Sexual health and wellbeing and the menopause: An EMAS clinical guide.

Introduction: Sexual health and wellbeing are significant aspects of quality of life. However, taking a sexual history is often avoided in medical practice, leaving a void in management and awareness. As the menopause can have a major impact on sexual health, it is imperative that healthcare providers are appropriately trained in sexual health and wellbeing and the aligned disciplines in order to achieve optimal care.

EMAS position statement: Thyroid disease and menopause.

Introduction: Thyroid diseases are common in women in their late reproductive years; therefore, thyroid disease and menopause may co-exist. Both conditions may present with a wide range of symptoms, leading to diagnostic challenges and delayed diagnosis. Aim To construct the first European Menopause and Andropause Society (EMAS) statement on thyroid diseases and menopause.

EMAS position statement: Testosterone replacement therapy in older men.

Introduction: Late-onset hypogonadism is the clinical entity characterised by low testosterone concentrations associated with clinical symptoms in the absence of organic disease in ageing men. It has been associated with metabolic syndrome, reduced bone mineral density, and increased cardiovascular morbidity and mortality risk. Although testosterone replacement therapy (TRT) reverses most of these conditions in young hypogonadal men, the risk/benefit ratio of TRT in older men is debatable.

EMAS position statement: Vitamin D and menopausal health.

Introduction: There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However, the effect of vitamin D supplementation on non-skeletal outcomes requires clarification, especially in postmenopausal women.

Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society.

This care pathway from the European Menopause and Andropause Society (EMAS) provides an updated pathway for monitoring and guidance of women at midlife, focusing on those approaching the end of the reproductive life-cycle, going through the menopausal transition and beyond. The care pathway is written by professionals involved in women's health and provides a stepwise individualized approach, stratified according to needs, symptoms and reproductive stage. Furthermore, the pathway provides details on screening for chronic diseases related to menopause and ageing.

The essential menopause curriculum for healthcare professionals: A European Menopause and Andropause Society (EMAS) position statement.

Introduction: The menopause, or the cessation of menstruation, is a stage of the life cycle which will occur in all women. Managing perimenopausal and postmenopausal health is a key issue for all areas of healthcare, not just gynecology.

Aim: To provide recommendations for the curriculum of education programs for healthcare professionals worldwide, so that all can receive high quality training on menopause.

Er:YAG laser in hysterectomized women with stress urinary incontinence: a VELA retrospective cohort, non-inferiority study.

To test whether the erbium-doped yttrium aluminum garnet (Er:YAG) SMOOTH laser treatment efficacy on stress urinary incontinence (SUI) in hysterectomized patients is non-inferior to its efficacy in non-hysterectomized patients. In this real-world, retrospective cohort study performed in Turkey, Croatia and Italy, we enrolled a consecutive sample of 35 hysterectomized and 34 non-hysterectomized patients with SUI. We used the Er:YAG SMOOTH laser (Fotona, Slovenia) with a wave length of 2940 nm.

Pixel CO Laser for the Treatment of Stress Urinary Incontinence: A Prospective Observational Multicenter Study.

Background And Objectives: Energy-based treatments have been found to be a promising treatment modality for improving stress urinary incontinence (SUI) symptoms. This prospective two-center study was designed to evaluate the efficacy of fractional-pixel CO laser for the treatment of SUI.

Study Design/materials And Methods: Eighty-five women with SUI symptoms as per the cough stress test and validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), were treated intravaginally with Pixel-CO laser.

Laser Therapy in the Treatment of Female Urinary Incontinence and Genitourinary Syndrome of Menopause: An Update.

Vaginal birth trauma is the leading cause of stress urinary incontinence (SUI) in women. Also, the process of ageing and hormonal deprivation in postmenopause alters the metabolism of connective tissues and decreases collagen production leading to pelvic floor dysfunction. Noninvasive treatment is recommended as first-line management of urinary incontinence (UI) in women.

Baseline ICIQ-UI score, body mass index, age, average birth weight, and perineometry duration as promising predictors of the short-term efficacy of Er:YAG laser treatment in stress urinary incontinent women: A prospective cohort study.

Background And Objective: A growing body of evidence indicates that a non-invasive erbium yttrium-aluminum-garnet (Er:YAG) laser may be an effective and highly tolerable treatment for stress urinary incontinence (SUI) in women. The primary objective was to identify pre-intervention predictors of short-term Er:YAG outcomes. The secondary objective was to identify patient segments with the best Er:YAG laser treatment short-term outcomes.

Cervical HPV type-specific pre-vaccination prevalence and age distribution in Croatia.

The main etiological factor of precancerous lesion and invasive cervical cancer are oncogenic human papillomaviruses types (HPVs). The objective of this study was to establish the distribution of the most common HPVs in different cervical lesions and cancer prior to the implementation of organized population-based cervical screening and HPV vaccination in Croatia. In this study, 4,432 cervical specimens, collected through a 16-year period, were tested for the presence of HPV-DNA by polymerase chain reaction (PCR) with three sets of broad-spectrum primers and type-specific primers for most common low-risk (LR) types (HPV-6, 11) and the most common high-risk (HR) types (HPV-16, 18, 31, 33, 45, 52, 58).

Minimally invasive, non-ablative Er:YAG laser treatment of stress urinary incontinence in women--a pilot study.

The study presents an assessment of mechanism of action and a pilot clinical study of efficacy and safety of the Er:YAG laser for the treatment of stress urinary incontinence (SUI). The subject of this study is a treatment of SUI with a 2940 nm Er:YAG laser, operating in a special SMOOTH mode designed to increase temperature of the vaginal mucosa up to maximally 60-65 °C without ablating the epidermis. Numerical modelling of the temperature distribution within mucosa tissue following an irradiation with the SMOOTH mode Er:YAG laser was performed in order to determine the appropriate range of laser parameters.

Short time efficacy and safety of focused monopolar radiofrequency device for labial laxity improvement-noninvasive labia tissue tightening. A prospective cohort study.

Background And Objective: To evaluate safety and efficacy of focused monopolar radio frequency (RF) device for non-invasive labia tissue tightening and improvement of labial laxity.

Methods: This prospective cohort study participants were 17 female subjects aged between 27 and 56 years with lax skin at the labia area. All subjects received four consecutive treatments at 7-day intervals with RF device (Exilis Protege IntimaR, BTL Industries Inc.

First assessment of short-term efficacy of Er:YAG laser treatment on stress urinary incontinence in women: prospective cohort study.

Objectives: This is the first assessment of efficacy and safety of the Er:YAG laser in the treatment of stress urinary incontinence. The aim of this study was to assess the short-term outcome of a non-invasive laser treatment for mild-to-severe stages of this condition and to check its applicability in different body mass index and age groups.

Methods: A prospective cohort, single-center study at the Ob/Gyn Clinic, Zagreb, Croatia recruited a consecutive sample of 73 female patients suffering from stress urinary incontinence.

Methylated Host Cell Gene Promoters and Human Papillomavirus Type 16 and 18 Predicting Cervical Lesions and Cancer.

Change in the host and/or human papillomavirus (HPV) DNA methylation profile is probably one of the main factors responsible for the malignant progression of cervical lesions to cancer. To investigate those changes we studied 173 cervical samples with different grades of cervical lesion, from normal to cervical cancer. The methylation status of nine cellular gene promoters, CCNA1, CDH1, C13ORF18, DAPK1, HIC1, RARβ2, hTERT1, hTERT2 and TWIST1, was investigated by Methylation Specific Polymerase Chain Reaction (MSP).

Ureaplasma urealyticum and Ureaplasma parvum in women of reproductive age.

Objectives: To determine the incidence of Ureaplasma urealyticum and Ureaplasma parvum (UP) in symptomatic and asymptomatic women of reproductive age and to estimate antibiotic susceptibility of ureaplasma isolates.

Materials And Methods: This study included 424 ureaplasma positive women of 1,370 tested women who visited gynecological practices during 2010. Cervicovaginal or urethral swab specimens from each patient were obtained for cultivation and molecular typing by RT-PCR.

Lower urinary tract infections and the effects of hormone therapy in postmenopausal women in the Zagreb region.

Urinary tract infections (UTI) remain one of the most common bacterial infections seen in adult women of all ages. In postmenopausal women, the aging process contributes to local complaints in the lower urogenital tissue, including UTI. Our study was conducted at gynecological practices of the health centers in the Zagreb region, Croatia, during 2009.

Olive oil biophenols and women's health.

Olea europea, the olive tree, is an ancient tree that originates from the Mediterranean environment of Asia Minor. The edible olive fruit is also used for its oil, gained by the process of pressing, a nutrient with proven beneficial effects. Virgin olive oil is the natural juice of the olive fruit, which plays a major role in the healthy Mediterranean diet.

The possibilities and limitations of direct digital radiography, ultrasound and computed tomography in diagnosing pleural mesotelioma.

The goal of this study was to compare the possibilities and limitations of direct digital radiography of the chest (DDR), the use of ultrasound of the chest (US) and single slice computed tomography of the chest (CT) in diagnosing pleural mesothelioma. The study was conducted during the course of one year, on 80 patients who were successively referred to a specialized institution, under clinical suspicion of mesothelioma. The method of investigation was the comparison of findings, obtained by the reviewed methods of examination, with the pathohistologic results of a biopsy performed on each patient.

Adherence with hormone replacement therapy in menopause.

Objective: Lack of adherence to therapy is a common problem in the treatment of various diseases and conditions and there are many well-documented reasons for it. This study was conducted to assess the effect of time spent on medical consultation in relation to the duration of adherence, as well as the reasons to adhere to or drop out from hormone replacement therapy (HRT).

Design And Methods: Two methods were used, self-filled questionnaires on a sample of patients and telephone interviews on a sample of doctors.

[Alternative hormone therapy in postmenopause].

Despite the fact that hormonal combination used in huge Wpmen's Health Initiative (WHI) is not common all over the world, and treated population is, because of age, in risk per se, study results have consternated not only lay users, but prescribers too. Namely, increased cancer, stroke and coronary heart disease risk associated with long term use of postmenopausal hormone therapy (HT) have rapidly declined the number of women treated with HT (either estrogen alone or estrogen plus progestogen). Considering recent position statements from leading organizations dealing with menopause, individualization of therapy and lower dosage HT becomes the state of the art.

[Bone histology in postmenopausal osteoporosis--variations in cellular activity].

Aim: Modern understanding of the etiology of postmenopausal osteoporosis is based on the imbalance between bone resorption and formation due to estrogen deficiency, which may take several forms and combinations of decreased and/or increased activity of both or one cell type. Studies of postmenopausal osteoporosis have pointed to the existence of heterogeneity in the remodeling imbalance. Bone histology analyzed in a group of women with established postmenopausal osteoporosis undergoing bone biopsy is part of the diagnostic procedure.

Menopause in Croatia. Socio-demographic characteristics, women's attitudes and source of information, compliance with HRT.

Objectives: Hormone replacement therapy (HRT) in Croatian postmenopausal women, attitudes towards it and factors influencing this decision.

Methods: A total of 1100 women were interviewed in Ob/Gyn offices using self-response questionnaire of 56 items, dealing with demographic data, personal and family medical history, surgeries, menstrual and menopausal status, body mass index (BMI), sexuality, knowledge and attitudes towards the menopause and HRT.

Results: The adherence to HRT in Croatia was found to be very short, averaging only 3 months.

Evaluation of genital human papillomavirus infections by polymerase chain reaction among Croatian women.

Infection with specific human papillomavirus (HPV) types is the strongest risk factor in cervical carcinogenesis. In this study we analysed, by means of polymerase chain reaction (PCR), cervical specimens obtained from consenting women with abnormal Pap smears collected from 1996 to 1998. Consensus- and type-specific-primers directed PCR were used in order to detect the presence and to determine the most common HPV types: 6, 11, 16, 18, 31 and 33.