Eating Behaviors and Physical Activity versus the Big Five Personality Traits in Women with a Hereditary Predisposition to Breast or Ovarian Cancer.

The Big Five personality traits-neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness-represent continuous, individual features that affect a number of vital health aspects, including morbidity, self-reported health status, or lifestyle. The aim of this study was to analyze the relationship between the eating behaviors and engagement in physical activity of women with a hereditary predisposition to breast or ovarian cancer and the Big Five personality traits. A total of 357 women, participants of 'The National Program for Families With Genetic/Familial High Risk for Cancer', were included in the study. In the healthy group, the following statistically significant predictors were found in variables: agreeableness-meal frequency (ß = 0.151; p = 0.030); neuroticism-consumption of fruits and vegetables (ß = -0.177; p = 0.016) and cereal products (ß = -0.223; p = 0.002); openness to experience-consumption of plant-based fats (ß = 0.141; p = 0.034) and physical activity (ß = 0.153; p = 0.021). In the cancer group, the frequency of dairy consumption (ß = 0.286; p = 0.003) and physical activity (ß = 0.370; p = 0.000) were found to be statistically significant predictors for the openness to experience variable. Neuroticism is associated with less frequent consumption of fresh fruits and vegetables as well as cereal products. Openness to experience was more often linked with a higher frequency of dairy consumption, plant-based fats, and physical activity. Women with breast or ovarian cancer and a higher openness to experience consumed dairy and engaged in physical activity more often than their peers with the remaining personality traits.

Cooperation between midwives and doulas in the context of perinatal care - a integrative review of qualitative and quantitative studies.

BACKGROUND: A doula is a person who provides support to women in the perinatal period without providing medical services. During childbirth, the doula becomes a member of the interdisciplinary team. This integrative review aims to analyse the nature of the cooperation between doulas and midwives, its efficiency and challenges and ways of strengthening this cooperation. METHODS: A structured integrative review of empirical and theoretical studies written in English was conducted. The literature search included MEDLINE, Cochrane, Scopus, ProQuest, Science Direct, Web of Science, and Embase Health Source: Nursing/Academic Edition databases. The analysis included papers published in 1995-2020. Dedicated documents were searched for different combinations of terms and standard logical operators. A manual search of the studies was included for additional references. RESULTS: Twenty-three articles from 75 full-text records were analysed. Three main themes emerged. (1) doulas are needed to prop up the system (2) barriers in collaboration between midwives and doulas; and (3) how cooperation between midwives and doulas can be strengthened. None of the articles referred directly to the impact of collaboration between midwives and doulas on the quality of perinatal care. CONCLUSION: This is the first review to analyse the impact of collaboration between midwives and doulas on the quality of perinatal care. Ensuring adequate collaboration between doulas and midwives requires effort from both of these professional groups and the health care system. However, such collaboration is supportive for birthing women and the perinatal care system. Further research in terms of the impact of this collaboration on the quality of perinatal care is needed.

SARS-CoV-2 in Pregnancy-A Retrospective Analysis of Selected Maternal and Fetal Laboratory Parameters.

Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate the effect of SARS CoV-2 infection on the mode of delivery, neonatal condition and selected maternal and fetal laboratory parameters. This was a single-center retrospective case-control study. This dataset was generated using electronic medical records collected by medical personnel. Two groups of patients, hospitalized between April, 2020 and February, 2021, were included in the study: study group (304)-pregnant women with SARS-CoV-2 and control group (N = 329)-healthy pregnant women or parturients. Mothers with a severe course of COVID-19 had higher activated partial thromboplastin-APTT (p = 0.02), C-Reactive Protein-CRP (p = 0.00) and procalcitonin (p = 0.032) levels as compared to pregnant women with mild or moderate course of the disease. Neonates born to SARS-CoV-2-infected mothers presented with worse condition at 1 and 5 minutes of life (p = 0.000 and 0.00, respectively) and lower Arterial Blood Gas-ABG pH scores (p = 0.016). Elective cesarean section is the most common mode of delivery for SARS-CoV2-infected mothers. Emergency cesarean sections are performed at earlier gestational age as compared to vaginal delivery and elective cesarean section. Lower Apgar scores were observed in neonates born to SARS-CoV-2-infected mothers who required oxygen therapy and whose procalcitonin levels were elevated. There is a relationship between more severe course of COVID-19 and APTT, as well as CRP and procalcitonin levels.

Determinants favoring weight regain after weight-loss therapy among postmenopausal women.

Little is known about the factors affecting body weight-loss maintenance among postmenopausal women. We thus performed an analysis to identify some sociodemographic, physiological, and behavioral predictors of weight regain in a targeted subpopulation of women who had lost weight 1 year earlier. We also measured how eating behaviors and habits as well as physical activity pattern differ among successful and unsuccessful weight-loss maintainers over the trial. Sixty-four postmenopausal women were followed up for a year after dieting, and the successful and unsuccessful maintainers were identified. The regainers had regained an average of 4.9 kg of their lost body weight, while the maintainers had regained only 1.5 kg. Regainers had fewer years of education and lower initial body weight loss than maintainers. They also showed poor dietary adherence during dieting, and had unhealthy patterns of eating involving the avoidance of breakfast and a lower intake of nuts, seeds, and pulses, and a higher intake of sweets, biscuits, cakes, and pastries over time (excluding the dieting period). All the significant sociodemographic, physiological and behavioral variables differentiating regainers and maintainers before and after dieting were then examined as independent variables in a logistic regression model. The model showed that less weight reduction during dieting, higher disinhibition scores after dieting, and avoidance of breakfast before dieting were significant predictors of body weight regain in postmenopausal women. From a practical point of view, early identification of postmenopausal women who are at risk of regaining lost weight can allow health professionals to create behavioral and dietary supports to help prevent this. A regular schedule of follow-ups over at least the first year should be considered for them-including psychological and dietary intervention, if necessary. Since this sample study included only postmenopausal women, our findings are not generalizable to other populations.

Postpartum depression - a medical or a social problem?

Objective: The aim of the study was to identify a group of women needed psychological support after delivery by identifying the medical and social factors that may influence the emotional changes during the postpartum period.Materials and method: A group of 835 pregnant women in second, third trimester of pregnancy, and during the postpartum period completed the Edinburgh Postnatal Depression Scale and the questionnaire consisting of difficulties that might occur in the four life fields: practical, family, emotional, and physical. The calculations have been carried out with the statistical package Statistica v10 and Cytel Studio v 9.0.0. At the Faculty of Information Science and Statistics of the Poznan University of Medical Sciences.Results: There is a series of medical and social risk factors potentially increasing the risk of postpartum depression, such as psychiatric disorders in the past, difficulties in the professional work, unsatisfactory relationship with partner, and others.Conclusions: Having selected a group of women with risk factors it seems reasonable to apply the Edinburgh Postnatal Depression Scale.

Quality of Life, Social Support, Acceptance of Illness, and Self-Efficacy among Pregnant Women with Hyperglycemia.

Carbohydrate metabolism disorders resulting in hyperglycemia are among the most common metabolic complications of pregnancy. According to 2017 data from the International Diabetes Federation (IDF), 16.2% of pregnancies are complicated with hyperglycemia, of which gestational diabetes mellitus (GDM) accounts for 86.4% of cases. Carbohydrate metabolism disorders developing during pregnancy require the patient to change her lifestyle or, in some cases, to undergo pharmaceutical treatment, which may affect various aspects of the patient's life, including her perceived quality of life (QoL). The purpose of the present study was to evaluate levels of QoL, social support, acceptance of illness, and self-efficacy among pregnant patients with hyperglycemia. The study was performed between July 2016 and September 2017 in a group of hyperglycemic pregnant women. The following instruments were used: the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Berlin Social Support Scales (BSSS), the Acceptance of Illness Scale (AIS), the Generalized Self-Efficacy Scale (GSES) and a standardized interview questionnaire. Participants rated their overall QoL (3.64 points) higher than their overall perceived health (3.43). In terms of social support, the highest scores were obtained in terms of actually received support (3.53) and perceived available instrumental support (3.52), while the lowest in terms of support seeking (2.99) and the need for support (2.95). The mean acceptance of illness score among the hyperglycemic pregnant women that were studied was 31.37, and the mean generalized self-efficacy score was 31.58. Participants' reported QoL in the various WHOQOL-BREF domains was associated with specific social support scales, acceptance of illness, and generalized self-efficacy.

Multicenter study on midwifery students' attitudes towards abortion and it's place in their future practice - Comparison of respondents at early and late stages of the university education.

Evidence based midwifery education and practice are fundamental to assure high quality care of childbearing women, also with complications. In Poland, midwifery education includes aspects of participation in the abortion. A cross-sectional study was designed to describe the attitudes towards abortion at the beginning and at the end of students' university education. The study was aimed to verify change of attitudes throughout the course of the university education. Most of the students approved abortion if the pregnancy constitutes a threat to woman's health or life, results from a rape, or whenever the fetus presents with a lethal defect. More than a half did not approve participation in the abortion if the fetus presents with a non-lethal defect. Generally, the acceptance rates were significantly higher among the final year students, but more than a half of them stated, that the abortion-related topics were inadequately addressed in their study curriculum. That bring to the conclusion that higher rates of abortion acceptance among the final year students, were not necessarily a manifestation of informed approval for this procedure, but rather a form of a "systemic" adjustment. Midwifery program need to be revised to support students in developing informed and evidence-based attitudes toward abortion.

Influence of socio-economic factors on emotional changes during the postnatal period.

OBJECTIVES: The aim of the study was to identify socio-economic factors that may influence the emotional changes which occur among new mothers in the first days postpartum. MATERIAL AND METHODS: A group of 541 women completed a questionnaire consisting of 30 multiple-choice questions, Edinburgh Postnatal Depression Scale (EPDS), and Hospital Anxiety and Depression Scale (HADS). Statistical calculations were performed with the use of Statistica v.10 and Cytel Studio v. 9.0.0. RESULTS: The findings revealed the presence of factors which might increase the risk of mood disorders during the postpartum period. CONCLUSIONS: Women who demonstrate warning symptoms should be screened for postnatal emotional changes and mood swings during their hospitalization after delivery. EPDS seems to be a suitable tool for early detection of emotional disturbances.

Modifiable lifestyle factors and ovarian cancer incidence in women.

INTRODUCTION: A correct diet plays an important role in the prevention of malignant tumours. The risk of the disease may be reduced by introducing a number of changes to the daily diet. The most important changes concern the amount of fat in the diet, dietary fibre, antioxidants in the food and the reduction of substances having a significant impact on the development of malignant tumours. OBJECTIVE: The aim of the study is to analyse the role of selected modifiable lifestyle factors affecting the development of ovarian cancer. MATERIAL AND METHODS: The study covered healthy women and women with diagnosed ovarian cancer. A total of 850 women aged between 21-84 were studied. The study included women visiting the Gynaecology and Obstetrics Hospital of the University of Medical Sciences in Poznan, Poland, between 2011-2013. Patients recognized with malignant ovarian cancer were qualified into the study based on the histopathological examination of the material obtained during surgery. RESULTS: Respondents who consumed fruit and vegetables several times a week have the odds ratio OR = 0.29 level; 95% CI 0.04-2.01 (p =.2085), compared to women not consuming fruit and vegetables at all. Consumption of 100 g of French fries and potato chips several times a week, results in a 2-fold increase in ovarian cancer. The OR for this group of women amounts to 2.06; 95% CI 0.53-7.99 (p=.2966). CONCLUSIONS: A diet rich in fruit and vegetables, including bulb vegetables, and grain products containing whole grains, should be introduced. It is recommended that the consumption of popular fast foods be eliminated.

Sleep disturbances in women with polycystic ovary syndrome.

Sleep disturbances in women with Polycystic Ovary Syndrome (PCOS) have been reported in recent years. The majority of published studies are related to Obstructive Sleep Apnea (OSA) while not many researches have analyzed any other causes of sleep disturbances. A group of ninety five women with Polycystic Ovary Syndrome were enrolled into the study. Sleep disturbances were assessed using validated questionnaires. On the grounds of Athens Insomnia Scale (AIS) evaluation a clinically significant insomnia was ascertained in 12.6% of women with PCOS, while according to Insomnia Severity Index (ISI) in 10.5%. Clinically significant insomnia according to both AIS and ISI, occurred significantly more often in women with PCOS than in women without PCOS based on the chi-square test. The Mann-Whitney U test revealed statistically significant difference between women with and without PCOS based on total values of ISI. An excessive daytime sleepiness occurred at 7.4% of women with PCOS. Statistically significant dependance between: clinically significant insomnia in both AIS and ISI and excessive daytime sleepiness indicated by Epworth Sleepiness Scale (ESS) was observed. Sleep disorders are common in women with PCOS. Screening assessment of sleep disturbances should be a part of medical diagnostics in women with PCOS.

Odds ratio analysis in women with endometrial cancer.

INTRODUCTION: Despite the progress in diagnosis and treatment of malignant tumours, the effects of treatment are insufficient. Reduction of the risk of cervical, ovarian, and endometrial cancer is possible by introducing preventative actions. AIM OF THE STUDY: The aim of the thesis is the analysis of selected risk factors that may affect the increase or decrease in the odds ratio of developing endometrial cancer. MATERIAL AND METHODS: The study was conducted among patients of the Gynaecology and Obstetrics Hospital of Poznan University of Medical Sciences in the years 2011-2013. The research included a total of 548 female respondents aged between 40 and 84 years. Women responded to questions assessing elements of lifestyle such as consumption of alcohol, smoking, and eating certain groups of foods. RESULTS: The respondents consuming fruits and vegetables several times a week have a reduced risk of odds ratio and the OR is 0.85; 95% CI: 0.18-4.09, compared to the women who rarely consume vegetables and fruits. Consumption of whole-wheat bread several times a week reduces the risk of developing the cancer, OR = 0.59; 95% CI: 0.14-2.47, compared to women not consuming wholegrain bread at all. Respondents who consumed red meat, such as veal, pork, and lamb in the amount of 101-200 g per day have an increased risk of developing the disease: OR = 2.16; 95% CI: 1.09-4.28, compared to women not consuming red meat at all. CONCLUSIONS: A diet rich in fruit and vegetables, onions, garlic, whole grains, and beans should be introduced in order to reduce the risk of endometrial cancer. The consumption of red meat and white pasta should be reduced or even eliminated.

[Correlation between intensity of menopausal symptoms and cognitive domain assessed with CNS-VS tests]. / Nasilenie objawów menopauzalnych a funkcje poznawcze oceniane bateria testów CNS-VS.

INTRODUCTION: Numerous publications suggest that many cognitive domains deteriorate with age. As far as postmenopausal women are concerned, the question remains whether the process is caused only by an ageing brain or also by the menopause. The objective of this research was to analyze a possible correlation between intensity and duration of menopausal symptoms and the level of cognitive domains measured with CNS-VS tests among post-menopausal women. METHODOLOGY: The group under examination included 383 postmenopausal women (at least 2 years after their last menstruation) from South-Eastern Poland. The following inclusion criteria were used: age 50-65, good overall health status, at least primary level of education, and FSH>30 mlU/ml. Cognitive domains were assessed using the CNS - VitalSigns diagnostic device. The intensity of menopausal symptoms was measured with the Kupperman Index and the Greene Scale. The statistical analysis was conducted with the use of the Statistica software. RESULTS: There were no significant relations between age at last menstruation and cognitive domains. BMI was oositively correlated with the Neurocognitive index (NCI) and memory visual memory processing speed, and executive functions. The intensity of menopausal symptoms measured with the Greene Scale was negatively correlated with NCI and most of the cognitive domains, whereas symptoms measured with the Kupperman Index were negatively correlated with NCI and visual memory CONCLUSIONS: Our findings suggest a correlation of the intensity and duration of menopausal symptoms with the revel of cognitive domain among menopausal women. The most significant consequences resulting from changes in the cognitive domains included psychological and vasomotor symptoms, as well as - to a lesser extent - somatic symptoms.

Emotional changes occurring in women in pregnancy, parturition and lying-in period according to factors exerting an effect on a woman during the peripartum period.

INTRODUCTION: Pregnancy, parturition and childcare, which are important moments in a woman's life, are connected with many emotional states of a future mother, a pregnant woman and a lying-in woman. The perinatal period is the time when the risk of psychological disorders in a pregnant woman may increase by even several times. Objective. The objective of the study was recognition of the main emotional and psychological changes in pregnant women, those in labour and lying-in, according to the factors occurring during the peripartum period. MATERIAL AND METHOD: The study was conducted in the form of a survey and covered a group of 108 mothers who were hospitalized in gynaecological-obstetric and obstetric wards in the Karol Marcinkowski Gynaecological-Obstetric University Hospital in Poznan. RESULTS: There are a number of factors which may exert a negative effect on the emotions of women in pregnancy, parturition, and during lying-in. The study showed that there is a close relationship between the occurrence of these factors and emotional states of the mothers after giving birth. CONCLUSION: Special attention should be given to women in whom already during pregnancy factors arise which may have a negative impact on their mental state. Emotions during pregnancy, parturition and lying-in are often quite extreme, and achieve a high intensity, as well being very variable within a short period of time.

Endometriosis in a post-laparoscopic scar--case report and literature review.

Endometriosis is an estrogen-dependent, chronic disease consisting in implantation and hyperplasia of the endometrium outside of the uterine cavity Endometriosis in post-laparoscopic scars applies to approx. 0.5-7% of the extraorganic locations of the disease. The purpose of the paper was to describe medical management and literature review for endometriosis in a post-laparoscopic scar. Two lesions located near the insertion site for the lower trocars were removed along with the border of healthy tissue. At the time of publication of this paper the patient did not report any complaints. In conclusion, each limited lesion in the subcutaneous tissue, with pain intensifying during menstruation, should suggest an initial diagnosis of scar endometriosis, regardless of patient age and type of surgery

The role of ghrelin, leptin and insulin in foetal development.

INTRODUCTION AND OBJECTIVE: The growing epidemic of childhood obesity has forced scientists to search for methods to prevent feeding disorders. Increasing interest in appetite regulating hormones has revealed their influence on energy homeostasis after birth or even in utero. STATE OF KNOWLEDGE: The presence of ghrelin in the stomach of human foetuses and the distinctive production in the pancreas of neonates suggests the role of ghrelin in pre- and post-natal development. The neonatal period appears to be a critical time for the formation of adipose tissue-hypothalamus circuits, thus the amount of adipocytes in foetal life may be a major regulator of food intake. Insulin's orexigenic effect in the arcuate nucleus of the hypothalamus can be a major modulator of foetal development. OBJECTIVE: This review, based on available literature, aims to analyses the role of appetite regulating hormones in foetal development. SUMMARY: Different concentrations of hormones, such as ghrelin, leptin and insulin during foetal life raises the question whether or not they can be modulated, thereby avoiding obesity before birth. Children with pancreas agenesis showed smaller body size at birth, which emphasises the probable role of insulin in foetal growth. Study of sheep foetuses with IUGR confirmed these finding. Appetite-regulating hormones show different roles in foetal development and seem to be essential in the perinatal period.

The assessment of selected factors influencing intent to get pregnant in the Greater Poland Region.

INTRODUCTION AND OBJECTIVE: Nowadays, people decide to have a baby by first analysing their financial situation. Tradition is no longer a factor which determines the decision whether or not to have a baby. A prognosis of the Polish Central Statistical Office (GUS) shows that the population of Poland will fall from 38 to 36 million by 2035. The aim of this study is to assess the procreation behaviour of women in Greater Poland Region. MATERIALS AND METHODS: For the research purpose, 3,120 women of reproductive age were examined by using an author designed questionnaire and a synthetic Family Financial Standard Index. RESULTS: 74.6% of the respondents lived in an urban area, 25.4% of women come from a rural area. 49% of examined women did not want to have a bigger family, 45% would like to have another child. Analysis of the reasons why women did not want to have another baby revealed that predominance of the financial factor - 67%, living conditions - 18.4% and health- 13.2%. Only 11.9% of the women declared their high financial status, 4.8% of families received family allowance from the government; 88.4% of the examined families did not receive any social benefits. Bad housing situation was declared by 5% of the respondents, 26.7% of the interviewees lived with family members, i.e. parents or grandparents. Analysis of the data concerning religious bonds showed that 67.6% of women declared their indifference to religion. CONCLUSIONS: The economic factor was an important reason limiting procreation. The bad situation on the real estate market combined with an insufficient range of social welfare led to a decrease in the birth-rate in the Greater Poland region. The impact of religion on family planning was less important. The influence of the analysed socio-economic factors on family planning was similar in rural and urban areas.

Material awareness on natural feeding.

INTRODUCTION: Natural breastfeeding is the only proper way to feed newborns and infants because it ensures their proper development. Breastfeeding enhances health and protects against the development of many diseases in childhood and adulthood. The primary benefits of breastfeeding include reduced incidences of infection in the respiratory system as well as a reduction in gastrointestinal and systemic infections. The benefits of breastfeeding also include decreased inflammation and improved immunity to disease in the infant. Further benefits of breastfeeding are reduced incidences of type 1 diabetes, Crohn's disease, and rheumatoid arthritis. OBJECTIVE: The aim of the study was to assess the degree of knowledge on maternal breastfeeding among current expecting mothers. MATERIALS AND METHOD: The study comprtisded 147 mothers hospitalized in the Gynecology-Obstetrics Hospital University of Medical Sciences in Poznan, Poland, during late July - August 2012. RESULTS: For 139 (93.88%) of the surveyed women, breastfeeding was a priority regarding the health of the child. Respondents most often used professional literature in order to gain knowledge about breastfeeding (63.27%). The least popular way of acquiring knowledge was through the media (27.21%). CONCLUSIONS: Analysis of the collected material on the surveyed women showed that women have a diverse range of knowledge about breastfeeding. Currently, breastfeeding is required to be promoted and supported by midwives, paediatricians and other health professionals.

Determinants of favourable neonatal outcome after premature rupture of membranes (PROM) before 24 weeks of pregnancy--review of the literature and a case report.

OBJECTIVES: Premature rupture of the membranes (PROM) in pregnancy refers to rupture of membranes of the amniotic sac and chorion. The aim of the study was to review the literature and analyze the course of pregnancy (primipara) complicated by the premature rupture of the membranes, and consequent loss of amniotic fluid after 19 weeks of gestation. STUDY DESIGN: A 27-year old primiparous patient was admitted to the Gynaecology and Obstetrics University Hospital in Poznan on 9 December 2010, due to suspected premature rupture of the membranes. On presentation, foetal development was at 19 weeks gestation. Standard clinical investigations included ultrasonography, amniotic fluid index measurements and laboratory blood tests. RESULTS: Ultrasonography confirmed the size of the foetus to be normal for the gestational age. However, no amniotic fluid pockets were visible and the amniotic fluid index was 0 cm. The patient was hospitalized on multiple occasions and as a result a decision was made to end the pregnancy prematurely by means of a caesarean section at 32 weeks of gestation. Longer-term observation of the newborn indicated that one year following delivery, the development of the baby was normal, and thus far no neurological injuries or complications have been observed. CONCLUSION: The pregnancy was ultimately successfully completed with the delivery of a healthy newborn at 32 weeks of gestation. A regime involving rigorous bed rest and antibiotic administration can positively extend the duration of pregnancies complicated by premature rupture of the membranes.

Three most important etiological factors of occurrence of stress urinary incontinence in nulliparous pre- and postmenopausal Polish women.

INTRODUCTION: Stress urinary incontinence (SUI) is a chronic disease which occurs in 50% of women with urinary incontinence. It is estimated that in association with a longer life span and ageing of the population, this disorder will become even more prevalent and will exert an increasingly stronger effect on the deterioration of the quality of life. OBJECTIVE: The objective of the study is analysis of the factors affecting the occurrence of SUI. METHODOLOGY: The analysis covered 260 patients aged 27-82. The criterion of enrolment into the study was: diagnosis of SUI without disorders of pelvi-genital statics, and negative obstetric history (nulliparous and non-pregnant women). The investigations covered, among other things, the effect surgeries in the area of the lesser pelvis, body mass index (BMI), cigarette smoking, concomitant internal diseases, and hormonal therapy, with consideration of the division into two groups: women before and after menopause. Statistical analysis was performed by means of chi 2 Pearson, t-Student test, and Fisher-Freeman-Halton test for p<0.05. RESULTS: The results of the analysis unequivocally indicate that the age of patients (p=0.0001), body mass index (BMI) (p=0.0001), and surgical procedure for the removal of the uterus by laparotomy (p=0.0001) exert the greatest effect on the occurrence of SUI in pre- and postmenopausal women. The effect of the remaining etiologic factors is rather controversial. CONCLUSION: A comprehensive analysis of risk factors may contribute to the improvement of the results of treatment and quality of life of pre- and postmenopausal patients.