Current Opinion in Obstetrics & Gynecology最新文献_第2页

Alternative treatments of adenomyosis - an update in procedural management and clinical outcomes. 子宫腺肌症的替代治疗--程序管理和临床结果的最新进展。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI: 10.1097/GCO.0000000000000972

Alison M Zeccola, Sarah E Allen

{"title":"Alternative treatments of adenomyosis - an update in procedural management and clinical outcomes.","authors":"Alison M Zeccola, Sarah E Allen","doi":"10.1097/GCO.0000000000000972","DOIUrl":"10.1097/GCO.0000000000000972","url":null,"abstract":"Purpose of review: Adenomyosis is a common cause of abnormal uterine bleeding (AUB), dysmenorrhea, and pelvic pain. Definitive diagnosis and treatment have historically been by uterine histopathology at time of hysterectomy; however, advances in imaging have supported earlier diagnosis and subsequent conservative treatment. This review aims to update the evidence supporting the uterine-sparing, procedural management options with a focus on clinical outcomes.Recent findings: Uterine artery embolization (UAE), radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and adenomyomectomy are minimally invasive interventions proven to be effective in reducing AUB and dysmenorrhea due to adenomyosis. Symptom improvement is associated with a decrease in uterine volume. Studies support the use of alternative treatment options given the overall low rates of symptom recurrence and reintervention. Combination therapy may be more effective than monotherapy.Summary: This review provides the current evidence for use of alternative treatment options for adenomyosis. Access to ablative therapies in the USA is limited and primarily off label, given lack of FDA approval. High-quality prospective and randomized controlled trials are needed in order to further delineate treatment comparisons, efficacy, safety, and ideal patient selection for these treatments. More data are needed to assess safety and utility in those desiring future fertility.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of lifestyle and dietary modifications for endometriosis development and symptom management. 调整生活方式和饮食对子宫内膜异位症发展和症状控制的影响。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-06-07 DOI: 10.1097/GCO.0000000000000969

Amber Trujillo Lalla, Christina Onyebuchi, Elisa Jorgensen, Nisse Clark

{"title":"Impact of lifestyle and dietary modifications for endometriosis development and symptom management.","authors":"Amber Trujillo Lalla, Christina Onyebuchi, Elisa Jorgensen, Nisse Clark","doi":"10.1097/GCO.0000000000000969","DOIUrl":"10.1097/GCO.0000000000000969","url":null,"abstract":"Purpose of review: Management of endometriosis is often complex and poorly studied. Patients with endometriosis have interest in how their lifestyle may affect their diagnosis. Self-management and lifestyle changes are often used as adjunct therapy, but best practices are not concrete in treatment guidelines.Recent findings: Lifestyle impact on endometriosis and possible self-management treatment therapies are reviewed. Overall, there is a need for future studies in all topics. Data suggest a link between endocrine-disrupting chemicals (EDCs), particularly persistent EDCs, and endometriosis. More work is needed to isolate and quantify exposures and explore their connection to endometriosis in order to provide guidance for clinical practice recommendations. There is insufficient evidence to support a superior diet for management of endometriosis; however, the Mediterranean diet may have the most benefit without nutrition concerns. Exercise may be another tool to improve endometriosis symptoms, but once again data are limited and best type and frequency is not well studied. Best evidence supports body-mind practices such as yoga, although new evidence suggests benefit from a holistic combination of several types of exercises.Summary: Overall, data on lifestyle effects and associated therapies are limited. Future high-quality studies are needed to guide practice.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond the cuff: a consideration of factors that affect sexual function after benign hysterectomy. 袖口之外：良性子宫切除术后影响性功能因素的思考。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-15 DOI: 10.1097/GCO.0000000000000959

Natalie Cohen, Riley Young, Emily Lin, Lisa Chao

{"title":"Beyond the cuff: a consideration of factors that affect sexual function after benign hysterectomy.","authors":"Natalie Cohen, Riley Young, Emily Lin, Lisa Chao","doi":"10.1097/GCO.0000000000000959","DOIUrl":"https://doi.org/10.1097/GCO.0000000000000959","url":null,"abstract":"Purpose of review: Hysterectomy is the most common gynecologic surgical procedure performed on women in the United States. While there are data supporting that hysterectomy for benign indication often does not reduce sexual function and may in fact improve sexual function as fibroids and endometriosis are resected, it remains unclear if there are factors within the perioperative period that affect sexual function in the years following surgery. To date, there is no consensus on what factors can optimize patients' sexual function after hysterectomy.Recent findings: We present the current literature that assesses factors which may contribute to sexual function after hysterectomy. Preoperative demographic factors, including increasing age, pelvic pain, and preoperative sexual dysfunction, play a large role in postoperative sexual function. Perioperatively, there is a growing amount of data suggesting that premenopausal salpingo-oophorectomy at the time of hysterectomy may increase the risk of sexual dysfunction after hysterectomy, and no conclusive evidence that subtotal hysterectomy improves sexual function. The route of hysterectomy and technique of cuff closure can impact sexual function after hysterectomy due to the risk of shortening the vaginal length.Summary: There is a lack of high-quality evidence that can provide a consensus on factors to optimize sexual function after hysterectomy. A growing area of research in the excision of endometriosis procedures is the consideration of nerve-sparing surgery. Considering the many variables that exist when counseling a patient on benign hysterectomy and its effects on sexual function, it is critical to understand the current research that exists with regards to these factors.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Climate change and human health: a primer on what women's health physicians can do on behalf of their patients and communities. 气候变化与人类健康：妇女保健医生可为病人和社区做些什么的入门指南。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-04-25 DOI: 10.1097/GCO.0000000000000958

Ruben Alvero

引用次数: 0

Emerging post-Dobbs liability concerns for providers handling embryos. 处理胚胎的医疗服务提供者在多布斯事件后新出现的责任问题。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-14 DOI: 10.1097/GCO.0000000000000962

Susan L Crockin, Francesca E Nardi

{"title":"Emerging post-Dobbs liability concerns for providers handling embryos.","authors":"Susan L Crockin, Francesca E Nardi","doi":"10.1097/GCO.0000000000000962","DOIUrl":"10.1097/GCO.0000000000000962","url":null,"abstract":"Purpose of review: This review outlines novel, emerging legal risks for in-vitro fertilization (IVF) providers and patients.Recent findings: This article reviews recent antiabortion legal developments that create novel legal risks to IVF. This article examines new potential liability for the handling or managing of embryos, and threats to safe, efficient, standard-of-care practice of IVF. It reviews established US and international judicial and regulatory frameworks based on scientifically grounded recognition of IVF embryos as deserving of 'special respect', and finds this approach to be an alternative for law and policy makers.Summary: Defining life as 'beginning at fertilization' (or 'conception') or otherwise embracing 'embryonic personhood' creates emerging legal vulnerabilities and concerns for IVF patients and professionals who handle embryos and threatens standard-of-care IVF. Internationally and domestically established, scientifically grounded understandings of IVF embryos, rather than religious beliefs, should be the basis for legal frameworks that accord appropriate - but not unlimited - protections to IVF embryos. This article presents this framework as an alternative to the current path being embraced by some US policymakers and courts, as a means of protecting the rights of patients, providers and the families they create.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Violence in the healthcare workplace. 医疗工作场所的暴力行为。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-16 DOI: 10.1097/GCO.0000000000000961

Courtney Hargreaves, Joseph R Wax

引用次数: 0

Advances in gynecologic simulation: implementation, validity, and new resources. 妇科模拟的进展：实施、有效性和新资源。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-20 DOI: 10.1097/GCO.0000000000000963

Kathryn Edmonds, Steve Warner, Scott Endicott

{"title":"Advances in gynecologic simulation: implementation, validity, and new resources.","authors":"Kathryn Edmonds, Steve Warner, Scott Endicott","doi":"10.1097/GCO.0000000000000963","DOIUrl":"10.1097/GCO.0000000000000963","url":null,"abstract":"Purpose of review: Simulation plays an integral role in gynecological surgical training that will continue and grow in the future. It aims to supplement surgical training as residents are experiencing decreased surgical volumes. It has also been recognized as a means for assessing a trainee's capabilities to the point of being incorporated into the board certification process. This review will highlight the recent updates in research and resources available for gynecologic surgery simulation.Recent findings: The literature reviewed demonstrated that, across the board, participants in simulation find it beneficial. A variety of low-fidelity and high-fidelity models, virtual reality programs, and artificial intelligence technology have been developed recently. As the field advances, researchers have started to investigate methods to increased engagement and provide feedback without the need for direct observation, the logical next step considerations to maximize the impact and availability of simulation.Summary: Gynecologic surgery training programs must stay abreast of the wide variety of simulation training available. Efforts should continue to be made to investigate the impact of simulation patient outcomes. The academic medicine community has a responsibility to ensure high-quality simulation is available to all surgical trainees to avoid disparities between low-resource and high-resource programs.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical treatment of colorectal endometriosis: an updated review. 结直肠子宫内膜异位症的手术治疗：最新综述。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-13 DOI: 10.1097/GCO.0000000000000960

Rebecca J Schneyer, Kacey M Hamilton, Raanan Meyer, Yosef Y Nasseri, Matthew T Siedhoff

{"title":"Surgical treatment of colorectal endometriosis: an updated review.","authors":"Rebecca J Schneyer, Kacey M Hamilton, Raanan Meyer, Yosef Y Nasseri, Matthew T Siedhoff","doi":"10.1097/GCO.0000000000000960","DOIUrl":"10.1097/GCO.0000000000000960","url":null,"abstract":"Purpose of review: This review aims to summarize recent literature on the surgical treatment of colorectal endometriosis.Recent findings: The last decade has seen a surge in the number of studies on bowel endometriosis, with a focus on preoperative evaluation, perioperative management, surgical approach, and surgical outcomes. Many of these studies have originated from large-volume referral centers with varying surgical approaches and philosophies. Colorectal surgery for endometriosis seems to have a positive impact on patient symptoms, quality of life, and fertility. However, these benefits must be weighed against a significant risk of postoperative complications and the potential for long-term bowel or bladder dysfunction, especially for more radical procedures involving the lower rectum. Importantly, most studies regarding surgical technique and outcomes have been limited by their observational design.Summary: The surgical management of bowel endometriosis is complex and should be approached by a multidisciplinary team. Methodical preoperative evaluation, including appropriate imaging, is vital for surgical planning and patient counseling. The decision to perform a more conservative or radical excision is nuanced and remains an area of controversy. High quality studies in the form of multicenter randomized controlled trials are needed before clear recommendations can be made.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review of sustainable practices for the gynecology operating room. 妇科手术室可持续发展实践回顾。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-28 DOI: 10.1097/GCO.0000000000000965

Elissa Trieu, Laura C Ramirez-Caban, Marie E Shockley

{"title":"Review of sustainable practices for the gynecology operating room.","authors":"Elissa Trieu, Laura C Ramirez-Caban, Marie E Shockley","doi":"10.1097/GCO.0000000000000965","DOIUrl":"10.1097/GCO.0000000000000965","url":null,"abstract":"Purpose of review: Climate change has immediate impacts on women's health. Hospitals and operating rooms are large contributors to greenhouse gas (GHG) emissions and waste. This article will review current green initiatives designed to minimize environmental impact in the operating room and highlight areas for future improvement.Recent findings: From a materials perspective, reusable goods result in less GHG emissions while being just as efficacious, well tolerated, and easy to use. Materials should be opened judiciously, only as necessary. Processing regulated medical waste produces greater GHG emissions, so waste should be properly sorted, and items which are not biohazard waste should be processed separately. Choosing appropriate anesthesia and utilizing an 'off' setting, in which operating rooms are shut down when not in use, can also drastically decrease the environmental impact of surgery. Further research is needed to determine effective implementation in hospitals.Summary: This article summarizes current attempts to make operating rooms more sustainable. Many practices result in a decreased carbon footprint and cost savings without adversely affecting patient outcomes. Gynecologic surgeons and the hospitals in which they practice need to focus on implementing these changes in a timely fashion.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recruiting and cultivating future leaders in laboratory science. 招募和培养实验室科学领域的未来领袖。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-04-29 DOI: 10.1097/GCO.0000000000000957

Alison Bartolucci, Charlene Alouf, Marlane Angle, Sangita Jindal

{"title":"Recruiting and cultivating future leaders in laboratory science.","authors":"Alison Bartolucci, Charlene Alouf, Marlane Angle, Sangita Jindal","doi":"10.1097/GCO.0000000000000957","DOIUrl":"10.1097/GCO.0000000000000957","url":null,"abstract":"Purpose of review: Technological in-vitro fertilization (IVF) advancements originate in the embryology laboratory, and are accompanied by increased regulatory oversight and risk management. Stakes have never been higher or the need greater for the recruitment and cultivation of leaders in laboratory science to navigate the direction of IVF. Current thought leaders in state-of-the-art laboratories must prioritize this mission to optimize and preserve the future of IVF.Recent findings: Leaders in laboratory science must be able to speak to patients, the lay public, business leaders, scientific colleagues and clinical embryologists. While technically gifted, laboratory leaders may benefit from leadership training. Recruitment of scientists into IVF is currently challenging due to a lack of branding and no clear pipeline for new scientists to enter the field. Once recruited however, cultivation of new leaders requires coaching and skill acquisition over time, in order to create multifaceted laboratory leadership.Summary: Laboratory leaders are typically recruited based on education and experience to lead teams of embryologists. These leaders will adopt new technologies in the laboratory. Therefore, laboratory leaders play a powerful role in IVF requiring leadership skills ultimately driving patient outcomes. These laboratory directors must possess innate leadership abilities or learn how to lead their teams.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0