1,721,035 research outputs found
Lympha technique for primary and early secondary prevention of lymphedema following cancer treatment
No full textLYMPHA proved to be an effective preventive procedure that contributes in giving our oncological patients a good quality of life. In this presentation, the author will report indications, technical aspects and benefits of LYMPHA technique
Targeting tyrosine-kinases in ovarian cancer.
No full textINTRODUCTION: Epithelial ovarian cancer (EOC) is the leading cause of gynaecologic cancer death. Although in some cases initial treatment is effective, most of the women diagnosed with EOC will probably need medical treatment for their disease. There is a critical need to develop effective new strategies for the management of patients with advanced or recurrent EOC, and targeted therapy with tyrosine kinase inhibitors (TKIs) has continued to be an area of active research and development in this setting. AREAS COVERED: This review summarises the available evidence on the use of TKIs in the clinical management of women with EOC. This article consists of material obtained via Medline, PubMed and EMBASE literature searches up to March 2013. EXPERT OPINION: Several Phase I/II and III trials evaluated TKIs in EOC; however, it is difficult to draw conclusions on the efficacy of TKI regimens in these patients. TKIs seem to be better tolerated than conventional chemotherapy with a different toxicity profile. A better understanding of the signalling pathways, the toxicity profiles, the potential pharmacokinetic interactions as well as the identification of predictive biomarkers are needed to better identify a targeted patient population before these agents become part of routine treatment
Self-reported sleep quality in patients undergoing voluntary termination of pregnancy
No full textOBJECTIVE: To investigate if the sleep pattern (SP) of women undergo- ing voluntary interruption of pregnancy is affected by the method of termina- tion of pregnancy (VToP, medical or surgical).
DESIGN: This prospective study, performed between August 2012 and April 2013, included women referred to our University hospital for VToP.
MATERIALS AND METHODS: Patients within 49 days of amenorrhea underwent medical interruption of pregnancy (group M) while those with amenorrhea comprised between 49 and 90 days underwent the surgical termi- nation of pregnancy (group S). Sleep quality, insomnia and excessive day- time sleepiness were assessed using the Pittsburgh sleep quality index (PSQI), Insomnia severity index (ISI) and the Epworth sleepiness scale (ESS), respectively. Patients were evaluated at baseline, at 1-month and 3- month after the VToP.
RESULTS: Of the 203 consecutive women approached for the study, 132 accepted to participate, yielding a response rate of 65.0%. Fifty-three women (40.2%) underwent medical VToP and 79 women underwent surgical VToP. At baseline, no difference was observed between group M and S in the prev- alence of poor sleep quality (group M: 60.4%, group S: 58.2%; p1⁄40.948), of clinically relevant insomnia was (group M: 3.8%, group S: 6.3%; p1⁄40.806) and of excessive daytime sleepiness (group M: 13.3%, group S: 13.9%; p1⁄40.888). 1-month after VToP, there was non-significant amelioration of PSQI, ISI and ESS in both groups. At 3-month, there was a significant improvement of the three questionnaires in both groups compared with base- line. Patients who underwent VToP, either medical or surgical for the first time showed baseline scores significantly worse than those who previously underwent VToP.
CONCLUSION: In women undergoing voluntary termination of preg- nancy, the sleep quality is not influenced by the interruption technique. Sleep quality of patients who undergo termination of pregnancy for the first time is significantly worse compared with those who previously underwent termina- tion of pregnancy
Preoperative evaluation of an appendiceal mucocele in a woman with endometriosis
No full textAppendiceal mucocele is a rare cause of pain in the right lower abdominal quadrant. This case report describes a case of coexistence of endometriosis and appendiceal mucocele, which were diagnosed preoperatively by computed tomography, magnetic resonance imaging and ultrasonography. Laparoscopic excision of the appendiceal mucocele and endometriosis resulted in the disappearance of the symptoms. © 2013 Wichtig Editore
Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura
No full textGoing Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura
No full textObjective: Evaluate patient satisfaction at 6-month treatment in women with symptomatic rectovaginal endometriosis and migraine without aura with (progestogen-only contraceptive pill, POP versus sequential combined oral contraceptives, COC) Study Design: A patient preference trial including 144 women (82 in the group COC and 62 in the group POP). Main outcome measure was the degree of patient satisfaction by using a Likert scale. Secondary objectives were to evaluate differences in endometriosis-related pain and changes in migraine features during the treatment. Results: In group POP, 38/62 women (61.2%) were satisfied or very satisfied after treatment, compared to 31/82 women (37.8%) in group COC (p = 0.005). The intensity of chronic pelvic pain and dyspareunia significantly decreased at 6-month treatment in both the groups. At 6-month treatment, the number of migraine attacks was lower than at baseline in group POP (p = 0.002), while it was not reduced in group COC (p = 0.521). The intensity of migraine attacks was significantly different between baseline and 6-month treatment in group POP (p < 0.001) but not in group COC (p = 0.078). Conclusions: POP is better tolerated than COC and it seems to ameliorate migraine attacks compared to COC in symptomatic patients with rectovaginal endometriosis and migraine without aura. Both drugs efficaciously relieve endometriosis-related pain symptoms. This study supports the use of the POP in women with rectovaginal endometriosis and coexisting migraine without aura. © 2014 Elsevier Ireland Ltd. All rights reserved
Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by rectovaginal endometriosis in patients with migraine without aura
No full textStudy question: In women with symptomatic rectovaginal endometriosis and mi- graine without aura which hormonal therapy (progestogen-only contraceptive pill, desogestrel, P versus sequential combined oral contraceptives, COC) causes higher satisfaction of patients?
Summary answer: Patients treated with P are more satisfied than those treated with COC. Both P and COC significantly decrease the intensity of endometriosis-associated pain symptoms. The severity of migraine attacks decreases in patients treated with P but not in those treated with COC.
What is known already: Comorbidities may increase the incidence of adverse effects and decrease the compliance to treatment. Epidemiological studies showed that migraine is more frequent in women with endometriosis than in women without this disease. This clinical scenario is a challenge for gynaecolo- gists because the benefits of hormonal treatment on pain symptoms should be balanced with changes in the severity of migraine potentially caused by hormonal therapy.
Study design, size, duration: This was a prospective patients preference trial. A power calculation demonstrated that 62 patients per group were required. An intention-to-treat analysis was performed. The study was performed between January 2009 and June 2012. The duration of treatment was six months. Participants/materials, setting, methods: The study included women with pain symptoms caused by rectovaginal endometriosis suffering migraine without aura. Patients rated the degree of satisfaction by using a Likert scale. Pain symptoms were measured with a visual analogue scale. The number, duration and severity of migraine attacks were evaluated by using a diary.
Main results and the role of chance: The study included 144 women (82 in the group COC and 62 in the group P). 11.3% of women in group P and 24.4% of those in group COC withdrew because of adverse effects ( p 1⁄4 0.054). 53.2% of women in group P were satisfied or very satisfied after treatment compared with 30.5% in group COC ( p 1⁄4 0.006). The intensity of chronic pelvic pain and dyspareunia sig- nificantly decreased at 6-month treatment both groups. At 6-month treatment, the number of migraine attacks was lower than at baseline in the group P ( p 1⁄4 0.002), while it was not reduced in group COC (p 1⁄4 0.521). The intensity of migraine attacks was significantly different between baseline and 6-month treatment in group P (p , 0.001) but not in group COC (p 1⁄4 0.078).
Limitations, reason for caution: Although several epidemiological studies sup- ported the relationship between endometriosis and migraine, this is the first study evaluating the optimal hormonal treatment for these patients. It remains to be demonstrated if the beneficial effects on migraine of desogestrel are maintained during longer treatment. Further prospective randomised trials are warranted. Wider implications of the findings: When pregnancy is not desired, COC or P treatment may be administered to symptomatic patients with rectovaginal endo- metriosis and migraine without aura. Both drugs efficaciously relieve endometriosis-related pain symptoms; however, P is better tolerated than COC and it seems to ameliorate migraine attacks compared with COC. This study sup- ports the use of the progestogen-only contraceptive pill in women with rectovagi- nal endometriosis and coexisting migraine without aura.
Study funding/competing interest(s): none Trial registration number: non
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