The Importance of the Kinematic Evaluation Methods of the Upper Limbs in Women with Breast Cancer Mastectomy: A Literature Review.

The kinematic assessment of the upper limbs in breast cancer (BC) survivors is one of the most common procedures to determine the recovery process after BC surgery. However, the methodology used is heterogeneous, finding various evaluation methods, which makes it difficult to compare results between studies. The objective of this review was to identify the technical features of the kinematic evaluation methods used in patients with mastectomy for BC. A literature review was conducted to search in electronic databases, such as PubMed, ScienceDirect, Clinical Key, Google Scholar, and Scopus. A total of 641 articles were obtained. After screening the title and the summary of the investigations, 20 manuscripts were kept for a deeper analysis. Different methodologies were found for the analysis of the kinematics of the upper limbs. Eight (40%) articles used the optoelectronic system, nine (45%) used the electromagnetic system, and three (15%) used other optoelectronic systems to assess shoulder kinematics. Each investigation studied different variables such as the type of surgery, the evaluation time, the age of the patients, the rehabilitation protocol, and so on. This makes the comparison among studies difficult, and the recovery process of the patients cannot be easily determined. In conclusion, the interpretation of the movement of the upper limbs should be easy to understand for oncologists, physiotherapists, clinicians, and researchers.

Differences in the Glenohumeral Joint before and after Unilateral Breast Cancer Surgery: Motion Capture Analysis.

After mastectomy, women might lose mobility and develop kinematic changes in the shoulder. The objective of this research was to compare the kinematics of the glenohumeral joint in women, before and after unilateral breast cancer surgery. This was a longitudinal study with a pre- and post-evaluation design; in total, 15 Mexican women who had a mastectomy for breast cancer and who received a physical therapy program after surgery were evaluated. Flexion-extension and abduction-adduction movements of the glenohumeral joint were evaluated (15 days before and 60 days after mastectomy). For the kinematic analysis of the glenohumeral joint, an optoelectronic motion capture system was used to monitor 41 reflective markers located in anatomical landmarks. There was no significant difference in the range of motion of the glenohumeral joint when comparing pre- and post-mastectomy, flexion-extension (p = 0.138), and abduction-adduction (p = 0.058). Furthermore, patients who received chemotherapy (53%) before mastectomy were more affected (lower range of motion) than those who did not receive it. There were no significant differences in the kinematics of the glenohumeral joint after mastectomy in this group of patients who received a physical therapy program after surgery. Moreover, patients who received chemotherapy treatment before breast cancer surgery tended to have a lower range of motion than those who did not receive it. Therefore, it is necessary for the physical rehabilitation team to attend to these patients even before the mastectomy.

Gastric responses to acute psychological stress in climacteric women: a pilot study.

OBJECTIVE: Women exhibit reduced ovarian sex hormones during the menopausal period that result in well-known physical and psychological symptoms. However, symptoms related to gastric motility (GM) have not been thoroughly investigated. We hypothesized that stress response gastric motility (SRGM) is lower in postmenopausal (PM) and perimenopausal (PERIM) women than in premenopausal (PREM) women. Estrogenic decline leads to neuroendocrine changes in different areas of the brain. These changes can result in hypothalamic vasomotor symptoms, disorders in eating behaviours, and altered blood pressure, in addition to psychological disorders such as stress, anxiety, depression, and irritability related to alterations in the limbic system. METHODS: In this pilot study, 55 PREM, PERIM, and PM women were clinically evaluated using the Nowack stress profile (SP) and State-Trait Anxiety Inventory (STAI). GM was assessed via electrical bioimpedance using two psychological stress tests (Stroop and Raven tests). RESULTS: Basal SP and STAI-anxiety test scores were similar among the three groups of women (P > 0.05). PERIM women had lower GM in the basal state (P < 0.05) than did other women. PREM and PM women had significantly decreased GM during the stress tests (P < 0.05). However, PERIM did not exhibit GM changes during stress tests (P > 0.05). CONCLUSION: Changes in sex hormones during PERIM may affect GM and SRGM.

Ethnic/racial differences in gastrointestinal symptoms and diagnosis associated with the risk of Helicobacter pylori infection in the US.

BACKGROUND: In the US, neither the prevalence nor the gastrointestinal (GI) diagnosis/symptoms associated with Helicobacter pylori (HP) have been examined in different racial/ethnic groups. AIM: To determine the racial/ethnic differences in HP infection associated with GI diagnoses/symptoms using the Cerner Health Facts® database. METHODS: This cross-sectional study collected data during the period of 2000-2015 from the following ethnic/racial groups: 8,236,317 white, 2,085,389 black, 426,622 Hispanic, 293,156 Asian Pacific/Islander (APIs), and 89,179 Native American/Alaskan Native (NA/AN) patients aged 21-65 years old; the data were then analyzed. The primary dependent variable was a diagnosis of HP (ICD-9-Clinical Modification/ICD-10 classification). SAS version 9.4 was used for the statistical analysis. The statistical analysis was performed on 11,130,663 patients with GI symptoms, and of these, 152,086 patients were positive for the infection. RESULTS: Hispanics and NA/ANs had the highest prevalence of HP associated with upper GI symptoms/diagnosis. Nevertheless, blacks and APIs presented the highest relative risk (RR) of HP associated with dyspepsia (RR [95% CI] =11.2 [10.7-11.9] and 14.2 [12.8-15.6]), peptic ulcer (RR =13.8 [13.3-14.5] and 10.7 [9.3-12.3]), and atrophic gastritis (RR =9 [8.5-9.6] and 7.4 [6.4-8.5]), respectively. In all racial/ethnic groups, HP was also associated with inflammatory bowel diseases, liver diseases, and celiac diseases. CONCLUSION: Black and API populations had the highest risk of HP associated with upper GI symptoms/diagnosis. Black patients also had the highest risk for HP associated with GI cancer.

Prevalencia de alcoholismo en trabajadores de la industria del cuero-calzado y su asociación con el nivel de desestrés / Prevalence in workers of leather-ffotwea industry and its association with desestrés level

Objetivo: Describir la prevalencia de alcoholismo en trabajadores de la industria cuero-calzado como consecuencia de estrés laboral. Justificación: Aumentar la calidad de vida en el trabajador debido a que el alcohol es utilizado para disminuir el cansancio, y el estrés disminuye los estados fisiológicos y de rendimiento laboral. Método: Se aplicó el cuestionario AUDIT (uso de alcohol [OMS]). El tipo de muestreo fue aleatorio con un I.C. al 90% = 50 cuestionarios. Resultados: El 60% estuvo integrado por mujeres y 40% por hombres. La media de edad fue de 28. El 70% de las mujeres obtuvo 21 puntos (elevado nivel de alcoholismo), y en los hombres fue de 33 puntos. Los hombres en fines de semana ingieren más alcohol que en jornadas acumuladas (2:1) por desestrés, p < 0,05 (prueba de X2). Existió una correlación significativa entre ser hombre e ingerir más alcohol en fines de semana (p < 0,05). Conclusión: Se observa una tendencia en el sexo femenino a ingerir cada vez más alcohol a corta edad sobre todo cuando se sienten estresadas, pero el género masculino ingiere grandes cantidades y lo siente habitual en fines de semana.

Objective: To describe the prevalence of alcoholism in workers as a result of the work stress. Justification: Increase the quality of life in the worker because the alcohol is used to reduce fatigue and stress decreases physiological states and work. Method: We applied the AUDIT questionnaire (alcohol use [WHO]). The type of sampling was random with an I.C. of 90% = 50 questionnaires. Results: The 60% were women and the 40% male. The age mean was 28. The 70% of women obtained 21 points (high level of alcoholism), and in men was 33 points. Men ingest more alcohol on weekends than in the cumulative working days (2:1) due de-stress, p < 0.05 (X2 test). There was a significant correlation between being a man and to ingest more alcohol on weekends (p < 0.05). Conclusion: It is observed a tendency in women to ingest alcohol at a more early age especially when they feel stressed, but males ingest more large amounts being it normal on weekends.

Comparison of mood among male and female workers as a function of reproductive stage / Comparación del ánimo entre los trabajadores hombres y mujeres como una función de la etapa reproductiva

El propósito de este estudio fue comparar la frecuencia de alteraciones del estado de ánimo de los trabajadores masculinos y femeninos maduros. También se intentó demostrar la relación de los síntomas con algunos aspectos psicológicos como la autoestima de los voluntarios (AE), la satisfacción marital (SM) y las actitudes hacia la sexualidad (AHS). Materiales y métodos: En un diseño transversal, se determina la frecuencia de la depresión, la ansiedad, los síntomas no específicos de la depresión (SNED), MS, y los sentimientos de síndrome del nido vacío (SSNV) en 103 hombres y 129 mujeres de 40 a 64 años de edad. Depresión, los SNED y la ansiedad fueron evaluados según los criterios DSM-III-R calificados con la prueba de Bech-Rafaelsen Hamilton. La AE se evaluó con la prueba Coopersmith, AHS y SSNV con un cuestionario previamente validado y SM con la prueba de selección De Weiss. Las mujeres se dividieron en función de su último período menstrual en pre, peri y postmenopáusicas. Resultados: Los resultados demostraron que el SSNV fue más frecuente en mujeres que en varones (p = 0,03). Las mujeres perimenopáusicas tuvieron mayor frecuencia de depresión, ansiedad y SNED que los hombres y las mujeres pre y posmenopáusicas. La AE fue asociada positivamente con alteraciones del estado de ánimo en el trabajo masculino y femenino. En los hombres, la MS estuvo significativamente asociada con SSNV y con la depresión y los SNED en las mujeres perimenopáusicas. Conclusiones: Llegamos a la conclusión de que las alteraciones del estado de ánimo son más frecuentes en las mujeres que en los hombres maduros. También hemos demostrado que en las mujeres maduras una pobre AE podría ser un factor de riesgo para el desarrollo de problemas del estado de ánimo. En ambos, hombres maduros y mujeres posmenopáusicas, la MS juega un papel importante en la aparición de SSNV.

Objectives: The purpose of this study was to compare the frequencies of mood alterations of mature male and female workers. Also we aimed to demonstrate the relationship of symptoms with some psychological aspects such as volunteer's self-esteem (SE), marital satisfaction (MS) and attitudes toward sexuality (ATS). Materials and methods: In a cross-sectional design, we determine the frequencies of depression, anxiety, non-specific symptoms of depression (NSSD), MS, and the feelings of empty nest syndrome (FENS) in 103 males and 129 females from 40 to 64 years of age. Depression, NSSD and anxiety were evaluated according to DSMIII-R criteria and scored with the Hamilton Bech-Rafaelsen test. SE was evaluated with the Coopersmith test, ATS and FENS with a previously validated questionnaire, and MS with the Pick De Weiss test. Women were divided according to their last menstrual period in pre- peri- and postmenopausal. Results: The results demonstrated that FENS were more frequent in females than in males (p=0.03). Perimenopausal women had higher frequencies of depression, anxiety, and NSSD than males and pre- and postmenopausal females did. SE was positively associated with mood alterations in both male and female labors. In males, MS was significant associated with FENS; and with depression and NSSD in perimenopausal females. Conclusions: We concluded that mood alterations are more frequent in mature females than in males. Also we demonstrated that in mature females poor SE could be a risk factor to development mood problems. In both mature male and postmenopausal females, MS plays an important role in the appearance of FENS.

El autoconcepto de mujeres sometidas a histerectomía / The women's selfconcept submitted to hysterectomy

Objetivo: el propósito del presente estudio fue comparar los puntajes del autoconcepto obtenidos por un grupo de mujeres antes y un año después de que fueron sometidas a histerectomía. Material y métodos: estudio prospectivo en el que participaron 44 mujeres de 30 a 60 años. Ninguna tenía antecedentes de trastornos psiquiátricos o de uso de fármacos antipsicóticos y/o antidepresivos. El autoconcepto de las mujeres se evaluó con la escala de Tennesse, que incluye una evaluación global y nueve sub-escalas específicas, y que ha sido previamente validado en población mexicana. Para analizar la información se elaboró un programa de computadora y los datos se analizaron con la prueba T para muestras dependientes. Resultados: la edad y escolaridad promedio y desviación estandar (X ± DE) de las participantes fue de 44,5 ± 6,9 y 5,8 ± 3,6 años respectivamente; 39 mujeres de las 44 completaron su evaluación un año después. La calificación global del autoconcepto disminuyó significativamente un año después de que se les practicó la histerectomía (642,3 ± 73,7 vs. 592,1 ± 34; p< 0,001). Ocho de las nueve subescalas también disminuyeron significativamente (p< 0,01). Conclusión: el autoconcepto y ocho sub-escalas de éste disminuyeron significativamente en este grupo de mujeres sometidas a histerectomía. El efecto que pudieran tener la ansiedad que produce la cirugía y el duelo provocado por la esterilidad se evitaron en este estudio al evaluar a las mujeres un año después del procedimiento. El efecto psicosocial de este tipo de cirugías debe considerarse en la preparación de las pacientes y de sus parejas.

Objective: the aim of this study was to compare the self-concept scores before and one year after hysterectomy, of a group of Mexican women. Methods: trought a prospective study, 44 female subjects from 30 to 60 years were evaluated using the Tennesse self-concept scale. Subjects were included if they did not have psychiatric diseases neither use antipsychotic / antidepressive drugs. A software was designed to analyze the information, and the scores of total and the nine individual profiles of self-concept were compared pre and post hysterectomy, using a dependent Student's T test. Results: the mean age and the schooling level of the volunteers were: 44.5 ± 6.9 years and 5.8 ± 3.6 (mean ± SD), respectively. From the 44 women evaluated in the pre-test, 39 complete the evaluation after one year of following. The mean values of the global self-concept scale decreased significantly (p< 0.001) from the beginning (642.3 ± 73.7) to one year after the hysterectomy (592.1 ± 34). The mean values of 8 from the 9 profiles, also decreased significantly (p< 0.01). Conclusion: hysterectomy decreases eight of the nine profiles of the self-concept of the women evaluated. The evaluation of the subjects self-concept one year after the hysterectomy, avoid the influence of grief by sterility or anxiety by the surgery itself. The decreases in the self-concept of a women submitted to hysterectomy should be considered in the clinical practice to prevent psychological effects.