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Benítez Marín MJ, Blanco Elena JA, Marín Clavijo J, Jiménez López J, Lubián López DM, González Mesa E. Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study. Int J Environ Res Public Health 2022; 19:11043. [PMID: 36078758 PMCID: PMC9518559 DOI: 10.3390/ijerph191711043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. METHOD It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. RESULTS The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. CONCLUSIONS We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.
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Affiliation(s)
- María José Benítez Marín
- Medicine School, Malaga University, 29071 Málaga, Spain
- Obstetrics and Gynecology Service, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Juan Antonio Blanco Elena
- Medicine School, Malaga University, 29071 Málaga, Spain
- General Surgery Service, Infanta Margarita Hospital, 14940 Córdoba, Spain
| | | | - Jesús Jiménez López
- Obstetrics and Gynecology Service, Regional University Hospital of Malaga, 29011 Málaga, Spain
- Surgical Specialties, Biochemistry and Immunology Department, Málaga University, 29071 Málaga, Spain
- Biomedical Research Institute of Malaga (IBIMA) Research Group in Maternal-Fetal Medicine, Epigenetics, Women’s Diseases and Reproductive Health, 29071 Málaga, Spain
| | - Daniel María Lubián López
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital of Jerez de la Frontera, University of Cadiz, 11407 Cadiz, Spain
| | - Ernesto González Mesa
- Obstetrics and Gynecology Service, Regional University Hospital of Malaga, 29011 Málaga, Spain
- Surgical Specialties, Biochemistry and Immunology Department, Málaga University, 29071 Málaga, Spain
- Biomedical Research Institute of Malaga (IBIMA) Research Group in Maternal-Fetal Medicine, Epigenetics, Women’s Diseases and Reproductive Health, 29071 Málaga, Spain
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Lubián López DM. Management of genitourinary syndrome of menopause in breast cancer survivors: An update. World J Clin Oncol 2022; 13:71-100. [PMID: 35316932 PMCID: PMC8894268 DOI: 10.5306/wjco.v13.i2.71] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
There is increasing attention about managing the adverse effects of adjuvant therapy (Chemotherapy and anti-estrogen treatment) for breast cancer survivors (BCSs). Vulvovaginal atrophy (VVA), caused by decreased levels of circulating estrogen to urogenital receptors, is commonly experienced by this patients. Women receiving antiestrogen therapy, specifically aromatase inhibitors, often suffer from vaginal dryness, itching, irritation, dyspareunia, and dysuria, collectively known as genitourinary syndrome of menopause (GSM), that it can in turn lead to pain, discomfort, impairment of sexual function and negatively impact on multiple domains of quality of life (QoL). The worsening of QoL in these patients due to GSM symptoms can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly. The diagnosis of VVA is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Systemic estrogen treatment is contraindicated in BCSs. In these patients, GSM may be prevented, reduced and managed in most cases but this requires early recognition and appropriate treatment, but it is normally undertreated by oncologists because of fear of cancer recurrence, specifically when considering treatment with vaginal estrogen therapy (VET) because of unknown levels of systemic absorption of estradiol. Lifestyle modifications and nonhormonal treatments (vaginal moisturizers, lubricants, and gels) are the first-line treatment for GSM both in healthy women as BCSs, but when these are not effective for symptom relief, other options can be considered, such as VET, ospemifene, local androgens, intravaginal dehydroepiandrosterone (prasterone), or laser therapy (erbium or CO2 Laser). The present data suggest that these therapies are effective for VVA in BCSs; however, safety remains controversial and a there is a major concern with all of these treatments. We review current evidence for various nonpharmacologic and pharmacologic therapeutic modalities for GSM in BCSs and highlight the substantial gaps in the evidence for safe and effective therapies and the need for future research. We include recommendations for an approach to the management of GSM in women at high risk for breast cancer, women with estrogen-receptor positive breast cancers, women with triple-negative breast cancers, and women with metastatic disease.
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Affiliation(s)
- Daniel María Lubián López
- Department of Mother and Child Health and Radiology, Faculty of Medicine, University of Cadiz, Cádiz 11100, Spain
- Department of Obstetrics and Gynecology Service, University Hospital of Jerez de la Frontera, Jerez de la Frontera 11407, Spain
- Department of Obstetrics and Gynecology, Hospital Viamed Bahía de Cádiz, Chiclana de la Frontera 11130, Cádiz, a Spain
- Department of Obstetrics and Gynecology, Hospital Quirónsalud Campo de Gibraltar, Los Barrios 11379, Cádiz, Spain
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Lubián López DM, Butrón Hinojo CA, Sánchez-Prieto M, Mendoza N, Sánchez-Borrego R. Sexual Dysfunction in Postmenopausal Women with Breast Cancer on Adjuvant Aromatase Inhibitor Therapy. Breast Care (Basel) 2021; 16:376-382. [PMID: 34602943 DOI: 10.1159/000510079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/10/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction The aim of this study was to investigate whether postmenopausal women with breast cancer (BC) on adjuvant aromatase inhibitor (AI) therapy have a higher prevalence of female sexual dysfunction (FSD). Second, the aim was to determine the quality of life (QoL) and level of anxiety depending on whether or not they are AI users. Methods A prospective cross-sectional study involving 168 patients was performed. Three questionnaires were carried out: sexual functioning was evaluated with the Female Sexual Function Index (FSFI), while the EORTC QLQ-BR23 measures to study QoL in patients with BC and the State-Trait Anxiety Inventory (STAI) questionnaire (trait and status) were used to assess anxiety status in patients under treatment with AIs or not. Results 47.6% (80/168) of the postmenopausal BC survivors were not sexually active (mean time after surgery: 48.6 months) despite a relatively low mean age (56.43 years). Postmenopausal AI-treated women had significantly worse sexual function as measured by the FSFI (23.40 ± 5.26 vs. 30.16 ± 2.24; p = 0.000). There were significant differences between both groups in all domains, except orgasm. The QoL score was 37.67 ± 7.38 in AI users versus 39.00 ± 1.44 among nonusers (p = 0.053). Patients under endocrine treatment also presented STAI scores significantly higher (25.83 ± 4.99 vs. 19.00 ± 7.12; p = 0.000). Trait anxiety was high in both groups, but this was not statistically significant. Conclusions We observed a high prevalence of sexual inactivity among BC survivors regardless of AI use. Patients with AI use presented significantly higher prevalence of FSD, worse QoL, and greater anxiety.
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Affiliation(s)
- Daniel María Lubián López
- Department of Obstetrics and Gynecology, University Hospital of Puerto Real, Cádiz, Spain.,Hospital Quirón Salud Campo de Gibraltar, University of Cádiz, Cádiz, Spain
| | | | - Manuel Sánchez-Prieto
- Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Barcelona, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
| | - Rafael Sánchez-Borrego
- Department of Obstetrics and Gynecology, DIATROS, Clínica de Atención a la Mujer, Barcelona, Spain
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Lubián López DM, Butrón Hinojo CA, Arjona Bernal JE, Fasero Laiz M, Alcolea Santiago J, Guerra Vilches V, Casaus Fernández M, Bueno Moral A, Olvera Perdigones A, Rodríguez Rodríguez B, Cuevas Palomino A, Presa Lorite J, Coronado Martín P, Sánchez-Prieto M, Sánchez-Borrego R, González-Mesa E. Resilience and psychological distress in pregnant women during quarantine due to the COVID-19 outbreak in Spain: a multicentre cross-sectional online survey. J Psychosom Obstet Gynaecol 2021; 42:115-122. [PMID: 33730970 DOI: 10.1080/0167482x.2021.1896491] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To examine the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women during the confinement due to the COVID-19 outbreak in Spain. MATERIALS AND METHODS Between 15 April and 14 May 2020, a multicentre cross-sectional survey was performed to study depression, anxiety and resilience in a sample of Spanish pregnant women during the lockdown set up by the Government in response to COVID-19 pandemic outbreak. We designed an anonymous online self-administered questionnaire (https://bit.ly/34RRpq1) that included the Spanish validated versions of the Edinburgh Postpartum Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Connor-Davidson Resilience 10-items Scale (CD-RISC-10). RESULTS A total of 514 pregnant women completed the survey. 72.8% had been confined < 40 days and 27.2% between 41 and 60 days. 182 (35.4%) participants scored over 10, with 21.3% scoring over 13 (75th Percentile) in depressive symptoms rates. We found high trait and anxiety scores, with 223 (43.4%) and 227 (44.2%) pregnant women scoring over the trait and state mean scores. Neither depression, anxiety or resilience levels showed any significant correlation with the length of confinement. We found low CD-RISC-10 scores. CONCLUSIONS We found a high prevalence of depression and anxiety symptoms during the quarantine, although we did not find an increased prevalence of psychological distress according to length of home confinement. Resilience correlated negatively with depression and anxiety.
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Affiliation(s)
- Daniel María Lubián López
- Faculty of Medicine, Department of Obstetrics and Gynecology, University Hospital of Jerez de la Frontera, Hospital Quiron Salud Campo de Gibraltar, Hospital Viamed Bahía de Cádiz, University of Cádiz, Cádiz, Spain
| | | | | | - María Fasero Laiz
- Department of Obstetrics and Gynecology, University Hospital of La Zarzuela, Madrid, Spain
| | | | | | | | - Ana Bueno Moral
- Department of Obstetrics and Gynecology, University Hospital of Málaga, Málaga, Spain
| | | | | | | | - Jesús Presa Lorite
- Department of Obstetrics and Gynecology, University Hospital of Jaen, Jaen, Spain
| | - Pluvio Coronado Martín
- Department of Obstetrics and Gynecology, Institute of Women's Health of the University Hospital of San Carlos, Madrid, Spain
| | - Manuel Sánchez-Prieto
- Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Barcelona, Spain
| | | | - Ernesto González-Mesa
- Department of Obstetrics and Gynecology, Hospital Quiron Salud, Málaga, Spain.,Department of Obstetrics and Gynecology, University Hospital of Málaga, Málaga, Spain
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Lubián López DM, Butrón Hinojo CA, Arjona Bernal JE, Fasero Laiz M, Alcolea Santiago J, Guerra Vilches V, Casaus Fernández M, Bueno Moral A, Olvera Perdigones A, Rodríguez Rodríguez B, Cuevas Palomino A, Presa Lorite J, Coronado Martín P, Sánchez-Borrego R, González Mesa E. Mood disorders and resilience during the first COVID-19 pandemic wave in Spain: Conclusions of the first Spanish survey. J Psychosom Res 2021; 140:110327. [PMID: 33302191 DOI: 10.1016/j.jpsychores.2020.110327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Daniel María Lubián López
- Faculty of Medicine, Department of Obstetrics and Gynecology, University Hospital of Jerez de la Frontera, Hospital Quiron Salud Campo de Gibraltar, Hospital Viamed Bahía de Cádiz, University of Cádiz, Spain.
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Lubián López DM, Castillo Lara M, Rodríguez Rodríguez B, Butrón Hinojo CA, Martínez Herrera A, Sánchez Borrego R, Mendoza Ladrón de Guevara N. Metabolic syndrome and prognostic factors in postmenopausal breast cancer patients. Breast J 2019; 25:548-551. [DOI: 10.1111/tbj.13280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel María Lubián López
- Department of Obstetrics and Gynecology Faculty of Medicine University Hospital of Puerto Real Cádiz Spain
| | - María Castillo Lara
- Department of Obstetrics and Gynecology Faculty of Medicine University Hospital of Puerto Real Cádiz Spain
| | - Begoña Rodríguez Rodríguez
- Department of Obstetrics and Gynecology Faculty of Medicine University Hospital of Puerto Real Cádiz Spain
| | - Carmen Aisha Butrón Hinojo
- Department of Obstetrics and Gynecology Faculty of Medicine University Hospital of Puerto Real Cádiz Spain
| | - Antonia Martínez Herrera
- Department of Obstetrics and Gynecology Faculty of Medicine University Hospital of Puerto Real Cádiz Spain
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López DML, Lara MC, Almagro DM, Herrera AM, Cortés RM, Cardoso RT. Metabolic syndrome and prognostic factors in postmenopausal breast cancer patients. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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