scholarly journals Uterine Adenomyosis: From Disease Pathogenesis to a New Medical Approach Using GnRH Antagonists

2021 ◽  
Vol 18 (19) ◽  
pp. 9941
Author(s):  
Jacques Donnez ◽  
Christina Anna Stratopoulou ◽  
Marie-Madeleine Dolmans
Keyword(s):  
Reproductive Age ◽  
Sex Steroid ◽  
Gnrh Antagonists ◽  
Chronic Disorder ◽  
High Prevalence ◽  
Steroid Signaling ◽  
Uterine Adenomyosis ◽  
Lesion Regression ◽  
Available Information

Uterine adenomyosis is a common chronic disorder frequently encountered in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Despite its high prevalence, its etiopathogenesis is not yet fully understood, so there are currently no specific drugs to treat the disease. A number of dysregulated mechanisms are believed to contribute to adenomyosis development and symptoms, including sex steroid signaling, endometrial proliferation and invasiveness, and aberrant immune response. Abnormal sex steroid signaling, particularly hyperestrogenism and subsequent progesterone resistance, are known to play a pivotal role in its pathogenesis, which is why various antiestrogenic agents have been used to manage adenomyosis-related symptoms. Among them, gonadotropin-releasing hormone (GnRH) antagonists are swiftly gaining ground, with recent studies reporting efficient lesion regression and symptom alleviation. The aim of the present review is to compile available information on the pathogenesis of adenomyosis, explore the etiology and mechanisms of hyperestrogenism, and discuss the potential of antiestrogenic therapies for treating the disease and improving patient quality of life.

scholarly journals Formation of mental disorders in dysmenorrea at early reproductive age

2009 ◽  
Vol 8 (4) ◽  
pp. 47-51
Author(s):  
R. F. Nasyrova ◽  
L. S. Sotnikova
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Social Factors ◽  
Reproductive Age ◽  
Female Patients ◽  
High Prevalence ◽  
Mental Disturbances

Clinical-psychopathological examination has been carried out as well as quality of life has been studied in female patients with dysmenorrea in period of puberty and at early reproductive age. It has been revealed that mental disturbances in studied nosology were represented by their high prevalence. In girls-adolescents with this pathology neurotic reactions were found more frequently, in women with dysmenorrea at early reproductive age persistent neurotic states predominated. It has been shown that formation and dynamic of mental disorders were determined by somatogenic, psychogenic and social factors.

Endometriosis: disease pathophysiology and the role of prostaglandins

2007 ◽  
Vol 9 (2) ◽  
pp. 1-20 ◽  
Author(s):  
Meng-Hsing Wu ◽  
Yutaka Shoji ◽  
Pei-Chin Chuang ◽  
Shaw-Jenq Tsai
Keyword(s):  
Chronic Pelvic Pain ◽  
Molecular Mechanisms ◽  
Modern Society ◽  
Reproductive Age ◽  
Health Concern ◽  
Public Health Concern ◽  
Reproductive Age Women ◽  
High Prevalence

Endometriosis is considered to be a polygenic disease with a complex, multifactorial aetiology that affects about 10% of women in the reproductive age. Women with endometriosis have symptoms that include chronic pelvic pain, dysmenorrhoea and dyspareunia, significantly reducing their quality of life. Endometriosis is also the primary cause of infertility in women, with the prevalence rate ranging from 20% to 50%. The high prevalence and severe outcomes of this disease have made it a major public health concern in modern society. Currently, the mechanism(s) responsible for the initiation and promotion of this disease remains obscure. In this review, we focus on the expression, regulation and action of prostaglandins in the cellular and molecular mechanisms that contribute to the development and/or maintenance of endometriosis.

scholarly journals Clinical-anamnestic features and life quality of patients with nodular and diffuse adenomyosis

2021 ◽  
pp. 68-76
Author(s):  
A. A. Gorpenko ◽  
V. D. Chuprynin ◽  
T. Yu. Smolnova ◽  
N. A. Buralkina
Keyword(s):  
Quality Of Life ◽  
Data Processing ◽  
Life Quality ◽  
Reproductive Age ◽  
Stage Iii ◽  
Biological Research ◽  
Control Group ◽  
Social Functions ◽  
High Prevalence

Introduction. Adenomyosis remains one of the significant challenges in modern gynecology and affects a large number of women of reproductive age. The clinical presentation of adenomyosis is variable, with severity of symptoms depending on the form of the disease. In case of the occurrence of severe pelvic pain, dysmenorrhea and dyspareunia, the disease disrupts social functions and leads to a decrease in the patient’s quality of life.Aim. To study clinical and anamnestic features and patient’s quality of life with diffuse and nodular forms of adenomyosis.Materials and methods. The study included 126 patients with various forms of adenomyosis (45 patients with nodular adenomyosis (NAM), 81 with stage III – IV DAM). The control group included 20 patients with tubo-peritoneal factor of infertility, without adenomyosis based on the ultrasound and hysteroscopy findings. All patients underwent a comprehensive examination, including general clinical, instrumental and laboratory tests. The study included a comparative analysis of the obtained data and determination of the clinical and anamnestic characteristics of the patients with stage III – IV DAM as compared with the patients with NAM. We also studied the quality of life of patients with NAM and DAM on the basis of a specialized questionnaire on the study of the quality of life of patients with endometriosis – Endometriosis Health Profile, ENR-5+6. Statistical analysis and data processing were conducted using Microsoft Excel (version 16), Statistica 10.0, StatPlus 7.3, GraphPad Prism 9 software. Data processing was performed in accordance with the guidelines for medical and biological research.Results and discussion. As compared with patients with nodular adenomyosis, the patients with stage III-IV diffuse adenomyosis are characterized by an older age (42.1 (4.6) and 34.6 (6.2) years, respectively; p <0.001), have a high prevalence of somatic (96 and 77%, respectively; p < 0.05) and gynecological pathology (79 and 51%, respectively; p < 0.001) in past medical history, a higher frequency of intrauterine manipulations (hysteroscopy, separate diagnostic curettage) (73 and 42%, respectively; p < 0.001) and medical abortions (52 and 28%, respectively, p < 0.001). Complaints of heavy menstruation, bloody vaginal discharge between periods, and intestinal symptoms had a special place among the complaints of such patients. Moderate to severe anemia, as a consequence of heavy menstrual bleeding, was also a frequent concomitant pathology.Conclusions. Stage III-IV DAM is characterized by a more severe course and marked symptoms as compared with NAM, and significantly affects the patient’s quality of life.

Musical Anhedonia

2020 ◽  
Vol 31 (2) ◽  
pp. 62-68
Author(s):  
Sara E. Holm ◽  
Alexander Schmidt ◽  
Christoph J. Ploner
Keyword(s):  
Quality Of Life ◽  
Nucleus Accumbens ◽  
Brain Damage ◽  
Parietal Cortex ◽  
Neurological Disorders ◽  
Brain Regions ◽  
Precise Information ◽  
Exact Localization ◽  
High Prevalence

Abstract. Some people, although they are perfectly healthy and happy, cannot enjoy music. These individuals have musical anhedonia, a condition which can be congenital or may occur after focal brain damage. To date, only a few cases of acquired musical anhedonia have been reported in the literature with lesions of the temporo-parietal cortex being particularly important. Even less literature exists on congenital musical anhedonia, in which impaired connectivity of temporal brain regions with the Nucleus accumbens is implicated. Nonetheless, there is no precise information on the prevalence, causes or exact localization of both congenital and acquired musical anhedonia. However, the frequent involvement of temporo-parietal brain regions in neurological disorders such as stroke suggest the possibility of a high prevalence of this disorder, which leads to a considerable reduction in the quality of life.

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

Possibilities and prospects of conservative therapy for endometriosis, as a chronical progressing disease (review of literature)

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Tatyana Yu. Pestrikova ◽  
Elena A. Yurasova ◽  
Igor V. Yurasov
Keyword(s):  
Quality Of Life ◽  
Abnormal Uterine Bleeding ◽  
Modern Medicine ◽  
Reproductive Age ◽  
Aim Analysis ◽  
Scientific Publications ◽  
Terra Incognita ◽  
Positive Effect

Relevance. Endometriosis is a common gynecological disease that affects up to 10% of women of reproductive age worldwide and is the main cause of pain and infertility. Endometriosis is a disease, although it has been known for a long time, nevertheless, in many ways it represents terra incognita for modern medicine. Aim. Analysis of literature on the feasibility of long-term and the use of the drug dienogest 2 mg (Vizanne), which has a positive effect on the quality of life of patients with endometriosis. Materials and methods. To write this review, a search was made for domestic and foreign publications in Russian and international search engines (PubMed, eLibrary, etc.) over the past 13 years. The review included articles from peer-reviewed literature. Results. The review presents data on the difficulties of verifying the diagnosis of endometriosis due to a combination of this pathology with pain, infertility, abnormal uterine bleeding. The pathogenesis of the origin of endometriosis-associated pain is presented. The efficacy of the use of the drug dienogest (Vizanne), which has a powerful antiproliferative effect that reduces the main symptoms of endometriosis (pain, bleeding), is substantiated. The expediency of long-term and safe use of the drug dienogest (Vizanne), which has a positive effect on the quality of life of patients with endometriosis, has been proved. Conclusions. Numerous scientific publications confirm the feasibility of prolonged use of the drug dienogest (Vizanne), to achieve remission during endometriosis.

The experience of using a diode laser in the herpes labial treatment

2020 ◽  
Vol 25 (1) ◽  
pp. 43-46
Author(s):  
S. L. Blashkova ◽  
E. V. Krikun ◽  
Yu. V. Fazylova ◽  
Yu. V. Blashkova
Keyword(s):  
Oral Cavity ◽  
Diode Laser ◽  
Comparison Group ◽  
Treatment Time ◽  
Local Treatment ◽  
Allergic Reactions ◽  
High Prevalence ◽  
Dental Diseases ◽  
Simplex Virus

Relevance. The relevance of the problem is in the high prevalence of the herpes simplex virus. According to WHO, nearly 90% of the population are carriers. Relapses can occur several times a year, which leads to disability and impairs the quality of life. Currently, there are a large number of drugs for general and local treatment. However, they are toxic and can cause allergic reactions. In recent years, a large number of studies have been devoted to the use of lasers in the treatment of dental diseases. Therefore, the question of the use of a laser in the treatment of herpetic lesions of the oral cavity remains relevant.Purpose. The research purpose was to determine the effectiveness of the use of a diode laser in the treatment of herpetic lesions of the lips.Materials and methods. We conducted a comparative assessment of the effectiveness of the use of a diode laser in monotherapy of herpetic lip lesions in 18 patients. The comparison group consisted of 18 patients, in the local treatment of which antiviral ointments were used.Results. The results of the study showed that the use of a diode laser can reduce treatment time, accelerate the epithelization of foci.Conclusion. The results of our study allow us to recommend the use of a diode laser in the complex treatment of herpetic lesions of the oral cavity.

scholarly journals Neglected femoral neck fractures in cerebral palsy: a narrative review

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Femoral Neck ◽  
Motor Function ◽  
Treatment Options ◽  
High Morbidity ◽  
Fibular Graft ◽  
Motor Impairments ◽  
High Prevalence ◽  
Neck Fracture

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019

scholarly journals Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

2021 ◽  
Vol 28 (4) ◽  
pp. 2789-2800
Author(s):  
Stephanie Lelond ◽  
Julie Ward ◽  
Pascal J. Lambert ◽  
Christina A. Kim
Keyword(s):  
Cox Regression ◽  
Advanced Pancreatic Cancer ◽  
Symptom Burden ◽  
Distress Score ◽  
Ambulatory Oncology ◽  
High Prevalence ◽  
Associated Symptoms ◽  
Report Symptom

Patients with advanced pancreatic cancer (APC) experience many disease-related symptoms. ESAS-r measures the severity of 9 symptom domains and has been validated for use in the ambulatory oncology setting. We aimed to describe symptom burden at baseline for patients with APC treated with modern chemotherapy (CT), and to determine whether symptom burden at baseline is prognostic. Patients diagnosed with APC between 2012–2016, treated with ≥1 cycle of CT, who completed ≥1 ESAS-r were identified. Descriptive statistics were used to report symptom burden and common moderate-to-severe symptoms. A joint model was used to describe the trajectory of ESAS-r during follow-up while controlling for death. Multivariable Cox regression was used to identify independent predictors of death. Of 123 patients identified, the median age was 65 and 61% had metastatic disease. The median baseline ESAS-r total symptom distress score (TSDS) was 24. A total of 86% of patients had at least one symptom score of ≥4 at baseline, with the most common being: fatigue, nausea, anxiety, and shortness of breath. Median overall survival was 10.2 months. Baseline TSDS was not predictive for worse survival in the era of modern CT. Patients with APC have a high burden of cancer-associated symptoms and a high prevalence of moderate-to-severe symptoms. Early intervention has the potential to improve quality of life in this group of patients and should be investigated.

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