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Santangelo G, Lagana AS, Giannini A, Murina F, Di Dio C, Ruggiero G, Di Donato V, Perniola G, Fischetti M, Casorelli A, Clemente F, Minnetti M, Lombardo F, Benedetti Panici P, Muzii L, Bogani G. Spotlight on Compounded Bioidentical Hormones. Gynecol Obstet Invest 2023; 89:31-40. [PMID: 38151014 DOI: 10.1159/000535982] [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: 10/15/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND The role of hormonal replacement therapy in menopause is under debate. The premature closure of the Women's Health Initiative (WHI) study in 2002 is still a source of concern among treating physicians. OBJECTIVES The interest in alternatives to conventional hormone therapy has significantly increased. The adoption of personalized steroid hormone galenic preparations, formulated by compounding pharmacies, has recently spread. METHODS In June 2023, an extensive literature search was conducted by different authors to identify relevant studies in various databases (MEDLINE, Embase, PubMed, and Cochrane). The studies that met the inclusion and exclusion criteria were further analyzed, and relevant data were extracted and analyzed for each paper. Any discrepancies between the investigators were resolved through a consensus approach. OUTCOMES The primary outcomes observed included the clinical utility of CBHT. This study reviewed the current evidence on the utility of compounded bioidentical hormones, concluding that improving knowledge and awareness of bioidentical hormones is necessary to consider their use in clinical practice. CONCLUSION AND OUTLOOK These formulations might provide effective options to best tailor therapies to each patient.
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Affiliation(s)
- Giusi Santangelo
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
- Department Oncologic Surgery, Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Antonio Simone Lagana
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood, "G. Barresi", University of Messina, Messina, Italy
| | - Andrea Giannini
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Filippo Murina
- Unit of Lower Genital Tract Disease, V. Buzzi Hospital, University of Milan, Milan, Italy
| | - Camilla Di Dio
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Gianfilippo Ruggiero
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Violante Di Donato
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giorgia Perniola
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Margherita Fischetti
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Assunta Casorelli
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Francesco Clemente
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Francesco Lombardo
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giorgio Bogani
- Department of Gynecological, Obstetrical and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
- Department Oncologic Surgery, Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Mikuš M, Matak L, Vujić G, Škegro B, Škegro I, Augustin G, Lagana AS, Ćorić M. The short form endometriosis health profile questionnaire (EHP-5): psychometric validity assessment of a Croatian version. Arch Gynecol Obstet 2023; 307:87-92. [PMID: 35819491 DOI: 10.1007/s00404-022-06691-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 05/06/2022] [Accepted: 06/26/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To translate, adapt and validate the Endometriosis Health Profile-5 (EHP-5) in Croatian population. METHODS This validation study is a part of a prospective, observational study (EHP-5 CRO) with aim of implementation of EHP-5 and to provide better insight in quality of life consideration of women with endometriosis in Croatian clinical practice. A 150 consecutive patients with surgically proven endometriosis were enrolled. The translation to Croatian followed standardized procedure. Cronbach's Alpha was calculated to calculate internal consistency reliability of EHP-5. The test-retest reliability was calculated using intraclass correlation coefficient (ICC). The t test for independent samples was used to assess known-groups validity. RESULTS Both EHP-5 core and EHP-5 modular parts of the questionnaire had good internal consistency, assessed by the Cronbach's Alpha coefficient (α = 0.793 and α = 0.842, respectively). Obtained results indicate very good reliability for core as well as for modular part of EHP-5 questionnaire (ICC = 0.896 and 0.936, respectively). The independent t test showed that women who reported their pain with VAS scale 7 or more had significantly higher results (p < 0.001) on EHP-5 (M = 50.63) compared with women who reported their pain 6 or less (M = 26.91). Furthermore, we found statistically significant difference between women who are infertile with women who are fertile (p < 0.001), whereby infertile women had higher average result on EHP-5 (M = 49.55) compared with fertile women (M = 34.36). CONCLUSIONS The Croatian version of the EHP-5 have very good psychometric characteristics and can be used as a reliable tool for assessing patients with endometriosis in everyday clinical practice.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
| | - Luka Matak
- Department of Obstetrics and Gynecology, General Hospital, Zadar, Croatia.
| | - Goran Vujić
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
| | - Bernarda Škegro
- Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, University Hospital Center, Zagreb, Croatia
| | - Goran Augustin
- Department of Surgery, University Hospital Center, Zagreb, Croatia
| | - Antonio Simone Lagana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Gynecology Oncology, University of Palermo, Palermo, Italy
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
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Herman T, Csehely S, Orosz M, Bhattoa HP, Deli T, Torok P, Lagana AS, Chiantera V, Jakab A. Impact of Endocrine Disorders on IVF Outcomes: Results from a Large, Single-Centre, Prospective Study. Reprod Sci 2022; 30:1878-1890. [DOI: 10.1007/s43032-022-01137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Endocrine disorders negatively influence the ovarian function, and increasing incidence of endocrine diseases with age may have further negative effects on pregnancy rate. Prospective cohort study of 231 consecutively enrolled patients underwent IVF treatment. In patients with known endocrine disorders, the laboratory parameters were corrected before IVF treatment. One hundred sixty one patients (69.7%) had at least one known and treated endocrine disorder (study group), and 70 patients were endocrine negative (control group). Endocrine disorders diagnosed were thyroid disorders (32.5%), diminished ovarian reserve (23.8%), insulin resistance (22.5%), PCOS (15.2%), hyperprolactinaemia (13.4%), obesity (12.1%), hypogonadotropic hypogonadism (0.8%) and congenital adrenal hyperplasia (0.2%). Before the IVF treatment, systematic endocrine laboratory examinations were performed in all patients. Higher age, BMI and FSH were found in the study group, while AMH level was lower. There were no differences in LH, E2, prolactin, TSH, FT3, FT4, TT, DHEAS, androstendione, 17-OHP and SHBG level between the study and control groups. The study group had higher baseline glucose, baseline insulin, 120-min glucose and 120-min insulin level after oral glucose tolerance test. With no difference in the IVF cycles performed, pregnancy rate was lower in the study group (61.43% vs. 34.16%; p = 0.003), and this difference (p = 0.0151) remained in age-corrected rates, as well. The analyses were also performed in individual endocrinology groups. The prevalence of endocrine disorders is high in females participating in IVF programs, and they are often accompanying each other. Even after proper correction, the presence of the endocrine disorder negatively influences the pregnancy rate in IVF treatment.
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Lagana AS, Vitale SG, De Dominici R, Padula F, Rapisarda AMC, Biondi A, Cianci S, Valenti G, Capriglione S, Frangez HB, Sturlese E. Fertility outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy A 12-years retrospective cohort study. Ann Ital Chir 2016; 87:461-465. [PMID: 27480601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy (EP). MATERIAL OF STUDY A retrospective cohort study was conducted between January 2002 and May 2014 on 132 women admitted to Unit of Gynecology and Obstetrics of the Department of Human Pathology in Adulthood and Childhood "G. Barresi", "Gaetano Martino" Hospital, University of Messina (Italy), with EP and who received surgical treatment, including laparoscopic salpingectomy (n=57) or salpingostomy (n=75). Main outcomes included intrauterine pregnancy (IUP), recurrent EP and persistent trophoblastic disease rates. RESULTS The IUP rates up to 24 months after surgery were 56.1% for salpingectomy and 60% for salpingostomy. The 2-year recurrent EP rates were 5.3% for salpingectomy and 18.7% for salpingostomy. The persistent trophoblastic disease rate were 1.8% for salpingectomy and 12% for salpingostomy. DISCUSSION Our results show that the reproductive outcomes after laparoscopic salpingectomy are similar to those observed after conservative treatment. CONCLUSIONS In the surgical treatment of EP, the clinician should choose the best treatment in accordance with the patient, considering the severity of the disease, the clinical characteristics of the patient and her desire to preserve fertility. KEY WORDS Ectopic pregnancy, Salpingectomy,Salpingostomy.
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Vitale SG, Gasbarro N, Lagana AS, Sapia F, Rapisarda AMC, Valenti G, Trovato MA, Rossetti D, Chiofalo B, Barrasso G, Tinelli A, Corrado F. Safe introduction of ancillary trocars in gynecological surgery: the "yellow island" anatomical landmark. Ann Ital Chir 2016; 87:608-611. [PMID: 27909270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM This technical note aims to suggest a safe introduction of ancillary trocars in gynaecological surgery, in order to prevent inferior epigastric artery damage. MATERIAL OF STUDY We performed a narrative overview, synthesizing the findings of literature retrieved from searches of computerized databases. RESULTS Among the different techniques, the identification of the "yellow island" as anatomical landmark seems to be a useful aid to avoid complication. This particular landmark is identified taking the lateral third of a line between the anterior superior iliac spine and the umbilicus as reference points, by a subperitoneal accumulation of adipose tissue located in that area. DISCUSSION "Yellow island" could be considered a safe place for trocars introduction because epigastric artery never runs there, even in patients with particular anatomical variants. This technique is particularly useful in obese patients, in which "yellow island" appears to be more evident respect to lean ones. Furthermore, the use of "open" trocars insertion may reduce the possibility of epigastric artery lesions respect to "Verres needle technique". CONCLUSION The identification of the "yellow island" anatomical landmark could be considered an useful aid for the safe introduction of ancillary trocars in gynaecological surgery. KEY WORDS Gynaecology, Laparoscopic surgery, Trocars placement.
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