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"I think we've got too many tests!": Prenatal providers' reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening.

BACKGROUND: The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expe … s to maintain ethical practice. METHODS: We used the online American Congress of Obstetricians and Gynecologists Physician Directory to identify a systematic sample of five prenatal care providers in each U.S. state and the District of Columbia. Beginning with the lowest zip code in each state, we took every fifth name from the directory, excluding providers w …

Office endometrial ablation with local anesthesia using the HydroThermAblator system: Comparison of outcomes in patients with submucous myomas with those with normal cavities in 246 cases performed over 5(1/2) years.

STUDY OBJECTIVE: To estimate the safety and efficacy of the HydroThermAblator (HTA) system for performance of endometrial ablation in the me … ame manner. All procedures were performed in the medical office procedure room by 7 board-certified gynecologists; most procedures were performed by the authors. MEASUREMENTS AND MAIN RESULTS: Of the 231 patients included in the analysis, 121 (53.4%) reported postablation amenorrhea, 62 (26.8%) reported light menses or spotting, 21 (9.1%) reported normal mense …

Effect of iron overload and dietary fat on indices of oxidative stress and hepatic fibrogenesis in rats.

The aim of this study was to assess the effects of any anti-adhesion barrier gel used after operative hysteroscopy for treating infertility associated with uterine cavity abnormalities. Gynecologists might use any barrier gel following operative hysteroscopy in infertile women for decreasing de novo adhesion formation; the use of any barrier gel is associated with less severe de novo adhesions and lower mean adhesion scores. Nevertheless, infertile women should be counseled that there is at the present no evidence for higher live birth or pregnancy rates. There is a lack of data for the outcom…

Is It Time to Inform This Patient that Further Antineoplastic Drug Therapy Will Not Be of Clinical Value?

A woman with heavy pre-treated ovarian cancer sought consultation regarding additional treatments. The case raises the vexing question of whether there may be a time in the course of the disease process where it is most appropriate to state further anti-neoplastic therapy will not be of clinical utility.

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… 949 4 Cantor MD Braddock CH III Derse AR Edwards DM Logue GL Nelson W Prudhomme AM Pearlman RA Reagan JE Wlody GS Fox E Do-not-resuscitate orders and medical futility Arch Intern Med 2003 163 2689 2694 14662622 10.1001/archinte.163.22.2689 5 Committee on Ethics American College of Obstetricians and Gynecologists …

NIH consensus development conference draft statement on vaginal birth after cesarean: new insights.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data on v … ersonnel in current guidelines, the panel recommends that the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists reassess this requirement with specific reference to other obstetric complications of comparable risk, risk stratification, and in light of limited physician and nursing resources. Healthcare organizatio …

Individualized survival prediction and risk stratification using machine learning for patients with malignant struma ovarii: a population-based study with external validation.

BACKGROUND: Malignant struma ovarii (MSO) is a rare thyroid-type cancer originating in ovarian teratoma. Prognosis of MSO is less studied without unanimous staging or stratification system. This study aimed to developed and validated a machine learning (ML)-based model to predict overall survival (OS) for patients with MSO and to risk-stratify them. METHODS: Patients with histologically confirmed MSO diagnosed in 1975-2021 from the Surveillance, Epidemiology, and End Results (SEER) program were identified as the training cohort. Patients in a systematic literature review were collected as the

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… The complexity of the disease requires multidisciplinary team (MDT) discussion including gynecologists, surgeons, endocrinologists, radiologists and pathologists. Prognosis of MSO remains controversial with most patients having favorable outcomes but some having lethal disease ( 7 - 9 ). … Taken together, although MSO is mainly treated by gynecologists and diagnosed postoperatively, its biological features may resemble an eutopic TC. MDT involving endocrine surgeons and nuclear radiologists should be considered for all patients with MSO. …

Squamous Cell Carcinoma of Unknown Primary: Multiple Skeletal Metastases Without Detectable Visceral Lesions.

The appropriate diagnosis of carcinoma of unknown primary can be challenging for physicians, especially when they cannot apply a logical and ordered diagnostic process due to the unorthodox clinical characteristics. Here, we report the case of a 75-year-old woman presenting with multiple skeletal metastases with neither detectable visceral lesions nor site-specific distribution. Histological examination of a skeletal biopsy specimen unexpectedly revealed squamous cell carcinoma (SCC). Further specialized investigations led to the diagnosis of SCC of unknown primary. This case highlights the di

Integration of geriatric assessment-guided care plan modifications and interventions into clinical paths of older adults with cancer (GORILLA): a feasibility approach.

PurposeA comprehensive geriatric assessment (CGA) followed by geriatric assessment-guided interventions was demonstrated to reduce treatment-related toxicities CTCAE III°-V° in older adults with cancer undergoing systemic cancer treatments, but implementation remains insufficient. Thus, we aimed to evaluate the feasibility of implementing CGA into routine care and multidisciplinary tumor boards (MDTs) in Germany within a bicentric feasibility trial (DRKS00035569; 19.12.2024).MethodsPatients ≥ 65 years with positive geriatric screening (G8 Results75 patients received CGA (62.5% females). Of tho

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… Questionnaires were completed by gynecologists (51.4%), radiation oncologists (14.3%), medical oncologists (20%), pulmonologists (11.4%), and palliative care specialists (2.9%). … One gynecologist, one radiation oncologist, one palliative care specialist, and one medical oncologist were interviewed. Two had participated in at least 2–4 MDTs with presented CGAs, two in more than ten MDTs. …

Лейкемия в период беременности: диагностика и терапевтический подход (обзор).

Цель настоящего исследования заключается в оценке эпидемиологических, диагностических и терапевтических данных о гематологических заболеваниях в период беременности. Лейкемия в период беременности встречается редко, а литературные данные не являются обширными. Факторы риска, эпидемиология и патогенез этих заболеваний не разработаны в полной мере. Кроме того, имеется подробный доклад о осложнениях в период беременности и об общем (на три месяца) лечении этих заболеваний, в частности о стратегии их лечения. В настоящем исследовании описывается возможность обеспечения в будущем беременности у жен

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… Professional advice and follow-up from specialized oncologists-hematologists and gynecologists are recommended for the potential maternal effects from the termination of therapy and the potential dangers for the fetus due to therapy. … The timing of childbirth is a shared decision of gynecologists, hematologists, oncologists and patients. Whenever it is possible and permitted by the health of the mother and the fetus, the pregnancy is allowed to be completed. …

[Analysis of maternal mortality in the Czech Republic in 2000].

OBJECTIVE: Analysis of maternal mortality in the Czech Republic in 2000. DESIGN: Retrospective statistical and clinical analysis. SETTING: … cases or reproduce in details all their aspects. We though believe that this form will help to our gynecologists to learn about courses of the deaths, particularly when the frequency of such cases is low and circumstances are unusual. Individual analyses include also conclusions of expert committees or analyses performed by the Czech Medical Chamber. Comments …

Joint SOGC-CCMG Opinion for Reproductive Genetic Carrier Screening: An Update for All Canadian Providers of Maternity and Reproductive Healthcare in the Era of Direct-to-Consumer Testing.

OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional r … ne [SMFM]; American College of Medical Genetics and Genomics; American College of Obstetricians and Gynecologists [ACOG]; CCMG; Royal College Obstetrics and Gynaecology [RCOG] [UK]; American Society of Human Genetics [ASHG]; International Society of Prenatal Diagnosis [ISPD])/provincial neonatal screening policies and programs; search terms (carrier screening, …

Updated Review for Guidelines for Cervical Cancer Screening in Immunosuppressed Women Without HIV Infection.

OBJECTIVE: The purpose of this review was to examine new evidence since the authors' 2019 guidelines for cervical cancer (CC) screening in non-HIV immunocompromised persons and to provide updated recommendations based on literature review and expert opinion. In addition, human papillomavirus (HPV) vaccine efficacy in these populations was reviewed. METHODS: A literature search was performed similar to the authors' previous publication but was conducted through March 2023. Risk of CC, squamous intraepithelial lesions, and HPV infection in those living with solid organ transplant (SOT), end-sta

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… At the time this manuscript was written, ASCCP, American College of Obstetricians and Gynecologists (ACOG), and US Preventive Services Task Force (USPTF) continued to endorse the previous recommendations starting with cytology at 21 years of age and cotesting and primary HPV at 30 years of age. … Overall, improving CC outcomes in this specific population requires a comprehensive approach that combines clinical care among gynecologists, primary care providers, oncologists, pediatricians, and immunologists with culturally proactive public health strategies. …

Evaluation of metabolic uptake in gynecological organs using FDG-PET in women diagnosed with nongynecological malignancies.

BACKGROUND/AIM: Gynecological malignancies, including those affecting the uterus, cervix, vagina, vulva, and adnexa, pose significant physical and psychosocial burdens. Early detection and effective management of these malignancies are critical for improving outcomes. This study aims to evaluate metabolic uptake patterns in gynecological organs using fluorodeoxyglucose positron emission tomography (FDG-PET) and to analyze their malignancy potential in women with nongynecological cancers. MATERIALS AND METHODS: A retrospective analysis was conducted on 221 women with nongynecological malignanc

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… For obstetricians and gynecologists, interpreting FDG-PET results in patients showing signs of malignancy represents a key step in the diagnosis and follow-up of gynecological cancers. …

[Ultrasonography in acute pelvic pain].

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Ap

ESCP Spring Workshop 2023: Advancing clinical pharmacy and care in diabetes and cardiovascular comorbidities-Antwerp, 20-21 April 2023.

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… PP24 Medical abortion: a practical quick reference algorithm to support the gynecologists M. C. Campanardi 1,* , N. Bellato 1 , M. Cambareri 1 , S. Nobili 1 , C. Veneziano 1 , F. Azteni 1 , M. L. Andena 1 , E. Ciceri 1 , P. Richelmi 1 , G. De Vivo 1 , S. … In view of the complexity of the MA guidelines, the aim of this work is to develop a quick reference-tool that can support gynecologists in their choice of treatment, evaluating differences between treatments and patient need. …

International Natural Procreative Technology Evaluation and Surveillance of Treatment for Subfertility (iNEST): enrollment and methods.

STUDY QUESTION: What is the feasibility of a prospective protocol to follow subfertile couples being treated with natural procreative techno … sites in four countries (mostly private clinical practices) with family physicians or obstetrician-gynecologists, data about clinic visits were submitted for 60% of participants, and diagnostic data for 77%. For data obtained directly from the couple, 59% of couples had at least one follow-up questionnaire, and the proportion of women and men responding to fil …

Курсы по болезням, результатам и осложнениям у беременных женщин и кормящих матерей с множественным склерозом, обработанных ритуксимабом или окрилизумабом: обзор нарации.

Множественный склероз (MS) в основном затрагивает женщин детородного возраста, и принятие решений в отношении методов лечения заболеваний во время беременности и кормления, особенно в отношении высокоэффективных методов лечения против CD20, таких, как ритуксимаб и окролизумаб, по-прежнему сопряжено с трудностями. Цель этого обзора состоит в обобщении имеющихся данных о ходе беременности, беременности и неонатальных исходах, осложнениях и соображениях безопасности у беременных и кормящих женщин, у которых цитусимаб или острелизумаб. Этот структурированный обзор описательной части был проведен в

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… American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Gynecology. ACOG practice bulletin No. 200: Early pregnancy loss. Obstet Gynecol. 2018;132:e197–207. doi: 10.1097/AOG.0000000000002899. 14. …

Management of Foot Ulcers and Chronic Wounds with Amniotic Membrane in Comorbid Patients: A Successful Experience.

Chronic wounds are defined as those with disturbances in normal healing. They involve symptoms like exudate, odor, pain or impaired mobility, severely impacting life quality. In the case of patients with additional comorbidities, these are known to aggravate the healing impairment. Amniotic membrane (AM) is gaining attention for its regenerative potential, as it has shown promise in treating hard-to-heal wounds, such as diabetic foot ulcers. This work examines a series of five patients who, while suffering an array of other chronic conditions, were treated with AM for the management of non-hea

Detection and genotyping of HPV-DNA through different types of diagnostic platforms in liquid-based cervical-cytology samples.

BACKGROUND: At present cervical cancer represents the second most common cancer in women worldwide and it reaches a global mortality rate of 52%. Only the early detection and the adequate treatment of pre-neoplastic lesions and early-stage cervical cancer decrease the mortality rate for this type of cancer. Cervical carcinoma screening, as a method of second prevention, is currently feasible through molecular research of high-risk HPV genotypes and in lots of organized screening programs the Pap-test is performed only in women with positive HPV-test. Currently, there are various diagnostic pla

Applications of Structural Expert Elicitations for Economic Evaluations: A Systematic Review Update.

BackgroundStructured expert elicitation (SEE) has become increasingly important in health technology assessment and economic evaluations. Complementing previous work, we aimed to synthesize recent developments in published SEE applications within health economics over the past 8 years.MethodsA systematic literature search was conducted in Medline and Embase databases from April 2017 to February 2026, supplemented with snowball sampling, to identify applications of SEE as part of economic evaluations. Data extraction and synthesis focused on expert selection, elicitation methods, and analytical

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… IQR | Mathematical | Yes | Equal weights Cope et al. (2019) [ 36 ] | Oncologists and hematologists with pediatric specialization and CAR-T therapy experience | Purposive sampling | 7 | FIM | MLV, LPL and UPL for survival rates at each time point | Mathematical | No | NA Grand et al. (2019) [ 41 ] | Gynecologist … specializing in endometriosis | Purposive sampling | 1 | FIM | NR | Mathematical | NR | NR Hitimana et al. (2019) [ 35 ] | Gynecologists/obstetricians with ≥ 5 years of practice | Purposive sampling | 8 | VIM | Median and quartiles, optimistic/ pessimistic scenarios, mode | Consensus | No | NA Rossi …