The impact of COVID-19 lockdown on admission to gynecological emergency departments: Results from a multicenter Italian study.

OBJECTIVE: To evaluate the impact of the COVID-19 lockdown on admissions to gynecological emergency departments (ED) of three Italian university hospitals with different rates of COVID-19 incidence. METHODS: A retrospective study was conducted in the gynecological EDs of Modena (Emilia-Romagna), Sassari and Cagliari (Sardinia) regarding all admissions to gynecological EDs during November 1 to 30, 2019, and March 11 to April 9, 2020 (lockdown period). RESULTS: A total of 691 women (mean age 38.3 ± 14.3 years) who were admitted to the gynecological EDs were included. The relative decrease in women evaluated from March 11 to April 9, 2020, was -56.6% (95% confidence interval [CI] 52.2-61.1). Time spent in the ED was also significantly shorter during this period (P=0.02) in comparison to November 1 to 30, 2019. The most evident decrease was observed for pelvic pain (-68.9% [95% CI 60.3-76.7]; -91 cases). The management of women suggests a more effective use of the ED, with higher rates of hospitalization (P=0.001) and recourse to emergent surgeries (P=0.005) and lower rates of discharge to home (P=0.03). CONCLUSION: The COVID-19 lockdown greatly reduced the rate of admission to gynecological EDs, but the real emergencies were filtered from the more deferrable ones.

Added benefits and user satisfaction with a low-dose oral contraceptive containing drospirenone: results of three multicentre trials.

The ethinylestradiol 20 microg/drospirenone 3 mg combined oral contraceptive (COC), administered in cycles of 21 days continuous use followed by a 7-day hormone-free interval (21/7) [Yasminelle], has been proven to be an effective and well tolerated contraceptive with an acceptable bleeding pattern and good safety profile. In addition, the ethinylestradiol 20 microg/drospirenone 3 mg 21/7 COC prevents water-retention-related weight gain, and improves physical and emotional well-being, consistent with other drospirenone-containing COCs. In clinical studies, >85% of those who received the ethinylestradiol 20 microg/drospirenone 3 mg 21/7 COC were satisfied or very satisfied with this contraceptive. The positive attributes of the ethinylestradiol 20 microg/drospirenone 3 mg 21/7 COC beyond contraceptive protection may have important implications for improving treatment compliance and reducing treatment discontinuation. Physical well-being stayed the same or improved during use of this COC in 56% and 34% of women, respectively. Emotional well-being stayed the same or improved in 71% and 20% of women, respectively.

Menopause and hormone replacement therapy: the 2017 Recommendations of the Italian Menopause Society.

Over the last decade, the risk benefits ratio of hormone replacement therapy (HRT) has been reevaluated mainly in tens of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausal Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these recommendations is to provide a simple and updated reference on postmenopausal HRT. The term HRT typically includes estrogen replacement therapy (ERT) and estrogen-progestogen therapy (EPT). EPT can be sequential, when progestogen is added to ERT for 10-14 days a month, or continuous combined when progestogen is administered continuously every day along with a fixed amount of estrogen, In the everyday language, HRT includes also tibolone and the tissue-selective estrogen complex.

[Bacterial vaginosis: efficacy of a local treatment with a gel containing a fraction derived from propinibacterium acnes]. / Vaginosi batterica: efficacia di un trattamento locale con un gel vaginale a base di una frazione batterica derivata da Propionibacterium acnes.

BACKGROUND: Bacterial vaginosis (BV) is favored by a decreased activity of vaginal immune system. The fraction derived from Propionibacterium acnes is known to activate the immune system and is used parenterally to treat respiratory and urinary infections. The employ of a fraction derived from Propionibacterium acnes locally, in the context of the vaginal immune system, is made possible by a vaginal gel in which this fraction is associated with hyaluronic acid, well-known for its moisturizing activity, and polycarbophil, capable of miming the function of cervical mucus. The aim of the study was to evaluate whether this preparation is efficacy in the treatment of vulvovaginal symptoms associated to BV. METHODS: After the diagnosis of BV and the evaluation of a Visual Analogic Score >6 for vulvovaginal itch and burning, 33 women participated in this study on a voluntary basis. They were treated with a vaginal gel (Immunovag®, Depofarma, Italy) for 5 days, with one vulvovaginal application a day. RESULTS: The day following the last application, the subjects reported a significant reduction of vulvovaginal symptoms and a significant reduction of vulvovaginal erythema and leucorrhea. In the vaginal swab performed before the treatment, anaerobic microorganisms were positive in 82% and negative in 18% of cases; when tested the day following the end of treatment, it was positive in 25% and negative in 75% of subjects. Symptom reduction rates did not differ between the groups with positive or negative vaginal swab. The results obtained in the subjects treated with Immunovag® were similar to those obtained in a group of women with BV treated with clindamycin cream (one daily vulvovaginal application of 100 mg, for 5 days). CONCLUSIONS: The activation of the vaginal immune system induced by Immunovag® can antagonize the symptoms of BV and counteract the growth of vaginal anaerobic microorganisms.