Pub Date : 2024-01-01Epub Date: 2024-02-17DOI: 10.1159/000537836
Tünde Herman, Péter Török, Antonio Simone Laganà, Vito Chiantera, Renato Venezia, Attila Jakab
<p><strong>Objective: </strong>The objective of this study was to analyze the impact of thyroid autoimmunity (TAI) on reproductive outcome parameters of intracytoplasmic sperm injection (ICSI) cycles as compared to TAI-negative ICSI cycles.</p><p><strong>Design: </strong>In this single in vitro fertilization (IVF) center retrospective study, 86 infertile women with elevated thyroid peroxidase or TGAb levels, but euthyroid after thyroxine replacement (study group), were compared to 69 female patients with no thyroid abnormalities (controls). Following ICSI treatment fertilization rate (FR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR) were analyzed.</p><p><strong>Materials, setting, methods: </strong>All subjects with various infertility factors were treated with ICSI in university-based IVF center. Patients in the study group received thyroxine replacement and were euthyroid at IVF treatment. Before the IVF cycles, endocrinological parameters were uniformly assessed: thyroid function and antibodies, reproductive hormones (anti-Müllerian hormone [AMH], follicular stimulating hormone [FSH], luteinizing hormone, E2, PRL, testosterone, DHEAS, 17-OHP, AD) and OGTT (0-60-120 min glucose and insulin). Following descriptive comparison of laboratory parameters, age-adjusted analyses of FR, CPR, MR, and LBR were performed.</p><p><strong>Results: </strong>TAI-positive women were older (mean age 35.31 ± 4.95 vs. 32.15 ± 4.87 years; p = 0.002), had higher FSH (8.4 ± 3.4 vs. 7.4 ± 2.32 U/L; p = 0.024), higher E2 (53.94 ± 47.61 vs. 42.93 ± 18.92 pg/mL; p = 0.025) levels, while AMH (2.88 ± 2.62 vs. 3.61 ± 1.69 ng/mL; p = 0.0002) was lower. There were no differences in TSH levels (1.64 ± 0.96 vs. 1.66 ± 0.65 µIU/mL; p = 0.652) between the two groups. FT3 (2.63 ± 0.58 vs. 2.98 ± 0.55 pg/mL; p = 0.002) was lower and FT4 (1.3 ± 0.29 vs. 1.13 ± 0.21 ng/dL; p = 0.0002) was higher in the TAI-positive group, reflecting clinically irrelevant differences. Egg cell counts (6 ± 3.8 vs. 7.5 ± 3.95; p = 0.015) were lower in TAI and remained so following age adjustment. Although the overall ICSI FR did not differ (62.9% vs. 69.1%, p = 0.12), it was lower for patients under 35 with TAI showing decreasing differences in line with age. The CPR (36.04% vs. 69.56%; p < 0.001) and LBR (23.25% vs. 60.86%; p < 0.001) were lower, the MR (35.48% vs. 12.5%; p = 0.024) was higher in the TAI group, and these differences remained after age adjustment.</p><p><strong>Limitations: </strong>Since the higher age of the study group may interfere with the effect of TAI, age adjustment calculations were necessary to perform to eliminate this confounding factor.</p><p><strong>Conclusion: </strong>Despite optimal thyroid supplementation in clinical or subclinical hypothyroidism, the presence of TAI negatively influences CPR and is connected to a higher MR, thus resulting in a lower LBR after ICSI. Decreased FR with ICSI in TAI patients may also contribute to p
目的与TAI阴性的ICSI周期相比，分析甲状腺自身免疫（TAI）对ICSI周期生殖结果参数的影响：在这项单一试管婴儿中心的回顾性研究中，86名TPOAb或TGAb水平升高但甲状腺素替代后甲状腺功能正常的不孕女性（研究组）与69名无甲状腺异常的女性患者（对照组）进行了比较。对ICSI治疗后的受精率（FR）、临床妊娠率（CPR）、流产率（MR）和活产率（LBR）进行分析：所有具有各种不孕症因素的受试者均在大学试管婴儿中心接受了卵胞浆内单精子显微注射治疗。研究组中的患者在接受体外受精治疗时接受了甲状腺素替代治疗，并保持健康。在试管婴儿周期前，对内分泌参数进行了统一评估：甲状腺功能和抗体、生殖激素（AMH、FSH、LH、E2、PRL、睾酮、DHEAS、17-OHP、AD）和 OGTT（0-60-120 分钟葡萄糖和胰岛素）。在对实验室参数进行描述性比较后，对 FR、CPR、MR 和 LBR 进行了年龄调整分析：结果：TAI 阳性女性年龄更大（平均年龄为 35.31±4.95 岁 vs. 32.15±4.87 岁；P=0.002），FSH 更高（8.4±3.4 vs. 7.4±2.32 U/L；P=0.024），E2（53.94±47.61 vs. 42.93±18.92 pg/ml；p=0.025）水平较高，而AMH（2.88±2.62 vs. 3.61±1.69 ng/ml；p=0.0002）较低。两组的促甲状腺激素水平（1.64±0.96 vs. 1.66±0.65 uIU/ml；P=0.652）无差异。TAI阳性组的FT3（2.63±0.58 vs. 2.98±0.55 pg/ml；p=0.002）较低，FT4（1.3±0.29 vs. 1.13±0.21 ng/dl；p=0.0002）较高，反映了临床上无意义的差异。TAI阳性组的卵细胞计数（6±3.8 vs. 7.5±3.95；p=0.015）较低，经年龄调整后仍然如此。尽管ICSI FR的总体水平没有差异（62.9% vs. 69.1%，p=0.12），但35岁以下患者的ICSI FR较低，而TAI的差异随着年龄的增长而减小。CPR（36.04% vs. 69.56%；P=0.12）：由于研究组的年龄较高，可能会干扰TAI的效果，因此有必要进行年龄调整计算，以消除这一干扰因素：结论：尽管临床或亚临床甲状腺功能减退症患者接受了最佳的甲状腺补充治疗，但TAI的存在会对临床妊娠率产生负面影响，并与较高的流产率有关，从而导致ICSI后的活产率降低。TAI患者ICSI受精率的降低也可能导致较差的结果，尤其是对年轻女性而言。
{"title":"Hashimoto's Thyroiditis Negatively Influences Intracytoplasmic Sperm Injection Outcome in Euthyroid Women on T4 Substitution Therapy: A Retrospective Study.","authors":"Tünde Herman, Péter Török, Antonio Simone Laganà, Vito Chiantera, Renato Venezia, Attila Jakab","doi":"10.1159/000537836","DOIUrl":"10.1159/000537836","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to analyze the impact of thyroid autoimmunity (TAI) on reproductive outcome parameters of intracytoplasmic sperm injection (ICSI) cycles as compared to TAI-negative ICSI cycles.</p><p><strong>Design: </strong>In this single in vitro fertilization (IVF) center retrospective study, 86 infertile women with elevated thyroid peroxidase or TGAb levels, but euthyroid after thyroxine replacement (study group), were compared to 69 female patients with no thyroid abnormalities (controls). Following ICSI treatment fertilization rate (FR), clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR) were analyzed.</p><p><strong>Materials, setting, methods: </strong>All subjects with various infertility factors were treated with ICSI in university-based IVF center. Patients in the study group received thyroxine replacement and were euthyroid at IVF treatment. Before the IVF cycles, endocrinological parameters were uniformly assessed: thyroid function and antibodies, reproductive hormones (anti-Müllerian hormone [AMH], follicular stimulating hormone [FSH], luteinizing hormone, E2, PRL, testosterone, DHEAS, 17-OHP, AD) and OGTT (0-60-120 min glucose and insulin). Following descriptive comparison of laboratory parameters, age-adjusted analyses of FR, CPR, MR, and LBR were performed.</p><p><strong>Results: </strong>TAI-positive women were older (mean age 35.31 ± 4.95 vs. 32.15 ± 4.87 years; p = 0.002), had higher FSH (8.4 ± 3.4 vs. 7.4 ± 2.32 U/L; p = 0.024), higher E2 (53.94 ± 47.61 vs. 42.93 ± 18.92 pg/mL; p = 0.025) levels, while AMH (2.88 ± 2.62 vs. 3.61 ± 1.69 ng/mL; p = 0.0002) was lower. There were no differences in TSH levels (1.64 ± 0.96 vs. 1.66 ± 0.65 µIU/mL; p = 0.652) between the two groups. FT3 (2.63 ± 0.58 vs. 2.98 ± 0.55 pg/mL; p = 0.002) was lower and FT4 (1.3 ± 0.29 vs. 1.13 ± 0.21 ng/dL; p = 0.0002) was higher in the TAI-positive group, reflecting clinically irrelevant differences. Egg cell counts (6 ± 3.8 vs. 7.5 ± 3.95; p = 0.015) were lower in TAI and remained so following age adjustment. Although the overall ICSI FR did not differ (62.9% vs. 69.1%, p = 0.12), it was lower for patients under 35 with TAI showing decreasing differences in line with age. The CPR (36.04% vs. 69.56%; p < 0.001) and LBR (23.25% vs. 60.86%; p < 0.001) were lower, the MR (35.48% vs. 12.5%; p = 0.024) was higher in the TAI group, and these differences remained after age adjustment.</p><p><strong>Limitations: </strong>Since the higher age of the study group may interfere with the effect of TAI, age adjustment calculations were necessary to perform to eliminate this confounding factor.</p><p><strong>Conclusion: </strong>Despite optimal thyroid supplementation in clinical or subclinical hypothyroidism, the presence of TAI negatively influences CPR and is connected to a higher MR, thus resulting in a lower LBR after ICSI. Decreased FR with ICSI in TAI patients may also contribute to p","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"150-158"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-23DOI: 10.1159/000535592
Barbara Gardella, Mattia Dominoni, Marianna Francesca Pasquali, Manuel Gotti, Sara Fraticelli, Marco Lucioni, Stefania Cesari, Giacomo Fiandrino, Annalisa De Silvestri, Caterina Zerbi, Tanja Lazic, Luca Arcaini, Marco Paulli, Arsenio Spinillo
<p><strong>Objective: </strong>Human papillomavirus (HPV) persistence is considered the main risk factor for neoplastic progression, and evidence suggests that regulatory T cells play an important role in the failure of viral elimination. Regulatory T cells may be involved in maintaining a microenvironment favourable for viral persistence and neoplasticity, through a deregulation of the local immune response. The association between altered immune function and the development of chronic infections, cancer (solid and haematological), and autoimmune diseases is documented in the literature. The purpose of this retrospective analysis was to evaluate the possible correlation between HPV cervical infection and lymphoma incidence in women attending colposcopy due to an abnormal Pap smear during a period of 15 years.</p><p><strong>Design: </strong>This is a cross-sectional study.</p><p><strong>Participants: </strong>We investigated retrospectively the incidence of haematological diseases in women aged 21-84 with an abnormal Pap smear who referred to our centre between 2004 and 2019.</p><p><strong>Setting: </strong>This study was conducted at the university hospital.</p><p><strong>Methods: </strong>In our analysis, we included women with diagnoses of HL and NHL after the detection of abnormal Pap smears and HPV infections. We excluded patients with a diagnosis of lymphoma preceding the date of the abnormal Pap smear and HPV test.</p><p><strong>Results: </strong>We divided the patients into two groups in order to analyse the standard incidence ratio (SIR): HL patients (19/7,064, 0.26%) and NHL patients (22/7,064, 0.31%). In our sample, we reported a significant risk of developing lymphoma compared to the general population, both for HL and NHL disease, at age <45 years. Regarding HL, the SIR of disease in women <45 years was 4.886 (95% CI 2.775-9.6029) and in women between 45 and 59 years was 2.612 (95% CI 0.96-7.108804). On the other hand, for NHL in women <45 years, we reported an SIR of about 3.007 (95%, CI 1.273-7.101575), in women aged 45-59 years, the SIR was 4.291 (95% CI 2.444-7.534399), and in women aged 60-74 years, the SIR was 3.283 (95% CI 1.054-10.22303).</p><p><strong>Limitations: </strong>This retrospective analysis was conducted in a single centre in Northern Italy and did not consider all interregional differences existing in the country in terms of HPV genotypes, ethnicity, and population characteristics. Regarding the analysis of SIR for HL and NHL, we did not divide the disease into subtypes because of the small sample of cases. Finally, we considered in our analysis only women with an abnormal Pap smear and not the general population.</p><p><strong>Conclusions: </strong>Women with chronic and persistent HPV infections may have a higher relative risk of developing lymphoma. This possible association may be caused by the deregulation of the immune system response against HPV and the failure of viral clearance, especially in you
目的：人类乳头瘤病毒（HPV）的持续存在被认为是肿瘤进展的主要风险因素，有证据表明，调节性 T 细胞在病毒清除失败中扮演着重要角色。调节性 T 细胞可能通过对局部免疫反应的调节，参与维持有利于病毒持续存在和瘤形成的微环境。文献记载了免疫功能改变与慢性感染、癌症（实体肿瘤和血液肿瘤）以及自身免疫性疾病的发生之间的联系。这项回顾性分析的目的是评估 15 年间因巴氏涂片异常而接受阴道镜检查的妇女中 HPV 宫颈感染与淋巴瘤发病率之间可能存在的相关性：我们回顾性地调查了2004年至2019年期间因子宫颈抹片检查异常而到我们中心就诊的21-84岁女性中血液病的发病率：地点：大学医院在分析中，我们纳入了在检测到巴氏涂片异常和人乳头瘤病毒感染后诊断为HL和NHL的女性。我们排除了在巴氏涂片和人乳头瘤病毒检测异常日期之前诊断出淋巴瘤的患者。结果 为了分析标准发病率（SIR），我们将患者分为两组：HL 患者（19/7064，0.26%）和 NHL 患者（22/7064，0.31%）。在我们的样本中，与普通人群相比，年龄小于 45 岁的 HL 和 NHL 患者罹患淋巴瘤的风险较高。关于 HL，女性患病的 SIR
{"title":"Retrospective Investigation of Human Papillomavirus Cervical Infection and Lymphoma Incidence: A Clinical and Pathological Evaluation.","authors":"Barbara Gardella, Mattia Dominoni, Marianna Francesca Pasquali, Manuel Gotti, Sara Fraticelli, Marco Lucioni, Stefania Cesari, Giacomo Fiandrino, Annalisa De Silvestri, Caterina Zerbi, Tanja Lazic, Luca Arcaini, Marco Paulli, Arsenio Spinillo","doi":"10.1159/000535592","DOIUrl":"10.1159/000535592","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) persistence is considered the main risk factor for neoplastic progression, and evidence suggests that regulatory T cells play an important role in the failure of viral elimination. Regulatory T cells may be involved in maintaining a microenvironment favourable for viral persistence and neoplasticity, through a deregulation of the local immune response. The association between altered immune function and the development of chronic infections, cancer (solid and haematological), and autoimmune diseases is documented in the literature. The purpose of this retrospective analysis was to evaluate the possible correlation between HPV cervical infection and lymphoma incidence in women attending colposcopy due to an abnormal Pap smear during a period of 15 years.</p><p><strong>Design: </strong>This is a cross-sectional study.</p><p><strong>Participants: </strong>We investigated retrospectively the incidence of haematological diseases in women aged 21-84 with an abnormal Pap smear who referred to our centre between 2004 and 2019.</p><p><strong>Setting: </strong>This study was conducted at the university hospital.</p><p><strong>Methods: </strong>In our analysis, we included women with diagnoses of HL and NHL after the detection of abnormal Pap smears and HPV infections. We excluded patients with a diagnosis of lymphoma preceding the date of the abnormal Pap smear and HPV test.</p><p><strong>Results: </strong>We divided the patients into two groups in order to analyse the standard incidence ratio (SIR): HL patients (19/7,064, 0.26%) and NHL patients (22/7,064, 0.31%). In our sample, we reported a significant risk of developing lymphoma compared to the general population, both for HL and NHL disease, at age <45 years. Regarding HL, the SIR of disease in women <45 years was 4.886 (95% CI 2.775-9.6029) and in women between 45 and 59 years was 2.612 (95% CI 0.96-7.108804). On the other hand, for NHL in women <45 years, we reported an SIR of about 3.007 (95%, CI 1.273-7.101575), in women aged 45-59 years, the SIR was 4.291 (95% CI 2.444-7.534399), and in women aged 60-74 years, the SIR was 3.283 (95% CI 1.054-10.22303).</p><p><strong>Limitations: </strong>This retrospective analysis was conducted in a single centre in Northern Italy and did not consider all interregional differences existing in the country in terms of HPV genotypes, ethnicity, and population characteristics. Regarding the analysis of SIR for HL and NHL, we did not divide the disease into subtypes because of the small sample of cases. Finally, we considered in our analysis only women with an abnormal Pap smear and not the general population.</p><p><strong>Conclusions: </strong>Women with chronic and persistent HPV infections may have a higher relative risk of developing lymphoma. This possible association may be caused by the deregulation of the immune system response against HPV and the failure of viral clearance, especially in you","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"95-102"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-24DOI: 10.1159/000535835
Corrado Terranova, Lorenzo Schiavoni, Fernando Ficarola, Francesco Plotti, Carlo De Cicco Nardone, Roberto Montera, Michela Lotierzo, Martina Bartolone, Giuseppe Pascarella, Alessia Mattei, Fabio Costa, Felice Eugenio Agrò, Roberto Angioli
<p><strong>Objectives: </strong>The aim of the study was to compare, in patients undergoing minor gynecological laparoscopic procedures, the effects of ultrasound (US)-guided transversus abdominis plane (TAP) + rectus sheath (RS) block versus no TAP/RS block in terms of post-surgical pain control using the numeric pain rating scale (NRS) and the degree of patient satisfaction, according to the main goals of Early Recovery After Surgery (ERAS) programs. The primary outcome is to value the postoperative abdominal pain using NRS in both groups. Secondary outcomes are to evaluate blood values, presence of postoperative nausea and vomiting (PONV), postoperative ileus, level of patient expected satisfaction, time of discharge, length of stay (LOS), and the amounts of additional analgesics required.</p><p><strong>Design: </strong>In this prospective randomized controlled trial, patients were randomly assigned to loco-regional anesthesia (LRA) group, who received TAP and RS block under US guidance, or no loco-regional anesthesia (N-LRA) group. Enrolled patients were randomized 1:1 to either receive bilateral TAP/RS block with ropivacaine or sham treatment (patches were applied on the abdominal wall of the patients under general anesthesia).</p><p><strong>Participants: </strong>All patients aged between 18 and 75 years, with ASA (American Society of Anesthesiologists) physical status 1-2, undergoing laparoscopic minor gynecological surgery, were enrolled.</p><p><strong>Setting: </strong>The study was conducted to the University of Campus Bio-Medico Hospital of Rome.</p><p><strong>Methods: </strong>Half an hour before surgery, all patients received gabapentin 300 mg per os. Once the patient underwent general anesthesia, US-guided bilateral TAP/RS block was performed by the anesthesiology team, while the uterine manipulator was positioned by a gynecology resident (not involved in the study). In the operative room, all patients received the same standardized anesthetic regimen. Postoperative abdominal pain was assessed at rest, after palpation, during movement, and after a cough by evaluating the patient at 6, 12, 18, 24, 36, 48, and 72 h after surgery, using the NRS from 0 to 10 in both groups. The amount of drug used for analgesia in the first 48 h after surgery was recorded. Moreover, hemoglobin, white blood cells, and c-reactive protein levels were recorded at 24, 48, and 72 h. The presence of PONV and the postoperative ileus was recorded throughout convalescence. The expected level of patient satisfaction at discharge and finally the LOS were assessed.</p><p><strong>Limitations: </strong>The major weakness of this study is that 60 mL of 0.5% ropivacaine was administered to each patient, without considering weight differences, yet contemporary literature rarely suggests volume/dose titration in fascial blocks.</p><p><strong>Results: </strong>A total of 104 women, undergoing gynecological minor laparoscopic surgery, were enrolled and assigned to LRA group
{"title":"The Role of TAP/RS Block in Minor Gynecologic Laparoscopic Surgery: A Randomized Clinical Trial.","authors":"Corrado Terranova, Lorenzo Schiavoni, Fernando Ficarola, Francesco Plotti, Carlo De Cicco Nardone, Roberto Montera, Michela Lotierzo, Martina Bartolone, Giuseppe Pascarella, Alessia Mattei, Fabio Costa, Felice Eugenio Agrò, Roberto Angioli","doi":"10.1159/000535835","DOIUrl":"10.1159/000535835","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to compare, in patients undergoing minor gynecological laparoscopic procedures, the effects of ultrasound (US)-guided transversus abdominis plane (TAP) + rectus sheath (RS) block versus no TAP/RS block in terms of post-surgical pain control using the numeric pain rating scale (NRS) and the degree of patient satisfaction, according to the main goals of Early Recovery After Surgery (ERAS) programs. The primary outcome is to value the postoperative abdominal pain using NRS in both groups. Secondary outcomes are to evaluate blood values, presence of postoperative nausea and vomiting (PONV), postoperative ileus, level of patient expected satisfaction, time of discharge, length of stay (LOS), and the amounts of additional analgesics required.</p><p><strong>Design: </strong>In this prospective randomized controlled trial, patients were randomly assigned to loco-regional anesthesia (LRA) group, who received TAP and RS block under US guidance, or no loco-regional anesthesia (N-LRA) group. Enrolled patients were randomized 1:1 to either receive bilateral TAP/RS block with ropivacaine or sham treatment (patches were applied on the abdominal wall of the patients under general anesthesia).</p><p><strong>Participants: </strong>All patients aged between 18 and 75 years, with ASA (American Society of Anesthesiologists) physical status 1-2, undergoing laparoscopic minor gynecological surgery, were enrolled.</p><p><strong>Setting: </strong>The study was conducted to the University of Campus Bio-Medico Hospital of Rome.</p><p><strong>Methods: </strong>Half an hour before surgery, all patients received gabapentin 300 mg per os. Once the patient underwent general anesthesia, US-guided bilateral TAP/RS block was performed by the anesthesiology team, while the uterine manipulator was positioned by a gynecology resident (not involved in the study). In the operative room, all patients received the same standardized anesthetic regimen. Postoperative abdominal pain was assessed at rest, after palpation, during movement, and after a cough by evaluating the patient at 6, 12, 18, 24, 36, 48, and 72 h after surgery, using the NRS from 0 to 10 in both groups. The amount of drug used for analgesia in the first 48 h after surgery was recorded. Moreover, hemoglobin, white blood cells, and c-reactive protein levels were recorded at 24, 48, and 72 h. The presence of PONV and the postoperative ileus was recorded throughout convalescence. The expected level of patient satisfaction at discharge and finally the LOS were assessed.</p><p><strong>Limitations: </strong>The major weakness of this study is that 60 mL of 0.5% ropivacaine was administered to each patient, without considering weight differences, yet contemporary literature rarely suggests volume/dose titration in fascial blocks.</p><p><strong>Results: </strong>A total of 104 women, undergoing gynecological minor laparoscopic surgery, were enrolled and assigned to LRA group","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"103-110"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-02-19DOI: 10.1159/000536081
Simona Dinicola, Vittorio Unfer, Christophe O Soulage, Maria Isidora Margarita Yap-Garcia, Arturo Bevilacqua, Salvatore Benvenga, Daniele Barbaro, Artur Wdowiak, Maurizio Nordio, Didier Dewailly, Marialuisa Appetecchia, Cesare Aragona, Maria Salomè Bezerra Espinola, Mariano Bizzarri, Pietro Cavalli, Annamaria Colao, Rosario D'Anna, Mónica Hebe Vazquez-Levin, Imelda Hernàndez Marin, Zdravko Kamenov, Antonio Simone Laganà, Giovanni Monastra, Mario Montanino Oliva, Ali Cenk Özay, Basilio Pintaudi, Giuseppina Porcaro, Olga Pustotina, Lali Pkhaladze, Nikos Prapas, Scott Roseff, Saghar Salehpour, Annarita Stringaro, Marat Tugushev, Virginia Unfer, Ivana Vucenik, Fabio Facchinetti
Background: d-Chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders.
Objectives: This perspective seeks to explore the mechanisms and functions of d-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation.
Methods: A narrative review of all the relevant papers known to the authors was conducted.
Outcome: d-Chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue transdifferentiation. These different modes of action have potential applications in a variety of therapeutic fields, including PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health.
Conclusions: d-Chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between d-chiro-inositol and its isomer myo-inositol. The insulin-sensitizing activities of d-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.
{"title":"<sc>d</sc>-Chiro-Inositol in Clinical Practice: A Perspective from the Experts Group on Inositol in Basic and Clinical Research (EGOI).","authors":"Simona Dinicola, Vittorio Unfer, Christophe O Soulage, Maria Isidora Margarita Yap-Garcia, Arturo Bevilacqua, Salvatore Benvenga, Daniele Barbaro, Artur Wdowiak, Maurizio Nordio, Didier Dewailly, Marialuisa Appetecchia, Cesare Aragona, Maria Salomè Bezerra Espinola, Mariano Bizzarri, Pietro Cavalli, Annamaria Colao, Rosario D'Anna, Mónica Hebe Vazquez-Levin, Imelda Hernàndez Marin, Zdravko Kamenov, Antonio Simone Laganà, Giovanni Monastra, Mario Montanino Oliva, Ali Cenk Özay, Basilio Pintaudi, Giuseppina Porcaro, Olga Pustotina, Lali Pkhaladze, Nikos Prapas, Scott Roseff, Saghar Salehpour, Annarita Stringaro, Marat Tugushev, Virginia Unfer, Ivana Vucenik, Fabio Facchinetti","doi":"10.1159/000536081","DOIUrl":"10.1159/000536081","url":null,"abstract":"<p><strong>Background: </strong><sc>d</sc>-Chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders.</p><p><strong>Objectives: </strong>This perspective seeks to explore the mechanisms and functions of <sc>d</sc>-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation.</p><p><strong>Methods: </strong>A narrative review of all the relevant papers known to the authors was conducted.</p><p><strong>Outcome: </strong><sc>d</sc>-Chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue transdifferentiation. These different modes of action have potential applications in a variety of therapeutic fields, including PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health.</p><p><strong>Conclusions: </strong><sc>d</sc>-Chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between <sc>d</sc>-chiro-inositol and its isomer myo-inositol. The insulin-sensitizing activities of <sc>d</sc>-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"284-294"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-04-26DOI: 10.1159/000539107
Christianne Lok, Michael Seckl
{"title":"Guidelines and Multidisciplinary Care Are Essential to Improve Survival Rates and Quality of Life Globally for Women with Gestational Trophoblastic Disease.","authors":"Christianne Lok, Michael Seckl","doi":"10.1159/000539107","DOIUrl":"10.1159/000539107","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"163-165"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Our aim was to perform a systematic review and meta-analysis for the association of neck circumference (NC) in polycystic ovary syndrome (PCOS) patients as compared to non-PCOS controls.
Methods: Primarily the PubMed/MEDLINE database and others such as SCOPUS, Google Scholar, Cochrane Library, were searched up to November 15, 2023 for observational studies comparing NC in PCOS versus non-PCOS women. The mean and SD values of NC and other covariates in PCOS and control groups were extracted by two independent reviewers, and the quality and risk of bias assessment was done using Newcastle-Ottawa Scale. The meta-analysis employed combined standardized mean differences (SMD) with 95% confidence intervals (CI) to compare NC between PCOS patients and controls. The heterogeneity and validity were addressed by subgroup, meta-regression, and sensitivity analyses. We conducted a Bootstrapped meta-analysis using 1,000 and 10,000 simulations to test the accuracy of the obtained results. The certainty of evidence was assessed by the GRADE approach.
Results: Our meta-analysis included 9 observational studies. The PCOS patients showed significantly higher NC values than the non-PCOS controls (SMD: 0.66, 95% CI: 0.41-0.91, p < 0.0001). In the bootstrap meta-analysis, the accuracy of the observed findings was proved (SMD = 0.66, 95% CI = 0.42-0.91) for the NC outcome. No publication bias was detected in the funnel plot analysis using Begg's and Egger's tests. The 95% prediction interval of 0.036-1.28 suggests that the true outcomes of the studies are generally in the same direction as the estimated average outcome. The sensitivity analysis provided the robustness of the outcome, and no single study was overly influential on the pooled estimate.
Conclusion: This meta-analysis provides accurate evidence for significantly higher NC values in PCOS as compared to non-PCOS controls. There is no sufficient evidence on the diagnostic accuracy measures for NC in PCOS. Hence, further research on its diagnostic utility in PCOS is needed.
{"title":"Neck Circumference in Polycystic Ovary Syndrome: A Systematic Review and Bootstrapped Meta-Analysis with GRADE Approach.","authors":"Mona Lisa, Seshadri Reddy Varikasuvu, Subodh Kumar, Saurabh Varshney, Pratima Gupta, Ashoo Grover, Faustino R Pérez-López, Vanita Lal, Harminder Singh, Shiv Kumar Mudgal","doi":"10.1159/000538092","DOIUrl":"10.1159/000538092","url":null,"abstract":"<p><strong>Introduction: </strong>Our aim was to perform a systematic review and meta-analysis for the association of neck circumference (NC) in polycystic ovary syndrome (PCOS) patients as compared to non-PCOS controls.</p><p><strong>Methods: </strong>Primarily the PubMed/MEDLINE database and others such as SCOPUS, Google Scholar, Cochrane Library, were searched up to November 15, 2023 for observational studies comparing NC in PCOS versus non-PCOS women. The mean and SD values of NC and other covariates in PCOS and control groups were extracted by two independent reviewers, and the quality and risk of bias assessment was done using Newcastle-Ottawa Scale. The meta-analysis employed combined standardized mean differences (SMD) with 95% confidence intervals (CI) to compare NC between PCOS patients and controls. The heterogeneity and validity were addressed by subgroup, meta-regression, and sensitivity analyses. We conducted a Bootstrapped meta-analysis using 1,000 and 10,000 simulations to test the accuracy of the obtained results. The certainty of evidence was assessed by the GRADE approach.</p><p><strong>Results: </strong>Our meta-analysis included 9 observational studies. The PCOS patients showed significantly higher NC values than the non-PCOS controls (SMD: 0.66, 95% CI: 0.41-0.91, p < 0.0001). In the bootstrap meta-analysis, the accuracy of the observed findings was proved (SMD = 0.66, 95% CI = 0.42-0.91) for the NC outcome. No publication bias was detected in the funnel plot analysis using Begg's and Egger's tests. The 95% prediction interval of 0.036-1.28 suggests that the true outcomes of the studies are generally in the same direction as the estimated average outcome. The sensitivity analysis provided the robustness of the outcome, and no single study was overly influential on the pooled estimate.</p><p><strong>Conclusion: </strong>This meta-analysis provides accurate evidence for significantly higher NC values in PCOS as compared to non-PCOS controls. There is no sufficient evidence on the diagnostic accuracy measures for NC in PCOS. Hence, further research on its diagnostic utility in PCOS is needed.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"267-277"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel C. Martin, Nancy Petersen, Tamer Seckin, I. Orbuch, Martin L. Robbins, Horace Roman
{"title":"In Memory of David Redwine","authors":"Daniel C. Martin, Nancy Petersen, Tamer Seckin, I. Orbuch, Martin L. Robbins, Horace Roman","doi":"10.1159/000535107","DOIUrl":"https://doi.org/10.1159/000535107","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":"55 49","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Front & Back Matter","authors":"","doi":"10.1159/000531776","DOIUrl":"https://doi.org/10.1159/000531776","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46491936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Front & Back Matter","authors":"","doi":"10.1159/000530482","DOIUrl":"https://doi.org/10.1159/000530482","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48486390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Front & Back Matter","authors":"","doi":"10.1159/000530396","DOIUrl":"https://doi.org/10.1159/000530396","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44962813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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