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Seminars in Reproductive Medicine

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https://www.readbyqxmd.com/read/28212593/micrornas-and-endometriosis-distinguishing-drivers-from-passengers-in-disease-pathogenesis
#1
Warren B Nothnick
Endometriosis is a disease common in women of reproductive age, characterized by pelvic pain and infertility. Despite its prevalence, the factors and mechanisms which contribute to the development and survival of ectopic lesions remain uncertain. MicroRNAs (miRNAs) are small RNA molecules that regulate posttranscriptional gene regulation which have been proposed to contribute to the pathogenesis of many diseases including that of endometriosis. This review summarizes the results of initial studies describing differentially expressed miRNAs between endometriotic lesion tissue and eutopic endometrium...
February 17, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28212592/novel-insights-into-gonadotropin-releasing-hormone-action-in-the-pituitary-gonadotrope
#2
Jessica L Brown, Mark Roberson
The hypothalamic-pituitary-gonadal axis controls reproduction via a series of hormones regulating gonadal function through interconnected feedback loops. Secretion of hypothalamic-derived gonadotropin-releasing hormone (GnRH) integrates inputs from higher brain centers to coordinate the activity of the pituitary gonadotrope and the biosynthesis and secretion of the gonadotropins which ultimately regulate gonadal function. Failure of GnRH to serve as the central integrator of this system has been associated with hypogonadotropic-hypogonadism and clinical infertility, while pharmacological application of GnRH analogs and gonadotropins have important implications of the treatment of such infertility...
February 17, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28076877/ultrasound-imaging-for-ovarian-and-deep-infiltrating-endometriosis
#3
Caterina Exacoustos, Errico Zupi, Emilio Piccione
The main challenges of imaging for endometriosis are the detection of nonovarian disease and the evaluation of the extension of the disease into pelvic structures. Transvaginal ultrasonography (TVS) has been proposed as the first-line imaging technique because it allows extensive exploration of the pelvis. The "typical" endometrioma is a unilocular cyst with homogeneous low-level echogenicity (ground glass echogenicity) of the cyst fluid. The use of color Doppler helps avoid classifying malignancies as endometriomas, defining the presence of vascular flow in papillations...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28049216/cancer-implications-for-patients-with-endometriosis
#4
Mary Ann Wilbur, Ie-Ming Shih, James H Segars, Amanda N Fader
Endometriosis is defined as the presence of viable endometrial glands and stroma outside of the uterus. It is a common disease, occurring in 5 to 15% of all women. Endometriosis is associated with chronic pelvic pain and infertility and often requires surgical intervention for definitive treatment. Although it is a benign gynecologic condition, endometriosis shares pathophysiologic features with cancer. In recent years, both histologic and epidemiologic evidence has accumulated, suggesting that ovarian endometriosis may give rise to malignant ovarian tumors, primarily those that are epithelial in origin, known as endometriosis-associated ovarian carcinoma (EAOC) including ovarian clear cell carcinoma, endometrioid carcinoma, and the least common, seromucinous tumors...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28049215/surgical-management-of-endometriosis-in-patients-with-chronic-pelvic-pain
#5
Rebecca Flyckt, Suejin Kim, Tommaso Falcone
Surgical approaches to endometriosis patients with chronic pelvic pain are multimodal and require individualization. Laparoscopic approaches are preferred over laparotomy when conservatively treating endometriosis via excision or ablation/fulguration of lesions. The available data support cystectomy over fenestration or fulguration for endometriomas; however, there may be associated decreases in ovarian reserve with endometrioma treatment. Presacral neurectomy may be useful in patients with midline pain and LUNA is not effective for the treatment of pelvic pain related to endometriosis...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28049214/relating-chronic-pelvic-pain-and-endometriosis-to-signs-of-sensitization-and-myofascial-pain-and-dysfunction
#6
Jacqueline V Aredo, Katrina J Heyrana, Barbara I Karp, Jay P Shah, Pamela Stratton
Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28002850/medical-management-of-endometriosis-in-patients-with-chronic-pelvic-pain
#7
Mohamed A Bedaiwy, Catherine Allaire, Paul Yong, Sukinah Alfaraj
Endometriosis is a common cause of pelvic pain in women of reproductive age. Traditional medical therapies are hormonal in nature, including estrogen-progestin contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) agonists. Other hormonal options are androgens and aromatase inhibitors, with research also suggesting a possible role for GnRH antagonists and selective progesterone receptor modulators. Other than nonsteroidal anti-inflammatories, further work is required for nonhormonal therapies such as antiangiogenic and immune-modulating drugs...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27992932/endometriosis-in-the-adolescent-patient
#8
Mallory A Stuparich, Nicole M Donnellan, Joseph S Sanfilippo
The recognition and management of endometriosis in the adolescent patient is challenging. A strong clinical suspicion for endometriosis should be maintained in the adolescent who suffers from acyclic pelvic pain as well as absenteeism from school and lack of participation in daily activities. Risk factors include the presence of an obstructive Mullerian anomaly, a family history of endometriosis, and conditions that prolong exposure to endogenous and exogenous estrogens. Empiric medical therapy with nonsteroidal anti-inflammatory drugs and combined oral contraceptive pills may be considered in most adolescents with endometriosis...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27992931/extrapelvic-endometriosis
#9
Anne C Davis, Jeffrey M Goldberg
Extrapelvic endometriosis is a rare and complex phenomenon. The pathologic mechanism of intrapelvic endometriosis is generally accepted as being largely due to retrograde menstruation through the fallopian tubes; however, the mechanism by which extrapelvic endometriosis forms has proven to be much more elusive. This article reviews the pathophysiology, clinical signs and symptoms, diagnostic techniques, and treatment recommendations for extrapelvic endometriosis of the umbilicus, abdominal wall, thorax, and vulva...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27975335/tommaso-falcone-md-frcs-c-facog
#10
Serdar Bulun
No abstract text is available yet for this article.
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27951614/nerve-sparing-and-surgery-for-deep-infiltrating-endometriosis-pessimism-of-the-intellect-or-optimism-of-the-will
#11
Basma Darwish, Horace Roman
Nerve-sparing surgery is an emerging technique for surgery-related dysfunction. Within the past 15 years, an essential progress in recognition and understanding of the anatomy of the pelvic autonomous nervous system has been made. Surgical preservation of vegetative nerves has become well known in many cancer centers. The technique has led to improvement of the quality of life following oncologic radical procedures. Positive results have led to the adoption of such techniques in the surgical treatment of deep infiltrating endometriosis in an aim to prevent urinary, rectal, and sexual dysfunction...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27951613/strategies-for-management-of-colorectal-endometriosis
#12
Mauricio Simões Abrão, Giuliano Moysés Borrelli, Roberto Clarizia, Rosanne Marie Kho, Marcello Ceccaroni
Endometriosis has clearly three distinct clinical presentations and deep endometriosis, especially compromising the rectosigmoid is probably the most concerning one for both patients and surgeons. Currently, with the available tools, it is mandatory to have a precise diagnostic of this type of disease prior to indication of treatment. Strategies to manage this form of endometriosis will take into account several involved aspects, such as age of the patient, reproductive desire or infertility, clinical symptoms, as well as the extension and localization of the disease...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27951612/clinical-management-of-endometriosis
#13
Tommaso Falcone
No abstract text is available yet for this article.
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926972/management-of-endometriosis-in-the-infertile-patient
#14
Edgardo Somigliana, Paola Vigano, Laura Benaglia, Andrea Busnelli, Nicola Berlanda, Paolo Vercellini
The management of endometriosis-related infertility remains debated. However, in recent years, the role of in vitro fertilization (IVF) has progressively grown. Reasons to explain this change include (1) the improvement of the effectiveness and safety of IVF, (2) the raised awareness of the modest effectiveness of surgery, (3) the inherent risks of surgery including in particular the damage to the ovarian reserve when ovarian endometriomas have to be removed, (4) the ineffectiveness of intrauterine insemination and the possible risks of endometriosis progression associated with the use of this technique...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926971/management-of-endometriomas
#15
Ludovico Muzii, Chiara Di Tucci, Mara Di Feliciantonio, Giulia Galati, Ludovica Verrelli, Violante Di Donato, Claudia Marchetti, Pierluigi Benedetti Panici
Ovarian endometriomas affect 17 to 44% of women with endometriosis, and are often associated with pelvic pain and infertility. Treatment options include expectant management, medical and/or surgical treatment, and in vitro fertilization and embryo transfer (IVF-ET). The choice of treatment depends mostly on the associated symptoms. In most cases, surgery is the preferred choice, since endometriomas do not respond to medical treatment, which may only treat associated pain. In case of infertility, IVF-ET may be a suitable alternative to surgery, particularly when there is no associated pain...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926970/management-of-endometriosis-involving-the-urinary-tract
#16
Mobolaji O Ajao, Jon I Einarsson
Endometriosis is a common cause of infertility and disabling pelvic pain in reproductive age women. The most widely accepted theory of its pathogenesis is the retrograde flow of menstrual products, although extra-abdominal and extrapelvic diagnoses have been made. After the pelvic peritoneum and gynecologic structures, the most commonly affected sites are the lower gastrointestinal and urinary tracts. When the urinary tract is involved, the bladder is the predominant site, followed by the ureters. The focus of this seminar will thus be these two anatomic sites...
January 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27813040/clarisa-r-gracia-md-msce
#17
Richard S Legro
No abstract text is available yet for this article.
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27750362/subclinical-hypothyroidism-impact-on-fertility-obstetric-and-neonatal-outcomes
#18
Rebecca S Usadi, Kathryn S Merriam
The incidence of subclinical hypothyroidism (SCH) in pregnancy was classically thought to be low; however, with new definition of normal TSH range in pregnancy, there has been an increase in the percentage of women who meet classification for SCH. The diagnosis of SCH is important not only for monitoring for maternal conversion to overt hypothyroidism, but also for identifying obstetric and neonatal outcomes related to SCH. Although there have been proven associations between maternal overt hypothyroidism and adverse obstetric and neonatal outcomes, there has been conflicting data on the correlation between SCH and these outcomes...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27750361/thyroid-autoimmunity-and-reproductive-function
#19
Natalie M Crawford, Anne Z Steiner
Thyroid hormones are important for normal reproductive function, and maternal thyroid dysfunction has been associated with infertility, miscarriage, preterm birth, and poor neurodevelopment in the offspring. Thyroid autoimmunity is the leading cause of thyroid dysfunction in women of reproductive age. Women with thyroid autoimmunity, even with normal thyroid function, appear to be at a higher risk for poor reproductive outcomes, including miscarriage and preterm birth. Thyroxine replacement in women with thyroid autoimmunity with or without appreciable thyroid dysfunction may improve pregnancy outcomes...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27741551/thyroid-cancer-in-pregnancy
#20
Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
November 2016: Seminars in Reproductive Medicine
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