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1.
Vet Clin North Am Food Anim Pract ; 36(3): 735-743, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33032703

RESUMO

Whether poisoned by grazing toxic plants or by eating feeds that are contaminated by toxic plants, affected livestock often have compromised reproductive function including infertility, abortion, and fetal deformities. Certainly all diagnostic tools-field studies, clinical signs, gross and microscopic pathology as well as chemical identification of plant and plant toxins in animal samples-are essential to make an accurate diagnosis, to develop intervening management strategies and to improve the reproductive performance. The objectives of this review are to briefly introduce toxic plants that are reproductive toxins, abortifacients, or teratogens.


Assuntos
Abortivos/envenenamento , Anormalidades Congênitas/veterinária , Doenças dos Genitais Femininos/veterinária , Doenças dos Genitais Masculinos/veterinária , Gado , Intoxicação por Plantas/veterinária , Plantas Tóxicas/envenenamento , Animais , Anormalidades Congênitas/etiologia , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Masculinos/etiologia , Infertilidade , Masculino , Intoxicação por Plantas/etiologia
2.
Ann Hematol ; 99(6): 1361-1368, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32342133

RESUMO

In everyday gynecological practice, there is an unmet need to manage survivors after allogeneic hematopoietic cell transplantation (allo-HCT). The major gynecological complications include premature ovarian insufficiency (POI), chronic graft-versus-host disease (cGVHD) of the anogenital zone (cGVHDgyn), and secondary neoplasms. Aiming to assess a real-life scale of problems associated with HCT, we performed a detailed analysis of a consecutive series of females after allo-HCT who were referred for a routine gynecological evaluation. The study includes 38 females after allo-HCT in whom gynecological examination with cervical smear and USG were performed, followed by colposcopy according to NCCN guidelines. NIH scoring system was used to classify a grade of cGVHDgyn. The incidence of cGVHD was 71% whereas GVHDgyn was 29%, including 5 patients with score 3 at the time of diagnosis. The other manifestations (frequently noted) included the skin, mucosa, eyes, and liver. Menopause was diagnosed in 93% females, and in 81% of them, POI criteria were fulfilled. Ovarian function resumed in 2 cases. The rate of abnormal cytology was 26%: 4 ASCUS, 1 AGUS, 1 LSIL, 3 HSIL/ASC-H, and one cytological suspicion of cervical cancer. GVHDgyn was documented in 10 patients, and 6 of them had abnormal cervical cytology. Early topical estrogen therapy led to a significant reduction in vaginal dryness (p < 0.05), dyspareunia (p < 0.05), and less frequent cGVHDgyn (p < 0.05). GVHDgyn develops in about 30% of long-term allo-HCT survivors. Topical estrogens and hormonal replacement therapy alleviate symptoms and prevent the occurrence of severe consequences of menopause.


Assuntos
Gerenciamento Clínico , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/tendências , Sobreviventes , Adolescente , Adulto , Feminino , Seguimentos , Doenças dos Genitais Femininos/diagnóstico , Humanos , Pessoa de Meia-Idade , Transplante Homólogo/efeitos adversos , Transplante Homólogo/tendências , Adulto Jovem
3.
Obstet Gynecol ; 135(5): 1242-1243, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32332410

RESUMO

Seizure disorders frequently are diagnosed and managed during adolescence; therefore, obstetrician-gynecologists who care for adolescents should be familiar with epilepsy and other seizure disorders, as well as antiepileptic drugs. Patients diagnosed with seizure disorders during childhood may have increased seizure activity with puberty and menarche due to the neuroactive properties of endogenous steroid hormones. Compared with patients without epilepsy, patients with epilepsy are more likely to experience anovulatory cycles, irregular menstrual bleeding, and amenorrhea. Although hormonal suppression should not be initiated before puberty or menarche, prepubertal counseling may be appropriate, and obstetrician-gynecologists may work with young patients and their families to develop a plan to initiate with menarche. Additionally, obstetrician-gynecologists should be aware of any medication changes, including antiepileptics, for adolescent patients with seizure disorders. Research on hormonal therapy for the treatment of epilepsy is scant; however, the anticonvulsant properties of various progestins have been explored as potential treatment. There is no conclusive evidence that combination hormonal contraception increases epileptic seizures, and epilepsy itself poses no increased risk of an adverse outcome for those using combined oral contraceptive pills, the contraceptive patch, or a contraceptive ring. Because many antiepileptic drugs are teratogenic, discussing sexual health with and providing effective contraceptive choices to this population is critical. Obstetrician-gynecologists should work with patients with seizure disorders to develop a plan when pregnancy occurs.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/terapia , Doenças dos Genitais Femininos/terapia , Ginecologia/métodos , Adolescente , Criança , Anticoncepcionais/uso terapêutico , Aconselhamento/métodos , Gerenciamento Clínico , Epilepsia/complicações , Feminino , Doenças dos Genitais Femininos/etiologia , Humanos , Menarca , Gravidez , Adulto Jovem
4.
Obstet Gynecol ; 135(5): e213-e220, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32332416

RESUMO

Seizure disorders frequently are diagnosed and managed during adolescence; therefore, obstetrician-gynecologists who care for adolescents should be familiar with epilepsy and other seizure disorders, as well as antiepileptic drugs. Patients diagnosed with seizure disorders during childhood may have increased seizure activity with puberty and menarche due to the neuroactive properties of endogenous steroid hormones. Compared with patients without epilepsy, patients with epilepsy are more likely to experience anovulatory cycles, irregular menstrual bleeding, and amenorrhea. Although hormonal suppression should not be initiated before puberty or menarche, prepubertal counseling may be appropriate, and obstetrician-gynecologists may work with young patients and their families to develop a plan to initiate with menarche. Additionally, obstetrician-gynecologists should be aware of any medication changes, including antiepileptics, for adolescent patients with seizure disorders. Research on hormonal therapy for the treatment of epilepsy is scant; however, the anticonvulsant properties of various progestins have been explored as potential treatment. There is no conclusive evidence that combination hormonal contraception increases epileptic seizures, and epilepsy itself poses no increased risk of an adverse outcome for those using combined oral contraceptive pills, the contraceptive patch, or a contraceptive ring. Because many antiepileptic drugs are teratogenic, discussing sexual health with and providing effective contraceptive choices to this population is critical. Obstetrician-gynecologists should work with patients with seizure disorders to develop a plan when pregnancy occurs.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/terapia , Doenças dos Genitais Femininos/terapia , Ginecologia/métodos , Adolescente , Criança , Anticoncepcionais/uso terapêutico , Aconselhamento/métodos , Gerenciamento Clínico , Epilepsia/complicações , Feminino , Doenças dos Genitais Femininos/etiologia , Humanos , Menarca , Gravidez , Adulto Jovem
7.
Obstet Gynecol Clin North Am ; 46(4): 755-781, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31677753

RESUMO

3D ultrasound imaging of the female pelvis is one of the most important recent advances in diagnostic imaging. Volume acquisitions can provide a large number of images of the pelvic organs simultaneously and in any plane or orientation desired. The coronal plane of the uterus is only visible when reconstructed from a volume and is key to imaging the uterus for indications such as uterine anomalies, IUD positioning, locations of fibroids and polyps, or early pregnancies. 3D ultrasonography has huge potential for evaluating infertile patients, performing difficult procedures under guidance, and studying patients with abnormal uterine bleeding, hydrosalpinges, and cancer.


Assuntos
Doenças dos Genitais Femininos/diagnóstico por imagem , Genitália Feminina/diagnóstico por imagem , Pelve/diagnóstico por imagem , Ultrassonografia/métodos , Feminino , Doenças dos Genitais Femininos/etiologia , Humanos , Imageamento Tridimensional
8.
Prog. obstet. ginecol. (Ed. impr.) ; 62(5): 436-442, sept.-oct. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-192125

RESUMO

OBJECTIVE: To assess the perception and personal opinions of gynecologists regarding genitourinary syndrome of menopause (GSM) and to analyze potential differences with those of postmenopausal women. MATERIAL AND METHODS: Spanish gynecologists completed a web-based survey. Each item had four possible answers: < 10%, 10%-50%, 50%-90%, and virtually all women. Results were then compared with those of the Spanish cohort of the REVIVE study. RESULTS: From 633 gynecologists, a third would ask all postmenopausal women about genitourinary syndrome of menopause symptoms and 43.68% would perform a vulvovaginal examination on all postmenopausal women. According to the most frequent answers, 50-90% of women would have genitourinary syndrome of menopause symptoms but < 10% would know that genitourinary syndrome of menopause is a chronic and treatable condition. Up to 90% of women with genitourinary syndrome of menopause would avoid sexual intercourse because of vulvovaginal discomfort or pain. Moreover, 50-90% of women with genitourinary syndrome of menopause would not have any treatment. When comparing results for gynecologists and postmenopausal women, there were some coincidences but also some worrying disparities. CONCLUSIONS: Spanish gynecologists know about genitourinary syndrome of menopause. However, they must be more proactive, to improve the patient-doctor relationship and to be more aware of the sexual life of postmenopausal women. Moreover, many postmenopausal women could benefit from genitourinary syndrome of menopause treatments. Good patient-doctor relationships, and more patient education, are essential


OBJETIVO: evaluar la percepción y las opiniones personales de los ginecólogos sobre el síndrome genitourinario de la menopausia y analizar las posibles diferencias con la percepción de las de las mujeres posmenopáusicas. MATERIAL Y MÉTODOS: los ginecólogos españoles completaron una encuesta en la web. Cada elemento tenía cuatro respuestas posibles: < 10%, 10%-50%, 50%-90% y prácticamente todas las mujeres. Los resultados se compararon entonces con los de la cohorte española del estudio REVIVE. RESULTADOS: de los 633 ginecólogos, un tercio preguntaría a todas las mujeres posmenopáusicas sobre los síntomas del síndrome genitourinario de la menopausia y el 43,68% realizaría un examen vulvovaginal a todas las mujeres posmenopáusicas. Según las respuestas más frecuentes, 50-90% de las mujeres tendrían síntomas del síndrome genitourinario de la menopausia, pero < 10% sabría que el síndrome genitourinario de la menopausia es una condición crónica y con tratamiento. Hasta el 90% de las mujeres con síndrome genitourinario de la menopausia evitarían las relaciones sexuales debido a molestias o dolores vulvovaginales. Además, el 50-90% de las mujeres con síndrome genitourinario de la menopausia no estarían recibiendo ningún tratamiento. Al comparar los resultados de los ginecólogos y los de las mujeres posmenopáusicas hubo algunas coincidencias, pero también algunas discrepancias preocupantes. CONCLUSIONES: los ginecólogos españoles conocen el síndrome genitourinario de la menopausia. Sin embargo, deben ser más proactivos, para mejorar la relación médico-paciente y para ser más conscientes de la vida sexual de las mujeres posmenopáusicas. Además, muchas mujeres posmenopáusicas podrían beneficiarse de los tratamientos del síndrome genitourinario de la menopausia. La buena relación médico-paciente y una mayor educación de la paciente son esenciales


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Pós-Menopausa , Relações Médico-Paciente , Exame Ginecológico , Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/etiologia , Inquéritos e Questionários , Estudos de Coortes , Atrofia , Espanha
9.
Obstet Gynecol ; 134(2): 241-249, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31306326

RESUMO

OBJECTIVE: To explore the rates and risk factors for sustaining a genitourinary injury during hysterectomy for benign indications. METHODS: In this population-based cohort study, all women who underwent hysterectomy for benign indications were identified from the Office of Statewide Health Planning and Development databases in California (2005-2011). Genitourinary injuries were further classified as identified at the time of hysterectomy, identified after the date of hysterectomy; or unidentified until a fistula developed. RESULTS: Of the 296,130 women undergoing hysterectomy for benign indications, there were 2,817 (1.0%) ureteral injuries, 2,058 (0.7%) bladder injuries and 834 (0.3%) genitourinary fistulas (80/834 of which developed after an injury repair). Diagnosis was delayed in 18.6% and 5.5% of ureteral and bladder injuries, respectively. Subsequent genitourinary fistula development was lower if the injury was identified immediately (compared with delayed) for both ureteral (0.7% vs 3.4% odds ratio [OR] 0.28; 95% CI 0.14-0.57) and bladder injuries (2.5% vs 6.5% OR 0.37; 95% CI 0.16-0.83). Indwelling ureteral stent placement alone was more successful in decreasing the risk of a second ureteral repair for immediately recognized ureteral injuries (99.0% vs 39.8% for delayed injuries). With multivariate adjustment, prolapse repair (OR 1.44, 95% CI 1.30-1.58), an incontinence procedure (OR 1.40, 95% CI 1.21-1.61), mesh augmented prolapse repair (OR 1.55, 95% CI 1.31-1.83), diagnosis of endometriosis (OR 1.46, 95% CI 1.36-1.56), and surgery at a facility in the bottom quartile of hysterectomy volume (OR 1.37, 95% CI 1.01-1.89) were all associated with an increased likelihood of a genitourinary injury. An exclusively vaginal (OR 0.56, 95% CI 0.53-0.64) or laparoscopic (OR 0.80, 95% CI 0.75-0.86) approach was associated with lower risk of a genitourinary injury as compared with an abdominal approach. CONCLUSION: Genitourinary injury occurs in 1.8% of hysterectomies for benign indications; immediate identification and repair is associated with a reduced risk of subsequent genitourinary fistula formation.


Assuntos
Doenças Urogenitais Femininas/etiologia , Fístula/etiologia , Histerectomia/efeitos adversos , Ureter/lesões , Bexiga Urinária/lesões , Endometriose/cirurgia , Feminino , Doenças dos Genitais Femininos/etiologia , Humanos , Histerectomia/métodos , Complicações Intraoperatórias/etiologia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/cirurgia , Fístula Urinária/etiologia , Neoplasias Uterinas/cirurgia
10.
J Agric Food Chem ; 67(25): 7073-7081, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31240927

RESUMO

Obesity has been demonstrated as a disruptor of female fertility. Our previous study showed the antiobesity effects of calcium on HFD-fed male mice. However, the role of calcium in alleviating reproductive dysfunction of HFD-fed female mice remains unclear. Here, we found that HFD led to estrus cycle irregularity (longer cycle duration and shorter estrus period) and subfertility (longer conception time, lower fertility index, and less implantations) in mice. However, the HFD-induced reproductive abnormality was alleviated by calcium supplementation. Additionally, calcium supplementation enhanced activation/thermogenesis of BAT and browning of WAT in HFD-fed mice. Consequently, the abnormality of energy metabolism and glucose homeostasis induced by HFD were improved by calcium supplementation, with elevated metabolic rates and core temperature. In conclusion, these data showed that calcium supplementation alleviated HFD-induced estrous cycle irregularity and subfertility associated with concomitantly enhanced BAT thermogenesis and WAT browning, suggesting the potential application of calcium in improving obesity-related reproductive disorders.


Assuntos
Tecido Adiposo Marrom/fisiopatologia , Tecido Adiposo Branco/fisiopatologia , Cálcio/administração & dosagem , Ciclo Estral/efeitos dos fármacos , Doenças dos Genitais Femininos/tratamento farmacológico , Infertilidade/tratamento farmacológico , Obesidade/complicações , Termogênese/efeitos dos fármacos , Tecido Adiposo Marrom/efeitos dos fármacos , Tecido Adiposo Branco/efeitos dos fármacos , Animais , Dieta Hiperlipídica/efeitos adversos , Suplementos Nutricionais/análise , Metabolismo Energético/efeitos dos fármacos , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/metabolismo , Doenças dos Genitais Femininos/fisiopatologia , Humanos , Infertilidade/etiologia , Infertilidade/metabolismo , Infertilidade/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
11.
Clin Exp Rheumatol ; 37 Suppl 121(6): 48-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31172922

RESUMO

OBJECTIVES: Behçet's syndrome (BS) is a rare multi-system inflammatory disorder. Clinical phenotypic variance across geographical regions is recognised but UK BS patients' variance by age groups and gender has not been studied. This study compares the clinical features of adult and juvenile onset Behçet's Syndrome (JBS) in a UK population. METHODS: Two clinical databases of BS patients were compared. The JBS database was collected at the Great Ormond Street Hospital for Children, London (n=46). The adult database was collected at the Hammersmith Hospital, London (n=560). RESULTS: Oro-genital aphthosis had high prevalence in both the JBS and the adult cohort (oral: 97.8% vs. 96.6%, genital: 73.9% vs. 75.7%). The JBS cohort was more likely to have gastrointestinal involvement (21.7% vs. 4.5%, p<0.001) and arthritis (21.7% vs. 9.6%, p=0.021) compared to adults. The JBS cohort was less likely to have eye involvement (4.3% vs. 37%, p<0.001), skin (21.7% vs. 55.4%, p<0.001) and vascular involvement (6.5% vs. 17.5% p=0.063). JBS females had a higher rate of genital aphthosis than JBS males (87.5% vs. 59.1%, p=0.044). Adult females had higher rates of genital (85.2% vs. 64.5%, p<0.001) and oral (99.0% vs. 93.8%, p=0.001) aphthosis than adult males. Adult males were more likely to have ophthalmological (44.9% vs. 30.3%, p<0.001) and vascular (23.0% vs. 12.8%, p=0.002) manifestations than adult females. CONCLUSIONS: UK JBS patients displayed less ocular and skin manifestations compared to the adult BS patients. This information will aid clinicians in diagnosing BS in UK adult and paediatric populations.


Assuntos
Síndrome de Behçet , Adulto , Fatores Etários , Idade de Início , Síndrome de Behçet/patologia , Síndrome de Behçet/fisiopatologia , Criança , Estudos de Coortes , Feminino , Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Masculinos/diagnóstico , Doenças dos Genitais Masculinos/etiologia , Humanos , Masculino , Vasculite Retiniana/diagnóstico , Vasculite Retiniana/etiologia , Fatores Sexuais , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/etiologia , Avaliação de Sintomas , Reino Unido
12.
Urol Int ; 103(2): 211-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31129663

RESUMO

The objective is to observe if it could be possible to use the apoptosis test to distinguish different aetiologies in chronic pelvic pain syndrome (CPPS). A prospective study was done, 106 patients, 57 had previously been diagnosed with urological chronic pelvic pain (UCPP)/interstitial cystitis (IC) and 49 patients with gynaecological chronic pelvic pain (GCPP). Neoplastic cells cultures were exposed to the urine of patients with UCPP/IC and patients with GCPP. The urine ability to provoque apoptosis on them was analysed. The apoptosis degree was measured by quantifying the percentage of cells in phase subG0, determined by a flow cytometry analysis. It is observed that the cell cultures exposed to urine of patients with UCPP had a significantly higher sub-G1 peak and G2 phase than those of the cells exposed to urine from patient's GCPP. The average values of apoptosis in patients with UCPP were significantly higher to that obtained in -patients having GCPP. With the apoptosis tests having a value >10%, it is considered as positive as well. This means that when we are faced with a patient who has UCPP or non-bladder chronic pelvic pain, the probability of having an UCPP increases by 45% when the apoptosis test is positive for a value >10%. Urine from patients with UCPP has significantly higher apoptotic effect over than the effect produced by urine from patients with GCPP. The apoptosis test could be useful as an illness biomarker.


Assuntos
Apoptose , Dor Crônica/etiologia , Doenças dos Genitais Femininos/etiologia , Dor Pélvica/etiologia , Doenças Urológicas/etiologia , Adulto , Dor Crônica/patologia , Feminino , Doenças dos Genitais Femininos/complicações , Doenças dos Genitais Femininos/patologia , Humanos , Pessoa de Meia-Idade , Dor Pélvica/patologia , Estudos Prospectivos , Autorrelato , Doenças Urológicas/complicações , Doenças Urológicas/patologia , Adulto Jovem
13.
Arch Gynecol Obstet ; 300(1): 117-126, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31093741

RESUMO

BACKGROUND: Acute colonic pseudo-obstruction or Ogilvie's syndrome (OS) is a rare form of postsurgical or posttraumatic complication. OS rarely occurs in the postoperative course of gynecologic and obstetric patients and is difficult to diagnose. CASE PRESENTATION: We present the case of an 83-years-old patient with carcinosarcoma of the uterus who developed OS with non-obstructive dilation of the right hemicolon and intraabdominal compression after total abdominal hysterectomy, omentectomy, and lymphadenectomy. Laparotomy with colonic decompression and abdominal dressing was performed. Subsequently, the patient developed pneumonia and peritonitis and died due to septic shock. SYSTEMATIC LITERATURE REVIEW: We identified 49 case reports and 10 case series describing 17 gynecologic (cervical cancer, n = 2; carcinosarcoma of the uterus, n = 1; benign gynecologic condition, n = 14) and 76 obstetric patients (cesarean section, n = 66; OS during pregnancy or after vaginal delivery, n = 10). Outcome data were available for 59 patients. First-line treatment was conservative in 22/59 (37%) cases, laparotomy with decompression or colon resection was performed in 20/59 (34%) cases, endoscopic decompression in 12/59 (20%) cases, and i.v. neostigmine in 4/59 (7%) cases. Resolution was achieved in 22/59 (37%) of patients. The most common second-line treatment was right hemicolectomy. Adverse events grade 3 and 4 were observed in 8/59 and 31/59 patients (together 66%), respectively, mortality was 3/59 (5%). CONCLUSION: OS is a rare postoperative complication of gynecologic and obstetric patients with a good prognosis, but a high morbidity. Pregnancy seems to be a predisposing factor for OS. Conservative treatment is a successful first-line approach.


Assuntos
Pseudo-Obstrução do Colo/diagnóstico , Doenças dos Genitais Femininos/etiologia , Doença Aguda , Idoso de 80 Anos ou mais , Pseudo-Obstrução do Colo/patologia , Feminino , Humanos
14.
Mol Cell Endocrinol ; 497: 110429, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31026479

RESUMO

A growing body of evidences demonstrated that sexuality is an important topic in the clinical research of eating disorders (EDs), due to its association with specific psychopathological features, and etiological factors. The present review took into consideration the complex relationship between sexual behaviours, hormonal alterations and EDs psychopathology. Studies pertaining sexual behaviours in EDs were divided into those focusing on sexual dysfunctions, and those related to risky sexual behaviours. The limited number of studies on sexual dysfunctions, reported a controversial association with weight status and hormonal alterations, and a clear relationship with severity of specific psychopathology (e.g. body image disturbance). Risky sexual behaviours have been associated with impulsivity and dissociation, as well as with abnormal stress response. Finally, both restriction and uncontrolled eating have been found to be responsible for several complex metabolic alterations, determining varied sexual and gynecologic problems, such as amenorrhea, hypogonadism, genital vascular problems, infertility, and miscarriage, although it is also possible that alterations in feeding and stress hormones contribute to altered eating behaviour.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Hormônios Esteroides Gonadais/metabolismo , Comportamento Sexual , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Doenças dos Genitais Femininos/etiologia , Humanos , Psicopatologia , Disfunções Sexuais Psicogênicas/complicações
15.
J Acquir Immune Defic Syndr ; 80(5): 489-493, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-30730357

RESUMO

Evidence suggests that there are important interactions between HIV and female genital schistosomiasis (FGS) that may have significant effects on individual and population health. However, the exact way they interact and the health impacts of the interactions are not well understood. In this article, we discuss what is known about the interactions between FGS and HIV, and the potential impact of the interactions. This includes the likelihood that FGS is an important health problem for HIV-positive women in Schistosoma-endemic areas potentially associated with an increased risk of mortality, cancer, and infertility. In addition, it may be significantly impacting the HIV epidemic in sub-Saharan Africa by making young women more susceptible to HIV. We call for immediate action and argue that research is urgently required to address these knowledge gaps and propose a research agenda to achieve this.


Assuntos
Doenças dos Genitais Femininos/etiologia , Infecções por HIV/complicações , Esquistossomose Urinária/etiologia , Animais , Pesquisa Biomédica , Coinfecção/parasitologia , Coinfecção/virologia , Feminino , Doenças dos Genitais Femininos/parasitologia , Infecções por HIV/parasitologia , Humanos , Schistosoma haematobium , Esquistossomose Urinária/virologia
16.
Eur J Gastroenterol Hepatol ; 31(4): 425-433, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30676472

RESUMO

Coeliac disease (CD) is a chronic gluten-dependent enteropathy very common in the general population and characterized by an extremely heterogeneous clinical picture. Although its prevalence is growing worldwide, case-finding strategy remains the mainstay to diagnosis. Thus, correct identification of high-risk categories of patients who need to be tested for CD is an essential part of medical knowledge to a large number of specialists and primary care providers. In this regard, although CD might have a serious effect on women's reproductive health, a widespread consensus is lacking on which categories of obstetric and gynaecological disorders should be tested for CD. The aim of this review is to critically summarize the current literature relevant to CD and obstetric and gynaecological disorders and to provide practical proposals that may be helpful to clinicians involved in the management of these patients.


Assuntos
Doença Celíaca/complicações , Doenças dos Genitais Femininos/etiologia , Complicações na Gravidez/etiologia , Doença Celíaca/diagnóstico , Feminino , Feto/anormalidades , Doenças dos Genitais Femininos/diagnóstico , Humanos , Infertilidade Feminina/etiologia , Gravidez , Complicações na Gravidez/diagnóstico , Resultado da Gravidez , Cuidado Pré-Natal/métodos
18.
Int Urogynecol J ; 30(4): 537-544, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30327850

RESUMO

INTRODUCTION AND HYPOTHESIS: Vaginal apical suspension is essential for the surgical treatment of pelvic organ prolapse (POP). We aim to evaluate whether the method of apical repair is associated with different re-operation rates for POP recurrence or surgical complications. METHODS: Population-based, retrospective cohort study of all Ontario women receiving primary apical POP repairs from 2003 to 2015. Primary exposure was the method of apical POP repair. Primary outcome was re-operation for recurrent POP, and secondary outcomes were surgical procedures for genito-intestinal (GI) or genitourinary (GU) complications, fistula repair, and mesh revision or removal. RESULTS: Forty-three thousand four hundred fifty-eight women were included. Overall, the number of mesh-based apical repairs decreased over time, while the number of native-tissue repairs slightly increased (p < 0.001). Multivariable Cox proportional hazards (Cox PH) analysis demonstrated a significant increase in repeat POP operations for transvaginal mesh apical repairs (adjusted HR 1.28 [95% CI: 1.10-1.48]), but not in abdominal mesh repairs (adjusted HR 0.96 [95% CI: 0.81-1.13]) compared with vaginal native tissue apical repairs. Overall risk of repeat surgery for fistulas or GI and GU complications remained low (< 0.5%). Risk of mesh removal or revision was 11.5-11.9%, with no difference between abdominal versus vaginal mesh on multivariable analysis (adjusted HR 0.99 [95% CI: 0.78-1.26]). CONCLUSIONS: Re-operation for recurrent POP is highest in transvaginal mesh apical repairs; however, this risk did not differ between abdominal mesh and vaginal native tissue apical repairs. GI and GU re-operations are rare. There is no difference in mesh removal or revision rates between abdominal and vaginal mesh repairs.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Prolapso de Órgão Pélvico/cirurgia , Reoperação/estatística & dados numéricos , Telas Cirúrgicas/estatística & dados numéricos , Vagina/cirurgia , Abdome/cirurgia , Idoso , Remoção de Dispositivo , Feminino , Fístula/etiologia , Fístula/cirurgia , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/tendências , Humanos , Fístula Intestinal/etiologia , Fístula Intestinal/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Recidiva , Estudos Retrospectivos , Telas Cirúrgicas/efeitos adversos , Fístula Urinária/etiologia , Fístula Urinária/cirurgia
19.
Pediatr Surg Int ; 35(2): 233-237, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30392127

RESUMO

PURPOSE: Traditionally, the care of children and adults has been arbitrarily separated into pediatric and adult medicine and surgery. Despite progress in pediatric surgical techniques, patients born with congenital anomalies still suffer from significant functional sequelae, which persist into adulthood. We aim to describe some of the most common problems experienced by adult patients with congenital colorectal malformations. METHODS: Following IRB approval, we performed a retrospective database review of all adult patients who were treated by our group from 1983 until 2017. RESULTS: We identified 88 cases. 51 patients had ARM, 18 cloacas, 9 presacral masses, 3 HD, 2 spina bifida and 5 with other diagnoses (3 vaginal anomalies, 1 cloacal exstrophy, 1 obstructed seminal vesical). The specific problems addressed were: complications from previous operations (41), rectal prolapse (25), fecal incontinence (11), gynecologic concerns (12), urologic concerns (6), and recurrent recto urogenital fistula (3). We performed 83 surgical interventions, including 13 rectal prolapse repair, 13 continent appendicostomies, 44 PSARP or redo PSARP, 11 resections of presacral masses, 11 vaginoplasties, 2 examinations under anesthesia, and 2 Mitrofanoff procedures. Five patients were treated medically (bowel management program, obstetric, urologic evaluation). CONCLUSION: There is a growing need to better prepare adult providers to assume the care of patients born with congenital colorectal disease as these patients transition to adulthood. A collaboration between specialized pediatric referral centers with adult colorectal surgeons, urologists and gynecologists is a potential pathway for the adequate transition of care.


Assuntos
Malformações Anorretais/epidemiologia , Anormalidades Congênitas/epidemiologia , Transição para Assistência do Adulto , Adolescente , Adulto , Malformações Anorretais/terapia , Colorado/epidemiologia , Anormalidades Congênitas/terapia , Bases de Dados Factuais , Procedimentos Cirúrgicos do Sistema Digestório , Incontinência Fecal/etiologia , Feminino , Doenças dos Genitais Femininos/etiologia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia , Prolapso Retal/etiologia , Estudos Retrospectivos , Doenças Urológicas/etiologia , Adulto Jovem
20.
Biol Reprod ; 101(6): 1102-1114, 2019 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-30544156

RESUMO

The existence of different bacterial communities throughout the female reproductive tract has challenged the traditional view of human fetal development as a sterile event. There is still no consensus on what physiological microbiota exists in the upper reproductive tract of the vast majority of women who are not in periods of infection or pregnancy, and the role of bacteria that colonize the upper reproductive tract in uterine diseases or pregnancy outcomes is not well established. Despite published studies and advances in uterine microbiome sequencing, some study aspects-such as study design, sampling method, DNA extraction, sequencing methods, downstream analysis, and assignment of taxa-have not yet been improved and standardized. It is time to further investigate the uterine microbiome to increase our understanding of the female reproductive tract and to develop more personalized reproductive therapies, highlighting the potential importance of using microbiological assessment in infertile patients.


Assuntos
Microbiota , Útero/microbiologia , Biomassa , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/microbiologia , Neoplasias dos Genitais Femininos/etiologia , Neoplasias dos Genitais Femininos/microbiologia , Genitália Feminina/microbiologia , Genitália Feminina/fisiologia , Humanos , Microbiota/genética , Microbiota/fisiologia , Medicina de Precisão , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/microbiologia , Útero/fisiologia
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