Current Opinion in Obstetrics & Gynecology最新文献_第9页

Two years in a post- Dobbs world: clinical, social and professional consequences. 后多布斯世界的两年：临床、社会和专业后果。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-12-01 Epub Date: 2024-07-10 DOI: 10.1097/GCO.0000000000000975

Isabel Beshar, Megan Corn, Paul D Blumenthal

{"title":"Two years in a post- Dobbs world: clinical, social and professional consequences.","authors":"Isabel Beshar, Megan Corn, Paul D Blumenthal","doi":"10.1097/GCO.0000000000000975","DOIUrl":"10.1097/GCO.0000000000000975","url":null,"abstract":"Purpose of review: Dobbs v Jackson Women's Health Organization revoked the decades-old precedent that pregnancy termination is a constitutional right. This review article explores the research landscape describing the consequences of overturning Roe v Wade for patients and providers.Recent findings: To date, fourteen states have enforced total bans on abortion, with seven more restricting abortion access to levels not seen since before Roe. Dobbs has had immediate and swift consequences from clinical, social and professional perspectives, with increases in maternal mortality and demand for long-acting and permanent contraception, matched by declines in both access to methotrexate and applications to Obstetrics & Gynecology training programs.Summary: Eighteen million patients now live in states where abortion access is highly if not completely inaccessible. Abortion restrictions have profound implications beyond those desiring pregnancy termination; future research should continue to explore the ways Dobbs has affected clinical care, public health and social practices.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"426-432"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984011","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

Patient navigation in reproductive healthcare. 生殖保健中的患者导航。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-12-01 Epub Date: 2024-09-17 DOI: 10.1097/GCO.0000000000000997

Melissa Schechter, Eve Espey, Jamie W Krashin

{"title":"Patient navigation in reproductive healthcare.","authors":"Melissa Schechter, Eve Espey, Jamie W Krashin","doi":"10.1097/GCO.0000000000000997","DOIUrl":"10.1097/GCO.0000000000000997","url":null,"abstract":"Purpose of review: This review summarizes evidence about barriers to abortion care pre- Dobbs and post- Dobbs , inequities in abortion access, and approaches to improving access to abortion care with use of patient navigators.Recent findings: The Dobbs decision and resulting state-level restrictions exacerbated economic, knowledge, and logistic barriers to abortion care. Abortion funds and emotional support are two main resources to help address these barriers; however, only with coordination can patients and clinics fully benefit from the resources. Patient navigation provides that coordination. Evidence shows it improves reproductive outcomes, is acceptable to patients and providers, and engages community health workers and community-based organizations.Summary: Increasing legal restrictions and barriers to abortion care have motivated advocates to identify effective interventions to facilitate patient-centered and culturally competent care. Navigators have improved postpartum care by increasing attendance, education and helping coordinate overall care. They have improved referrals and access to abortion care in statewide programs.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"420-425"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373615","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

Editorial introductions. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-12-01 Epub Date: 2024-10-31 DOI: 10.1097/GCO.0000000000000994

引用次数: 0

New management approaches for female sexual dysfunction. 女性性功能障碍的新管理方法。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI: 10.1097/GCO.0000000000000984

Lori A Brotto, Melanie Altas

{"title":"New management approaches for female sexual dysfunction.","authors":"Lori A Brotto, Melanie Altas","doi":"10.1097/GCO.0000000000000984","DOIUrl":"10.1097/GCO.0000000000000984","url":null,"abstract":"Purpose of review: The goal of this paper is to review the most recent studies evaluating treatments for female sexual dysfunction (FSD), including distressing symptoms of desire, arousal, and orgasm disorder. We divide the sections into psychological and pharmacological.Recent findings: There is excellent evidence in favour of mindfulness, cognitive behavioural therapy, and psychoeducation for improving low sexual desire in women, and less evidence in support of these approaches to address other sexual dysfunctions in women. There are two US Food and Drug Administration (FDA) approved pharmacological treatments for low desire in premenopausal women that have modest benefits above placebo, and a significant proportion of users will experience side effects. Evidence also supports the use of transdermal testosterone for low desire in postmenopausal women.Summary: Sexual dysfunction in women is common and distressing, and there are a variety of psychological and pharmacological treatments. More research is needed to better understand the predictors of a positive treatment response in order to deliver more personalized care.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"372-377"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898967","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

Unravelling the vaginal microbiome, impact on health and disease. 揭示阴道微生物群对健康和疾病的影响。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1097/GCO.0000000000000976

Erica L Plummer, Lenka A Vodstrcil, Catriona S Bradshaw

{"title":"Unravelling the vaginal microbiome, impact on health and disease.","authors":"Erica L Plummer, Lenka A Vodstrcil, Catriona S Bradshaw","doi":"10.1097/GCO.0000000000000976","DOIUrl":"10.1097/GCO.0000000000000976","url":null,"abstract":"Purpose of review: The vaginal microbiome has a fundamental role in supporting optimal vaginal, reproductive, and sexual health. Conversely, dysbiosis of the vaginal microbiome is linked to vaginal symptoms and adverse health outcomes. This review summarizes recent literature concerning the role of the vaginal microbiome in health and disease, with a focus on the most common vaginal dysbiosis, bacterial vaginosis.Recent findings: Molecular studies have expanded our understanding of the composition of the vaginal microbiome. Lactic acid-producing lactobacilli are an important component of host defences against pathogens, whereas a paucity of lactobacilli is associated with adverse sequelae. Bacterial vaginosis is characterized by low levels of lactobacilli and increased levels of nonoptimal anaerobes; however, the exact cause remains unclear. Furthermore, despite decades of research, bacterial vaginosis recurrence rates following standard treatment are unacceptably high. Strategies to improve bacterial vaginosis cure and promote an optimal lactobacilli-dominated vaginal microbiome are being investigated. Importantly, historical and emerging evidence supports the sexual transmission of bacterial vaginosis, which opens exciting opportunities for novel treatments that incorporate partners.Summary: A mechanistic and deeper understanding of the vaginal microbiome in health and disease is needed to inform ongoing development of therapeutics to improve bacterial vaginosis cure. Partner treatment holds promise for improving bacterial vaginosis cure.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"338-344"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898970","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

Providing adolescent-friendly sexually transmitted infection screening and treatment services. 提供适合青少年的性传播感染筛查和治疗服务。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1097/GCO.0000000000000978

Julie C Friedman, Bianca Cannon, Nichole Tyson, Melissa Kang

{"title":"Providing adolescent-friendly sexually transmitted infection screening and treatment services.","authors":"Julie C Friedman, Bianca Cannon, Nichole Tyson, Melissa Kang","doi":"10.1097/GCO.0000000000000978","DOIUrl":"10.1097/GCO.0000000000000978","url":null,"abstract":"Purpose of review: There are high rates of sexually transmitted infections (STIs) worldwide. Adolescents and young adults (AYA) ages 15-24 years remain one of the populations that is most vulnerable to STIs. The goal of this review is to summarize recent international updates in adolescent STI screening and treatment.Recent findings: Normalizing sexual history taking and STI testing, and advocating for adolescents to receive comprehensive sexuality education improves stigma surrounding sexual health. The global rise in syphilis is pervasive and includes high rates of infection among AYA and women of reproductive age - universal screening may be indicated depending on local epidemiology. Gonococcal antimicrobial resistance remains a significant public health concern worldwide, thus judicious use of antimicrobials and reporting cases of resistance is crucial. Sexual health services are increasingly using virtual platforms, which may be an effective strategy for STI testing and treatment among AYA.Summary: Specific areas of focus to address the STI epidemic among AYA include reducing stigma surrounding sexual health, screening, and treatment of STIs, especially with the global rise in syphilis and high rates of gonorrhea resistance, in addition to increased use of telehealth services as effective education and intervention strategies.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"362-371"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898969","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

Medical management of endometriosis. 子宫内膜异位症的药物治疗。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-17 DOI: 10.1097/GCO.0000000000000983

Anais Alonso, Kate Gunther, Sarah Maheux-Lacroix, Jason Abbott

{"title":"Medical management of endometriosis.","authors":"Anais Alonso, Kate Gunther, Sarah Maheux-Lacroix, Jason Abbott","doi":"10.1097/GCO.0000000000000983","DOIUrl":"10.1097/GCO.0000000000000983","url":null,"abstract":"Purpose of review: While laparoscopic surgery plays a key role in the management of endometriosis, symptoms commonly recur, and repeat surgery comes with increased risk. Medical management, including hormonal and nonhormonal treatment, is vital in managing painful symptoms. This review summarizes recent evidence regarding various medical management options available to treat pelvic pain associated with endometriosis.Recent findings: Efficacy of dienogest vs. combined oral contraceptive on pain associated with endometriosis: randomized clinical trial.Once daily oral relugolix combination therapy vs. placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2).A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis.Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study.Summary: All symptomatic women with suspected endometriosis who are not desiring immediate fertility can be offered suppressive treatment to control symptoms and slow the progression of disease. First-line treatments include the combined oral contraceptive pill and progestogens. Second-line treatments include gonadotropin-releasing hormone agonists and antagonists but current guidelines recommend that these should be reserved for people whose symptoms fail to be controlled by first-line agents. The use of complementary and alternative medicines is also increasing in both volume and number of agents used.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"353-361"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI: 10.1097/GCO.0000000000000985

引用次数: 0

Enhancing equity in cervical screening - initiatives to increase screening participation. 加强宫颈癌筛查的公平性--提高筛查参与率的举措。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-22 DOI: 10.1097/GCO.0000000000000979

Telma Costa, Deborah Bateson, Yin Ling Woo

{"title":"Enhancing equity in cervical screening - initiatives to increase screening participation.","authors":"Telma Costa, Deborah Bateson, Yin Ling Woo","doi":"10.1097/GCO.0000000000000979","DOIUrl":"10.1097/GCO.0000000000000979","url":null,"abstract":"Purpose of review: Cervical cancer can be eliminated as a public health problem through a three-pillar approach including high coverage of human papillomavirus (HPV) vaccination and HPV-based cervical screening, and treatment of precancers and invasive cancers. However, access inequities prevent many women and people with a cervix benefitting from these life-saving advances. This review focuses on evidence-based interventions that can improve equity and scale-up of cervical screening.Recent findings: The transition from conventional cytology to HPV screening provides multiple opportunities to address equity and a multipronged approach can be used to identify priority groups, understand barriers and develop tailored solutions. There are proven financing mechanisms, tools, technologies and screening delivery methods to overcome screening barriers in different settings. This includes self-sampling interventions, point-of-care testing, health service integration, consumer-led co-design processes and digital screening registries.Summary: To achieve cervical cancer elimination globally, cervical screening must be delivered in an inclusive, culturally safe and context-appropriate manner. There are multiple tools and strategies that can be implemented to improve participation of never- and under-screened groups, and to enhance equity in cervical screening.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"345-352"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898965","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

Expanding access to postpartum contraception. 扩大产后避孕的覆盖面。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.1097/GCO.0000000000000982

Michelle Cooper, Kirsten Black, Sharon Cameron

{"title":"Expanding access to postpartum contraception.","authors":"Michelle Cooper, Kirsten Black, Sharon Cameron","doi":"10.1097/GCO.0000000000000982","DOIUrl":"10.1097/GCO.0000000000000982","url":null,"abstract":"Purpose of review: Women are particularly vulnerable to unintended pregnancy in the 12 months following a birth. Improving access to postpartum contraception within maternity settings can prevent unintended and closely spaced births, improving the health of mother and child. This review will summarize the recent research in postpartum contraception (PPC), building on existing knowledge and developments in this field.Recent findings: Current models of postpartum contraceptive provision may not adequately meet women's needs. The COVID-19 pandemic led to changes in postpartum contraceptive provision, with an increasing emphasis placed on maternity services. Antenatal contraceptive discussion is associated with increased postpartum contraceptive planning and uptake of methods after birth. Digital health interventions may be a useful tool to support information about contraception. The most effective long-acting reversible contraceptive (LARC) methods, such as the intrauterine device (IUD) and implant, can be challenging to provide in the maternity setting because of availability of trained providers. Postpartum IUD insertion remains relatively under-utilized, despite evidence supporting its safety, efficacy and cost-effectiveness.Summary: Antenatal information needs to be partnered with access to the full range of methods immediately after birth to reduce barriers to PPC uptake. Training and education of maternity providers is central to successful implementation of PPC services.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"331-337"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0