Shift work, body mass index and associated breast cancer risks in postmenopausal women.

INTRODUCTION AND OBJECTIVE: Shift work increases the risk of breast cancer, but the mechanisms is still under discussion. This study evaluates the relationship between breast cancer and shift work on the basis of overweight and obesity among postmenopausal women. MATERIAL AND METHODS: We examined this association using data from a case-control study carried between 2015 and 2019. The study involved 111 postmenopausal women with breast cancer and the same number of control participants. A self-reporting questionnaire was used for data collection. Multivariate logistic regression was conducted to find correlations between variables and determine the strength of relationships. RESULTS: A 2.65-fold risk of breast cancer (OR=2.65; 95% CI: 1.34-5.22) was found among shift work women, compared with postmenopausal women not performing shift work. The association was modified by body mass index, showing a risk rate 9.84 times higher (OR=9.84; 95% CI: 2.14-45.19) among shift work and overweight women, compared to non-overweight women who had never been shift workers. CONCLUSIONS: About 49% of controls and 72% of cases had ever worked in a job that required shift work. The risk of breast cancer in postmenopausal women is associated with shift work, especially among overweight women. Some preventive measures to reduce the risk of breast cancer, in particular regarding a healthy lifestyle and weight control in this group of working women, should be implemented.

Clinical replicability of rehabilitation interventions in randomized controlled trials reported in main journals is inadequate.

OBJECTIVE: The objective of this study was to study if randomized controlled trials (RCTs) in rehabilitation (a field where complex interventions prevail) published in main journals include all the details needed to replicate the intervention in clinical practice (clinical replicability). STUDY DESIGN AND SETTING: Forty-seven rehabilitation clinicians of 5 professions from 7 teams (Belgium, Italy, Malaysia, Pakistan, Poland, Puerto Rico, the USA) reviewed 76 RCTs published by main rehabilitation journals exploring 14 domains chosen through consensus and piloting. RESULTS: The response rate was 99%. Inter-rater agreement was moderate/good. All clinicians considered unanimously 12 (16%) RCTs clinically replicable and none not replicable. At least one "absent" information was found by all participants in 60 RCTs (79%), and by a minimum of 85% in the remaining 16 (21%). Information considered to be less well described (8-19% "perfect" information) included two providers (skills, experience) and two delivery (cautions, relationships) items. The best described (50-79% "perfect") were the classic methodological items included in CONSORT (descending order: participants, materials, procedures, setting, and intervention). CONCLUSION: Clinical replicability must be considered in RCTs reporting, particularly for complex interventions. Classical methodological checklists such as CONSORT are not enough, and also Template for Intervention Description and Clinical replication do not cover all the requirements. This study supports the need for field-specific checklists.

[Evaluation of the therapeutic impact of selected physiotherapy treatments on the treatment of lymphoedema and the assessment of the state of knowledge on risk factors, information acquisition and prophylaxis against women after surgical treatment of breast cancer].

OBJECTIVE: Introduction: Breast cancer is a disease with high incidence. In Poland, it is the most common cause of death among cancer in women. A common method of treatment is a breast-saving procedure or its radical removal along with nearby lymph nodes. The most common complication after resection is lymphoedema. The aim: The aim of the study was to assess the effectiveness of a selected series of physiotherapy treatments to reduce lymphoedema in women after surgical treatment of breast cancer, assessment of risk factors in women after surgical treatment of breast cancer, assessment of how women collect information on the prevention of lymphoedema, evaluation of women after mastectomy surgery to prevent the formation of lymphoedema. PATIENTS AND METHODS: Materials and methods: The study involved 43 patients with lymphoedema after surgical treatment of breast cancer. Patients' own questionnaire was performed and two upper limb circumferences were measured (before and after the end of a series of physiotherapy treatments). RESULTS: Results: In 43 examined women (100&) after the surgery associated with the occurrence of breast cancer, lymphatic edema of the upper limb on the operated side occurred. Edema of the entire limb appeared in 25 subjects (58.14&), and in the arm and forearm, 10 patients (23.26&), arm and forearm in 8 women (18.60&). Edema occurred in different period from the time of surgery and affected a different area. After the therapy, the patients were found to have reduced limb circumferences of the operated side at all levels. The largest decrease was observed at level III (10 cm below the elbow) on average by 1.75 cm, and the smallest at level I (in the medial part of the metacarpus excluding the thumb). CONCLUSION: Conclusions: Physiotherapy treatments have a significant impact on the reduction of lymphatic edema in women after surgical treatment of breast cancer. In women after mastectomy, there is no basic knowledge about risk factors for lymphoedema. Physicians have the largest share in the education of women after mastectomy. The most common actions in the field of anti-oedematous prophylaxis are kinesitherapy, automassage and proper posture position with high laying of the upper limb on the operated side.

Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis.

BACKGROUND: The aim of the study was to estimate the influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. MATERIAL AND METHODS: 125 patients were randomly assigned to 4 groups: • group I received one-wave laser irradiation (wave length 810 nm, dose 8 J/point) • group II received two-wave MLS laser irradiation (power 1100 mW, frequency 2000 Hz, dose 12.4 J/point) • group III received a similar regimen of two-wave MLS laser irradiation, but at a dose of 6.6 J per point • group IV was a placebo group where laser therapy procedures were simulated without actual irradiation. The effectiveness of the therapy was evaluated by means of Lequesne's scale, a modified Laitinen questionnaire and a visual analogue scale (VAS). Statistical analysis utilised non-parametric Wilcoxon's and Mann-Whitney's tests. Calculations were carried out with MedCalc v. 11.6.1.0. RESULTS: Statistically significant improvements in knee joint function and pain relief were seen in all groups (I, II and III). When groups I, II and III were compared, the largest improvement was found in group II (MLS laser, dose 12.4 J/point). The degrees of improvement in groups I and III were similar. CONCLUSIONS: One-wave laser irradiation at a dose of 8 J per point and two-wave laser irradiation with doses of 12.4 J and 6.6 J per point significantly improved knee joint function and relieved knee pain in patients with osteoarthritis.

Comparative evaluation of the direct analgesic efficacy of selected physiotherapeutic methods in subjects with knee joint degenerative disease - preliminary report.

BACKGROUND: The goals of the study were to evaluate the efficacy of two physiotherapeutic procedures: low energy laser therapy and low frequency transcutaneous electric nerve stimulation (TENS) and to compare these modalities with regard to their therapeutic effects in patients with knee osteoarthritis. MATERIAL AND METHODS: Fifty (50) subjects were enrolled into the study and divided into two groups of 25 subjects. Group A received 10 MLS laser therapy sessions with a synchronised laser beam at doses of 12 J per treated site. Group B received ten sessions of low frequency TENS. The procedures were carried out every day for two weeks (5 times a week). All patients completed a personal data questionnaire and underwent an examination of knee joint motion range and circumference. Subjective pain intensity was assessed using the VAS pain scale and the modified Laitinen questionnaire. RESULTS: An analysis of the results of the treatment demonstrated statistically significant pain reduction in both groups. This improvement was significantly higher in the two-phase laser therapy group vs. the LF-TENS group. No statistically significant improvement was noted in either of the groups regarding the knee joint range of motion. CONCLUSIONS: 1. Synchronised laser beam (MLS) therapy and low-frequency TENS contribute to direct pain relief effects in subjects with knee osteoarthritis. 2. The study confirmed better analgesic effects of two-phase laser therapy vs. LF-TENS.

The analgesic effectiveness of laser therapy in patients with gonarthrosis: an evaluation.

Background. Osteoarthrosis is a very common disease of the musculo-skeletal system. Laser therapy can be used to alleviate the pain associated with this syndrome, which markedly impinge the patients physical comfort and limit physical activity. Material and methods. The research involved 32 patients (26 women and 6 men, average age 57.3 A+/-12.1 years) with pain complaints in one knee joint and radiologically confirmed degenerative changes. The control group consisted of 32 matched patients awaiting treatment. Laser biostimulation was applied with a semiconductor laser (400 mW, wave length 810 nm). Contact (point) irradiation was applied, with a surface energy density of 12.7 J/cm2. One series of 10 procedures was performed on one knee joint, 5 days a week. Pain intensity was evaluated with the Visual Analogue Scale (VAS) and a modified version of the Laitinen questionnaire. Results. In 29 patients (91%) there was a statistically significant reduction in pain complaints in the affected knee measured by VAS. In 19 patients (59%) there was a statistically significant reduction in the frequency and intensity of pain complaints on the Laitinen questionnaire. The improvement in daily motor activity and the reduced use of antalgesic drugs were not statistically significant. Conclusions. Laser biostimulation in patients with knee pain reduces symptoms on the VAS, and significantly reduces the intensity and frequency of pain as assessed by the Laitinen questionnaire. One series of laser treatments has no significant effect on motor activity and use of painkillers in patients with chronic knee pain due to osteoarthrosis.

The impact of kinesitherapy supported by katalitic worm compresses for some of biomechanical indexes of the movement organ of patients with degeneration disease.

Background. Degenerative disease limits physical efficiency of patients. The aim of our research was estimating the efficacy of kinesitherapy complemented by thermotherapy. Material and methods. Our research involved 53 patients with degeneration disease. We used kinesitherapy with thermotherapy in treatment. The Ritchie's index, range movements of selected joints and morning stiffness time were estimated. Results. Significant decrease of studied factors was obtained as a result of kinesitherapy complemented by thermotherapy applied in treatement of patients with degeneration disease. Conclusions. Our results indicate thermotherapy as a good complement of kinesitherapy in case of degeneration diseases.