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Bohsas H, Alibrahim H, Swed S, Abouainain Y, Aljabali A, Kazan L, Jabban YKE, Mehmood Q, Sawaf B, Eissa N, Alkasem M, Edrees Y, Cherrez-Ojeda I, Fathey S, Rashid G, Hafez W, AbdElrahim E, Osman H, Emran TB, Khan Pathan R, Khandaker MU. Prevalence and knowledge of polycystic ovary syndrome (PCOS) and health-related practices among women of Syria: a cross-sectional study. J Psychosom Obstet Gynaecol 2024; 45:2318194. [PMID: 38635351 DOI: 10.1080/0167482x.2024.2318194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/08/2024] [Indexed: 04/20/2024] Open
Abstract
Polycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women's PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18-45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21-29, and 69.6% held bachelor's degrees. Those with a bachelor's degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.
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Affiliation(s)
| | | | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Lazaward Kazan
- Faculty of Medicine, Altınbaş University, Istanbul, Turkey
| | | | | | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Nourhan Eissa
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Meriam Alkasem
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Yasmine Edrees
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | - Gowhar Rashid
- Department of Amity Medical School, Amity University, Haryana, India
| | - Wael Hafez
- NMC Royal Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Elrashed AbdElrahim
- Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hamid Osman
- Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Refat Khan Pathan
- Department of Computing and Information Systems, School of Engineering and Technology, Sunway University, Bandar Sunway, Malaysia
| | - Mayeen Uddin Khandaker
- Faculty of Graduate Studies, Daffodil International University, Daffodil Smart City, Dhaka, Bangladesh
- Applied Physics and Radiation Technologies Group, CCDCU, School of Engineering and Technology, Sunway University, Bandar Sunway, Malaysia
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Mattar CN, Chew WL, Lai PS. Embryo and fetal gene editing: Technical challenges and progress toward clinical applications. Mol Ther Methods Clin Dev 2024; 32:101229. [PMID: 38533521 PMCID: PMC10963250 DOI: 10.1016/j.omtm.2024.101229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Gene modification therapies (GMTs) are slowly but steadily making progress toward clinical application. As the majority of rare diseases have an identified genetic cause, and as rare diseases collectively affect 5% of the global population, it is increasingly important to devise gene correction strategies to address the root causes of the most devastating of these diseases and to provide access to these novel therapies to the most affected populations. The main barriers to providing greater access to GMTs continue to be the prohibitive cost of developing these novel drugs at clinically relevant doses, subtherapeutic effects, and toxicity related to the specific agents or high doses required. In vivo strategy and treating younger patients at an earlier course of their disease could lower these barriers. Although currently regarded as niche specialties, prenatal and preconception GMTs offer a robust solution to some of these barriers. Indeed, treating either the fetus or embryo benefits from economy of scale, targeting pre-pathological tissues in the fetus prior to full pathogenesis, or increasing the likelihood of complete tissue targeting by correcting pluripotent embryonic cells. Here, we review advances in embryo and fetal GMTs and discuss requirements for clinical application.
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Affiliation(s)
- Citra N.Z. Mattar
- Experimental Fetal Medicine Group, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, Singapore 119228
- Department of Obstetrics and Gynaecology, National University Health System, Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, Singapore 119228
| | - Wei Leong Chew
- Genome Institute of Singapore, Agency for Science, Technology and Research (A∗STAR), Singapore, 60 Biopolis St, Singapore, Singapore 138672
| | - Poh San Lai
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, Singapore 119228
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Ratislavová K, Horová J, Marek P. Measuring Women's Satisfaction with Childbirth: A Literature Review of Measurement Properties. Zdr Varst 2024; 63:100-108. [PMID: 38517034 PMCID: PMC10954241 DOI: 10.2478/sjph-2024-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/07/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Patient satisfaction is an important indicator of the quality of care provided. Evaluating women's satisfaction with childbirth is essential to improving obstetric care and ensuring a positive experience for mothers and newborns. The tools used to measure women's satisfaction with childbirth are very heterogeneous and multidimensional. Assessment tools used in practice should be tested and meet characteristics that are consistently validated.The aim is to identify currently available instruments measuring women's satisfaction with childbirth and to evaluate their structure, content and psychometric properties. Methods A systematic search for sources was carried out according to the criteria set. For the included studies, psychometric properties were assessed in accordance with the principles of the guideline for completing systematic reviews of patient-reported outcome measures, COSMIN. Results The review included 31 studies that reported the psychometric properties of six measurement instruments (questionnaires, scales). Content validity, structural validity, internal consistency, reliability and cross-cultural validity were assessed for the included studies. The Childbirth Experience Questionnaire (CEQ/CEQ2) and Birth Satisfaction Scale - Revised (BSS-R) were the most commonly used questionnaires in the studies. Conclusions Thorough testing of tools measuring women's satisfaction with childbirth, and adapting them to cultural and social contexts, is still essential. It is crucial that valid and reliable questionnaires are available for midwives in practice, for use in research, to inform clinical practice and for the results to help develop the services offered.
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Affiliation(s)
- Kateřina Ratislavová
- University of West Bohemia, Faculty of Health Care Studies, Husova street 11, Pilsen, 301 00, Czech Republic
| | - Jana Horová
- University of West Bohemia, Faculty of Health Care Studies, Husova street 11, Pilsen, 301 00, Czech Republic
| | - Patrice Marek
- University of West Bohemia, Faculty of Applied Sciences, Technicka street 8, Pilsen, 301 00, Czech Republic
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Ural ÜM. The effect of injectable platelet rich fibrin as a nonsurgical treatment of the female stress urinary incontinence. Arch Gynecol Obstet 2024; 309:2229-2236. [PMID: 38424182 DOI: 10.1007/s00404-024-07431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The complications of surgical treatments of stress urinary incontinence have led to the search for less invasive and safer treatment procedures. We aimed to investigate the efficacy of locally administered injectable platelet-rich fibrin (i-PRF), an autologous material that plays an important role in tissue regeneration, in women with stress urinary incontinence. METHODS Thirty-four women were included in this prospective, single-center, and interventional study, suffering from stress urinary incontinence refractory to conservative treatment. Three consecutive i-PRF injections were applied to the mid-urethra localization at anterior vaginal wall with an interval of 1 month. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires were used to measure pre‑treatment, 1 month and 6 months post‑treatment symptom severity and the clinical outcomes were recorded. RESULTS The mean age of the patients was 51.5 ± 9.8 years. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires results revealed significant clinical improvement of stress urinary incontinence severity afer the administration of i-PRF (p < 0.001). The results at 1 and 6 months after treatment did not change statistically significantly. CONCLUSION This study demonstrated that locally administiration of i-PRF is efective in relieving SUI symptoms with high success rates without any adverse effects reported. i-PRF injection may have the potential to be a novel, minimally invasive, and low-risk procedure, that could be an alternative and simple treatment modality to surgery for female patients with stress urinary incontinence. Additionally, it may create new avenues for research on therapeutic implementation of i-PRF.
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Affiliation(s)
- Ülkü Mete Ural
- Department of Obstetrics and Gynecology, Faculty of Medicine, Bolu Abant İzzet Baysal University, Gölköy Yerleşkesi, 14030, Bolu, Turkey.
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Garnier L, Parant F, Bulteau C, Pescarmona R, Cerruto E, Moret S, Miguet-Bensouda C, Nohuz E, Chene G. Plasma and peritoneal fluid cytokine profiles in patient with Essure® implant: Towards a molecular signature? Eur J Obstet Gynecol Reprod Biol 2024; 296:349-353. [PMID: 38537321 DOI: 10.1016/j.ejogrb.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE(S) Many patients with Essure® implant may experience adverse events related to the device. Although local inflammation does not appear to be the pathophysiological mechanism underlying the symptoms, systemic inflammation could play a role. In the present study, as cytokines are involved in the inflammatory process, we proposed to investigate the profile of circulating and peritoneal cytokines. STUDY DESIGN In this retrospective study, we evaluated the levels of cytokines in peritoneal fluid (PF) as well as in plasma sample from three different groups: Essure® group, endometriosis group (known to be associated with immune dysregulation), and control group. RESULTS There were 60 symptomatic patients with Essure® device, 30 patients with endometriosis and a control group of 30 patients. The PF levels of Interleukin-10 (IL-10), Interleukin-6 (IL-6), and Monocyte chemoattractant protein-1 (MCP-1) were statistically higher in endometriosis group than in Essure® group and control group. The plasma level of MCP-1 was higher in Essure® group than in endometriosis group and control group. The plasma level of TNF-α was higher in Essure® group than in control group. CONCLUSIONS The chemokine MCP-1 as well as the pro-inflammatory TNF-α, are known to be increased in patients with fibromyalgia and chronic fatigue syndrome. Since patients with Essure® may exhibit symptoms similar to fibromyalgia, MCP-1 and TNF-α may be relevant markers in symptomatic patients with Essure®. Because of the lack of longitudinal data (no evaluation of postoperative cytokine profile and no assessment of the level of clinical improvement), other studies are needed to confirm these preliminary results.
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Affiliation(s)
- Lorna Garnier
- Immunology Laboratory, Hôpital Lyon-Sud, Hospices Civils de Lyon, Chemin du Grand-Revoyet, University hospital of Lyon, 69495 Pierre-Bénite, France
| | - François Parant
- Trace Element Analysis Laboratory, Biochemistry Department, CBAPS, Centre hospitalier Lyon-Sud, Chemin du Grand-Revoyet, University hospital of Lyon, 69495 Pierre-Benite, France
| | - Claire Bulteau
- Immunology Laboratory, Hôpital Lyon-Sud, Hospices Civils de Lyon, Chemin du Grand-Revoyet, University hospital of Lyon, 69495 Pierre-Bénite, France
| | - Remi Pescarmona
- Immunology Laboratory, Hôpital Lyon-Sud, Hospices Civils de Lyon, Chemin du Grand-Revoyet, University hospital of Lyon, 69495 Pierre-Bénite, France
| | - Emanuele Cerruto
- Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France
| | - Stephanie Moret
- Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France
| | - Chloe Miguet-Bensouda
- Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France
| | - Erdogan Nohuz
- Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France
| | - Gautier Chene
- Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France; University Claude Bernard of Lyon 1, EMR 3738 CICLY, 69000 Lyon, France.
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Kehl S. Obesity at term: What to consider? How to deliver? Arch Gynecol Obstet 2024; 309:1725-1733. [PMID: 38326633 DOI: 10.1007/s00404-023-07354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/17/2023] [Indexed: 02/09/2024]
Abstract
Obesity presents significant challenges during pregnancy, increasing the risk of complications and adverse outcomes for both mother and baby. With the rising prevalence of obesity among pregnant women, questions arise regarding optimal management, including timing of delivery and choice of delivery mode. Labour induction in obese women may require a combination of mechanical and pharmacological methods due to increased risk of failed induction. Caesarean section in obese women presents unique challenges, requiring comprehensive perioperative planning and specialized care to optimize outcomes. However, specific guidelines tailored to obese patients undergoing caesarean sections are lacking. Postpartum care should include vigilant monitoring for complications. Addressing obesity in pregnancy necessitates a multidisciplinary approach and specialized care to ensure the best outcomes.
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Affiliation(s)
- Sven Kehl
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Universitätsstr. 21-23, 91054, Erlangen, Germany.
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Bonavina G, Lina Spinillo S, Sotiriadis A, Bulfoni A, Kaltoud R, Salvatore S, Candiani M, Ivo Cavoretto P. Effect of type III female genital mutilation on obstetric outcomes: A systematic review and meta-analysis. Heliyon 2024; 10:e29336. [PMID: 38628703 PMCID: PMC11019231 DOI: 10.1016/j.heliyon.2024.e29336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
Background Controversial evidence suggests a potential association between female genital mutilation (FGM/C) and adverse obstetric outcomes, with type III FGM/C (infibulation) carrying the greatest risk. The aim of this systematic review and meta-analysis was to assess current rate of adverse obstetric outcomes in women with type III female genital mutilation and cutting (FGM/C; infibulation) delivering across different settings worldwide. Methods We searched PubMed, Scopus, Embase, and ClinicalTrials.gov databases from inception to Jan 1, 2023. Studies were selected if they included the main outcome of postpartum haemorrhage (PPH) or secondary outcomes, which included major conditions affecting maternal-neonatal health during labour and delivery. DerSimonian-Laird random effects meta-analysis including pooled effect estimates with corresponding 95 % confidence intervals was performed. Heterogeneity was assessed using the I2 statistic. Meta regression for relevant covariates was performed when data on relevant confounders were available. The Newcastle-Ottawa scale (NOS) was used to assess quality of observational studies. The level of evidence was assessed with the GRADE method. Results 14 observational studies including 15,320 type III FGM/C women and 59,347 controls were eligible. The risk for postpartum haemorrhage was significantly increased in type III FGM/C, in the main analysis (OR 1.83, 95 % CI 1.03 to 3.24, I2 = 93 %), in pooling of data adjusted for confounders (aOR 1.76, CI 1.42 to 2.17, I2 = 0 %), and in sensitivity analysis of higher quality studies with NOS≥7 (OR 2.76, CI 1.38 to 5.51, I2 = 95 %). Meta-regression showed that nulliparity was significantly and positively associated with postpartum haemorrhage. Similarly, analysis of data adjusted for confounders showed an increased risk of episiotomy in type III FGM/C (aOR 1.56, CI 1.03 to 2.35, I2 = 52 %). Sensitivity analysis of studies with NOS≥7 revealed a significant increase for episiotomy (OR 7.53, CI 1.19 to 47.54, I2 = 96 %), perineal tears (OR 4.24, CI 1.09 to 16.46, I2 = 66 %), prolonged second stage of labour (OR 5.19, 95 % CI 1.00 to 26.85, I2 = 66 %), and Apgar score less than 7 (OR 4.19, CI 1.64 to 10.70, I2 = 0 %). No difference was found regarding obstetric anal sphincter injuries and mode of delivery in these women. Deinfibulation achieved similar obstetric and neonatal outcomes to women who never had type III FGM. The overall quality of the studies was adequate (median NOS score: 7; IQR: 6-8), the level of evidence, according to the GRADE assessment, was low. Conclusions These results consistently show an increased risk of adverse obstetric outcomes in women with FGM/C type III. Infibulation substantially increases the risk for PPH, particularly in nulliparae. Systematic Review registration: PROSPERO CRD42023421993.
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Affiliation(s)
- Giulia Bonavina
- Department of Obstetrics and Gynecology, IRCCS Humanitas Research Hospital, Humanitas University, 20090, Milan, Italy
- Department of Obstetrics and Gynecology, Port Sudan Maternity Teaching Hospital, Red Sea State University, 33312, Port Sudan, Red Sea State, Sudan
| | - Silvia Lina Spinillo
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
- University Vita-Salute, 20132, Milan, Italy
| | - Alexandros Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Alessandro Bulfoni
- Department of Obstetrics and Gynecology, IRCCS Humanitas Research Hospital, Humanitas University, 20090, Milan, Italy
| | - Randa Kaltoud
- Department of Obstetrics and Gynecology, Port Sudan Maternity Teaching Hospital, Red Sea State University, 33312, Port Sudan, Red Sea State, Sudan
| | - Stefano Salvatore
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
- University Vita-Salute, 20132, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
- University Vita-Salute, 20132, Milan, Italy
| | - Paolo Ivo Cavoretto
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
- University Vita-Salute, 20132, Milan, Italy
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Kong FS, Huang P, Chen JH, Ma Y. The Novel Insight of Gut Microbiota from Mouse Model to Clinical Patients and the Role of NF-κB Pathway in Polycystic Ovary Syndrome. Reprod Sci 2024:10.1007/s43032-024-01562-3. [PMID: 38653859 DOI: 10.1007/s43032-024-01562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
Polycystic Ovary Syndrome (PCOS) is a metabolic disorder characterized by hyperandrogenism and related symptoms in women of reproductive age. Emerging evidence suggests that chronic low-grade inflammation plays a significant role in the development of PCOS. The gut microbiota, a complex bacterial ecosystem, has been extensively studied for various diseases, including PCOS, while the underlying mechanisms are not fully understood. This review comprehensively summarizes the changes in gut microbiota and metabolites observed in PCOS and their potential association with the condition. Additionally, we discuss the role of abnormal nuclear factor κB signaling in the pathogenesis of PCOS. These findings offer valuable insights into the mechanisms of PCOS and may pave the way for the development of control and therapeutic strategies for this condition in clinical practice. By bridging the gap between mouse models and clinical patients, this review contributes to a better understanding of the interplay between gut microbiota and inflammation in PCOS, thus paving new ways for future investigations and interventions.
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Affiliation(s)
- Fan-Sheng Kong
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Panwang Huang
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jian-Huan Chen
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
- Joint Primate Research Center for Chronic Diseases, Institute of Zoology of Guangdong Academy of Science, Jiangnan University, Wuxi, Jiangsu, China.
- Jiangnan University Brain Institute, Wuxi, Jiangsu, China.
| | - Yaping Ma
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China.
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
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Mori LP, Zaia V, Montagna E, Vilarino FL, Barbosa CP. Endometriosis in infertile women: an observational and comparative study of quality of life, anxiety, and depression. BMC Womens Health 2024; 24:251. [PMID: 38654250 DOI: 10.1186/s12905-024-03080-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND A women's chances of getting pregnant decreases in cases of infertility, which may have several clinical etiologies. The prevalence of infertility is estimated as 10-15% worldwide. One of the causes of infertility is endometriosis, defined as the presence of an endometrial gland and/or stroma outside the uterus, inducing a chronic inflammatory reaction. Thus, infertility and endometriosis are diagnoses that significantly affect women's mental health. This study accessed and compared the levels of depression, anxiety, and quality of life in infertile women with and without endometriosis. METHODS was an observational and cross-sectional study which included 201 infertile women, 81 of whom were also diagnosed with endometriosis. The STROBE Guidelines was used. The data were collected using validated scales: Hamilton D Questionnaire, Beck Depression Inventory, and Fertility Quality of Life Questionnaire; The data were collected at the Ideia Fertil Institute (Santo Andre, Brazil), between February 28 and June 8, 2019. RESULTS the infertile women with endometriosis reported higher presence of depressive symptoms and a lower quality of life compared to women with infertility only. Similar presence of anxiety symptoms was observed regardless of being diagnosed with endometriosis. Women with infertility and endometriosis presented lower levels in quality-of-life domains when compared to women with infertility only - Mind and Body (58.33 × 79.17, p < 0.001), Relational (75 × 81.25, p = 0.009), Social (66.67 × 77.08, p = 0.001), Emotional (50.62 × 67.43, p < 0.001). CONCLUSION the findings indicate the need for increased psychosocial support care for women suffering from infertility and endometriosis to assist them in maintaining and managing their own mental health and achieving their reproductive goals.
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Affiliation(s)
- Lilian Pagano Mori
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
| | - Victor Zaia
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil.
- Instituto Ideia Fertil de Saúde Reprodutiva, , Santo Andre - SP, Brasil.
| | - Erik Montagna
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
| | | | - Caio Parente Barbosa
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
- Instituto Ideia Fertil de Saúde Reprodutiva, , Santo Andre - SP, Brasil
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Watters A, Ekpe E, Okafor A, Donelan E. Patient Perspectives on Outpatient versus Inpatient Cervical Ripening for Induction of Labor. Am J Perinatol 2024. [PMID: 38569508 DOI: 10.1055/a-2298-5166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Our objective was to compare patient perceived control and experience with outpatient versus inpatient cervical ripening. STUDY DESIGN This is a retrospective mixed-methods analysis of a quality improvement initiative focused on the impact to patients of incorporating outpatient cervical ripening into routine practice. Postpartum inpatients who had elected for outpatient cervical ripening (outpatients) and those who met criteria for outpatient cervical ripening but opted for an inpatient setting (inpatients) were invited to participate in the study. Patients completed the Perceived Control in Childbirth Scale, and scores were compared between outpatient and inpatient groups using Mann-Whitney U test. In addition, semistructured questions elicited feedback prior to hospital discharge, and these qualitative data were analyzed using iterative thematic analysis. RESULTS The study population consisted of 36 outpatients and 38 inpatients. The median score on the Perceived Control in Childbirth Scale was 69 for outpatients and 67 for inpatients (p-value = 0.49), out of a maximum score of 72 (representing the highest level of perceived control). Both groups reported similarly high levels of perceived control, regardless of cervical ripening setting. In the qualitative analysis, pain was the most common theme in both groups. Inpatients reported more distress despite access to stronger pain medications. Outpatients utilized a variety of distraction techniques and expressed gratitude for their setting more than inpatients. CONCLUSION Outpatient cervical ripening can be a patient-centered solution to obstetric throughput challenges arising from increased numbers of inductions. Those who underwent outpatient cervical ripening had similar perceived control to those who underwent inpatient cervical ripening, suggesting that individual patient preferences are most important in determining the optimal setting for care. The patients' reported experiences identified focus areas for process improvement efforts and future research, including improving patient education regarding expectations and innovating new pain management strategies for cervical ripening. KEY POINTS · Patient experiences must inform patient-centered care.. · Perceived control with cervical ripening was high.. · Pain with cervical ripening was the most cited theme..
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Affiliation(s)
- Amber Watters
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Etoroabasi Ekpe
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Illinois
| | - Annette Okafor
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- University of Illinois College of Medicine, Chicago, Illinois
| | - Emily Donelan
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Obstetrics and Gynecology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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11
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Price EJ, Benjamin S, Bombardieri M, Bowman S, Carty S, Ciurtin C, Crampton B, Dawson A, Fisher BA, Giles I, Glennon P, Gupta M, Hackett KL, Larkin G, Ng WF, Ramanan AV, Rassam S, Rauz S, Smith G, Sutcliffe N, Tappuni A, Walsh SB. British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease. Rheumatology (Oxford) 2024:keae152. [PMID: 38621708 DOI: 10.1093/rheumatology/keae152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/02/2024] [Indexed: 04/17/2024] Open
Abstract
Sjögren disease (SD) is a chronic, autoimmune disease of unknown aetiology with significant impact on quality of life. Although dryness (sicca) of the eyes and mouth are the classically described features, dryness of other mucosal surfaces and systemic manifestations are common. The key management aim should be to empower the individual to manage their condition-conserving, replacing and stimulating secretions; and preventing damage and suppressing systemic disease activity. This guideline builds on and widens the recommendations developed for the first guideline published in 2017. We have included advice on the management of children and adolescents where appropriate to provide a comprehensive guideline for UK-based rheumatology teams.
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Affiliation(s)
- Elizabeth J Price
- Department of Rheumatology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Stuart Benjamin
- The Academy Library and Information Service, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Michele Bombardieri
- Department of Rheumatology, Barts and The London School of Medicine and Dentistry, Barts Health NHS Trust, London, UK
- Centre for Experimental Medicine and Rheumatology, The William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Simon Bowman
- Department of Rheumatology, Milton Keynes University Hospital, Milton Keynes, UK
- Department of Rheumatology, University Hospitals Birmingham NHSFT, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Sara Carty
- Department of Rheumatology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Coziana Ciurtin
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Bridget Crampton
- Patient Representative, Sjogren's UK Helpline Lead, Sjogren's UK (British Sjögren's Syndrome Association), Birmingham, UK
| | - Annabel Dawson
- Patient Representative, Sjogren's UK (British Sjögren's Syndrome Association), Birmingham, UK
| | - Benjamin A Fisher
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - Peter Glennon
- General Practice, NHS Staffordshire & Stoke on Trent ICB, Stafford, UK
| | - Monica Gupta
- Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK
| | - Katie L Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | | | - Wan-Fai Ng
- Translational and Clinical Research Institute & Newcastle NIHR Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Department of Rheumatology, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Athimalaipet V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Saad Rassam
- Haematology and Haemato-Oncology, KIMS Hospital, Maidstone, Kent, UK
| | - Saaeha Rauz
- Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Guy Smith
- Department of Ophthalmology, Great Western Hospital NHS Foundation Trust, Swindon, UK
| | | | - Anwar Tappuni
- Institute of Dentistry, Queen Mary University of London, London, UK
| | - Stephen B Walsh
- London Tubular Centre, University College London, London, UK
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12
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Wu H, Wang H, Sun L, Liu M, Wang H, Sun X, Zhang W. Association Between rs2278426 Polymorphism of the ANGPTL8 Gene and Polycystic Ovary Syndrome. Diabetes Metab Syndr Obes 2024; 17:1749-1760. [PMID: 38645655 PMCID: PMC11032162 DOI: 10.2147/dmso.s455274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose To study the relationship between the single nucleotide polymorphism (SNP) rs2278426 in the angiopoietin-like protein 8 gene (ANGPTL8) and polycystic ovary syndrome (PCOS). Patients and methods A total of 122 patients with PCOS and 108 controls were recruited for comparison of glucose, lipid, insulin, sex hormone, and ANGPTL8 levels. Polymerase chain reaction (PCR) and gene sequencing were performed for comparison of the frequency of the CC, CT, and TT rs2278426 genotypes and the rs2278426 allele distributions between the PCOS and control groups and between the obese and non-obese subgroups of the PCOS and control groups. Results The frequency of the T allele was significantly higher in the PCOS group than that in the controls (P = 0.037). In the dominant genetic model, the proportion of the CT+TT genotype in the PCOS group was significantly higher than that in the controls (P = 0.047). Subgroup analysis demonstrated that the T allele proportion was significantly higher in obese PCOS group than obese control group (P = 0.027). PCOS with the CT+TT genotype had significantly higher body mass index (BMI; P = 0.001), triglyceride (TG; P = 0.005), homeostasis model assessment of insulin resistance (HOMA-IR; P = 0.035), testosterone (P = 0.041), and ANGPTL8 (P = 0.037) levels and significantly lower high-density lipoprotein (HDL) levels (P = 0.025) than PCOS with the CC genotype. Obese PCOS group with the CT+TT genotype had significantly higher TG (P = 0.015), luteinizing hormone (LH; P = 0.030), fasting insulin (FINS; P = 0.039), HOMA-IR (P = 0.018), and ANGPTL8 (P = 0.049) levels than obese PCOS group with the CC genotype. Conclusion Polymorphisms of rs2278426 may induce glycolipid metabolic disorders by affecting ANGPTL8 levels and functions in Han Chinese females with obesity from the Shandong region, increasing the risk of PCOS in this population.
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Affiliation(s)
- Han Wu
- Center for Reproductive Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, People’s Republic of China
| | - Hui Wang
- Gynecological Minimally Invasive Surgery Center, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, People’s Republic of China
| | - Lixia Sun
- Department of Hematology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, People’s Republic of China
| | - Mengchen Liu
- Center for Reproductive Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, People’s Republic of China
| | - Haoran Wang
- Center for Reproductive Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, People’s Republic of China
| | - Xianchang Sun
- Department of Physiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, People’s Republic of China
| | - Wenjuan Zhang
- Center for Reproductive Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, People’s Republic of China
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13
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Minareci Y, Ak N, Sozen H, Tosun OA, Kucukgergin C, Aydin F, Bingul İ, Salihoglu MY, Topuz S. The evaluation of miR-1181 and miR-4314 as serum microRNA biomarkers for epithelial ovarian cancer diagnosis and prognosis. Mol Biol Rep 2024; 51:515. [PMID: 38622482 DOI: 10.1007/s11033-024-09464-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 03/21/2024] [Indexed: 04/17/2024]
Abstract
AIM Epithelial ovarian cancer (EOC) is the most ominous tumor of gynecological cancers due to its poor early detection rate and unfavorable prognosis. To date, there is no reliable screening method for the diagnosis of ovarian cancer at an early stage. MiRNAs are small non-coding RNA molecules, and their main function is to regulate gene expression. The present study compared the serum miR-1181 and miR-4314 levels in patients with EOC and healthy controls to measure the diagnostic and prognostic value as candidate biomarkers. MATERIALS AND METHODS We collected serum samples from a total of 135 participants (69 patients with EOC and 66 healthy controls). Relative expressions of miR-1181 and miR-4314 were measured by quantitative real-time polymerase chain reaction assay (qPCR). RESULTS The present study revealed that both serum miR-1181 and miR-4314 levels in patients with EOC were significantly increased compared to healthy controls for each marker. In addition, there was a significant relationship between miR-1181 and miR-4314 overexpressions and the stage and prognosis of the disease. Finally, patients with high expression levels of miR-1181 and miR-4314 had significantly shorter survival rates than those with low expression levels. CONCLUSION The current study proposed that serum miR-1181 and miR-4314 could discriminate the EOC patients from healthy controls. In addition, both miR-1181 and miR-4314 may be predictive biomarkers for ovarian cancer prognosis. Further studies are needed to confirm the findings of the present study.
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Affiliation(s)
- Yagmur Minareci
- Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul University, Istanbul, Turkey.
| | - Naziye Ak
- Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Hamdullah Sozen
- Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul University, Istanbul, Turkey
| | - Ozgur A Tosun
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Goztepe Research and Education Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Canan Kucukgergin
- Faculty of Medicine, Department of Biochemistry, Istanbul University, Istanbul, Turkey
| | - Fatih Aydin
- Faculty of Medicine, Department of Biochemistry, Istanbul University, Istanbul, Turkey
| | - İlknur Bingul
- Faculty of Medicine, Department of Biochemistry, Istanbul University, Istanbul, Turkey
| | - M Yavuz Salihoglu
- Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul University, Istanbul, Turkey
| | - Samet Topuz
- Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul University, Istanbul, Turkey
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14
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Taylor AKL, Bartels HC, Brophy DP, O'Brien D, Corcoran SM. Imaging and video of late preterm delivery by midline laparotomy due to incarcerated uterus: A case report and literature review of a rare but morbid condition. Int J Gynaecol Obstet 2024. [PMID: 38610116 DOI: 10.1002/ijgo.15536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Incarcerated gravid uterus (IGU) is a rare and serious obstetric complication. IGU is defined as the entrapment of the gravid uterus between the pubic symphysis and the sacral promontory. The incidence of IGU is 1 in 3000-10 000 cases. IGU is associated with significant obstetric complications, including preterm labor, intrauterine fetal death, growth restriction, renal failure, uterine ischemia/rupture and thrombosis. Here, we present the case of a primigravida with urinary retention at 14 weeks. On transabdominal ultrasound at 19+5/7 weeks the cervix was difficult to visualize, and the anterior uterine wall appeared thickened. The bladder was elongated superior to the uterus and the placenta was low-lying. Initially the patient was managed with intermittent self-catheterization, and subsequently indwelling catheterization was required from 22 weeks. At 30 weeks, the patient was transferred to a tertiary center and magnetic resonance imaging (MRI) was preformed due to challenging visualization of the cervix on ultrasound and the patient's continued symptoms of constipation and recurrent urinary infections. The MRI found a retroflexed gravid uterus, with vagina and endocervix displaced anteriorly and compressed by the gravid uterus. The findings were consistent with an incarcerated uterus. The patient subsequently had positive urinary cultures for Pseudomonas and rising creatinine. Given the obstructive uropathy and associated morbidity and mortality, a plan for elective pre-term delivery at 33+6/7 weeks was made. Delivery was by midline laparotomy, normal anatomy was restored after manual evacuation of the fundus from below the sacral promontory, and an uncomplicated lower segment transverse uterine cesarean section was performed.
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Affiliation(s)
- A K L Taylor
- Obstetrics and Gynaecology Department, National Maternity Hospital, Dublin, Ireland
| | - H C Bartels
- Obstetrics and Gynaecology Department, National Maternity Hospital, Dublin, Ireland
- Gynaecology Department, St Vincent's University Hospital, Dublin, Ireland
| | - D P Brophy
- Radiology Department, St Vincent's University Hospital, Dublin, Ireland
| | - D O'Brien
- Obstetrics and Gynaecology Department, National Maternity Hospital, Dublin, Ireland
- Gynaecology Department, St Vincent's University Hospital, Dublin, Ireland
| | - S M Corcoran
- Obstetrics and Gynaecology Department, National Maternity Hospital, Dublin, Ireland
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15
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Tesfai FM, Nagi J, Morrison I, Boal M, Olaitan A, Chandrasekaran D, Stoyanov D, Lanceley A, Francis N. Objective assessment tools in laparoscopic or robotic-assisted gynecological surgery: A systematic review. Acta Obstet Gynecol Scand 2024. [PMID: 38610108 DOI: 10.1111/aogs.14840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/28/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION There is a growing emphasis on proficiency-based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity. MATERIAL AND METHODS A systematic search (1989-2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single-group (with pre- and post-training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta-analysis. RESULTS A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure-specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes. CONCLUSIONS Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.
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Affiliation(s)
- Freweini Martha Tesfai
- The Griffin Institute, Northwick Park & St Marks' Hospital, London, UK
- EGA Institute for Women's Health, University College London, London, UK
- Wellcome/EPSRC Center for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | | | - Iona Morrison
- Yeovil District Hospital, Somerset Foundation NHS Trust, Yeovil, UK
| | - Matt Boal
- The Griffin Institute, Northwick Park & St Marks' Hospital, London, UK
- EGA Institute for Women's Health, University College London, London, UK
- Wellcome/EPSRC Center for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | | | - Dhivya Chandrasekaran
- EGA Institute for Women's Health, University College London, London, UK
- Department of Gynecological Oncology, University College of London Hospitals, London, UK
| | - Danail Stoyanov
- EGA Institute for Women's Health, University College London, London, UK
- Wellcome/EPSRC Center for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | - Anne Lanceley
- EGA Institute for Women's Health, University College London, London, UK
| | - Nader Francis
- The Griffin Institute, Northwick Park & St Marks' Hospital, London, UK
- EGA Institute for Women's Health, University College London, London, UK
- Yeovil District Hospital, Somerset Foundation NHS Trust, Yeovil, UK
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16
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Bazo-Alvarez JC, Copez-Lonzoy A, Ipanaqué-Zapata M, Bazalar-Palacios J, Rivera EL, Flores-Ramos EC. Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru. BMC Public Health 2024; 24:1022. [PMID: 38609932 PMCID: PMC11015581 DOI: 10.1186/s12889-024-18467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.
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Affiliation(s)
- Juan Carlos Bazo-Alvarez
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru.
- Research Department of Primary Care and Population Health, University College London, London, UK.
| | - Anthony Copez-Lonzoy
- Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Perú
| | | | | | | | - Elaine C Flores-Ramos
- Centre on Climate Change & Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Stanford Center for Innovation in Global Health, Stanford Woods Institute for the Environment, Stanford, USA
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17
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Eidhammer A, Glavind J, Skrubbeltrang C, Melgaard D. Healing Architecture in Birthing Rooms: A Scoping Review. HERD 2024:19375867241238439. [PMID: 38591577 DOI: 10.1177/19375867241238439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
AIM The purpose of this scoping review is to map the knowledge about the multisensory birthing room regarding the birth experience and birth outcomes. BACKGROUND The concept of multisensory birthing rooms is relatively novel, making it relevant to explore its impact. METHODS Five databases were searched. The search was limited to articles in English, Danish, Norwegian, and Swedish. There were no time limitations. Fourteen relevant articles were identified providing knowledge about multisensory birthing rooms. RESULTS Eight articles focused on birth experience, six articles focused on birth outcome, and one on the organization of the maternity care. Seven of the studies identified that sensory birthing rooms have a positive impact on the birth experience and one qualitative study could not demonstrate a better overall birth experience. Five articles described an improvement for selected birth outcomes. On the other hand, a randomized controlled trial study could not demonstrate an effect on either the use of oxytocin or birth outcomes such as pain and cesarean section. The definition and description of the concept weaken the existing studies scientifically. CONCLUSIONS This scoping review revealed that multisensory birthing rooms have many definitions and variations in the content of the sensory exposure; therefore, it is difficult to standardize and evaluate the effect of its use. There is limited knowledge concerning the multisensory birthing room and its impact on the birth experience and the birth outcome. Multisensory birthing rooms may have a positive impact on the birth experience. Whereas there are conflicting results regarding birth outcomes.
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Affiliation(s)
- Anya Eidhammer
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Hjoerring, Denmark
- Department of Clinical Medicine, Aalborg University, Denmark
| | - Julie Glavind
- Department of Obstetrics and Gynecology, Institute for Clinical Medicine, Aarhus University Hospital, Denmark
| | | | - Dorte Melgaard
- Department of Clinical Medicine, Aalborg University, Denmark
- Department of Acute Medicine and Trauma Care, Aalborg University Hospital, Denmark
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18
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Yeşildere Sağlam H, Reyhan FA, Dağlı E. What Should a Breastfeeding Place in Public Spaces Be Like? A Qualitative Study on Women's Experiences. HERD 2024:19375867241237508. [PMID: 38591576 DOI: 10.1177/19375867241237508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Mothers need a place in public spaces where they can comfortably breastfeed and care for their babies. The availability and design features of these places are critical for meeting mothers' safety and comfort needs while they are breastfeeding. AIM This study was conducted to examine mothers' experiences with breastfeeding places in public spaces. METHODS This study, which was planned as a phenomenological research, one of qualitative research designs, was conducted with mothers (n = 18) with breastfeeding experience in public places. Data were collected through in-depth interviews using a semi-structured questionnaire developed by the researchers. The thematic analysis method was employed to evaluate the data. RESULTS Study findings were examined under two main themes and 12 subthemes. Getting to the breastfeeding place was actually enough for many of the participants. Women who could not breastfeed for any reason in breastfeeding places stated that they came up with some solutions, such as breastfeeding in the car, feeding with formula, and not taking the baby with them. Participants' basic expectations about the breastfeeding place were that it met cleanliness, hygiene, privacy, and ventilation conditions. CONCLUSIONS It was found that women who tended to spend more time in public spaces recently encountered similar problems during the breastfeeding process. Breastfeeding environments should meet minimum standards such as cleanliness and privacy as well as having the necessary comfort, aesthetics, and decoration features.
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Affiliation(s)
- Havva Yeşildere Sağlam
- Nursing Department, Faculty of Health Sciences, Kütahya Health Sciences University, Turkey
| | - Feyza Aktaş Reyhan
- Midwifery Department, Faculty of Health Sciences, Kütahya Health Sciences University, Turkey
| | - Elif Dağlı
- Department of Health Care Services, Abdi Sütcü Vocational School of Health Services, Çukurova University, Adana, Turkey
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19
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Xiao S, Du J, Yuan G, Luo X, Song L. Granulosa Cells-Related MicroRNAs in Ovarian Diseases: Mechanism, Facts and Perspectives. Reprod Sci 2024:10.1007/s43032-024-01523-w. [PMID: 38594585 DOI: 10.1007/s43032-024-01523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
MicroRNAs (miRNAs) are a class of short single-stranded, noncoding RNAs that affect the translation of mRNAs by imperfectly binding to homologous 3'UTRs. Research on miRNAs in ovarian diseases is constantly expanding because miRNAs are powerful regulators of gene expression and cellular processes and are promising biomarkers. miRNA mimics, miRNA inhibitors and molecules targeting miRNAs (antimiRs) have shown promise as novel therapeutic agents in preclinical development. Granulosa cells (GCs) are supporting cells for developing oocytes in the ovary. GCs regulate female reproductive health by producing sex hormones and LH receptors. Increasing research has reported the relevance of miRNAs in GC pathophysiology. With in-depth studies of disease mechanisms, there are an increasing number of studies on the biomolecular pathways of miRNAs in gynecology and endocrinology. In the present review, we summarize the different functions of GC-related microRNAs in various ovarian disorders, such as polycystic ovary syndrome, premature ovarian insufficiency, premature ovarian failure and ovarian granulosa cell tumors.
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Affiliation(s)
- Shengmin Xiao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China
| | - Juan Du
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China
| | - Guanghui Yuan
- Department of Oncology, Hejiang Hospital of Traditional Chinese Medicine, Luzhou, 611137, People's Republic of China
| | - Xiaohong Luo
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China.
| | - Linjiang Song
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China.
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20
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Affiliation(s)
- Chethana Krishna Rao
- Barts and the London, School of Medicine and Dentistry (QMUL), Garrod Building, London, UK
| | - Adila Bashir
- Barts and the London, School of Medicine and Dentistry (QMUL), Garrod Building, London, UK
| | - Parmis Vafapour
- Barts and the London, School of Medicine and Dentistry (QMUL), Garrod Building, London, UK
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21
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Awoyemi T, Jiang S, Rahbar M, Logentherian P, Collett G, Zhang W, Cribbs A, Cerdeira S, Vatish M. MicroRNA analysis of medium/large placenta extracellular vesicles in normal and preeclampsia pregnancies. Front Cardiovasc Med 2024; 11:1371168. [PMID: 38628314 PMCID: PMC11018924 DOI: 10.3389/fcvm.2024.1371168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
Background Preeclampsia (PE) is a hypertensive disorder of pregnancy, affecting 2%-8% of pregnancies worldwide, and is the leading cause of adverse maternal and fetal outcomes. The disease is characterized by oxidative and cellular stress and widespread endothelial dysfunction. While the precise mechanisms are not entirely understood, the pathogenesis of PE is closely linked to placental dysfunction and, to some extent, syncytiotrophoblast extracellular vesicle release (STB-EVs). These vesicles can be divided into the less well-studied medium/large EVs (220-1,000 nm) released in response to stress and small EVs (<220 nm) released as a component of intercellular communication. The previously described production of m/lSTB-EVs in response to cellular stress combined with the overwhelming occurrence of cellular and oxidative stress in PE prompted us to evaluate the microRNAome of PE m/lSTB-EVs. We hypothesized that the microRNAome profile of m/lSTB-EVs is different in PE compared to normal pregnancy (NP), which might permit the identification of potential circulating biomarkers not previously described in PE. Methods/study design We performed small RNA sequencing on medium/large STB-EVs isolated from PE and NP placentae using dual-lobe ex vivo perfusion. The sequencing data was bioinformatically analyzed to identify differentially regulated microRNAs. Identified microRNAs were validated with quantitative PCR analysis. We completed our analysis by performing an in-silico prediction of STB-EV mechanistic pathways. Results We identified significant differences between PE and NP in the STB-EVs micro ribonucleic acid (microRNA) profiles. We verified the differential expression of hsa-miR-193b-5p, hsa-miR-324-5p, hsa-miR-652-3p, hsa-miR-3196, hsa-miR-9-5p, hsa-miR-421, and hsa-miR-210-3p in the medium/large STB-EVs. We also confirmed the differential abundance of hsa-miR-9-5p in maternal serum extracellular vesicles (S EVs). In addition, we integrated the results of these microRNAs into the previously published messenger RNA (mRNA) data to better understand the relationship between these biomolecules. Conclusions We identified a differentially regulated micro-RNA, hsa-miR-9-5p, that may have biomarker potential and uncovered mechanistic pathways that may be important in the pathophysiology of PE.
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Affiliation(s)
- Toluwalase Awoyemi
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Shuhan Jiang
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Maryam Rahbar
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Prasanna Logentherian
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Gavin Collett
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Wei Zhang
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Adam Cribbs
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Sofia Cerdeira
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Manu Vatish
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
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22
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Gallo-Galán LM, Gallo-Vallejo MA, Gallo-Vallejo JL. [Medical recommendations from primary care on physical exercise in the postpartum]. Semergen 2024; 50:102148. [PMID: 38064768 DOI: 10.1016/j.semerg.2023.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 04/01/2024]
Abstract
There is evidence that demonstrates the benefits of practicing physical activity/exercise for the mother after childbirth. However, this postpartum period (PP) is often a missed opportunity in a lifetime for women to start or resume physical exercise and get the great benefits that it can bring them. The objective of this article was to analyze the benefits of physical exercise during PP; the prescription of physical exercise; recommendations on when to resume your practice; barriers and facilitators; physical exercise during breastfeeding; as well as its role in the most frequent illnesses and discomforts in this period, always keeping in mind that the work of the primary care doctor is essential to motivate and encourage women to perform physical exercise in the PP.
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Affiliation(s)
- L M Gallo-Galán
- Servicio de Obstetricia y Ginecología, Hospital Universitario Sanitas La Moraleja, Madrid, España
| | - M A Gallo-Vallejo
- Centro de Medicina Deportiva, Concejalía de Deportes del Ayuntamiento de Granada, Granada, España
| | - J L Gallo-Vallejo
- Servicio de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, España; Departamento de Obstetricia y Ginecología de la Universidad de Granada, Granada, España.
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23
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Jafarzade A. Minimally Invasive Cesarean Section - Extraperitoneal Cesarean Section. The Outcomes of Applying to the Same Patient More than Once. Case Series. Z Geburtshilfe Neonatol 2024; 228:188-191. [PMID: 38096918 DOI: 10.1055/a-2215-3145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Extraperitoneal caesarean section (EPCS) provides intraoperative and postoperative advantages to patients compared to transperitoneal (TPCS). Nevertheless, it is less preferred. METHODS Extraperitoneal caesarean section (EPCS) is a type of caesarean section performed without entering the peritoneal cavity. RESULTS In this study, EPCS was successfully performed again in patients who had previously undergone EPCS. CONCLUSION This method, which reduces maternal mortality and health expenditures, can be performed more than once.
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Affiliation(s)
- Aytaj Jafarzade
- Gynecology and Obstetric Department, Koru Ankara Hospital, Turkey
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24
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Balgobin S, Balk EM, Porter AE, Misal M, Grisales T, Meriwether KV, Jeppson PC, Doyle PJ, Aschkenazi SO, Miranne JM, Hobson DT, Howard DL, Mama S, Gupta A, Antosh DD. Enabling Technologies for Gynecologic Vaginal Surgery: A Systematic Review. Obstet Gynecol 2024; 143:524-537. [PMID: 38301255 DOI: 10.1097/aog.0000000000005522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/07/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To systematically review the literature to evaluate clinical and surgical outcomes for technologies that facilitate vaginal surgical procedures. DATA SOURCES We systematically searched MEDLINE, EMBASE, and ClinicalTrials.gov from January 1990 to May 2022. METHODS OF STUDY SELECTION Comparative and single-arm studies with data on contemporary tools or technologies facilitating intraoperative performance of vaginal gynecologic surgical procedures for benign indications were included. Citations were independently double screened, and eligible full-text articles were extracted by two reviewers. Data collected included study characteristics, technology, patient demographics, and intraoperative and postoperative outcomes. Risk of bias for comparative studies was assessed using established methods, and restricted maximum likelihood model meta-analyses were conducted as indicated. TABULATION, INTEGRATION, AND RESULTS The search yielded 8,658 abstracts, with 116 eligible studies that evaluated pedicle sealing devices (n=32), nonrobotic and robotic vaginal natural orifice transluminal endoscopic surgery (n=64), suture capture devices (n=17), loop ligatures (n=2), and table-mounted telescopic cameras (n=1). Based on 19 comparative studies, pedicle sealing devices lowered vaginal hysterectomy operative time by 15.9 minutes (95% CI, -23.3 to -85), blood loss by 36.9 mL (95% CI, -56.9 to -17.0), hospital stay by 0.2 days (95% CI, -0.4 to -0.1), and visual analog scale pain scores by 1.4 points on a subjective 10-point scale (95% CI, -1.7 to -1.1). Three nonrandomized comparative studies and 53 single-arm studies supported the feasibility of nonrobotic vaginal natural orifice transluminal endoscopic surgery for hysterectomy, adnexal surgery, pelvic reconstruction, and myomectomy. Data were limited for robotic vaginal natural orifice transluminal endoscopic surgery, suture capture devices, loop ligatures, and table-mounted cameras due to few studies or study heterogeneity. CONCLUSION Pedicle sealing devices lower operative time and blood loss for vaginal hysterectomy, with modest reductions in hospital stay and pain scores. Although other technologies identified in the literature may have potential to facilitate vaginal surgical procedures and improve outcomes, additional comparative effectiveness research is needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42022327490.
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Affiliation(s)
- Sunil Balgobin
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, the Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, and the Division of Urogynecology, Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas; the Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island; the Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio; the Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California; the Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico; the Woman's Center for Advanced Pelvic Surgery, Phoenix, Arizona; the Departments of Obstetrics and Gynecology and Urology, School of Medicine & Dentistry, University of Rochester, Rochester, New York; the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Waukesha, Wisconsin; the Division of Urogynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan; the Department of Obstetrics, Gynecology, and Reproductive Health, Rutgers New Jersey Medical School, Newark, and the Department of Obstetrics and Gynecology, Cooper Medical School of Rowan University, Camden, New Jersey; and the Division of Female Pelvic Medicine & Reconstructive Surgery, University of Louisville Health, Louisville, Kentucky
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25
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Walters B, Midwinter I, Chew-Graham CA, Jordan KP, Sharma G, Chappell LC, Crosbie EJ, Parwani P, Mamas MA, Wu P. Pregnancy-Associated Cancer: A Systematic Review and Meta-Analysis. Mayo Clin Proc Innov Qual Outcomes 2024; 8:188-199. [PMID: 38524280 PMCID: PMC10957385 DOI: 10.1016/j.mayocpiqo.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
This study aimed to systematically evaluate and quantify the risk of adverse maternal and neonatal outcomes in patients with pregnancy-associated cancer (PAC). This study was conducted from February 13, 2021, through July 24, 2023. A systematic search of MEDLINE, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials was conducted to identify studies reporting outcomes for patients with PAC. The study was registered on PROSPERO. Two reviewers independently conducted screening, data extraction, and quality assessment. The associations were quantified using random-effects meta-analysis. The initial search produced 29,401 titles and abstracts, after which 147 unique full-text articles were screened, of which 22 articles with 59,190 pregnancies with PAC from 70,097,167 births were included in the meta-analysis. Women with PAC were at significantly increased risk of cesarean deliveries (risk ratio [RR], 1.58; 95% CI, 1.31-1.89), preterm birth (RR, 3.07; 95% CI, 2.37-3.98), venous thromboembolism (RR, 6.76; 95% CI, 5.08-8.99), and maternal death (RR, 41.58; 95% CI, 20.38-84.83). The only outcome with reduced risk was instrumental mode of delivery (RR, 0.67; 95% CI, 0.52-0.87). Pregnancy-associated cancer increases risk of adverse outcomes, including a 7-fold risk of venous thromboembolism and a 42-fold risk of maternal death. Further research is required to better understand the mechanisms leading to these adverse outcomes, especially for women who are not diagnosed until the postpartum period. Affected women should have counseling regarding their increased risk of adverse outcomes.
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Affiliation(s)
- Ben Walters
- Academic Department of Obstetrics and Gynaecology, Royal Stoke Hospital, Stoke-on-Trent, United Kingdom
| | - India Midwinter
- Academic Department of Obstetrics and Gynaecology, Royal Stoke Hospital, Stoke-on-Trent, United Kingdom
| | - Carolyn A. Chew-Graham
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - Kelvin P. Jordan
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - Garima Sharma
- Division of Cardiology, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lucy C. Chappell
- School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Emma J. Crosbie
- Department of Obstetrics and Gynaecology, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA
| | - Mamas A. Mamas
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
- Keele Cardiovascular Research Group, Centre for Prognosis Research, School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - Pensée Wu
- Academic Department of Obstetrics and Gynaecology, Royal Stoke Hospital, Stoke-on-Trent, United Kingdom
- Keele Cardiovascular Research Group, Centre for Prognosis Research, School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, United Kingdom
- Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, United Kingdom
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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26
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Hendrickson WK, Allshouse AA, Nygaard IE, Swenson CW. Overactive Bladder in Late Pregnancy to 1 Year After First Vaginal Delivery. Urogynecology (Phila) 2024; 30:433-442. [PMID: 37903370 PMCID: PMC10987286 DOI: 10.1097/spv.0000000000001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
IMPORTANCE Understanding overactive bladder (OAB) during pregnancy and postpartum may increase our knowledge of pathophysiology. OBJECTIVES The purpose of this study was to understand the prevalence and severity of OAB during pregnancy through 1 year postpartum as well as the associated factors. STUDY DESIGN This is a secondary analysis of a prospective cohort study evaluating primiparous women with a singleton term vaginal delivery assessed at the third trimester, 8 weeks postpartum, and 1 year postpartum. Overactive bladder was defined as urinary urgency plus nocturia or frequency, or urgency urinary incontinence (UUI). Overactive bladder severity was defined using average visual analog scores (0-100) from OAB symptoms on the Epidemiology of Prolapse and Incontinence Questionnaire. We evaluated associations with OAB at each time point using logistic regression. RESULTS Among 579 participants, mean age was 29 years. Overactive bladder prevalence was higher at 8 weeks postpartum (23%) than at the third trimester (18%, P = 0.03) and 1 year postpartum (19%, P = 0.03). Overactive bladder severity was higher at the third trimester (42.2) than at 8 weeks postpartum (23.3, P = 0.008), but not at 1 year postpartum (29.1, P = 0.1). In those with OAB, UUI severity was higher at 1 year postpartum compared with that at the third trimester ( P = 0.02). Younger age was associated with third trimester OAB. At 8 weeks postpartum, OAB was associated with older age, urinary tract infection after delivery, birth weight ≥3,500 g, and third trimester OAB. At 1 year postpartum, OAB was associated with birth weight ≥3,500 g and third trimester OAB. CONCLUSIONS Overactive bladder affects 1 in 5 primiparous women during pregnancy or after vaginal delivery. The increased severity of UUI postpartum and the association between higher birth weight and OAB postpartum suggest an effect of delivery.
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Affiliation(s)
- Whitney K. Hendrickson
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, UT
| | - Amanda A. Allshouse
- Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, UT
| | - Ingrid E. Nygaard
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, UT
| | - Carolyn W. Swenson
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, UT
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Kuenkel E, Jaeger A, Bohlmann I, Bergauer F, Kuehler-Obbarius C, Prieske K, Maass-Poppenhusen K, Schmalfeldt B, Woelber L. The use of colposcopy for triage in HPV-positive women aged 65 years and older. Arch Gynecol Obstet 2024; 309:1561-1567. [PMID: 38081959 PMCID: PMC10894107 DOI: 10.1007/s00404-023-07281-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/22/2023] [Indexed: 02/25/2024]
Abstract
PURPOSE Persistent high-risk HPV infection is associated with an elevated risk for prevalent CIN II + despite normal cytology (NILM). Our study aims to evaluate the clinical relevance of a persistent high-risk HPV infection without cytologic changes in women aged ≥ 65 and to determine the role of colposcopy for triage in these cases. METHODS 211 patients aged ≥ 65 with persistent HPV infection and normal cytology (NILM) who presented for colposcopy at five certified centers between January 2021 and April 2022 were included in the study. Colposcopic findings, HPV subtypes, when available, histology and p16/Ki67 staining were assessed as well as individual risk factors such as smoking and previous HPV-related surgery. RESULTS 87.7% (185/211) of the included women had a type 3 transformation zone. In 83.4% (176/211), a biopsy was taken [thereof 163 endocervical curettages (ECC)]. In 35/211 women (16.6%), sampling was not possible during colposcopy due to an inaccessible cervix, pain during examination or obliteration of the cervical canal. Out of these, 6 women received a diagnostic excision. CIN II + was detected in 10.6% of all histologies (excisional or biopsy) (20/182). 50% of the women with a CIN II + where HPV 16 positive. Taking only the women diagnosed with CIN III or AIS into account, (n = 12) 75% were HPV 16 positive. Interestingly, 80% of the women with CIN II + had an abnormal cytology when repeatedly taken during colposcopy, vice versa an endocervical lesion was diagnosed in 53% of women with abnormal repeat cytology (27/51). CONCLUSION The prevalence of CIN II + in women is ≥ 65 with persistent hr HPV infection but NILM cytology is similar to that in younger women. However, more than 85% of the women have a type 3 transformation zone. Colposcopy is, therefore, not helpful to diagnose the women who need treatment in this age group.
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Affiliation(s)
- E Kuenkel
- Dysplasia Unit Women's Practice Heussweg, Frauenarztpraxis und Dysplasie-Einheit Heussweg, Heussweg 37, 20255, Hamburg, Germany.
| | - A Jaeger
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Dysplasia Unit at Jerusalem Hospital, Moorkamp 2-6, 20357, Hamburg, Germany
| | - I Bohlmann
- Dysplasia Munich, Nymphenburger Str. 77, 80636, Munich, Germany
| | - F Bergauer
- Dysplasia Munich, Nymphenburger Str. 77, 80636, Munich, Germany
| | - C Kuehler-Obbarius
- Dysplasia Unit Women's Practice Heussweg, Frauenarztpraxis und Dysplasie-Einheit Heussweg, Heussweg 37, 20255, Hamburg, Germany
- Cytologylaboratory Dr. Med. Kühler-Obbarius, Fangdieckstr. 75a, 22547, Hamburg, Germany
| | - K Prieske
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Dysplasia Unit at Jerusalem Hospital, Moorkamp 2-6, 20357, Hamburg, Germany
| | - K Maass-Poppenhusen
- Department of Gynecology, University Hospital Campus Kiel, Arnold Heller Str. 3, 24105, Kiel, Germany
| | - B Schmalfeldt
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - L Woelber
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Dysplasia Unit at Jerusalem Hospital, Moorkamp 2-6, 20357, Hamburg, Germany
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28
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Zhang J, Wang D, Peng L, Shi X, Shi Y, Zhang G. Preoperative evaluation and a nomogram prediction model for pelvic lymph node metastasis in endometrial cancer. Eur J Surg Oncol 2024; 50:108230. [PMID: 38430704 DOI: 10.1016/j.ejso.2024.108230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE The primary objective of this study is to explore the preoperative risk factors of pelvic lymph node metastasis (PLNM) in endometrial cancer patients, and construct a nomogram prediction model. MATERIALS AND METHODS We retrospectively collected various preoperative clinical characteristics of patients and analyzed their relationship with PLNM. Logistic regression analysis was used to screen for independent risk factors for PLNM of endometrial cancer. A nomogram prediction model was constructed, the receiver operating characteristic (ROC), calibration curve and decision curve analysis (DCA) were constructed and used to assess discrimination, calibration, and net benefit. RESULTS Out of the 276 patients, 74 (26.81%) with postoperative pathological confirmation of PLNM. Multivariate logistic regressive analysis demonstrated that preoperative depth of myometrial invasion (DIM) ≥50% determined by Magnetic Resonance Imaging (MRI) (p = 0.003), carbohydrate antigen 125 (CA125) (p = 0.030), carbohydrate antigen 19-9 (CA 19-9) (p = 0.044), and platelet/lymphocyte ratio (PLR) (p = 0.025) could serve as independent risk factors for PLNM. A risk factors-based nomogram prediction model was constructed, which showed good discrimination (AUC = 0.841, p < 0.001) and good efficacy (C-index = 0.842) and good calibration (mean absolute error = 0.046). DCA showed that the model can provide clinical benefits. CONCLUSIONS Preoperative DIM ≥50% determined by MRI, serum CA 19-9, CA125 and PLR could be utilized to predict PLNM in endometrial cancer patients. This nomogram prediction model can provide preoperative help for evaluation and identification of patients with endometrial cancer, and provide a theoretical basis for clinical intervention.
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Affiliation(s)
- Jie Zhang
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Dengfeng Wang
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Liping Peng
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Xunwei Shi
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yu Shi
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Guonan Zhang
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
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Nagata C, Suto M, Morisaki N, Kobayashi T, Takehara K. Annual numbers of diagnoses and medical expenses for obstetric diseases in Japan: A report from the National Database of Health Insurance Claims. J Obstet Gynaecol Res 2024; 50:596-603. [PMID: 38273716 DOI: 10.1111/jog.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
AIM The present study aimed to estimate the total numbers of obstetric diseases diagnosed, total amounts of medical expenses claimed for obstetric diseases, their averages per livebirth, and yearly trends in Japan. METHODS This is a secondary analysis of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) (data from 2015 to 2019). The target population was women of reproductive age (15-49 years old) with diseases in pregnancy, childbirth, and the puerperium, defined by having O codes according to the International Classification of Diseases 10th Revision. We calculated the numbers of obstetric diseases diagnosed, amounts of medical expenses claimed for obstetric diseases marked with the "main injury/disease decision flag," and the totals divided by the annual numbers of livebirths, by year and women's age group. RESULTS From 2015 to 2019, both the numbers of obstetric diseases diagnosed and amounts of medical expenses claimed for obstetric diseases per livebirth were on an upward trend, whereas the total numbers of obstetric diseases diagnosed were decreased. Women in advanced age groups had a higher number of diagnoses and a higher amount of medical expenses for obstetric diseases per livebirth. "Preterm labour without delivery" had the highest amounts of medical expenses claimed for and the second highest numbers of diagnoses throughout the study period. CONCLUSIONS This study suggests that pregnant women in Japan would have an increasing number of obstetric complications and necessary medical expenses year by year. Further study is warranted to elucidate these trends and identify possible mitigation measures.
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Affiliation(s)
- Chie Nagata
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Tohru Kobayashi
- Department of Data Science, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
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Li Y, Guo Y, Wu D, Ai L, Wu R, Ping Z, Zhu K. Phenylbutyric acid inhibits hypoxia-induced trophoblast apoptosis and autophagy in preeclampsia via the PERK/ATF-4/CHOP pathway. Mol Reprod Dev 2024; 91:e23742. [PMID: 38644727 DOI: 10.1002/mrd.23742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 04/23/2024]
Abstract
Preeclampsia (PE) is a common pregnancy complication with a high mortality rate. Abnormally activated endoplasmic reticulum stress (ERS) is believed to be responsible for the destruction of key placental cells-trophoblasts. Phenylbutyric acid (4-PBA), an ERS inhibitor, is involved in regulating the development of ERS-related diseases. At present, how 4-PBA affects trophoblasts and its mechanisms is still unclear. In this study, PE cell models were established by stimulating HTR-8/SVneo cells with hypoxia. To verify the underlying mechanisms of 4-PBA on PE, CCT020312, an activator of PERK, was also used. The results showed that 4-PBA restored hypoxia-induced trophoblast viability, inhibited HIF-1α protein expression, inflammation, and PERK/ATF-4/CHOP pathway. Hoechst 33342 staining and flow cytometry results confirmed that 4-PBA decreased hypoxia-induced apoptosis in trophoblasts. The results of the JC-1 analysis and apoptosis initiation enzyme activity assay also demonstrated that 4-PBA inhibited apoptosis related to the mitochondrial pathway. Furthermore, by detecting autophagy in trophoblasts, an increased number of autophagic vesicles, damaged mitochondria, enhanced dansylcadaverine fluorescence, enhanced levels of autophagy proteins Beclin-1, LC3II, and decreased p62 were seen in hypoxia-stimulated cells. These changes were reversed by 4-PBA. Furthermore, it was observed that CCT020312 reversed the effects of 4-PBA on the viability, apoptosis, and autophagosome number of hypoxia-induced trophoblasts. In summary, 4-PBA reduces autophagy and apoptosis via the PERK/ATF-4/CHOP pathway and mitochondrial pathway, thereby restoring the viability of hypoxic trophoblasts. These findings provide a solid evidence base for the use of 4-PBA in PE treatment and guide a new direction for improving the outcomes of patients with PE.
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Affiliation(s)
- Yinfeng Li
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Yongjie Guo
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Dan Wu
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Ling Ai
- Department of Obstetrics, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Rongrong Wu
- Department of Laboratory, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Zepeng Ping
- Department of Obstetrics, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
| | - Kangyuan Zhu
- Department of ICU, Jiaxing Maternity and Children Health Care Hospital, Jiaxing, Zhejiang, China
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Nongo BH, Isah DA, Ahmed AB, Abdul OA. Vaginal Endometrial Stroma Sarcoma: A Case Report of A Rare Disease. J West Afr Coll Surg 2024; 14:233-237. [PMID: 38562395 PMCID: PMC10980312 DOI: 10.4103/jwas.jwas_120_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/06/2023] [Indexed: 04/04/2024]
Abstract
Vaginal endometrial stromal sarcoma (VESS) arising in the vagina is an extremely rare extrauterine endometrial stromal sarcoma, Stroma Sarcoma. To the best of our knowledge, there have been only a few reported cases in the literature. Therefore, we herein report a case of VESS originating in the vagina. A 27-year-old woman complained of heavy and intermittent vaginal bleeding and abdominal swelling all of six months duration. A mass that was firm to hard in consistency was found in the middle and upper segments of the anterior, right lateral, and posterior fornices and wall of the vagina. An excisional biopsy was taken and the immunohistochemistry result revealed VESS. A cystoscopy was done which revealed polypoid metastatic nodules in the bladder (this put the stage of the disease at IV). She also had laparotomy following features of mechanical obstruction from previous pelvic and intraperitoneal adhesions which were formed from previous laparotomy.
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Affiliation(s)
- Benjamin Howe Nongo
- Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Dennis Anthony Isah
- Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja, Nigeria
- College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Abimiku Bawa Ahmed
- College of Health Sciences, University of Abuja, Abuja, Nigeria
- Department of Histopathology, University of Abuja Teaching Hospital, Abuja, Nigeria
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Rodrigues S, Silva P, Borges AC, de Sousa NQ, Silva JN, Escuriet R. Effect of Perineal Massage and Warm Compresses Technique in Postpartum Pelvic Floor Dysfunction. A Secondary Analysis from a Randomised Controlled Trial. Reprod Sci 2024; 31:1006-1016. [PMID: 38097899 DOI: 10.1007/s43032-023-01424-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/04/2023] [Indexed: 03/24/2024]
Abstract
Pelvic floor dysfunction (PFD) is common to be associated with pregnancy and birth. To date, no research has been done to understand whether the perineal massage and warm compresses technique has an impact on pelvic floor dysfunction. To assess the impact of perineal massage and warm compresses technique during the second stage of labor in pelvic floor dysfunction at 3 and 6 months postpartum. Of the 800 women recruited to randomised controlled trial to prevent perineal trauma, 496 were included in the study, with 242 (48.8%) assigned to the Perineal Massage and Warm Compresses (PeMWaC) group and 254 (51.2%) to the control group (hands-on). Used the Pelvic Floor Distress Inventory-20 (PFDI-20). The questionnaire is divided into three subscales: Urinary (UDI), Colorectal-Anal (CRADI), and Pelvic Organ Prolapse Distress Inventory (POPDI). The PeMWaC group had a significantly higher frequency of intact perineum (p < 0.001) and low-severity vaginal tears (tears without any other degree of perineal trauma) (p = 0.031) compared to the control group, while the control group had significantly more patients who suffered high-severity vaginal/perineal trauma (second degree perineal tears) (p = 0.031) and patients without spontaneous perineal trauma or vaginal tears who underwent episiotomy (p < 0.001). In addition, at 3 months postpartum, women in the control group had a higher Urinary Distress Inventory (UDI) score and global score, compared to the PeMWaC group, and after controlling for confounding variables, the perineal massage and warm compresses technique was associated with lower UDI scores at 3 months postpartum compared to control group. At 6 months postpartum, there were no differences in the UDI or global scores, indicating general recovery from perineal trauma. In addition to reducing perineal trauma during birth, the perineal massage and warm compresses technique was associated with a lower prevalence of early PFD symptoms, mainly urinary distress, at 3 months.Trial registration http://www.ClinicalTrials.gov NCT05854888, retrospectively registered.
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Affiliation(s)
- Silvia Rodrigues
- Biomedical Sciences Institute Abel Salazar, Portugal and Hospital of Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal.
| | - Paulo Silva
- Hospital of Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal
| | - Ana Catarina Borges
- Department of Obstetrics and Gynecology, Hospital de Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal
| | - Natacha Quintal de Sousa
- Department of Obstetrics and Gynecology, Hospital de Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal
| | - João Neves Silva
- ISAVE - Instituto Superior de Saúde, CICS - Centro Interdisciplinar em Ciências da Saúde, Braga, Portugal
| | - Ramon Escuriet
- Health and Integrated Care Division, Catalan Health Service, Barcelona, Spain
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Rodriguez‐Wallberg KA, Pettersson K. The challenges of cancer during pregnancy. Acta Obstet Gynecol Scand 2024; 103:628-629. [PMID: 38572775 PMCID: PMC10993338 DOI: 10.1111/aogs.14835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Kenny A. Rodriguez‐Wallberg
- Department of Reproductive MedicineKarolinska University HospitalStockholmSweden
- Department of Oncology‐PathologyKarolinska InstitutetStockholmSweden
| | - Karin Pettersson
- Department of Obstetrics and GynecologyKarolinska Institutet CLINTEC and Karolinska University HospitalStockholmSweden
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Andres MP, Riccio LGC, Abrao HM, Manzini MS, Braga L, Abrao MS. Visual Analogue Scale Cut-off Point of Seven Represents Poor Quality of Life in Patients with Endometriosis. Reprod Sci 2024; 31:1146-1150. [PMID: 38057531 DOI: 10.1007/s43032-023-01406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
Establishing objective criteria to assess endometriosis symptoms is crucial in defining therapeutic strategies. The visual analogue scale (VAS) is the most used system to enhance the accuracy and reduce the subjectivity of pain assessment, and symptoms of endometriosis are considered severe when the VAS score is ≥ 7 cm. Pain symptoms can significantly impact patients' quality of life, resulting in psychological and social distress. The aim of this study is to evaluate whether a VAS cut-off point of 7 cm for each pain symptom correlates with a diminished quality of life in women with endometriosis. This retrospective study included 1129 patients who underwent surgical treatment for endometriosis. Dysmenorrhea, acyclic pelvic pain, deep dyspareunia, dyschezia, and dysuria were assessed using a 0-10 cm VAS. The Short Form-36 (SF-36) questionnaire was employed to evaluate the quality of life 6 months prior to surgery. Dysmenorrhea was the most prevalent symptom reported in 93.6% of cases, with a mean VAS of 7.6 cm. The quality of life reported was reduced in most patients, with domain scores ranging from 49.4 to 80.1. The mean SF-36 scores in all domains were significantly lower in patients with severe pain (VAS score ≥ 7 cm) compared to those with mild to moderate pain (VAS < 7 cm). This trend was observed across all evaluated pain symptoms. Our research demonstrates that the prevalent VAS cut-off point for establishing severe pain symptoms in endometriosis (VAS ≥ 7 cm) accurately represents the negative impact of the disease on women's quality of life, as assessed via the SF-36 questionnaire.
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Affiliation(s)
- Marina Paula Andres
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
- Gynecologic Division, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | - Luiza Gama Coelho Riccio
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
- Faculdade de Medicina da Universidade Santo Amaro, São Paulo, SP, Brazil
| | - Henrique Mendonca Abrao
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
- Gynecologic Division, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | | | - Lais Braga
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Mauricio Simoes Abrao
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil.
- Gynecologic Division, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
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Ghesquière L, Bengler C, Drumez E, Subtil D, Houfflin-Debarge V, Insubri S, Garabedian C. Factors associated with successful balloon catheter labor induction in women with a previous caesarean section: A retrospective single-center evaluation. J Gynecol Obstet Hum Reprod 2024; 53:102743. [PMID: 38341084 DOI: 10.1016/j.jogoh.2024.102743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Labor induction of women with a history of uterine scarring is an increasingly frequent situation and one for which there are currently no clear professional recommendations favoring one method over another. The objectives of this study were to determine the success rate of balloon catheter induction in women with a history of caesarean section and to evaluate the main factors associated with vaginal delivery. MATERIALS AND METHODS This single-center retrospective study was conducted between January 1, 2014, and December 31, 2018, in Lille, France, and included all women with one previous caesarean section who were induced by first-line balloon catheter induction. Multivariate analysis was performed to identify the factors associated with the primary outcome (vaginal delivery). RESULTS Of the 310 women in the sample, 192 delivered vaginally (62 %). After adjustment, factors associated with successful induction (vaginal delivery) were the number of previous vaginal deliveries (odds ratio [OR] 1.37; 95 % confidence interval [CI] 1.04-1.81), evolution of the Bishop score after balloon removal (OR 1.24; 95 % CI 1.10-1.41), and the initial Bishop score (OR 1.17; 95 % CI 1.00-1.37). Uterine rupture was observed in three women (1 %). CONCLUSION The vaginal delivery rate after balloon catheter induction in women with a previous caesarean section was 62 %. Prognostic factors for vaginal delivery include previous vaginal delivery, the initial Bishop score, and evolution of the Bishop score after balloon catheter induction.
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Affiliation(s)
- Louise Ghesquière
- Department of Obstetrics, CHU Lille, Lille F-59000, France; ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Univ. Lille, CHU Lille, Lille F-59000, France.
| | - Cyril Bengler
- Department of Obstetrics, CHU Lille, Lille F-59000, France
| | - Elodie Drumez
- ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Univ. Lille, CHU Lille, Lille F-59000, France; Department of Biostatistics, CHRU Lille, France
| | - Damien Subtil
- Department of Obstetrics, CHU Lille, Lille F-59000, France; ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Univ. Lille, CHU Lille, Lille F-59000, France
| | - Véronique Houfflin-Debarge
- Department of Obstetrics, CHU Lille, Lille F-59000, France; ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Univ. Lille, CHU Lille, Lille F-59000, France
| | | | - Charles Garabedian
- Department of Obstetrics, CHU Lille, Lille F-59000, France; ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Univ. Lille, CHU Lille, Lille F-59000, France
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36
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Young SW, Jha P, Chamié L, Rodgers S, Kho RM, Horrow MM, Glanc P, Feldman M, Groszmann Y, Khan Z, Young SL, Poder L, Burnett TL, Hu EM, Egan S, VanBuren W. Society of Radiologists in Ultrasound Consensus on Routine Pelvic US for Endometriosis. Radiology 2024; 311:e232191. [PMID: 38591980 DOI: 10.1148/radiol.232191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Endometriosis is a prevalent and potentially debilitating condition that mostly affects individuals of reproductive age, and often has a substantial diagnostic delay. US is usually the first-line imaging modality used when patients report chronic pelvic pain or have issues of infertility, both common symptoms of endometriosis. Other than the visualization of an endometrioma, sonologists frequently do not appreciate endometriosis on routine transvaginal US images. Given a substantial body of literature describing techniques to depict endometriosis at US, the Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts to make recommendations aimed at improving the screening process for endometriosis. The panel was composed of experts in the imaging and management of endometriosis, including radiologists, sonographers, gynecologists, reproductive endocrinologists, and minimally invasive gynecologic surgeons. A comprehensive literature review combined with a modified Delphi technique achieved a consensus. This statement defines the targeted screening population, describes techniques for augmenting pelvic US, establishes direct and indirect observations for endometriosis at US, creates an observational grading and reporting system, and makes recommendations for additional imaging and patient management. The panel recommends transvaginal US of the posterior compartment, observation of the relative positioning of the uterus and ovaries, and the uterine sliding sign maneuver to improve the detection of endometriosis. These additional techniques can be performed in 5 minutes or less and could ultimately decrease the delay of an endometriosis diagnosis in at-risk patients.
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Affiliation(s)
- Scott W Young
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Priyanka Jha
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Luciana Chamié
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Shuchi Rodgers
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Rosanne M Kho
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Mindy M Horrow
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Phyllis Glanc
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Myra Feldman
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Yvette Groszmann
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Zaraq Khan
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Steven L Young
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Liina Poder
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Tatnai L Burnett
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Eric M Hu
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Susan Egan
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
| | - Wendaline VanBuren
- From the Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.W.Y.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Radiology, Chamié Imagem da Mulher, São Paulo, Brazil (L.C.); Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pa (S.R., M.M.H.); Department of Obstetrics and Gynecology, Banner Health System, Phoenix, Ariz (R.M.K.); Department of Medical Imaging, University of Toronto, Toronto, Canada (P.G.); Imaging Institute, Cleveland Clinic Foundation, Cleveland, Ohio (M.F.); Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Mass (Y.G.); Department of Obstetrics and Gynecology (Z.K., T.L.B.) and Department of Radiology (W.V.B.), Mayo Clinic, Rochester, Minn; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC (S.L.Y.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (L.P.); Department of Radiology, Intermountain Healthcare, Salt Lake City, Utah (E.M.H.); and Department of Radiology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ (S.E.)
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Tartaglia S, Di Ilio C, Romanzi F, Moresi S, Nardi E, Bevilacqua E, Arena V, Lanzone A. Effects of SARS-Cov-2 mRNA vaccine on placental histopathology: Comparison of a population of uncomplicated COVID-19 positive pregnant women. Placenta 2024; 149:64-71. [PMID: 38527377 DOI: 10.1016/j.placenta.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 03/05/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
1. INTRODUCTION This study investigates the impact of SARS-CoV-2 infection on placental histopathology in pregnant women, comparing outcomes between vaccinated and non-vaccinated individuals. Despite known adverse pregnancy outcomes linked to SARS-CoV-2 infection, the specific effects on the placenta remain unclear. Although vaccination has demonstrated a substantial reduction in infection severity, its impact on placental health requires more insight. 2. METHODS Between March 2021 and July 2022, 387 COVID-19-positive women were admitted for delivery. Of these, 98 with non-severe symptoms were analyzed: 35 vaccinated during pregnancy, and 63 non-vaccinated. Two independent pathologists evaluated all placental specimens. 3. RESULTS The only differing obstetrical characteristic between groups was the mode of delivery (p 0.047), lacking clinical implications. Over 85% of placentas exhibited microscopic abnormalities, predominantly maternal vascular supply disorders (vaccinated 89.1%; unvaccinated 85.5%). Comparing vaccinated and unvaccinated groups revealed statistically significant differences, notably in increased focal perivillous fibrin deposits (IFPFD) [17.1% vs. 33.3% (p 0.04)] and avascular fibrotic villi (AFV) [0% vs. 11.1% (p 0.04)]. Binomial logistic regression confirmed the vaccine's protective role against IFPFD (aOR 0.36; 95%CI 013-0.99) and AVF (aOR 0.06, 95% CI 0.003-0.98). A sub-analysis in vaccinated women showed a positive correlation between the timing of the first dose and IFPFD presence (p 0.018). 4. DISCUSSION The lower incidence of maternal and fetal vascular malperfusion placental features in vaccinated women, coupled with the timing correlation, supports the vaccine's protective effect on placental tissue in COVID-19-infected pregnant patients. Notably, no side effects were reported post-vaccination, emphasizing the vaccine's safety and advocating for its secure administration in pregnant populations.
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Affiliation(s)
- Silvio Tartaglia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienza della Salute della Donna e del Bambino e di Sanità Pubblica, 00168, Rome, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Chiara Di Ilio
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Romanzi
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sascia Moresi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienza della Salute della Donna e del Bambino e di Sanità Pubblica, 00168, Rome, Italy
| | - Eleonora Nardi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Elisa Bevilacqua
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienza della Salute della Donna e del Bambino e di Sanità Pubblica, 00168, Rome, Italy
| | - Vincenzo Arena
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, unità di Gineco-patologia e Patologia Mammaria, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, 00168, Rome, Italy
| | - Antonio Lanzone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienza della Salute della Donna e del Bambino e di Sanità Pubblica, 00168, Rome, Italy; Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
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Li H, Zheng P, Li Z, Han Q, Zhou B, Wang K. C-type lectin 2D (CLEC2D) is upregulated in clear cell renal cell carcinoma (ccRCC) tissues and predicts poor prognosis. Heliyon 2024; 10:e27354. [PMID: 38509909 PMCID: PMC10950488 DOI: 10.1016/j.heliyon.2024.e27354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is known as the most common type of renal cancer. Recently, a series of advances have been made in targeted therapy for ccRCC. To combat this highly metastatic tumor, novel therapeutic targets still need to be developed. C-type lectins (CLECs) contain a characteristic C-type lectin-like domain and affect several physiological functions. The effects of C-type lectin 2D (CLEC2D) on cancer progression have been revealed in several types of cancers; however, its expression in ccRCC tissues, and the possible effects on the progression and metastasis of ccRCC, are still unclear. Herein, we found the high mRNA and protein levels of CLEC2D in ccRCC tissues. We further found that CLEC2D expression was correlated with the prognosis of ccRCC patients and correlated with the tumor size (p = 0.019*) of patients. In addition, CLEC2D affected tumor immune infiltration, confirmed by the further analysis. CLEC2D knockdown suppressed the proliferation of ccRCC cells in vitro and restrained ccRCC tumor growth and immune infiltration in mice. Therefore, we believe that CLEC2D has the potential to serve as a promising ccRCC therapeutic target.
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Affiliation(s)
- Huibing Li
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - Pengyi Zheng
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - Zhijun Li
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - Qingjiang Han
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - Bisheng Zhou
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - Kaixuan Wang
- Department of Urology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
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Wang Y, Tang C, Li Y, Hu W. Puerperal septic shock complicated with symmetrical peripheral gangrene: A case report. Medicine (Baltimore) 2024; 103:e37571. [PMID: 38552074 PMCID: PMC10977569 DOI: 10.1097/md.0000000000037571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/21/2024] [Indexed: 04/02/2024] Open
Abstract
RATIONALE Puerperal sepsis is a life-threatening condition caused by infection that can rapidly progress to multisystem infection and toxin-mediated shock. Symmetrical peripheral gangrene is defined as symmetrical distal ischemic damage in two or more sites in the absence of major vascular occlusive disease. The syndrome is devastating and rare. In this study, we introduce a case of puerperal septicemia complicated by symmetrical peripheral gangrene. PATIENT CONCERNS A 23-year-old woman delivered a live female infant vaginally after cervical balloon dilatation at 39 weeks of gestation. Persistent hyperthermia developed on the first postpartum day. After experiencing ventricular fibrillation, acute liver failure, and acute pulmonary edema, she developed blackened extremities on the 5th postpartum day. DIAGNOSES Puerperal septicemia complicated by symmetrical peripheral gangrene. INTERVENTIONS Upon transfer to our hospital, the patient was enrolled in the intensive care unit and underwent anti-infective and amputation surgery. OUTCOMES After the surgery, the patient recovered well and was successfully discharged from the hospital. LESSONS Early detection and timely treatment is the best way to reduce the mortality and sequelae of puerperal sepsis. Physicians should be alert to the possibility of comorbid symmetrical peripheral gangrene when sepsis patients present with hepatic impairment.
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Affiliation(s)
- Yue Wang
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cen Tang
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yajin Li
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wanqin Hu
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Zhang LL, Wang YS, Bai LP, Zheng A. Comparison of hysterectomy cases performed by transvaginal natural orifice transluminal endoscopic surgery: A paired sample cross-sectional study. Medicine (Baltimore) 2024; 103:e37551. [PMID: 38552066 PMCID: PMC10977547 DOI: 10.1097/md.0000000000037551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/19/2024] [Indexed: 04/02/2024] Open
Abstract
This study aimed to investigate the feasibility, indications, and benefits of transvaginal natural orifice transluminal endoscopic surgery (v-NOTES) hysterectomy for nonmalignant gynecological diseases. The clinical data, including the baseline information and surgical conditions of 81 patients who underwent v-NOTES hysterectomy for nonmalignant gynecological diseases in a tertiary university hospital from October 2018 to August 2022, were retrospectively analyzed and compared with the total laparoscopic hysterectomy group (200 cases) and the transumbilical laparoendoscopic Single Site Surgery group (150 cases). In comparison with the other 2 groups, the highest proportion of patients in the v-NOTES group had cervical intraepithelial neoplasia. Accordingly, mean preoperative uterine volume measured by sonography was significantly smaller in the v-notes group. In the v-NOTES group, the mean number of vaginal deliveries and age were significantly higher, while the mean number of previous abdominal surgeries was lower compared to the other 2 groups. The V-NOTES group had a shorter operation time, shorter postoperative urinary catheter insertion time, earlier intestinal recovery days, shorter hospital stay, and lower visual analogue scale scores after surgery, and the differences were statistically significant. When indicated appropriately, v-NOTES hysterectomy can be a feasible and advantageous surgical modality. In particular, in comparison to the laparoendoscopic Single Site Surgery and total laparoscopic hysterectomy groups, the v-NOTES group had advantages in postoperative recovery and had more aesthetic surgical results.
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Affiliation(s)
- Ling-li Zhang
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yi-si Wang
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Li-ping Bai
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Ai Zheng
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
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Almont T, Sougué PO, Houpert R, Beaubrun-Renard M, Montabord C, Joachim C, Véronique-Baudin J, Bouhnik AD, Bendiane MK, Mancini J, Huyghe É. Communication and sexual function and frequency in breast cancer patients 2 years after diagnosis: results from the VICAN 2 study. J Sex Med 2024; 21:333-341. [PMID: 38410031 DOI: 10.1093/jsxmed/qdae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 12/18/2023] [Accepted: 12/30/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Breast cancer treatments may have impacts on several aspects of sexual health, including psychological, psychosexual, physiological, physical, and relational. AIM In this study we sought to assess sexual function and sexual frequency in breast cancer patients 2 years after diagnosis. METHODS We selected all breast cancer participants from the the French national VIe après le CANcer 2 (VICAN 2) longitudinal study. Data sources included patient and medical questionnaires, along with medico-administrative databases. OUTCOMES Outcomes assessed were the dimensions of sexual function and frequency from the Relationship and Sexuality Scale and communication about sexuality with healthcare providers. RESULTS Out of 1350 participating women, 60.2% experienced a decrease in sexual desire, 61.4% reported a lower frequency of intercourse, and 49.5% faced decreased ability to orgasm. In contrast, 64.8% had engaged in sexual intercourse in the previous 2 weeks, 89.5% were "Somewhat" to "Very much" satisfied with the frequency of intimate touching and kisses with their partner, and 81.6% expressed satisfaction with their intercourse frequency. However, a mere 15% of women discussed sexuality with the healthcare providers. Independent factors associated with increased communication about sexuality included age younger than 50 years (OR = 1.90 95% CI [1.28-2.82], P = .001), being in a partner relationship (OR = 2.53 95% CI [1.28-2.82], P = .003), monthly income above 1,500 euros (OR = 1.73 95% CI [1.15-2.60], P = .009), and absence of diabetes (OR = 6.11 95% CI [1.39-26.93], P = .017). CLINICAL TRANSLATION The study findings underscore the need for continuing education in oncosexology and dedicated sexual health interventions that should involve a holistic approach that takes into consideration age, treatments, relationship status, and whether the patient has diabetes. STRENGTHS AND LIMITATIONS Strengths of the study are the sample size, the national representativeness, and data reliability. However, the cross-sectional design could introduce potential recall, recency, or social desirability biases. Also, social determinants influencing sexual health, such as ethnicity or geographic locations, have not been considered in the analyses. CONCLUSIONS This study revealed that sexual disorders persist 2 years after a breast cancer diagnosis, with a noticeable communication gap regarding sexuality between patients and medical teams. These findings underscore the necessity for tailored sexual health interventions, particularly designed for women who are single, older aged, and diabetes patients.
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Affiliation(s)
- Thierry Almont
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Prisca Ouowéné Sougué
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Rémi Houpert
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Murielle Beaubrun-Renard
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Christelle Montabord
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Clarisse Joachim
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Anne-Déborah Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
| | - Marc-Karim Bendiane
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France
- ORS PACA, Observatoire Régional de la Santé, 27 Bd Jean Moulin, 13005 Marseille, Provence-Alpes-Côte d'Azur, France
| | - Julien Mancini
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Public Health Department, Service Biostatistique et Technologies de l'Information et de la Communication (BIOSTIC), hôpital Timone, APHM, 13005 Marseille, France
| | - Éric Huyghe
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
- Urology Department, Centre Hospitalier Universitaire de Toulouse, 1, avenue du Professeur Jean Poulhès - TSA 50032 - 31059 Toulouse, France
- Francophone Association for Supportive Care in Cancer (AFSOS), 33130 Bègles, France
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Lin L, Sun Y. Injection therapy for urinary incontinence: An innovation under the minimally invasive pinhole. Neurourol Urodyn 2024. [PMID: 38530001 DOI: 10.1002/nau.25454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Lusha Lin
- West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yao Sun
- Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China
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Reyhan FA, Yeşildere Sağlam H, Sayiner FD. How Does the Breastfeeding Environment Affect Satisfaction? A Scale Development Study. HERD 2024:19375867241238467. [PMID: 38512991 DOI: 10.1177/19375867241238467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Women need a safe and comfortable environment to breastfeed their babies. The quality of breastfeeding environments in social areas is important for women's breastfeeding satisfaction. AIM The aim of this study was to develop a measurement tool for the evaluation of breastfeeding environments and to examine the impact of the quality of breastfeeding environments in social areas on breastfeeding satisfaction. METHOD The first phase of the study was conducted in methodological design and the second phase in cross-sectional design. The draft scale was applied to 365 women who had breastfeeding experiences in social environments during the postpartum 6 months-3 years period. In the first stage, scale development analyses were applied. In the second stage, the developed scale was applied to 255 women. Frequency, percentage, Cronbach's α coefficient, and correlation analysis were used in the analysis of the data. RESULTS The Ideal Breastfeeding Environment Assessment Scale, consisting of 23 items and four subdimensions, was obtained in the study. As a result of the application of the scale in the second stage, the mean score of the breastfeeding environments evaluated by the women was 23.43 ± 8.36. A statistically significant moderate-weak correlation was found between the ideality of breastfeeding environments and the satisfaction levels of women (p < .001). CONCLUSION It was determined that the developed scale is a valid and reliable measurement tool that can be used to evaluate breastfeeding environments. As the quality of breastfeeding environments increases, women's breastfeeding satisfaction increases.
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Affiliation(s)
- Feyza Aktaş Reyhan
- Faculty of Health Sciences, Department of Midwifery, Kütahya Health Sciences University, Kütahya, Turkey
| | - Havva Yeşildere Sağlam
- Faculty of Health Sciences, Department of Nursing, Kütahya Health Sciences University, Kütahya, Turkey
| | - Fatma Deniz Sayiner
- Faculty of Health Sciences, Department of Midwifery, Eskisehir Osmangazi University, Eskisehir, Turkey
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Atuesinya Azusong E, Teye-Kwadjo E, Asante KO. Effect of childbirth experience on the psychological well-being of postpartum women in Accra, Ghana. J Reprod Infant Psychol 2024:1-22. [PMID: 38511351 DOI: 10.1080/02646838.2024.2329721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Women's experience of childbirth can affect their mental health outcomes, many years after the delivery. Consequently, the World Health Organisation has provided recommendations to ensure women receive positive birth experiences during intrapartum care. Yet, negative childbirth experience is widespread in Ghana. This study examined the association between women's childbirth experience (i.e. own capacity, professional support, perceived safety, and participation) and their psychological well-being, and whether or not perceived social support and resilience moderate the childbirth experience - psychological well-being relationship. METHODS Mothers (N = 117) who had given birth in the past month and were receiving postnatal care at two health facilities in the Greater Accra Region of Ghana provided the data for the current analysis. Data were collected using the Childbirth Experience Questionnaire, WHO-5 Well-Being Index, Multidimensional Scale of Perceived Social Support, and Brief Resilience Scale. Hierarchical Linear Regression was used to analyse the data. RESULTS Results showed that childbirth experience domains of own capacity and perceived safety were significantly, and positively associated with psychological well-being. The domains of professional support and participation were not associated with psychological well-being in this sample. Perceived social support and resilience did not moderate the association between childbirth experience and psychological well-being. CONCLUSION The results suggest that efforts by birth practitioners (i.e. midwives, obstetricians, and gynaecologists) to give Ghanaian women positive childbirth experiences through the encouragement of personal control over the birthing process as well as ensuring the safety of the birthing procedure and environment would provide women with optimal mental health outcomes.
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Affiliation(s)
| | - Enoch Teye-Kwadjo
- Department of Psychology, University of Ghana, Accra, Ghana
- Department of Industrial Psychology, Stellenbosch University, Matieland, South Africa
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
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Marcelin C, Maas P, Jambon E, Maaloum R, Andreo IM, Le Bras Y, Roman H, Grenier N, Brun JL, Cornelis FH. Long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis. Eur Radiol 2024:10.1007/s00330-024-10689-5. [PMID: 38512491 DOI: 10.1007/s00330-024-10689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To retrospectively evaluate the long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis (AWE). METHOD The Institutional Review Board approved this retrospective observational review of 40 consecutive patients, of a median age of 37 years (interquartile range [IQR] 32-40 years), presenting with a total of 52 symptomatic AWE nodules. All patients underwent cryoablation between January 2013 and May 2022 with a minimum follow-up period of 12 months. Outcomes were assessed using a visual analog scale (VAS) that measured pain, as well as by magnetic resonance imaging (MRI). The pain-free survival rates were derived using the Kaplan-Meier estimator. Adverse events were analyzed and graded using the classification system of the Cardiovascular and Interventional Radiological Society of Europe. RESULTS The median follow-up time was 40.5 months (IQR 26.5-47.2 months). The median VAS score before cryoablation was 8 (IQR 7-9). Complete relief of symptoms was documented in 80% (32/40) of patients at 3 months after initial cryoablation and correlated with the absence of residual endometriosis nodules on MRI. The median pain-free survival rates were 89.2% [95% CI, 70.1-96.4%] at 36 months and 76.8% [95% CI, 55.3-83.8%] after 60 months. No patient or lesion characteristics were found to be prognostic of failure. No major adverse events or side effects were reported in long term. CONCLUSION Cryoablation safely and effectively afforded long-term pain relief for patients with AWE nodules. CLINICAL RELEVANCE STATEMENT AWE cryoablation was found to be safe and effective in the long-term. KEY POINTS • Cryoablation is highly effective with 80% of patients experiencing complete relief of AWE symptoms after a single procedure. • Cryoablation is safe without long-term adverse events or side effects. • The median pain-free survival rates are 89.2% at 36 months and 76.8% at 60 months.
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Affiliation(s)
- Clément Marcelin
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France.
- Université de Bordeaux, INSERM, Bordeaux Institute of Oncology, BRIC U1312, 33000, Bordeaux, France.
| | - Philippe Maas
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Eva Jambon
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Rim Maaloum
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Isabelle Molina Andreo
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Yann Le Bras
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Horace Roman
- Clinique Tivoli- Ducos, Institut Franco-Européen Multidisciplinaire d'Endométriose (IFEMEndo), 33000, Bordeaux, France
| | - Nicolas Grenier
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Jean-Luc Brun
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service de gynécologie, 33000, Bordeaux, France
| | - Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
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Xie N, Wang F, Chen D, Zhou J, Xu J, Qu F. Immune dysfunction mediated by the competitive endogenous RNA network in fetal side placental tissue of polycystic ovary syndrome. PLoS One 2024; 19:e0300461. [PMID: 38512862 PMCID: PMC10956758 DOI: 10.1371/journal.pone.0300461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
Polycystic ovary syndrome (PCOS), a common endocrine and metabolic disorder affecting women in their reproductive years. Emerging evidence suggests that the maternal-fetal immune system is crucial for proper pregnancy. However, whether immune function is altered at the end of pregnancy in PCOS women and the underlying molecular mechanisms is currently unexplored. Herein, the basic maternal immune system was investigated (n = 136 in the control group; n = 103 in the PCOS group), and whole-transcriptome sequencing was carried out to quantify the mRNAs, miRNAs, and lncRNAs expression levels in fetal side placental tissue of women with PCOS. GO, KEGG, and GSEA analysis were employed for functional enrichment analysis. The process of identifying hub genes was conducted utilizing the protein-protein interaction network. CIBERSORT and Connectivity Map were deployed to determine immune cell infiltration and predict potential drugs, respectively. A network of mRNA-miRNA-lncRNA was constructed and then validated by qRT-PCR. First, red blood cell count, neutrophil count, lymphocyte count, hypersensitive C-reactive protein, and procalcitonin were significantly elevated, while placental growth factor was hindered in PCOS women. We identified 308 DEmRNAs, 77 DEmiRNAs, and 332 DElncRNAs in PCOS samples. Functional enrichment analysis revealed that there were significant changes observed in terms of the immune system, especially the chemokine pathway. Eight genes, including FOS, JUN, EGR1, CXCL10, CXCR1, CXCR2, CXCL11, and CXCL8, were considered as hub genes. Furthermore, the degree of infiltration of neutrophils was dramatically decreased in PCOS tissues. In total, 57 ceRNA events were finally obtained, and immune-related ceRNA networks were validated. Some potential drug candidates, such as enalapril and RS-100329, could have a function in PCOS therapy. This study represents the inaugural attempt to evaluate the immune system at the end of pregnancy and placental ceRNA networks in PCOS, indicating alterations in the chemokine pathway, which may impact fetal and placental growth, and provides new therapy targets.
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Affiliation(s)
- Ningning Xie
- Department of Obstetrics and Gynecology, International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Fangfang Wang
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Danqing Chen
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jue Zhou
- College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Jian Xu
- Department of Obstetrics and Gynecology, International Institutes of Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Fan Qu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Schiavone MJ, Pérez MP, Aquieri A, Nosetto D, Pronotti MV, Mazzei M, Kudrle C, Avaca H. The Role of Obesity in the Development of Preeclampsia. Curr Hypertens Rep 2024:10.1007/s11906-024-01299-z. [PMID: 38512586 DOI: 10.1007/s11906-024-01299-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE OF REVIEW This comprehensive review provides an in-depth exploration of the complex relationship between obesity and preeclampsia (PE) and emphasizes the clinical implications of this association. It highlights the crucial role of screening tools in assessing individual risk and determining the need for additional antenatal care among women with obesity. The review investigates various markers for identifying the risk of developing PE, while emphasizing the significance of interventions such as exercise, weight management, and a balanced diet in reducing the incidence of preeclampsia and improving outcomes for both mother and fetus. RECENT FINDINGS Actually, there is a global pandemic of obesity, particularly among women of childbearing age and pregnant women. PE, which is characterized by maternal hypertension, proteinuria, and complications, affects 2-4% of pregnancies worldwide, posing significant risks to maternal and perinatal health. Women with obesity face an elevated risk of developing PE due to the systemic inflammation resulting from excess adiposity, which can adversely affect placental development. Adipose tissue, rich in proinflammatory cytokines and complement proteins, contributes to the pathogenesis of PE by promoting the expression of antiangiogenic factors in the mother. This review emphasizes the need for appropriate screening, interventions, and a holistic approach to reduce the incidence of preeclampsia and enhance maternal-fetal well-being, thus providing valuable insights into the multifaceted association between obesity and PE.
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Affiliation(s)
- Miguel Javier Schiavone
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Mariana Paula Pérez
- Department of Hypertension, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Analía Aquieri
- Department of Hypertension, Hospital de Clínicas José de San Martín, Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniela Nosetto
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Victoria Pronotti
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Mazzei
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Cyntia Kudrle
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Horacio Avaca
- Department of Hypertension, Hospital Británico de Buenos Aires, Solís 2184 - C 1134 ADT - CABA, Ciudad Autónoma de Buenos Aires, Argentina
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Machín-Martín E, González-de la Torre H, Bordón-Reyes H, Jeppesen-Gutiérrez J, Martín-Martínez A. Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context. BMC Pregnancy Childbirth 2024; 24:207. [PMID: 38504191 PMCID: PMC10949694 DOI: 10.1186/s12884-024-06400-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Several instruments have been designed to assess the childbirth experience. The Childbirth Experience Questionnaire (CEQ) is one of the most widely used tools. There is an improved version of this instrument, the Childbirth Experience Questionnaire (CEQ 2.0), which has not been adapted or validated for use in Spain. The aim of present study is to adapt the CEQ 2.0 to the Spanish context and evaluate its psychometric properties. METHODS This research was carried out in 2 stages. In the first stage, a methodological study was carried out in which the instrument was translated and back-translated, content validity was assessed by 10 experts (by calculating Aiken's V coefficient) and face validity was assessed in a sample of 30 postpartum women. In the second stage, a cross-sectional study was carried out to evaluate construct validity by using confirmatory factor analysis, reliability evaluation (internal consistency and temporal stability) and validation by known groups. RESULTS In Stage 1, a Spanish version of the CEQ 2.0 (CEQ-E 2.0) was obtained with adequate face and content validity, with Aiken V scores greater than 0.70 for all items. A final sample of 500 women participated in Stage 2 of the study. The fit values for the obtained four-domain model were RMSEA = 0.038 [95% CI: 0.038-0.042], CFI = 0.989 [95% CI: 0.984-0.991], and GFI = 0.990 [95% CI: 0.982-0.991]. The overall Omega and Cronbach's Alpha coefficients were 0.872 [95% CI: 0.850-0.891] and 0.870 [95% CI: 0.849-0.890] respectively. A coefficient of intraclass correlation of 0.824 [95% CI: 0.314-0.936] (p ≤ 0.001) and a concordance coefficient of 0.694 [95% CI: 0.523-0.811] were obtained. CONCLUSIONS The Spanish version of CEQ 2.0 (CEQ-E 2.0), has adequate psychometric properties and is a valid, useful, and reliable instrument for assessing the childbirth experience in Spanish women.
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Affiliation(s)
- Elisabet Machín-Martín
- University of Las Palmas de Gran Canaria, Edificio Ciencias de La Salud, C/Blas Cabrera Felipe S/N, 35016, Las Palmas de Gran Canaria, CP, Spain
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria-Canary Health Service, Avda Marítima del Sur S/N, 35016, Las Palmas de Gran Canaria, CP, Spain
| | - Héctor González-de la Torre
- Research Support Unit of Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N, 35016, Las Palmas de Gran Canaria, CP, Spain.
- Department of Nursing, University of Las Palmas de Gran Canaria, Edificio Ciencias de La Salud, C/Blas Cabrera Felipe S/N, Las Palmas de Gran Canaria, CP, 35016, Spain.
| | - Haridian Bordón-Reyes
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria-Canary Health Service, Avda Marítima del Sur S/N, 35016, Las Palmas de Gran Canaria, CP, Spain
| | - Julia Jeppesen-Gutiérrez
- Multiprofessional Teaching Unit of Obstetrics and Gynaecology of the University Hospital Complex Insular Materno-Infantil of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N. CP:35016, Las Palmas de Gran Canaria-Canary Islands, Spain
| | - Alicia Martín-Martínez
- University of Las Palmas de Gran Canaria, Edificio Ciencias de La Salud, C/Blas Cabrera Felipe S/N, 35016, Las Palmas de Gran Canaria, CP, Spain
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria-Canary Health Service, Avda Marítima del Sur S/N, 35016, Las Palmas de Gran Canaria, CP, Spain
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Goodfellow L, Care A, Curran C, Roberts D, Turner MA, Knight M, Zarko A. Preterm prelabour rupture of membranes before 23 weeks' gestation: prospective observational study. BMJ Med 2024; 3:e000729. [PMID: 38601318 PMCID: PMC11005708 DOI: 10.1136/bmjmed-2023-000729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 04/12/2024]
Abstract
Objective To describe perinatal and maternal outcomes of preterm prelabour rupture of membranes (PPROM) before 23 weeks' gestation in a national cohort. Design Prospective observational study. Setting National population based cohort study with the UK Obstetric Surveillance System (UKOSS), a research infrastructure of all 194 obstetric units in the UK, 1 September 2019 to 28 February 2021. Participants 326 women with singleton and 38 with multiple pregnancies with PPROM between 16+0 and 22+6 weeks+days' gestation. Main outcome measures Perinatal outcomes of live birth, survival to discharge from hospital, and severe morbidity, defined as intraventricular haemorrhage grade 3 or 4, or requiring supplemental oxygen at 36 weeks' postmenstrual age, or both. Maternal outcomes were surgery for removal of the placenta, sepsis, admission to an intensive treatment unit, and death. Clinical data included rates of termination of pregnancy for medical reasons. Results Perinatal outcomes were calculated with all terminations of pregnancy for medical reasons excluded, and a worst-best range was calculated assuming that all terminations for medical reasons and those with missing data would have died (minimum value) or all would be liveborn (maximum value). For singleton pregnancies, the live birth rate was 44% (98/223), range 30-62% (98/326-201/326), perinatal survival to discharge from hospital was 26% (54/207), range 17-53% (54/326-173/326), and 18% (38/207), range 12-48% (38/326-157/326) of babies survived without severe morbidity. The rate of maternal sepsis was 12% (39/326) in singleton and 29% (11/38) in multiple pregnancies (P=0.004). Surgery for removal of the placenta was needed in 20% (65/326) and 16% (6/38) of singleton and twin pregnancies, respectively. Five women became severely unwell with sepsis; two died and another three required care in the intensive treatment unit. Conclusions In this study, 26% of women who had very early PPROM with expectant management had babies that survived to discharge from hospital. Morbidity and mortality rates were high for both mothers and neonates. Maternal sepsis is a considerable risk that needs more research. These data should be used in counselling families with PPROM before 23 weeks' gestation, and currently available guidelines should be updated accordingly.
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Affiliation(s)
- Laura Goodfellow
- Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Angharad Care
- Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Ciara Curran
- Little Heartbeats Patient Support Group, Buxton, UK
| | | | - Mark A Turner
- Women's and Children's Health, University of Liverpool, Liverpool, UK
| | | | - Alfirevic Zarko
- Women's and Children's Health, University of Liverpool, Liverpool, UK
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Akesson C, Richards EG, Yao M, Ross J, Grima J, May L, Roversi G, Ferrando CA. Pelvic Floor Dysfunction Among Persons With Marfan and Loeys-Dietz Syndrome. Urogynecology (Phila) 2024:02273501-990000000-00192. [PMID: 38517279 DOI: 10.1097/spv.0000000000001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
IMPORTANCE Connective tissue disorders are proposed in the literature to be predisposing risk factors for pelvic floor disorders. Prior data characterizing the prevalence of and symptom burden related to pelvic floor disorders are limited for individuals with Marfan syndrome and are nonexistent for those with Loeys-Dietz syndrome. OBJECTIVE The objective of this study was to determine the prevalence and severity of symptoms related to pelvic floor disorders among individuals with Marfan syndrome and Loeys-Dietz syndrome using the Pelvic Floor Distress Inventory-20 (PFDI-20). STUDY DESIGN In this cross-sectional study, a survey including the PFDI-20 was administered to biologically female individuals older than 18 years with a confirmed diagnosis of Marfan syndrome or Loeys-Dietz Syndrome. Respondents were solicited through the websites, email lists, and social media forums of The Marfan Foundation and The Loeys-Dietz syndrome Foundation. RESULTS A total of 286 respondents were included in the final analysis, 213 with Marfan syndrome and 73 with Loeys-Dietz syndrome. The median PFDI-20 score of the cohort was 43.8. Individuals with Loeys-Dietz syndrome had higher PFDI-20 scores and were more likely to have established risk factors for pelvic floor disorders that correlated with their PFDI-20 scores compared with those with Marfan syndrome. CONCLUSIONS Respondents with Marfan syndrome and Loeys-Dietz syndrome experience a high burden of symptoms related to pelvic floor disorders. Despite the similar pathophysiology and clinical manifestations of these disorders, there were differences in PFDI-20 responses that may suggest that these diseases differ in the ways they affect the pelvic floor.
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Affiliation(s)
- Cydni Akesson
- From the Cleveland Clinic Lerner College of Medicine
| | | | - Meng Yao
- Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH
| | - James Ross
- Jersey Shore University Medical Center, Neptune Township, NJ
| | | | - Lauren May
- The Marfan Foundation, Port Washington, NY
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