1,720,967 research outputs found
Hysteroscopy and female infertility: a fresh look to a busy corner
No full textHysteroscopy has evolved from the traditional art of examining the uterine cavity for diagnostic purposes to an invaluable modality to concomitantly diagnose and (see and) treat a multitude of intrauterine pathologies, especially in the field and clinics specialising in female reproduction. This article reviews the literature on the most common cervical, endometrial, uterine and tubal pathologies such as chronic endometritis, endometrial polyps, adenomyosis, endometriosis, endometrial atrophy, adhesions, endometrial hyperplasia, cancer, and uterine malformations. The aim is to determine the efficiency of hysteroscopy compared with other available techniques as a diagnostic and treatment tool and its association with the success of in vitro fertilisation procedures. Although hysteroscopy requires an experienced operator for optimal results and is still an invasive procedure, it has the unique advantage of combining great diagnostic and treatment opportunities before and after ART procedures. In conclusion, hysteroscopy should be recommended as a first-line procedure in all cases with female infertility, and a special effort should be made for its implementation in the development of new high-tech procedures for identification and treatment infertility-associated conditions
Evaluation and treatment of infertile women with Asherman syndrome: an updated review focusing on the role of hysteroscopy
No full textAsherman syndrome is a rare acquired clinical condition resulting in the obliteration of the uterine cavity caused by the presence of partial or complete fibrous intrauterine adhesions involving at least two-thirds of the uterine cavity potentially obstructing the internal cervical orifice. Common reported symptoms of the disease are alterations of the menstrual pattern with decreased menstrual bleeding leading up to amenorrhoea and infertility. Hysteroscopy is
currently considered the gold standard diagnostic and therapeutic approach for patients with intrauterine adhesions. An integrated approach, including preoperative, intraoperative and postoperative therapeutic measures, however, are warranted owing to the complexity of the syndrome. This review aims to summarize the most recent evidence on the recommended preoperative, intraoperative and postoperative procedures to restore the uterine cavity and a functional endometrium, as well as on the concomitant use of adjuvant therapies to achieve optimal fertility outcomes
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Reproductive outcomes of infertile women undergoing "see and treat" office hysteroscopy: a retrospective observational study
No full textIntroduction: This study aimed to assess the feasibility and efficacy of office hysteroscopy to diagnose and treat the specific uterine pathologies frequently diagnosed and thought to be
associated with female infertility.
Material and methods: Using office hysteroscopy, we examined the uterine cavity in women
with primary or secondary infertility and evaluated the reproductive outcomes of those affected
by one or more pathologies, including cervico-isthmic adhesions, intrauterine polyps and intrauterine
adhesions. Additional patient characteristics considered were age and parity, uterine
pathology, pain during hysteroscopy, and outcomes including spontaneous pregnancies
achieved and time between treatment and pregnancy.
Results: Reproductive outcomes of 200 patients affected by one or more uterine pathologies
were evaluated. Cervico-isthmic adhesions were the most frequent findings in older women,
with nearly 80% of them achieving pregnancy sooner than the others in our study.
Spontaneous pregnancy rates following office hysteroscopy were 76%, 53% and 22% in women
with cervico-isthmic adhesions, polyps (< 5mm) and intrauterine adhesions, respectively.
Conclusions: Office hysteroscopy is a feasible and highly effective diagnostic and therapeutic
procedure for cervico-isthmic and intrauterine adhesions, as well as for small polyps, allowing
the resolution of female infertility related to these pathologies, without trauma and with only
minimal discomfort
Management of anxiety and pain perception in women undergoing office hysteroscopy: a systematic review
No full textPurpose The aim of this review is to provide an overview of the literature about the perception and management of anxiety
and pain in women undergoing an office hysteroscopic procedure.
Methods We performed a systematic literature search in Embase, PubMed/MEDLINE, Cochrane Library and Web of Science
for original studies written in English (registered in PROSPERO 2019-CRD42019132341), using the terms ‘hysteroscopy’
AND ‘pain’ AND ‘anxiety’ published up to January 2019. Only original articles (randomized, observational and retrospective
studies) about management of anxiety and pain related to the hysteroscopic procedure were considered eligible.
Results Our literature search produced 84 records. After exclusions, 11 studies including 2222 patients showed the following
results: (a) pain experienced during hysteroscopy is negatively affected by preprocedural anxiety; (b) pharmacological
interventions seem to be help in reducing pain during hysteroscopy; (c) waiting time before the procedure is a significant
factor affecting patients’ anxiety; (d) music during the procedure may be helpful in reducing anxiety.
Conclusions The utilization of office hysteroscopy is hampered by varying levels of anxiety and pain perceived by women
who are candidates for the procedure. For these reasons, it is essential to identify effective pharmacological and non-pharmacological
strategies to alleviate these factors. We recommend further studies especially focusing on non-pharmacological
interventions to facilitate the dissemination of good clinical practices among hysteroscopists
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Distension media delivery systems in hysteroscopy: past, present and future
No full textTo examine the uterine cavity and/or to perform hysteroscopic surgery, one has to access the
uterine cavity through the cervix, distend the cavity with a fluid (liquid or gas) to visualize it
with a telescope and/or a camera system and use energy (mechanical or thermal) to affect and/
or remove tissue. Distension of the uterine cavity then is an important component of hysteroscopy,
and during the last century, numerous attempts have been made to achieve an undistorted
and unobstructed panoramic view of the uterine cavity. In order to achieve this goal, the
uterine cavity has been distended with fluids using a variety of techniques, including gravityassisted
systems, pressure cuffed systems, and electronic pumps. Excessive fluid intravasation
during hysteroscopy can lead to significant complications, and hence, automated fluid delivery
systems have been developed recently to provide a safe and more efficient method of fluid
delivery. This review aims to describe the evolution of distension media delivery systems
chronologically from the 1900s to the present day
Vilaprisan, a New Selective Progesterone Receptor Modulator in Uterine Fibroid Pharmacotherapy-Will it Really be a Breakthrough?
No full textBackground: Vilaprisan (VPR) is a new orally available selective progesterone receptor modulator (SPRM), with anti-proliferative activity against uterine fibroids (UFs). It definitively causes suppression of ovulation and inhibition of proliferation of endometrial, myometrial and UF cells.
Purpose: This review aims to summarize current knowledge on VPR from all studies, including clinical trials, conducted to date and to contextualize the potential role of VPR in future medical regimens for the treatment of UFs.
Methods: We performed a literature search in PubMed US National Library of Medicine and Google Scholar databases. Both databases were extensively searched for all original and review articles/book chapters as well as congress abstracts published in English until July 2019. The use of VPR for UF therapy was identified by using the keywords: "uterine fibroids" and "vilaprisan".
Results: In phase I and II clinical trials, VPR was shown to be effective in ameliorating UF-related clinical symptoms, especially abnormal or excessive uterine bleeding and in shrinking UFs. The tolerability of VPR is roughly similar to that of ulipristal acetate (UPA) and it tends to be more favorable than that of GnRH-agonists.
Conclusion: Presently, all trials examining the utility of VPR for the treatment of UF are halted; likely, due to the recently reported cases of hepato-toxicity with UPA, in addition to non reassuring toxicology results from preclinical long-term testing on rodents, carried out in parallel with late stage testing on humans. An accurate summary of robust data related to the safety of VPR is urgently needed to draw definitive conclusions on the future clinical development of this drug for UF therapy
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