Endometriosis

2019 ◽  
Author(s):  
Valerie A Flores ◽  
Hugh S Taylor
Keyword(s):  
Pelvic Pain ◽  
Treatment Options ◽  
Reproductive Age ◽  
Fertility Treatment ◽  
Future Research ◽  
Retrograde Menstruation ◽  
Reproductive Age Women ◽  
Aberrant Gene Expression ◽  
Aberrant Gene

Endometriosis is a chronic, gynecologic disease affecting 6 to 10% of reproductive age women. Pelvic pain, dyspareunia, and infertility are the most common symptoms of endometriosis that can have a significant impact on patients’ lives. Although the etiology remains largely unknown, the role of estrogens in the development and growth of endometriosis is well characterized. Medical and surgical therapies are the two cornerstones of endometriosis management. Following diagnosis of endometriosis, treatment options will be dependent on patient preference (ie, seeking pain relief versus fertility treatment). Future research aimed at targeting altered molecular pathways in patients with endometriosis will hopefully help mitigate the burden of this debilitating disease. This review contains 5 figures, 7 tables, and 75 references. Key Words: aberrant gene expression, altered immunity, endometriosis, infertility, medical and surgical therapy, pelvic pain, retrograde menstruation, stem cells

Endometriosis

2019 ◽  
Author(s):  
Valerie A Flores ◽  
Hugh S Taylor
Keyword(s):  
Pelvic Pain ◽  
Treatment Options ◽  
Reproductive Age ◽  
Fertility Treatment ◽  
Future Research ◽  
Retrograde Menstruation ◽  
Reproductive Age Women ◽  
Aberrant Gene Expression ◽  
Aberrant Gene

Endometriosis is a chronic, gynecologic disease affecting 6 to 10% of reproductive age women. Pelvic pain, dyspareunia, and infertility are the most common symptoms of endometriosis that can have a significant impact on patients’ lives. Although the etiology remains largely unknown, the role of estrogens in the development and growth of endometriosis is well characterized. Medical and surgical therapies are the two cornerstones of endometriosis management. Following diagnosis of endometriosis, treatment options will be dependent on patient preference (ie, seeking pain relief versus fertility treatment). Future research aimed at targeting altered molecular pathways in patients with endometriosis will hopefully help mitigate the burden of this debilitating disease. This review contains 5 figures, 7 tables, and 75 references. Key Words: aberrant gene expression, altered immunity, endometriosis, infertility, medical and surgical therapy, pelvic pain, retrograde menstruation, stem cells

scholarly journals Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach

2021 ◽  
pp. 238008442110144
Author(s):  
N.R. Paul ◽  
S.R. Baker ◽  
B.J. Gibson
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Treatment Options ◽  
Study Data ◽  
Primary Objective ◽  
Major Surgery ◽  
Future Research ◽  
Decision Making Process ◽  
Theory Approach

Introduction: Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision. Objectives: The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment. Methods: This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding. Results: The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face. Conclusion: The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies. Knowledge Transfer Statement: The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.

scholarly journals Updated Costs of Uterine Fibroid Treatments Including Focused Ultrasound Surgery

2018 ◽  
Author(s):  
Bijan J. Borah ◽  
Elizabeth A. Stewart
Keyword(s):  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Invasive Treatment ◽  
Ultrasound Surgery ◽  
Non Invasive ◽  
Focused Ultrasound Surgery ◽  
Reproductive Age Women

Uterine leiomyomas (fibroids) affect 20–40% of reproductive age women and are the major indication for hysterectomy. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a new, potentially disruptive, non-invasive and uterine-sparing treatment option that has been shown to yield similar or better clinical outcomes than other uterine-sparing interventions. However, the costs of MRgFUS and other minimally-invasive treatment options have not been studied using US practice data. This study attempts to fill this void. And since uterine fibroids are the first FDA-approved indication for MRgFUS treatment, this study may also have implications for other indications which are now investigational.

scholarly journals The role of leptin in the pathogenesis of ovarian insufficiency in obesity women

2016 ◽  
Vol 65 (3) ◽  
pp. 18-24
Author(s):  
Ekaterina М Riazantceva
Keyword(s):  
Reproductive Age ◽  
Blood Levels ◽  
Obese Women ◽  
Ovarian Dysfunction ◽  
Ovarian Insufficiency ◽  
Reproductive Age Women ◽  
Alimentary Obesity ◽  
Immunoenzymatic Assay ◽  
Follicular Stimulating Hormone

Actuality. Ovarian insufficiency can be diagnosed in more than 30% of reproductive age women with obesity. The role of leptin in the pathogenesis of ovarian insufficiency in obesity is not well understood and needs to be detalised. The aim of the study: to ivestigate the role of leptin in the pathogenesis of ovarian insufficiency in obesity. Materials and methods. 50 reproductive age females with BMI > 26.5 kg/m2 were studied. 10 healthy reproductive age females were used as control. Blood levels of leptin, gonadotropins, prolactin, sex steroid hormones were measured by immunoenzymatic assay and pelvic echoscopy were performed in all studied patients and co ntrols. Results. 72% of obese women had signs of ovarian insufficiency, such as ovarian enlargement and increased antral follicular count. The level of leptin did not correlate with the presence or absence of ovarian insufficiency in our patient group. The positive correlation between leptin level and BMI, luteinizing hormone (LG) and oestradiol and negative correlation between leptin level and follicular stimulating hormone (FSH) were revealed. Conclusion. The results of our study do not support the hyperleptinemia as the main cause of ovarian dysfunction in alimentary obesity. The most potential reason of ovarian dysfunction in these women could be ovarian or non-ovarian origin hyperoestrogenia leading to premature LG piques, and, thus, disturbing folliculogenesis in ovaria.

scholarly journals Oocyte maturation and quality: role of cyclic nucleotides

Reproduction ◽  
2016 ◽  
Vol 152 (5) ◽  
pp. R143-R157 ◽  
Author(s):  
R B Gilchrist ◽  
A M Luciano ◽  
D Richani ◽  
H T Zeng ◽  
X Wang ◽  
...  
Keyword(s):  
Cyclic Nucleotides ◽  
Treatment Options ◽  
Oocyte Quality ◽  
Fertility Treatment ◽  
Lower Efficiency ◽  
Oocyte Meiosis ◽  
Developmental Capacity ◽  
Oocyte Meiotic Maturation

The cyclic nucleotides, cAMP and cGMP, are the key molecules controlling mammalian oocyte meiosis. Their roles in oocyte biology have been at the forefront of oocyte research for decades, and many of the long-standing controversies in relation to the regulation of oocyte meiotic maturation are now resolved. It is now clear that the follicle prevents meiotic resumption through the actions of natriuretic peptides and cGMP – inhibiting the hydrolysis of intra-oocyte cAMP – and that the pre-ovulatory gonadotrophin surge reverses these processes. The gonadotrophin surge also leads to a transient spike in cAMP in the somatic compartment of the follicle. Research over the past two decades has conclusively demonstrated that this surge in cAMP is important for the subsequent developmental capacity of the oocyte. This is important, as oocyte in vitro maturation (IVM) systems practised clinically do not recapitulate this cAMP surge in vitro, possibly accounting for the lower efficiency of IVM compared with clinical IVF. This review particularly focuses on this latter aspect – the role of cAMP/cGMP in the regulation of oocyte quality. We conclude that clinical practice of IVM should reflect this new understanding of the role of cyclic nucleotides, thereby creating a new generation of ART and fertility treatment options.

scholarly journals DAZL regulates mRNA deadenylation independently of translation in germ cells

2021 ◽  
Author(s):  
Richard W. P. Smith ◽  
Barbara Gorgoni ◽  
Zoë C. Johnston ◽  
William A. Richardson ◽  
Kelsey M. Grieve ◽  
...  
Keyword(s):  
Gene Expression ◽  
Germ Cells ◽  
Mrna Translation ◽  
Aberrant Gene Expression ◽  
Mechanistic Analysis ◽  
Deleted In Azoospermia ◽  
Aberrant Gene ◽  
Mutually Independent ◽  
Mrna Fate

ABSTRACTAberrant gene expression during gametogenesis is one of the factors underlying infertility, which affects roughly 15% of couples worldwide. Deleted-in-Azoospermia-Like (DAZL), a member of the DAZ-gene family, encodes an mRNA-specific regulator of translation which is essential for gametogenesis in both sexes. In this study we show that DAZL controls gene expression in oocytes by regulating the length of the mRNA poly(A) tail, a major determinant of temporal and amplitudinal gene regulation in germ cells, in which gene expression is regulated entirely post-transcriptionally. We show that DAZL does not induce polyadenylation but that binding of DAZL efficiently inhibits mRNA deadenylation induced by oocyte maturation. We reveal that this activity depends on DAZL-mediated recruitment of poly(A)-binding protein, PABP, to the mRNA. Although DAZL also activates mRNA translation via PABP recruitment, mechanistic analysis revealed that neither translation nor translational activation are required for DAZL to stabilise the poly(A) tail, suggesting two mutually independent posttranscriptional roles for the DAZL-PABP complex. We show that recruited PABP must maintain its ability to bind RNA, leading to a model in which DAZL recruits PABP and/or stabilises PABP binding to poly(A) thereby preventing access of deadenylases. These results indicate that the role of DAZL in regulating germ-cell mRNA fate is more complex than previously thought and inform on the poorly understood links between mRNA translation and deadenylation, showing that they can be mechanistically separable.

MP07-12 MICROBIAL COMPOSITION DEFINES PELVIC PAIN PHENOTYPES IN REPRODUCTIVE-AGE WOMEN

2020 ◽  
Vol 203 ◽  
pp. e100-e101
Author(s):  
A. Lenore Ackerman* ◽  
Muhammed Khalique ◽  
James Ackerman ◽  
Zhi Cheng ◽  
Karyn Eilber ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Reproductive Age ◽  
Microbial Composition ◽  
Reproductive Age Women

Catamenial mononeuropathy and radiculopathy: a treatable neuropathic disorder

1998 ◽  
Vol 88 (5) ◽  
pp. 827-830 ◽  
Author(s):  
Eric L. Zager ◽  
Samantha M. Pfeifer ◽  
Mark J. Brown ◽  
Michael H. Torosian ◽  
David B. Hackney
Keyword(s):  
Treatment Options ◽  
Reproductive Age ◽  
Leg Pain ◽  
Sensory Loss ◽  
Pathological Examination ◽  
Nerve Roots ◽  
Content Type ◽  
Reproductive Age Women ◽  
Analgesic Medication ◽  
Fine Print

Object. The aim of this study was to investigate the indications and treatment options in patients with lower-extremity neuropathies and radiculopathies caused by endometriosis. Methods. The authors identified five patients whose symptoms included catamenial pain, weakness, and sensory loss involving the sciatic and femoral nerves and multiple lumbosacral nerve roots. Radiographic studies supported the diagnosis of catamenial neuropathy or radiculopathy, but definitive diagnosis depended on surgical and pathological examination. Treatment of symptoms, including physical therapy and a course of antiinflammatory or analgesic medication, was not helpful. Patients responded favorably to hormonal therapy. Laparoscopy or open exploration for extrapelvic lesions was performed for diagnosis or for treatment when hormone therapy failed. Pain and sensory symptoms responded well to therapy. Weakness improved, but never recovered completely. Conclusions. Catamenial neuropathy or radiculopathy should be considered when evaluating reproductive-age women with recurring focal neuropathic leg pain, weakness, and sensory loss.

Dicarbonyl stress and glyoxalases in ovarian function

2014 ◽  
Vol 42 (2) ◽  
pp. 433-438 ◽  
Author(s):  
Carla Tatone ◽  
Ursula Eichenlaub-Ritter ◽  
Fernanda Amicarelli
Keyword(s):  
Ovarian Function ◽  
Reproductive Age ◽  
Oocyte Competence ◽  
Reproductive Age Women ◽  
Glycation End Products ◽  
Lower Fertility ◽  
Main Regulator ◽  
Ovarian Syndrome ◽  
New Strategies

The ovary is the main regulator of female fertility. Changes in maternal health and physiology can disrupt intraovarian homoeostasis thereby compromising oocyte competence and fertility. Research has only recently devoted attention to the involvement of dicarbonyl stress in ovarian function. On this basis, the present review focuses on clinical and experimental research supporting the role of dicarbonyl overload and AGEs (advanced glycation end-products) as key contributors to perturbations of the ovarian microenvironment leading to lower fertility. Particular emphasis has been given to oocyte susceptibility to methylglyoxal, a powerful glycating agent, whose levels are known to increase during aging and metabolic disorders. According to the literature, the ovary and the oocyte itself can rely on the glyoxalase system to counteract the possible dicarbonyl overload such as that which may occur in reproductive-age women and patients with PCOS (polycystic ovarian syndrome) or diabetes. Overall, although biochemical methods for proper evaluation of dicarbonyl stress in oocytes and the ovarian microenvironment need to be established, AGEs can be proposed as predictive markers and/or therapeutic targets in new strategies for improving reproductive counselling and infertility therapies.

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