scholarly journals The Evolving Role of Natural Compounds in the Medical Treatment of Uterine Fibroids

2020 ◽  
Vol 9 (5) ◽  
pp. 1479 ◽  
Author(s):  
Michał Ciebiera ◽  
Mohamed Ali ◽  
Lillian Prince ◽  
Tia Jackson-Bey ◽  
Ihor Atabiekov ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Negative Impact ◽  
Hot Flashes ◽  
Uterine Fibroids ◽  
Epigallocatechin Gallate ◽  
Natural Compounds ◽  
Appropriate Treatment ◽  
Future Fertility ◽  
Function Impairment ◽  
Genetic And Environmental Factors

Uterine fibroids (UFs) remain a significant health issue for many women, with a disproportionate impact on women of color, likely due to both genetic and environmental factors. The prevalence of UFs is estimated to be approximately 70% depending on population. UF-derived clinical symptoms include pelvic pain, excessive uterine bleeding, gastrointestinal and voiding problems, as well as impaired fertility. Nowadays numerous methods of UF treatment are available—from conservative treatment to invasive surgeries. Selecting an appropriate treatment option should be individualized and adjusted to the patient's expectations as much as possible. So far, the mainstay of treatment is surgery, but their negative impact of future fertility is clear. On the other hand, emerging new pharmaceutical options have significant adverse effects like liver function impairment, hot flashes, bone density loss, endometrial changes, and inability to attempt conception during treatment. Several natural compounds are found to help treat UFs and relieve their symptoms. In this review we summarize all the current available data about natural compounds that may be beneficial for patients with UFs, especially those who want to preserve their future fertility or have treatment while actively pursuing conception. Vitamin D, epigallocatechin gallate, berberine, curcumin, and others are being used as alternative UF treatments. Moreover, we propose the concept of using combined therapies of natural compounds on their own or combined with hormonal agents to manage UFs. There is a strong need for more human clinical trials involving these compounds before promoting widespread usage.

scholarly journals The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

2020 ◽  
Author(s):  
Panagiotis Tsikouras ◽  
Anastasia Bothou ◽  
Xanthoula Anthoulaki ◽  
Anna Chalkidou ◽  
Spyridon Michalopoulos ◽  
...  
Keyword(s):  
Treatment Option ◽  
Clinical Symptoms ◽  
Uterine Fibroids ◽  
Desire To Have Children ◽  
Future Fertility ◽  
Hospitalization Period ◽  
Exact Etiology ◽  
Pelvic Symptoms ◽  
Collaborative Efforts ◽  
Safe Treatment Option

Uterine fibroids have remarkably heterogeneous clinical characteristics with unknown exact etiology. The treatment of fibroids should be individualized based on their size, location, growth rate, the symptoms that they cause, the desire to have children and the age of the woman. Embolization is currently the most advanced non-surgical technique. The majority of women report satisfactory post-treatment results like shorter hospitalization period and recovery time in comparison to hysterectomy and improvement or complete remission of clinical symptoms. Complications include amenorrhea (in the majority of cases: recurrence after three months) and infections that are generally treated with antibiotics. The results from most clinical studies and our published experience indicate that embolization improves pelvic symptoms related to uterine fibroids. Collaborative efforts between gynecologists and interventional radiologists are necessary in order to optimize the safety and efficacy of this procedure. In the future, embolization could be generally recommended as treatment option for women who desire future fertility/pregnancy.

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

2012 ◽  
Vol 167 (5) ◽  
pp. 609-618 ◽  
Author(s):  
Bernadette Biondi
Keyword(s):  
Heart Failure ◽  
Thyroid Dysfunction ◽  
Clinical Symptoms ◽  
Systolic Function ◽  
Evidence Synthesis ◽  
The United States ◽  
Antithyroid Drugs ◽  
Cardiac Symptoms ◽  
Appropriate Treatment ◽  
Increased Risk

ContextHeart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction.Evidence AcquisitionReports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.Evidence SynthesisThe outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or >10 mU/l.ConclusionsThe timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.

P–749 Knowledge of women undergoing surgery for endometrioma regarding the impact of the disease and its treatment on ovarian reserve and fertility

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Horan ◽  
L Glover ◽  
P Downey ◽  
M Wingfield
Keyword(s):  
Ovarian Reserve ◽  
Negative Impact ◽  
Histological Diagnosis ◽  
Ovarian Cysts ◽  
Medical Setting ◽  
Future Fertility ◽  
Group 2 ◽  
Ovarian Endometriomas ◽  
The Impact ◽  
Group 1

Abstract Study question Do women undergoing surgery for endometrioma due to pain, a cyst and/or subfertility understand the impact of the disease and its treatment on ovarian reserve and fertility. Summary answer The majority of women treated in a fertility setting are well informed compared to those in a general medical setting. What is known already: Infertility affects 30% to 50% of women with endometriosis. Ovarian endometriomas are reported in 17–44% of infertile women with endometriosis and are typically associated with more severe disease. Endometriomas are associated with diminished ovarian reserve, due to the endometrioma per se or due to surgical interventions required to treat and excise the disease. ESHRE guidelines recommend that women should be informed pre-operatively of the potential reduction in ovarian reserve associated with surgery and that ovarian reserve tests should be performed when future fertility is a concern. Study design, size, duration In conjunction with our histopathology colleagues we identified a cohort of women with a histological diagnosis of one or more ovarian endometriomas who underwent surgery in our unit between 2010 and 2019. We developed a scoping questionnaire, targeted at women currently over the age of 40, who had previously undergone surgery for endometrioma under the age of 35. Patients were contacted by telephone and consent obtained to send an email with a survey link. Participants/materials, setting, methods We identified 47 women who had a histological diagnosis of endometrioma. Of these, 30 were contactable by telephone, of whom 29 consented to being sent information regarding the study and a link to the questionnaire. 21 women completed the survey. Respondents were divided into 2 groups for analysis. Group 1 cited ‘fertility’ or ‘both pain and fertility’ as an indication for their surgery while group 2 had ‘pain’ or ‘ovarian cysts’ but no fertility concerns. Main results and the role of chance: The majority (62%) of patients were diagnosed with endometriosis while aged 25–34. The indication for surgery was evenly divided between pain (32%), fertility (37%) and ovarian cysts (37%). 60% of women reported having endometriomas diagnosed preoperatively. Striking differences were noted between groups 1 and 2. Of the women who cited ‘fertility’ or ‘both pain and fertility’ (n = 9) as an indication for their surgery, 78% (n = 7) reported being aware of any possible negative impact of endometriosis on their fertility, with 78% also being aware of the possible negative impact of surgery for endometriosis on their fertility. This compared to only 36% (n = 4) and 27% (n = 3) respectively in Group 2. In group 1, 56% (n = 5) remembered having an AMH level checked pre operatively while 78% (n = 7) also had an ultrasound pre-operatively. In contrast, only 33% (n = 3) of Group 2 remember having an AMH level checked pre operatively though 64% (n = 7) had an ultrasound pre-operatively. Of those whose surgery was performed by a fertility specialist, 75% (n = 6) reported being aware of the impact of endometriosis and also the impact of surgery on ovarian reserve, compared to 44% (n = 4) of those who surgery was performed by a non-fertility specialist. Limitations, reasons for caution This is a retrospective study and the numbers are small. We were only able to identify women with an endometrioma via pathology records, so those with no excision of disease (eg those who had ablation of an endometrioma) were excluded from this analysis. Wider implications of the findings: This suggests the majority of patients treated in a fertility setting are counselled regarding the benefit of surgery but also the risk to ovarian reserve. This is not the case in other settings. It is time to disseminate guidelines such as those produced by ESHRE to our general gynaecology colleagues. Trial registration number Not applicable

scholarly journals DIAGNOSIS OF ORAL MUCOSAL PATHOLOGY IN PATIENTS WITH VARIOUS MANIFESTATIONS OF GROUP B VITAMIN IMBALANCE

2021 ◽  
Vol 16 (4) ◽  
pp. 77-83
Author(s):  
Anna Yatsenko ◽  
Lidiya Trankovskaya ◽  
Olga Artyulova
Keyword(s):  
Oral Cavity ◽  
Oral Mucosa ◽  
Human Body ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Vitamin B12 Deficiency ◽  
Vitamin Deficiency ◽  
The Body ◽  
B Vitamins ◽  
Group B

Subject. The scientific works of recent years show an increase in the degree of negative impact of vitamin deficiency and vitamin-like substances on the state of health of the population. With the deficiency of most vitamins, synthetic processes and regeneration of oral tissues are reduced, so often the initial signs of hypovitaminosis are stomatitis, gingivitis, glossitis, and therefore, it is dentists who are the first to diagnose deviations in the body associated with vitamin deficiency. This justifies the relevance and practical value of studying and describing clinical cases of manifestations of deficient vitamin conditions in the oral cavity. The object – is to study the effect of B vitamins on the oral mucosa in order to increase the effectiveness of diagnosis of vitamin-deficient conditions of the human body. Methodology. These clinical examples illustrate the management experience of patients with manifestations of deficient vitamin conditions on the oral mucosa. Clinical and laboratory methods of diagnosing the analysed conditions of the organism were applied. Statistical processing of materials was carried out using the STATISTICA 10 software (StatSoft, Inc., USA). Results. The deficient condition of the organism in relation to vitamins B2, B6, B12 in patients 18-75 years old has been studied. Characteristic clinical changes on the oral mucosa of the examined patients were established. So, in most patients with vitamin B2 deficiency, the classic Sebrel triad was found: dermatitis, glossitis, cheilitis. In those examined with a lack of vitamin B6, language desquamations (smoothed, polished language) were determined in the 83.6%, often combined with glossodinia. Patients with vitamin B12 deficiency were characterized by a lesion in the form of Meller-Gunter glossitis in 74.9% of cases, moreover, 67.6% of patients showed paresthesia in the area of tongue and oral mucosa. Conclusions. The study found that the first clinical symptoms of deficient conditions of the presented vitamins of group B were found from the oral cavity. Thus, it is the dentist who is the first to diagnose the pathological states of lack of group B vitamins in the human body, which emphasizes the importance and relevance of continuing to study these states of the body.

scholarly journals Pregnancy-related lumbopelvic pain: classification and diagnostics according to European guidelines and a review of literature

2017 ◽  
Vol 21 (3) ◽  
pp. 58-63
Author(s):  
Małgorzata Starzec ◽  
Aleksandra Truszczyńska-Baszak
Keyword(s):  
Lumbar Spine ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Mechanical Load ◽  
Pelvic Girdle ◽  
Pelvic Girdle Pain ◽  
Lumbar Pain ◽  
Foreign Literature ◽  
European Guidelines ◽  
Pain Syndromes

Lumbopelvic pain associated with pregnancy may originate from the lumbar spine, the pelvic girdle or may be mixed. According to European guidelines, individual subtypes of pain require different procedures, for which a detailed differential diagnosis is necessary. These ailments arouse a lot of controversy. The aim of the work was to present the current state of knowledge on the aforementioned ailments, including European guidelines and the latest trends in foreign literature. The diagnosis of lumbopelvic pain, with particular emphasis on the pathophysiology and methods of differentiation of both pain syndromes, was discussed. Lumbar spine pain is mainly related to the mechanical load caused by a pregnant uterus. In the case of pelvic girdle pain, the main cause is the disorder of optimal stability, which depends on the correct mechanisms of force and form closure. Pelvic girdle pain is characterized by other clinical symptoms and risk factors, it also often remains after pregnancy, having negative impact on the daily functioning of a woman even years after giving birth. Depending on the location (one or both sacroiliac joints, pubic symphysis), several types of this pain syndrome are distinguished. The worst prognosis is pelvic pain associated with the involvement of all three joints at the same time. Until now, this term has not been more widely used in the Polish-language literature. The complexity of chronic pain syndromes, in which the discomforts of the pregnancy period may develop, entails the necessity of early identifi cation and deliberate action. Knowledge of the etiopathogenesis of these ailments is a prerequisite for therapeutic success. Introduction of terminology popular in foreign literature will improve treatment of these diseases, adapting it to current standards and will also enable better exchange of experience between professionals. pelvic girdle pain, lumbar pain, pregnancy

scholarly journals Virtual Reality for Stroke Rehabilitation: assessment, training and the effect of virtual therapy

2011 ◽  
Vol 14 (2) ◽  
pp. 23-32 ◽  
Author(s):  
Paweł Kiper ◽  
Andrea Turolla ◽  
Lamberto Piron ◽  
Michela Agostini ◽  
Alfonc Baba ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Negative Impact ◽  
Innovative Technology ◽  
Rehabilitation Outcomes ◽  
Function Impairment ◽  
Sensory Modalities ◽  
Task Practice ◽  
Adaptive Nature ◽  
Virtual Therapy

The motor function impairment deriving from stroke injury has a negative impact on autonomy and on the activities of daily living. Several studies have demonstrated that learning new motor skills is important to induce neuroplasticity and functional recovery. To facilitate the activation of brain areas and consequently neuroplasticity, it may be advantageous to combine traditional motor rehabilitation with innovative technology, in order to promote motor re-learning and skill re-acquisition by means of an enhanced training. Following these principles, exercises should involve multiple sensory modalities exploiting the adaptive nature of the nervous system, in order to promote active patient participation. Movement re-learning could be improved by means of training in an enriched environment focused on optimizing the affordances between the motor system and the physical environment: virtual reality technologies allow for the possibility to create specific settings where the affordances are optimized. Several autors report that patients treated in virtual representation could, in both acute and chronic stroke, improve their arm motor function. Reinforced Feedback in a Virtual Environment (RFVE), can incorporate the elements necessary to maximize motor learning, such as repetitive and differentiated task practice, feedback of performance and results, and reinforcement of the motivation. The RFVE approach may lead to better rehabilitation outcomes in the treatment of the upper limb in stroke patients.

scholarly journals Pneumonitis from immune checkpoint inhibitors and COVID-19: current concern in cancer treatment

2020 ◽  
Vol 8 (2) ◽  
pp. e000952 ◽  
Author(s):  
Ernesto Rossi ◽  
Giovanni Schinzari ◽  
Giampaolo Tortora
Keyword(s):  
Adverse Event ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Clinical Symptoms ◽  
Checkpoint Inhibitors ◽  
Radiological Findings ◽  
Serious Adverse Event ◽  
Appropriate Treatment ◽  
Current Concern ◽  
Coronavirus Infection

Pneumonitis is a rare but serious adverse event caused by cancer immunotherapy. The diagnosis between COVID-19-induced pneumonia and immunotherapy-induced pneumonitis may be challenging in the era of COVID-19 outbreak. Some clinical symptoms and radiological findings of pneumonitis can be attributed to the coronavirus infection as well as to an immune-related adverse event. Identifying the exact cause of a pneumonitis in patients on treatment with immunotherapy is crucial to promptly start the most appropriate treatment. The proper management of immune checkpoint inhibitors for the risk of pneumonia must take into account a series of parameters. Accurate attention should be payed to symptoms like cough, fever and dyspnea during immunotherapy.

scholarly journals Leaving A Mark, An Animal-Assisted Intervention Programme for Children Who Have Been Exposed to Gender-Based Violence: A Pilot Study

2019 ◽  
Vol 16 (21) ◽  
pp. 4084 ◽  
Author(s):  
Alexander Muela ◽  
Josune Azpiroz ◽  
Noelia Calzada ◽  
Goretti Soroa ◽  
Aitor Aritzeta
Keyword(s):  
Domestic Violence ◽  
Internalizing Symptoms ◽  
Family System ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Physical And Mental Health ◽  
Gender Based Violence ◽  
Intervention Programme ◽  
Gender Based ◽  
Animal Assisted Intervention

Gender-based violence is one of the most serious social and health problems faced by women around the world. Importantly, it has a negative impact not only on the woman’s physical and mental health, but also on all members of the family system in which it takes place. The aims of this study were to implement Leaving a Mark, an animal-assisted intervention (AAI) programme for children who have been exposed to gender-based violence, and to examine its effect on their associated clinical symptoms. The participants were 19 children (13 boys and 6 girls; Mage = 8.89, SD = 2.23) who had been exposed to domestic violence perpetrated either by their father or their mother’s intimate partner. Clinical symptoms were assessed using the Child Behaviour Checklist (CBCL). After taking part in the AAI programme, the children showed a reduction in internalizing symptoms and in symptoms associated with post-traumatic stress disorder. However, no significant changes were observed in externalizing symptoms or in affective and behavioural dysregulation (CBCL-Dysregulation Profile). These results provide preliminary support for the use of the Leaving a Mark programme with children who have been exposed to domestic violence. However, further studies with a larger sample and more rigorous design are required.

scholarly journals Unmet Medical Needs in the Management of Ulcerative Colitis: Results of an Italian Delphi Consensus

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Marco Daperno ◽  
Alessandro Armuzzi ◽  
Silvio Danese ◽  
Walter Fries ◽  
Giuseppina Liguori ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Unmet Needs ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Delphi Process ◽  
Delphi Consensus ◽  
Medical Needs

Background. The lifelong and remitting nature of ulcerative colitis results in considerable disability and a substantial negative impact on quality of life. The major goal of the therapy of ulcerative colitis is considered to be the modification of the course of the disease, so that the patient’s quality of life can be improved while minimising disease-related disability. Although considerable progress in understanding the molecular pathways involved in ulcerative colitis has led to improved treatment options, there is currently no definitive cure for ulcerative colitis, there remain considerable unmet needs in terms of long-term efficacy and safety, and there are many patients who continue to be burdened by physical and psychological symptoms. Defining unmet needs can help to increase the awareness of the shortcomings of current therapeutic management and highlight the need to achieve not only a control of clinical symptoms but also control of mucosal healing, in order to attain the best possible long-term outcomes. Methods. With the aim of providing a better understanding of the unmet needs of patients towards improving overall care, a Delphi process was used to obtain consensus among a group of Italian ulcerative colitis experts. The consensus group met with a major focus of delineating the unmet needs of current treatment strategies and overall management of ulcerative colitis, while also focusing on quality of life and patient care. Results. Three main areas were identified: (i) treatment, (ii) monitoring and risk management, and (iii) patient-related issues. A high level of consensus was reached on all but one of the statements identified. Conclusions. The findings arising from the Delphi process provide valuable insights into the unmet needs in the management of moderate-to-severe ulcerative colitis from the clinician’s perspective, while emphasising the benefits of therapeutic individualization and suggesting areas that need additional study with the aim of optimising the treatment of patients with ulcerative colitis.

New and Emerging Therapies for Uterine Fibroids

2017 ◽  
Vol 35 (06) ◽  
pp. 549-559 ◽  
Author(s):  
Kate Fritton ◽  
Mostafa Borahay
Keyword(s):  
Uterine Fibroids ◽  
Epigallocatechin Gallate ◽  
Limited Efficacy ◽  
Emerging Therapies ◽  
Novel Targets ◽  
New Treatments ◽  
Receptor Modulators ◽  
Selective Progesterone Receptor Modulators ◽  
Progesterone Receptor Modulators

AbstractThe pain, bleeding, and anemia associated with uterine fibroids debilitate many women. In addition to limited efficacy, the side effects of the currently used medical therapies prevent long-term use and nearly all pregnancies. Thus, women hoping to achieve pregnancy have limited options and usually opt for myomectomy. Once completed childbearing, many patients proceed with hysterectomy despite its risks and costs. Thus, there is a clear need for a new medical treatment for fibroids that is safe and effective. To this end, researchers have investigated several new treatments over the recent years, including both hormonal and nonhormonal ones. Some examples include selective progesterone receptor modulators, vitamin D, aromatase inhibitors, gene therapy, simvastatin, nanoparticles, epigallocatechin gallate, and intratumor collagenase injections. The aim of this article is to review and critically analyze the evidence (both laboratory and clinical) for these emerging therapies. We will discuss strengths and weaknesses of studies, areas where further evidence is needed, and finally deliberate on novel targets potentially amenable for development of future therapeutics.

Sign in / Sign up

Export Citation Format

Share Document