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Life
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Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a...
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Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a Tailored Care

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 13921

Special Issue Editors

Dr. Giovanni Delli Carpini

E-Mail Website
Guest Editor
Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Università Politecnica delle Marche, Ancona, Italy
Interests: gynecologic oncology; uterine fibroids; endometriosis; lower genital tract pathology
Prof. Dr. Andrea Ciavattini

E-Mail Website
Guest Editor
Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
Interests: pre-invasive and invasive cervical lesions; pre-invasive and invasive endometrial pathology; gynecologic oncology; endoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The challenges of modern medicine require the overcoming of traditional models of care. Gynecological pathology embraces many aspects of care. In fact, the gynecologist's attention ranges from physiology and disease prevention to benign and malignant pathology. Gynecological diseases are among the most frequent and may significantly impact the quality of life and health of young women, also considering the potential effect on fertility. It is logical to state that such widespread pathologies will have different clinical manifestations and that not all women with the same pathology can benefit from a unique therapeutic approach.

Personalized medicine should be the answer to heterogeneous clinical manifestations and the ever-increasing availability of genetic, molecular, and clinical information. Modern diagnostic and therapeutic approaches in gynecological care must be supported by an increasingly tailored approach.

The first fundamental phase of a tailored approach is risk stratification and creating a patient-specific profile to determine the individual predisposition to disease, offer timely prevention, choose the best diagnostic path, administer targeted therapies at the right time, and minimize errors and money wasting. In particular, integrating data from genetic and molecular studies with clinical information is a crucial step toward personalized medicine. However, obtaining solid scientific evidence in this sense seems to be increasingly difficult. There is a clear need for well-designed studies that consider multiple aspects of the diagnostic and therapeutic path of gynecological pathologies. It is also necessary to increase knowledge of modern methods of data analysis and predictive model design by artificial intelligence and machine learning to apply them in the best way in support of traditional methods towards personalized medicine.

Therefore, this Special Issue aims to collect articles concerning genetic, molecular, and clinical data that can be of support for the definition of a patient-specific risk profile for gynecological pathologies and clinical risk models obtained through innovative data analysis methods, as well as high-level reviews describing the state-of-the-art regarding a personalized treatment approach for gynecological pathologies or modern methods of complex data analysis.

Dr. Giovanni Delli Carpini
Prof. Dr. Andrea Ciavattini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gynecology
  • tailored approach
  • predictive models
  • diagnostic path
  • genetic profile
  • molecular analysis
  • gynecological oncology
  • uterine fibroids
  • endometriosis

Published Papers (4 papers)

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Research

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13 pages, 12017 KiB  
Article
The Utility of Rectal Water Contrast Transvaginal Ultrasound for Assessment of Deep Bowel Endometriosis
by Martyna Masternak, Malwina Grabczak, Tomasz Szaflik, Beata Mroczkowska, Łukasz Mokros, Beata Smolarz, Hanna Romanowicz and Krzysztof Szyłło
Life 2023, 13(5), 1151; https://doi.org/10.3390/life13051151 - 10 May 2023
Viewed by 2697
Abstract
Deep infiltrating endometriosis (DIE) is characterized by the presence of endometrial tissue outside the uterine cavity that infiltrates at least 5-mm deep below the peritoneal layer. Imagining examinations are the first-choice methods to detect DIE. The aim of this study is to assess [...] Read more.
Deep infiltrating endometriosis (DIE) is characterized by the presence of endometrial tissue outside the uterine cavity that infiltrates at least 5-mm deep below the peritoneal layer. Imagining examinations are the first-choice methods to detect DIE. The aim of this study is to assess whether rectal water contrast transvaginal sonography (RWC-TVS) can be a useful tool for the estimation of the size of deep bowel endometriotic nodules. This retrospective study includes 31 patients subjected to RWC-TVS who underwent surgery due to deep bowel endometriosis between January 2021 and December 2022. Nodule dimensions measured via ultrasound were compared to those of histopathological samples taken after surgery. In total, 52% of patients had endometriosis limited only to the intestines, 19% had endometriotic nodules located at uterosacral ligaments and posterior vaginal fornix, 6% at the anterior compartment, and 13% at a different location. Additionally, 6% of patients had nodules at more than two locations. In all but one case, the intestinal nodules could be seen on RWC-TVS images. The largest nodule dimension measured via RWC-TVS and the size of the equivalent histopathological sample correlated (R = 0.406, p = 0.03). Thus, RWC-TVS allows for the detection of DIE and moderate estimation of the nodule sizes and should be practiced during a diagnostic process. Full article
(This article belongs to the Special Issue Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a Tailored Care)
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Review

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14 pages, 299 KiB  
Review
Clotting Factor Deficiencies as an Underlying Cause of Abnormal Uterine Bleeding in Women of Reproductive Age: A Literature Review
by Maria Effrosyni Livanou, Alkis Matsas, Serena Valsami, Dimitrios T. Papadimitriou, Athanasios Kontogiannis and Panagiotis Christopoulos
Life 2023, 13(6), 1321; https://doi.org/10.3390/life13061321 - 5 Jun 2023
Viewed by 2154
Abstract
Clotting Factor deficiencies are rare disorders with variations in clinical presentation and severity of symptoms ranging from asymptomatic to mild to life-threatening bleeding. Thus, they pose a diagnostic and therapeutic challenge, mainly for the primary health care providers, general practitioners, and gynecologists who [...] Read more.
Clotting Factor deficiencies are rare disorders with variations in clinical presentation and severity of symptoms ranging from asymptomatic to mild to life-threatening bleeding. Thus, they pose a diagnostic and therapeutic challenge, mainly for the primary health care providers, general practitioners, and gynecologists who are more likely to first encounter these patients. An additional diagnostic challenge arises from the variable laboratory presentations, as PT, PTT, and BT are not always affected. The morbidity is higher among women of reproductive age since Abnormal Uterine Bleeding–specifically Heavy Menstrual Bleeding–is one of the most prevalent manifestations of these disorders, and in some cases of severe deficiencies has led to life-threatening episodes of bleeding requiring blood transfusions or even immediate surgical intervention. Physician awareness is important as, in the case of some of these disorders–i.e., Factor XIII deficiency–prophylactic treatment is available and recommended. Although uncommon, the potential for rare bleeding disorders and for hemophilia carrier states should be considered in women with HMB, after more prevalent causes have been excluded. Currently, there is no consensus on the management of women in these instances and it is reliant on the physicians’ knowledge. Full article
(This article belongs to the Special Issue Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a Tailored Care)
13 pages, 747 KiB  
Review
Vitamin Effects in Primary Dysmenorrhea
by Alkis Matsas, Athanasios Sachinidis, Malamatenia Lamprinou, Eleni Stamoula and Panagiotis Christopoulos
Life 2023, 13(6), 1308; https://doi.org/10.3390/life13061308 - 1 Jun 2023
Cited by 4 | Viewed by 3266
Abstract
Background: Primary dysmenorrhea is considered to be one of the most common gynecological complaints, affecting women’s daily activities and social life. The severity of dysmenorrhea varies among women, and its management is of high importance for them. Given that non-steroidal anti-inflammatory drugs (NSAIDs), [...] Read more.
Background: Primary dysmenorrhea is considered to be one of the most common gynecological complaints, affecting women’s daily activities and social life. The severity of dysmenorrhea varies among women, and its management is of high importance for them. Given that non-steroidal anti-inflammatory drugs (NSAIDs), the established treatment for dysmenorrhea, are associated with many adverse events, alternative therapeutic options are under evaluation. Emerging evidence correlates management of dysmenorrhea with micronutrients, especially vitamins. Purpose: The aim of this narrative review is to highlight and provide evidence of the potential benefits of vitamins for the management of dysmenorrhea. Methods: The articles were searched on PubMed, Scopus and Google Scholar. The searching process was based on keywords, such as “primary dysmenorrhea”, “vitamins”, “supplementation”, “vitamin D”, “vitamin E” and others. Our search focused on data derived from clinical trials, published only during the last decade (older articles were excluded). Results: In this review, 13 clinical trials were investigated. Most of them supported the anti-inflammatory, antioxidant and analgesic properties of vitamins. Particularly, vitamins D and E revealed a desirable effect on dysmenorrhea relief Conclusion: Despite the scarcity and heterogeneity of related research, the studies indicate a role of vitamins for the management of primary dysmenorrhea, proposing that they should be considered as alternative therapeutic candidates for clinical use. Nevertheless, this correlation warrants further research. Full article
(This article belongs to the Special Issue Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a Tailored Care)
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13 pages, 502 KiB  
Review
Berberine—A Promising Therapeutic Approach to Polycystic Ovary Syndrome in Infertile/Pregnant Women
by Oana-Maria Ionescu, Francesca Frincu, Andra Mehedintu, Mihaela Plotogea, Monica Cirstoiu, Aida Petca, Valentin Varlas and Claudia Mehedintu
Life 2023, 13(1), 125; https://doi.org/10.3390/life13010125 - 2 Jan 2023
Cited by 5 | Viewed by 5338
Abstract
Polycystic ovary syndrome (PCOS) is a disorder with an unknown etiology that features a wide range of endocrine and metabolic abnormalities that hamper fertility. PCOS women experience difficulties getting pregnant, and if pregnant, they are prone to miscarriage, gestational diabetes, pregnancy-induced hypertension and [...] Read more.
Polycystic ovary syndrome (PCOS) is a disorder with an unknown etiology that features a wide range of endocrine and metabolic abnormalities that hamper fertility. PCOS women experience difficulties getting pregnant, and if pregnant, they are prone to miscarriage, gestational diabetes, pregnancy-induced hypertension and preeclampsia, high fetal morbidity, and perinatal mortality. Insulin, the pancreatic hormone best known for its important role in glucose metabolism, has an underrated position in reproduction. PCOS women who have associated insulin resistance (with consequent hyperinsulinemia) have fertility issues and adverse pregnancy outcomes. Lowering the endogen insulin levels and insulin resistance appears to be a target to improve fertility and pregnancy outcomes in those women. Berberine is an alkaloid with a high concentration in various medicinal herbs that exhibits a hypoglycaemic effect alongside a broad range of other therapeutic activities. Its medical benefits may stand up for treating different conditions, including diabetes mellitus. So far, a small number of pharmacological/clinical trials available in the English language draw attention towards the good results of berberine’s use in PCOS women with insulin resistance for improving fertility and pregnancy outcomes. Our study aims to uncover how berberine can counteract the negative effect of insulin resistance in PCOS women and improve fertility and pregnancy outcomes. Full article
(This article belongs to the Special Issue Modern Diagnostic and Therapeutic Approaches in Gynecological Pathology towards a Tailored Care)
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