An International Menopause Society study of vasomotor symptoms in Bangkok and Chiang Mai, Thailand.

OBJECTIVES: To examine relationships between location, demographics, lifestyle, beliefs, and experience of hot flushes and night sweats (HFNS) amongst women living in two cities in Thailand. METHODS: Cross-sectional study of peri- and postmenopausal women, aged 45-55 years, from Bangkok and Chiang Mai. Participants completed questionnaires (demographics, health, HFNS (prevalence, frequency and problem-rating) and beliefs about menopause). A sub-sample of women from each location was interviewed. RESULTS: A total of 632 women (320 Bangkok and 312 Chiang Mai) aged 50.88 (standard deviation 3.06) years, took part. The prevalence of HFNS was 65%, average HFNS frequency 8.7 (10.8) per week and problem rating 4.3/10. Women from Chiang Mai had significantly more problematic HFNS, but prevalence and frequency were similar in both sites. Poor general health predicted HFNS prevalence and frequency, while Chiang Mai location, HFNS frequency, age, diet and beliefs about menopause were associated with problematic HFNS. Location remained significant after controlling for education, occupation and age; location was partially explained by beliefs. Qualitative interview responses illustrated the differences in beliefs about menopause between locations. CONCLUSION: HFNS reports are prevalent with moderate frequency and problem-ratings in these urban centers in Thailand. The results will be included in the broader International Menopause Society study of Climate, Altitude and Temperature (IMS-CAT) of the impact of climate on HFNS.

The risk of residual neoplasia in women with microinvasive squamous cervical carcinoma and positive cone margins.

The objective was to evaluate the prevalence and factors affecting residual disease in women with cervical microinvasive carcinoma (MIC) with positive cone margins for high-grade lesions and invasive carcinoma. We reviewed histopathology slides of 129 women with MIC who had high-grade lesions or invasive carcinoma at cone margins. These patients underwent hysterectomy following cone biopsy between January 1994 and June 2004. Of the 129 patients, 77 (59.7%) had residual disease in the hysterectomy specimens, in which 57 (44.2%) had residual high-grade lesions. Twenty patients (15.5%) had residual invasive carcinoma: 18 were microinvasive and 2 were invasive. Factors significantly affecting the risk of residual disease included positive postconization endocervical curettage (P= 0.001), positive cone margins for invasive carcinoma (P= 0.003), and depth of stromal invasion >1 mm (P= 0.014). Cox proportional hazards analysis revealed positive cone margins for invasive carcinoma as significant predictor of residual invasive disease (hazard ratio, 3.22; 95% CI 1.21-8.60, P= 0.019) In summary, patients with MIC and positive cone margins for high-grade lesions or invasive carcinoma are at high risk of residual neoplasia. Repeat cone biopsy should be performed to determine exactly the severity of lesion before planning treatment.