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Journal of Food Biochemistry Jul 2022Polycystic ovarian syndrome (PCOS) is caused by abnormal production of androgens resulting in the formation of small fluid-filled sacs in the ovaries. This condition... (Review)
Review
Polycystic ovarian syndrome (PCOS) is caused by abnormal production of androgens resulting in the formation of small fluid-filled sacs in the ovaries. This condition worsens the life quality of women by disturbing their physiology and psychology in reproductive age. PCOS may also be associated with other morbidities like diabetes and hypertension. Numerous factors like imbalanced dietary patterns, poor lifestyle activities, improper care and medication, late diagnosis, and ignorance are involved in the prevalence of this disease in women. Hence, an early diagnosis and improved dietary and lifestyle management may improve the life quality and timely recovery of the patient from this disease. Various herbal extracts show a positive correlation in reducing the indicators associated with PCOS. This review discusses the effect of dietary and lifestyle practices on PCOS as prominent features. It has been recommended that a balanced diet with 40% energy from carbohydrates, 30% from fats, and 30% from protein with optimum physical activity could reduce severe PCOS symptoms and improve metabolic balance. Furthermore, recommendations for modification of diet and lifestyle activities are made which may positively influence the recovery from PCOS. PRACTICAL APPLICATIONS: Polycystic ovarian syndrome (PCOS) severely affects the life quality of suffering women. The dietary patterns, lifestyle activities, and co-medical conditions collectively affect the severity and related consequences of PCOS. This article provides sufficient information on dietary and lifestyle modifications to effectively manage this disease. Furthermore, dietitians, nutritionists, gynecologists, and obstetrics physicians can benefit from the information provided in it to understand and develop the management strategies to alleviate the disease symptoms and severity.
Topics: Diet; Female; Humans; Life Style; Polycystic Ovary Syndrome; Pregnancy
PubMed: 35199348
DOI: 10.1111/jfbc.14117 -
Topics in Companion Animal Medicine Jun 2021Functional ovarian cysts occur as solitary or multiple fluid-filled structures of variable size that are unilateral or bilateral in the bitches of age 6-8 years. Though... (Review)
Review
Functional ovarian cysts occur as solitary or multiple fluid-filled structures of variable size that are unilateral or bilateral in the bitches of age 6-8 years. Though the pathogenesis is obscure, insufficient LH surge, intrafollicular changes in gonadotrophin receptors and growth factors are the possible reasons behind the occurrence of hormonally active ovarian cysts that predisposes the bitch to the development of cystic endometrial hyperplasia-pyometra complex and occasionally hyper estrogenism. In the presence of suggestive signs, ultrasonography is the practical imaging modality for the clinical diagnosis that can be confirmed by assay of ovarian steroids and histopathology. Medical management with gonadotrophin-releasing hormone analogues and human chorionic gonadotrophin is not preferred as they are not always successful. As uterine pathologies are highly likely by the time of diagnosis, ovariohysterectomy is the treatment of choice for the follicular and luteal cysts. Understanding the cellular and molecular changes in the hypothalamo-hypophyseal ovarian axis will improve our understanding on the canine ovarian cysts.
Topics: Animals; Dog Diseases; Dogs; Endometrial Hyperplasia; Female; Humans; Ovarian Cysts; Pyometra
PubMed: 33434678
DOI: 10.1016/j.tcam.2021.100511 -
American Journal of Obstetrics and... Nov 2021
Topics: Delivery, Obstetric; Diagnosis, Differential; Female; Humans; Ovarian Cysts; Pregnancy; Prognosis; Ultrasonography, Prenatal
PubMed: 34507793
DOI: 10.1016/j.ajog.2021.06.042 -
Nature Cell Biology Aug 2022Endometriosis is characterized by the growth of endometrial-like tissue outside the uterus. It affects many women during their reproductive age, causing years of pelvic...
Endometriosis is characterized by the growth of endometrial-like tissue outside the uterus. It affects many women during their reproductive age, causing years of pelvic pain and potential infertility. Its pathophysiology remains largely unknown, which limits early diagnosis and treatment. We characterized peritoneal and ovarian lesions at single-cell transcriptome resolution and compared them to matched eutopic endometrium, unaffected endometrium and organoids derived from these tissues, generating data on over 122,000 cells across 14 individuals. We spatially localized many of the cell types using imaging mass cytometry. We identify a perivascular mural cell specific to the peritoneal lesions, with dual roles in angiogenesis promotion and immune cell trafficking. We define an immunotolerant peritoneal niche, fundamental differences in eutopic endometrium and between lesion microenvironments and an unreported progenitor-like epithelial cell subpopulation. Altogether, this study provides a holistic view of the endometriosis microenvironment that represents a comprehensive cell atlas of the disease in individuals undergoing hormonal treatment, providing essential information for future therapeutics and diagnostics.
Topics: Choristoma; Endometriosis; Endometrium; Female; Humans; Ovarian Cysts; Ovarian Neoplasms; Single-Cell Analysis; Tumor Microenvironment
PubMed: 35864314
DOI: 10.1038/s41556-022-00961-5 -
Radiographics : a Review Publication of... 2021Adnexal torsion is the twisting of the ovary, and often of the fallopian tube, on its ligamental supports, resulting in vascular compromise and ovarian infarction. The... (Review)
Review
Adnexal torsion is the twisting of the ovary, and often of the fallopian tube, on its ligamental supports, resulting in vascular compromise and ovarian infarction. The definitive management is surgical detorsion, and prompt diagnosis facilitates preservation of the ovary, which is particularly important because this condition predominantly affects premenopausal women. The majority of patients present with severe acute pain, vomiting, and a surgical abdomen, and the diagnosis is often made clinically with corroborative US. However, the symptoms of adnexal torsion can be variable and nonspecific, making an early diagnosis challenging unless this condition is clinically suspected. When adnexal torsion is not clinically suspected, CT or MRI may be performed. Imaging has an important role in identifying adnexal torsion and accelerating definitive treatment, particularly in cases in which the diagnosis is not an early consideration. Several imaging features are characteristic of adnexal torsion and can be seen to varying degrees across different modalities: a massive, edematous ovary migrated to the midline; peripherally displaced ovarian follicles resembling a string of pearls; a benign ovarian lesion acting as a lead mass; surrounding inflammatory change or free fluid; and the uterus pulled toward the side of the affected ovary. Hemorrhage and absence of internal flow or enhancement are suggestive of ovarian infarction. Pertinent conditions to consider in the differential diagnosis are a ruptured hemorrhagic ovarian cyst, massive ovarian edema, ovarian hyperstimulation, and a degenerating leiomyoma. RSNA, 2021.
Topics: Adnexal Diseases; Female; Humans; Magnetic Resonance Imaging; Ovarian Cysts; Ovarian Torsion; Torsion Abnormality
PubMed: 33577417
DOI: 10.1148/rg.2021200118 -
The Israel Medical Association Journal... Jan 2022A paraovarian cyst (POC) is located between the ovary and the fallopian tube. In many cases POCs are diagnosed and managed as ovarian cysts. But since POC are a distinct...
BACKGROUND
A paraovarian cyst (POC) is located between the ovary and the fallopian tube. In many cases POCs are diagnosed and managed as ovarian cysts. But since POC are a distinct entity in their clinical presentation and surgical intervention, they should be better defined.
OBJECTIVES
To describe the clinical perioperative and operative characteristics of patients with POCs in order to improve pre-operative diagnosis and management.
METHODS
A retrospective cohort study of patients with an operative diagnosis of POC between 2007 and 2019 in a single university-affiliated tertiary care medical center was included. Demographic characteristics as well as symptoms, sonographic appearance, surgery findings, and histology results were retrieved from electronic medical records.
RESULTS
During the study period 114 patients were surgically diagnosed with POC, 57.9% were in their reproductive years and 24.6% were adolescents. Most presented with abdominal pain (77.2%). Preoperative sonographic exams accurately diagnosed POC in only 44.7% of cases, and 50.9% underwent surgery due to suspected torsion, which was surgically confirmed in 70.7% of cases. Among women with confirmed torsion, 28.9% involved the fallopian tube without involvement of the ipsilateral ovary. Histology results showed benign cysts in all cases, except two, with a pathological diagnosis of serous borderline tumor.
CONCLUSIONS
POC should always be part of the differential diagnosis of women presenting with lower abdominal pain and sonographic evidence of adnexal cysts. If POC is suspected there should be a high level of suspicion for adnexal torsion and low threshold for surgical intervention, especially in adolescent, population who are prone to torsion.
Topics: Abdominal Pain; Adult; Cysts; Diagnosis, Differential; Fallopian Tube Diseases; Female; Gynecologic Surgical Procedures; Humans; Israel; Outcome and Process Assessment, Health Care; Ovarian Cysts; Postoperative Complications; Retrospective Studies; Tertiary Care Centers; Torsion Abnormality; Ultrasonography
PubMed: 35077040
DOI: No ID Found -
The Medical Clinics of North America Mar 2023Fibroids, endometriosis, and ovarian cysts are common conditions. Fibroids can be asymptomatic or present with heavy menstrual bleeding, pelvic pressure, and pain.... (Review)
Review
Fibroids, endometriosis, and ovarian cysts are common conditions. Fibroids can be asymptomatic or present with heavy menstrual bleeding, pelvic pressure, and pain. Endometriosis is a common cause of cyclical pelvic pain. Ovarian cysts are generally diagnosed incidentally. Transvaginal ultrasound is the performed imaging modality for all structural gynecological disease. Symptomatic management is recommended for each condition. Fibroids can be managed medically or surgically depending on the patient's symptoms and desire for future fertility. Nonsteroidal anti-inflammatory drugs are the first-line therapy for endometriosis followed by oral contraceptives and surgical management. Ovarian cysts can be managed expectantly.
Topics: Female; Humans; Endometriosis; Genital Diseases, Female; Leiomyoma; Ultrasonography; Ovarian Cysts
PubMed: 36759100
DOI: 10.1016/j.mcna.2022.10.010 -
Obstetrics and Gynecology Jun 2024Ovarian endometriomas affect many patients with endometriosis and have significant effects on quality of life, fertility, and risk of malignancy. Endometriomas range... (Review)
Review
Ovarian endometriomas affect many patients with endometriosis and have significant effects on quality of life, fertility, and risk of malignancy. Endometriomas range from small (1-3 cm), densely fibrotic cysts to large (20 cm or greater) cysts with varying degrees of fibrosis. Endometriomas are hypothesized to form from endometriotic invasion or metaplasia of functional cysts or alternatively from ovarian surface endometriosis that bleeds into the ovarian cortex. Different mechanisms of endometrioma formation may help explain the phenotypic variability observed among endometriomas. Laparoscopic surgery is the preferred first-line modality of diagnosis and treatment of endometriomas. Ovarian cystectomy is preferred over cyst ablation or sclerotherapy for enabling pathologic diagnosis, improving symptoms, preventing recurrence, and optimizing fertility outcomes. Cystectomy for small, densely adherent endometriomas is made challenging by dense fibrosis of the cyst capsule obliterating the plane with normal ovarian cortex, whereas cystectomy for large endometriomas can carry unique challenges as a result of adhesions between the cyst and pelvic structures. Preoperative and postoperative hormonal suppression can improve operative outcomes and decrease the risk of endometrioma recurrence. Whether the optimal management, fertility consequences, and malignant potential of endometriomas vary on the basis of size and phenotype remains to be fully explored.
Topics: Humans; Female; Endometriosis; Ovarian Diseases; Laparoscopy; Ovarian Cysts
PubMed: 38626453
DOI: 10.1097/AOG.0000000000005587 -
The British Journal of Radiology Feb 2023Incidental ovarian lesions are asymptomatic lesions that are accidentally discovered during a CT or MRI examinations that involves the pelvic cavity or during a routine... (Review)
Review
Incidental ovarian lesions are asymptomatic lesions that are accidentally discovered during a CT or MRI examinations that involves the pelvic cavity or during a routine obstetric ultrasound study. Incidental ovarian masses are usually benign with a very low risk of malignancy yet underlying malignant pathology may be discovered during the diagnostic work-up of these lesions. Suspicion of malignancy is directly correlating with the increase in the patient's age, the increase in the size of the lesion, the presence of the solid components or thick septa and a high color scale of the ovarian mass. Following standard reporting and management protocols are essential to choose the proper work-up of these lesions to avoid unnecessary additional imaging and operative intervention. In this article, we will provide a review of the characteristic imaging features of some incidental and yet commonly encountered ovarian lesions. We will also summarize the recently published algorithms that are important for consistent reporting and standard management of these lesions.
Topics: Female; Humans; Ovarian Cysts; Ovarian Neoplasms; Magnetic Resonance Imaging; Incidental Findings
PubMed: 35142537
DOI: 10.1259/bjr.20211325