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Topic Review
Mechanism of Chronic Pelvic Pain in Endometriosis
Endometriosis, which is the presence of endometrial stroma and glands outside the uterus, is one of the most frequently diagnosed gynecologic diseases in reproductive women. Patients with endometriosis suffer from various pain symptoms such as dysmenorrhea, dyspareunia, and chronic pelvic pain. The pathophysiology for chronic pain in patients with endometriosis has not been fully understood. Altered inflammatory responses have been shown to contribute to pain symptoms.
  • 581
  • 13 Nov 2023
Topic Review
Hypertensive Disorders of Pregnancy from Preconception to Postpartum
Delaying childbearing until later in life can carry significant risks for women and their babies. Women who are older than 35 at delivery have increased rates of gestational diabetes, preterm birth, stillbirth, cesarean delivery, pre-eclampsia and maternal and neonatal morbidity and mortality. Pre-eclampsia is defined by the International Society for the Study of Hypertension in Pregnancy (ISSHP) as gestational hypertension accompanied by one or more of the following new-onset conditions at ≥20 weeks’ gestation.
  • 578
  • 21 Jul 2023
Topic Review
Unmet Goals of Pregnancy and Type 2 Diabetes
The increased frequency of type 2 diabetes worldwide has led to a concomitant increase in pregnancies complicated by type 2 diabetes This is mainly due to two factors: the earlier age of diabetes onset and the advanced age of pregnancy occurrence. Patients with type 2 diabetes in pregnancy show a high frequency of maternal and fetal complications, posing a series of problems in the follow-up of these women.
  • 571
  • 23 May 2023
Topic Review
Lysinuric Protein Intolerance in Pregnancy
Lysinuric protein intolerance (LPI) is a rare inborn error of metabolism (IEM), classified as an inherited aminoaciduria, caused by mutations in the SLC7A7 gene, leading to a defective cationic amino acid transport. The metabolic adaptations to the demands of pregnancy and delivery cause significant physiological stress, so those patients affected by IEM are at greater risk of decompensation.
  • 568
  • 13 Oct 2023
Topic Review
Changes in Gut Microbiome and Pathologies in Pregnancy
Pregnancy is a special period in a woman’s life when her organism undergoes multiple physiological changes so that the fetus has optimal conditions for growth and development. These include modifications in the composition of the microbiome that occur between the first and third trimesters of pregnancy. There is an increase in Akkermansia, Bifidobacterium, and Firmicutes, which have been associated with an increase in the need for energy storage. The growth in Proteobacteria and Actinobacteria levels has a protective effect on both the mother and the fetus via proinflammatory mechanisms.
  • 565
  • 25 Sep 2023
Topic Review
Diagnosis and Treatment of Fistulae
Gynecological fistulae are a rare but severe complication of radiation therapy, pelvic surgery, prolonged labor, cesarean deliveries, or inflammatory bowel diseases. A gynecological fistula is an abnormal pathway formed between the urinary and gynecological tract, most commonly located between the urinary bladder and vagina. Vesico-uterine and vesicovaginal fistulae are an important health issue, common in women of reproductive age in developing countries with limited access to obstetrical care. Various surgical techniques have been described for vesicovaginal fistula (VVF) repair, depending on the location, severity, and cause of the fistula and the surgeon’s experience.
  • 563
  • 17 Aug 2023
Topic Review
The Impact of Dysmenorrhea
Endometriosis in adolescent patients is a challenging problem presenting clinical and pathological differences than premenopausal women. Adolescents and young women with dysmenorrhea and painful symptoms that suggest endometriosis, should be referred to dedicated endometriosis centers for an early diagnosis and appropriate medical and surgical management
  • 557
  • 11 Sep 2023
Topic Review
Effects of Bariatric Surgery on Women during Pregnancy
It has been shown that women with obesity planning pregnancy should reduce their body weight because obesity is a risk factor for adverse obstetric and neonatal outcomes. Bariatric surgery effectively reduces excessive body weight and the health risks in women with obesity during pregnancy and their offspring. However, at least a year interval between surgery and conception is recommended. An interdisciplinary medical team should provide patient care during pregnancy with knowledge and skills related to people after bariatric surgery. Due to the increased risk of mental disorders, especially depression, it is necessary to constantly monitor the mental state of women and provide psychological support and education on a healthy lifestyle during pregnancy and the postpartum period.
  • 557
  • 25 Oct 2023
Topic Review
Link between Early Life and Breast Anomalies
Several factors during childhood and adolescence are thought to be associated with the development of proliferative benign breast diseases and breast cancer in adulthood.
  • 552
  • 06 Apr 2023
Topic Review
Molecular Pathology for Sex Cord–Stromal Tumors of Ovary
Ovarian sex cord–stromal tumors (SCSTs) account for 8% of all primary ovarian neo-plasms. Accurate diagnosis is crucial since each subtype has a specific prognostic and treatment. Apart from fibrosarcomas, stromal tumors are benign while sex cord tumors may recur, sometimes with a significant time to relapse. Although the diagnosis based on morphology is straightforward, in some cases the distinction between stromal tumors and sex cord tumors may be tricky. Indeed, the immunophenotype is usually nonspecific between stromal tumors and sex cord tumors.
  • 552
  • 25 Dec 2023
Topic Review
Adenomyosis and Infertility
Adenomyosis (the presence of ectopic endometrial glands and stroma below the endometrial–myometrial junction) is a benign condition which is increasingly diagnosed in younger women suffering from infertility. Adenomyosis is a common gynecological disorder, affecting women of reproductive age. It negatively affects in vitro fertilization, pregnancy and the live birth rate, as well as increases the risk of miscarriage. With the advent of non-invasive diagnoses with MRI and TVUS, the role of adenomyosis in infertility has been better recognized.
  • 549
  • 31 Aug 2023
Topic Review
Vitamin D and Urogenital Functions in Postmenopausal Women
Recent years have witnessed the emergence of growing evidence concerning vitamin D's potential role in women's health, specifically in postmenopausal women. This evidence also includes its connection to various genitourinary disorders and symptoms. Numerous clinical studies have observed improvements in vulvovaginal symptoms linked to the genitourinary syndrome of menopause (GSM) with vitamin D supplementation. These studies have reported positive effects on various aspects such as vaginal pH, dryness, sexual functioning, reduced libido, and a decrease in urinary tract infections. Many mechanisms underlying these pharmacological effects have since been proposed. Vitamin D receptors (VDRs) have been identified as a major contributor to its effects. It is now well known that VDRs are expressed in the superficial layers of the urogenital organs. Additionally, vitamin D plays a crucial role in supporting immune function and modulating the body's defense mechanisms. However, the characterization of these effects requires more investigation. Reviewing existing evidence regarding vitamin D's impact on post-menopausal women's vaginal, sexual, and urological health is the purpose of this article. As research in this area continues, there is a potential for vitamin D to support women's urogenital and sexual health during the menopausal transition and postmenopausal periods.
  • 545
  • 07 Sep 2023
Topic Review
Menstrual Blood-Derived Stem Cells for Vaginal Atrophy Management
Risk-reducing bilateral salpingo-oophorectomy (RRSO) is a surgical procedure that includes bilateral removal of the ovaries and fallopian tubes and is often recommended for individuals who carry breast cancer gene 1 (BRCA1) and 2 (BRCA2) mutations, which are associated with hereditary breast and ovarian cancer syndrome (HBOC).
  • 545
  • 23 Jan 2024
Topic Review
Gonadotropin and Ovarian Hormone Monitoring
FSH, estrogen and progesterone testing are widely utilized in clinical practice. Lateral flow assays (LFAs) are cost-effective tools used for diagnosing infectious diseases, pregnancy, and substance testing.
  • 544
  • 20 Oct 2023
Topic Review
Bacterial Vaginosis and Post-Operative Pelvic Infections
Bacterial vaginosis (BV) represents a condition in which the normal protective Lactobacilli, especially those that produce H2O2, are replaced by high quantities of facultative anaerobes, leading to gynecologic and obstetric post-operative complications. BV is an important cause of obstetric and gynecological adverse sequelae and it could lead to an increased risk of contracting sexually transmitted infections such as gonorrhea, genital herpes, Chlamydia, Trichomonas, and human immunodeficiency virus.
  • 539
  • 12 May 2023
Topic Review
Pregnancy Arrhythmias
Pregnancy is closely associated with an elevated risk of arrhythmias, constituting the predominant cardiovascular complication during this period. Pregnancy may induce the exacerbation of previously controlled arrhythmias and, in some instances, arrhythmias may present for the first time in pregnancy.
  • 536
  • 20 Feb 2024
Topic Review
Placental Hypoxia Biomarkers in Placental Insufficiency Syndromes
Placental hypoxia poses significant risks to both the developing fetus and the mother during pregnancy, underscoring the importance of early detection and monitoring. Effectively identifying placental hypoxia and evaluating the deterioration in placental function requires reliable biomarkers. Molecular biomarkers in placental tissue can only be determined post-delivery and while maternal blood biomarkers can be measured over time, they can merely serve as proxies for placental function. Therefore, there is an increasing demand for non-invasive imaging techniques capable of directly assessing the placental condition over time. Advancements in imaging technologies, including photoacoustic and magnetic resonance imaging, offer promising tools for detecting and monitoring placental hypoxia. Integrating molecular and imaging biomarkers may revolutionize the detection and monitoring of placental hypoxia, improving pregnancy outcomes and reducing long-term health complications. 
  • 535
  • 23 Aug 2023
Topic Review
Prenatal Alcohol Exposure and Metabolic Disorders in Pediatrics
Prenatal alcohol exposure is responsible for increasing chronic disease risk in later life, including obesity and metabolic syndrome. Alcohol drinking may compromise endogenous antioxidant capacity, causing an increase in free radicals and reactive oxygen species in the newborn. Excessive reactive oxygen species could attack the cellular proteins, lipids, and nucleic acids, leading to cellular dysfunction. Moreover, oxidative stress could play a crucial role in the altered synthesis and release of neurotrophins and progressive mitochondrial modifications with uncontrolled apoptosis.
  • 534
  • 28 Feb 2024
Topic Review
Management of Insomnia in Menopausal Women
Insomnia is one of the major complaints of menopausal women with advancing age and may be complexly related to a variety of causes.
  • 533
  • 19 Mar 2024
Topic Review
Phenotypes of Endometriosis and Adenomyosis
The link between endometriosis and adenomyosis has been suggested in theories that identified endometrial abnormalities in instances where both conditions coexist, particularly in patients with infertility. When—during the second half of the 19th century—the presence of epithelial cells on the peritoneal surface and within the myometrium was first identified, endometriosis (except for ovarian endometriomas) and adenomyosis were considered under the common name ‘adenomyoma’. Subsequently, in the 1920s, as they came to be regarded as separate entities, the terms adenomyosis and endometriosis gained wide acceptance. Interestingly, the term endometriosis also came to be used as an overarching term that encompasses instances where endometrial tissue is present outside the lining of the uterus. Adenomyosis came to be referred to as endometriosis interna to distinguish it from cases where the aberrant endometrium is present outside the uterus, which was referred to as endometriosis externa.
  • 531
  • 16 Jan 2024
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