Clinica e Investigacion en Ginecologia y Obstetricia最新文献

Uso de plasma rico en plaquetas en el campo de la reproducción humana asistida 在人类辅助生殖领域使用富血小板血浆

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-11-27 DOI: 10.1016/j.gine.2024.101016

P. Luque González , M. Pineda Mateo , J. Rodríguez Sánchez-Reyman

{"title":"Uso de plasma rico en plaquetas en el campo de la reproducción humana asistida","authors":"P. Luque González , M. Pineda Mateo , J. Rodríguez Sánchez-Reyman","doi":"10.1016/j.gine.2024.101016","DOIUrl":"10.1016/j.gine.2024.101016","url":null,"abstract":"<div><div>Assisted reproductive therapies have a limited success rate. New therapies are currently being investigated to increase their effectiveness, such as the use of platelet-rich plasma (PRP). This agent has demonstrated efficacy at the level of regenerative medicine and consists of the administration of blood plasma extracted from the patient herself with a high platelet count. Given the recent incorporation of this treatment in clinical research, the objective is to carry out a bibliographic review to elucidate the characteristics of its use, effects and benefits. The literature available in the main databases offers very optimistic results. It has been shown that PRP favors endometrial regeneration and folliculogenesis as well as restoration of the menstrual cycle, which may be useful in patients with thin endometrium refractory to classical treatments, chronic endometritis, repeated implantation failure, early ovarian failure or Asherman's syndrome. However, there are few studies and they have a small sample size, so it is necessary to continue and expand the research on PRP.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 101016"},"PeriodicalIF":0.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722615","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}

引用次数: 0

Bases fisiológicas, técnicas y principales indicaciones de preservación de la fertilidad en la paciente oncológica 肿瘤患者保留生育能力的生理基础、技术和主要适应症。

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-28 DOI: 10.1016/j.gine.2024.101005

Y. Barral , M. Vidal , S. Peralta , L. Magnano

{"title":"Bases fisiológicas, técnicas y principales indicaciones de preservación de la fertilidad en la paciente oncológica","authors":"Y. Barral , M. Vidal , S. Peralta , L. Magnano","doi":"10.1016/j.gine.2024.101005","DOIUrl":"10.1016/j.gine.2024.101005","url":null,"abstract":"<div><div>In recent decades, the use of fertility preservation techniques in women with oncologic pathology has increased, aiming to improve their future reproductive prognosis. This trend is attributed to the increasing incidence of neoplasms in women of reproductive age, improved survival rates, and the progressive delay of motherhood. The gonadotoxicity of chemotherapy is influenced by factors like the patient's age, baseline ovarian reserve, and the type and cumulative dose of chemotherapy. Therefore, it is crucial to provide appropriate reproductive counseling and refer patients to specialized fertility preservation programs, where comprehensive assessment of gonadotoxic risk and individual patient risk are performed. Oocyte cryopreservation is the main technique for fertility preservation, non-experimental since 2013. Controlled ovarian stimulation starts at any phase of the menstrual cycle (<em>random start</em>), avoiding the delay in starting chemotherapy. In addition, the treatment with letrozole is recommended to breast cancer patients performing ovarian stimulation to prevent excessive increases in serum estrogen levels. The ovarian cortex cryopreservation is still considered experimental in many countries. However, it is performed in some cases, for example, when chemotherapy cannot be delayed for 2 weeks or in prepubertal patients. At the present time, gonadotropin-releasing hormone (GnRH) treatment is not regarded as a fertility preservation technique. However, it can be employed in certain clinical contexts.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 101005"},"PeriodicalIF":0.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528477","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}

引用次数: 0

Diagnostic rentability of IOTA models for differentiating between benign and malignant complex adnexal masses 用于区分良性和恶性复杂附件肿块的 IOTA 模型的诊断可租性

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-19 DOI: 10.1016/j.gine.2024.101000

A. Rodríguez Pérez , A. Caruso , M. Pantoja Garrido , I. Rodríguez Jiménez , A. Polo Velasco , J.J. Fernández Alba

{"title":"Diagnostic rentability of IOTA models for differentiating between benign and malignant complex adnexal masses","authors":"A. Rodríguez Pérez , A. Caruso , M. Pantoja Garrido , I. Rodríguez Jiménez , A. Polo Velasco , J.J. Fernández Alba","doi":"10.1016/j.gine.2024.101000","DOIUrl":"10.1016/j.gine.2024.101000","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic accuracy of the <em>International Ovarian Tumor Analysis (IOTA)</em> Logistic Regression Model 1, 2 (LR1, LR2) ADNEX model and IOTA Simple Rules, in the pre-surgical evaluation of ovarian tumors classified as complex adnexal masses.</div></div><div><h3>Methods</h3><div>This is a cross-sectional observational study of diagnostic accuracy. We will select patients, who undergo surgical intervention due to adnexal mass with indeterminate, intermediate or high suspicion of malignancy (GI-RADS 4–5), as assessed by an expert ultrasound operator. We analyzed and compared the diagnostic performance and predictive capacity of the different models in the studied population, and also we analyzed each model by creating subgroups based on menopausal status.</div></div><div><h3>Results</h3><div>One hundred thirty five malignant masses (45%), one hundred forty benign (46.7%) and twenty five border line (8.3%) were included.</div><div>LR1 and LR2 models, and ADNEX were applicable to all lesions; however, in 72 lesions (24%), the simple rules were inconclusive.</div><div>We observed better performance for LR1 and simple rules, based on the following results: Sensitivity: LR1 91%. Specificity: simple rules 86%. PPV: simple rules 79%. NPV: LR1 88%.</div></div><div><h3>Conclusions</h3><div>Our study suggests that the subgroup of patients with complex adnexal masses, the IOTA risk stratification through LR1 shows higher sensitivity for risk stratification of malignancy, while simple rules has the highest specificity and diagnostic accuracy. However, it is inconclusive in one out of every four adnexal masses. Additionally, LR1–LR2 and ADNEX do not show significant differences in diagnostic accuracy.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 101000"},"PeriodicalIF":0.1,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528478","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}

引用次数: 0

Fisioterapia en el dolor tras cesárea 剖腹产后疼痛的物理治疗

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-16 DOI: 10.1016/j.gine.2024.101002

L. Monroy Martínez , I. Da Cuña Carrera , A. Alonso Calvete , L. Núñez Remiseiro , M. Fernández Paz

{"title":"Fisioterapia en el dolor tras cesárea","authors":"L. Monroy Martínez , I. Da Cuña Carrera , A. Alonso Calvete , L. Núñez Remiseiro , M. Fernández Paz","doi":"10.1016/j.gine.2024.101002","DOIUrl":"10.1016/j.gine.2024.101002","url":null,"abstract":"<div><div>Cesarean section is one of the most commonly performed surgeries in obstetrics and involves the removal of a neonate through an abdominal and uterine incision. This intervention can cause different consequences, such as pain, which can be treated using physiotherapy techniques. The objective of this work is to analyze the existing literature to know what the effects of physiotherapy are on pain after cesarean section. A bibliographic search was carried out in the databases PudMed, Cinahl, Medline, PEDro, Scopus, Web of Science and ENFISPO. The search terms «Pain», «Cesarean Section», «Physiotherapy», «Physical Therapy» and «Physical Therapy Modalities» were used. Studies were limited to randomized clinical trials published in English or Spanish. Of the 220 initial results, 12 articles were chosen for analysis. The therapies carried out were varied, including electrotherapy, massage therapy and cryotherapy to analyze different variables. Physiotherapy is beneficial in controlling pain in patients after a cesarean section through techniques such as TENS. Other therapies such as massage therapy and cryotherapy seem to obtain some improvements, but it cannot be concluded that they have significant benefits.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 101002"},"PeriodicalIF":0.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441298","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}

引用次数: 0

Violencia obstétrica: primera, segunda y tercera víctima 产科暴力：第一、第二和第三受害者

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-15 DOI: 10.1016/j.gine.2024.101001

L. Guillén Vargas , E.M. Aragoneses Tiburcio , M.J. Galván León , J.M. Martínez-Sánchez

引用次数: 0

¿Es la gestación a edad materna muy avanzada éticamente aceptable? 从伦理角度讲，孕产妇晚期妊娠是否可以接受？

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-14 DOI: 10.1016/j.gine.2024.101003

A. Martínez-Varea

{"title":"¿Es la gestación a edad materna muy avanzada éticamente aceptable?","authors":"A. Martínez-Varea","doi":"10.1016/j.gine.2024.101003","DOIUrl":"10.1016/j.gine.2024.101003","url":null,"abstract":"<div><div>In recent years, there has been an increase in the age at which women conceive and have children, especially in developed countries.</div><div>This study aims to elucidate whether pregnancy at a very advanced maternal age is ethically acceptable or if it is better to promote pregnancy at a younger age. The specific objectives include evaluating the medical risks associated with pregnancy at a very advanced maternal age and analyzing the ethical and social implications of pregnancies at advanced maternal ages.</div><div>A systematic review was conducted using PubMed and Web of Science with the keywords pregnancy outcome, 45 years, 50 years, very advanced maternal age, menopause, ethics, bioethics. Studies published in the last 10 years in Spanish or English were included. Reviews, meta-analyses, clinical cases, letters to the editor, comments, and opinion articles were excluded.</div><div>The systematic review revealed that pregnancy at age 45 or older is associated with more adverse maternal-fetal outcomes compared to younger ages. Thus, patients of very advanced maternal age should receive appropriate prenatal counseling and close prenatal monitoring. Women of very advanced age wishing to conceive with their own oocytes should be informed about the low probabilities of success and high risk of embryonic aneuploidies. Preimplantation genetic diagnosis is recommended for women over 43 years with good ovarian reserve, and in vitro fertilization cycles should be limited to three for patients aged 44-45 years. Patients aged 45-46 years should be informed about the minimal probability of success with autologous oocytes.</div><div>As a conclusion, pregnancy at a very advanced maternal age is increasingly common and is considered ethically acceptable by both patients and specialists in reproductive medicine and obstetrics and gynecology.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 101003"},"PeriodicalIF":0.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433429","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}

引用次数: 0

Management of thoracic neuropathic pain with an ESP block in a pregnant patient 用 ESP 阻滞治疗怀孕患者的胸椎神经痛

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-11 DOI: 10.1016/j.gine.2024.101004

L. Arce Gálvez , R.E. Valencia Gómez , A. Ceballos Vejarano , J. Daes Mora , D.A. Méndez Vega

引用次数: 0

Diagnóstico de cáncer renal metastásico en gestante a través de lesiones cutáneas: descripción de un caso clínico 通过皮肤病变诊断孕妇患有转移性肾癌：病例报告描述

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-10-05 DOI: 10.1016/j.gine.2024.100999

A. Ramírez Castán , M.J. Cuerva González , J.L. Bartha Rasero

{"title":"Diagnóstico de cáncer renal metastásico en gestante a través de lesiones cutáneas: descripción de un caso clínico","authors":"A. Ramírez Castán , M.J. Cuerva González , J.L. Bartha Rasero","doi":"10.1016/j.gine.2024.100999","DOIUrl":"10.1016/j.gine.2024.100999","url":null,"abstract":"<div><h3>Introduction</h3><div>Gestational cancer affects approximately 1 in 1,000 pregnant women, with renal cell carcinoma (RCC) being the most common in the urinary tract. RCC dissemination can include cutaneous metastases in 2.8-6.8% of cases. A multidisciplinary approach to RCC during pregnancy is crucial due to diagnostic and therapeutic challenges that can impact maternal and neonatal outcomes.</div></div><div><h3>Symptoms and Clinical Findings</h3><div>A 15-week pregnant woman presents with asymptomatic cutaneous lesions for 4 months. Physical examination reveals two erythematous-violaceous nodules in the right hypochondrium and two in the right thigh, all adherent to deep planes and without palpable lymphadenopathy.</div></div><div><h3>Diagnosis, Therapeutic Intervention, and Results</h3><div>Excisional skin biopsy with immunohistochemical and molecular studies suggests cutaneous metastasis of papillary-pattern renal carcinoma. Nuclear magnetic resonance reveals multiple metastatic implants and lymphadenopathies. Despite recommendations to terminate pregnancy for targeted therapy, the patient chooses to continue. At week 31, a cesarean section is performed due to maternal clinical deterioration from disease progression. Oncologic treatment with Cabozantinib begins postpartum. Six months later, the patient remains stable with significant lesion improvement.</div></div><div><h3>Conclusion</h3><div>Diagnosing cancer during pregnancy presents a complex challenge, balancing maternal prognosis with fetal health is critical. Emphasizing a multidisciplinary approach and early consultation optimizes both clinical and emotional management.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 100999"},"PeriodicalIF":0.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423093","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}

引用次数: 0

Descripción de un caso: liposarcoma de mama radioinducido 病例报告：放射性诱导的乳腺脂肪肉瘤

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-09-30 DOI: 10.1016/j.gine.2024.100998

M.I. Limia Pérez , J.A. Moreno Domingo , L. Juez González , M.J. Fernández Mellado , S. Ajuriagogeaskoa , L. Muñoz Arberas , A. Urones Goikoetxea

{"title":"Descripción de un caso: liposarcoma de mama radioinducido","authors":"M.I. Limia Pérez , J.A. Moreno Domingo , L. Juez González , M.J. Fernández Mellado , S. Ajuriagogeaskoa , L. Muñoz Arberas , A. Urones Goikoetxea","doi":"10.1016/j.gine.2024.100998","DOIUrl":"10.1016/j.gine.2024.100998","url":null,"abstract":"<div><h3>Main symptoms and/or clinical findings</h3><div>Breast sarcoma is a very rare entity that constitutes only 1% of all primary malignant breast tumors. It has a very poor prognosis with a high risk of recurrence. In this article, we present the case of a patient diagnosed with breast liposarcoma after having received radiotherapy for a previous breast carcinoma.</div></div><div><h3>Main diagnoses</h3><div>Due to the rarity of breast liposarcoma, it is important to make an adequate differential diagnosis. In our case, the study of overexpression of the MDM2 and/or CDK4 proteins allowed us to establish the definitive diagnosis.</div></div><div><h3>Therapeutic interventions and results</h3><div>The patient in our case underwent surgery, obtaining tumor-free margins with a favorable subsequent evolution. She currently has 18months of disease-free survival.</div></div><div><h3>Conclusion</h3><div>The treatment of breast liposarcoma is mainly surgical since this sarcoma has a poor response to both chemotherapy and radiotherapy. The correct tumor resection is the most important prognostic factor for local control of the disease and long-term survival.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 100998"},"PeriodicalIF":0.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358184","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}

引用次数: 0

Update on second trimester ultrasound scanning in pregnancy 孕期超声波扫描的最新进展

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2024-09-25 DOI: 10.1016/j.gine.2024.100997

I. Pelayo-Delgado , E. Gómez-Montes , M. Álvaro-Navidad

{"title":"Update on second trimester ultrasound scanning in pregnancy","authors":"I. Pelayo-Delgado , E. Gómez-Montes , M. Álvaro-Navidad","doi":"10.1016/j.gine.2024.100997","DOIUrl":"10.1016/j.gine.2024.100997","url":null,"abstract":"<div><div>Second trimester ultrasound is a standardised examination in pregnancy that should be routinely offered to all pregnant women, both for monitoring foetal growth and for screening for malformations. It should be performed between 18 and 24 weeks (in Spain from 18+0 to 22+0 weeks of gestation), by trained personnel and with appropriate equipment. The report should reflect foetal position and movements, biometry, amount of amniotic fluid, placental location and appearance, and foetal morphology. The foetal anatomy should include the study of the head (ossification and neurosonography), neck (discarding masses), thoracic cavity and its contents, abdomen and pelvis (studying stomach, umbilical vein, entrance of umbilical cord, kidneys, bladder), spine (in sagittal, coronal and axial planes), extremities (three segments, movement), and genitalia. Special attention should be paid to foetal heart examination (situs, four chamber view, left ventricular and right ventricular outflow-tracts, three-vessel and three-vessel-and trachea views). Neurosonography is also important with the transventricular, transcerebellar and transthalamic plane.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 100997"},"PeriodicalIF":0.1,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319854","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}

引用次数: 0