The Application of Different Surgical Methods in Endometrial Cancer

Endometrial cancer is a common gynecological malignancy in women, which accounts for the second in malignant tumor of female reproductive system. Obesity, high blood pressure and diabetes are risk factors for endometrial cancer. At present, the treatments of endometrial cancer focus on surgical treatment, followed by radiotherapy, chemotherapy and endocrine therapy. The progress of surgical method is transferring from traditional laparotomy, laparoscopy, single port laparoscope to Da Vinci robotic surgery system. Different surgical options should be personalized according to the patient’s situation. We compared the pros and cons of different surgical methods and introduced the clinical value of the Sentinel lymph node mapping in hope of giving some information for clinic.

Office Procedures in Cosmetic Gynaecology

Female genital cosmetic surgery is a set of multiple procedures focused on improving genital appearance, structure, and function. Sexual dysfunction affects a large proportion of the female population and appears to be associated with distorted genital anatomy although what women perceive as normal varies vastly depending on cultural and social beliefs. Cosmetic gynaecology office procedures are simple, quick, and effective solutions to improve sexual function as well as body image with minimal interventions and minimal side-effects. In this narrative review, we present these widely used minimally invasive aesthetic gynaecology interventions, focusing on their efficacy, and reported complications. Recommendations regarding heath professionals’ approach and ethical issues arising are also discussed.

Ovarian Cryopreservation: An Overview of Current Evidence around the Globe

Advancements in cancer as well as, autoimmunological or hematological conditions treatment have significantly increased the survival rate as well as, the Quality of Life (QoL) for these patients. In addition, Assisted Reproductive Techniques (ART) offers a variety of therapeutic approaches that aim towards fertility preservation and hormonal restoration after treatment. Ovarian Tissue Cryopreservation (OTC) and Ovarian Tissue Transplantation (OTT) have been proposed as an efficient alternative to reserve fertility and hormona function in cases of prepubertal young girls and women needed to be treated immediately with radiation and/or chemotherapy. In this narrative review, current scientific evidence is summarized in order to explore OTC/OTT. In addition to the qualitive presentation of our findings, we provide cumulative evidence from other published studies to demonstrate the clinical potential and limitations of these procedures.

Spectral Artificial Vision Endoscopy for Assisting the Differential Diagnosis of Endometrial Polyps, In Vivo

We are the first to present results from a pilot clinical study designed for the purpose of establishing spectral mapping patterns, as a potential novel imaging assay for identifying and discriminating between functional and nonfunctional endometrial polyps in vivo. The Spectral Artificial Vision Endoscope (SAVE) was used and validated in this study. The SAVE system, adapted to a regular hysteroscope, was able to operate in several imaging modes, including color imaging, infrared imaging, narrow band imaging and spectral mapping, all acquired at a video rate and simultaneously. The spectral maps generated by the SAVE system for 28 patients with endometrial polyps displayed characteristic patterns capable of discriminating functional from nonfunctional polyps with remarkable consistency (Spearman R=0.912, p<10-6). These preliminary clinical validation results highlighted the great potential of the in vivo spectral mapping imaging modality as an adjunct tool to conventional color camera-based hysteroscopy, offering improved and quantitative diagnosis.

Clotrimazole, Pregnancy and Endocrine Disruption: A Narrative Review

Background: Clotrimazole is an antifungal drug commonly used in human medicine. It is considered to be safe in pregnancy. Besides this medical assumption ecotoxicology has developed over the last years an awareness of pharmaceuticals which have been detected in surface waters and are of concern for the biosphere. Some of those drugs are endocrine disruptors. So is clotrimazole.Methods: Selective internet research on this subject incorporating medical and ecotoxicological positions.Conclusions: Ecotoxicology and human medicine postulate divergent positions about the harmful effects of clotrimazole. Medicine bases its assumption on thousands of healthy newborn babies whose mothers were treated with clotrimazole during pregnancy. This argument is easy to refute as clotrimazole is an endocrine disruptor and possible consequences of exposure during sensitive periods of pregnancy will only show up much later in life. As a result medicine is challenged to incorporate ecotoxicological concerns into its advice for pregnant women.

Open Neural Tube Defects: A Case Presentation of 30-year-old Secundigravida with Spina Bifida of the Fetus

Spina bifida is a neural tube defect that occurs in about 1 in 1,500 pregnancies. Open spinal defects are associated with paralysis, incontinence and hydrocephalus requiring postnatal shunting of the cerebrospinal fluid. Neural tube defects are preventable through preconceptional folic acid supplementation. Occasionally, the diagnosis is made during routine anomaly scan at 18-20 weeks of gestation, as the earliest signs of the anomaly can be seen at the end of first trimester. The information provided by ultrasound plays a crucial role in patient counseling and pregnancy management. The authors report a case of prenatal diagnosis of spina bifida aperta with focus on detailed ultrasound presentation and difficulties in consulting in relation to the prognosis for the newborns.

The Human Female Paradox: Biological Disadvantage Preimplantation, Biological Advantage, Thereafter

The vital statistics show that human females outlive males at every biological stage. Once the embryo arrives in the uterus, more males die at every stage, at least until the eighth decade when the majority of survivors are female. Unexpectedly, the same statistics also show that more boys are born than girls, which is difficult to explain, because the sperm that determine the sex of the fetus, are not skewed toward males. Recently, new data reveal the reason for the increased number of male births; they imply the significant loss of females before the fetus arrives in the womb. Thereafter, there is an excessive loss of males – not only in utero but throughout their lives. One likely reason for the sex differences in fetal survival is the way that humans compensate for the sex difference in number of X chromosomes.

Genetic, Prenatal, and Preimplantation Genetic Diagnosis of Glutaric Aciduria Type I

Purpose: Glutaric Acid Type I (GA-I) is an inherited metabolic disorder. Although the treatment guidelines for GA-I were established a decade ago, they cannot block the vertical heredity. We aim to apply genetic methods to block the inheritance of GA-I and verifies the efficiency of Next-Generation Sequencing (NGS)-based Preimplantation Genetic Testing for Monogenic disease (PGT-M) of GA-I.Materials and methods: A non-consanguineous Chinese family was diagnosed with GA-I by Sanger sequencing. PGT-M and prenatal diagnosis (PND) were performed for the carrier. 5 blastocysts were used for the trophectoderm biopsy. After Whole-Genome Amplification (WGA), the WGA products were used for Sanger sequencing, NGS-based PGT-M and PGT-A. Sanger sequencing-based PND was performed in second trimester to confirm the results of PGT-M.Results: A compound heterozygous mutation was diagnosed in the GCDH gene with co-segregation. One is [c.533G>A (p.G178E)] and another is [c.914C>T (p.S305L)]. 2 blastocysts were diagnosed as normal and one of them was transferred into the mother’s uterus. Finally, a healthy female was born 39 weeks after transplantation.Conclusion: Our study successfully applied NGS-based PGT-M to avoid GA-I and highlights the efficiency of genetic diagnoses. It has significant implications on genetic counseling and genetic diagnosis for GA-I.

Anodontia Detected by Prenatal Sonography: A Case Report

Anodontia is a rare orofacial complex developmental malformation. In contrast to normal tooth germ with roundhypo echogenic structure arranged in an arch-like manner in alveolar bone, anodontia shows an arch-like hyper echogenic structure without any dental alveoli. Prenatal ultrasound is a reliable method for detecting anodontia inearly gestational age.

Outcomes of Single Incision Anchored Anterior Vaginal Mesh Repair for Recurrent Vaginal Prolapse

Objective: To report the safety and efficacy of single incision anchored anterior vaginal mesh repair for women with recurrent anterior vaginal prolapse.Methods: Retrospective study of women with recurrent anterior vaginal prolapse, Stage 2 or beyond, who underwent single incision anchored vaginal mesh repair with Anterior Elevate (American Medical Systems, Minnetonka, USA) between June 2012 and October 2016. Pre-operatively, the Prolapse Quality-of-Life questionnaire (P-QOL) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12) were completed. Post-operatively, women completed the P-QOL, PISQ-12 and the global impression of improvement questionnaire (PGI-I). Preoperative POP-Q and post operative POP-Q examination at up to 24 months follow up were recorded. At average follow up of 36 months, participants were interviewed via telephone using questions from the P-QOL, PISQ and PGI-I.Results: 45 women had single incision anterior vaginal mesh kit repair for recurrent prolapse. Postoperatively, 85% of women reported cure of their prolapse symptoms. At 24 months, 80.0% had POP-Q stage 0 or 1 in the anterior compartment, and 93.8% achieved anatomical cure of apical prolapse (point C above 0). During structured telephone interview at mean follow up of 36 months, on PGI-I, 70% reported feeling ‘much better’ or ‘very much better’.Conclusion: Vaginal surgery using single incision lightweight mesh kits can be an effective approach for women with recurrent anterior vaginal prolapse, resulting in subjective and objective cure rates of over 80% with reasonable safety profile up to 60 months postoperatively.