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Mon, 21 Mar 2016 19:29:00 +0100As you study for the United States Medical Licensing Examination® (USMLE®) Step 1 exam, take time to hone your skills with this exclusive scoop on one of the most challenging USMLE test prep questions and expert strategies to help you pass with flying colors. Find out what this month’s toughest question is, and view an expert video explanation of the answer from Kaplan Medical. Welcome to this month’s installment of the AMA Wire® series, “Tutor talk: Tips from Kaplan Medical on the most missed USMLE test prep questions from Kaplan’s Qbank”: Step 1. Each month, we’re revealing the top questions physicians in training miss on the USMLE, a helpful analysis of answers and videos featuring tips on how to advance your test-taking strategies. See all posts in this series. Thi...
Sun, 20 Mar 2016 18:07:31 +0100Purpose: Female athlete triad (FAT) including low energy availability, functional hypothalamic amenorrhea, and low bone mineral density (BMD) is a serious problem in elite athletes. The purpose of this study was to assess the female athlete triad in different sports. (Source: Osteoarthritis and Cartilage)
Tue, 15 Mar 2016 00:00:00 +0100We report the first WES-discovered FSHR mutation, validated by quantitative flow cytometry. WES is a valuable tool for diagnosis of rare genetic diseases, and flow cytometry allows for quantitative characterization of purported variants. WES-assisted diagnosis allows for treatments aimed at the underlying molecular etiology of disease. Future studies should focus on pharmacological and assisted reproductive treatments aimed at the disrupted FSHR, so that patients with FSH resistance can be treated by personalized medicine. STUDY FUNDING/COMPETING INTEREST(S) E.V. is partially funded by the DSD Translational Research Network (NICHD 1R01HD068138). M.S.B. is funded by the Neuroendocrinology, Sex Differences and Reproduction training grant (NICHD 5T32HD007228). The authors have no competing i...
Fri, 11 Mar 2016 21:52:02 +0100CONCLUSIONS: The stress of TBI results in anovulation and central hypothalamic-pituitary-ovarian (HPG) axis suppression. Future work will examine acute/chronic consequences of post-TBI hypercortisolemia and associated HPG suppression, the temporal association of HPG suppression with other neuroendocrine adaptations and how HPG suppression impacts multidimensional recovery for women with TBI. PMID: 26963638 [PubMed - as supplied by publisher] (Source: Brain Injury)
Thu, 10 Mar 2016 00:00:00 +0100CONCLUSIONS: This study provides evidence that, by including a steroid profile in the definition of hyperandrogenemia, the majority of women with PCOS are hyperandrogenic, although a clinical and biochemical heterogeneity exists. In addition, these data demonstrate that hirsutism and high androgen levels cannot be used indifferently to define hyperandrogenism. PMID: 26964728 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Tue, 01 Mar 2016 06:00:00 +0100Conclusions: There remains a need for effective MS treatment, particularly for nonrelapsing forms of MS. Mitoxantrone was the first nonbiologic drug approved by the Food and Drug Administration for use in MS. Chromophore modification of anthracenedione agents yielded a novel class of DNA binding agents (aza-anthracenediones such as pixantrone and aza-anthrapyrazoles such as BBR3378) with the potential for less cardiotoxicity compared with mitoxantrone. There is a need for long-term observation for delayed toxicity among humans enrolled in pixantrone trials. Preclinical toxicity studies for delayed toxicities in rodents and other models are warranted before consideration of derivatives of anthracenediones, aza-anthrazenediones, or aza-anthrapyrazoles for use in human MS clinical trials. (So...
Sat, 27 Feb 2016 07:21:23 +0100Objective: To evaluate the effect of isolated vitamin D supplementation (VITD) on the rate of falls and postural balance in postmenopausal women fallers. Methods: In this double-blind, placebo-controlled trial, 160 Brazilian younger postmenopausal women were randomized into two groups: VITD group, vitamin D3 supplementation 1,000 IU/day/orally (n = 80) and placebo group (n = 80). Women with amenorrhea at least 12 months, age 50 to 65 years, and a history of falls (previous 12 months) were included. Those with neurological or musculoskeletal disorders, vestibulopathies, drugs use that could affect balance and osteoporosis were excluded. The intervention time was 9 months. Postural balance was assessed by stabilometry (computerized force platform) and investigation on the occurrence/rec...
Sat, 27 Feb 2016 07:21:23 +0100Objective: The study aims to evaluate the effectiveness and safety of Chinese herbal medicine granules Danzhi Qing’e formula (DZQE), Erzhi formula (EZ), and their combination (Combined formula) in the treatment of menopausal symptoms at different stages of menopause. Methods: Women between the ages of 40 to 60 years, who met menopausal symptoms diagnostic criteria and experienced hot flushes at least 14 times/week in the last 4 weeks, were recruited to participate in a stratified randomized, double-blind, placebo-controlled clinical trial (n = 389). They received a treatment period of 8 weeks and were followed up for 4 weeks. Participants were categorized into two subgroups: 197 in the perimenopausal subgroup (menstrual disorder to 1 y after amenorrhea) and 192 in the early postme...
Fri, 26 Feb 2016 22:43:03 +0100CONCLUSION: Preeclampsia is mainly due to decreased excretion of norepinephrine and other vasoactive amines. PMID: 26910507 [PubMed - as supplied by publisher] (Source: Hypertension in Pregnancy)
Thu, 25 Feb 2016 00:00:00 +0100Conclusion This technique of laparoscopic reconstruction of vagina in transverse vaginal septum avoided the abdominal incision leading to pain and adhesion formation. It provided a better view for dissection. This technique created a patent vagina in a single sitting with no postoperative dysparunia and restoration of fertility. (Source: Journal of Minimally Invasive Gynecology)
Thu, 25 Feb 2016 00:00:00 +0100Imperforate hymen with hematometrocolpos in adolescent females is a rare pediatric condition. Classical presentation includes abdominal pain or a pelvic mass in female patients with primary amenorrhea. Atypical complaints and reluctance among emergency physicians to perform genital examination in the emergency department or the pediatric emergency department (PED) may delay correct diagnosis. (Source: The Journal of Emergency Medicine)
Fri, 19 Feb 2016 14:08:31 +0100We present a case of primary amenorrhea due to the rare clinical syndrome of Testicular Regression Syndrome. (Source: Journal of Pediatric and Adolescent Gynecology)
Fri, 19 Feb 2016 14:08:30 +0100Hormonal contraception is indicated for menstrual management and/or contraception in the transgender female-to-male (FTM) population (transmen). Gender dysphoria increases in some patients after menarche, leading patients to seek menstrual management. Although testosterone therapy often leads to amenorrhea, it is not a contraceptive, and cases of pregnancy have been reported among transmen on testosterone. Thus, transmen who are sexually active with natal males are at risk for unintended pregnancy. (Source: Journal of Pediatric and Adolescent Gynecology)
Fri, 19 Feb 2016 14:08:30 +0100Sex cord stromal tumor, steroid cell, NOS is a rare tumor that accounts for < 0.1% of all ovarian tumors1. These tumors often have androgenic and virilizing symptoms. (Source: Journal of Pediatric and Adolescent Gynecology)
Fri, 19 Feb 2016 10:54:03 +0100DISCUSSION: To our knowledge, this is the first study to present evidence of a link between childhood stressors, menstrual cycle disruption and fertility difficulties. The effect of childhood stress on fertility may be mediated through altered functioning of the HPA axis, acting to suppress fertility in response to less than optimal reproductive circumstances. PMID: 25826282 [PubMed - in process] (Source: Journal of Psychosomatic Obstetrics and Gynaecology)
Thu, 18 Feb 2016 11:12:02 +0100Authors: Paz-Filho GJ Abstract Leptin, an adipokine synthesized and secreted mainly by the adipose tissue, has multiple effects on the regulation of food intake, energy expenditure, and metabolism. Its recently-approved analogue, metreleptin, has been evaluated in clinical trials for the treatment of patients with leptin deficiency due to mutations in the leptin gene, lipodystrophy syndromes, and hypothalamic amenorrhea. In such patients, leptin replacement therapy has led to changes in brain structure and function in intra- and extrahypothalamic areas, including the hippocampus. Furthermore, in one of those patients, improvements in neurocognitive development have been observed. In addition to this evidence linking leptin to neural plasticity and function, observational studies ev...
Thu, 18 Feb 2016 00:00:00 +0100ConclusionClinical hyperandrogenism is not a good predictor for biochemical hyperandrogenism in Thai women with PCOS. A modified Ferriman–Gallwey score cut‐off point of 8 has low sensitivity but high specificity for hyperandrogenemia; therefore, it is useful for the diagnosis but not useful for the exclusion of hyperandrogenemia in Thai women with PCOS. (Source: Journal of Obstetrics and Gynaecology Research)
Thu, 18 Feb 2016 00:00:00 +0100Conclusion: About 50% of the pts considered not to have received adequate information on fertility and other gynaecological consequences of anti cancer treatment.This study shows how important gynaecologic considerations are for young breast cancer patients. Information about impact of treatment, fertility preservation techniques and symptoms of premature ovarian failure should be part of the treatment of these patients. Specific time should be devoted during the different consultations before, during and after treatments.Citation Format: Mailliez A, Bregegere S, Bonneterre J. Fertility and other gynaecological concerns in young women treated with chemotherapy for breast cancer between 2003 and 2012. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cance...
Thu, 18 Feb 2016 00:00:00 +0100Background: Chemotherapy-related amenorrhea (CRA) impacts quality of life and reproductive options, and may play a role in treatment decision-making for young breast cancer patients. Although age, increasing doses of alkylating agents, and tamoxifen are known to increase the risk of chemotherapy-related amenorrhea (CRA), it is difficult to predict which women will develop CRA in order to inform fertility preservation and treatment decisions. We sought to investigate whether single nucleotide polymorphisms (SNPs) that have been associated with a younger age at natural menopause and ovarian reserve in non-oncologic populations were predictive of CRA in two large German clinical trials that administered gonadotoxic chemotherapy.Methods: A total of 1322 premenopausal participants under age 50 ...
Tue, 16 Feb 2016 00:00:00 +0100Conclusions Treatment of FtM gender dysphoric adolescents with lynestrenol monotherapy and in combination with testosterone esters is effective, safe, and inexpensive; however, suppression of gonadotropins is incomplete. Regular blood controls allow screening for unphysiological changes in safety parameters or hormonal levels and for medication abuse. (Source: Biology of Sex Differences)
Tue, 16 Feb 2016 00:00:00 +0100CONCLUSION: Amniotic fluid embolism is a rare and difficult diagnosis, especially in unconventional settings, yet it can be facilitated by screening for amniotic markers and tryptase. PMID: 26883961 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)
Tue, 16 Feb 2016 00:00:00 +0100CONCLUSION: These results emphasize the challenge in determining definitive menopause in women with chemotherapy-induced amenorrhea. The risk of OFR during treatment with AIs in amenorrheic women in their 40s is high, and AI therapy should be avoided in these patients. PMID: 26884554 [PubMed - as supplied by publisher] (Source: Clinical Genitourinary Cancer)
Mon, 15 Feb 2016 00:00:00 +0100Suleyman Sahin, Fatih Karatas, B Hacioglu, A Aytekin, I Imamoglu, N Koseoglu, E Sari, M AltinbasJournal of Cancer Research and Therapeutics 2015 11(4):1024-1024 Krukenberg tumor (KT), mostly originates from gastric cancer, is the metastatic tumor of ovaries accounting for 1–2% of all ovarian cancer. Common presenting symptoms include abdominal pain, distension, and ascites. Rests of the patients have non-specific gastrointestinal symptoms including dyspepsia, weight loss, nausea and vomiting. Gynecologic symptoms such as virilization, menstrual bleeding or irregularity and amenorrhea are much less frequent in the literature cases. Here, we present an unusual case of KT presented with amenorrhea as the sole initial symptom. (Source: Journal of Cancer Research and Th...
Sun, 14 Feb 2016 14:57:02 +0100CONCLUSION: Ulipristal acetate has been shown to induce amenorrhea rapidly in women with uterine fibroids, and it can be a useful treatment in the emergency management of fibroid-related acute abnormal uterine bleeding. PMID: 26872761 [PubMed - as supplied by publisher] (Source: Journal of Obstetrics and Gynaecology Canada : JOGC)
Fri, 12 Feb 2016 00:00:00 +0100CONCLUSION: Kangaroo care for LBW infants is highly effective in our context. This method should be spread to a large majority of health centers in the country. PMID: 26879969 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)
Wed, 10 Feb 2016 00:00:00 +0100Imperforate hymen prevents menstrual blood drainage, which causes cyclic lower abdominal pain and amenorrhea. Untreated cases may develop serious complications as endometriosis and infertility. Hymenectomy represents the adequate treatment. (Source: Journal of Pediatric and Adolescent Gynecology)
Fri, 05 Feb 2016 00:00:00 +0100We report a case of 20-year-old female who presented with primary amenorrhea to our department. Investigations revealed the absence of female internal genitalia and the presence of testes on MRI in the inguinal canal under the skin. Gonadectomy was done and she was put on female hormone replacement therapy. (Source: The Egyptian Journal of Radiology and Nuclear Medicine)
Sat, 23 Jan 2016 14:04:46 +0100Individuals with a history of obesity or overweight represent a substantial portion of adolescents presenting for evaluation of eating disorders (ED). One of the medical complications of weight loss in patients with ED is amenorrhea, which is associated with reduced bone mineral density and increased fracture risk. Return of menses (ROM) usually accompanies weight restoration and is a clinical marker of return to health. However, biological and behavioral factors including prior weight status could affect ROM, but these have not been examined in adolescents. (Source: Journal of Adolescent Health)
Thu, 21 Jan 2016 09:34:02 +0100CONCLUSION: Pituitary metastasis of GTN is possible and is a curable disease that should be considered in young women with a history of choriocarcinoma who have neurologic symptoms. This metastasis responds well to chemotherapy. PMID: 26775466 [PubMed - in process] (Source: Journal of Reproductive Medicine)
Thu, 21 Jan 2016 00:00:00 +0100CONCLUSIONS: The risk of high frequency headache is increased in women during the perimenopause compared to premenopause in the fully adjusted model. The fact that the increased risk of high frequency headache was not statistically significant for menopause in the fully adjusted models suggests that different mechanisms might account for the increased risk for this stage of the menopausal transition. Recognition of the increased risk of high frequency headache during the menopausal transition suggests a need for optimized preventive treatment of migraine during this time of women's life. PMID: 26797693 [PubMed - as supplied by publisher] (Source: Headache)
Wed, 20 Jan 2016 19:51:03 +0100Authors: Parlak M, Ellidağ HY, Türkkahraman D Abstract Congenital adrenal hyperplasia (CAH) describes a group of disorders characterized by enzyme defects in adrenal steroidogenesis. 21-hydroxylase deficiency (21-OHD) is the most commonly encountered form. The analysis of steroids in pediatric cases requires high-sensitivity assays. A 14-year-old Syrian girl was referred for evaluation of short stature, amenorrhea, and hirsutism. On physical examination, breast development was Tanner stage 1. She had a phallic clitoris with a single urogenital orifice. Laboratory findings revealed primary adrenal deficiency with high androgen levels and low levels of 17-hydroxyprogesterone (17-OHP), (<0.05 ng/mL) and estrogen. This unexpected result led to suspicion of a high-dose hook effect....
Mon, 18 Jan 2016 00:00:00 +0100Abstract This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN...
Sat, 16 Jan 2016 00:00:00 +0100Conclusion These aforementioned results suggest that F. umbellata extracts as used by the traditional practitioner have estrogen-like effects and may alleviate some menopausal problems such as vaginal dryness and hot flushes. Graphical abstract (Source: Journal of Ethnopharmacology)
Fri, 15 Jan 2016 07:35:03 +0100CONCLUSION: Presence of such mutation and polymorphism is a significant indicator of 5αRD2 deficiency in Southeast region of Turkey where consanguineous marriage is highly common. PMID: 26761946 [PubMed - as supplied by publisher] (Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology)
Fri, 15 Jan 2016 07:20:02 +0100CONCLUSIONS: Sheehan's syndrome is still common in Xinjiang, especially in rural areas. Long diagnosis delay in most of the patients indicates that women might be lacking correct diagnosis and treatment. Physicians need to be aware of the most important clues for diagnosis such as lack of lactation in the postpartum period and failure to resume menstruation. PMID: 26732159 [PubMed - as supplied by publisher] (Source: Hormones)
Wed, 13 Jan 2016 22:46:48 +0100Conclusion: In case of persistent primary amenorrhea, despite estrogen replacement, this unusual combination should be considered in girls with CHARGE syndrome.Horm Res Paediatr (Source: Hormone Research in Paediatrics)
Wed, 13 Jan 2016 00:00:00 +0100ConclusionPeople with AN have reduced BMD, increased odds of osteoporosis and risk of fractures. Proactive monitoring and interventions are required to ameliorate bone loss in AN. (Source: Acta Psychiatrica Scandinavica)
Wed, 13 Jan 2016 00:00:00 +0100We report three cases of Craig’s disease diagnosed at ultrasound: one at 26 weeks of amenorrhea and two others at 30 weeks of amenorrhea. We discuss according to the literature the main ultrasound aspects and specify the place of other radiographic explorations during the monitoring of this condition. (Source: Journal of Diagnostic Medical Sonography)
Mon, 11 Jan 2016 00:00:00 +0100Conclusion UAE could be considered as a minimally invasive treatment option for patients with adenomyosis. Further research to compare the efficacy and safety of UAE with conventional hysterectomy is warranted. (Source: International Journal of Gynecology and Obstetrics)
Tue, 05 Jan 2016 00:00:00 +0100In 40 women with Functional Hypothalamic Amenorrea, 4 women had elevated Anti Mullerian Hormone and increased ovarian volume and higher testosterone suggesting the possible co-existence of Polycystic Ovary Syndrome. Functional Hypothalamic Amenorrhea may develop in some women with ovulatory Polycystic Ovary Syndrome. (Source: American Journal of Obstetrics and Gynecology)
Tue, 05 Jan 2016 00:00:00 +0100Functional hypothalamic amenorrhea is a disorder characterized by cessation of menstrual cycles in the absence of organic disease. In most patients, it occurs in adult life after a stressful event and may be related to a condition of mild chronic energy deprivation. The endocrine pattern is characterized by low estrogen levels with an absent response to a progestogen challenge test and low-normal gonadotropin levels. A few studies have shown that some of these women may have some features of polycystic ovary syndrome; these features include an increased androgen response to gonadotropins, increased anti-Mullerian hormone levels, and altered ovarian morphology or increased ovarian size. These findings suggest a link between these 2 completely different disorders: functional hypothalamic am...
Fri, 01 Jan 2016 00:00:00 +0100ConclusionsThe risk of high frequency headache is increased in women during the perimenopause compared to premenopause in the fully adjusted model. The fact that the increased risk of high frequency headache was not statistically significant for menopause in the fully adjusted models suggests that different mechanisms might account for the increased risk for this stage of the menopausal transition. Recognition of the increased risk of high frequency headache during the menopausal transition suggests a need for optimized preventive treatment of migraine during this time of women's life. (Source: Headache: The Journal of Head and Face Pain)
Mon, 21 Dec 2015 00:00:00 +0100In conclusion, cyclophosphamide was efficacious and led to sustained response of severe NPSLE in a cohort with long follow-up. PMID: 26692040 [PubMed - as supplied by publisher] (Source: Lupus)
Sun, 20 Dec 2015 23:44:52 +0100Authors: Romano ME, Lomenick JP, Callahan ST PMID: 23162941 [PubMed - indexed for MEDLINE] (Source: Adolescent Medicine: State of the Art Reviews)
Sun, 20 Dec 2015 22:56:44 +0100Authors: Warenik-Szymankiewicz A, Słopień R, Pawlak M, Sajdak S Abstract The authors present a case of a pregnancy after ovarian wedge resection by laparotomy after unsuccessful ovarian drilling. A 28-year- old patient was admitted to the present outpatient clinic because of infertility, secondary amenorrhea, and hirsutism. Three years prior she had undergone laparoscopic ovarian drilling with no effect on menstrual pattern and fertility. After clinical and ultrasonographic ex- aminations, polycystic ovarian syndrome (PCOS) was diagnosed and consequently laparotomy with ovarian wedge resection was de- cided upon. Six weeks later patient was diagnosed with an early pregnancy. PMID: 26524825 [PubMed - in process] (Source: Clinical and Experimental Obstetrics and Gynecology)
Sun, 20 Dec 2015 22:56:44 +0100CONCLUSIONS: Endometrial preparation with endometrial curettage seems to be a good alternative to hormonal pretreatment. It has the advantage of avoiding delays, side effects, and cost of hormonal pretreatment. Moreover, microwave endometrial ablation after endometrial curettage is successful and highly acceptable. PMID: 26411213 [PubMed - indexed for MEDLINE] (Source: Clinical and Experimental Obstetrics and Gynecology)
Sun, 20 Dec 2015 22:56:44 +0100CONCLUSION: This exploratory study highlights some potential associations between first trimester drug exposure and risk of spontaneous abortion. Further studies have to be carried out to investigate these findings. PMID: 26411206 [PubMed - indexed for MEDLINE] (Source: Clinical and Experimental Obstetrics and Gynecology)
Sun, 20 Dec 2015 22:56:44 +0100CONCLUSION: In women with DUB, endometrial ablation with Novasure bipolar radiofrequency impedance-controlled system is associated with increased rates of amenorrhea at 12-months post-treatment as compared to the MEA method. PMID: 26152008 [PubMed - indexed for MEDLINE] (Source: Clinical and Experimental Obstetrics and Gynecology)
Sun, 20 Dec 2015 21:10:21 +0100The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. CLINICAL NEED AND TARGET POPULATION: CELIAC DISEASE: Celiac disease is an autoimmune disease characterized by a chronic inflammatory state of the proximal small bowel mucosa accompanied by structural and functional changes. TECHNOLOGY UNDER EVALUATION: SEROLOGIC TESTS FOR CELIAC DISEASE: There are a numbe...
Fri, 18 Dec 2015 00:00:00 +0100Conclusions A combination of patient amenorrhea, BMI, total testosterone, anti-Müllerian hormone, ovarian volume, ovarian stromal artery pulsatility index, and visceral fat area could be used to predict clomiphene-citrate treatment response in patients with PCOS experiencing infertility. ClinicalTrials.gov: NCT02269306 (Source: International Journal of Gynecology and Obstetrics)
Thu, 17 Dec 2015 00:00:00 +0100Conclusions Based on these high rates of childbirth following BEACOPP chemotherapy, we have concluded that intensified chemotherapy is not a definite predictor of reduced fertility in young HL patients. (Source: Journal of Assisted Reproduction and Genetics)
Thu, 17 Dec 2015 00:00:00 +0100Abstract In neuroendocrine system the increase in oxidative status is produced by a glucocorticoid—dependent and transcriptional increase in pro-oxidative drive, with concurrent inhibition of the antioxidant defense system, ultimately leading to increased neuronal cell death. Functional hypothalamic disturbances and neuroendocirne aberrations have both short and long term consequences for reproductive health. Understandably, an impaired or diminished hypothalamic–pituitary–ovarian axis leads to anovulation and hypoestrogenism. Anovulation is directly linked to the neurohormonal and hormonal background of Functional Hypothalamic Amenorrhea. Impairment of pulsatile Gonadotropin Releasing Hormone secretion causes the impairment of pulsatile Lutenizing Hormone (LH) and Follicle ...
Wed, 16 Dec 2015 00:00:00 +0100CONCLUSIONS: In the absence of CYC treatment, the prevalence of POF in lupus patients is consistent with that reported in the general population. The existence of autoimmune processes at the ovary seems unlikely in most lupus patients. PMID: 26678443 [PubMed - as supplied by publisher] (Source: Lupus)
Sat, 12 Dec 2015 01:53:32 +0100Authors: Karimi-Zarchi M, Mousavi A, Gilani MM, Barooti E, Miratashi-Yazdi A, Dehghani A Abstract PURPOSE OF REVIEW: The aim of this study was to describe fertility preservation methods to improve quality of life of early stages of cervical cancer. RECENT FINDING: Although definite treatment of early stages of cervical cancer including stages IA,IB1 and IIA non-bulky is radial hysterectomy, this method is used in perimenopousal period in which fertility preservation is not important. Whenever fertility preservation is so important, some methods like radical trachelectomy and laparoscopic lymphadenectomy are used to rule out lymphatic metastases. SUMMARY: If any visible lesion on cervix is found, pelvic MRI is helpful and during operation, trachelectomy samples are sent for ...
Thu, 10 Dec 2015 00:00:00 +0100CONCLUSIONS: Symptoms or diagnosis of PCOS are associated with dyslipidemia, hyperandrogenemia and significantly increased weight gain especially in early adulthood. This observation is important as it may identify a sensitive time period when weight gain plays a crucial role in the emergence of PCOS and when preventive actions against metabolic and cardiovascular diseases should be implemented. PMID: 26652764 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Wed, 09 Dec 2015 16:28:03 +0100Authors: Yang BQ, Xu JH, Teng YC Abstract At present, there have been no standard research outcomes as to whether the levonorgestrel intrauterine system (LNG-IUS) or thermal balloon ablation (TBA) is superior for the treatment of patients suffering from heavy menstrual bleeding (HMB). Therefore, in the present study, a meta-analysis of randomized controlled trials (RCTs) was conducted in order to compare the effectiveness and affordability of the LNG-IUS with TBA in the treatment of HMB. A literature search of the following electronic databases was conducted: PubMed, EMBASE, the Cochrane Library, Google Scholar, the Chinese Scientific Journals Database, and the China National Knowledge Infrastructure; and a statistical analysis was performed using RevMan 5.2 software. Seven RCTs in...
Tue, 08 Dec 2015 00:00:00 +0100Conclusion In the treatment of heavy menstrual bleeding, bipolar radiofrequency endometrial ablation is superior to balloon endometrial ablation as an office procedure in amenorrhea rate, patient satisfaction and quality of life. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)
Tue, 08 Dec 2015 00:00:00 +0100Despite renewed interest in postpartum family planning programs, the question of the time at which women should be expected to start contraception after a birth remains unanswered. Three indicators of postpartum unmet need consider women to be fully exposed to the risk of pregnancy at different times: right after delivery (prospective indicator), after six months of amenorrhea (intermediate indicator), and at the end of amenorrhea (classic indicator). DHS data from 57 countries in 2005–13 indicate that 62 percent (prospective), 43 percent (intermediate), and 32 percent (classic) of women in the first year after a birth have an unmet need for contraception (40 percent when including abstinence). While the protection afforded by postpartum abstinence and lactational amenorrhea lowers unmet...
Tue, 08 Dec 2015 00:00:00 +0100This article provides programmatic guidance and identifies future research priorities through a review of interventions to improve postpartum contraception. Thirty‐five interventions in low‐ and middle‐income countries were identified and classified according to timing and nature of administration: antenatal, postnatal, both ante‐ and postnatal, and integration with other services. With the exception of single, short antenatal interventions, the evidence of impact is positive but incomplete. A major gap in knowledge concerns demand for, and means of promoting, immediate postpartum family planning services in Asia and Africa. Counseling before discharge is likely to have an impact on subsequent contraceptive uptake. Integration of family planning into immunization and pediatric serv...
Tue, 08 Dec 2015 00:00:00 +0100Nidhi Agrawal, Harsh Vardhan, Singh Khokhar, Naresh Rai, Rajeev Saxena, Shahida RiyazJournal of Cytology 2015 32(4):284-286Steroid cell tumors (SCTs) of the ovary are a rare subgroup of sex cord tumors that account for less than 0.1% of all ovarian tumors. These tumors can produce steroids, especially testosterone, which produces symptoms such as hirsutism, amenorrhea/oligomenorrhea, and male patterned voice. For evaluation of the androgen excess, testosterone and dehydroepiandrosterone sulfate (DHEA-S) are the first laboratory tests to be measured. Abdominal ultrasound and magnetic resonance imaging (MRI) are useful radiologic imaging techniques. Although SCTs are generally benign, the risk of malignant transformation is always present. Surgical excision of tumor is the most import...
Tue, 08 Dec 2015 00:00:00 +0100CONCLUSION: Successful live birth was achieved in a woman with 17-hydroxylase deficiency through IVF, cryopreservation of all embryos and FET after adequate endometrial preparation. PMID: 26647153 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Sun, 06 Dec 2015 00:00:00 +0100The objective of this study was to investigate fracture risk in PCOS. In the PCOS Denmark study, women with PCOS and/or hirsutism were identified in the Danish National Patient Register (1995–2012). Each patient was assigned three age‐matched controls on the index date of PCOS diagnosis. Individuals with a previous endocrine diagnosis were excluded. Within PCOS Denmark, we embedded a well‐characterized subcohort of patients, PCOS OUH, diagnosed with PCOS at Odense University Hospital (n = 1217). We identified incident fractures by International Classification of Diseases, 10th Revision (ICD‐10) codes and used conditional Cox regression analyses to compare fracture risk. In the PCOS Denmark study, there were 19,199 women with PCOS and 57,483 controls were included, mean age 30.6...
Thu, 03 Dec 2015 00:00:00 +0100We present a case of PSTS ascertained after breech delivery. A 20‐year‐old woman presented with primary amenorrhea. The patient was born by breech delivery and had a history of treatment for pituitary dwarfism. Her laboratory findings showed pituitary hypothyroidism, and hormone replacement therapy was initiated. At 28 years old, she became pregnant and had a normal delivery at 38 weeks' gestation. One year after delivery, her thyroid hormone level changed. Laboratory test showed adrenocortical insufficiency, and magnetic resonance imaging of the pituitary gland showed transection of the pituitary stalk and development of an ectopic posterior lobe. These findings were compatible with PSTS. When a patient who has been born by breech delivery presents with symptoms of pituitary deficienc...
Thu, 03 Dec 2015 00:00:00 +0100Conclusion In our study, a self-performed LSUP test showed good concordance with blood test and appeared to be relevant, efficient and safe for women to monitor MToP success. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)
Wed, 02 Dec 2015 22:17:52 +0100Authors: Laggari V, Christogiorgos S, Deligeoroglou E, Tsiantis J, Creatsas G Abstract Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) is characterized by complete or partial absence of the vagina, uterus and proximal fallopian tubes and diagnosis is usually made in late adolescence, when primary amenorrhea appears as the major symptom. Polycystic Ovary Syndrome (PCOS), which is the most common endocrine disorder among women of reproductive age, includes a variety of clinical manifestations (menstrual irregularities, hirsuitism, acne, alopecia, obesity and infertility), due to androgen hypersecretion, insulin resistance and chronic anovulation. Both MRKHS and PCOS have been studied concerning the psychological aspects and have been associated with emotional distress as well as sel...
Mon, 30 Nov 2015 00:00:00 +0100To identify factors associated with cancer treatment–induced amenorrhea and time to return of menses. (Source: Fertility and Sterility)
Sun, 29 Nov 2015 00:00:00 +0100CONCLUSIONS: From our data, 12% of SLE patients developed POF. A cumulative dose of CYC of more than 10 g was the only risk factor for POF. To prevent these events, systematic evaluation and early recognition of POF should be promoted in the care of SLE patients. PMID: 26621134 [PubMed - as supplied by publisher] (Source: Lupus)
Fri, 27 Nov 2015 00:00:00 +0100To evaluate uterine development by estrogen replacement therapy in patients with primary amenorrhea due to hypogonadism. (Source: Journal of Pediatric and Adolescent Gynecology)
Wed, 25 Nov 2015 00:00:00 +0100Conclusion Temporary ovarian suppression with LHRHa in young breast cancer patients is associated with a reduced risk of chemotherapy-induced POF and seems to increase the pregnancy rate, without an apparent negative consequence on prognosis. (Source: Annals of Oncology)
Wed, 25 Nov 2015 00:00:00 +0100Conclusions Inequalities in the use of contraception between Roma and non-Roma women exist. Promoting modern methods of contraception and education about the importance of the use of contraception should be in the focus of national health policies and strategies related to reproductive health to reduce these inequalities. (Source: Journal of Public Health)
Fri, 20 Nov 2015 03:02:04 +0100Authors: Lange R, Von Linsingen C, Mata F, Moraes AB, Arruda M, Vieira Neto L Abstract Ring chromosomes (RCs) are uncommon cytogenetic findings, and RC11 has only been described in 19 cases in the literature. Endocrine abnormalities associated with RC11 were reported for two of these cases. The clinical features of RC11 can result from an alteration in the structure of the genetic material, ring instability, mosaicism, and various extents of genetic material loss. We herein describe a case of RC11 with clinical features of 11q-syndrome and endocrine abnormalities that have not yet been reported. A 20-year-old female patient had facial dysmorphism, short stature, psychomotor developmental delays, a ventricular septal defect, and thrombocytopenia. Karyotyping demonstrated RC11 (46,XX...
Fri, 20 Nov 2015 00:31:36 +0100CONCLUSION: In menopausal patients with low FSH and no return of menstrual cycles, further investigations should be pursued in order to exclude a possible pituitary mass. PMID: 25330695 [PubMed - indexed for MEDLINE] (Source: Journal of Reproductive Medicine)
Thu, 19 Nov 2015 23:57:44 +0100CONCLUSION: To conclude, PMSI data are apparently becoming more and more reliable for two reasons: on one hand, the importance of these data for budgetary promotion in hospitals; on the other, the increasing use of this information for statistical and epidemiological purposes. PMID: 26143088 [PubMed - in process] (Source: Revue d Epidemiologie et de Sante Publique)
Wed, 18 Nov 2015 20:16:05 +0100We present a case of Roberts syndrome, diagnosed in moment of delivery, after a pregnancy without prenatal follow-up. The stillborn baby was naturally delivered by a 17-year-old primiparous woman at 38 weeks of amenorrhea. The pregnancy was not followed due to socioeconomic and family situation, and no prenatal ultrasound was performed. The male baby has 2650 g and presented several morphological abnormalities and tight double umbilical abdominal loop. The macroscopic evaluation showed: dolichocephaly, hypoplastic inferior maxilla with micrognathia, antimongoloid palpebral slant, pterygium colli, abnormal and lower implanted ears, superior limbs phocomelia, syndactyly at lower left limb and tetradactyly in all limbs, bilateral cryptorchidism, pancreatic aplasia. Roberts syndrome is a rare ...
Wed, 18 Nov 2015 15:58:48 +0100Trachyspermum ammi commonly known as Ajwain in India is distributed throughout India and is mostly cultivated in Gujarat and Rajasthan. The fruit possesses stimulant, antispasmodic and carminative properties and is used traditionally as an important remedial agent for flatulence, atonic dyspepsia, diarrhea, abdominal tumors, abdominal pains, piles, bronchial problems, lack of appetite, galactogogue, asthma and amenorrhea. Medicinally, it has been proven to possess various pharmacological activities like antifungal, antioxidant, antimicrobial, antinociceptive, cytotoxic, hypolipidemic, antihypertensive, antispasmodic, broncho-dilating actions, antilithiasis, diuretic, abortifacient, antitussive, nematicidal, anthelmintic and antifilarial. Further, studies reveal the presence of ...
Mon, 16 Nov 2015 00:00:00 +0100A 32-year-old pregnant (20 weeks of amenorrhea) woman, after change in dietary intake (due to a trip to Korea), developed over 3 weeks progressive neuropsychological disorders associated with behavior disorders. The patient rapidly worsened, and had impaired consciousness and a coma. Biological tests showed hyperammonemia (173 µmol/L), glutamine chromatographic peak, and increased urinary orotic acid concentration. Brain MRI (figure 1) and spectroscopy (figure 2) findings were consistent with urea cycle disorders.1,2 A novel heterozygous mutation p.Ala209Glu (c.626C>A) in OTC gene was identified. She was treated with sodium benzoate, sodium phenylacetate, citrulline, hemofiltration, and reduced protein intake. Consciousness improved, and pregnancy was carried to completion, but mi...
Sat, 14 Nov 2015 00:00:00 +0100Conclusion: The clinical and molecular findings reported here provide further evidence that 5q31.3 microdeletion syndrome is a clinically discernible PURA-related disorder and describe the previously unreported natural evolution of the disease in a 26 years old patient. (Source: Molecular Cytogenetics)
Fri, 13 Nov 2015 00:00:00 +0100This study tested only three chemotherapeutic agents. The experimental methodology described here could be applied to other drugs for detailed analysis of their ovarian cytotoxicity. WIDER IMPLICATIONS OF THE FINDINGS These findings indicate that in vivo and in vitro cytotoxic actions of chemotherapy drugs on the ovarian follicles and granulosa cells vary depending upon the their mechanism of action and the nature of the granulosa cells. STUDY FUNDING/COMPETING INTEREST(S) The School of Medicine and the Graduate School of Health Sciences of Koc University, and American Hospital Women's Health Center, Comprehensive Cancer Care and Fertility Preservation Programs, Istanbul Turkey. All authors declare no conflict of interest. (Source: Human Reproduction)
Fri, 13 Nov 2015 00:00:00 +0100In premenopausal women, amenorrhea contributes to endothelial dysfunction. It is unknown whether this vascular functional change is associated with vascular structural change. (Source: Atherosclerosis)
Mon, 09 Nov 2015 19:51:21 +0100Conclusion: ETV may be followed by endocrinological complications like amenorrhea that are rarely reported.Pediatr Neurosurg (Source: Pediatric Neurosurgery)
Sat, 07 Nov 2015 17:22:02 +0100We report an Arab family with four affected XX siblings. The eldest presented with abdominal pain and was diagnosed with a retroperitoneal malignant mixed germ cell tumour. She was hypertensive and hypogonadal. One sibling presented with headache due to hypertension while the other two siblings were diagnosed with hypertension on a routine school check. A homozygous R96Q missense mutation in P450c17 was detected in the index case who had primary amenorrhea and lack of secondary sexual characters at 17 years. The middle two siblings were identical twins and had no secondary sexual characters at the age of 14. All siblings had hypokalemia, very low level of adrenal androgens, high ACTH and high levels of aldosterone substrates. Treatment was commenced with steroid replacement and puberty ind...
Thu, 05 Nov 2015 00:00:00 +0100ConclusionIncreased plasma total cholesterol was related to amenorrhea in adolescent girls with eating disorders and weight loss. Oestrogens appeared to mediate the effect of starvation on cholesterol, most effectively in premenarcheal girls. Re‐establishing menstruation is an important goal in the treatment of eating disorders, in order to avoid dyslipidaemia and the risk of future cardiovascular disease.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)
Thu, 05 Nov 2015 00:00:00 +0100Conclusion The Minerva system was found to be safe and effective for treating patients suffering from menorrhagia. The procedure is quick and effective, does not require endometrial pretreatment, and precludes the need for additional surgical interventions to manage menorrhagia. (Source: Journal of Minimally Invasive Gynecology)
Sun, 01 Nov 2015 00:00:00 +0100ConclusionWomen with PCOS had reduced risk of fractures, in particular of the appendicular skeleton. The risk reduction was greater in women with younger age at diagnosis suggesting that the skeletal effects of PCOS may be greater in women who have not yet reached peak bone mass. Reduced participation in sports activities was probably not the reason for the reduced risk of fractures. This article is protected by copyright. All rights reserved (Source: Journal of Bone and Mineral Research)
Sun, 01 Nov 2015 00:00:00 +0100Authors: Keskin MZ, Budak S, Can E, İlbey YÖ Abstract Vesicouterine fistula (VUF) is a very rare occurrence and is estimated to occur in only 1-4% of all genitourinary fistulas; 90% of cases are Youssef syndrome, which is accompanied by amenorrhea and cyclic hematuria (menouria). In this article, a renal transplant donor who was incidentally diagnosed with Youssef syndrome 20 years after a second cesarean delivery. PMID: 26834907 [PubMed] (Source: Canadian Urological Association Journal)
Sat, 31 Oct 2015 20:06:03 +0100Authors: Hoffmanová I, Sánchez D, Džupa V Abstract Celiac disease (gluten-sensitive enteropathy) is currently regarded as a multisystem autoimmune disorder; its clinical signs and symptoms do not involve merely the gastrointestinal tract but are associated with several other medical specialties, including orthopaedics and traumatology. In orthopaedic and trauma patients, celiac disease should be suspected in the following diagnoses: osteomalacia, premenopausal osteoporosis, post-menopausal osteoporosis more severe than expected and refractory to medication, osteoporosis in men under 55 years of age, recurrent bone fractures in the limbs, large joint arthralgia or arthritis of unclear aetiology, erosive spondyloarthropathy particularly in patients with the history of chronic diar...
Sat, 31 Oct 2015 00:00:00 +0100CONCLUSION: The absence of laminaria and the reduction of the interval mifepristone-misoprostol of 24hours do not change the time to delivery and allow to reduce the duration of hospitalization, the number of emergency pretreatment-induced fetal death and the cost of the TOP. PMID: 26530171 [PubMed - as supplied by publisher] (Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction)
Fri, 30 Oct 2015 14:24:34 +0100This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics. (Source: Clinical Obstetrics and Gynecology)
Wed, 28 Oct 2015 19:31:41 +0100Turner syndrome is a form of gonadal dysgenesis that affects 1/2500 live births. Patients often have streak gonads and may present with primary amenorrhea or premature ovarian failure. Patients with a mosaic karyotype that includes a Y chromosome are at increased risk for gonadoblastoma and subsequent transformation into malignancy. Gonadectomy is recommended for these patients, typically at adolescence. The following video highlights a case of a laparoscopic bilateral salpingo-oopherectomy for streak gonads in a patient with Turner syndrome. (Source: The Journal of Minimally Invasive Gynecology)
Wed, 28 Oct 2015 19:25:41 +0100Congenital absence of the uterine cervix associated with a functioning endometrium is a rare Müllerian anomaly, often accompanied by a partial or complete absence of the vagina. Amenorrhea and cyclic lower abdominal pain are the first symptoms presenting in a pubescent girl, and can be associated with upper abdominal pain and fever. In the past, the surgical solutions offered went from hysterectomy with the creation of a neovagina, to the recanalisation around stents of the rudimentary cervix. This video shows our technique for the anastomosis of the hysterotomy site with the residual vaginal vault apex or with the vestibular mucosa by means of a combined laparoscopic-perineal approach. (Source: The Journal of Minimally Invasive Gynecology)
Wed, 28 Oct 2015 19:24:13 +0100A 31-year-old woman, presented with amenorrhea, 9 months after stopping of breastfeeding. Ultrasound and MRI revealed a 3.2 cm solid lesion, arising from the uterine wall. Serum hCG was slightly elevated (16 IU/L, normal value (Source: The Journal of Minimally Invasive Gynecology)
Sun, 25 Oct 2015 23:26:26 +0100Uterine anomalies are a potential cause for amenorrhea, infertility, and abnormal obstetrical outcomes in young women . Uterine anomalies occur due to failed formation or fusion of the paired Müllerian ducts early in embryonic life and are also referred to as Müllerian duct anomalies. Uterine anomalies may also be associated with symptoms of pain or a mass due to hematometros, hematocolpos, endometriosis, or ectopic pregnancy . The overall incidence of uterine anomalies is often quoted to be 2%-3%. (Source: Canadian Association of Radiologists Journal)
Sat, 24 Oct 2015 00:00:00 +0100To compare the effectiveness of bipolar radiofrequency (Novasure®) ablation and balloon endometrial ablation (Thermablate®).Study design: We performed a multi-center double blind, randomized controlled trial in three hospitals in The Netherlands. Women with heavy menstrual bleeding were randomly allocated to bipolar or balloon endometrial ablation, performed in the office, using a paracervical block. The primary outcome was amenorrhea. Secondary outcome measures were pain, satisfaction, quality of life and reintervention. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)
Wed, 21 Oct 2015 00:30:03 +0100Ovarian development and maintenance are poorly understood; however, diseases that affect these processes can offer insights into the underlying mechanisms. XX female gonadal dysgenesis (XX-GD) is a rare, genetically heterogeneous disorder that is characterized by underdeveloped, dysfunctional ovaries, with subsequent lack of spontaneous pubertal development, primary amenorrhea, uterine hypoplasia, and hypergonadotropic hypogonadism. Here, we report an extended consanguineous family of Palestinian origin, in which 4 females exhibited XX-GD. Using homozygosity mapping and whole-exome sequencing, we identified a recessive missense mutation in nucleoporin-107 (NUP107, c.1339G>A, p.D447N). This mutation segregated with the XX-GD phenotype and was not present in available databases or in 150 hea...
Sun, 18 Oct 2015 00:00:00 +0100This article reviews the existing fertility preservation options for females diagnosed with Turner syndrome and provides practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in females, occurring in approximately one in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency (POI) and infertility. Although about 70-80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder may possess a small residual of ovarian follicles at birth or early childhood. (Source: Journal of Pediatric and Adolescent Gynecology)
Sun, 18 Oct 2015 00:00:00 +0100In this article we review the existing fertility preservation options for women diagnosed with Turner syndrome and provide practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in women, occurring in approximately 1 in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency and infertility. Although approximately 70%-80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder might possess a small residual of ovarian follicles at birth or early childhood. (Source: Journal of Pediatric and Adolescent Gynecology)
Sat, 17 Oct 2015 13:57:55 +0100Authors: Hsu MI Abstract Polycystic ovary syndrome (PCOS) is one of the most common hormonal endocrine disorders in women of reproductive age. It consists of a heterogeneous collection of signs and symptoms that together form a disorder spectrum. The diagnosis of PCOS is principally based on clinical and physical findings. The extent of metabolic abnormalities in women with PCOS varies with phenotype, body weight, age, and ethnicity. For general population, the prevalence of hyperandrogenism and oligomenorrhea decreases with age, while complications such as insulin resistance and other metabolic disturbances increase with age. Obese women with PCOS have a higher risk of developing oligomenorrhea, amenorrhea, hyperandrogenemia, insulin resistance, and lower luteinizing hormone (LH) ...
Sat, 17 Oct 2015 00:00:00 +0100Conclusion: The country needs to scale-up target interventions that are aimed at uplifting the education status of women and improving their economic wellbeing, because such interventions have a positive impact on fertility reduction and on improving maternal and reproductive health outcomes. (Source: Epidemiologic Perspectives and Innovations)
Fri, 16 Oct 2015 00:00:00 +0100CONCLUSIONS: Our findings suggest that 5α-reductase 2 deficiency and androgen insensitivity syndrome are possibly the two most common causes of 46,XY disorders of sex development in the Hong Kong Chinese population. Since hormonal findings can be unreliable, mutational analysis of the SRD5A2 and AR genes should be considered the first-line tests for these patients. PMID: 26492835 [PubMed - as supplied by publisher] (Source: Hong Kong Med J)
Thu, 15 Oct 2015 00:00:00 +0100CONCLUSION: PCT in the diagnostic of CA is not useful in the management of patients. PMID: 26477627 [PubMed - as supplied by publisher] (Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction)