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Topic Review
Clotting Factor Deficiencies in Abnormal Uterine Bleeding
Clotting Factor deficiencies are rare disorders with variations in clinical presentation and severity of symptoms ranging from asymptomatic to mild to life-threatening bleeding. Thus, they pose a diagnostic and therapeutic challenge, mainly for the primary health care providers, general practitioners, and gynecologists who are more likely to first encounter these patients. An additional diagnostic challenge arises from the variable laboratory presentations, as PT, PTT, and BT are not always affected. The morbidity is higher among women of reproductive age since Abnormal Uterine Bleeding–specifically Heavy Menstrual Bleeding–is one of the most prevalent manifestations of these disorders, and in some cases of severe deficiencies has led to life-threatening episodes of bleeding requiring blood transfusions or even immediate surgical intervention. Physician awareness is important as, in the case of some of these disorders–i.e., Factor XIII deficiency–prophylactic treatment is available and recommended.
  • 802
  • 30 Jun 2023
Topic Review
Transplacental Treatment of Fetal Tachyarrhythmia
Fetal arrhythmias are diagnosed in 1–3% of pregnancies. Despite this, they account for up to 20% of consultations related to fetal congenital heart disease in referral units. Among rhythm disorders, fetal tachyarrhythmias affect approximately 0.1% of pregnancies.
  • 801
  • 11 May 2023
Topic Review
Systemic Manifestations of Preeclampsia
Preeclampsia is a systemic disorder that may present with various symptoms and signs. The manifestation of preeclampsia is widely perceived to be centered around hypertension and proteinuria, but clinical presentations could be variable in essence. 
  • 799
  • 18 Sep 2023
Topic Review
MRI Staging in Locally Advanced Vulvar Cancer
MR imaging provides excellent spatial and contrast resolution to stage locally advanced vulvar cancer (LAVC) for tumor and nodal evaluation in order to facilitate the planning of treatment. Although there are no standard indications for how to estimate the clinical stage of International Federation of Gynecology and Obstetrics at diagnosis, MR imaging can depict the tumor and its extension to the vulvar region and adjacent organs, such as the vagina, urethra, and anus. Optimizing the MR imaging protocol and technique is fundamental for correct staging.
  • 793
  • 30 Nov 2021
Topic Review
Clinical and Physiological Significance of L-Arginine Methabolism
L-arginine is transported by members of the cationic amino acid transporter (CAT) family. This transport system is Na+-independent, pH-insensitive, and activated by hyper-polarization and substrate trans-stimulation.
  • 793
  • 15 Dec 2022
Topic Review
Fertility Sparing Surgery and Borderline Ovarian Tumours
Fertility sparing surgery (FSS) is now a widely acceptable treatment for the management of Borderline Ovarian Tumours (BOTs) in women of reproductive age. However, many clinicians face the dilemma of balancing the risks of disease recurrence with progression to lethal malignancy whilst preserving fertility, in the absence of clear standardized guidelines. 
  • 792
  • 07 Apr 2022
Topic Review
Raman Spectroscopy for Early Detection of Cervical Cancer
Cervical cancer is the fourth most common women’s cancer in the world, and unfortunately mainly affects younger women. Current methods for screening and diagnosis of cervical cancer and precancer are therefore limited, and there has been much interest in the use of optical spectroscopic approaches, such as Raman spectroscopy, to provide an objective test based on the biochemical fingerprint of the cervical cells or tissues. Raman spectroscopy is based on inelastic scattering, which has been used to study the biomolecular fingerprint of cells or tissues. It involves shining a laser on a sample and measuring the scattered photons. When a photon collides on a molecule, it either retains its energy (known as Rayleigh scattering) or exchanges energy with the molecule (known as Raman scattering).
  • 792
  • 23 Mar 2023
Topic Review
Müllerian Agenesis Causing Congenital Uterine Factor Infertility
Infertility affects around 1 in 5 couples in the world. Congenital absence of the uterus results in absolute infertility in females. Müllerian agenesis is the nondevelopment of the uterus. Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a condition of uterovaginal agenesis in the presence of normal ovaries and the 46 XX Karyotype. With advancements in reproductive techniques, women with MA having biological offspring is possible. 
  • 792
  • 02 Jan 2024
Topic Review
Prader-Willi Syndrome and Physical Activity
Prader-Willi syndrome (PWS) is the most frequent cause of genetic obesity, with a prevalence between one in 20,000 and one in 30,000 births. PWS is a complex genetic neurodevelopmental disorder caused by an absence of expression of imprinted alleles of paternal origin on chromosome 15. PWS is characterized by severe hypotonia and feeding difficulties in early infancy, followed in early childhood by excessive eating and gradual development of severe obesity.
  • 790
  • 25 Jun 2021
Topic Review
Ovarian Clear Cell Carcinoma
This entry summarizes the recent advances in the process and prevention of carcinogenesis, the characteristic nature of tumors, and the treatment of post-refractory ovarian clear cell carcinomas (OCCCs), which are highly linked to oxidative stress. 
  • 789
  • 09 Feb 2021
Topic Review
Nuclear Medicine in the Gynecological Malignancies
Gynecological malignancies include ovarian, cervical, and endometrial cancer, and greatly affect female health and quality of life worldwide. Despite promising advancements in the detection and the treatment of cancers, there are still uncertainties in the diagnostic methods, which in turn can contribute to patient mortality.
  • 788
  • 22 Apr 2022
Topic Review
Regulated Cell Death Mechanisms in Endometriosis
Regulated cell death (RCD) represents a distinct mode of cell demise, differing from accidental cell death (ACD), characterized by specific signaling cascades orchestrated by diverse biomolecules. The regular process of cell death plays a crucial role in upholding internal homeostasis, acting as a safeguard against biological or chemical damage.
  • 788
  • 17 Feb 2024
Topic Review
Recurrent Pregnancy Loss
Recurrent pregnancy loss is a common problem in the reproductive age population of women. It can be caused by many different conditions. This problem is addressed in international guidelines that take a slightly different approach to its diagnosis and treatment.
  • 781
  • 10 Aug 2023
Topic Review
Prenatal Opioid Exposure
Prenatal opioid exposure (POE) has been linked with increased infant risk, including attention-deficit hyperactivity disorder (ADHD) symptoms in childhood. The objective of the meta-analysis was to systematically investigate the association between POE and ADHD symptoms in children 2-18 years.
  • 779
  • 23 Feb 2021
Topic Review
Cervical Cancer and Treatment
The premalignancy of the uterine cervix is preventable and treatable if neoplasia is detected early. “Screen-and-treat” is a commonly adopted clinical management for precancerous lesions. In general, the standard curative options for precancers include large loop excision of the transformation zone (LLETZ) or loop electrosurgical excision procedure (LEEP), cryotherapy, and cold knife conization, while for locally advanced cervical cancer, hysterectomy, radiotherapy, chemotherapy, and radiotherapy with concurrent chemotherapy and immunotherapy are offered to the patients.
  • 777
  • 28 Jun 2022
Topic Review
Hyperthermic Intraperitoneal Chemotherapy in Epithelial Ovarian Cancers
Most patients with epithelial ovarian cancers (EOCs) are at advanced stages (stage III–IV), for which the recurrence rate is high and the 5-year survival rate is low. The most effective treatment for advanced diseases involves a debulking surgery followed by adjuvant intravenous chemotherapy with carboplatin and paclitaxel. Nevertheless, systemic treatment with intravenous chemotherapeutic agents for peritoneal metastasis appears to be less effective due to the poor blood supply to the peritoneal surface with low drug penetration into tumor nodules. Based on this reason, hyperthermic intraperitoneal chemotherapy (HIPEC) emerges as a new therapeutic alternative. By convection and diffusion, the hyperthermic chemotherapeutic agents can directly contact intraperitoneal tumors and produce cytotoxicity. In a two-compartment model, the peritoneal–plasma barrier blocks the leakage of chemotherapeutic agents from peritoneal cavity and tumor tissues to local vessels, thus maintaining a higher concentration of chemotherapeutic agents within the tumor tissues to facilitate tumor apoptosis and a lower concentration of chemotherapeutic agents within the local vessels to decrease systemic toxicity. 
  • 773
  • 18 Sep 2023
Topic Review
Vibrational Biospectroscopy for Endometrial Cancer Diagnosis and Screening
Endometrial cancer (EC) is the sixth most common cancer and the fourth leading cause of death among women worldwide. Early detection and treatment are associated with a favourable prognosis and reduction in mortality. Unlike other common cancers, however, screening strategies lack the required sensitivity, specificity and accuracy to be successfully implemented in clinical practice and current diagnostic approaches are invasive, costly and time consuming. Such limitations highlight the unmet need to develop diagnostic and screening alternatives for EC, which should be accurate, rapid, minimally invasive and cost-effective. Vibrational spectroscopic techniques, Mid-Infrared Absorption Spectroscopy and Raman, exploit the atomic vibrational absorption induced by interaction of light and a biological sample, to generate a unique spectral response: a “biochemical fingerprint”. These are non-destructive techniques and, combined with multivariate statistical analysis, have been shown over the last decade to provide discrimination between cancerous and healthy samples, demonstrating a promising role in both cancer screening and diagnosis. 
  • 771
  • 18 May 2022
Topic Review
Experimental Therapeutic Strategies for Thin Endometrium
Infertility caused by a thin endometrium remains a significant challenge in assisted reproduction and is often associated with a low success rate after treatment with assisted reproductive technology. There is a lack of consensus in the field concerning both its diagnostic criteria and clinical management. The available treatment options are few with limited efficacy. Advances in cell therapy and bioengineering have, however, shown promising results for the treatment of a thin endometrium. Notably, these novel interventions have demonstrated the ability to increase endometrial thickness, restore endometrial function, and improve reproductive outcomes.
  • 769
  • 13 Nov 2023
Topic Review
Deep Infiltrating Endometriosis in Adolescence
Endometriosis has a prevalence of 10% worldwide in premenopausal women. Probably, endometriosis begins early in the life of young girls, and it is commonly diagnosed later in life. The prevalence of deep infiltrating endometriosis (DIE) in adolescence is currently unknown due to diagnostic limits and underestimation of clinical symptoms. Dysmenorrhea is a common symptom in adolescents affected by DIE, often accompanied by dyspareunia and chronic acyclic pelvic pain. Ultrasonography—either performed transabdominal, transvaginal or transrectal—should be considered the first-line imaging technique despite the potential for missed diagnosis due to early-stage disease. Magnetic resonance imaging should be preferred in the case of virgo patients or when ultrasonographic exam is not accepted. Diagnostic laparoscopy is deemed acceptable in the case of suspected DIE not responding to conventional hormonal therapy. An early medical and/or surgical treatment may reduce disease progression with an immediate improvement in quality of life and fertility, but at the same time, painful symptoms may persist or even recur due to the surgery itself. 
  • 760
  • 31 Jan 2024
Topic Review
Catastrophic Antiphospholipid Syndrome
Unlike classic antiphospholipid syndrome (APS), catastrophic antiphospholipid syndrome (CAPS) causes multiple microthrombosis due to an increased inflammatory response, known as a “thrombotic storm”. CAPS typically develops after infection, trauma, or surgery and begins with the following symptoms: fever, thrombocytopenia, muscle weakness, visual and cognitive disturbances, abdominal pain, renal failure, and disseminated intravascular coagulation. Although the presence of antiphospholipid antibodies in the blood is one of the diagnostic criteria, the level of these antibodies can fluctuate significantly, which complicates the diagnostic process and can lead to erroneous interpretation of rapidly developing symptoms.
  • 757
  • 23 Feb 2024
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