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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).
  • 547
  • 23 Jan 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.
  • 546
  • 19 Mar 2024
Topic Review
Progesterone and Its Metabolites in Luteal Phase Deficiency
Progesterone action is the key physiological element of the menstrual cycle. It also plays an important role in the development of the mammary gland and influences the function of the central nervous system and the cardiovascular system. It predominates in the luteal phase. Just after ovulation, progesterone secretion is stable and does not correlate with luteinizing hormone (LH) pulses, while in the middle and late luteal phases, progesterone secretion is episodic and correlates well with pulsatile LH release. During this period, the frequency and amplitude of LH pulses gradually decrease. A decreased plasma progesterone concentration in the luteal phase may predict the occurrence of premenstrual syndrome (PMS).
  • 541
  • 23 Apr 2023
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.
  • 541
  • 16 Jan 2024
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.
  • 537
  • 28 Feb 2024
Topic Review
Vitamin D with Ovarian Reserve Markers and Depression
Since the identification of vitamin D receptors in both the female reproductive tract and the central nervous system, further data have shown that vitamin D is involved in the processes of reproductive and mental health.
  • 530
  • 05 Jan 2024
Topic Review
COVID-19, HLH and Pregnant/Postpartum Women
The term ‘cytokine storm’ (CS) applies to a pathological autoimmune reaction when the interactions that lead to cytokine production are destabilised and may even lead to death. CS may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is noteworthy that many of the criteria used to diagnose haemophagocytic lymphohistiocytosis (HLH) are described as COVID-19 mortality predictors. Cytokine storms are considered to be an important cause of death in patients with the severe course of SARS-CoV-2 infection. Due to the fact that pregnant women are in an immunosuppressive state, viral pulmonary infections are more perilous for them—possible risks include miscarriage, intrauterine growth restriction or birth before the term; sometimes ventilation support is needed. HLH should be considered in pregnant and puerperal women suffering from moderately severe to severe COVID-19 and presenting with: fever unresponsive to antibiotic therapy, cytopenia, hepatitis and hyperferritinaemia.
  • 527
  • 26 Sep 2023
Topic Review
Bacterial Vaginosis and Vulvovaginal Candidiasis
Among the infectious causes of vulvovaginal symptoms, bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) dominate. Apart from infrequent mixed infections, both are considered independent and caused by unrelated pathogenic mechanisms.
  • 522
  • 19 Jan 2024
Topic Review
MicroRNAs in Uteroplacental Vascular Dysfunction
Pregnancy complications of preeclampsia and intrauterine growth restriction (IUGR) are major causes of maternal and perinatal/neonatal morbidity and mortality. Although their etiologies remain elusive, it is generally accepted that they are secondary to placental insufficiency conferred by both failure in spiral artery remodeling and uteroplacental vascular malfunction. MicroRNAs (miRNAs) are small no-coding RNA molecules that regulate gene expression at the post-transcriptional level. Increasing evidence suggests that miRNAs participate in virtually all biological processes and are involved in numerous human diseases. Differentially expressed miRNAs in the placenta are typical features of both preeclampsia and IUGR. Dysregulated miRNAs target genes of various signaling pathways in uteroplacental tissues, contributing to the development of both complications. 
  • 518
  • 06 Mar 2023
Topic Review
The Bidirectional Relationship between Endometriosis and Microbiota
Endometriosis is an inflammatory and estrogen-dependent condition, affecting approximately 6–10% of women in their reproductive years. The pathogenesis and histological findings are characterized by endometrial glandular and stromal tissue growing beyond the uterus. It is classified into three types: superficial, ovarian, and deep endometriosis. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease.
  • 508
  • 28 Dec 2023
Topic Review
Vaginal Microbiome during Pregnancy in Health and Disease
Many aetiological agents pose a risk to pregnancy; in particular, infections of the genital tract by various pathogens that can cause serious health issues for both mothers and their fetuses have become a major public health issue all over the world for their high and growing prevalence. Genital infections can have a long duration, and women with these infections before pregnancy might also have increased risks of adverse outcomes including macrosomia, preterm birth (PTB), and spontaneous abortion. Multiple types of viral, bacterial, fungal, and parasitic infections have been identified that can affect the health of the pregnant woman, the pregnancy, and the infant after delivery.
  • 503
  • 22 Dec 2023
Topic Review
Stress of Prematurity in Experience of COVID-19 Pandemic
Stress is a process that triggers various physiological, hormonal and psychological mechanisms in response to a threat, which significantly affects the health of an individual. The COVID-19 pandemic introduced a lot of social changes that required constant adaptation to unfavorable conditions. Maternal stress and anxiety increase the levels of corticotropin-releasing hormone (CRH) in the placenta, which in turn affects the incidence of preterm birth and many other related maternal and neonatal complications.
  • 502
  • 26 Sep 2023
Topic Review
Next-Generation Sequencing's Application in ctDNA Detection and Quantification
Circulating tumour DNA (ctDNA) facilitates longitudinal study of the tumour genome, which, unlike tumour tissue biopsies, globally reflects intratumor and intermetastatis heterogeneity. Despite its costs, next-generation sequencing (NGS) has revolutionised the study of ctDNA, ensuring a more comprehensive and multimodal approach, increasing data collection, and introducing new variables that can be correlated with clinical outcomes. Current NGS strategies can comprise a tumour-informed set of genes or the entire genome and detect a tumour fraction as low as 10−5.
  • 498
  • 20 Feb 2024
Topic Review
Paternal Role in Pregnancy and in Birth Outcome
Recurrent pregnancy loss (RPL) is defined as three or more consecutive abortions and constitutes about 1% of all cases of pregnancy loss. RPL is a multifactorial disease and recognizes several causes, including anatomic (uterine malformations), endocrine, infectious, immunologic, genetic, and idiopathic.
  • 496
  • 14 Mar 2024
Topic Review
Etiology and Pathogenesis of EC in Fertile Women
Endometrial cancer (EC) affects the lining of the uterus and is usually diagnosed in postmenopausal women, but about 5% of cases occur in women under 40, and approximately 20% of cases are diagnosed before menopause.
  • 489
  • 24 Jul 2023
Topic Review
Cutaneous Metastasis of Endometrial Cancer and Long-Term Survival
The most prevalent gynecologic cancer is endometrial cancer. In 2018, there were 121,600 new cases of this cancer diagnosed in Europe, roughly 6.6% of all malignancies found in women. A total of 29,600 gynecologic-cancer-related deaths are predicted to occur each year, accounting for over 3.5% of all cancer-related deaths.
  • 476
  • 14 Nov 2023
Topic Review
Fertility Preservation in Female Cancer Survivors
Recent advances in anticancer treatment have significantly improved the survival rate of young females; unfortunately, in about one third of cancer survivors the risk of ovarian insufficiency and infertility is still quite relevant. As the possibility of becoming a mother after recovery from a juvenile cancer is an important part of the quality of life, several procedures to preserve fertility have been developed: ovarian surgical transposition, induction of ovarian quiescence by gonadotropin-releasing hormone agonists (GnRH-a) treatment, and oocyte and/or ovarian cortical tissue cryopreservation. Ovarian tissue cryostorage and allografting is a valuable technique that applies even to prepubertal girls; however, some patients cannot benefit from it due to the high risk of reintroducing cancer cells during allograft in cases of ovary-metastasizing neoplasias, such as leukemias or NH lymphomas.
  • 470
  • 24 Oct 2023
Topic Review
Prenatal Melatonin in Regulation of Childhood Obesity
There is a growing awareness that pregnancy can set the foundations for an array of diverse medical conditions in the offspring, including obesity. A wide assortment of factors, including genetic, epigenetic, lifestyle, and diet can influence foetal outcomes. A growing number of studies show that many prenatal risk factors for poor foetal metabolic outcomes, including gestational diabetes and night-shift work, are associated with a decrease in pineal gland-derived melatonin and associated alterations in the circadian rhythm. An important aspect of circadian melatonin’s effects is mediated via the circadian gene, BMAL1, including in the regulation of mitochondrial metabolism and the mitochondrial melatoninergic pathway. Alterations in the regulation of mitochondrial metabolic shifts between glycolysis and oxidative phosphorylation in immune and glia cells seem crucial to a host of human medical conditions, including in the development of obesity and the association of obesity with the risk of other medical conditions. The gut microbiome is another important hub in the pathoetiology and pathophysiology of many medical conditions, with negative consequences mediated by a decrease in the short-chain fatty acid, butyrate. The effects of butyrate are partly mediated via an increase in the melatoninergic pathway, indicating interactions of the gut microbiome with melatonin. Some of the effects of melatonin seem mediated via the alpha 7 nicotinic receptor, whilst both melatonin and butyrate may regulate obesity through the opioidergic system. Oxytocin, a recently recognized inhibitor of obesity, may also be acting via the opioidergic system. The early developmental regulation of these processes and factors by melatonin are crucial to the development of obesity and many diverse comorbidities.
  • 469
  • 29 Feb 2024
Topic Review
Radiomics in Gynaecological Imaging
Radiomics is an emerging field of research based on extracting mathematical descriptive features from medical images with the aim of improving diagnostic performance and providing increasing support to clinical decisions. A number of studies have been published regarding different possible applications of radiomics in gynaecological imaging. Many fields have been explored, such as tumour diagnosis and staging, differentiation of histological subtypes, assessment of distant metastases, prediction of response to therapy, recurrence, and patients’ outcome. 
  • 466
  • 03 Nov 2023
Topic Review
Nutritional Implications of Bariatric Surgery on Pregnancy Management
One in three women of reproductive age is obese. The mainstay treatment for obesity is bariatric surgery, and the following weight reduction results in a decrease in pregnancy adverse effects, including gestational diabetes mellitus, pregnancy-induced hypertension, and macrosomia. However, nutritional and vitamin deficiencies due to changes in the gastrointestinal tract after bariatric surgery are associated with an increase in the risk of fetal growth retardation and small for gestational-age neonates. 
  • 460
  • 01 Nov 2023
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