Este mes en... European Journal of Obstetrics & Gynecology and Reproductive Biology
Sumarios de Revistas
Este mes en... European Journal of Obstetrics & Gynecology and Reproductive Biology:
Aldo-keto reductase activity after diethylhexyl phthalate exposure in eutopic and ectopic endometrial cells Endometriosis is a multifactorial gynaecological disease in reproductive-age women. Endometriotic tissue is characterized by high prostaglandin levels and progesterone resistance. Human aldo-keto reductases (AKRs) convert progesterone to a less potent metabolite and cause progesterone resistance. Therefore, in this study, we evaluated whether diethylhexyl phthalate (DEHP) alters AKR expression in human ectopic and eutopic endometrium.
Management of Atypical Polypoid Adenomyomas. A case series Atypical polypoid adenomyomas (APAs) are endometrial, non-malignant, focal, and non-invasive lesions that are intriguing for their histological resemblence to invasive endometrioid adenocarcinoma or malignant mixed Müllerian tumor. The aim of this study was to present our clinical experience, regarding the reproductive outcome, the recurrence rate, and the association with hyperplasia and cancer, in a small series of patients with APA.
Genital discomfort: yeast, trichomonas and bacterial vaginosis are only the tip of the iceberg Dear editor, it is well known that genital discomfort in women (discharge, pruritus, dyspareunia, malodor) is a common problem and are the main reason for visiting a primary gynecologic clinic . Unfortunately, symptoms are nonspecific and are caused by various etiologies [2,3]. Proper diagnosis is based on a thorough genital examination, sampling vaginal pH and performing a wet-mount (microscopy of vaginal discharge) . Occasionally there is need to send a culture, perform molecular biology tests or obtain a biopsy .
A rare fundal papillary adenofibromatous uterine cyst in a postmenopausal woman: A first case report The uterine cysts are rarely diagnosed when compared to ovarian cysts . Practically, uterine cysts may be cystic degeneration of uterine leiomyoma, cystic adenomyosis, congenital uterine cysts and echinococcal cysts . Adenofibroma is an extremely rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group . These tumors tend to occur in postmenopausal and elderly women . We report a rare case of papillary adenofibromatous uterine cyst in a postmenopausal woman.
EBCOG Position Statement on Ageing and Sexual Health Life expectancy has increased remarkably in recent years. In 2013 in the European Union, life expectancy at birth was 83.3 years for women and 77.8 years for men . Worldwide, the number of postmenopausal women is estimated to reach 1.1 billion in 2025 . Overall life expectancy at age 60 is approximately another 25 years. Therefore a statement on ageing and sexual health is timely because older people remain sexually active for longer than in the past.
Ever growing demand for in vitro fertilization despite stable biological fertility—A European paradox Since the landmark discoveries of in vitro fertilization (IVF) in 1978 and its main variant intra cytoplasmic sperm injection (ICSI) in 1992–jointly called ‘IVF’ unless mentioned separately – the use of IVF has grown tremendously in high-income countries; in this study we mainly focus on Europe. Between 1997 and 2011 almost 900,000 IVF-infants were born in Europe and this number must have surpassed over 1,4 million by now . Worldwide over 5 million IVF babies were born by the end of 2013, mostly in high-income countries .
Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective.
EBCOG position statement on female genital mutilation Female Genital Mutilation (FGM) affects more than 200 million girls and women in at least 30 countries, mostly in Africa, but also in the Middle East and Asia . WHO defines FGM as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons” . Although FGM is traditional in many cultures, it is harmful to women’s health and wellbeing. The development of effective strategies to diminish and prevent detrimental procedures is now a public health priority.
EBCOG Position Statement on Caesarean Section in Europe Caesarean section is an irreplaceable life saving operation, but it is also seen by some as an alternative to vaginal birth. However the procedure is not without complications, and has implications for future pregnancies and births, some negative . There is evidence that caesarean section may also affect the immediate and future health of the baby [2–4]. The costs of caesarean section are much higher than vaginal birth and this will have implications for national budgets .
Episiotomy: What angle do you cut to the midline? Although episiotomies are the commonest obstetric procedure performed the technique of performing one varies amongst obstetricians and midwives. The angle of episiotomy to the midline in particular has been shown to influence the risk of developing obstetric anal sphincter injuries (OASIS). In order to identify the differences in technique and to identify targets for training we undertook a practice survey of episiotomies to analyse the differences in technique between grades of obstetricians and midwives.
Prenatal diagnosis of Ectrodactyly–Ectodermal dysplasia–Cleft (EEC) syndrome in a Chinese woman with a TP63 mutation Ectrodactyly–Ectodermal dysplasia–Cleft (EEC) syndrome is a very rare orthopaedic malformation. The affected limb, split hand/split foot, is also called lobster claw hand/foot as there is a median cleft in upper and lower limbs because of the absence of central digital rays, giving the affected limbs the appearance of lobster claws. The only proven mutations known to underlie EEC in humans have been found in the TP63 gene . Clinical variability exists in subjects with different TP63 mutations, even in patients in the same family.
Prenatal diagnosis of trisomy 20 mosaicism associated with hypoplastic nasal bone as a single sonographic marker A 28-year-old woman (gravida 0, para 0) presented at 20+4 weeks of gestation for the second trimester analytical scan. The medical history was insignificant and we note that the first trimester ultrasound examination was missed. An absent nasal bone was the unique sonographic finding amniocentesis was performed (Fig. 1). Cytogenetic analysis included 3 independent cultures (Flask method) and 12/48 cells (25%) cells had an extra chromosome 20 (mos 47, XY, +20 /46, XY ). A-fetoprotein was 5.5μg/ml (0.66MoM).
How strong is the evidence for using blood biomarkers alone to screen for alcohol consumption during pregnancy? A systematic review Accurate and early identification of women at risk from alcohol consumption during pregnancy allows education and support programmes to be targeted at those most in need. We aimed to conduct a systematic review to compare the efficacy of blood analysis and maternal self-report in detecting at risk women during pregnancy. This review investigated diagnostic accuracy. We searched four databases (Medline, Embase, Psychinfo and CINAHL) for relevant articles and conducted hand searches of recent issues of key journals in the field.
Prognostic Factors for Niche Development in the Uterine Caesarean Section Scar In a prospective study on 134 women after their first cesarean section prognostic factors for developing an uterine niche (scar defect) measured with sonohysterography were evaluated. With multivariable logistic regression anlaysis the following prognostic factors were identified; enlarged cervical dilatation and induction of labour. Contractions before labour reduced the risk for niche development. The predictive value of the model made with this prognostic factors was low. The development of a niche is a multifactorial proces and more studies are needed.
The Second Victim: a Review Amongst the lay and media population there is a perception that pregnancy, labour and delivery is always physiological, morbidity and mortality should be “never events” and that error is the only cause of adverse events. Those working in maternity care know that it is an imperfect art, where adverse outcomes and errors will occur. When errors do occur, there is a domino effect with three groups being involved − the patient (first victim), the staff (second victims) and the organization (third victims).
Incidence of urinary tract injury and utility of routine cystoscopy during total laparoscopic hysterectomy for endometrial cancer Current literature reports indicate an incidence of 0.7–4.0% for urinary tract injuries during minimally-invasive hysterectomy [1–5]. However, there is limited information for urinary tract injuries for patients undergoing these procedures for cancer diagnoses. Given a paradigm shift towards minimally-invasive hysterectomy for endometrial cancer due to its benefits in decreased surgical morbidity, examining the utility of routine cystoscopy during total laparoscopic hysterectomy (TLH) is of utmost importance in the management of women with endometrial cancer.
Aviso para pacientes:
Esta página contiene información urológica dirigida a profesionales de la sanidad.
Si tiene algún problema relacionado con esta patología,
consulte con su urólogo o médico de familia.
Si desea información diseñada para pacientes y público general. puede visitar:
Portal de Información Urológica para Pacientes