Diagnosis, Prevention and Treatment for Diseases Specific to Women

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 78792

Special Issue Editor


E-Mail Website
Guest Editor
Department of Women’s Health, The University of Shiga Prefecture, Shiga 522-8533, Japan
Interests: gynecologic oncology; dietary therapy; edema; women’s health; medical equipment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Women’s health belongs to the branch of medicine that focuses on the diagnosis and treatment of diseases and conditions that affect a woman’s physical and emotional well-being.

In the forthcoming Special Issue on “Diagnosis, prevention, and treatment for diseases specific to women”, we would like call for papers on a wide range of topics relating to the diagnosis, prevention, treatment, and nursing care regarding reproductive diseases, including maternal and child health, genital diseases, breast diseases, endocrine (hormonal) diseases including menstruation, birth-control, and menopause, and finally general health topics (medical diseases) specific to women.

We warmly welcome your submissions, including novel and interesting original articles or reviews in this Special Issue.

Prof. Dr. Masafumi Koshiyama
Guest Editor

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. Medicina 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 1800 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

  • Women’s health
  • Gynecologic disease
  • Gynecologic cancer
  • Perinatal disease
  • Endocrine disease
  • Medical disease

Published Papers (22 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

13 pages, 1872 KiB  
Article
Accuracy of Opportunistic Bone Mineral Density Assessment on Staging Computed Tomography for Gynaecological Cancers
by Catherine Anne O’Gorman, Sarah Milne, Gerard Lambe, Aleksandra Sobota, Peter Beddy and Noreen Gleeson
Medicina 2021, 57(12), 1386; https://doi.org/10.3390/medicina57121386 - 20 Dec 2021
Cited by 3 | Viewed by 3915
Abstract
Background and Objectives: Women with gynecological cancers constitute a high-risk cohort for loss of bone density. International guidance stipulates women undergoing cancer treatments associated with bone loss should have a quantitative assessment of bone density. Access to Dual-energy X-ray Absorptiometry (DXA) is [...] Read more.
Background and Objectives: Women with gynecological cancers constitute a high-risk cohort for loss of bone density. International guidance stipulates women undergoing cancer treatments associated with bone loss should have a quantitative assessment of bone density. Access to Dual-energy X-ray Absorptiometry (DXA) is limited. This study aimed to assess the accuracy of opportunistic bone density measurement on staging computed tomography (CT) scans for gynaecological malignancies, in comparison to the gold standard DXA. Materials and Methods: Women with a staging CT scan of the abdomen and pelvis for a new diagnosis of gynecological cancer were recruited. DXA was performed within 6 weeks of treatment for gynaecological cancer. Lumbar bone density was measured by CT attenuation values, in Hounsfield units (HU), of the anterior trabecular region. Correlations between CT and DXA parameters were analysed. Receiver Operating Characteristic(ROC) curves for diagnosis of low bone density and osteoporosis were analysed. Results: Final cohort included 48 of 50 women recruited. There was good diagnostic accuracy for abnormal bone density and osteoporosis, with areas under the ROC curve at L1 of 0.77 (p = 0.002) and 0.80 (p = 0.020) respectively. CT-HU of 170–190 yielded sensitivities of 87–90%, positive predictive values of 75–84% and negative predictive values of 71–75% for the diagnosis of low bone mineral density. CT-HU of 90–110 yielded specificities of 85–93% for the diagnosis of osteoporosis. Moderate correlations were found between CT-HU and both DXA T-scores and diagnostic categories. Conclusions: This is the first study to assess the opportunistic application of CT in the assessment of bone health in women with gynaecological cancer, a cohort at high-risk of osteoporosis. The correlation between bone density assessment in CT-HU and DXA, and strong AUC values for the diagnosis of low bone density (0.77) and osteoporosis (0.80) support this pragmatic solution in resolving the care-gap in cancer treatment-induced bone loss, often associated with poor access to DXA. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

15 pages, 4968 KiB  
Article
The Influence of SARS-CoV-2 Pandemic in the Diagnosis and Treatment of Cervical Dysplasia
by Anca-Maria Istrate-Ofițeru, Elena-Iuliana-Anamaria Berbecaru, Dan Ruican, Rodica Daniela Nagy, Cătălina Rămescu, Gabriela-Camelia Roșu, Larisa Iovan, Laurențiu Mihai Dîră, George-Lucian Zorilă, Maria-Loredana Țieranu and Dominic-Gabriel Iliescu
Medicina 2021, 57(10), 1101; https://doi.org/10.3390/medicina57101101 - 14 Oct 2021
Cited by 5 | Viewed by 3388
Abstract
Background and objectives. The risk of developing invasive cancer increased during the COVID-19 pandemic, especially in Romania, where the incidence of this disease is high due to limited medical education and broad screening. This study’s objective is to analyze the number of [...] Read more.
Background and objectives. The risk of developing invasive cancer increased during the COVID-19 pandemic, especially in Romania, where the incidence of this disease is high due to limited medical education and broad screening. This study’s objective is to analyze the number of patients admitted with different types of cervical dysplasia and the treatment applied for the lesions during the SARS-CoV-2 pandemic compared to the same period for the year before the pandemic. Materials and methods: This is a retrospective study that took place in the Obstetrics and Gynecology Clinics I/II (OG I/II) of the Emergency County Hospital of Craiova during the SARS-CoV-2 pandemic (SP) (15.03.2020–14.03.2021) and in the 12 months before (non-pandemic period) (NPP) (15.03.2019–14.03.2020). The study includes 396 patients with pathological PAP smear results. All the patients included in this study were clinically examined and with colposcopy. The patients with Low-Grade Dysplasia were managed in a conservatory manner and reevaluated after six months. The patients with High-Grade Dysplasia were admitted for an excisional biopsy of the lesion. The excised fragments were sent to the Pathological Anatomy Laboratory for a histopathological examination. Results: This study reveals a decrease of more than half in the number of patients admitted with cervical intraepithelial neoplasia (CIN) lesions during the pandemic compared to the same period of the year before. The number of biopsies and excisional procedures has been decreasing by more than a factor of three during the pandemic period compared to the year before. Conclusion: During the SARS-CoV-2 pandemic, we found that the patients’ admission rate, diagnosis, and treatment was almost four times lower. As hospital restrictions were not dictated for cancer/precancer management during SP, we may assume that the differences were due to the fear of becoming infected with SARS-CoV-2 due to hospitalization. In the context of poor screening performance and high cervical cancer incidence, the influence of the SP may result in a further increase of severe cases related to this condition. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

12 pages, 7241 KiB  
Article
Transvaginal Sonographic Evaluation of Cesarean Section Scar Niche in Pregnancy: A Prospective Longitudinal Study
by Egle Savukyne, Egle Machtejeviene, Saulius Paskauskas, Gitana Ramoniene and Ruta Jolanta Nadisauskiene
Medicina 2021, 57(10), 1091; https://doi.org/10.3390/medicina57101091 - 12 Oct 2021
Cited by 7 | Viewed by 4468
Abstract
Background and Objectives: To investigate the prevalence of a Cesarean section (CS) scar niche during pregnancy, assessed by transvaginal ultrasound imaging, and to relate scar measurements, demographic and obstetric variables to the niche evolution and final pregnancy outcome. Materials and Methods: In [...] Read more.
Background and Objectives: To investigate the prevalence of a Cesarean section (CS) scar niche during pregnancy, assessed by transvaginal ultrasound imaging, and to relate scar measurements, demographic and obstetric variables to the niche evolution and final pregnancy outcome. Materials and Methods: In this prospective observational study, we used transvaginal sonography to examine the uterine scars of 122 women at 11+0–13+6, 18+0–20+6 and 32+0–35+6 weeks of gestation. A scar was defined as visible on pregnant status when the area of hypoechogenic myometrial discontinuity of the lower uterine segment was identified. The CS scar niche (“defect”) was defined as an indentation at the site of the CS scar with a depth of at least 2 mm in the sagittal plane. We measured the hypoechogenic part of the CS niche in two dimensions, as myometrial thickness adjacent to the niche and the residual myometrial thickness (RMT). In the second and third trimesters of pregnancy, the full lower uterine segment (LUS) thickness and the myometrial layer thickness were measured at the thinnest part of the scar area. Two independent examiners measured CS scars in a non-selected subset of patients (n = 24). Descriptive analysis was used to assess scar visibility, and the intraclass correlation coefficient (ICC) was calculated to show the strength of absolute agreement between two examiners for scar measurements. Factors associated with the CS scar niche, including maternal age, BMI, smoking status, previous vaginal delivery, obstetrics complications and a history of previous uterine curettage, were investigated. Clinical information about pregnancy outcomes and complications was obtained from the hospital’s electronic medical database. Results: The scar was visible in 77.9% of the women. Among those with a visible CS scar, the incidence of a CS scar niche was 51.6%. The intra- and interobserver agreement for CS scar niche measurements was excellent (ICC 0.98 and 0.89, respectively). Comparing subgroups of women in terms of CS scar niche (n = 49) and non-niche (n = 73), there was no statistically significant correlation between maternal age (p = 0.486), BMI (p = 0.529), gestational diabetes (p = 1.000), smoking status (p = 0.662), previous vaginal delivery after CS (p = 1.000) and niche development. Uterine scar niches were seen in 56.3% (18/48) of the women who had undergone uterine curettage, compared with 34.4% (31/74) without uterine curettage (p = 0.045). We observed an absence of correlation between the uterine scar niche at the first trimester of pregnancy and mode of delivery (p = 0.337). Two cases (4.7%) of uterine scar dehiscence were confirmed following a trial of vaginal delivery. Conclusions: Based on ultrasonography examination, the CS scar niche remained visible in half of the cases with a visible CS scar at the first trimester of pregnancy and could be reproducibly measured by a transvaginal scan. Previous uterine curettage was associated with an increased risk for uterine niche formation in a subsequent pregnancy. Uterine scar dehiscence might be potentially related to the CS scar niche. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

8 pages, 281 KiB  
Article
IL-6 597A/G (rs1800797) and 174G/C (rs1800795) Gene Polymorphisms in the Development of Cervical Cancer in Lithuanian Women
by Agne Vitkauskaite, Joana Celiesiute, Vijoleta Juseviciute, Kristina Jariene, Erika Skrodeniene, Gabriele Samuolyte, Ruta Jolanta Nadisauskiene and Daiva Vaitkiene
Medicina 2021, 57(10), 1025; https://doi.org/10.3390/medicina57101025 - 26 Sep 2021
Cited by 8 | Viewed by 1836
Abstract
Our study aimed to evaluate the distribution of genotypes and allele frequencies of IL-6 597A/G (rs1800797) and 174G/C (rs1800795) polymorphisms in HPV infected and uninfected healthy women and cervical cancer patients. A PCR based Multiplex HPV genotyping test kit was used for in [...] Read more.
Our study aimed to evaluate the distribution of genotypes and allele frequencies of IL-6 597A/G (rs1800797) and 174G/C (rs1800795) polymorphisms in HPV infected and uninfected healthy women and cervical cancer patients. A PCR based Multiplex HPV genotyping test kit was used for in vitro detection and differentiation of high risk HPV genotypes. Genotyping of two polymorphisms, IL-6 597A/G (rs1800797) and 174G/C (rs1800795), was performed using the KASP genotyping assay kit. Cervical cancer patients were more likely to be HPV positive than control patients. Allele C of IL-6 rs1800795 was associated with a higher risk of cervical cancer by 2.26-fold and genotype CC by 5.37-fold. Genotype CC of IL-6 rs1800795 was more frequent in the HPV positive group compared with the HPV negative group (p = 0.002). Allele G of IL-6 rs1800797 was more frequently found in women with HPV16/HPV18 compared to other HPV types (p = 0.045). Women with AA genotypes of IL-6 rs1800797 were less frequently infected with HPV16/HPV18 compared to other HPV types (p = 0.045). The major finding of the study is the significant association of C allele and CC genotype of IL-6 1800795 gene with cervical cancer in the Lithuanian population. Genotype CC of IL-6 rs1800795 has a significant association with HPV infection as well. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
13 pages, 997 KiB  
Article
Clinical Results of a Massive Blood Transfusion Protocol for Postpartum Hemorrhage in a University Hospital in Japan: A Retrospective Study
by Daigo Ochiai, Yushi Abe, Rie Yamazaki, Tomoe Uemura, Ayako Toriumi, Hiroko Matsuhashi, Yuya Tanaka, Satoru Ikenoue, Yoshifumi Kasuga, Ryuji Tanosaki and Mamoru Tanaka
Medicina 2021, 57(9), 983; https://doi.org/10.3390/medicina57090983 - 18 Sep 2021
Cited by 6 | Viewed by 3369
Abstract
Background and objectives: Massive postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide. A massive transfusion protocol (MTP) may be used to provide significant benefits in the management of PPH; however, only a limited number of hospitals use MTP [...] Read more.
Background and objectives: Massive postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide. A massive transfusion protocol (MTP) may be used to provide significant benefits in the management of PPH; however, only a limited number of hospitals use MTP protocol to manage massive obstetric hemorrhages, especially in Japan. This study aimed to assess the clinical outcomes in patients in whom MTP was activated in our hospital. Materials and Methods: We retrospectively reviewed the etiology of PPH, transfusion outcomes, and laboratory findings among the patients treated with MTP after delivery in our hospital. Results: MTP was applied in 24 cases (0.7% of deliveries). Among them, MTP was activated within 2 h of delivery in 15 patients (62.5%). The median estimated blood loss was 5017 mL. Additional procedures to control bleeding were performed in 19 cases, including transarterial embolization (18 cases, 75%) and hysterectomy (1 case, 4.2%). The mean number of units of red blood cells, fresh frozen plasma, and platelets were 17.9, 20.2, and 20.4 units, respectively. The correlation coefficients of any two items among red blood cells, fresh frozen plasma, platelets, blood loss, and obstetrical disseminated intravascular coagulation score ranged from 0.757 to 0.892, indicating high levels of correlation coefficients. Although prothrombin time and activated partial thromboplastin time levels were significantly higher in the <150 mg/dL fibrinogen group than in the ≥150 mg/dL fibrinogen group at the onset of PPH, the amount of blood loss and blood transfusion were comparable between the two groups. Conclusions: Our MTP provides early access to blood products for patients experiencing severe PPH and could contribute to improving maternal outcomes after resuscitation in our hospital. Our study suggests the implementation of a hospital-specific MTP protocol to improve the supply and utilization of blood products to physicians managing major obstetric hemorrhage. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

9 pages, 288 KiB  
Article
The Experience of Healthy Pregnancy in High Parity Women: A Phenomenological Study in North Jordan
by Ghadeer Alzboon and Gülşen Vural
Medicina 2021, 57(8), 853; https://doi.org/10.3390/medicina57080853 - 22 Aug 2021
Cited by 1 | Viewed by 1914
Abstract
Background and Objectives: High parity women are more likely to have poor quality of life during pregnancy than low parity women. Thus, the aim of this study was to explore the lived experience of healthy pregnancy among high parity women in North [...] Read more.
Background and Objectives: High parity women are more likely to have poor quality of life during pregnancy than low parity women. Thus, the aim of this study was to explore the lived experience of healthy pregnancy among high parity women in North Jordan. Materials and Methods: A descriptive phenomenological design was employed in this study to complement previously published quantitative results. Fourteen pregnant women, who had four children or more, were recruited purposely according to inclusion criteria from Irbid city in North Jordan. Data were collected using face-to-face, semi-structured interviews. Colaizzi’s method was employed to analyze the verbatim data. Results: There were three main themes which emerged from participants significant statements: they had new discomforts, antenatal care and follow-up, and social issues. Each extracted theme was linked to some factors (subthemes), which had a positive or negative impact on the quality of life of high parity women during pregnancy. High parity women who experienced multiple stressors had a poor quality of life. Conclusions: Experiencing new discomforts, less or no antenatal care, and a lack of social support negatively affected the quality of life among high parity women. Antenatal interventions should be designed based on high parity women’s perceptions of their health and wellbeing in order to improve their quality of life and ultimately prevent maternal morbidity and mortality. Further quantitative studies are needed to explore the impact of previous mentioned factors on maternal quality of life and outcomes. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
9 pages, 925 KiB  
Article
Comparison of Postoperative Adjuvant Chemotherapy and Concurrent Chemoradiotherapy for FIGO2018 Stage IIIC1 Cervical Cancer: A Retrospective Study
by Masahiro Kagabu, Takayuki Nagasawa, Shunsuke Tatsuki, Yasuko Fukagawa, Hidetoshi Tomabechi, Eriko Takatori, Yoshitaka Kaido, Tadahiro Shoji and Tsukasa Baba
Medicina 2021, 57(6), 548; https://doi.org/10.3390/medicina57060548 - 29 May 2021
Cited by 1 | Viewed by 2486
Abstract
Background and Objectives: In October 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its classification of advanced stages of cervical cancer. The main points of the classification are as follows: stage IIIC is newly established; pelvic lymph node metastasis is [...] Read more.
Background and Objectives: In October 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its classification of advanced stages of cervical cancer. The main points of the classification are as follows: stage IIIC is newly established; pelvic lymph node metastasis is stage IIIC1; and para-aortic lymph node metastasis is stage IIIC2. Currently, in Japan, radical hysterectomy is performed in advanced stages IA2 to IIB of FIGO2014, and concurrent chemoradiotherapy (CCRT) is recommended for patients with positive lymph nodes. However, the efficacy of CCRT is not always satisfactory. The aim of this study was to compare postoperative adjuvant chemotherapy (CT) and postoperative CCRT in stage IIIC1 patients. Materials and Methods: Of the 40 patients who had undergone a radical hysterectomy at Iwate Medical University between January 2011 and December 2016 and were pathologically diagnosed as having positive pelvic lymph nodes, 21 patients in the adjuvant CT group and 19 patients in the postoperative CCRT group were compared. Results: The 5 year survival rates were 77.9% in the CT group and 74.7% in the CCRT group, with no significant difference. There was no significant difference in overall survival or progression-free survival between the two groups. There was no significant difference between CT and CCRT in postoperative adjuvant therapy in the new classification IIIC1 stage. Conclusions: The results of the prospective Japanese Gynecologic Oncology Group (JGOG) 1082 study are pending, but the present results suggest that CT may be a treatment option in rural areas where radiotherapy facilities are limited. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

10 pages, 789 KiB  
Article
Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables
by Cristina Civilotti, Rossana Botto, Daniela Acquadro Maran, Brigitta De Leonardis, Beatrice Bianciotto and Maria Rosa Stanizzo
Medicina 2021, 57(5), 454; https://doi.org/10.3390/medicina57050454 - 07 May 2021
Cited by 19 | Viewed by 4361
Abstract
Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of [...] Read more.
Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of patients most at risk of developing psychiatric disorders. The present study analyzes, in a sample of women newly diagnosed with breast cancer, the relationships between their levels of anxiety and depression and several socio-demographic characteristics. The study was cross-sectional. Materials and Methods: Four hundred and seventy eight women newly diagnosed with breast cancer completed the Hospital Anxiety and Depression Scale during the pre-surgical phase. Results: Findings show that almost 40% of the sample had clinically relevant anxious symptoms and about a quarter of the sample had significant depressive symptoms. Their prevalence was higher in widows. Moreover, depressive symptoms were higher in older women and anxious symptoms were higher in patients with a lower educational level. In the pre-surgical phase, women can suffer from clinically relevant anxiety and depression, especially the widows, older women, and women with a lower educational level. Conclusions: Identifying the most psychologically vulnerable patients, due to specific socio-demographic characteristics, is essential in order to provide adequate psycho-oncological treatments to the categories of patients, who are most at risk of developing psychopathological concerns. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

10 pages, 1450 KiB  
Article
The Fertility Indicator Equation Using Serum Progesterone and Urinary Pregnanediol-3-Glucuronide for Assessment of Ovulatory to Luteal Phase Transition
by Stephen J. Usala, María Elena Alliende and A. Alexandre Trindade
Medicina 2021, 57(2), 134; https://doi.org/10.3390/medicina57020134 - 03 Feb 2021
Cited by 2 | Viewed by 2124
Abstract
Background and Objectives: The Fertility Indicator Equation (FIE) has been shown to signal the fertile phase during the ovulatory menstrual cycle. It was hypothesized that this formulation, a product of two sequential normalized changes with a sign indicating direction of change, could [...] Read more.
Background and Objectives: The Fertility Indicator Equation (FIE) has been shown to signal the fertile phase during the ovulatory menstrual cycle. It was hypothesized that this formulation, a product of two sequential normalized changes with a sign indicating direction of change, could be used to identify the transition from ovulatory to luteal phase with daily serum progesterone (P) and urinary pregnanediol-3-glucuronide (PDG) levels. Materials and Methods: Day-specific serum P levels from two different laboratories and day-specific urinary PDG levels from an additional two different laboratories were submitted for FIE analysis. These day-specific levels included mean or median, 5th, 10th, 90th and 95th percentile data. They were indexed to the day of ovulation, day 0, by ultrasonography, serum or urinary luteinizing hormone (LH). Results: All data sets showed a clear “cluster”—a periovulatory sequence of positive FIE values with a maximum. All clusters of +FIE signaled the transition from the ovulatory to luteal phase and were at least four days in length. The start day for the serum P and urinary PDG FIE clusters ranged from −3 to −1 and −3 to +2, respectively. The end day for serum P and PDG clusters went from +2 to +7 and +4 to +8, respectively. Outside these periovulatory FIE-P and FIE-PDG clusters, there were no consecutive positive FIE values. In addition, the maximum FIE-P and FIE-PDG values throughout the entire cycles were found in the clusters. Conclusions: FIE analysis with either daily serum P or urinary PDG levels provided a distinctive signature to recognize the periovulatory interval. The Fertility Indicator Equation served to robustly signal the transition from the ovulatory phase to the luteal phase. This may have applications in natural family planning especially with the recent emergence of home PDG tests. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

15 pages, 324 KiB  
Article
Factors Affecting Quality of Work Life in a Sample of Cancer Survivor Female Nurses
by Ju Hyun Jin and Eun Ju Lee
Medicina 2020, 56(12), 721; https://doi.org/10.3390/medicina56120721 - 21 Dec 2020
Cited by 5 | Viewed by 1848
Abstract
Background and objectives: Identifying the factors affecting the Quality of Work Life (QWL) of cancer survivor female nurses is important and necessary to overcome the various challenges experienced by these professionals upon returning to work following recovery from the disease. Therefore, this study [...] Read more.
Background and objectives: Identifying the factors affecting the Quality of Work Life (QWL) of cancer survivor female nurses is important and necessary to overcome the various challenges experienced by these professionals upon returning to work following recovery from the disease. Therefore, this study aimed to identify the factors affecting the level of nurses’ QWL. Materials and Methods: A cross-sectional survey was conducted among 115 registered female nurses who had survived cancer, in general hospitals and clinics in South Korea. SPSS statistics version 21 was used for ordinary least squares, and Stata version 12.0 was used for quantile regression analysis. Results: Workplace spirituality affected all quantiles of QWL except the 90% quantile; fatigue was an affecting factor in the 20%, 30%, and 70% quantiles; and job stress in the 20%, 30%, 40%, and 60%, 70%, 80% quantiles. For workplace spirituality, the effect size was 0.33 (p < 0.001) in the 10% quantile, increasing to 0.45 (p < 0.001) in the 80% quantile. Conclusions: Based on the results of this study, suggestions for clinical practice include providing the mediating strategies and programs to manage fatigue and job stress as well as workplace spirituality. Job-related factors such as shift work should also be considered. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
13 pages, 1188 KiB  
Article
Early-Stage Ovarian Malignancy Score versus Risk of Malignancy Indices: Accuracy and Clinical Utility for Preoperative Diagnosis of Women with Adnexal Masses
by Phichayut Phinyo, Jayanton Patumanond, Panprapha Saenrungmuaeng, Watcharin Chirdchim, Tanyong Pipanmekaporn, Apichat Tantraworasin, Theera Tongsong and Charuwan Tantipalakorn
Medicina 2020, 56(12), 702; https://doi.org/10.3390/medicina56120702 - 16 Dec 2020
Cited by 2 | Viewed by 2167
Abstract
Background and objectives: To compare the diagnostic accuracy and clinical utility of the Early-stage Ovarian Malignancy (EOM) score with the Risk of Malignancy Index (RMI) in the presurgical assessment of women presenting with adnexal masses. Materials and Methods: A secondary analysis was carried [...] Read more.
Background and objectives: To compare the diagnostic accuracy and clinical utility of the Early-stage Ovarian Malignancy (EOM) score with the Risk of Malignancy Index (RMI) in the presurgical assessment of women presenting with adnexal masses. Materials and Methods: A secondary analysis was carried out in a retrospective cohort of women who presented with an adnexal mass and were scheduled for surgery at Phrapokklao Hospital between September 2013 and December 2017. The clinical characteristics, ultrasonographic features of the masses, and preoperative CA-125 levels were recorded. The EOM and the RMI score were calculated and compared in terms of accuracy and clinical utility. Decision curve analysis (DCA), which examined the net benefit (NB) of applying the EOM and the RMI in practice at a range of threshold probabilities, was presented. Results: In this study, data from 270 patients were analyzed. Fifty-four (20.0%) women in the sample had early-stage ovarian cancer. All four RMI versions demonstrated a lower sensitivity for the detection of patients with early-stage ovarian cancer compared to an EOM score ≥ 15. An EOM ≥ 15 resulted in a higher proportion of net true positive or NB than all versions of the RMIs from a threshold probability of 5% to 30%. Conclusions: It also showed a higher capability to reduce the number of inappropriate referrals than the RMIs at a threshold probability between 5% and 30%. The EOM score showed higher diagnostic sensitivity and has the potential to be clinically more useful than the RMIs to triage women who present with adnexal masses for referral to oncologic gynecologists. Further external validation is required to support our findings. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

9 pages, 636 KiB  
Article
Uterine Artery Doppler Ultrasonography for First Trimester Prediction of Preeclampsia in Individuals at Risk from Low-Resource Settings
by Mihaela Oancea, Mihaela Grigore, Razvan Ciortea, Doru Diculescu, Diana Bodean, Carmen Bucuri, Stefan Strilciuc, Maria Rada and Dan Mihu
Medicina 2020, 56(9), 428; https://doi.org/10.3390/medicina56090428 - 26 Aug 2020
Cited by 9 | Viewed by 4488
Abstract
Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian [...] Read more.
Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11–14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%; specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

8 pages, 303 KiB  
Article
The Relationship between the IFNG (rs2430561) Polymorphism and Metabolic Syndrome in Perimenopausal Women
by Daria Schneider-Matyka, Małgorzata Szkup, Aleksander Jerzy Owczarek, Marzanna Stanisławska, Anna Knyszyńska, Anna Lubkowska, Elżbieta Grochans and Anna Jurczak
Medicina 2020, 56(8), 384; https://doi.org/10.3390/medicina56080384 - 31 Jul 2020
Cited by 1 | Viewed by 1953
Abstract
Background and Objectives: Metabolic syndrome (MetS) is a multiple risk factor for atherosclerosis, cardiovascular disease, type 2 diabetes and strokes. One-third of middle-age women are at risk of MetS, which predisposes them to type 2 diabetes and cardiovascular disease. Changes in the regulation [...] Read more.
Background and Objectives: Metabolic syndrome (MetS) is a multiple risk factor for atherosclerosis, cardiovascular disease, type 2 diabetes and strokes. One-third of middle-age women are at risk of MetS, which predisposes them to type 2 diabetes and cardiovascular disease. Changes in the regulation of anti-inflammatory cytokines―which play an important role in pathologic processes―may contribute to inflammatory disorders. Cytokine polymorphisms are known to have an impact on gene expression. The purpose of this study was to search for the relationship between the IFNG polymorphisms and the levels of proinflammatory cytokines. Materials and Methods: This study, conducted in West Pomeranian Voivodeship, Poland, involved 416 women. Of these women, 33.6% of them had primary education, 44.8% lived in cities with a population of over 100,000, and 82.7% were married. Of the participants, 28.4% met the criteria for MetS. The study involved: interview performed to collect sociodemographic and medical data, anthropometric measurements, as well as venous blood collection for biochemical analysis, genetic testing and the measurement of inflammatory markers. Results: The link between the IFNG (rs2430561) polymorphism and serum PIC (proinflammatory cytokines) levels was tested with regard to MetS. In the MetS+ subgroup, the T/T and A/T genotypes of the IFNG gene were accompanied by higher IL-6 levels than in the MetS− subgroup. Conclusion: Our study has not confirmed a direct link between the IFNG polymorphisms and the levels of inflammatory biomarkers. Nevertheless, the T/T and A/T genotypes of the IFNG gene may predispose to elevated IL-6 levels. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)

Review

Jump to: Research, Other

12 pages, 290 KiB  
Review
Expectations and Challenges of First-Line Maintenance Therapy for Advanced Ovarian Cancer
by Tadahiro Shoji, Chie Sato, Hidetoshi Tomabechi, Eriko Takatori, Yoshitaka Kaido, Takayuki Nagasawa, Masahiro Kagabu and Tsukasa Baba
Medicina 2021, 57(5), 501; https://doi.org/10.3390/medicina57050501 - 15 May 2021
Cited by 6 | Viewed by 2474
Abstract
The incidence of ovarian cancer, which has had a poor prognosis, is increasing annually. Currently, the prognosis is expected to improve with the use of molecular-targeted drugs and immune checkpoint inhibitors as maintenance therapies after the first-line chemotherapy. The GOG218 and ICON7 studies [...] Read more.
The incidence of ovarian cancer, which has had a poor prognosis, is increasing annually. Currently, the prognosis is expected to improve with the use of molecular-targeted drugs and immune checkpoint inhibitors as maintenance therapies after the first-line chemotherapy. The GOG218 and ICON7 studies reported the usefulness of bevacizumab and the SOLO-1 and PRIMA (A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study of Niraparib Maintenance Treatment in Patients With Advanced Ovarian Cancer Following Response on Front-Line Platinum-Based Chemotherapy) studies have reported the usefulness of olaparib and niraparib, respectively. The ATHENA study investigating the usefulness of rucaparib is currently ongoing. Although clinical studies of immune checkpoint inhibitors are lagging in the field of gynecology, many clinical studies using programmed death cell-1 (PD-1) and PD-1 ligand 1 (PD-L1) antibodies are currently ongoing. Some biomarkers have been identified for molecular-targeted drugs, but none have been identified for immune checkpoint inhibitors, which is a challenge that should be addressed in the future. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
15 pages, 865 KiB  
Review
Current Overview of Osteogenesis Imperfecta
by Mari Deguchi, Shunichiro Tsuji, Daisuke Katsura, Kyoko Kasahara, Fuminori Kimura and Takashi Murakami
Medicina 2021, 57(5), 464; https://doi.org/10.3390/medicina57050464 - 10 May 2021
Cited by 21 | Viewed by 8643
Abstract
Osteogenesis imperfecta (OI), or brittle bone disease, is a heterogeneous disorder characterised by bone fragility, multiple fractures, bone deformity, and short stature. OI is a heterogeneous disorder primarily caused by mutations in the genes involved in the production of type 1 collagen. Severe [...] Read more.
Osteogenesis imperfecta (OI), or brittle bone disease, is a heterogeneous disorder characterised by bone fragility, multiple fractures, bone deformity, and short stature. OI is a heterogeneous disorder primarily caused by mutations in the genes involved in the production of type 1 collagen. Severe OI is perinatally lethal, while mild OI can sometimes not be recognised until adulthood. Severe or lethal OI can usually be diagnosed using antenatal ultrasound and confirmed by various imaging modalities and genetic testing. The combination of imaging parameters obtained by ultrasound, computed tomography (CT), and magnetic resource imaging (MRI) can not only detect OI accurately but also predict lethality before birth. Moreover, genetic testing, either noninvasive or invasive, can further confirm the diagnosis prenatally. Early and precise diagnoses provide parents with more time to decide on reproductive options. The currently available postnatal treatments for OI are not curative, and individuals with severe OI suffer multiple fractures and bone deformities throughout their lives. In utero mesenchymal stem cell transplantation has been drawing attention as a promising therapy for severe OI, and a clinical trial to assess the safety and efficacy of cell therapy is currently ongoing. In the future, early diagnosis followed by in utero stem cell transplantation should be adopted as a new therapeutic option for severe OI. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

12 pages, 698 KiB  
Review
The Preventive Effect of Dietary Antioxidants on Cervical Cancer Development
by Ayumi Ono, Masafumi Koshiyama, Miwa Nakagawa, Yumiko Watanabe, Eri Ikuta, Keiko Seki and Makiko Oowaki
Medicina 2020, 56(11), 604; https://doi.org/10.3390/medicina56110604 - 10 Nov 2020
Cited by 22 | Viewed by 4908
Abstract
Cervical cancer results from a continuous process, starting from a normal cervical epithelium after human papillomavirus (HPV) infection and progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive squamous carcinoma (ISC). In recent decades, dietary antioxidants, such as vitamins, have received [...] Read more.
Cervical cancer results from a continuous process, starting from a normal cervical epithelium after human papillomavirus (HPV) infection and progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive squamous carcinoma (ISC). In recent decades, dietary antioxidants, such as vitamins, have received much attention in relation to cancer prevention. We reviewed the relevant literature to investigate the dietary and nutrient intake on cervical cancer. The intake of vitamins A and D and carotenoids may inhibit early cervical cancer development. The intake of folate may prevent or inhibit HPV infection rom progressing to various grades of CIN. The intake of vitamins C and E may widely inhibit the process of cervical cancer development. Polyphenols are often used in cases of cervical cancer in combination chemotherapy and radiation therapy. Regarding nutrients, different antioxidants may have differing abilities to intervene in the natural history of cervical diseases associated with HPV infection. Regarding foods, the intake of both vegetables and fruits containing multiple vitamins may widely suppress cervical cancer development. Most previous papers have described epidemiological studies. Thus, further research using in vitro and in vivo approaches will be needed to clarify the effects of the dietary and nutrient intake in detail. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

Other

Jump to: Research, Review

5 pages, 498 KiB  
Brief Report
Cyclic Progesterone Therapy in Androgenic Polycystic Ovary Syndrome (PCOS)—A 6-Month Pilot Study of a Single Woman’s Experience Changes
by Sonia Shirin, Faye Murray, Azita Goshtasebi, Dharani Kalidasan and Jerilynn C. Prior
Medicina 2021, 57(10), 1024; https://doi.org/10.3390/medicina57101024 - 26 Sep 2021
Cited by 4 | Viewed by 3617
Abstract
Background and Objectives: Women with androgenic Polycystic Ovary Syndrome (PCOS) have increased endometrial cancer risk that cyclic progesterone will prevent; it may also reverse PCOS’s neuroendocrine origins. This pilot study’s purpose was to document 6-month experience changes in a woman with PCOS taking [...] Read more.
Background and Objectives: Women with androgenic Polycystic Ovary Syndrome (PCOS) have increased endometrial cancer risk that cyclic progesterone will prevent; it may also reverse PCOS’s neuroendocrine origins. This pilot study’s purpose was to document 6-month experience changes in a woman with PCOS taking cyclic progesterone therapy because she was intolerant of combined hormonal contraceptive therapy, the current PCOS standard of care. A 31-year-old normal-weight woman with PCOS had heavy flow, irregular cycles, and was combined hormonal contraceptives-intolerant. She was prescribed cyclic oral micronized progesterone (OMP) (300 mg/h.s. cycle days 14–27). She kept Menstrual Cycle Diary© (Diary) records, starting with the 1st treatment cycle for six cycles; she was on no other therapy. Statistical analysis a priori hypothesized progesterone decreases high estradiol (E2) experiences (flow, cervical mucus, fluid retention, front-of-the-breast tenderness and anxiety); analysis focused on these. Our objectives: (1) changes from cycles 1 to 6 in E2-related experiences; and (2) follicular phase E2-related changes from cycle 1 (no therapy) to cycles 3 and 6. Materials and Methods: Data from consecutive Diaries were entered into an SPSS database and analyzed by Wilcoxon Signed Rank Test (Objective #1) within-person whole cycle ordinal data, and (Objective #2 follicular phase) repeated measures ANOVA. Results: Cyclic OMP was associated with regular, shorter cycles (±SD) (28.2 ± 0.8 days). Comparison of cycles 1–6 showed decreased fluid retention (p = 0.001), breast tenderness (p = 0.002), and cervical mucus (p = 0.048); there were no changes in flow or anxiety. Fluid retention in the follicular phase also significantly decreased over time (F (1.2, 14.7) = 6.7, p = 0.017). Conclusions: Pilot daily Diary data suggest women with PCOS have improved everyday experiences on cyclic progesterone therapy. Larger prospective studies with more objective outcomes and randomized controlled trials of this innovative PCOS therapy are needed. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

9 pages, 1769 KiB  
Case Report
Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review
by Reona Shiro, Kosuke Murakami, Masaharu Miyauchi, Yasuhiro Sanada and Noriomi Matsumura
Medicina 2021, 57(6), 613; https://doi.org/10.3390/medicina57060613 - 12 Jun 2021
Cited by 11 | Viewed by 3354
Abstract
Background and Objectives: Maternal brain tumors diagnosed during pregnancy are very rare, and their clinical course remains incompletely understood. We recently experienced a case of a brain tumor diagnosed at 30 weeks of gestation, and the treatment was initiated after delivery at [...] Read more.
Background and Objectives: Maternal brain tumors diagnosed during pregnancy are very rare, and their clinical course remains incompletely understood. We recently experienced a case of a brain tumor diagnosed at 30 weeks of gestation, and the treatment was initiated after delivery at 32 weeks of gestation. In this study, we reviewed case reports of brain tumors diagnosed during pregnancy, focusing on whether the brain tumor was treated during pregnancy or after termination of pregnancy and on the timing of therapeutic intervention. Materials and Methods: We searched PubMed and Ichushi-Web for articles published after January 2000 that reported cases of maternal brain tumors diagnosed during pregnancy. The patients were divided into two groups according to whether the tumor was treated during pregnancy (Group A) or after termination of pregnancy (Group B). Results: In total, 42 patients were included in the study (13 (31%) in Group A and 29 (69%) in Group B). The most common symptoms before diagnosis were those caused by increased intracranial pressure (57.1%). The diagnosis was made at 18 ± 6 weeks of gestation in Group A and 26 ± 9 weeks of gestation in Group B (p = 0.007). In all cases diagnosed after 34 weeks of gestation, termination of pregnancy was followed by treatment. Treatment was initiated within two weeks of diagnosis in 50% of patients in Group A and 30% in Group B. Conclusions: When severe symptoms caused by increased intracranial pressure last for several weeks, imaging tests should be considered. Termination of pregnancy is a good option for a brain tumor diagnosed after 34 weeks of gestation, while comprehensive treatment decisions should be made based on the severity of symptoms and the course of pregnancy in other cases. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

9 pages, 304 KiB  
Systematic Review
Prevalence of Pathogens and Other Microorganisms in Premenopausal and Postmenopausal Women with Vulvovaginal Symptoms: A Retrospective Study in a Single Institute in South Korea
by Jong-Chul Baek, Hyen-Chul Jo, Seon-Mi Lee, Ji-Eun Park, In-Ae Cho and Joo-Hyun Sung
Medicina 2021, 57(6), 577; https://doi.org/10.3390/medicina57060577 - 04 Jun 2021
Cited by 1 | Viewed by 2686
Abstract
Background and Objectives: Vaginitis causes vulvovaginal symptoms, including itching, irritation, vaginal discharge, burning, or foul odor. It is one of the most common diseases encountered in gynecologic practice. Hypoestrogenism due to menopause has a considerable negative effect on vaginal health and leads to [...] Read more.
Background and Objectives: Vaginitis causes vulvovaginal symptoms, including itching, irritation, vaginal discharge, burning, or foul odor. It is one of the most common diseases encountered in gynecologic practice. Hypoestrogenism due to menopause has a considerable negative effect on vaginal health and leads to changes in the vaginal pH and vaginal microflora, which are related to a change in the causes and microorganisms of vaginitis. Thus the aim here was to investigate the prevalence of pathogens and other microorganisms in premenopausal and postmenopausal women with vulvovaginal symptoms, using an STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge. Materials and Methods: From January 2018 to December 2019, records of patients diagnosed with vaginitis at Changwon Gyeongsang National University Hospital were retrospectively reviewed. The premenopausal and postmenopausal subjects were categorized into Group A and Group B, respectively. and the data of symptoms, general characteristics, and results of both STD 12-Multiplex real-time PCR test and routine culture of vaginal discharge were retrieved. Results: On the STD 12-Multiplex real-time PCR test, Gardnerella vaginalis was the most common microorganism in both groups. Ureaplasma parvum was the second most common one, followed by Candida speceies. On the routine culture of vaginal discharge, Escherichia coli was the most common aerobic bacterial microorganism in both groups, followed by Streptococcus agalactiae (Group B Streptococcus, GBS). There was no significant difference between the two groups. Pathogens and other microorganisms of patients with vulvovaginal symptoms that showed a statistically significant difference between the two groups were Ureaplasa parvum, Ureaplasma urealyticulum, Trichomonas vaginalis, and Staphylococcus aureus. Conclusion: In this study, the prevalence of pathogens and other microorganisms in menopausal women with vulvovaginal symptoms did not show a significant difference from premenopausal women. Therefore, management strategies for patients with vulvovaginal symptoms should be developed through accurate diagnosis using appropriate diagnostic methods. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
6 pages, 4223 KiB  
Case Report
Clitoromegaly, Vulvovaginal Hemangioma Mimicking Pelvic Organ Prolapse, and Heavy Menstrual Bleeding: Gynecologic Manifestations of Klippel-Trénaunay Syndrome
by Gina Nam, Sa Ra Lee and SeungA Choi
Medicina 2021, 57(4), 366; https://doi.org/10.3390/medicina57040366 - 09 Apr 2021
Cited by 4 | Viewed by 7716
Abstract
Klippel-Trénaunay Syndrome (KTS) is a genetic vascular malformation involving the capillary, lymphatic, and venous channels. Prenatal sonographic diagnosis of KTS with an enlarged fetal limb is well-known; however, postnatal gynecologic manifestations are rarely reported. KTS can cause clitoromegaly, vulvovaginal hemangioma, and heavy menstrual [...] Read more.
Klippel-Trénaunay Syndrome (KTS) is a genetic vascular malformation involving the capillary, lymphatic, and venous channels. Prenatal sonographic diagnosis of KTS with an enlarged fetal limb is well-known; however, postnatal gynecologic manifestations are rarely reported. KTS can cause clitoromegaly, vulvovaginal hemangioma, and heavy menstrual bleeding. Somatic mosaicism of the PIK3CA gene is considered as responsible for KTS but reports based on whole-genome sequencing are limited. A 31-year-old woman with KTS presented with bulging of the clitoris and vagina. Analysis of whole-genome sequencing variant data revealed that gene ontology terms related to development and differentiation such as ‘skeletal system morphogenesis’, ‘embryonic morphogenesis’, and ‘sensory organ development’ were nominally significant in non-coding regions. Variants in non-coding genes may be responsible for this phenotype. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

6 pages, 257 KiB  
Case Report
Dietary Treatment from Birth to Pregnancy in a Woman with Methylmalonic Aciduria
by Agnieszka Kowalik, Anita MacDonald and Jolanta Sykut-Cegielska
Medicina 2021, 57(2), 128; https://doi.org/10.3390/medicina57020128 - 02 Feb 2021
Cited by 1 | Viewed by 1700
Abstract
Methylmalonic aciduria is treated with a natural protein-restricted diet with adequate energy intake to sustain metabolic balance. Natural protein is a source of methylmalonic acid precursors, and intake is individually modified according to the severity and clinical course of the disease. The experience [...] Read more.
Methylmalonic aciduria is treated with a natural protein-restricted diet with adequate energy intake to sustain metabolic balance. Natural protein is a source of methylmalonic acid precursors, and intake is individually modified according to the severity and clinical course of the disease. The experience and approach to MMA treatment in European centers is variable with different amounts of natural protein and precursor-free l-amino acids being prescribed, although the outcome appears independent of the use of precursor-free l-amino acids. Further long-term outcome data is necessary for early treated patients with MMA. This case study, a woman with MMA followed from birth to the age of 35 years, including pregnancy, illustrates the long-term course of the disease and lifetime changes in dietary treatment. A low natural protein diet (1.5 g–1.0 g/kg/day) was the foundation of treatment, but temporary supplementation with precursor-free l-amino acids, vitamin-mineral mixture, and energy supplements were necessary at different timepoints (in childhood, adolescence, adulthood and pregnancy). Childhood psychomotor development was slightly delayed but within the normal range in adulthood. There were few episodes of metabolic decompensation requiring IV glucose, but at age 27 years, she required intensive care following steroid treatment. In pregnancy, she remained stable but received intensive biochemical and medical follow-up. This successful long-term follow-up of a patient with MMA from childhood, throughout pregnancy, delivery, and postpartum confirms that careful clinical, biochemical, and dietetic monitoring is crucial to ensure a favourable outcomes in MMA. Personalized treatment is necessary according to the individual clinical course. Knowledge about long-term treatment and clinical outcome is important information to influence future MMA clinical guidelines. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
11 pages, 1083 KiB  
Case Report
Positive Anti-SSA/Ro Antibody in a Woman with SARS-CoV-2 Infection Using Immunophenotyping: A Case Report
by Po-I Huang, Ting-Chun Lin, Feng-Cheng Liu, Yi-Jung Ho, Jeng-Wei Lu and Te-Yu Lin
Medicina 2020, 56(10), 521; https://doi.org/10.3390/medicina56100521 - 05 Oct 2020
Cited by 5 | Viewed by 3848
Abstract
The clinical spectrum of novel coronavirus infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia, with respiratory failure and even death. Autoantibodies, especially antiphospholipid antibodies, can occur in severe infections. Other autoantibodies are seldom reported. [...] Read more.
The clinical spectrum of novel coronavirus infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia, with respiratory failure and even death. Autoantibodies, especially antiphospholipid antibodies, can occur in severe infections. Other autoantibodies are seldom reported. Here, a 60-year-old female patient without dry-mouth symptoms detected positive for anti-60 kDa SSA/Ro antibodies on day 43 after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To investigate this unique clinical case of SARS-CoV-2 infection, immunological characteristics of this case were detected by using flow cytometry and were compared to the other three groups of patients—health subjects, 2019 novel coronavirus disease (COVID-19) recovery patients, and Sjögren’s syndrome (SS) patients. Monitoring the autoantibody level and the development of subsequently related autoimmune diseases are warranted after SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Diseases Specific to Women)
Show Figures

Figure 1

Back to TopTop