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The Journal of Clinical Endocrinology... Oct 2019This Position Statement has been endorsed by the International Menopause Society, The Endocrine Society, The European Menopause and Andropause Society, The International...
This Position Statement has been endorsed by the International Menopause Society, The Endocrine Society, The European Menopause and Andropause Society, The International Society for Sexual Medicine, The International Society for the Study of Women's Sexual Health, The North American Menopause Society, The Federacion Latinoamericana de Sociedades de Climaterio y Menopausia, The Royal College of Obstetricians and Gynecologists, The International Society of Endocrinology, The Endocrine Society of Australia, and The Royal Australian and New Zealand College of Obstetricians and Gynecologists.
Topics: Androgens; Female; Humans; Off-Label Use; Postmenopause; Premenopause; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Testosterone
PubMed: 31498871
DOI: 10.1210/jc.2019-01603 -
BMC Women's Health Nov 2021Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%.... (Review)
Review
BACKGROUND
Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%. Due to the variety of endometriosis-associated symptoms, a great variety of treatments have been implemented. The aim of this review is to give an overview on therapeutical approaches of eight national and international widely used guidelines.
METHODS
Six national (College National des Gynecologues et Obstetriciens Francais, National German Guideline (S2k), Society of Obstetricians and Gynaecologists of Canada, American College of Obstetricians (ACOG) and Gynecologists, American Society for Reproductive Medicine (ASRM) and National Institute for Health and Care (NICE) and two international (World Endometriosis Society, European Society of Human Reproduction and Embryology) guidelines are included in this review.
CONCLUSION
All the above-mentioned guidelines agree that the combined oral contraceptive pill, progestogens are therapies recommended for endometriosis associated pain. Concerning infertility, there is no clear consensus about surgical treatment. Discrepancies are also found on recommendation of the second- and third-line treatments.
Topics: Canada; Endometriosis; Female; Humans; Pelvis; Reproductive Medicine
PubMed: 34844587
DOI: 10.1186/s12905-021-01545-5 -
Deutsches Arzteblatt International Apr 2021Vaccination during pregnancy can protect both the expecting mother and the unborn and newborn child from infectious diseases. (Review)
Review
BACKGROUND
Vaccination during pregnancy can protect both the expecting mother and the unborn and newborn child from infectious diseases.
METHODS
This review is based on publications retrieved by a selective literature search on the immunological particularities of infectious diseases affecting pregnant women, unborn children, and neonates, with particular attention to the guidelines of the German Standing Committee on Vaccinations (Ständige Impfkommission, STIKO) and the pertinent guidelines.
RESULTS
Vaccination during pregnancy protects the expecting mother from a severe course of a number of different infectious diseases. Vaccination with inactivated vaccines against influenza, tetanus, and pertussis is effective, safe, and well tolerated. Women who are pregnant or of child-bearing age should be immunized against tetanus according to the STIKO recommendations. All pregnant women from the second trimester onward should receive an inactivated quadrivalent influenza vaccine. The immunity acquired after vaccination with an acellular pertussis vaccine is present only for a limited time. In a cohort study involving 72,781 pregnant women, pertussis vaccination during pregnancy was found to yield 91% protection against pertussis for their subsequently born children in the first three months of life. Further types of vaccine can also be given during pregnancy if indicated. Additional reasonable measures to protect the health of mother and child include the vaccination of other persons in close contact as well as the closure of relevant vaccination gaps among young adults, particularly women of child-bearing age. Treating physicians play a crucial role in encouraging vaccine acceptance by their patients.
CONCLUSION
Maternal immunization is a safe and effective strategy for giving neo - nates passive immune protection against life-threatening infections by the vertical transmission of maternal antibodies until they are able to build up their own adaptive immunity.
Topics: Cohort Studies; Female; Humans; Infant, Newborn; Influenza Vaccines; Influenza, Human; Pregnancy; Vaccination; Whooping Cough; Young Adult
PubMed: 34114547
DOI: 10.3238/arztebl.m2021.0020 -
Journal of General Internal Medicine Sep 2022The Veterans Health Administration (VA) refers patients to community providers for specialty services not available on-site. However, community-level specialist...
BACKGROUND
The Veterans Health Administration (VA) refers patients to community providers for specialty services not available on-site. However, community-level specialist shortages may impede access to care.
OBJECTIVE
Compare gynecologist supply in veterans' county of residence versus at their VA site.
DESIGN
We identified women veteran VA patients from fiscal year (FY) 2017 administrative data and assessed availability of a VA gynecologist within 50 miles (hereafter called "local") of veterans' VA homesites (per national VA organizational survey data). For the same cohort, we then assessed community-level gynecologist availability; counties with < 2 gynecologists/10,000 women (per the Area Health Resource File) were "inadequate-supply" counties. We examined the proportion of women veterans with local VA gynecologist availability in counties with inadequate versus adequate gynecologist supply, stratified by individual and VA homesite characteristics. Chi-square tests assessed statistical differences.
PARTICIPANTS
All women veteran FY2017 VA primary care users nationally.
MAIN MEASURES
Availability of a VA gynecologist within 50 miles of a veteran's VA homesite; county-level "inadequate-supply" of gynecologists.
KEY RESULTS
Among 407,482 women, 9% were in gynecologist supply deserts (i.e., lacking local VA gynecologist and living in an inadequate-supply county). The sub-populations with the highest proportions in gynecologist supply deserts were rural residents (24%), those who got their primary care at non-VAMC satellite clinics (13%), those who got their care at a site without a women's clinic (13%), and those with American Indian or Alaska Native (12%), or white (12%) race. Among those in inadequate-supply counties, 59.9% had gynecologists at their local VA; however, 40.1% lacked a local VA gynecologist.
CONCLUSIONS
Most veterans living in inadequate-supply counties had local VA gynecology care, reflecting VA's critical role as a safety net provider. However, for those in gynecologist supply deserts, expanded transportation options, modified staffing models, or tele-gynecology hubs may offer solutions to extend VA gynecology capacity.
Topics: Ambulatory Care Facilities; Female; Gynecology; Health Services Accessibility; Hospitals, Veterans; Humans; United States; United States Department of Veterans Affairs; Veterans
PubMed: 36042097
DOI: 10.1007/s11606-022-07591-5 -
The Obstetrician & Gynaecologist : the... Jan 2021Lynch syndrome is an autosomal dominant condition closely associated with colorectal, endometrial and ovarian cancer.Women with Lynch syndrome are at increased risk of... (Review)
Review
KEY CONTENT
Lynch syndrome is an autosomal dominant condition closely associated with colorectal, endometrial and ovarian cancer.Women with Lynch syndrome are at increased risk of both endometrial and ovarian cancer and should be offered personalised counselling regarding family planning, red flag symptoms and risk-reducing strategies.Surveillance for gynaecological cancer in women with Lynch syndrome remains controversial; more robust data are needed to determine its effectiveness.Universal testing for Lynch syndrome in endometrial cancer is being adopted by centres across Europe and is now recommended by the National Institute for Health and Care Excellence; thus, gynaecologists must become familiar with testing strategies and their results.Testing strategies involve risk stratification of cancers based on phenotypical features and definitive germline testing.
LEARNING OBJECTIVES
To define the pathogenesis of Lynch syndrome and its associated gynaecological cancers.To understand the testing strategies for Lynch syndrome in women with gynaecological cancer.To learn how best to counsel women with Lynch syndrome regarding gynaecological cancer and risk-reducing strategies to enable informed decision-making.
ETHICAL ISSUES
Offering gynaecological surveillance despite a lack of robust evidence for its clinical effectiveness may falsely reassure women and delay risk-reducing hysterectomy.Genetic testing may yield variants of unknown significance with ill-defined clinical implications, which can lead to confusion and anxiety.Genetic testing has implications not only for the individual, but also for the whole family, so expert counselling is crucial.
PubMed: 33679238
DOI: 10.1111/tog.12706 -
Oncology Research 2021Metastasis and paclitaxel (PTX) resistance are the main reason for the poor prognosis of ovarian cancer (OC). Evidence showed that RNA-binding proteins (RBPs) and long...
Metastasis and paclitaxel (PTX) resistance are the main reason for the poor prognosis of ovarian cancer (OC). Evidence showed that RNA-binding proteins (RBPs) and long noncoding RNAs (lncRNAs) can modulate post-transcriptional regulation. The aim of this study was to determine the relationship among RBP, lncRNA and OC and to further guide clinical therapy. Immunohistochemistry revealed that pre-mRNA processing factor 6 (PRPF6) was upregulated in OC chemoresistant tissues and was closely related to advanced (Federation of International of Gynecologists and Obstetricians) FIGO stages and chemo-resistance. PRPF6 promoted progression, and PTX resistance and . And the transcripts of small nucleolar RNA host gene SNHG16-L/S were differentially expressed in OC cells and tissues as detected through real-time PCR (RT-PCR). SNHG16-L/S had opposite effects on progression and PTX resistance in OC. Mechanistically, SNHG16-L inhibited GATA-binding protein 3 (GATA3) transcription by binding to CCAAT/enhancer-binding protein B (CEBPB). Moreover, PRPF6 induced the alternative splicing of SNHG16, causing downregulation of SNHG16-L and, leading to the upregulation of GATA3 expression to further promote metastasis and PTX-resistance in OC. Totally, these data unveiled that PRPF6 promotes metastasis and PTX resistance of OC through SNHG16-L/CEBPB/GATA3 axis, which provides a new direction for OC treatment.
Topics: Humans; Female; Paclitaxel; Ovarian Neoplasms; Down-Regulation; Up-Regulation; Gynecologists; RNA Splicing Factors; Transcription Factors; GATA3 Transcription Factor; CCAAT-Enhancer-Binding Protein-beta
PubMed: 37303939
DOI: 10.32604/or.2022.03561 -
Bioscience Trends Dec 2022On June 24, 2022, the US Supreme Court overturned Roe v. Wade, which marked a further restriction on women's abortion rights in the US. It has sparked a wide range of... (Review)
Review
On June 24, 2022, the US Supreme Court overturned Roe v. Wade, which marked a further restriction on women's abortion rights in the US. It has sparked a wide range of societal reactions around the world. Women in different countries enjoy diverse abortion rights due to conditions in their respective nations and cultures. Abortion protects women's rights to a certain extent, and especially in the event of unintended pregnancy. An inappropriate abortion ban will affect women's health and lives and all aspects of medicine, including the lives of doctors, patient access, and the development of medical technology. This review provides a gynecologist's perspective on the impact of abortion policies on women's health and the medical system. This review also attempts to determine the reason for the government's abortion ban.
Topics: Pregnancy; Female; Humans; Abortion, Induced; Women's Rights; Policy; Government Regulation
PubMed: 36450578
DOI: 10.5582/bst.2022.01354 -
Acta Bio-medica : Atenei Parmensis Jan 2022Nepal is one of the first South Asian countries to include anti discrimination laws against LGBTQ community, yet they face disparity in all sectors, including health....
Nepal is one of the first South Asian countries to include anti discrimination laws against LGBTQ community, yet they face disparity in all sectors, including health. This group has special reproductive and sexual health needs, which has to be assessed and treated on an individual level. Most gynecologist in Nepal have not been trained to care for this vulnerable group and thus are not comfortable having them in clinical settings. History taking is essential to reach to an accurate diagnosis however, since the first year of medical school, history taking has been based on heteronormativity. To end disparities in reproductive health, learning modules for history taking for LGBTQ community is necessary for medical students, residents and for gynecologists. This would help display confidence and openness towards them and focus on individualized care.
Topics: Gynecology; Humans; Medical History Taking; Schools, Medical; Students, Medical
PubMed: 35075073
DOI: 10.23750/abm.v92i6.11940 -
Australian Journal of General Practice 2024Endometriosis is a chronic inflammatory condition defined as endometrial-like tissue proliferating outside the uterus. It is a common yet frequently under-recognised... (Review)
Review
BACKGROUND
Endometriosis is a chronic inflammatory condition defined as endometrial-like tissue proliferating outside the uterus. It is a common yet frequently under-recognised condition affecting one in nine Australian women.
OBJECTIVE
This paper aims to provide a summary of the recommendations for the diagnosis and management of endometriosis-associated pain and infertility from the most recent evidence-based guidelines on endometriosis by the European Society of Human Reproduction and Embryology, the Royal Australian College of Obstetricians and Gynaecologists and the National Institute for Health and Care Excellence.
DISCUSSION
Effective management of endometriosis requires prompt diagnosis to enable early multidisciplinary intervention that aligns with patient needs and priorities. Assessment includes a thorough history, pelvic examination where appropriate and referral for transvaginal ultrasound and/or magnetic resonance imaging. If endometriosis is suspected based on clinical symptoms but imaging is negative or empirical treatment is ineffective, individuals should be referred to a gynaecologist for further assessment and consideration of laparoscopy. Management options include hormonal and surgical therapies.
Topics: Female; Humans; Endometriosis; Pelvic Pain; Australia; Ultrasonography; Magnetic Resonance Imaging
PubMed: 38316472
DOI: 10.31128/AJGP/04-23-6805 -
Journal of Minimally Invasive Gynecology 2020
PubMed: 32470521
DOI: 10.1016/j.jmig.2020.05.019