M. Gorostidi, R. Ruiz, I. Jaunarena, P. Cobas, A. Lekuona, I. Díez
Introduction: Endometrial cancer (EC) is the most common gynecological cancer in developed countries. Histological grade (G) and myometrial invasion (MI) are important risk factors, and together with the histological type and other postoperative data establish the risk of lymph node involvement and guide the adjuvant treatments. The objective of this study was to assess the validity of a preoperative stratification model that combines preoperative histological grade and MI as identified by magnetic resonance imaging (MRI) to select candidates for lymph node staging and optimize surgical planning for our patients. Material and methods: It´s an observational retrospective cohort study including 294 patients diagnosed with EC at Donostia University Hospital from January 2012 to December 2017. Preoperative endometrial biopsy, including histological type and grade, preoperative MRI was compared with the definitive histological diagnosis. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the MRI-based diagnosis were calculated. Results: After inclusion and exclusion criteria 242 cases of type I or II EC were analyzed. Our model was found to have a Se of 91.4% (95% CI 83.2-95.8) and a Sp of 90.7% (95% CI 85.2-94.3). Percentage of down staging was 6.2% (15 unnecessary lymphadenectomies) and the upstaging rate was 2.9%. The NPV of the model was very high (95.4%, 95% CI 90.9-97.8). The diagnostic odds ratio for our model was 147.95 (95% CI 52.9-410.5), with a diagnostic accuracy of 91.7% (95% 87.6-94.6). Conclusions: A preoperative strategy that includes the determination of the tumor grade based on an endometrial biopsy and an assessment of MI by MRI is of great help in pre-surgical planning for endometrial cancer surgery, allowing an extra peritoneal approach and optimizing the use of physical and human resources. MRI presents excellent discriminatory power in the detection of MI in EC, with no significant variation by pathological subtype.
子宫内膜癌(EC)是发达国家最常见的妇科癌症。组织学分级(G)和肌层浸润(MI)是重要的危险因素，与组织学分型及术后其他资料共同确定淋巴结累及的风险，指导辅助治疗。本研究的目的是评估术前分层模型的有效性，该模型结合了磁共振成像(MRI)识别的术前组织学分级和心肌梗死，以选择淋巴结分期候选人并优化患者的手术计划。材料和方法:这是一项观察性回顾性队列研究，包括2012年1月至2017年12月在多诺斯蒂亚大学医院诊断为EC的294例患者。术前子宫内膜活检，包括组织学类型和分级，术前MRI与明确的组织学诊断进行比较。计算mri诊断的敏感性(Sn)、特异性(Sp)、阳性预测值(PPV)和阴性预测值(NPV)。结果:根据纳入和排除标准，分析了242例I型或II型EC。我们的模型Se为91.4% (95% CI 83.2-95.8)， Sp为90.7% (95% CI 85.2-94.3)。低分期率为6.2%(非必要淋巴结切除15例)，高分期率为2.9%。该模型的NPV非常高(95.4%，95% CI 90.9 ~ 97.8)。我们模型的诊断优势比为147.95 (95% CI 52.9-410.5)，诊断准确率为91.7%(95% 87.6-94.6)。结论:术前策略包括根据子宫内膜活检确定肿瘤分级和通过MRI评估心肌梗死，这对子宫内膜癌手术的术前计划有很大帮助，允许腹膜外入路并优化物理和人力资源的使用。MRI对EC中心肌梗死的鉴别能力较好，病理亚型差异不显著。
{"title":"Preoperative predictive model of surgical planning in endometrial carcinoma using MRI and tumor grade in endometrial biopsy","authors":"M. Gorostidi, R. Ruiz, I. Jaunarena, P. Cobas, A. Lekuona, I. Díez","doi":"10.31579/2578-8965/065","DOIUrl":"https://doi.org/10.31579/2578-8965/065","url":null,"abstract":"Introduction: Endometrial cancer (EC) is the most common gynecological cancer in developed countries. Histological grade (G) and myometrial invasion (MI) are important risk factors, and together with the histological type and other postoperative data establish the risk of lymph node involvement and guide the adjuvant treatments. The objective of this study was to assess the validity of a preoperative stratification model that combines preoperative histological grade and MI as identified by magnetic resonance imaging (MRI) to select candidates for lymph node staging and optimize surgical planning for our patients. Material and methods: It´s an observational retrospective cohort study including 294 patients diagnosed with EC at Donostia University Hospital from January 2012 to December 2017. Preoperative endometrial biopsy, including histological type and grade, preoperative MRI was compared with the definitive histological diagnosis. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the MRI-based diagnosis were calculated. Results: After inclusion and exclusion criteria 242 cases of type I or II EC were analyzed. Our model was found to have a Se of 91.4% (95% CI 83.2-95.8) and a Sp of 90.7% (95% CI 85.2-94.3). Percentage of down staging was 6.2% (15 unnecessary lymphadenectomies) and the upstaging rate was 2.9%. The NPV of the model was very high (95.4%, 95% CI 90.9-97.8). The diagnostic odds ratio for our model was 147.95 (95% CI 52.9-410.5), with a diagnostic accuracy of 91.7% (95% 87.6-94.6). Conclusions: A preoperative strategy that includes the determination of the tumor grade based on an endometrial biopsy and an assessment of MI by MRI is of great help in pre-surgical planning for endometrial cancer surgery, allowing an extra peritoneal approach and optimizing the use of physical and human resources. MRI presents excellent discriminatory power in the detection of MI in EC, with no significant variation by pathological subtype.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86745940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The human placenta once was thrown after the delivery, found to be a very useful organ though it has very short life. With more and new research the old concept about placenta has changed. Now it is well established that health of growing embryo depends on the health of the placenta. To begin with immunology of neonate also depends on transplacental transport. It is well established that the health of the growing embryo depends on the health of the transplacental transport. Normally, IgG can be transported through placenta however, in Covid-19 infected pregnant woman even IgM, which is much bigger molecule than IgG, can also be transported and are found in the embryo.
{"title":"The Immuno-Pathology of the Human Placenta","authors":"P. D. Gupta, Alpana Gupta","doi":"10.31579/2578-8965/0060","DOIUrl":"https://doi.org/10.31579/2578-8965/0060","url":null,"abstract":"The human placenta once was thrown after the delivery, found to be a very useful organ though it has very short life. With more and new research the old concept about placenta has changed. Now it is well established that health of growing embryo depends on the health of the placenta. To begin with immunology of neonate also depends on transplacental transport. It is well established that the health of the growing embryo depends on the health of the transplacental transport. Normally, IgG can be transported through placenta however, in Covid-19 infected pregnant woman even IgM, which is much bigger molecule than IgG, can also be transported and are found in the embryo.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"289 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83141568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meigs’ syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. Other benign cysts of the ovary (such as struma ovarii, mucinous cystadenoma, serous cystadenoma and teratomas), leiomyoma of the uterus, and secondary metastatic tumours to ovary if associated with hydro thorax and ascites are referred to as ‘Pseudo‐Meigs” syndrome. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy or tuberculosis. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented an 18 years old girl with giant ovarian serous cystadenoma with associated pseudo-meigs syndrome, successfully managed in a low resources setting.
{"title":"A Rare Case of Giant Ovarian Serous Cystadenoma presenting as Psuedo-Meigs Syndrome","authors":"Richmond Ronald Gomes","doi":"10.31579/2578-8965/056","DOIUrl":"https://doi.org/10.31579/2578-8965/056","url":null,"abstract":"Meigs’ syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. Other benign cysts of the ovary (such as struma ovarii, mucinous cystadenoma, serous cystadenoma and teratomas), leiomyoma of the uterus, and secondary metastatic tumours to ovary if associated with hydro thorax and ascites are referred to as ‘Pseudo‐Meigs” syndrome. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy or tuberculosis. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented an 18 years old girl with giant ovarian serous cystadenoma with associated pseudo-meigs syndrome, successfully managed in a low resources setting.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"160 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85361281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: Overuse of cesarean section and its implications are of growing concern. Suspected fetal distress has been the commonest indication for cesarean in last few decades heart rate changes shown by fetus without being adversely affected and CTG has been criticized to create unnecessary higher rate of operative deliveries. There is need to know which fetal heart rate abnormality is important and leading to two adverse neonatal outcome to decrease unnecessary operative deliveries. Therefore Caesarean Audit was planned. Material and methods: A total of hundred women were included who underwent emergency cesarean section for suspected fetal distress in labour or without labour detected by cardiotocography or intermittent auscultation were included for analysis. Details were noted in pre designated proforma. Results: During the audit period, total number of caesarean done due to fetal distress analysed during the period were 100.The most common fetal heart rate abnormality was nonspecific in form of single or transient deceleration seen in 63% of cases where records were also incomplete, it was followed by persistent deceleration on cardiotocography which was present in 16% of the cases. In 57 women who were primigravida 14 (24%) patients had nonspecific fetal heart rate patterns and intra operative findings were normal in this group. These were avoidable cesareans. Various Intraoperative findings, observed ,maximum no. of cases had meconium stained liquor seen in 63% of the cases followed by abruption in 9 cases followed by other findings like loop of cord around the neck of foetus, thin scar or scar dehiscence . Maternal resuscitation was carried out only in 53% of cases. Detection delivery interval of less than 30 minutes was present in 4% of cases. In fetal outcomes 16% of babies diagnosed with fetal distress, had poor outcome where Apgar score < 7 and 12 babies had asphyxia related NICU admission. 82% of babies had absolutely normal fetal outcome among which majority (78%) did not require any form resuscitation. which were thus avoidable cases. Conclusions: Correct Knowledge about Standardized fetal heart rate interpretations on CTG and there standardized management protocols like Maternal resuscitative measures ,follow up to ensure fast detection delivery interval should be practiced strictly in all cases of non reassuring Fetal Heart rate patterns. There should be consistent efforts in reducing the rate of cesarean sections particularly primary cesarean deliveries and in order to understand the degree to which cesarean delivery is preventable it is important to know no why cesareans are being performed. Therefore caesarean audit is need of the hour
{"title":"Cesarean Audit for fetal distress- A indispensable tool to reduce Obstetrician Distress","authors":"Anuradha Singh","doi":"10.31579/2578-8965/058","DOIUrl":"https://doi.org/10.31579/2578-8965/058","url":null,"abstract":"Background and Objectives: Overuse of cesarean section and its implications are of growing concern. Suspected fetal distress has been the commonest indication for cesarean in last few decades heart rate changes shown by fetus without being adversely affected and CTG has been criticized to create unnecessary higher rate of operative deliveries. There is need to know which fetal heart rate abnormality is important and leading to two adverse neonatal outcome to decrease unnecessary operative deliveries. Therefore Caesarean Audit was planned. Material and methods: A total of hundred women were included who underwent emergency cesarean section for suspected fetal distress in labour or without labour detected by cardiotocography or intermittent auscultation were included for analysis. Details were noted in pre designated proforma. Results: During the audit period, total number of caesarean done due to fetal distress analysed during the period were 100.The most common fetal heart rate abnormality was nonspecific in form of single or transient deceleration seen in 63% of cases where records were also incomplete, it was followed by persistent deceleration on cardiotocography which was present in 16% of the cases. In 57 women who were primigravida 14 (24%) patients had nonspecific fetal heart rate patterns and intra operative findings were normal in this group. These were avoidable cesareans. Various Intraoperative findings, observed ,maximum no. of cases had meconium stained liquor seen in 63% of the cases followed by abruption in 9 cases followed by other findings like loop of cord around the neck of foetus, thin scar or scar dehiscence . Maternal resuscitation was carried out only in 53% of cases. Detection delivery interval of less than 30 minutes was present in 4% of cases. In fetal outcomes 16% of babies diagnosed with fetal distress, had poor outcome where Apgar score < 7 and 12 babies had asphyxia related NICU admission. 82% of babies had absolutely normal fetal outcome among which majority (78%) did not require any form resuscitation. which were thus avoidable cases. Conclusions: Correct Knowledge about Standardized fetal heart rate interpretations on CTG and there standardized management protocols like Maternal resuscitative measures ,follow up to ensure fast detection delivery interval should be practiced strictly in all cases of non reassuring Fetal Heart rate patterns. There should be consistent efforts in reducing the rate of cesarean sections particularly primary cesarean deliveries and in order to understand the degree to which cesarean delivery is preventable it is important to know no why cesareans are being performed. Therefore caesarean audit is need of the hour","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78753147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanan Elzeblawy Hassan, Ragaa Mohammed, S. Ramadan, Hagar Masaud
Background: Sexuality is an important part of normal human functioning. Gynecological cancer and its treatments can affect one or more phases of the sexual response cycle, through alterations of sexual function. Sexual dysfunction is one of the most distressful symptoms among cervical cancer survivors. Sexual distress is a broad term encompassing any sexual discomfort and dysfunction. Sexual difficulties following cervical cancer can be stressful for couples as it can feel like a core part of the relationship has disappeared. Aim: The study is conducted to evaluate the impact of an educational program on sexual issues (sexual dysfunction & sexual distress) among cervical cancer survivors' women in Northern Upper Egypt. Methods; Design: A quasi-experimental design. Setting: out-patient clinic in the oncology unit at Beni-Suef University Hospital. Subjects: A purposive sample of 70 women. Tools: structured interviewing questionnaire sheet, female sexual function index, and female sexual distress scale. Results: The results of the study revealed regression of all items of women’s sexual distress scores, and progression of all items of women’s sexual items post-program compared to pre-one. Conclusion: The teaching program was very effective in improving sexuality among cervical cancer survivors' women. Recommendations: Disseminate the educational booklet at health centers and oncology outpatients. Integrate psychologist, psychosexual specialist, and social worker in treatment and counseling program for women with cervical cancer in the early stage of their treatment.
{"title":"Impact of an Educational Program on Sexual Issues among Cervical Cancer Survivors' Women in Northern Upper Egypt","authors":"Hanan Elzeblawy Hassan, Ragaa Mohammed, S. Ramadan, Hagar Masaud","doi":"10.31579/2578-8965/095","DOIUrl":"https://doi.org/10.31579/2578-8965/095","url":null,"abstract":"Background: Sexuality is an important part of normal human functioning. Gynecological cancer and its treatments can affect one or more phases of the sexual response cycle, through alterations of sexual function. Sexual dysfunction is one of the most distressful symptoms among cervical cancer survivors. Sexual distress is a broad term encompassing any sexual discomfort and dysfunction. Sexual difficulties following cervical cancer can be stressful for couples as it can feel like a core part of the relationship has disappeared. Aim: The study is conducted to evaluate the impact of an educational program on sexual issues (sexual dysfunction & sexual distress) among cervical cancer survivors' women in Northern Upper Egypt. Methods; Design: A quasi-experimental design. Setting: out-patient clinic in the oncology unit at Beni-Suef University Hospital. Subjects: A purposive sample of 70 women. Tools: structured interviewing questionnaire sheet, female sexual function index, and female sexual distress scale. Results: The results of the study revealed regression of all items of women’s sexual distress scores, and progression of all items of women’s sexual items post-program compared to pre-one. Conclusion: The teaching program was very effective in improving sexuality among cervical cancer survivors' women. Recommendations: Disseminate the educational booklet at health centers and oncology outpatients. Integrate psychologist, psychosexual specialist, and social worker in treatment and counseling program for women with cervical cancer in the early stage of their treatment.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90964991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gender is neither male nor female, but rather maleness or femaleness. We all lie on a spectrum. An equation for gender has been devised.
性别既不是男性也不是女性，而是男性或女性。我们都生活在一个光谱上。人们设计了一个性别等式。
{"title":"Gender Spectrum: Homosexuality, & Gender Dysphoria","authors":"Paul T E Cusack","doi":"10.31579/2578-8965/055","DOIUrl":"https://doi.org/10.31579/2578-8965/055","url":null,"abstract":"Gender is neither male nor female, but rather maleness or femaleness. We all lie on a spectrum. An equation for gender has been devised.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80236328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian fibroma is one of the rarest solid tumor of the ovary. When it is associated to ascites and to a pleural effusion it realized the rare entity known as Demons Meigs’ syndrome. The diagnosis of this type of tumors is often difficult and it is usually diagnosed through histopathological examination. A malignant tumor must be eliminated especially when it’s associated to an elevated CA 125 serum level. It is confirmed by histopathological examination of surgical specimen. Surgery is the unique treatment of this syndrome by removing the ovarian fibroma (cystectomy) in young women or by salpingo oophorectomy in old one. The resolution of peritoneal and pleural effusion after tumors removing without recurrence confirmed the diagnosis of Meigs syndrome. We report a case of Meigs’syndrome in post-menopausal woman revealed by bilateral ovarian fibroma associated to elevated CA125 serum level mimicked an ovarian malignancy process.
{"title":"Meigs syndrome revealed by bilateral ovarian fibroma in postmenopausal woman","authors":"F. Mangoub","doi":"10.31579/2578-8965/050","DOIUrl":"https://doi.org/10.31579/2578-8965/050","url":null,"abstract":"Ovarian fibroma is one of the rarest solid tumor of the ovary. When it is associated to ascites and to a pleural effusion it realized the rare entity known as Demons Meigs’ syndrome. The diagnosis of this type of tumors is often difficult and it is usually diagnosed through histopathological examination. A malignant tumor must be eliminated especially when it’s associated to an elevated CA 125 serum level. It is confirmed by histopathological examination of surgical specimen. Surgery is the unique treatment of this syndrome by removing the ovarian fibroma (cystectomy) in young women or by salpingo oophorectomy in old one. The resolution of peritoneal and pleural effusion after tumors removing without recurrence confirmed the diagnosis of Meigs syndrome. We report a case of Meigs’syndrome in post-menopausal woman revealed by bilateral ovarian fibroma associated to elevated CA125 serum level mimicked an ovarian malignancy process.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82110709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
FDA approval of CDK4 / 6 inhibitors (Palbociclib, Ribociclib and Abemaciclib) for metastatic and advanced breast cancer, in combination or not with Fulvestrant or Letrozole, has improved the prognosis of this type of patient population. Palliative radiotherapy with antalgic purpose in most of the cases is often part of the multidisciplinary treatment of bone involvement metastatic breast cancer. In the context of the approval of these innovative therapies and of the development of radiotherapy techniques, including stereotactic radiosurgery, it is necessary to identify the best therapeutic sequence and parameters (dose, volume, fraction size) to obtain a synergistic effect. Considering the toxicity profiles of new therapies (especially lymphopenia and neutropenia) and the different mechanisms of the induction of these toxicities towards radiotherapy and chemotherapy, it is also necessary to demonstrate the safety profile of concomitant or sequential irradiation with the administration of CDK4 / 6 inhibitors in combination with radiation therapy.
{"title":"New therapeutic challenges in metastatic breast cancer: the association of CDK4 / 6 inhibitors with radiotherapy. A short review","authors":"Tudor Calistru","doi":"10.31579/2578-8965/054","DOIUrl":"https://doi.org/10.31579/2578-8965/054","url":null,"abstract":"FDA approval of CDK4 / 6 inhibitors (Palbociclib, Ribociclib and Abemaciclib) for metastatic and advanced breast cancer, in combination or not with Fulvestrant or Letrozole, has improved the prognosis of this type of patient population. Palliative radiotherapy with antalgic purpose in most of the cases is often part of the multidisciplinary treatment of bone involvement metastatic breast cancer. In the context of the approval of these innovative therapies and of the development of radiotherapy techniques, including stereotactic radiosurgery, it is necessary to identify the best therapeutic sequence and parameters (dose, volume, fraction size) to obtain a synergistic effect. Considering the toxicity profiles of new therapies (especially lymphopenia and neutropenia) and the different mechanisms of the induction of these toxicities towards radiotherapy and chemotherapy, it is also necessary to demonstrate the safety profile of concomitant or sequential irradiation with the administration of CDK4 / 6 inhibitors in combination with radiation therapy.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82812246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One of the leading mechanisms for the development of severe preeclampsia in pregnant women is a decrease in perfusion pressure in the life-supporting organs, followed by the development of multiple organ failure. In recent years, there have been studies indicating the influence of intraperitoneal hypertension on the perfusion pressure of the pelvic and abdominal organs with the subsequent development of obstetric complications [ 4,2] according to the classification of JAN(2006), pregnancy is included in the list of conditions accompanied by an increase in intraperitoneal pressure. Thus, the prevention and treatment of increased intra-abdominal pressure in pathology accompanied by multiple organ dysfunction and insufficiency, which is observed in preeclampsia, is one of the important problems of modern medicine. The purpose of our study was to determine the feasibility of abdominal drainage during operative delivery for severe preeclampsia.
{"title":"Expediency of abdominal drainage after operative delivery in severe preeclampsia","authors":"V. A. Kramarsky, Protopopova N. V.","doi":"10.31579/2578-8965/052","DOIUrl":"https://doi.org/10.31579/2578-8965/052","url":null,"abstract":"One of the leading mechanisms for the development of severe preeclampsia in pregnant women is a decrease in perfusion pressure in the life-supporting organs, followed by the development of multiple organ failure. In recent years, there have been studies indicating the influence of intraperitoneal hypertension on the perfusion pressure of the pelvic and abdominal organs with the subsequent development of obstetric complications [ 4,2] according to the classification of JAN(2006), pregnancy is included in the list of conditions accompanied by an increase in intraperitoneal pressure. Thus, the prevention and treatment of increased intra-abdominal pressure in pathology accompanied by multiple organ dysfunction and insufficiency, which is observed in preeclampsia, is one of the important problems of modern medicine. The purpose of our study was to determine the feasibility of abdominal drainage during operative delivery for severe preeclampsia.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89936255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adolescence is the process that occurs after childhood and before adulthood (15-19) years. Teenage pregnancy is adverse for the mother and her child including low birth weight and high perinatal mortality. Complications between pregnancy and childbirth are the second leading cause of death among girls between the ages of 15 and 19 in the world. Violence against a pregnant woman by her partner is frequent. Adolescent mothers are among the greatest abusers of their children, and abuse can start from fetal life. They are also involved in the death of their newborns. Educational and community empowerment with a family response to educational proposals includes the issue of masculinity and the role of adolescents caring for their children, as well as examining the families' pleasure in the prevention and response to pregnancy.
{"title":"Adolescent Mother and Child Abuse","authors":"Miguel Oliveros Donohue","doi":"10.31579/2578-8965/051","DOIUrl":"https://doi.org/10.31579/2578-8965/051","url":null,"abstract":"Adolescence is the process that occurs after childhood and before adulthood (15-19) years. Teenage pregnancy is adverse for the mother and her child including low birth weight and high perinatal mortality. Complications between pregnancy and childbirth are the second leading cause of death among girls between the ages of 15 and 19 in the world. Violence against a pregnant woman by her partner is frequent. Adolescent mothers are among the greatest abusers of their children, and abuse can start from fetal life. They are also involved in the death of their newborns. Educational and community empowerment with a family response to educational proposals includes the issue of masculinity and the role of adolescents caring for their children, as well as examining the families' pleasure in the prevention and response to pregnancy.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"484 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89761002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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