Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Consenso multidisciplinar de mastitis granulomatosa: algoritmo diagnóstico y terapéutico","authors":"L. López-Vendrell ,&nbsp;L. Blay ,&nbsp;P. Rodriguez ,&nbsp;I. Pascual ,&nbsp;M.Á. Luna ,&nbsp;C. Rios ,&nbsp;A. Mariscal ,&nbsp;A. Olivé ,&nbsp;J.F. Julian ,&nbsp;I. Casafont","doi":"10.1016/j.gine.2024.100954","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100954","url":null,"abstract":"<div><p>Idiopathic granulomatous mastitis (IGM) is a benign chronic inflammatory disease affecting the breast stroma. Diagnosis is by exclusion and requires histopathological confirmation, as its clinical and radiological presentation may be similar to breast carcinoma. Treatment is mainly medical, complemented by percutaneous drainage and ultimately surgical.</p><p>Although it is a benign pathology, it can cause significant impairment of quality of life. Due to its nature, it requires a multidisciplinary approach. It is necessary to protocolise the management of this entity both to establish the diagnosis and to initiate appropriate treatment early and prevent progression to advanced stages.</p><p>The aim of this work is to standardise the diagnosis and treatment of IGM from a multidisciplinary approach following medical consensus. The diagnostic algorithm is described, considering risk factors for IGM, typical radiological signs in order to be able to detect suspected cases early and subsequently ensure early treatment, which is described in the following algorithm for treatment. We also describe a specific follow-up circuit.</p><p>These multidisciplinary diagnostic-therapeutic algorithms are proposed to raise awareness and standardise the approach to this rare disease, accelerating its diagnosis and optimising its treatment.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100954"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296224","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":"Manejo reproductivo de las mujeres con la premutación del FMR1. Revisión de la literatura","authors":"I. Agustí ,&nbsp;A. Borrás ,&nbsp;L. Rodriguez-Revenga ,&nbsp;D. Manau","doi":"10.1016/j.gine.2024.100955","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100955","url":null,"abstract":"<div><p>ertility preservation is indicated in most cases of oncologic diseases and when gonadotoxic treatments are prescribed. However, in recent years, there has been an increase in preservation cycles carried out for benign diseases and conditions with a risk of developing premature ovarian failure. Premature ovarian insufficiency is related to a genetic disorder in 10% of cases. The most common known conditions are <em>FMR1</em> premutation and Turner syndrome, and recently, other diseases such as mutations in the <em>BRCA 1/2</em> genes have been implicated in this pathology.</p><p>We conducted a bibliographic review on premature ovarian insufficiency associated with the premutation of the <em>FMR1</em> gene or <em>Fragile</em> X <em>Messenger Ribonucleoprotein 1</em>, the various pathophysiological theories described, and the difficulty in predicting which women will develop ovarian failure due to the lack of a useful predictive marker. Additionally, we evaluated different recommendations for managing these women and when to indicate the implementation of fertility preservation techniques. This option could prevent the psychological impact women of these women's reproductive health impairment.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100955"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296225","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":"Breast cancer with synchronous massive metastasis in uterine myoma: A case report and literature review","authors":"S. Eroglu ,&nbsp;S. Celik ,&nbsp;F. Tatlidil ,&nbsp;C. Caliskan ,&nbsp;S.M. Aydin","doi":"10.1016/j.gine.2024.100953","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100953","url":null,"abstract":"<div><h3>Introduction</h3><p>Metastasis of breast cancer to the uterus is an exceptionally rare occurrence, typically presenting with vaginal bleeding as the predominant symptom. Here, we present a case of synchronous lobular breast cancer metastasis to a uterine myoma.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>A 42-year-old infertile patient was admitted to the gynecology clinic with the complaints of meno/metrorrhagia. Ultrasound revealed a 5<!--> <!-->cm intramural myoma on the anterior wall of the uterus, leading to a myomectomy. The patient exhibited no symptoms related to breast cancer.</p></div><div><h3>Main diagnosis</h3><p>Histomorphological and immunohistochemical findings were indicative of breast-derived lobular carcinoma metastasis into leiomyoma.</p></div><div><h3>Therapeutic interventions and outcomes</h3><p>Positron emission tomography/computed tomography (PET/CT) scan revealed no pathological involvement beyond the breast and both axillary lymph nodes. The patient was diagnosed with stage IV breast lobular cancer and initiated chemotherapy treatment. Presently, the patient is undergoing regular monitoring at six-month intervals.</p></div><div><h3>Conclusion</h3><p>Uterine metastasis from extragenital organ cancers is exceedingly rare. In this instance, lobular breast cancer metastasis was confined to the uterine myoma. Clinicians and pathologists should exercise caution regarding gynecological metastases in breast cancer cases.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100953"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141898","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":"Preservación de la fertilidad en el paciente pediátrico y adolescente con cáncer","authors":"M. Andrés Moreno ,&nbsp;H. Martínez Sánchez ,&nbsp;F. Moreno Macián","doi":"10.1016/j.gine.2024.100966","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100966","url":null,"abstract":"<div><p>The significant increase in pediatric and adolescent cancer survivors in the last few decades, has highlighted on options to minimize long-term side effects related to treatment. Fertility preservation alternatives in girls after a cancer diagnosis are moving from being considered experimental to becoming an increasingly widespread healthcare practice. On the other hand, the real possibilities in prepubertal boys still have a longer way to improve. Since these are minor and especially vulnerable patients, multidisciplinary work is essential, with homogeneous criteria in patient selection and application of techniques. The following publication summarizes the state of the art on this subject, emphasizing the differentiating features in relation to the adult population.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100966"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141067919","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":"Sexual self-concept and intimacy in context of vaginismus: A case–control study","authors":"M. Banaei ,&nbsp;F. Alidost ,&nbsp;H. Shahrahmani ,&nbsp;F. Yazdani ,&nbsp;Z. Sepehri ,&nbsp;N. Kariman","doi":"10.1016/j.gine.2024.100965","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100965","url":null,"abstract":"<div><h3>Background</h3><p>As sexuality and its related issues are significantly associated with sociocultural settings, addressing the sexual health status of individuals in different societies is of the utmost importance. Women with vaginismus have more stress, anxiety, depression, and they also feel hopeless and have low self-esteem. And this problem can disturb intimacy between couples and women's sexual self-concept. Therefore, the present study was to determine and compare sexual self-concept and intimacy in women presenting with and without vaginismus.</p></div><div><h3>Methods</h3><p>This case–control study was conducted in 2021–2022 on 240 women with and without vaginismus, referring to selected sexual health clinics based in Iran. The data collection tools recruited were the demographic characteristics’ information, the Multidimensional Sexual Self-Concept Questionnaire, and the Sexual Intimacy Scale. To calculate the odds ratio of the studied variables, the logistic regression analysis using the SPSS Statistics software (ver. 25) was also employed.</p></div><div><h3>Results</h3><p>The mean age of women with and without vaginismus was 27.85<!--> <!-->±<!--> <!-->4.62 and 28.51<!--> <!-->±<!--> <!-->4.34, respectively. According to the regression results, the variables of sexual intimacy (odds ratio (OR)<!--> <!-->=<!--> <!-->0.864, <em>P</em> <!-->&lt;<!--> <!-->0.001), sexual awareness (OR<!--> <!-->=<!--> <!-->6.090, <em>P</em> <!-->=<!--> <!-->0.003), sexual-anxiety (OR<!--> <!-->=<!--> <!-->1.613, <em>P</em> <!-->&lt;<!--> <!-->0.001), fear of sex (OR<!--> <!-->=<!--> <!-->1.338, <em>P</em> <!-->=<!--> <!-->0.021) and sexual problem prevention (OR<!--> <!-->=<!--> <!-->0.765, <em>P</em> <!-->=<!--> <!-->0.016) were significantly associated with vaginismus.</p></div><div><h3>Conclusions</h3><p>According to these results, sexual intimacy, sexual awareness, sexual-anxiety, fear of sex and sexual problem prevention were significantly associated with vaginismus. Therefore, it is suggested that for the treatment of women with vaginismus, interventions can be designed to improve sexual intimacy, sexual knowledge and positive sexual self-concept and reduce sexual anxiety.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100965"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947760","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":"Non-elective caesarean section risk assessment using Machine Learning techniques","authors":"L. López-Mendizábal ,&nbsp;C. Varea ,&nbsp;A. Berlanga ,&nbsp;M.A. Patricio ,&nbsp;J.M. Molina ,&nbsp;J.L. Bartha","doi":"10.1016/j.gine.2024.100949","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100949","url":null,"abstract":"<div><h3>Background</h3><p>The sustained increase and the disparities in the rate of caesarean deliveries (CS) pose a public health challenge. Optimising the use of CS is of global concern and a challenge for public health. Machine Learning (ML) techniques can assist clinicians in decision-making, improving treatment modalities and patient outcomes.</p></div><div><h3>Methods</h3><p>Original data correspond to the 41,037 deliveries that took place at La Paz University Maternity Hospital (Madrid, Spain) between 2010 and 2018. Machine Learning (ML) model algorithm Random Forest (RF) was performed to determine the risk of CS. The first analysis was Mean Decrease Accuracy carried out on 50 permutations. The second analysis was ceteris-paribus and partial-dependence profiles.</p></div><div><h3>Results</h3><p>The RF models obtained identify a higher risk of CS delivery in multiple gestations, macrosomic foetuses and in those with prolonged gestation associated with other maternal–foetal characteristics. Results deny the consideration that older nulliparous mothers represent a specific obstetrtic risk goup.</p></div><div><h3>Conclusions</h3><p>ML techniques can be very useful in identifying risk factors to be addressed to optimise the number of CS. Macrosomia prevention programmes, reduction in the rate of multiple pregnancies or finishing pregnancy before the onset of risks associated with prolonged pregnancy may be ways to optimise the number of CS.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100949"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139943023","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":"Terapias innovadoras en pacientes con baja reserva ovárica e insuficiencia ovárica primaria","authors":"M. Méndez ,&nbsp;J. Ferreri ,&nbsp;L. Abelló ,&nbsp;F. Fàbregues","doi":"10.1016/j.gine.2024.100956","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100956","url":null,"abstract":"<div><p>Premature or primary ovarian insufficiency (POI) is characterized by the loss of ovarian function in women under 40<!--> <!-->years of age, with a prevalence of 1% of the female population. Women with POI face subfertility and premature symptoms associated with menopause. Currently, reproductive options for these patients are limited, primarily relying on oocyte donation. However, recent advances in the knowledge of the initial phases of folliculogenesis have allowed the proposal of new therapeutic strategies to try to restore ovarian function in these patients. In this paper, the physiological background, preliminary results on POI and DOR (decreased ovarian reserve) patients, as well as future challenges associated with these innovative treatments are addressed. The ovarian reactivation strategies analyzed in this review include surgical procedures (IVA and Drug-Free IVA), the infusion of growth factors from activated platelets (Platelet-Rich Plasma) or the use of stem cells and factors released by them (Stem Cell-Based Therapy), and the use of mitochondrial transfer therapies.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 3","pages":"Article 100956"},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290380","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":"Preservación de la fertilidad en personas transgénero del espectro masculino. Revisión narrativa de la literatura","authors":"A. Borrás Capó ,&nbsp;M. Méndez ,&nbsp;M. Mora Porta ,&nbsp;D. Manau Trullàs","doi":"10.1016/j.gine.2024.100950","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100950","url":null,"abstract":"<div><p>Gender affirming hormone therapy (GAHT) in transmasculine people (individuals who identify as men or on the masculine spectrum and were assigned female sex at birth) makes it possible to modify the secondary sexual characteristics of the sex assigned at birth, thus alleviating the symptoms of gender dysphoria, during the process called transition. However, it is necessary to highlight that the effect of GAHT on long-term fertility and its potential gonadotoxic effects are currently unknown. Knowledge of the effects of testosterone on fertility and reproduction has increased recently, whilst the request for comprehensive reproductive counselling and the option of performing fertility preservation (FP) techniques have increased exponentially in recent years, leading to profound changes in the clinical management of this population.</p><p>In this review, we analyzed all the information published regarding the effect of GAHT on reproduction and the FP techniques available in this group, mainly oocyte vitrification. In addition, we carry out an exhaustive analysis of the reproductive results published to date after the use of preservation techniques and present the latest laboratory advances concerning ovarian tissue cryopreservation and in vitro oocyte maturation, together with future options in the transmasculine people.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100950"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139743910","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":"Preservación de la fertilidad en el tumor ovárico borderline","authors":"S. Peón Muñoz","doi":"10.1016/j.gine.2023.100933","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100933","url":null,"abstract":"<div><p>Borderline ovarian tumors (BOTs) are defined as “tumors of low malignant potential”. These are epithelial neoplasms that debut mainly in young women, and are usually diagnosed in the initial stages of the disease.</p><p>The main key to its treatment is surgery, thus compromising the fertility of the patient who has not fulfilled her reproductive desire. In general, the choice of surgery for BOTs should consider the characteristics of the tumor, the patient's fertility desires, and the extent of the disease. The decisions made in this regard must be individualized and advised by a multidisciplinary team.</p><p>Fertility preservation (FP) plays an important role in the management of these patients, and there are different strategies to improve and maintain their quality of life.</p><p>Reproductive counseling should be an integral part of clinical management, with risks and benefits carefully considered.</p><p>Given its low incidence, there is little literature on the matter, requiring well-designed prospective studies to address specific fertility problems both in the initial diagnosis and in recurrences of patients with BOTs.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100933"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100577","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":"¿Cuál es el manejo óptimo de la leiomiomatosis peritoneal diseminada? Un caso clínico con 15 años de seguimiento sin malignización","authors":"A. de Labaig Revert,&nbsp;V.M. Patiño Maraver,&nbsp;M.M. Muñoz Díaz","doi":"10.1016/j.gine.2024.100952","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100952","url":null,"abstract":"<div><h3>Introduction</h3><p>Disseminated peritoneal leiomyomatosis (DPL) is a benign pathology, defined by the presence of multiple disseminated nodules in the peritoneum of different sizes composed of bundles of smooth muscle cells. Several theories are postulated about its origin related to hormonal stimulus, genetic susceptibility and iatrogenesis after surgeries such as laparocopic myomectomies.</p></div><div><h3>Clinical findings</h3><p>Patients usually present with abdominal discomfort of various kinds, and it may even be asymptomatic, being an incidental finding on imaging tests.</p></div><div><h3>Main diagnoses</h3><p>The differential diagnosis usually includes carcinomatosis, endometriosis, endosalpingiosis, tumours of the gastrointestinal tract or leiomyosarcoma.</p></div><div><h3>Therapeutic interventions</h3><p>There is insufficient evidence about the best approach, with some advocating expectant management or medical treatment and others advocating more radical surgical management. Among medical treatments, one of the most widely used are GnRH agonists, aromatase inhibitors and selective progesterone receptor modulators such as ulipristal acetate have also been used with good results.</p></div><div><h3>Results</h3><p>In this case we present a patient with LPD with 15 years of follow-up in our hospital, with no evidence of malignancy.</p></div><div><h3>Conclusion</h3><p>Knowing the generally benign nature of this disease, it is necessary to opt for the least invasive approach possible. The long-term evolution of this disease is unknown, as most published cases do not have sufficient follow-up time.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100952"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141948","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}