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Topic Review
Molecular Characterizations of Gynecologic Carcinosarcomas
Carcinosarcomas are biphasic tumors composed of an epithelial component and a mesenchymal component. These most commonly arise from the uterus or ovary but can arise from other organs as well, such as the lung or breast. Gynecologic carcinosarcomas are rare but aggressive, comprising less than 5% of uterine and ovarian cancers. However, relative to other high-grade uterine cancers, survival outcomes are much worse. The same is true for ovarian carcinosarcomas relative to high-grade serous ovarian cancers, even when matched for clinical stages.
  • 624
  • 08 Oct 2022
Topic Review
Endometrial Cancer Prevention, Early Diagnosis and Treatment
Endometrial cancer is the fourth most common female malignancy in high socioeconomic index nations and the sixth most common cancer in women worldwide. The disease incidence has increased globally by 132% in the last 30 years, and this trend is set to continue in light of an ageing population and increasing levels of obesity and diabetes. Although more women than ever before are dying of endometrial cancer, the mortality rates are falling due to recent advances in early diagnosis and treatment. Our understanding of the molecular drivers of endometrial cancer has increased substantially, and doctors are now, for the first time, starting to translate this knowledge into the true personalisation of care.
  • 624
  • 05 Mar 2024
Topic Review
Umbilical Endometriosis and Pathogenic Theory Proposal
Endometriosis is a benign gynecological disorder that affects about 5% of reproductive-aged women. The pelvic cavity is the most common location of endometriotic implants, but about 12% of lesions are extragenital and, among the extra-pelvic sites, endometriosis of the abdominal wall (AWE) is the most common. Umbilical endometriosis (UE), or Villar’s nodule, as first described by Villar in 1886, is defined as the presence of endometrial glands and/or stroma within the umbilicus.
  • 623
  • 28 Feb 2022
Topic Review
Intravenous Immunoglobulins Treatment for Autoimmune Diseases
Intravenous administration of immunoglobulins has been routinely used for many years in clinical practice, developed initially as replacement therapy in immunodeficiency disorders. The use of intravenous immunoglobulins (IVIGs) is embedded in the modern algorithms for the management of a few diseases, while in most cases, their application is off-label and thus different from their registered therapeutic indications according to the summary of product characteristics. 
  • 622
  • 21 Mar 2023
Topic Review
Novel Biomolecules in Gestational Diabetes Mellitus 2.0 Pathogenesis
Gestational diabetes mellitus (GDM) has become a major public health problem and one of the most discussed issues in modern obstetrics. GDM is associated with serious adverse perinatal outcomes and long-term health consequences for both the mother and child. Currently, the importance and purposefulness of finding a biopredictor that will enable the identification of women with an increased risk of developing GDM as early as the beginning of pregnancy are highly emphasized. Both “older” molecules, such as adiponectin and leptin, and “newer” adipokines, including fatty acid-binding protein 4 (FABP4), have proven to be of pathophysiological importance in GDM.
  • 620
  • 20 Apr 2022
Topic Review
Possible Therapeutic Strategies for ADPKD Patients
Gender exerts a significant influence on the occurrence and progression of many renal diseases, including ADPKD. ADPKD, impacting roughly 12 million individuals globally, affects both men and women equally. Mutations in PKD1 and PKD2 genes contribute to ADPKD, with gender playing a crucial role in disease manifestation and progression.
  • 615
  • 04 Mar 2024
Topic Review
Regulatory Mechanism of Extracellular Matrix in Uterine Fibroids
Uterine fibroids (UFs), also known as leiomyomas, are benign tumors of the myometrium affecting over 70% of women worldwide, particularly women of color. Although benign, UFs are associated with significant morbidity; they are the primary indication for hysterectomy and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor. So far, the molecular mechanisms underlying the pathogenesis of UFs are still quite limited. 
  • 611
  • 18 Apr 2023
Topic Review
CTAs in Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) has been associated with worse prognoses due to the limited treatment options. Thus, there is a need to characterise new biomarkers or treatment targets to improve patient outcomes. Cancer testis antigens (CTAs) are a group of antigens that are preferentially expressed in tumours and exhibit strong immunogenicity, as such, CTAs hold great promise as potential treatment targets and biomarkers in cancer.
  • 606
  • 01 Dec 2021
Topic Review
Psychological Symptoms of Endometriosis
Endometriosis is a chronic inflammatory disease that is defined by the growth of endometrial-like tissues outside of the uterus. Endometriosis is currently the second most common gynecological disease and is associated with severe pain, vegetative impairment, and infertility. In association, there are considerable psychological symptoms that limit the quality of life of those affected. This is a brief summary of the current endometriosis literature that is linked to the RDoC domain "Negative Valence".
  • 603
  • 10 Aug 2023
Topic Review
Defining Premenstrual Syndrome
Premenstrual Syndrome (PMS) is a complex physiological and psychological condition that affects a significant number of women during their reproductive years. Although the exact etiology of PMS remains unclear, its symptoms, including mood swings, bloating, irritability, and fatigue, can significantly impair the quality of life for affected individuals. The management of PMS traditionally involves pharmacological interventions; however, emerging evidence suggests that exercise may offer a valuable non-pharmacological approach to alleviate PMS symptoms. 
  • 602
  • 06 Jul 2023
Topic Review
Placental Syndromes
Human placentation in a unique and complex process. It is associated with intensive adaptation in the maternal body, which allows the pregnancy to be maintained and to develop. Adaptation includes changes in the maternal circulation and pulmonary, secretory and immune system changes. These complex mechanisms, dependent on each other, are essential to allow the creation of the placenta and its functioning. Preeclampsia (PE) was the first pregnancy disorder whose etiopathogenesis was connected to abnormal placentation. In 1992, Christopher W. G. Redman proposed the two-stage hypothesis of PE development: earlier placental stage (deficient placentation) and later maternal symptoms (evolving from systemic vascular inflammation). Roberts and Redman assumed that factors inducing maternal endothelial dysfunction were the link between the two stages. Those factors had an angiogenic function and included vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)—both with proangiogenic functions—and soluble decoy receptor for VEGF and PlGF (named soluble fms-like tyrosine kinase-1 or sFlt) and soluble endoglin (sEng)—with antiangiogenic functions. Nowadays, impaired placentation and disturbed maternal adaptation may lead to several pregnancy complications. In 2019, in a paper by Anne Cathrine Staff, they were called placental syndromes, as they all arise from impaired trophoblast invasion or trophoblast stress. They include pregnancy loss, fetal growth restriction (FGR), preeclampsia (PE), preterm delivery, premature rupture of membranes (PROM), placental abruption and intrauterine fetal demise.
  • 599
  • 25 Aug 2022
Topic Review
Pathogenesis of Adenomyosis
Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases and in older individuals. Adenomyosis, endometriosis and cancers may share a common pathogenic mechanism that includes hormonal factors, genetic predisposition, growth factors, inflammation, immune system dysregulation, environmental factors and oxidative stress. Endometriosis and adenomyosis both exhibit malignant behaviour. The most common risk factor for malignant transformation is prolonged exposure to oestrogens. The golden standard for diagnosis is histopathology. Colman and Rosenthal emphasised the most important characteristics in adenomyosis-associated cancer.
  • 595
  • 25 Jun 2023
Topic Review
Maternal Oxygen Administration during Labor
Oxygen administration to the mother aims to increase fetal oxygen diffusion across the placenta. This therapy is commonly performed during labor, especially in  case of a non-reassuring fetal heart rate. However, benefits and potential risks are controversial, especially in case of a normoxemic pregnant patient. In fact, its impact on placental gas exchange and the fetal acid–base equilibrium is not fully understood; it probably affects the sensible placental oxygen equilibrium and causes a time-dependent vasoconstriction of umbilical and placental vessels. The subsequent hyperoxia might also cause the generation of radical oxygen species, raising concerns for the developing fetal cells. Moreover, this practice affects the maternal cardiovascular system: it can cause alterations of the cardiac index, heart rate and vascular resistance, and unclear effects on uterine blood flow. In conclusion, there is no evidence that maternal oxygen administration can provide any benefit in the case of a non-reassuring fetal heart rate pattern, while it bears possible collateral effects. Oxygen administration during labor should be reserved for cases of maternal hypoxia. 
  • 594
  • 04 Sep 2023
Topic Review
Neonatal Outcomes of Children Born from Frozen Embryo
The growing use of ART (assisted reproductive techniques) has led to a progressive improvement of protocols; embryo freezing is certainly one of the most important innovations. This technique is selectively offered as a tailored approach to reduce the incidence of multiple pregnancies and, most importantly, to lower the risk of developing ovarian hyperstimulation syndrome when used in conjunction with an ovulation-triggering GnRH antagonist. The increase in transfer cycles with frozen embryos made it possible to study the effects of the technique in children thus conceived. Particularly noteworthy is the increase in macrosomal and LGA (large for gestational age) newborns, in addition to a decrease in SGA (small for gestational age) and LBW (low birth weight) newborns.
  • 594
  • 17 Oct 2023
Topic Review
Laser Treatment for GSM in Breast Cancer Survivors
Breast cancer treatment, such as chemotherapy and endocrine therapy, can cause earlier and more sudden menopausal symptoms. Genitourinary syndrome of menopause (GSM) is one of the most bothersome side effects of breast cancer treatment, resulting in sexual dysfunction and impaired quality of life. The most recent data show the feasibility and safety of vaginal laser to treat GSM for breast cancer survivors. 
  • 593
  • 01 Feb 2023
Topic Review
Congenital Hepatitis C Virus and Fetal Ascites
Perinatal Hepatitis C Virus (HCV) transmission occurs in 4–7% of the cases with detectable viremia at delivery. HCV testing in pregnancy is recommended. The fetal infection was previously described as asymptomatic although there are two cases, including this one, to report the presence of isolated fetal ascites in HCV infected fetuses.
  • 591
  • 21 Nov 2022
Topic Review
Estro-Progestins and Pain Relief in Endometriosis
Endometriosis is a benign, hormone-responsive chronic disease that affects women of reproductive age; long-term treatment to balance satisfactory tolerability with clinical efficacy is necessary for these patients. The first-line therapy for endometriosis is predominantly medical treatment, in order to improve symptoms or prevent post-surgical disease recurrence. Multiple factors including age and women preference, pain severity, and endometriosis stage must be considered in the choice of the most suitable therapy. Estrogen-progestogins are generally used as first-line hormone therapies among different medical options currently effective for endometriosis management. Several studies have shown that they are able to improve pain symptoms in most patients, are well tolerated, and are inexpensive. Combined hormonal contraception treatment, administered cyclically or continuously, with different types of hormones and route of administration, results in clinically noticeable decrease in dysmenorrhea, noncyclic pelvic pain, dyspareunia, and recurrence rate after surgery, and also in quality of life improvement.
  • 587
  • 29 Jun 2022
Topic Review
Inflammatory Molecules Responsible for Preterm Birth
It is estimated that inflammation at the placental–maternal interface is directly responsible for or contributes to the development of 50% of all premature deliveries. Chorioamnionitis, also known as the premature rupture of the amniotic membrane in the mother, is the root cause of persistent inflammation that preterm newborns experience. Beyond contributing to the onset of early labor, inflammation is a critical element in advancing several conditions in neonates, including necrotizing enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity and periventricular leukomalacia. Notably, the immune systems of preterm infants are not fully developed; immune defense mechanisms and immunosuppression (tolerance) have a delicate balance that is easily upset in this patient category.
  • 586
  • 13 Jan 2023
Topic Review
Non-Neoplastic Ovarian Masses in Children and Adolescents
Most abdominal masses in the pediatric population derive from the ovaries. Ovarian masses, which include both non-neoplastic lesions and neoplastic tumors, can occur in all ages although their incidence, clinical presentation and histological distribution vary among different age groups. Herein, pediatric non-neoplastic ovarian masses are described. These include benign tumor-like lesions that are not composed of neoplastic cells, such as functional cysts, endometrioma, torsion, abscess and lymphangioma.
  • 585
  • 10 Jul 2023
Topic Review
Contained Power Morcellation in Laparoscopic Uterine Myoma Surgeries
Uterine fibromas are the most common benign uterine tumors. Although the majority of leiomyomas remain asymptomatic, they can cause serious clinical problems, including abnormal uterine bleeding, pelvic pain, and infertility, which require effective gynecological intervention. Depending on the symptoms as well as patients’ preferences, various treatment options are available, such as medical therapy, non-invasive procedures, and surgical methods. Regardless of the extent of the surgery, the preferred option is the laparoscopic approach. To reduce the risk of spreading occult malignancy and myometrial cells associated with fragmentation of the specimen before its removal from the peritoneal cavity, special systems for laparoscopic contained morcellation have been developed.
  • 581
  • 13 Oct 2023
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