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Causes of Bleeding
Published in John C. Petrozza, Uterine Fibroids, 2020
Ophelia Yin, Carter M. Owen, Kamaria Cayton, James H. Segars
The most compelling evidence supporting that differences in angiogenic factors between fibroids and normal myometrium can translate to gross changes such as blood vessel formation comes from studies by Hague et al. [19] and Di Lieto et al. [21, 22]. Hague et al. [19] assessed 52 fibroid uteri and 39 control uteri and found that ADM and VEGF were upregulated in the myometrium and endometrium of fibroid uteri. Despite the expectation that all angiogenic factors would be associated with blood vessel formation, the investigators concluded that only ADM levels correlated with higher vascular density and endothelial cell proliferation in adjacent myometrium. Di Lieto et al. [21, 22] also discovered that treatment of fibroid uteri with a gonadotropin-releasing hormone analogue (GnRH-a), a treatment often used for AUB associated with fibroids, reduced protein expression of PDGF, bFGF and VEGF, as well as vascular density and angiogenesis, demonstrating that hormone action, angiogenic factors and gross vascular changes are all interconnected. Notably, plasma iron levels and hemoglobin values improved in patients treated with GnRH-a, supporting the idea that inhibition of vascular growth can result in clinical outcomes associated with decreased bleeding.
Comparison of the ongoing pregnancy rate of in vitro fertilisation following tubal occlusion by microcoil placement versus laparoscopic tubal ligation for hydrosalpinges
Published in Human Fertility, 2022
Zhi Qin Chen, Ernest Hung Yu Ng, Miao Xin Chen, Mei Zhao, Jia Ping Pan, Hong Chen, Xiao Ming Teng
Women started their IVF with ovarian stimulation using either the long agonist or antagonist protocols 8–12 weeks after the treatment of their hydrosalpinges. For the long protocol, gonadotropin-releasing hormone analogue (GnRHa) was given for pituitary desensitisation. On Day 2–3 of the menstrual cycle and they underwent transvaginal ultrasound examination and serum oestradiol measurement. Human menopausal gonadotrophin (hMG) (Lebaode, Lizhu, china) or recombinant FSH (Puregon, Organon, Dublin, Ireland or Gonal F, Merck Serono S.p.A, Modugno, Italy) was given at 150–225 IU per day based on the AFC count, age of women and previous ovarian response, according to the standard operation procedures of the centre. Ovarian response was monitored by serial transvaginal scanning with or without hormonal monitoring. Further dosage adjustments were based on the ovarian response at the discretion of the clinicians in charge. For the antagonist protocol, antagonist 0.25mg daily (Orgalutran, Organon, Dublin, Ireland) was given from the 6th day of ovarian stimulation until the day of ovulation trigger.
Commentary on guidelines for the pharmacological treatment of paraphilic disorders
Published in The World Journal of Biological Psychiatry, 2020
Nevertheless, continuing efforts to evaluate the pharmacological treatment of these disorders continue. Uncontrolled open-label studies have suggested that androgen reduction treatment has been effective in reducing sexual offending (Rosler and Witztum 1998, 2009). Their reports concerned 100 males treated with triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone analogue, together with supportive psychotherapy followed for up to 15 years; as long as patients continued with pharmacological treatment, no recidivism was detected. Recently (Landgren et al. 2020) reported on a randomised clinical trial of dagarelix, a gonadotropin-releasing hormone antagonist that reduces testosterone. This was found to reduce the risk score of committing sexual abuse in men with paedophilic disorder 2 weeks after the initial injection. This study was considered to be a milestone (Briken 2020). Both studies, however, relied on outcome measures with very limited validation, especially given the reliance on self-report from a forensic population where such a report can be unreliable.
Results of 14 years of brachytherapy for localized prostate cancer in Denmark: the Herlev cohort
Published in Scandinavian Journal of Urology, 2018
Mikael G. Jacobsen, Frederik B. Thomsen, Mikkel Fode, Rasmus Bisbjerg, Peter B. Østergren
Men treated with BT for localized PCa between August 1998 and December 2012 at Herlev and Gentofte Hospital, Denmark, were included in the study. BT was offered to patients with localized, non-metastatic PCa (cT1–2, N0, M0) with pretreatment prostate-specific antigen (PSA) < 20 ng/ml, no serious comorbidities or presence of severe obstructive urinary symptoms, and where seed implantation was deemed feasible by ultrasound. A few patients with higher risk features and a strong request for BT were offered the treatment. Selected patients with large prostate glands were offered downsizing with a gonadotropin-releasing hormone analogue for 3 months before BT. Pre-BT lymph-node dissection and bone scintigraphy or sodium fluoride positron emission tomography/computed tomography (PET/CT) was performed in patients with cT ≥2c and/or PSA >10 µg/l and/or Gleason score 7 (4 + 3)–10 to exclude N1 and M1 disease. Postoperatively, patients were followed with PSA measurements and clinical evaluation after 1, 3, 6, 9, 12, 18 and 24 months, and then yearly. After 3–5 years, patients were referred for continued control with their general practitioner and recommended yearly PSA measurement.