Minerva ginecologica
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Minerva ginecologica · Dec 2010
Role and application of hysterosalpingography and Fallopian tube recanalization.
The prevalence of infertility in the United States is 15-20% and this condition represents an important medical problem. The purpose of this work was to evaluate therapeutical efficacy of 2 consecutive hysterosalpingography (HSG) followed each other after 4 week compared with the fallopian tube recanalization (FTR). ⋯ Therapeutical efficacy of two consecutive HSG followed each other after four week compared with the FTR are similar when the second HSG shows the presence of Fallopian tube patency.
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Chronic pelvic pain (CPP) is a common complaint of women presenting for gynecologic and primary care. Evaluation of CPP requires obtaining a careful history including not only obstetrical and gynecologic information but also screening for gastrointestinal, urologic, musculoskeletal, and neurological disorders. A detailed physical examination is also necessary. ⋯ Treatments may be directed toward specific causes or may be targeted to general pain management. The most effective therapy may involve using both approaches. The diagnosis and treatment of each of the above disorders, and the management of CPP itself, is discussed.
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Minerva ginecologica · Apr 2010
ReviewNew technologies for reproductive medicine: laparoscopy, endoscopy, robotic surgery and gynecology. A review of the literature.
Computer-enhanced telesurgery, called robotic-assisted surgery, is the latest innovation in the minimal invasive surgery field. In gynecology, this machine has been applied in several applications, in the fields of benign gynecology, reproductive medicine, urogynecology, and oncology. The purpose of this paper was to review the published scientific literature regarding robotics and its application to gynecology thus far and summarize findings of this computer enhanced laparoscopic technique. ⋯ Computer enhanced technology may enable more surgeons to convert their laparotomies to laparoscopic surgery with its associated benefits. It appears that in the hands of experienced laparoscopic surgeons, final outcomes are the same when using or not using the robot. There is good evidence that robotic surgery facilitates laparoscopic surgery, with equivalent if not better operative time and comparable surgical outcomes, shorter hospital stays, and fewer major complications than those surgeries utilizing the laparotomy approach.
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Peripartum cardiomyopathy (PPCM) is a life-threatening condition of unknown cause that occurs in previously healthy women during the peripartum period. It is characterized by left ventricular (LV) dysfunction and symptoms of heart failure which occurs between the last trimester of pregnancy and the first five months of the postpartum period. ⋯ Patients with PPCM often present with heart failure and therefore standard treatment for heart failure is recommended. Depending on the recovery of ventricular function subsequent pregnancies carry a higher risk of relapse of PPCM.
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Minerva ginecologica · Dec 2009
ReviewClinical use of selective estrogen receptor modulators and down regulators with the main focus on breast cancer.
Selective estrogen receptor modulators (SERMs) and selective estrogen down regulators (SERDs) act as estrogen receptor (ER) agonists or antagonist depending on the targeted tissue and the specific configuration of the used SERM or SERD. Effects on bone, endometrium and breast cancer are of interest. Endocrine treatments have been used in breast cancer since the end of the 19th century. ⋯ The sequencing of endocrine therapies and the combination of endocrine therapies with new targeted therapies in hormone sensitive breast cancer remains a very important research issue. Polymorphisms in genes coding for tamoxifen metabolizing enzymes, as for instance, the CYP2D6 genotype, have the potential of becoming clinically useful predictive marker for tamoxifen response. With this meaningful newer knowledge it is possible that the place of tamoxifen in the treatment of breast cancer will be redefined in the future.