Clinica e Investigacion en Ginecologia y Obstetricia最新文献_第9页

Controversias en el tratamiento de la endometriosis en la mujer estéril 不孕妇女子宫内膜异位症治疗的争议

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100890

J. Gilabert-Estelles , L. Rodríguez-Tabernero

{"title":"Controversias en el tratamiento de la endometriosis en la mujer estéril","authors":"J. Gilabert-Estelles , L. Rodríguez-Tabernero","doi":"10.1016/j.gine.2023.100890","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100890","url":null,"abstract":"<div><p>Endometriosis is a very complex disease that limits the lives of women who suffer from it in many areas of their lives, both due to the painful symptoms it causes and the medical complications it generates. In addition, it is capable of causing sterility by different mechanisms.</p><p>In the present work we intend to review the management of the patient with endometriosis and sterility, which has important particularities with respect to the usual treatment of endometriosis. Most of the medical treatments used have an anovulatory effect, which is why they prevent pregnancy, and surgical treatments can in turn have a detrimental effect on the ovarian reserve and the time necessary to achieve pregnancy. On the other hand, assisted reproduction techniques do not always achieve the desired objective and may require associated surgeries such as in the case of the presence of hydrosalpinx or ovaries not accessible to follicular puncture.</p><p>We also carried out a critical review of the medical literature and the guidelines of the different scientific societies to try to establish general criteria for the approach to these patients with endometriosis and sterility, who as a general rule should be treated by assisted reproductive techniques. A special analysis is made of the specific situations in which a differentiated approach with previous surgery is required when the function of a pelvic organ is in danger or in deep endometriosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100890"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49832933","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}

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Nuevo paradigma en la cirugía del mioma: reparación uterina 肌瘤手术的新范式：子宫修复

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100859

Maria Luisa Cañete , Alicia Hernandez , Violeta Romero , Ignacio Lobo , Juan Luis Alcazar

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Niveles de vitamina D en sangre materna y su relación con el consumo de pescado y los parámetros antropométricos de los recién nacidos en una cohorte de parejas madre/hijos de Sevilla 塞维利亚母子夫妇队列中母亲血液中维生素D水平及其与鱼类消费和新生儿人体测量参数的关系

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100860

B. Dahiri , P. Carbonero-Aguilar , I. Martin-Carrasco , R. Carrillo , N. Florez , L. Cerrillos , R. Ostos , J. Bautista , I. Moreno

{"title":"Niveles de vitamina D en sangre materna y su relación con el consumo de pescado y los parámetros antropométricos de los recién nacidos en una cohorte de parejas madre/hijos de Sevilla","authors":"B. Dahiri , P. Carbonero-Aguilar , I. Martin-Carrasco , R. Carrillo , N. Florez , L. Cerrillos , R. Ostos , J. Bautista , I. Moreno","doi":"10.1016/j.gine.2023.100860","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100860","url":null,"abstract":"<div><h3>Introduction</h3><p>To compare maternal vitamin D levels with the area of residence or the consumption of fish, as well as its relationship with the weight, length and cranial perimeter of babies.</p></div><div><h3>Materials and methods</h3><p>Cohort of 100 mother–child pairs (<em>n</em>    <.05). When applying the <em>t</em>-Student and the Wilcoxon test, there is no relationship between vitamin D levels and the area of residence or with maternal fish consumption (both <em>P</em>  <!-->.05).</p></div><div><h3>Conclusions</h3><p>Eighty percent of mothers present deficient and insufficient values of vitamin D. There is no correlation between this parameter and the length and cephalic perimeter of the baby, observing a negative correlation with birth weight. No correlation was observed between the area of residence or the consumption of fish and vitamin D levels in mothers. We suggest dietary supplements for pregnant mothers and monitoring of vitamin D levels in babies.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100860"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49832927","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

El tratamiento hormonal es imperativo para todas las pacientes: lo antes posible y siempre 激素治疗对所有患者都至关重要：尽快并始终

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100856

M.Á. Martínez-Zamora

{"title":"El tratamiento hormonal es imperativo para todas las pacientes: lo antes posible y siempre","authors":"M.Á. Martínez-Zamora","doi":"10.1016/j.gine.2023.100856","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100856","url":null,"abstract":"<div><p>Endometriosis is nowadays considered an inflammatory chronic benign disease that responds to hormone manipulation and affects up to 10% of women in fertile age. It seems that innate or acquired changes in the endometrium ability to implant, invade and grow in an inflammatory milieu with estrogenic dependence and progesterone resistance are the responsible for new endometriosis implants and contribute to perpetuate the illness. There is, at the moment, no optimal known treatment that achieves the four basic objectives for the treatment of endometriosis: treat the symptoms, improve fertility, eliminate endometrial implants, and avoid illness progression. As is now considered a chronic condition, the prescribed medical treatment, until the patient arrives to the physiological menopause status or gets pregnant, must be considered in the long term, and must be effective and safe. Therefore, the realistic objectives of the treatment are the reduction or abolishment of symptoms and/or improve fertility. As a consequence of the limitations and risks of endometriosis surgeries, the first-line treatment is hormonal. This must be individualized according to age, parity, pregnancy desire, associated symptoms, other illnesses and patients preferences. Globally, there are two main types of first-line hormonal treatments: estroprogestins in extended or continuous regimens and some progestins in different routes of administration (dienogest, norethisterone acetate or desogestrel orally, and levonorgestrel high-dose intrauterine device). The different hormonal treatments and their pros and cons are explained in the manuscript.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100856"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49832929","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

Controversias en el tratamiento de los miomas 肌瘤治疗的争议

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100854

M. Gracia , J. Isern Quitllet

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Fallo ovárico, una problemática para las mujeres en edad reproductiva y su relación genética 卵巢衰竭，育龄妇女的一个问题及其遗传关系

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100849

L.I. Jaramillo Jaramillo, M.D. Roldan Tabares, S. Castañeda Palacio, L.M. Martínez-Sánchez

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Manejo conservador con radioterapia e inmunoquimioterapia en el linfoma difuso de células B grandes primario de cuello uterino: Diagnóstico y tratamiento de una entidad rara 原发性大弥散性B细胞淋巴瘤放疗和免疫化疗的保守治疗:罕见实体的诊断和治疗

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100857

J.F. Robles Díaz

{"title":"Manejo conservador con radioterapia e inmunoquimioterapia en el linfoma difuso de células B grandes primario de cuello uterino: Diagnóstico y tratamiento de una entidad rara","authors":"J.F. Robles Díaz","doi":"10.1016/j.gine.2023.100857","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100857","url":null,"abstract":"<div><h3>Introduction</h3><p>Primary malignant cervical lymphoma is a very rare disease, which represents only 0.008% of all cervical tumors and 2% of all female extranodal lymphomas.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>The case of a 66-year-old woman from the Peruvian Andes is presented, with a disease period of 4 months characterized by gynaecorrhagia, with evidence of a 5cm tumor cervix. Immunohistochemistry was performed on the biopsy of cervix to differentiate lymphoma from squamous cell carcinoma.</p></div><div><h3>Primary diagnosis</h3><p>Primary diffuse large B-cell lymphoma of the cervix with Ann Arbor IE IPI low-risk staging.</p></div><div><h3>Therapeutic interventions and results</h3><p>She being managed with immunochemotherapy (rituximab, cyclophosphamide, adriamycin, vincristine and prednisone), followed by consolidative external radiotherapy at a dose of 3,000cGy in 15 sessions with a special IMRT technique. Resulting in satisfactory disease control and no complications from irradiation.</p></div><div><h3>Conclusion</h3><p>Primary diffuse large B-cell lymphoma of the cervix is very rare, therefore, in a case of primary stromal lesion of the cervix, suspicion of lymphoma should be taken into account.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100857"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49870558","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

Concept of opportunistic bilateral salpingectomy in a sample of Mexican gynecologists. What should residents be trained on? 机会性双侧输卵管切除术在墨西哥妇科医生样本中的概念。住院医生应该接受哪些培训?

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100878

J.C. Tirado-Tapia , E. Sanchez-Valdivieso

{"title":"Concept of opportunistic bilateral salpingectomy in a sample of Mexican gynecologists. What should residents be trained on?","authors":"J.C. Tirado-Tapia , E. Sanchez-Valdivieso","doi":"10.1016/j.gine.2023.100878","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100878","url":null,"abstract":"<div><h3>Background</h3><p>Ovarian cancer is the fifth deadliest cancer among women. There is no effective screening method. It has been suggested that ovarian cancer originates from precursor lesions in the fimbriae of the fallopian tubes.</p></div><div><h3>Objective</h3><p>The aim of this study was to determine the level of knowledge of opportunistic bilateral salpingectomy by gynecologists.</p></div><div><h3>Methods</h3><p>A cross-sectional study was carried out and a survey was sent electronically to gynecologists and gynecology residents. Demographic characteristics as well as questions of interest related to clinical practice and indication for surgery were included.</p></div><div><h3>Results</h3><p>52 subjects were included, 21 women and 31 men, with a mean age of 40.7 years. Thirty-five board certified gynecologists, as well as 17 gynecology residents, were included as part of the total survey group. Thirty-six individuals (69.2%) reported performing elective salpingectomy. The motivation they had to perform salpingectomy as a method of sterilization was: “reduction in the risk of ovarian cancer in the future” (55.6%). The indication for elective salpingectomy while performing other procedures was: “to prevent ovarian cancer” (61.1%). Certified gynecologists (42.9%) as well as residents (41.1%) considered “transvaginal ultrasound screening” as the best primary prevention method for ovarian cancer in low-risk women.</p></div><div><h3>Conclusions</h3><p>Opportunistic bilateral salpingectomy is safe and cost-effective. However, when gynecologists are interviewed to find out their level of knowledge, there is poor acceptance of opportunistic bilateral salpingectomy in Mexico. A training strategy should be designed in the gynecology residency in order to motivate ovarian cancer prevention.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100878"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49870198","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}

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Conceptos actuales en cirugía histeroscópica: superando barreras y ampliando límites 宫腔镜手术的当前概念：克服障碍和扩大界限

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100853

S. Haimovich Segal , E. Moratalla Bartolome , C. Ross Cerro , C. Vidal Mazo , C. Pérez Sagaseta

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Endometriosis: papel del láser de CO2 en el abordaje quirúrgico 子宫内膜异位症：二氧化碳激光在手术入路中的作用

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100855

M. Rius, F. Carmona

{"title":"Endometriosis: papel del láser de CO2 en el abordaje quirúrgico","authors":"M. Rius, F. Carmona","doi":"10.1016/j.gine.2023.100855","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100855","url":null,"abstract":"<div><p>The surgical treatment of choice for endometrioma is cystectomy or endometrioma decapsulation. However, there is sufficient scientific evidence showing that this technique is associated with a decrease in ovarian reserve, either due to the removal of healthy ovarian tissue during the procedure or due to thermal damage performed during the control of haemostasis. For this reason, new surgical approaches have been described to alleviate this negative effect on ovarian reserve. The use of the CO<sub>2</sub> laser in gynecology has been known since the 1980s, and vaporization of the endometrioma capsule using this laser is a simple, easy-to-use, easily reproducible, and technically accessible technique. Although it was initially thought that the recurrence rate with this technique was higher, several studies show the opposite. Likewise, the damage to the ovarian reserve is less compared to decapsulation, in terms of better follicular count and antimullerian hormone level. Although the rates of spontaneous pregnancy and assisted reproductive techniques are similar, in assisted reproductive techniques patients treated with CO<sub>2</sub> laser vaporization have a higher follicular count and antimullerian hormone level compared to patients treated with decapsulation. To this day, the treatment of endometrioma continues to be a matter of discussion. However, the studies reviewed below favor ablative techniques in terms of better preserving ovarian reserve without increased risk of recurrence.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 3","pages":"Article 100855"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49832932","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