Clinical Medicine Insights-Reproductive Health最新文献_第6页

Fertility preservation in gynecological cancers. 妇科癌症患者的生育保护。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-03-21 DOI: 10.4137/CMRH.S10794

Shakuntala Chhabra, Imran Kutchi

{"title":"Fertility preservation in gynecological cancers.","authors":"Shakuntala Chhabra, Imran Kutchi","doi":"10.4137/CMRH.S10794","DOIUrl":"10.4137/CMRH.S10794","url":null,"abstract":"For cancers of reproductive system in women, fertility preservation is complex. Fertility is also affected by therapies, however prevention is possible. Radiotherapy affects gonads, uterus, and subsequent pregnancy outcomes in all ages. However, degree and damage depend on dose, irradiation field, and age at the time of exposure. Ovarian transposition is considered if ovarian involvement is unlikely. Gonadotoxic effects of chemotherapy are related to agent's type, cumulative doses, age, and ovarian reserve. Some agents are highly toxic. Rendering follicular development quiescent by suppression of gonadotropins does reduce the ovarian damage. Simple or radical trachelectomy can be used in early cervical cancer. Fertility saving surgery is possible only in early stage low grade epithelial cancers of the ovary, however, in germ cell tumors even in advanced stages it may be possible to preserve fertility. There are no standard recommendations for endometrial cancer. Embryo, oocyte, and ovarian tissue cryopreservation are possible. The human embryo is very resistant to damage. In view of these possibilities, it is advocated that attention to long term health and quality of life in gonadotoxic therapy must be incorporated into plans as early as possible. ","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ovarian Stem Cells-the Pros and Cons. 卵巢干细胞的利弊。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-03-20 DOI: 10.4137/CMRH.S11086

Ayelet Evron, Zeev Blumenfeld

引用次数: 7

Preimplantation genetic screening: a practical guide. 植入前遗传学筛查:实用指南。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-02-27 DOI: 10.4137/CMRH.S10852

Paul R Brezina, Raymond W Ke, William H Kutteh

引用次数: 22

Emerging options for emergency contraception. 紧急避孕的新兴选择。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-02-18 DOI: 10.4137/CMRH.S8145

Atsuko Koyama, Laura Hagopian, Judith Linden

引用次数: 0

Preimplantation genetic testing in the 21st century: uncharted territory. 21世纪的胚胎植入前基因检测:未知领域。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-02-10 DOI: 10.4137/CMRH.S10914

Paul R Brezina

引用次数: 10

Trends in hysterectomy for genital prolapse: rural experience. 子宫切除术治疗生殖器脱垂的趋势:农村经验。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-01-29 DOI: 10.4137/CMRH.S10804

Shakuntala Chhabra, Manjiri Ramteke, Sonali Mehta, Nisha Bhole, Yojna Yadav

{"title":"Trends in hysterectomy for genital prolapse: rural experience.","authors":"Shakuntala Chhabra, Manjiri Ramteke, Sonali Mehta, Nisha Bhole, Yojna Yadav","doi":"10.4137/CMRH.S10804","DOIUrl":"https://doi.org/10.4137/CMRH.S10804","url":null,"abstract":"The present study was conducted to investigate the trends of vaginal hysterectomy for genital prolapse in last 20 years by analyzing case records of affected women. During the analysis period, 4831 women underwent hysterectomy; records of 4223 (87.5%) were available. Of these, 911 (21.6%), 2.7% of 34,080 gynecological admissions, had vaginal hysterectomy for genital prolapse (study subjects). Eighty percent women who had vaginal hysterectomy for genital prolapse were over 40 years of age; however, most of these women had had the disorder for years before they presented. Only 4 (0.4%) women had not given birth, 874 (96%) women had had two or more births, and 383 (42%) had had 5 or more births. Having given birth was the major factor responsible for genital prolapse. In all, 94.2% of women presented with something coming out of the vagina.\" Some women presented with abnormal vaginal bleeding or pain in abdomen as the chief complaint although they had had uterovaginal prolapse for years. There was no mortality and morbidity decreased over the years. There has been no change in the rate of vaginal hysterectomy for genital prolapse over the years. Surgical morbidity decreased trend, possibly because of the preoperative, intraoperative, and postoperative precautions taken, especially preoperative treatment of urinary and genital tract infection. Attempts need to be made to have safe births and a healthy life style so as to prevent genital prolapse and in case it occurs, therapy to prevent progression so that major interventions like hysterectomy are averted. Meticulous preoperative evaluation and planned therapy help in reducing surgical morbidity, if surgery becomes essential. ","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S10804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The participation of prospective fathers in preconception care. 准父亲对孕前护理的参与。

Clinical Medicine Insights-Reproductive Health Pub Date : 2013-01-22 DOI: 10.4137/CMRH.S10930

Andrew E Czeizel, Benjamin Czeizel, Attila Vereczkey

引用次数: 7

Ovarian Damage During chemotherapy in Autoimmune Diseases: Broad Health Implications beyond Fertility. 自身免疫性疾病化疗期间卵巢损伤:生育之外的广泛健康影响。

Clinical Medicine Insights-Reproductive Health Pub Date : 2012-10-24 DOI: 10.4137/CMRH.S10415

Wendy Marder, Senait Fisseha, Martha A Ganser, Emily C Somers

{"title":"Ovarian Damage During chemotherapy in Autoimmune Diseases: Broad Health Implications beyond Fertility.","authors":"Wendy Marder, Senait Fisseha, Martha A Ganser, Emily C Somers","doi":"10.4137/CMRH.S10415","DOIUrl":"https://doi.org/10.4137/CMRH.S10415","url":null,"abstract":"Women with autoimmune diseases such as lupus, scleroderma, and vasculitis receiving cyclophosphamide for severe disease manifestations risk primary ovarian insufficiency(POI) due to gonadotoxicity of this therapy. In addition to loss of reproductive potential, POI is associated with increased risk of morbidity and mortality. Practitioners caring for women requiring gonadotoxic therapies should be familiar with long-term health implications of POI and strategies for ovarian preservation. Accumulating evidence supports the effectiveness of adjunctive gonadotropin releasing hormone analog (GnRH-a) for ovarian protection during gonadotoxic therapy in cancer and autoimmune populations. GnRH-a is less costly and invasive than assisted reproductive technologies used for achievement of future pregnancies, but is not Food and Drug Administration approved for ovarian preservation. This review focuses on POI comorbidities and strategies for mitigation of related sequelae, which can accumulate over decades of hypoesteogenism. These issues are arguably more pronounced for women with chronic autoimmune diseases, in whom superimposed POI further heightens risks of cardiovascular disease and osteoporosis. Therefore, even if future pregnancy is not desired, ovarian protection during gonadotoxic therapy should be a major goal of disease management.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S10415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31678291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 27

Monitoring maternal Beta carotene and retinol consumption may decrease the incidence of neurodevelopmental disorders in offspring. 监测母体β -胡萝卜素和视黄醇的摄入量可能会降低后代神经发育障碍的发生率。

Clinical Medicine Insights-Reproductive Health Pub Date : 2011-12-19 DOI: 10.4137/CMRH.S8372

Joel S Goldberg

{"title":"Monitoring maternal Beta carotene and retinol consumption may decrease the incidence of neurodevelopmental disorders in offspring.","authors":"Joel S Goldberg","doi":"10.4137/CMRH.S8372","DOIUrl":"https://doi.org/10.4137/CMRH.S8372","url":null,"abstract":"Retinoic acids (13-cis and 13-trans) are known teratogens, and their precursor is retinol, a form of vitamin A. In 1995, Rothman et al demonstrated an association between excessive vitamin A, >10,000 IU/day, during the first trimester of pregnancy and teratogenic effects, particularly in the central nervous system. However, vitamin A deficiency has long been known to be deleterious to the mother and fetus. Therefore, there may be a narrow therapeutic ratio for vitamin A during pregnancy that has not previously been fully appreciated. Neurodevelopmental disorders may not be apparent by macroscopic brain examination or imaging, and proving the existence of a behavioral teratogen is not straightforward. However, an excess of retinoic acid and some neurodevelopmental disorders are both associated with abnormalities in cerebellar morphology. Physical and chemical evidence strongly supports the notion that beta carotene crosses the placenta and is metabolized to retinol. Only very limited amounts of beta carotene are stored in fetal fat cells as evidenced by the fact that maternal fat is yellow from beta carotene, whereas non-brown neonatal fat is white. Furthermore, newborns of carotenemic mothers do not share the yellow complexion of their mothers. The excess 13-trans retinoic acid derived from metabolized beta carotene in the fetus increases the concentration of the more teratogenic 13-cis retinoic acid since the isomerization equilibrium is shifted to the left. Therefore, this paper proposes that consideration be given to monitoring all potential sources of fetal 13-cis and 13-trans retinoic acid, including nutritional supplements, dietary retinol, and beta carotene, particularly in the first trimester of pregnancy. ","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S8372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

The new extended-cycle levonorgestrel-ethinyl estradiol oral contraceptives. 新型延长周期左炔诺孕酮-乙炔雌二醇口服避孕药。

Clinical Medicine Insights-Reproductive Health Pub Date : 2011-09-19 DOI: 10.4137/CMRH.S5030

Rachel A Bonnema, Abby L Spencer

{"title":"The new extended-cycle levonorgestrel-ethinyl estradiol oral contraceptives.","authors":"Rachel A Bonnema, Abby L Spencer","doi":"10.4137/CMRH.S5030","DOIUrl":"10.4137/CMRH.S5030","url":null,"abstract":"Effective contraceptive counseling requires an understanding of a woman's preferences and medical history as well as the risks, benefits, side effects, and contraindications of each contraceptive method. Hormonal contraceptives using a variety of delivery methods are highly effective and this review highlights the new extended-cycle levonorgestrel-ethinyl estradiol contraceptives. Extended-cycle OCPs are unique in offering fewer or no withdrawal bleeds over the course of one year but providers need to carefully counsel women regarding the initial increased breakthrough bleeding. Extended-cycle OCPs may be of particular benefit in women with medical comorbidities who would benefit from less withdrawal bleeds, those desiring to avoid monthly menses due to increased hormonal withdrawal symptoms, or simply women who don't desire a monthly period. The risks associated with all extended-cycle OCPs have been found to be similar to those of traditional OCPs therefore counseling on the risks and side effects is comparable to that of any combined hormonal contraceptives. Newer extended-cycle regimens shorten or eliminate the hormone-free interval, decrease frequency of menses to four times per year or eliminate menses altogether. This can reduce the risk of common menstrual symptoms, endometriosis, or severe dysmenorrhea by offering potentially greater ovarian suppression and preventing endogenous estradiol production while still providing highly effective, rapidly reversible, and safe contraception. ","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0