñas / Variants of precocious puberty in girls

Introducción: El inicio de la pubertad está determinado por la interacción entre factores genéticos y reguladores. En las niñas ocurre alrededor de los ocho años. Puede afectarse cuando existe una pubertad adelantada, pubertad precoz o una variante de la pubertad. Para su diferenciación los estudios imagenológicos se han convertido en una herramienta vital. Objetivo: Describir aspectos fisiopatológicos, clínico-epidemiológicos y del diagnóstico por imágenes de la pubertad precoz y de sus variantes puberales en las niñas. Métodos: Se realizó una revisión sistemática a través de términos de búsqueda según descriptores en ciencias de la salud. Se utilizaron artículos de libre acceso en las bases de datos de PubMed, SciELO y Google Académico. De un total de 125 artículos, se utilizaron 45 de mayor interés: 34 en idioma español y nueve en inglés, que incluyeron libros y revistas. Análisis e integración de la información: Constituye un desafío distinguir la pubertad precoz de la telarquia, pubarquia, adrenarquia o menarquia aislada de aparición precoz, ya que son variantes del desarrollo puberal. Para su diagnóstico es importante descartar una causa tratable subyacente. El examen físico, análisis de laboratorio y estudios por imágenes, permiten diferenciar las formas completas de sus variantes y las posibles causas que determinan la estimulación de la producción hormonal. Conclusiones: El conocimiento del desarrollo normal de la pubertad y la aparición de sus variantes en las niñas resultan de gran utilidad. Su detección temprana ayudaría a recibir atención médica y descartar mediante métodos de imágenes sus causas secundarias(AU)

Introduction: The start of puberty is determined by the interaction between genetic and regulatory factors. Among girls this occurs around the age of eight years. However, the process may be affected by the presence of early puberty, precocious puberty or a variant of puberty. Imaging studies have become a vital tool for their differentiation. Objective: Describe the pathophysiological, clinical-epidemiological and imaging diagnostic aspects of precocious puberty and its pubertal variants in girls. Methods: A systematic review was conducted using search terms obtained from health sciences descriptors. The documents reviewed were open access papers from the databases PubMed, SciELO and Google Scholar. Of a total 125 papers retrieved, a selection was made of the 45 of greatest interest: 34 in Spanish and 9 in English, including books and journals. Data analysis and integration: Distinguishing precocious puberty from thelarche, pubarche, adrenarche or isolated premature menarche is a challenge, for these are variants of pubertal development. Ruling out an underlying treatable cause is important for diagnosis. Physical examination, laboratory analysis and imaging studies make it possible to differentiate complete forms from their variants and the possible causes determining the stimulation of hormone production. Conclusions: Knowledge about the normal development of puberty and the emergence of its variants in girls is very useful. Early detection would pave the way for medical care, including imaging studies to rule out its secondary causes(AU)