1,721,729 research outputs found
Endocrine role of the placenta and related membranes
No full textGoing back to any textbook on obstetrics and gynecology or endocrinology published in the 1970s, the chapter on endocrinology of the placenta was clearly defined and limited. In the recent past the vast majority of medical students throughout the world simply learned that protein (hCG, hPL) and steroid (progesterone, estradiol, estriol) hormones are the major products of human trophoblast. Even though it was stated that they play a role in the maintenance of pregnancy, for several years the investigations on the endocrine function of human placenta did not show a significant development. At that time the fetal membranes (amnion and chorion) and maternal decidua had no endocrine relevance: they represented an anatomical interface expressing some capacity for producing prostaglandins
Inhibin, activin and follistatin in the human placenta: a new family of regulatory proteins
No full textThe family of inhibin-related proteins has been investigated extensively in the last decade. It is composed of three members: inhibin, activin and follistatin. Inhibin and activin are chemically related, while follistatin acts as an activin-binding protein. Initially identified as regulators of pituitary follice stimulating hormone (FSH) secretion, inhibin, activin and follistatin have more recently been characterized as growth factors, embryo modulators and immune factors. Human placenta, amnion, chorion and maternal decidua express mRNAs for inhibin, activin and follistatin, and the presence of both immunoreactive and bioactive proteins has been demonstrated. The proteins are present in maternal and fetal circulation, and are measurable in amniotic fluid with changes related to gestational age and to the occurrence of gestational diseases. Various biological actions have been described in embryo and intrauterine tissues, which suggest a role for these proteins in the development of the gestational unit. However, several questions remain to be elucidated. The chemical forms of inhibin, activin and follistatin produced by human placenta and the mechanisms involved in the regulation of their secretion are largely unknown. The nature of the receptors for these proteins and the physiological implications of receptor activation have not yet been elucidated and this will require further investigation
Endometriosis and bowel comorbidities
No full textEndometriosis is an estrogen-dependent gynecological condition characterized by the presence and growth of ectopic endometrial tissue, often associated with inflammation, severe and chronic pain, and infertility. Lesions are categorized as superficial peritoneal lesions, endometriomas, or deep infiltrating nodules, with high degree of individual variability in lesion color, size, and morphology. Numerous factors involved in this disease, including inflammation, angiogenesis, cytokine/chemokine expression, and endocrine alterations such as steroid and steroid receptor expression.
When endometrial-like glands and stroma infiltrate the bowel wall, reaching at least the subserous fat tissue or the adjacent subserous plexus, the condition is diagnosed as intestinal endometriosis.
Matherial and methods
The aim of this study is to analyze the bowel comorbidities of the endometriosis. In particular, the frequency of endometriosis in young women with abdominal pain and to evaluate the most feared complication after surgery.
In the first time, we consider the young fertile age women with right iliac fossa (RIF) pain . This is one of the most common complaint in those presenting at the emergency department and requiring acute care.
A group of fertile age women (18-45 years) undergoing emergency surgery for acute RIF pain
According to the intraoperative and pathology findings, patients were subdivided into 2 groups: group A was composed by those with histological diagnosis of endometriosis, whereas group B identified the controls. During the surgery, peritoneal samples were taken and analized. The present study showed that in women undergoing appendectomy for a RIF pain, superficial peritoneal endometriosis (SUP) is an incidental diagnosis in 23% of cases.
In the second time, we consider the bowel endometriosis. When endometriosis infiltrate the bowel wall, reaching at least the subserous fat tissue or the adjacent subserous plexus, the condition is diagnosed as intestinal endometriosis
Medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptives, progesterone, and gonadotropin-releasing hormone. Instead, surgical treatment includes shaving or resection.
We performed this study with the aim of identifying the number of leaks in colonic resections for deep endometriosis.
Conclusions
Endometriosis is a very common condition in fertile young women. Knowing the degree of infiltration and deciding on the best treatment strategy should not be undervalued
Feto-maternal biology and ethics of human society
Full text linkAbstract The growing interest in human reproduction and the identity of the embryo have prompted us to bring some considerations to the attention of scientists. In particular, we focus on the interactive relationship between the embryo and the mother starting from the earliest stages of development. Principles governing the acceptance and growth of the embryo in the uterus may represent a model for mutual tolerance and peaceful co-existence in human society.</p
Modern operative hysteroscopy
Full text linkHysteroscopy is an endoscopic surgical procedure that has become an important tool to evaluate intrauterine pathology. It offers a direct visualization of the entire uterine cavity and provides the possibility of performing biopsy of suspected lesions that can be missed by dilatation and curettage (D&C). In most cases, the intrauterine pathologies can be diagnosed and treated at the same setting as office hysteroscopy ("see and treat approach"). For example, endometrial polyps can be diagnosed and removed; similarly, intrauterine adhesions can be liberated in the outpatient setting without the need for an operating theatre. Today, many hysteroscopic procedures can be performed in the office or outpatient setting. This is due to the feasibility of operative hysteroscopy using saline as a distending medium, the vaginoscopic approach of hysteroscopy and the availability of mini-hysteroscopic endoscopes. There is good evidence to suggest that hysteroscopy in an ambulatory setting is preferable for the patient, and that it avoids complications, allows a quicker recovery time and lowers cost. Advances in technology have led to miniaturization of high-definition hysteroscopes without compromising optical performance, thereby making hysteroscopy a simple, safe and well-tolerated office procedure. The new surgical technology such as bipolar electrosurgery, endometrial ablation devices, hysteroscopic sterilization, and morcellators has revolutionized this surgical modality. The modern development of hysteroscopy completely transformed the approach to the uterine intracavitary pathologies moving from a blind procedure under general anesthesia to an outpatient procedure performed under direct visualization, offering therapeutic and irreplaceable possibilities of treatment that should belong to every modern gynecologist
Modern operative hysteroscopy
No full textHysteroscopy is an endoscopic surgical procedure that has become an important tool to evaluate intrauterine pathology. It offers a direct visualization of the entire uterine cavity and provides the possibility of performing biopsy of suspected lesions that can be missed by dilatation and curettage (D&C). In most cases, the intrauterine pathologies can be diagnosed and treated at the same setting as office hysteroscopy ("see and treat approach"). For example, endometrial polyps can be diagnosed and removed; similarly, intrauterine adhesions can be liberated in the outpatient setting without the need for an operating theatre. Today, many hysteroscopic procedures can be performed in the office or outpatient setting. This is due to the feasibility of operative hysteroscopy using saline as a distending medium, the vaginoscopic approach of hysteroscopy and the availability of mini-hysteroscopic endoscopes. There is good evidence to suggest that hysteroscopy in an ambulatory setting is preferable for the patient, and that it avoids complications, allows a quicker recovery time and lowers cost. Advances in technology have led to miniaturization of high-definition hysteroscopes without compromising optical performance, thereby making hysteroscopy a simple, safe and well-tolerated office procedure. The new surgical technology such as bipolar electrosurgery, endometrial ablation devices, hysteroscopic sterilization, and morcellators has revolutionized this surgical modality. The modern development of hysteroscopy completely transformed the approach to the uterine intracavitary pathologies moving from a blind procedure under general anesthesia to an outpatient procedure performed under direct visualization, offering therapeutic and irreplaceable possibilities of treatment that should belong to every modern gynecologist
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