Bacterial Vaginosis: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/028, June 2023).

Aim This official guideline was coordinated and published by the DGGG, OEGGG and SGGG with the involvement of additional professional societies. The aim of the guideline is to evaluate the relevant literature and use it to provide a consensus-based overview of the diagnosis and management of bacterial vaginosis. Methods This S2k-guideline was developed by representative members from different medical professional societies on behalf of the guidelines commission of the above-listed societies using a structured consensus process. Recommendations This guideline provides recommendations on the diagnosis, management, counselling, prophylaxis, and other aspects related to bacterial vaginosis.

[Contraception in Women with Sexually Transmitted Infections]. / Kontrazeption bei Frauen mit sexuell übertragbaren Infektionen.

Contraception in Women with Sexually Transmitted Infections Abstract. The use of contraception in sexually active women has two main functions; the prevention of unwanted pregnancy and the protection against sexually transmitted infections (STIs). In both cases, contraception does not guarantee complete protection. Unfortunately, the most effective contraceptive method against pregnancy offers minimal protection against STIs and the best contraceptive method against STIs, namely the condom, is not popular amongst many and when typically used does not offer the most effective prevention against pregnancy. In addition, there are a number of factors to consider when choosing a contraceptive method for women who already have a STI. For example, which contraceptive methods may be used safely and if there are any interactions to be aware of between medication and the contraceptive in question. Thus, the choice of the most suitable contraceptive method depends heavily on the individual and needs to be carefully considered. It is the balance between prevention of pregnancy, the protection against STIs as well as minimising the risk of STI transmission to an uninfected partner. These considerations must be discussed with the woman and if required and appropriate for the woman, with her partner as well.

Vulvovaginal Candidosis (Excluding Mucocutaneous Candidosis): Guideline of the German (DGGG), Austrian (OEGGG) and Swiss (SGGG) Society of Gynecology and Obstetrics (S2k-Level, AWMF Registry Number 015/072, September 2020).

Aim The aim of this official guideline, published and coordinated by the German (DGGG), Austrian (OEGGG) and Swiss (SGGG) Societies of Gynecology and Obstetrics in collaboration with the DMykG, DDG and AGII societies, was to provide consensus-based recommendations obtained by evaluating the relevant literature for the diagnosis, treatment and management of women with vulvovaginal candidosis. Methods This S2k guideline represents the structured consensus of a representative panel of experts with a range of different professional backgrounds commissioned by the Guideline Committee of the above-mentioned societies. Recommendations This guideline gives recommendations for the diagnosis, management, counseling, prophylaxis and screening of vulvovaginal candidosis.

[Steps following the histologically assured diagnosis of breast cancer]. / Was passiert nach histologischer Diagnosesicherung?

Steps following the histologically assured diagnosis of breast cancer Abstract. Herein we describe the steps following the histologically assured diagnosis of breast cancer. This includes the difficult process of delivering the bad news to the patient (ideally done by a breast surgeon) in which the NURSE model can be of valuable support. Furthermore, we describe the decision making of how to decide for the treatment best suited for the patient. One step in this process is the classification of the breast cancer based on the classification of the 12th St. Gallen conference in 2011. This differentiates between intrinsic subtypes and helps finding patients which would or would not benefit from chemotherapy. As breast cancer is the most frequent indication for a fertility counseling when having an oncological affection, such a counseling should be considered. A genetic counseling can be another important information for the patient. In some cases, a preoperative staging examination can add valuable information supporting the decision-making process and should be done. When all findings and reports are collected, the therapy concept should be fixed in a preoperative tumor conference including the decision whether the indication is given for a neoadjuvant chemotherapy or for an upfront surgery. When treated by a multidisciplinary team, the involvement of a breast cancer nurse as well as a psycho-oncologist is of high importance. This allows for an adequate attention to the emotion-based needs, fact-based needs and physical needs of the patient. By this a better handling of the situation by the patient and an improved quality of life for the patient can be induced and at the same time psychological consequences can be more easily recognized and consequently treated more efficiently.

Contraception counseling for young breast cancer patients: A practical needs assessment and a survey among medical oncologists.

BACKGROUND/METHODS: We analyzed an unselected, consecutive cohort of young breast cancer (BC) patients (≤40 years, n = 100) with regard to the contraceptive methods used at the time of diagnosis. Based on this data, we assessed the individual need for contraceptive counseling before cancer therapy. Secondly, in a study-specific self-report questionnaire, we surveyed 101 medical oncologists with the aim of evaluating attitudes towards contraception and how young patients are being counseled in the practical clinical setting. RESULTS: In 62% of our cohort of young BC patients, we identified situations in which contraceptive counseling was necessary at the time of BC diagnosis. The patients did not use contraception or used an ineffective method (TIER III/IV, 42%), or were using hormonal methods (12%) or IUDs (8%). Almost all respondents of the survey (99%) stated that contraception is an important aspect in the surveillance of young BC patients and the vast majority (90%) discussed this item before starting therapy. Only 20% of the respondents reported that they a) inform the patients that reliable contraception is necessary before starting therapy, b) ask whether contraceptive methods are used during ongoing therapy, and c) regularly refer their patients to specialist counseling by a gynecologist. CONCLUSIONS: A large proportion of young women require contraceptive counseling after newly diagnosed BC. Oncologists should be aware that the use of reliable contraceptive methods should not only be discussed before starting therapy, but also during ongoing therapy. Oncologists should consider actively referring their young patients to gynecologists to ensure proper contraceptive counseling.

Lifestyle and health-related predictors of cervical cancer screening attendance in a Swiss population-based study.

BACKGROUND: Since the implementation of cervical cancer (CC) screening, incidence and mortality rates have decreased worldwide. Little is known about lifestyle and health-related predictors of cervical cancer screening attendance in Switzerland. Our aim was to examine the relationship between lifestyle and health-related factors and the attendance to CC screening in Switzerland. METHODS: We analyzed data of 20-69 years old women (n=7319) of the Swiss Health Survey (SHS) 2012. Lifestyle factors included body mass index, smoking status, alcohol consumption, physical activity and attention to diet. Health-related factors of interest were diabetes, hypertension, high cholesterol levels, chronic diseases, self-perceived health, and psychological distress. We performed multivariable logistic regression analyses with the dichotomized CC screening status as outcome measure and adjusted for demographic factors. RESULTS: Obesity, low physical activity, and not paying attention to diet were statistically significantly associated with lower CC screening participation. High cholesterol levels and history of chronic diseases were statistically significantly positively associated with screening participation. CONCLUSION: Being obese, physically inactive and non-attention to diet are risk factors for CC screening attendance. These findings are of importance for improving the CC screening practices of low-user groups.

Differences in low-grade chronic inflammation and insulin resistance in women with previous gestational diabetes mellitus and women with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) are both characterized by an increase in insulin resistance. Our goal in the present study was to measure insulin resistance (as estimated by homeostasis model assessment, sex hormone-binding globulin (SHBG) and adiponectin concentrations) and parameters of low-grade inflammation in non-diabetic, non-hyperandrogenic ovulatory women with previous GDM (pGDM) and in non-diabetic women with classic PCOS, characterized by hyperandrogenism and oligo/anovulation. PATIENTS AND DESIGN: We evaluated 20 women with PCOS, 18 women with pGDM and 19 controls, all matched according to body mass index (BMI). Fasting blood samples were drawn in all women 3-6 days after spontaneous or dydrogesterone-induced withdrawal bleeding. Body fat distribution was assessed using dual-energy X-ray absorptiometry in all women. RESULTS: After adjusting for age and percent body fat, measures of insulin resistance such as SHBG and adiponectin concentrations were decreased and central obesity was increased in women with PCOS and pGDM compared with controls (all p < 0.05). Parameters of low-grade inflammation such as serum tumor necrosis factor-alpha and highly sensitive C-reactive protein concentrations, white blood cell and neutrophil count were increased only in women with PCOS compared with BMI-matched controls (all p < 0.05). CONCLUSIONS: Certain markers of insulin resistance are increased in both women with PCOS and women with pGDM, while low-grade inflammation is increased only in PCOS. PCOS and GDM might represent specific phenotypes of one disease entity with an increased risk of cardiovascular disease, whereby women with PCOS demonstrate an augmented cardiovascular risk profile.