Pulmonary benign metastasizing leiomyoma (PBML) is a rare condition characterized by the spread of uterine leiomyomas to the lungs, typically observed in premenopausal women with a history of hysterectomy or myomectomy. This report presents a unique case of a postmenopausal woman, aged 65, that emphasizes the clinical, radiological, histologic, and immunohistochemical aspects of the disease. On presentation, the patient suffered from severe pain. On imaging, a sizable lung tumor was found. Histopathological examination and immunoprofiling confirmed PBML. The patient underwent various treatments, including surgery, radiation therapy, and hormonal therapy, illustrating the challenges in managing PBML. A literature review underscores the rarity of PBML and its diverse clinical manifestations. This study provides valuable insights into the complexities of PBML.

UNASSIGNED: Proper nutrition is a crucial factor in preventing osteoporosis, a significant pathological cause linked to skeletal weakness; this study investigated the relationship between dietary diversity score and food group diversity score with osteoporosis in postmenopausal women.
UNASSIGNED: This case-control study was conducted on 378 menopausal women aged 45-85 in Tehran, Iran. The age-matching method to control the confounding effect of age was used. The method of dual-energy X-ray absorptiometry (DXA) was used for assessing the bone mineral density of lumbar vertebrae and femoral neck. The bone mass status was evaluated with WHO criteria. All subjects were divided into the osteoporosis group and the non-osteoporosis group according to their T-score. A convenience sampling method was utilized to select the participants, which included two groups: case (n = 189) and control (n = 189). Data was collected using demographic and anthropometric information questionnaires, a valid 147 item food frequency questionnaire, and a physical activity questionnaire. Statistical analyses were conducted using SPSS-26, and p-values less than 0.05 were deemed to be statistically significant.
UNASSIGNED: The results indicated significant differences in weight, body mass index, physical activity, smoking, and alcohol use between the two groups. The mean ± standard deviation of dietary diversity score (DDS) was lower in participants with osteoporosis (case) (3.31 ± 1.26) than in control (4.64 ± 1.33) (p < 0.001). The mean ± standard deviation of diversity score of cereals, fruits, and vegetables in the osteoporosis group (respectively: 0.71 ± 0.21, 0.94 ± 0.76, and 0.45 ± 0.44) was less than the control group (respectively: 0.80 ± 0.21, 1.64 ± 0.55 and 0.87 ± 0.42) (p < 0.001). After adjusting the confounding variables, the risk of osteoporosis had an inverse relationship with the diversity score of vegetable (OR = 0.16; 95%CI: 0.07-0.35), bread and cereal (OR = 0.21; 95% CI: 0.05-0.87) and fruit (OR = 0.35; 95%CI: 0.22-0.56) (p < 0.05). Nevertheless, no discernible correlation was seen between the tertiles of DDS, dairy and meat diversity score, and osteoporosis.
UNASSIGNED: We found a correlation between the diversity score of fruits, vegetables, and grains and osteoporosis. However, there is no significant correlation between the DDS triads and the diversity score of dairy products and meats with osteoporosis.

BACKGROUND: The prognostic value of the risk-of-recurrence (ROR) score calculated using PAM50 has been validated using clinical trials and patient cohorts. This study aimed to investigate the prognostic value of the PAM50 ROR score in Japanese patients with early breast cancer using long-term follow-up data.
METHODS: We enrolled postmenopausal patients with ER-positive, HER2-negative, stage I-II breast cancer who had undergone surgery at the Kyoto University Hospital between 2008 and 2014. The intrinsic subtype and ROR score were calculated using PAM50. The primary endpoint was invasive disease-free survival (IDFS).
RESULTS: We enrolled 146 patients, of whom 47 (32%) patients had node-positive disease, and 36 (25%) had received neoadjuvant or adjuvant chemotherapy. The proportions of intrinsic subtypes for luminal A, luminal B, HER2-enriched, and basal-like subtypes were 67%, 27%, 3%, and 2%, respectively. The median follow-up duration was 8.4 (range 6.3-10.0) years, and 21 IDFS events were observed. Based on the ROR score, 37%, 33%, and 30% of the patients were classified as low, intermediate, and high risks, respectively. Patients in the high-risk group had a significantly worse 8-year IDFS rate than those in the low-to-intermediate-risk groups (75.1% vs. 91.6%, p = 0.04). The same trend was observed in patients with and without neoadjuvant or adjuvant chemotherapy.
CONCLUSIONS: Using long-term follow-up data, this study showed that the ROR score can predict the prognosis of ER-positive, HER2-negative early breast cancer in Japanese postmenopausal patients. Further investigations are required to confirm the prognostic value of the ROR score in Asian populations.

BACKGROUND: Sarcopenia is a global health problem, there are currently several criteria for its diagnosis and the implementation of its own cut-off values for each population is recommended. The objective was to evaluate the handgrip strength (HG) in postmenopausal women from Buenos Aires and establish a cut-off value.
METHODS: A total of 704 women ≥50 years of age were evaluated, who answered a questionnaire on osteoporosis risk and HG was taken. Those with arthritis or pain in the hands were excluded, leaving 678 women for analysis. A subpopulation of 148 healthy women was selected to define the minimum normal value of the HG of our population.
RESULTS: The HG was 20.44 ± 5.19 kg, with a significant decrease in values after 70 years. The HG in the group of healthy women was 22.08 ± 5.13 kg. And the cutoff value of 17.5 kg was established in our population (first quintile). 28.6% of the total population presented decreased HG and reached 53.7% in women >80 years. HG <17.5 kg was associated with a 67% increased risk of falls in the total group of women >50 years.
CONCLUSIONS: The HG is a simple tool that is easy to implement in clinical practice and is considered the first step for the diagnosis of sarcopenia. The cut-off value of HG <17.5 kg could be used for the evaluation of sarcopenia in women >50 years of Buenos Aires.
Introducción: La sarcopenia es un problema de salud mundial, actualmente existen varios criterios para su diagnóstico y se recomienda la implementación de valores de corte propios para cada población. El objetivo fue evaluar la fuerza de prensión palmar (FPP), en mujeres postmenopáusicas de Buenos Aires y establecer un valor de corte para nuestra población. Métodos: Se evaluaron 704 mujeres ≥50 años, quienes respondieron un cuestionario sobre riesgo de osteoporosis y se tomó la FPP. Se excluyeron aquellas con artritis o dolor en las manos, quedando 678 mujeres para el análisis. Se seleccionó una subpoblación de 148 mujeres sanas para definir el valor mínimo normal de la FPP de nuestra población. Resultados: La FPP fue de 20.44 ± 5.19 kg, con una disminución significativa a partir de los 70 años. La FPP en el grupo de mujeres sanas fue de 22.08 ± 5.13 kg. Y se estableció el valor de corte de 17.5 kg en nuestra población (primer quintil). El 28.6% de la población total presentaban FPP disminuida y alcanzaba a un 53.7% en las mujeres >80 años. La FPP <17.5 kg se asoció con un incremento del 67% del riesgo de caídas en el grupo total de mujeres >50 años. Discusión: La FPP constituye una herramienta sencilla y de fácil implementación en la práctica clínica del consultorio y es considerada el primer paso para el diagnóstico de sarcopenia. El valor de corte de FPP <17.5 kg podría ser utilizado para la evaluación de sarcopenia en mujeres >50 años de Buenos Aires.

Pyometra is a gynecological condition characterized by pus accumulation in the endometrial cavity. It is a rare condition, and it should be included in the differential diagnosis of abdominal pain in postmenopausal women. We present a case of a 65-year-old postmenopausal woman with complaints of foul-smelling white discharge, itching in the perineal region, lower abdominal pain, and postmenopausal bleeding for two to three months. USG of the pelvis was done outside, which revealed heterogeneous ill-defined cervical growth with endometrial fluid collection and multiple uterine fibroids. CT and MRI of the pelvis were done in our hospital, which revealed an ill-defined heterogeneously enhancing growth in the cervix with multiple uterine fibroids and heterogeneous endometrial collection showing restricted diffusion in MRI suggestive of pyometra. Cervical biopsy revealed features suggestive of moderately differentiated squamous cell carcinoma.

Malignant transformation (MCT) of ovary is rare complications affecting elderly, squamous cell carcinoma being the most common. The prognosis worsens with extraovarian spread. We present two cases of MCT-derived SCC. Patients exhibited abdominal lump, pain, bowel symptoms, sometimes with weight loss; imaging revealed MCT. Age (51-60), postmenopausal status, large size (>20 cm), bilaterality, and complex ovarian lesions raised suspicion of malignancy. Elevated tumor markers (e.g., cancer antigen-125 and lactate dehydrogenase) were noted in one case. Intraoperative frozen section confirmed malignancy, guiding staging laparotomy. One case was advanced stage on histopathology. Intraoperative frozen section aids optimal staging.

Spontaneous perforations in pyometra occur rarely. Incidence is only 0.01%-0.5% in gynecological patients. Tubo-ovarian abscess (TOA) is seen less in postmenopausal women amounting the 6%-18% of the total cases of TOA reported. A 52-year-old P3L3 postmenopausal woman with abdominal pain was admitted to hospital. Emergency laparotomy was performed in view of pyoperitoneum. Intraoperatively, 1000 cc of foul-smelling pus was suctioned out from the peritoneal cavity a 2 cm × 2 cm sized perforation was seen at the right fundal region of the uterus and a right sided TOA was seen extending to the uterine cavity, left sided ovary was normal. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The patient got discharged on the 36th postoperative hospitalization day. Histopathological study revealed uterine purulent inflammation with no evidence of malignancy. The diagnosis of spontaneous perforation of pyometra is rarely made preoperatively and the possibility of a perforated pyometra should, therefore, be considered when elderly women suffer from acute abdominal pain. Hysterectomy and bilateral salpingo-oophorectomy may be the best choice procedure in these patients. There is probably a new trend in the epidemiology of TOA, occurring in older women who do not present the traditional risk factors for pelvic inflammatory disease and TOA.

Urinary incontinence is a prevalent condition affecting women. Pelvic floor physiotherapy is a specialized field of physiotherapy dedicated to assessing and treating pelvic floor muscles. This therapy has demonstrated benefits in addressing stress urinary incontinence in premenopausal women, with numerous studies supporting its efficacy in this population. However, pelvic floor physiotherapy in the treatment of postmenopausal women is less well-established, and furthermore, the types of urinary incontinence in postmenopausal women are much broader. We provide a comprehensive review of recent literature investigating the effectiveness of pelvic floor physiotherapy therapy for various conditions in postmenopausal women, including urinary incontinence, urgency urinary incontinence, pelvic organ prolapse, genitourinary syndrome of menopause, sexual dysfunction, and urinary incontinence in the context of obesity, frailty, mobility, and dementia. After evaluating the current literature, it is evident that there is insufficient data to definitively endorse or dismiss the utilization of Pelvic floor physiotherapy for treating urinary incontinence in postmenopausal women. Nevertheless, considering the low associated risks of pelvic floor physiotherapy, we advocate for the initiation of comprehensive, large-scale randomized studies aimed at evaluating its effectiveness in addressing urinary incontinence in postmenopausal women with special attention to vulnerable subgroups, including individuals who are obese, frail or experiencing cognitive impairment.

The incidental finding of endometrial thickness (ET) >4 mm in the absence of postmenopausal bleeding (PMB) is a common cause of referring women to secondary care. However, there is lack of consensus amongst gynecologists as regards the management. It is estimated that up to 15 % of endometrial cancers occur in women without PMB. The aim this study was to determine the optimal ET threshold, on trans-vaginal ultrasound scan, that discriminates normal endometrium from endometrial hyperplasia and cancer in this cohort. On using a thorough search strategy, a total 16 studies including 4088 women were deemed eligible. However, the data were not amenable to meta-analysis. There were wide variations in the thresholds reported with potential bias given the retrospective nature of the majority of the studies. Despite contacting authors, we could not obtain the primary data to generate a Receiver Operating Characteristic (ROC) Curve. No linear or curvilinear association was found between ET thresholds and the percentage of women diagnosed with endometrial hyperplasia and cancer using either Pearson\'s correlation, linear or curvilinear regression, or a simple visual scan/scatter diagram. The result of this study reveals the lack of evidence to inform clinical practice in this area, and there is a need for a well-designed multi-center prospective study.

Osteoporosis in menopausal women requires alternatives to current medications, considering their adverse effects. In this context, probiotics and isoflavone products are promising dietary interventions. The objective of our study was to examine the impacts of Lactobacillus acidophilus and its combination with daidzein and tempeh on calcium status, calcium transporters, and bone metabolism biomarkers in a post-menopausal osteoporotic rat model. A total of 48 female Wistar rats were exposed to a two-stage experiment involving calcium deficit induction and subsequent dietary interventions across six groups. Calcium levels, the gene expression of TRPV5 and TRPV6 calcium transporters, bone histopathology, serum bone metabolism markers, and blood biochemistry were evaluated. The results revealed that, while decreasing serum calcium levels, the groups that received the probiotic L. acidophilus and isoflavone combination exhibited increased bone metabolism biomarkers and decreased calcium transporter expressions, akin to the effects of bisphosphonate. Additionally, significant improvements in bone histopathology were observed in these groups. However, the group receiving probiotic L. acidophilus alone did not exhibit significant changes in bone resorption biomarkers, calcium transporter expression, or various blood parameters. Meanwhile, the combination of probiotic L. acidophilus with tempeh positively influenced hematological parameters and reduced cholesterol and triglyceride levels, but it led to elevated blood glucose levels. Correlation analyses highlighted associations between serum calcium levels, calcium transporter expression, and bone metabolism biomarkers. In conclusion, our findings suggest that the daily consumption of probiotic L. acidophilus in combination with isoflavone products may improve bone health in ovariectomized rats, warranting further research to elucidate potential interactions with other nutrients.