Minerva ginecologica最新文献

{"title":"Negative Cytomegalovirus at birth after prenatal diagnosis of infection and Valacyclovir treatment: false amniotic fluid positivity or viral negativization after prenatal therapy?","authors":"Marco De Santis, Massimo Apicella, Carmen De Luca, Luisa D'oria, Piero Valentini, Maurizio Sanguinetti, Antonio Lanzone, Lucia Masini, Rosaria Santangelo","doi":"10.23736/S0026-4784.20.04517-7","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04517-7","url":null,"abstract":"","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"179-181"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444453","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}

{"title":"Efficacy of physical examination-indicated cerclage in twin pregnancies compared with singleton pregnancies: a systematic review and meta-analysis.","authors":"Chunbo Li, K. Hua","doi":"10.23736/S0026-4784.20.04518-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04518-9","url":null,"abstract":"INTRODUCTION\u0000To compare the pregnancy outcomes of physical examination-indicated cerclage (PEIC) between twin and singleton pregnancies with acute cervical insufficiency.\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000We searched Medline, Ovid, Scopus, EBSCO, ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials from their commencement until Dec 2019 for relevant studies. Patient-level data abstraction and analysis were done by two independent authors.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000A total of five studies with 786 women were included in the final analysis. The pooled outcomes showed that PEIC was associated with a similar reduction in preterm birth (PTB) at <32 [Risk ratio (RR) 0.93, 95% CI 0.79- 1.11, I2 = 0%, P = 0.43], and 28 (RR 1.03, 95% CI 0.82-1.29, I2 = 0%, P = 0.81) weeks of gestation; however, a much higher frequency of PTB was observed at <36 (RR 0.74, 95% CI 0.66-0.83, I2 = 0%, P < 0.000), and 34 (RR 0.80, 95% CI 0.68- 0.93, I2 = 0%, P = 0.004) weeks of gestation in twin pregnancies than in singleton pregnancies. No significant differences in perinatal outcomes, including neonatal death (RR 1.03, 95% CI 0.64-1.67, I2 = 52%, P = 0.900), stillbirth (RR 0.73, 95% CI 0.37-1.44, I2=0%, P=0.360), perinatal mortality (RR 0.94, 95% CI 0.65-1.38, P = 0.760) and neonatal complications were found between twin and singleton pregnancies.\u0000\u0000\u0000CONCLUSIONS\u0000Our meta-analysis indicated that PEIC achieved good perinatal prognosis in both singleton and twin pregnancies. However, because the available evidence is insufficient to attain a strong conclusion, so further high-quality trials are needed to confirm our findings.","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49398723","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}

{"title":"Health concerns for HIV-exposed but non-infected children.","authors":"Jose R Fiore,&nbsp;Mariantonietta Di Stefano,&nbsp;Giuseppina Faleo,&nbsp;Serena Bruno,&nbsp;Teresa Santantonio,&nbsp;Pantaleo Greco","doi":"10.23736/S0026-4784.20.04520-7","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04520-7","url":null,"abstract":"","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"120-121"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37748840","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}

{"title":"Alcohol and breast cancer: a warning for gynecologists.","authors":"Gianni Testino,&nbsp;Rinaldo Pellicano","doi":"10.23736/S0026-4784.20.04521-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04521-9","url":null,"abstract":"","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"61-63"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37748841","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}

{"title":"A review of the use of hormonal contraception in women with non-cardiovascular coexisting medical conditions. A comprehensive review.","authors":"Tehila Feinberg,&nbsp;Michelle Rougerie,&nbsp;Yehuda S Dahan,&nbsp;Michael H Dahan","doi":"10.23736/S0026-4784.20.04509-8","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04509-8","url":null,"abstract":"INTRODUCTION Previously, the American College of Obstetrics and Gynecology (ACOG) had published an excellent practice bulletin addressing the use of hormone contraception in women with pre-existing medical conditions. This practice bulletin became out of date. The Centers for Disease Control and prevention (CDC) of the United States subsequently developed a point form guideline for the use of oral contraceptives in women with co-existing medical conditions. EVIDENCE ACQUISITION Although this acts as a guide, it leaves the clinician without an understanding of why they are doing what they are doing. This article, is one of two related to women with co-existing medical conditions. EVIDENCE SYNTHESIS In this article we will provide an update of the scientific knowledge since the publication of the ACOG guideline (2006). It is to be used as a supplement for those who desire more information than is found in the CDC guidelines. CONCLUSIONS Although some recommendations have remained unchanged over the years, the development of lower dose contraceptive pills as well as the increased incidence of comorbid conditions, such as metabolic syndrome, in younger women seeking contraception has brought along new research and new evidence to guide clinicians in the prescription of these medications.","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"82-89"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37748839","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}

{"title":"Evidence based appropriate triage strategies for implementing high risk HPV as primary technology in cervical cancer screening.","authors":"Sharmila A Pimple,&nbsp;Gauravi A Mishra,&nbsp;Kedar K Deodhar","doi":"10.23736/S0026-4784.20.04511-6","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04511-6","url":null,"abstract":"<p><p>Primary cervical cancer screening by HPV testing for high risk human papillomavirus (hrHPV) is expected to replace cytology-based programs in many parts of the world. Its high sensitivity and negative predictive value permit longer screening intervals up to beyond five years. However, low positive predictive value can lead to unnecessary referrals and overtreatment since most hrHPV infections are transient and will not develop disease. Therefore risk stratification is needed to effectively triage and identify women among the hrHPV positives, who are at an increased risk of cervical (pre)cancer who need further diagnostic evaluation to decide on further management. Several triage strategies like HPV16/18 genotyping, p16/Ki67 dual staining and DNA methylation markers (CADM1, MAL and miR-124-2) have been evaluated to determine suitable triage options. Triage with p16/Ki-67 dual-stain provided better long-term risk stratification than cytology with significant reduction in cumulative 5 years CIN3+ risk in p16/Ki-67 negative women. DNA methylation assays have shown higher specificity than cytology and higher sensitivity than HPV16/18 genotyping with added advantages of reproducibility and application on self-collected samples. Based on current evidence, Pap cytology with or without additional HPV16/18 genotyping remains the most recommended triage strategies for primary HPV screening. Other strategies will need more longitudinal studies to provide evidence of risk reduction in test negative results. WHO recommends Visual Inspection with Acetic Acid (VIA) for triaging HPV-positive women in LMIC settings. An optimal triage strategy that can be integrated with primary HPV screening should be able to segregate and reassure the large majority of women who are at very low risk of cervical cancer.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"96-105"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37931348","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}

{"title":"Efficacy of food supplement Acidif plus® in the treatment of uncomplicated UTIs in women: a pilot observational study.","authors":"Clorinda Barletta,&nbsp;Maria Paccone,&nbsp;Nadia Uccello,&nbsp;Lucrezia O Scaldarella,&nbsp;Carmine Romano,&nbsp;Giampaolo Mainini,&nbsp;Mario Passaro","doi":"10.23736/S0026-4784.20.04495-0","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04495-0","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are among the most common bacterial infection diagnosed in women. The standard therapy is represented by short course of anti-microbial treatment to eradicate causative pathogens. However, due to antibiotic treatment, normal microbiota of the gastrointestinal tract is at risk of depletion and prolonged use of antibiotics can lead to the development of resistant strains. The aim of this pilot study was to assess the efficacy of Acidif plus®, a novel preparation containing L-Methionine, Boswellia serrata and Hibiscus sabdariffa, in the treatment of UTIs in women, in comparison with standard antibiotic treatment with fosfomycin.</p><p><strong>Methods: </strong>We performed a pilot clinical study with 88 patients with uncomplicated UTIs treated in ambulatory care clinics. The subjects recruited in the study were divided into two groups: the treatment group included 57 patients with both symptomatic and asymptomatic uncomplicated, bacteriuria-positive UTIs, who were treated by oral administration of Acidif plus® two tablets per day (1 tablet in the morning and 1 tablet in the evening) for 7 days. The control group included 31 patients with both symptomatic and asymptomatic bacteriuria-positive uncomplicated UTIs, treated with fosfomycin for two consecutive days. Clinical improvement of symptoms and urine bacteriuria were evaluated as treatment outcomes.</p><p><strong>Results: </strong>More than 50% of Acidif plus® treated patients were free of symptoms of UTIs at the end of the treatment regime. In addition, Acidif plus® treatment was effective in eliminating the bacterial infection in the post-treatment urine cultures in more than 85% of the patients.</p><p><strong>Conclusions: </strong>In this study Acidif plus® treatment in patients with uncomplicated UTIs was found to be non-inferior to the standard antibiotic therapy. In acute setting, Acidif plus® was shown to be even more effective in alleviating the symptoms than fosfomycin and in eliminating bacteria in urine cultures. It is therefore possible to propose Acidif plus® as a potential alternative option to reduce the problem of multi-drug resistance in urinary infections.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"70-74"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37931346","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}

{"title":"Clinical management of endometriosis.","authors":"Miguel A Luna Russo,&nbsp;Julia N Chalif,&nbsp;Tommaso Falcone","doi":"10.23736/S0026-4784.20.04544-X","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04544-X","url":null,"abstract":"<p><p>Endometriosis is a disease of reproductive age women that is commonly characterized by symptoms that often negatively impact quality of life. The clinical management of endometriosis remains highly variable and mostly influenced by geographic location, practice patterns, and breadth of clinician experience. This variability in treatment has inspired a trend towards multidisciplinary and specialized care of patients suffering from this disease. Surgical sampling, followed by histologic confirmation of endometrial-like tissue, remains the standard for the definitive diagnosis of endometriosis. However, the high sensitivity and specificity of MRI and ultrasound has shed light on the path towards non-surgical diagnosis of deep infiltrating endometriosis. Molecular variability and intricacy of this disease has limited the development of biologic markers to target for non-invasive diagnosis and pharmacologic therapies. Surgical management of advanced-stage endometriosis can be difficult, mostly secondary to the invasive nature of the disease, and anatomical distortion requiring advanced surgical skills to manage. The high prevalence of chronic pelvic pain and other complex pain syndromes in patients with endometriosis also requires knowledge in the management of these types of issues in order to provide comprehensive care. Menopausal endometriosis, extrapelvic presentation, and potential malignant transformation of lesions are infrequent, requiring a high index of suspicion for timely diagnosis and treatment.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"106-118"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37931349","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}

{"title":"Recurrent postmenopausal bleeding: a survey of practice among gynecologists in Scotland.","authors":"Marwa M Allam,&nbsp;Mohammed S Allam,&nbsp;Mohamed K Mehasseb","doi":"10.23736/S0026-4784.20.04432-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04432-9","url":null,"abstract":"<p><strong>Background: </strong>The definition and management of recurrent postmenopausal bleeding (PMB) are not well described in the literature, with no consensus among the clinicians and no available contemporary UK evidence-based guidelines. We conducted this survey to examine the practice of gynecologists based in Scotland in relation to recurrent postmenopausal bleeding.</p><p><strong>Methods: </strong>A web-based questionnaire was sent to 200 non-training grade gynecologists in Scotland exploring their views on the definition, investigation and management of recurrent PMB. Data were extracted from the 61 responses received.</p><p><strong>Results: </strong>Seventy-seven percent of responders defined recurrent PMB as two or more episodes of PMB, while 21% defined it after three episodes. A bleed-free interval of 3 and 6 months was needed to identify a recurrence by 46% and 44% of responders, respectively. 70% would investigate recurrent PMB with a combination of transvaginal sonography, hysteroscopy and biopsy. Only 19% would arrange a pelvic MRI routinely, while 43% would never offer one. 72% would consider a hysterectomy at some stage, with 22% of responders offering it after 3 episodes of PMB with negative investigation. 18% would never offer a hysterectomy without an identified pathology. 32% of responders felt that the management of recurrent PMB required an individualized case-by-case approach.</p><p><strong>Conclusions: </strong>This survey highlights the need for a clinical guideline to address the wide variation in the management of recurrent PMB.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"64-69"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37931345","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}

{"title":"A review of the use of hormonal contraception in women with cardiovascular disease complications and risk factors. A systematic review.","authors":"Tehila Feinberg,&nbsp;Michelle Rougerie,&nbsp;Yehuda S Dahan,&nbsp;Michael H Dahan","doi":"10.23736/S0026-4784.20.04508-6","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04508-6","url":null,"abstract":"<p><strong>Introduction: </strong>The Centers for Disease Control and Prevention (CDC) developed a point form guideline for the use of oral contraceptives in women with coexisting medical conditions. Although this acts as a guide, it leaves the clinician without an understanding of why they are doing what they are doing.</p><p><strong>Evidence acquisition: </strong>In this article, which is one of two articles addressing coexisting medical condition and oral contraceptive use, an update of the scientific knowledge is provided.</p><p><strong>Evidence synthesis: </strong>The explanation of the guidelines are to be used as a supplement for those who desire more information than is found in the CDC guidelines and in general a review for clinicians dealing with women desiring hormonal contraception.</p><p><strong>Conclusions: </strong>The development of lower dose contraceptive pills as well as the increased incidence of comorbid conditions, such as metabolic syndrome, in younger women seeking contraception has brought along new research and new evidence to guide clinicians in the prescription of these medications.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 2","pages":"90-95"},"PeriodicalIF":1.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37748838","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}