Publications by authors named "Andrea Giannini"
Article Synopsis
- This scoping review examines treatment options for genitourinary syndrome of menopause (GSM), a commonly overlooked condition caused by reduced estrogen levels during menopause, leading to various symptoms impacting women's quality of life.
- The review analyzed 451 articles and ultimately included 19 studies that highlight first-line treatments like lubricants and moisturizers, as well as hormonal therapies such as selective estrogen receptor modulators and DHEA for managing severe symptoms.
- It emphasizes the importance of tailored therapy and effective communication to help women make informed treatment choices while calling for more research into GSM therapies, especially concerning safety in women with cancer histories.
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of intraoperative radiation therapy (IORT) for treating recurrent cervical and endometrial cancer, along with identifying predictors of postoperative complications and mortality over three years.
- A total of 80 patients were analyzed, revealing a 3-year survival rate of 48.6%, with complications occurring in 20.1% of cases and one patient dying within 30 days post-surgery.
- Key risk factors linked to higher complications and mortality included poor performance status (ECOG PS 2-3), prior chemotherapy/immunotherapy, and the presence of pelvic sidewall involvement.
Growing evidence has demonstrated the role of mutations of tumor biomarkers in diagnosing and treating epithelial ovarian cancer. This review aims to analyze recent literature on the correlation between tumor biomarkers and chemotherapy in nonmucinous ovarian cancer, providing suggestions for personalized treatment approaches. An extensive literature search was conducted to identify relevant studies and trials.
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- Endometriosis is a chronic inflammatory disease linked to estrogen, with a notable connection to specific ovarian cancers, such as clear cell and endometrioid carcinomas.
- Atypical endometriosis is considered a potential precursor to these ovarian tumors, primarily developing in the ovary rather than other areas.
- Recent research suggests that oxidative stress from iron in the endometriosis environment may contribute to the progression from endometriosis to ovarian cancer, though the exact mechanisms remain unclear.
Article Synopsis
- * The meta-analysis included data from 17 studies, revealing that VEIL had significantly lower rates of major complications compared to OIL (12.6% vs. 41.1%), though other factors like blood loss and hospital stay were similar between the two methods.
- * While VEIL appears to be a safer option, OIL is quicker, making it a valid alternative; further randomized trials are needed to better assess these outcomes.
Purpose: To determine the prognostic impact of microscopic residual disease after neoadjuvant chemotherapy (NACT) in patients undergoing interval debulking surgery (IDS) for advanced epithelial ovarian cancer (AEOC).
Methods: Patients affected by FIGO stage IIIC-IV ovarian cancer undergoing IDS between October 2010 and April 2016 were selected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier analysis.
Ovarian cancer affects thousands of women every year and represents the female cancer with the highest mortality rate. Effectively, it is a severe disease that requires a multidisciplinary approach for optimal treatment. Surgery currently is the cornerstone of its treatment and numerous methods have been analyzed and developed to predict the possibility of obtaining a residual tumor of 0 (RT=0).
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- - Hysteroscopy is an important gynecological procedure, but traditional training methods face ethical and safety concerns, increasing the need for simulation training to improve skills among medical students and residents.
- - A systematic review analyzed studies from January 2000 to December 2023, finding that simulation training, especially with virtual reality, significantly enhances hysteroscopic skills, although the long-term retention of these skills and the development of related non-technical skills need further investigation.
- - The findings suggest that simulation-based training is effective for skill improvement in hysteroscopy, but more rigorous research, including randomized trials, is crucial for confirming these benefits and exploring broader training outcomes.
Background: Uterine sarcomas (US) are rare cancer of possible occurrence even in women of childbearing age. To date, total hysterectomy is the standard treatment in the early stages. The possibilities of carrying out fertility-sparing treatments (FST) to save the fertility of women with unfulfilled reproductive desires are described in the literature, but to date, they can only be considered experimental.
View Article and Find Full Text PDFRobotic-assisted, laparoscopic, and vaginal hysterectomy in morbidly obese patients with endometrial hyperplasia and endometrial cancer.
Minim Invasive Ther Allied Technol
December 2024
Background: Hysterectomy for endometrial hyperplasia and endometrial cancer in morbidly obese patients is challenging. Here, we reported data regarding three minimally invasive approaches.
Method: This is a multicenter retrospective study evaluating 30-day and 90-day surgery-related outcomes of morbidly obese patients (those with BMI > 40kg/m) undergoing robotic-assisted, laparoscopic, and vaginal hysterectomy.
Objective: This study aimed to assess the efficacy of randomly started oral dienogest/ethinylestradiol (DNG/EE) for swift endometrial preparation prior to outpatient hysteroscopic polypectomy in perimenopausal women.
Method: A multicenter, prospective, randomized controlled trial was conducted in university hospitals. Eighty perimenopausal women scheduled for outpatient hysteroscopic polypectomy between January 2023 and March 2024 were randomly assigned to either intervention ( = 40) or control ( = 40) groups.
Hysteroscopy has truly revolutionized the field of diagnostic and operative gynecology. It is presently regarded as the gold standard method for both the diagnosis and treatment of intrauterine diseases and it has fundamentally altered the way gynecologists treat patients with such conditions. These pathologies can now be diagnosed and treated in an outpatient setting, thanks to technological advancements and instrument downsizing.
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- The menopause transition significantly increases a woman's risk of mood disorders due to fluctuations in estrogen and progesterone levels.
- Low estradiol levels after menopause impact the central nervous system, leading to an imbalance in neurotransmission that can result in symptoms like hot flashes, depression, and anxiety.
- The review highlights the complex neuroendocrine changes occurring during this transition, focusing on the various signaling pathways and neurotransmitters involved in mood alterations.
Article Synopsis
- Cervical cancer poses a major health risk for younger women, and tools like cold knife (CK) and carbon dioxide (CO) laser conization are used to treat pre-invasive lesions with the intent to cure incidental cervical cancer cases.
- A study involving 1,270 women showed that CO laser conization had a significantly lower rate of positive margins compared to CK conization (4.3% vs. 13.3%).
- Both techniques demonstrated similar oncological safety in cases of incidental cervical cancer diagnosis, with no recurrences noted after an average follow-up period of 53 months, and CO laser conization generally proved more effective at achieving clean margins.
Background: Hereditary breast and ovarian cancer syndrome (HBOC) predisposes women to an increased risk mainly of breast and tubo-ovarian cancer. The aim of the study is to investigate whether being diagnosed with HBOC syndrome is itself a risk factor for sexual dysfunction.
Methods: An ad hoc questionnaire, including baseline demographic and clinical data, and the Sexual Function Questionnaire 28 (SFQ28) were administered to HBOC female carriers (study group) and to a control group.
Background And Objective: Pelvic organ prolapse (POP) affects 40% of women, with a 12%-19% lifetime surgical risk. Italy showed high practice variation in POP surgery, possibly impacting equity of access to healthcare services, a central goal of Beveridge-like health systems. According to the literature, unwarranted variation, influenced by physician attitudes or resource allocation, must be reduced.
View Article and Find Full Text PDFThe role of artificial intelligence in cosmetic and functional gynecology: Stepping into the third millennium.
Eur J Obstet Gynecol Reprod Biol X
September 2024
Cosmetic and functional gynecology have gained popularity among patients, but the scientific literature in this field, particularly regarding the cosmetic aspect, is lacking. The use of evidence-based medicine is crucial to validate diagnostic tools and treatment protocols. However, the advent of artificial intelligence (AI) offers a promising solution to address this issue.
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- The study aimed to evaluate whether using a V-Y reconstructive flap after surgery for vulvar cancer improves surgical outcomes compared to surgery without reconstruction.
- It involved a comparison of 361 patients, identifying risk factors for complications, with results showing that higher body mass index, diabetes, and age were linked to increased risk of wound issues.
- Findings indicated that V-Y reconstruction significantly decreased postoperative complications, especially in patients with larger lesions, highlighting its benefits for those with significant surgical defects.
Introduction: This Special Report aims to highlight the importance of tailored therapies in women with Polycystic Ovary Syndrome (PCOS), avoiding prescribing generalized or unsuitable therapies based on oral contraceptive pills (OCPs).
Areas Covered: This article discusses the benefits and risks of OCP-based therapy, highlighting the possible undesirable effects, especially in those patients exhibiting risk factors as women with PCOS, and the importance of carefully evaluated tailored therapeutic approaches. Literature searches were performed with the use of PubMed, Google Scholar, and Web of Science between January and February 2024.
Objective: To evaluate the use of oral nomegestrol acetate/estradiol in random start rapid preparation of endometrium before office hysteroscopic polypectomy.
Study Design: Multicenter, prospective, randomized controlled trial.
Setting: University hospitals.
Article Synopsis
- Lateral suspension is a surgical procedure designed to fix apical prolapse by placing T-shaped mesh in the abdomen, but there’s no consensus on its safety or indications.
- A Delphi process involved 21 international expert surgeons discussing and reaching agreement on various aspects of laparoscopic lateral suspension (LLS) through rounds of statements and discussions.
- The consensus highlighted LLS as a safe and effective method for treating pelvic organ prolapse, along with key technical details and indications for the procedure.
Endometriosis is characterized by the growth of endometrial-like tissue outside the uterus, and it is associated with alterations in the expression of hormone receptors and inflammation. Estetrol (E) is a weak estrogen that recently has been approved for contraception. We evaluated the effect of E on the growth of endometriotic-like lesions and the expression of TNF-α, estrogen receptors (ERs), and progesterone receptors (PRs) in an in vivo murine model.
View Article and Find Full Text PDFMutations in genes encoding for proteins along the RAS-RAF-MEK-ERK pathway have been detected in a variety of tumor entities including ovarian carcinomas. In the recent years, several inhibitors of this pathway have been developed, whose antitumor potential is currently being assessed in different clinical trials. Low grade serous ovarian carcinoma, is a rare gynecological tumor which shows favorable overall survival, compared to the general ovarian cancer population, but worrying resistance to conventional chemotherapies.
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