{"title":"An exploratory, prospective cohort study of non-invasive dynamic quadripolar radiofrequency energy in vulvar lichen management. The new-generation DQRF™ option","authors":"V. Prestia, Elena G. Bertozzi, M. Raichi","doi":"10.15761/ogr.1000158","DOIUrl":"https://doi.org/10.15761/ogr.1000158","url":null,"abstract":"Introduction: The main vulvar lichen treatment goal is itch reduction; improving and preserving the skin integrity and texture, healing the fissures and erosions, and preventing the later disfiguring fibrosis are the other crucial treatment goals. The side effect burden of high-potency topical corticosteroids, the current gold standard, can be heavy and alternative options are welcome. The paper illustrates the first exploratory outcomes in vulvar lichen planus and lichen sclerosus by the latest low- energy technological evolution of radiofrequency treatments, Dynamic Quadripolar RadioFrequency™, in synergistic combination with in-depth penetration of active principles via Ultra-Pulsed Radioporation™. Methods: Explorative cohort study in 58 ambulatory women 27 to 80 years old, eighteen nulliparous and 26 uniparous, 53.4% in the postmenopausal period. The DQRF™ treatment program mainly aimed at symptom control, with four weekly sessions - 10 minutes over the lichenified vulvar areas and 10 minutes of vaginal rejuvenation even without evidence of lichen vaginal extension. Assessments (baseline and at the end of the treatment cycle): pain and dyspareunia (10-cm impromptu Visual Analogue Scales), vulvar burning (4-score Likert-like impromptu scale), vulvar lesions (binary evaluation - Yes / No). Results: After a month, vulvar lichen inflammation appeared cooled down, and all cohort women reported dramatic improvements in daily and sexual symptoms - variable between -81.2% and -92% for pain, burning and itching, and -83% for dyspareunia. Conclusions: Control of lichen inflammation, as documented by sequential photographs, is likely the rationale behind the very favourable outcomes after DQRF™ + UPR™ treatment. Well-designed comparative studies are critical to defining the role of the novel radiofrequency technology in vulvar lichen management.","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"25 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87406504","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}
Firas Al-Rshoud, Azmi Qudsi, Firas Wael Naffa, Bayan Al Omari, Areen Ghazi AlFalah
{"title":"The Use and Efficacy of Mobile Fertility-tracking Applications as a Method of Contraception: a Survey.","authors":"Firas Al-Rshoud, Azmi Qudsi, Firas Wael Naffa, Bayan Al Omari, Areen Ghazi AlFalah","doi":"10.1007/s13669-021-00305-4","DOIUrl":"https://doi.org/10.1007/s13669-021-00305-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to investigate the use and efficacy of fertility tracking applications as a natural contraceptive method since there has been a worldwide increase in the development and use of applications that monitor the menstrual cycle and fertility window. An anonymous online survey had been conducted in order to achieve this goal, and a total of 375 married women from Jordan responded to our survey.</p><p><strong>Recent findings: </strong>Topics discussed include fertility awareness-based methods (FAM) of contraception in which mobile applications fall into, and their efficacy and failure rates, comparing them with other methods of contraception while taking into account the typical and perfect use of each method. Motivation has also been looked at as a factor affecting the efficacy of FAM and advantages/disadvantages of this method were discussed. The prevalence of mobile applications that monitor fertility signs and their expected increased use over the next years was also discussed.</p><p><strong>Summary: </strong>The use of fertility tracking applications is not uncommon amongst sexually active women in reproductive age, and the majority of users rely on them to track their fertility window. However, the efficacy of such applications as a method of contraception is not high and there is a significant failure rate especially if used alone. It is worth noting that 50% of women who reported failure relied solely on mobile applications and fertility window assessment without using other methods of contraception, and thus we advise women to use more reliable methods of contraception and not rely solely on such applications.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"10 2","pages":"25-29"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s13669-021-00305-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25558624","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}
B. Eiben, H. Borth, N. Kutur, C. Courtis, Anna Teubert, S. Knippenberg, Thomas Winkler, R. Glaubitz
{"title":"Clinical experience with noninvasive prenatal testing in Germany: Analysis of over 500 high-risk cases for trisomy 21, 18, 13 and monosomy X","authors":"B. Eiben, H. Borth, N. Kutur, C. Courtis, Anna Teubert, S. Knippenberg, Thomas Winkler, R. Glaubitz","doi":"10.15761/ogr.1000157","DOIUrl":"https://doi.org/10.15761/ogr.1000157","url":null,"abstract":"Analysis of 545 NIPT high-risk cases with high risk for trisomy 21 (T21), 18 (T18), and 13 (T13), as well as monosomy X (MX) from routine NIPT testing in a single prenatal center in Germany. Analysis was performed using the VeriSeq NIPT Solution v2 (Illumina Inc., USA). The assessment of true vs false positive results were based on clinical outcome data. The average fetal fraction of 9.7% was within the expected range in T21 and MX but lower in T18 and T13. For all high-risk groups sensitivity and specificity was far above 99%. The positive predictive value (PPV) was highest at trisomy 21 with 94.1%, followed by trisomy 18 with 80.9%. For trisomy 13 and Monosomy X, the PPV was clearly lower at 60.5% and 65.6%, respectively. PPV was dependent on different indications and maternal age. We could show that statistical tools of the method like the log likelihood ratio (LLR) score and T-Statistics value are important to distinguish between (clinical) false positive and true positive NIPT results in trisomies. The relationship between results and quality scores is less significant for MX cases. The study shows that the Illumina VeriSeq v2 procedure is a highly reliable NIPT method with a low no call rate in the hands of experienced diagnostic laboratories.","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"09 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86036268","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":"Challenges in managing a pregnancy with underlying renal fibromuscular dysplasia","authors":"Kumaressan Ragunathan, Selva Ashwini Selvaraj","doi":"10.15761/ogr.1000159","DOIUrl":"https://doi.org/10.15761/ogr.1000159","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"33 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86062515","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}
C. Monteith, Eva Forman, A. Kampmeijer, S. Jaleel, B. Hayes, K. Flood
{"title":"The natural history of moderate-severe ventriculomegaly: A review of cases managed expectantly in an Irish tertiary Centre","authors":"C. Monteith, Eva Forman, A. Kampmeijer, S. Jaleel, B. Hayes, K. Flood","doi":"10.15761/ogr.1000154","DOIUrl":"https://doi.org/10.15761/ogr.1000154","url":null,"abstract":"Introduction: Prenatal counselling for cerebral ventriculomegaly is challenging due to varied factors and prognoses. There is limited data about the natural history of affected pregnancies managed expectantly. We sought to review the prenatal course, obstetric and paediatric outcomes in cases of moderate to severe cerebral ventriculomegaly in an Irish tertiary maternity unit. Materials and methods: Retrospective review of patients attending the Fetal Assessment Unit from 2006-2014 with lateral cerebral ventricular measurements >12 mm on ultrasound. Results: During the nine-year period, 93 cases were identified with pregnancy outcome data available for 80 cases and 54 continuing in our institution. Vaginal delivery was achieved in 28.9% of women with 71.1% undergoing caesarean. There were 9 cases of intrauterine demise and an additional six neonatal deaths and three paediatric deaths. An isolated neural tube defect was present in 12 babies. Of the remaining 33 babies a diagnosis was confirmed in 60.6% of which, 45% were achieved antenatally. Conclusions: A diagnosis was obtained in 70% of live births. The presence of ventriculomegaly had a significant impact on the mode of delivery and maternal morbidity. The survival rate was 66.6% with high rate of neurodevelopmental delay recognized in survivors particularly in cases without a clear diagnosis.","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"4 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75338414","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":"Correction to: Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review","authors":"Shaalini Ramanadhan, W. Jusko, A. Edelman","doi":"10.1007/s13669-020-00301-0","DOIUrl":"https://doi.org/10.1007/s13669-020-00301-0","url":null,"abstract":"","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"10 1","pages":"14-15"},"PeriodicalIF":0.5,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s13669-020-00301-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43280511","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":"Medical transition for gender diverse patients.","authors":"Chelsea N Fortin, Molly B Moravek","doi":"10.1007/s13669-020-00297-7","DOIUrl":"https://doi.org/10.1007/s13669-020-00297-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to provide an up-to-date overview of gender-affirming hormone therapy, including the various hormone regimens available, the efficacy and potential risks of these treatments, and considerations for surveillance and long-term care.</p><p><strong>Recent findings: </strong>Recent studies reaffirm that hormone therapy has positive physical and psychological effects for many transgender individuals. The overall risks of treatment are low. Transgender women may have an increased risk of venous thromboembolism and breast cancer based on recent cohort studies, but these findings have yet to be confirmed with randomized controlled trials. Important long-term considerations include metabolic, cardiovascular, and skeletal health.</p><p><strong>Summary: </strong>High-quality, long-term studies on the effectiveness and safety of various gender-affirming hormone treatment regimens are lacking, but the currently available evidence suggests that it is overall safe and effective with appropriate oversight.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"9 4","pages":"166-177"},"PeriodicalIF":0.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s13669-020-00297-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9157964","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}
{"title":"Long-term Health Consequences of Endometriosis - Pathways and Mediation by Treatment.","authors":"Leslie V Farland, Holly R Harris","doi":"10.1007/s13669-020-00287-9","DOIUrl":"https://doi.org/10.1007/s13669-020-00287-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to discuss the most up to date research on endometriosis and chronic disease risk, highlighting the role treatments for endometriosis may play in these associations.</p><p><strong>Recent findings: </strong>Previous studies have shown a consistent association between endometriosis and risk for epithelial ovarian cancer but the association with other cancers is less clear. Current research indicates that endometriosis may in be associated with risk of systemic lupus erythematosus, and potentially other autoimmune diseases. Limited evidence is also present for the association between endometriosis and cardiovascular disease and related conditions (e.g,. hypertension, hypercholesterolemia). A potential explanation for a portion of the increased risk of chronic diseases among women with endometriosis may relate to treatments for endometriosis impacting these outcomes.</p><p><strong>Summary: </strong>Given the prevalence of endometriosis, understanding the relation between endometriosis and other chronic diseases has the potential to impact the health of many women. However, few high-quality studies with limited biases and adequate follow-up currently exist. Future multi-disciplinary research in prospective cohorts, with ample follow-up time, and detailed information on endometriosis characteristics and treatment is critical to advancing our understanding of this disease and its consequences.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"9 3","pages":"79-88"},"PeriodicalIF":0.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s13669-020-00287-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25341835","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}
{"title":"Interactions between Hormonal Contraception and Anti-Retroviral Therapy: An Updated Review.","authors":"Gopika R Krishna, Lisa B Haddad","doi":"10.1007/s13669-020-00289-7","DOIUrl":"https://doi.org/10.1007/s13669-020-00289-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hormonal contraception provides women living with HIV the ability to control their fertility and avoid pregnancy-related morbidity. Due to shared metabolic pathways, there has been concern over drug-drug interactions between hormonal contraception and anti-retroviral therapy, which may affect the drugs' safety and efficacy. This article aims to provide an updated review of the most recent data around hormonal contraceptives and anti-retroviral therapy.</p><p><strong>Recent findings: </strong>Prior data have suggested possible pharmacologic interactions between certain hormonal contraceptives and anti-retroviral therapy. The most significant interactions implicated include those between progestin-based contraceptive implants and efavirenz as well as between combined hormonal contraceptives and protease inhibitors. Most past studies, however, feature small sample sizes with few clinical outcomes reported.</p><p><strong>Summary: </strong>Recent data since 2017 have largely affirmed prior studies on this topic, showing possible pharmacokinetic relationships between certain contraceptives and anti-retrovirals. Notably, while the effectiveness of progestin-based contraceptives, specifically the implant, appears reduced with efavirenz use, the overall effectiveness may remain higher than most other contraceptive methods. Larger studies are needed to provide further guidance before contraceptive-prescribing recommendations can be changed.</p>","PeriodicalId":44726,"journal":{"name":"Current Obstetrics and Gynecology Reports","volume":"9 3","pages":"98-104"},"PeriodicalIF":0.5,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s13669-020-00289-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25341834","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}