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Female Urogenital Diseases and Pregnancy Complications - Top 30 Publications

Ovarian Cancer Treatment - Are We Getting Warmer?

Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections - United States, 2014.

Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4). To assess the effects of these recommendations, CDC analyzed the Truven Health MarketScan Commercial Database* to examine antibiotic prescriptions filled by pregnant women with UTIs. Among 482,917 pregnancies in 2014, 7.2% of women had an outpatient UTI diagnosis during the 90 days before the date of last menstrual period (LMP) or during pregnancy. Among pregnant women with UTIs, the most frequently prescribed antibiotics during the first trimester were nitrofurantoin, ciprofloxacin, cephalexin, and trimethoprim-sulfamethoxazole. Given the potential risks associated with use of some of these antibiotics in early pregnancy and the potential for unrecognized pregnancy, women's health care providers should be familiar with the ACOG recommendations and consider the possibility of early pregnancy when treating women of reproductive age.

IVF Transfer of Fresh or Frozen Embryos in Women without Polycystic Ovaries.

Among women who are undergoing in vitro fertilization (IVF), the transfer of frozen embryos has been shown to result in a higher rate of live birth than the transfer of fresh embryos in those with infertility associated with the polycystic ovary syndrome. It is not known whether frozen-embryo transfer results in similar benefit in women with infertility that is not associated with the polycystic ovary syndrome.

Transfer of Fresh versus Frozen Embryos in Ovulatory Women.

Elective frozen-embryo transfer has been shown to result in a higher live-birth rate than fresh-embryo transfer among anovulatory women with the polycystic ovary syndrome. It is uncertain whether frozen-embryo transfer increases live-birth rates among ovulatory women with infertility.

Proliferative lupus nephritis in the absence of overt systemic lupus erythematosus: A historical study of 12 adult patients.

Severe lupus nephritis in the absence of systemic lupus erythematosus (SLE) is a rare condition with an unclear clinical presentation and outcome.We conducted a historical observational study of 12 adult (age >18 years) patients with biopsy-proven severe lupus nephritis or lupus-like nephritis without SLE immunological markers at diagnosis or during follow-up. Excluded were patients with chronic infections with HIV or hepatitis B or C; patients with a bacterial infectious disease; and patients with pure membranous nephropathy. Electron microscopy was retrospectively performed when the material was available. End points were the proportion of patients with a complete response (urine protein to creatinine ratio <0.5 g/day and a normal or near-normal eGFR), partial response (≥50% reduction in proteinuria to subnephrotic levels and a normal or near-normal eGFR), or nonresponse at 12 months or later after the initiation of the treatment.The study included 12 patients (66% female) with a median age of 36.5 years. At diagnosis, median creatinine and proteinuria levels were 1.21 mg/dL (range 0.5-11.6) and 7.5 g/day (1.4-26.7), respectively. Six patients had nephrotic syndrome and acute kidney injury. Renal biopsy examinations revealed class III or class IV A/C lupus nephritis in all cases. Electron microscopy was performed on samples from 5 patients. The results showed mesangial and subendothelial dense deposits consistent with LN in 4 cases, and a retrospective diagnosis of pseudo-amyloid fibrillary glomerulonephritis was made in 1 patient.Patients received immunosuppressive therapy consisting of induction therapy followed by maintenance therapy, similar to treatment for severe lupus nephritis. Remission was recorded in 10 patients at 12 months after the initiation of treatment. One patient reached end-stage renal disease. After a median follow-up of 24 months, 2 patients relapsed.Lupus nephritis in the absence of overt SLE is a nosological entity requiring careful etiological investigation, including systematic electron microscopy examination of renal biopsies to rule out fibrillary glomerulonephritis. In this series, most patients presented with severe glomerulonephritis, which was highly similar to lupus nephritis at presentation and in terms of response to immunosuppressive therapy.

Kimura disease of buccal region in a pediatric patient with nephrotic syndrome: A case report.

Kimura disease is a rare benign, chronic inflammatory disorder that typically presents with slowly enlarging, nontender, subcutaneous swellings in the head and neck region. The occurrence of Kimura disease in the oral cavity is extremely rare.

Evaluating a magnetic resonance imaging of the third-trimester abdominal pregnancy: What the radiologist needs to know.

A 33-week abdominal pregnancy is an extremely rare type of ectopic pregnancy that is potentially life-threatening for the mother and fetus. Reports of using magnetic resonance imaging (MRI) in the third-trimester abdominal pregnancy are very few.

Analysis of diagnosis and treatment of complicated cervical severe adhesion atresia after removal of endometrial stromal nodule: A case report.

Endometrial stromal nodule (ESN) is a rare benign endometrial stroma tumor.Experiences are helpful for avoiding and treating similar postoperative complications (cervical adhesions and atresia).

Uterine inflammatory myofibroblastic tumor: more common than expected: Case report and review.

Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm composed of spindled to epithelioid cells with prominent myxoid stroma and inflammatory infiltrate. It has a low but definite malignant potential. However, its management has never been standardized.

Renal hybrid oncocytic/chromophobe tumor associated with multiple schwannomas: Case report and literature review.

Renal hybrid oncocytic/chromophobe tumors (HOCTs) are benign tumors containing a mixture of cells with features of chromophobe renal cell carcinoma (CHRCC) and renal oncocytoma (RO). Sporadic HOCT, which means HOCT occurs in patients without Birt-Hogg-Dubé syndrome (BHDS) or renal oncocytosis, is extremely rare. In this article, we would report a new case of a patient with both sporadic HOCT and multiple Schwannomas, which is even rarer than simplex sporadic HOCT.

Acute kidney injury due to povidone-iodine ingestion: A case report.

Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described.

Treatment of cornual pregnancy in a patient with adenomyosis by high-intensity focused ultrasound (HIFU) ablation: A case report.

Cornual ectopic pregnancy in adenomyosis patients is a rare clinical condition, which may require careful approach for accurate diagnosis and treatment.

Efficacy of the multidisciplinary tumor board conference in gynecologic oncology: A prospective study.

Evidence has shown that multidisciplinary tumor board conferences (MTBCs) improve patient management for various cancer types. However, few retrospective studies have investigated MTBC efficacy for patients with gynecologic cancers. Here, we prospectively aimed to evaluate how MTBCs influence patient management in gynecologic oncology. This prospective study included 85 consecutive cases that were presented at gynecologic oncology MTBCs in our tertiary university hospital between January 2015 and April 2016. The primary endpoint was treatment plan change rate, which included both major and minor changes. Major changes were defined as exchange, addition, or subtraction of treatment modality. Minor changes included all other, such as intramodality changes or treatment time changes. The secondary endpoints were the change rates of diagnosis, diagnostic work-up, and radiological and pathological findings.The treatment plan change rate, irrespective of changes in diagnostic work-up, was 27.1%, which included 10.6% major and 16.5% minor changes. Among the treatment plan changes, changes in the treatment plan change rate alone were noted in 16.5% of cases, and changes in diagnosis and radiological findings occurred in 7.1% and 3.5% of cases, respectively. Diagnosis and radiological findings, irrespective of changes in diagnostic work-up, were also changed in 9.4% and 10.6% of cases, respectively. However, there were no changes in pathological findings. Moreover, there was a change of diagnostic method for further work-up in 23.5% of cases. The implementation rate of MTBC-determined treatment changes was 91.8%. Gynecologic oncology MTBCs resulted in considerable changes in treatment plans. Diagnosis, diagnostic work-up, and radiological findings were influenced by MTBCs. The data emphasize the importance of adopting a multidisciplinary team approach for gynecologic cancer management.

Normalizers for microRNA quantification in plasma of patients with vulvar intraepithelial neoplasia lesions and vulvar carcinoma.

The role of circulating microRNAs as a promising tool for diagnosing cancer and monitoring anticancer therapies has been widely studied in the past decades. To date, no suitable reference microRNAs for normalizing quantitative real-time polymerase chain reaction assays has been identified in vulvar intraepithelial neoplasia lesions and vulvar squamous cell carcinoma. The purpose of this study was to select appropriate references for gene expression studies in plasma of patients with these lesions. Expression levels of six microRNAs-hsa-miR-425-5p, hsa-miR-191-5p, hsa-miR-93-5p, hsa-miR-423-5p, hsa-miR-103a-3p, and hsa-miR-16-5p-were analyzed by quantitative reverse transcription polymerase chain reaction in plasma samples obtained from 17 patients with vulvar intraepithelial neoplasia lesion and 27 patients with vulvar squamous cell carcinoma. The expression stability of these candidate normalizers was assayed using geNorm algorithm. hsa-miR-93-5p was revealed as the most stably expressed reference in plasma samples of both vulvar intraepithelial neoplasia lesion and vulvar squamous cell carcinoma patients. The results pointed at hsa-miR-93-5p and hsa-miR-425-5p as microRNAs that retained the greatest robustness in plasma of vulvar intraepithelial neoplasia lesion and vulvar squamous cell carcinoma patients, respectively. Our work is the first report on reference microRNA selection for quantitative real-time polymerase chain reaction applications in vulvar intraepithelial neoplasia lesion and vulvar squamous cell carcinoma. The candidate microRNA stability values for the two types of lesions are provided and might serve for normalization of the future novel microRNA biomarkers in these rare entities.

Acute Pyelonephritis in Adults.

Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014.

Over the past 2 decades, there has been increased attention and effort to reduce disparities in live donor kidney transplantation (LDKT) for black, Hispanic, and Asian patients with end-stage kidney disease. The goal of this study was to investigate whether these efforts have been successful.

Serological prevalence of Coxiella burnetii in dairy goats and ewes diagnosed with adverse pregnancy outcomes in Greece.

<i>Coxiella burnetii</i> is an obligatory intracellular bacterial pathogen causing the zoonotic disease Q fever. The most common reservoirs of <i>C. burnetii</i> are wild mammals, birds and ticks. Pregnant domestic ruminants infected with this bacterium are also a major source of human infection.

Attitudes of women after the age of 50 towards preventive screening.

Prevention is one of the major branches of the health sector. The National Health Programme encompasses main risk factors, elimination of which may lead to a reduced incidence of illnesses in the society. At the same time, the criteria of selecting people eligible for preventive screening are established according to risk groups determined by sex, as well as age in the population of women. The perimenopausal and menopausal period contributes to occurrence of numerous systemic diseases and to an increased risk of illnesses, especially cancers.

Chromium in urothelial carcinoma of the bladder.

Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, the involvement of heavy metals in tumourigenesis of urothelial carcinoma of the bladder has been poorly investigated. Therefore, the aim of this study was to examine the relationship between chromium (Cr) and bladder cancer.

New directions in cervical cancer prophylaxis worldwide and in Poland - Case study of the Polish rural female population.

Cervical cancer is one of the most frequent malignant neoplasms in females. Such neoplasms can be almost completely eliminated by means of adequate primary and secondary prophylaxis. The most developed countries focus their attention on the improvement of prophylaxis systems, test quality, and efficacy improvement, as well as on the expansion of the primary prophylaxis. In Poland, the discussions focus on the improvement of the malfunctioning population programme.

Application of dietetics in reproductive medicine.

In the light of up-to-date epidemiological data concerning the prevalence of infertility, and also considering the scale of the problem of obesity and proven cause-effect relationship between abnormal body weight and infertility, it is justifiable to undertake the task of systematization of the state of knowledge concerning nutritional correlates of infertility, in order to create a scientific basis for the formulation of the assumptions of a fertility diet. The study is an attempt to systematize the current state of knowledge concerning the importance of energy and structural (qualitative) aspects of nutrition in the prevention and treatment of infertility.

Psychological consequences of IVF fertilization - Review of research.

Due to the reported efficacy of in vitro fertilization (IVF) this method of dealing with infertility is increasing being used. Experiencing IVF can be a source of psychological and emotional difficulties for couples trying to have a child. A systematic review was performed to discuss IVF as a psychological issue that impacts on the functioning of individuals, couples and families. Ebsco, Science Direct and PsycARTICLES databases were searched using the keywords: IVF fertilization, IVF psychology, infertility, and IVF consequences, using published peer reviewed articles from 2006 onwards. Studies in the English and Polish languages, peer reviewed and investigating general IVF and infertility psychological issues were included. Data was collected by the authors between June 2015-January 2016.

The Impact of Labiaplasty on Sexuality.

Labiaplasty is one of the aesthetic procedures that has shown the greatest increase in the number of operations in recent years, although the absolute number of these procedures is still very low. Labia minora hypertrophy causes not only functional discomfort and sexual difficulties, but also embarrassment and aesthetic concern. The aim of this study was to assess the impact of labiaplasty on the patient's quality of life, self-esteem, and sexual function.

Movie Review of The Immortal Life of Henrietta Lacks.

The Efficacy of Wide Resection for Musculoskeletal Metastatic Lesions of Renal Cell Carcinoma.

This study evaluated the outcome of wide resection for metastatic renal cell carcinoma (RCC) to the bone or soft tissue.

Bevacizumab Added to Moderate-dose Chemotherapy for Refractory Uterine Cancer.

Bevacizumab (bev), when added to a moderate dose combination of previously failed cytotoxins, as a third- and fourth-line therapy for refractory gastric, cholangiocarcinoma, and ovarian cancers, produced high-quality responses. The regimen was based on preclinical models designed in order to simultaneously partner both bev and each of the cytotoxins with 4-5 synergistic drugs.

Long-term Outcomes of Carbon-ion Radiotherapy for Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix.

To evaluate the long-term outcomes of carbon-ion radiotherapy (C-ion RT) for locally advanced cervical squamous cell carcinoma (LAC-SqCC) in 2 prospective phase I/II studies.

Pazopanib for Metastatic Renal Cell Carcinoma: A Registry-based Analysis of 426 Patients.

Pazopanib is approved for the first-line treatment of patients with metastatic renal cell carcinoma (mRCC). The present study was a retrospective registry-based analysis of 426 patients with mRCC treated with pazopanib as first-line targeted therapy.

Debulking Surgery for Pelvic Recurrence After Surgically-treated Tubal Gestational Choriocarcinoma - A Case Report and Literature Review.

Gestational choriocarcinomas are very rare malignancies, with only few cases being reported so far. Moreover, the presence of pelvic recurrences after surgically-treated gestational choriocarcinomas is even scarcer situations. We present the case of a 19-year-old patient who was initially submitted to surgery with preoperative diagnosis of ectopic pregnancy. At that moment a left salpingectomy was performed, and the histopathological studies revealed the presence of a left tubal gestational choriocarcinoma. The patient was submitted to adjuvant chemotherapy with methotrexate and dactinomycin. However, six months later she was diagnosed with a pelvic recurrence so she was resubmitted to surgery, debulking to no residual disease being successfully performed. The histopathological studies confirmed the presence of a recurrent tumor with gestational choriocarcinoma structure.

Value of Diaphragmatic Surgery During Interval Debulking Surgery.

The aim of this study was to assess the value of diaphragmatic surgery to achieve optimal debulking in patients with advanced ovarian cancer treated by neoadjuvant chemotherapy (NAC).