Placental-site trophoblastic tumor with bone metastasis: A diagnostic and therapeutic challenge.

Placental-site trophoblastic tumor (PSTT) is a rare pathological entity included in the spectrum of gestational trophoblastic neoplasia (GTN). It is a neoplasia with metastatic potential that, once metastasized, has poor prognosis because the tumor tends to be less sensitive to chemotherapy. We present a rare case of gestational trophoblastic neoplasia, in which hysterectomy for persistent gestational trophoblastic disease after hydatidiform mole, revealed a primary PSTT in the uterus.

Random-start ovarian stimulation in an oocyte donation programme: a large, single-centre, experience.

Research Question: Do live birth rates differ between recipients matched with donors using conventional ovarian stimulation compared with those using random-start protocols?

Design: Retrospective analysis of 891 ovarian stimulations in egg donors (January-December 2018) and clinical outcomes in matched recipients (n = 935). Donors commenced ovarian stimulation on day 1-3 of the menstrual cycle (n = 223) or in the mid/late-follicular (n = 388) or luteal phase (n = 280) under a conventional antagonist protocol. Live birth rate of matched recipients was the main outcome.

Pharmacological interactions and menopausal hormone therapy: a review.

Importance And Objective: Menopausal hormone therapy (HT) is widely used, and there are several statements of international scientific societies to guide prescribers; however, a summary of existing literature about possible drug interactions with HT does not exist, although many midlife women take medications for other conditions. Therefore, our objective was to create a document that presents and synthesizes the most relevant interactions. The impact of the interaction itself and the number of candidates for HT who are likely to use other treatments are considered based on the best available evidence.

What do TSECs provide in the menopausal hormone therapy?

Tissue-selective estrogen complex (TSEC) is projected as a progestogen-free option for the treatment of estrogen deficiency symptoms in postmenopausal, non-hysterectomized women. TSEC combines the benefits of estrogen with a selective estrogen receptor modulator (SERM), in this case bazedoxifene acetate (BZA), which has an antagonistic effect on the endometrium, thus avoiding the use of progestins. The authorized TSEC combination (conjugated estrogens [CE] 0.

Spanish Menopause Society position statement: Use of denosumab in postmenopausal women.

Denosumab is a new drug developed for the treatment of osteoporosis. Moreover, increasing evidences link denosumab with benefits in cancer, an area of interest for those in charge of the postmenopausal health. Denosumab has shown efficacy in the control of bone loss associated with hypogonadic states created by chemotherapy in breast and other cancers.

Is a bowel resection necessary for deep endometriosis with rectovaginal or colorectal involvement?

Background: The purpose of this paper is to report the long-term results of surgery without bowel resection in patients suffering from deep infiltrating endometriosis with rectovaginal or colorectal involvement.

Methods: This retrospective observational study identified 42 patients suffering with deep infiltrating endometriosis who underwent surgery. Conservative surgery was performed in 23 women (only one of them with bowel resection), and 19 women underwent a hysterectomy and bilateral salpingo-oophorectomy (HBSO).

Spanish Menopause Society position statement: use of tibolone in postmenopausal women.

Tibolone is a drug with complex tissue-specific action that exhibits a combination of estrogenic, progestogenic, and slight androgenic activity. Its variable profile explains its clinical effects, depending on the target tissue where it is metabolized, its metabolites' affinity for and potency in hormone receptors, and probable enzymatic activity modulation.In recent reviews and clinical trials, the effectiveness of tibolone in alleviating different hot flush menopause symptoms, mainly in mood and sexuality disorders, has been noted.

Position of the Spanish Menopause Society regarding the management of menopausal symptoms in breast cancer patients.

Breast cancer is the most common female cancer in Spain. Its high prevalence, its high survival rate, and its incidence are the reasons treatment is increasingly sought for common problems by young women who have survived it. Besides the contraception and fertility issues, many breast cancer survivors develop sexual disorders and menopausal symptoms, whether as a consequence of treatment-induced menopause or side effects of treatment.

Effect of human interferon-alpha-2b on experimental endometriosis in rats: comparison between short and long series of treatment.

Objective: A randomised and controlled experimental study was carried out to determine the effect of short and long series of treatment with recombinant human interferon-alpha-2b on surgically induced endometriosis in rats.

Study Design: Ninety-six Wistar adult female rats, which had undergone an autotransplant into the peritoneal cavity of four endometrial fragments measuring 4.5mm at the side, were randomly divided into three groups.

Lowering the age at menarche and risk of early menarche in a population of Spanish postmenopausal women during the past two decades.

Aim: The purpose of this study is to confirm in our population the decreasing secular trend in the age of menarche (AAM) observed in other European countries. Another aim is to investigate the association between early menarche and breast cancer, metabolic disorders risk or early menopause.

Materials And Methods: We conducted a nationwide population-based study of 1980 Caucasoid Spanish postmenopausal women from 2003 to 2006 to investigate the AAM, the duration of the fertile period and the relation of early menarche with breast cancer and some metabolic disorders.

Treatment of endometriosis with transvaginal ultrasound-guided drainage and recombinant interleukin-2 left in the cysts: a third clinical trial.

Background: To analyze the therapeutic results of recombinant interleukin-2 (rIL-2) left in the cysts after transvaginal ultrasound (US)-guided drainage of endometriomas as an alternative to surgery.

Methods: Prospective and randomized clinical trial. A total of 25 consecutive patients were included.

Multigenic combination of estrogen-related genes is associated with age at natural menopause in a Spanish population.

Objective: Age at natural menopause (ANM) can be considered a complex parameter that depends on the interaction of multiple factors. In the present study, the role of interaction between genetic variants within estrogen synthesis and signalling pathways in the ANM in Spanish women is studied.

Material And Methods: Nine single nucleotide polymorphisms (SNPs) located at different candidate genes related to the estrogen signalling pathway were analysed in 1980 Spanish postmenopausal women.

Knowledge and compliance from patients with postmenopausal osteoporosis treatment.

Objective: The aim of this study was to evaluate the knowledge, attitudes and expectations of patients receiving treatment for postmenopausal osteoporosis, analysing the factors related to good compliance with treatment.

Methods: A national, epidemiological, cross-sectional study collected information on personal medical history, family history, bone densitometry, and treatment and compliance of patients over 45 years who were receiving treatment for osteoporosis and provided their informed consent. The patients anonymously completed a questionnaire about their knowledge of osteoporosis and the Morisky and Green treatment compliance evaluation test.

Impact of anthropometric parameters on quality of life during menopause.

Objective: To investigate whether body mass index (BMI), abdominal obesity, and fat distribution in postmenopausal women influence quality of life.

Design: Cross-sectional survey.

Setting: Outpatient clinics in the hospital setting and private practices.

[General recommendations over perimenopausal transition therapy].

Background: Medical attention during perimenopause requires different therapeutic strategies.

Objective: To define strategies for the attention of perimenopause women that can favor a healthy aging.

Methods: Review of influencing factors and lifestyle modifications that can be introduced in perimenopause to prevent pathologies.

A digenic combination of polymorphisms within ESR1 and ESR2 genes are associated with age at menarche in the Spanish population.

In the present study, the authors look at an association of genetic variants within estrogen synthesis and signaling pathways and age at menarche (AAM) in Spanish women. They analyzed 9 polymorphisms in 6 different genes in 714 well-characterized postmenopausal women from Spain. They performed a quantitative trait locus study of these markers individually or in digenic combinations in relation to AAM.

Intraperitoneal recombinant interleukin-2 activates leukocytes in rat endometriosis.

The aim of this double-blinded study was to determine changes in leukocyte populations in blood, peritoneal lavage fluid, eutopic and ectopic endometrium after treatment with recombinant rat interleukin-2 (IL-2) using an in vivo experimental model of rat endometriosis. The in vivo model involved transplanting four square fragments of autologous endometrium onto the inner surface of the abdominal wall in 20 Wistar rats. The control group was constituted by 20 sham-operated rats.

The effect of intraperitoneal interleukin-2 on surgically induced endometriosis in rats.

Objective: To evaluate the effect of interleukin-2 (IL-2) on an experimental model of endometriosis.

Study Design: Double blind and randomized experimental prospective placebo-controlled study. Experimental endometriosis was induced in 66 three-month-old female Wistar rats, by auto-transplanting fragments of endometrium to the peritoneum.

Multilocus analysis of estrogen-related genes in Spanish postmenopausal women suggests an interactive role of ESR1, ESR2 and NRIP1 genes in the pathogenesis of osteoporosis.

Osteoporosis is a common disease with multiple environmental and genetic risk factors involved. Using a marker-by-marker approach, the role of different estrogen-related genes has been analyzed in different populations, but most of these studies ignore the complex multigenic nature of human osteoporosis. Looking for markers related to osteoporosis, we have analyzed five single nucleotide polymorphisms located in genes related to the estrogen pathway, Follicle Stimulating Hormone Receptor (FSHR) gene, the CYP19 aromatase (CYP19A1) gene, the Estrogen Receptor alpha (ESR1) gene, the Estrogen Receptor beta (ESR2) gene and the Nuclear Receptor Interacting Protein 1 (NRIP1) gene in 265 unrelated postmenopausal women.

Treatment of endometriosis with transvaginal ultrasound-guided drainage under GnRH analogues and recombinant interleukin-2 left in the cysts.

Background: To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues.

Methods: Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four consecutive patients with endometriomas initially sent to us for laparotomy and conservative surgery for endometriosis were included.

Complex genital malformation: ectopic ureter ending in a supposed mesonephric duct in a woman with renal agenesis and ipsilateral blind hemivagina.

We present a clinical case of a patient with left renal agenesis and ipsilateral blind hemivagina who also had one or more atretic ectopic ureters opening into supposed mesonephric duct, which in turn opened into, or joined onto, the ipsilateral hemicervix, continuing with the blind hemivagina. The diagram of this complex genitourinary malformation would strongly support our hypothesis of the embryology of the human vagina as deriving from the Wolffian ducts and the Mullerian tubercle.

GnRH analogues, transvaginal ultrasound-guided drainage and intracystic injection of recombinant interleukin-2 in the treatment of endometriosis.

We performed a double-blind, randomised controlled trial to evaluate the results of ultrasound-guided aspiration of endometriomas under the effect of GnRH analogues and a possible additional beneficial effect by leaving 600000 IU of recombinant interleukin-2 (rIL-2) in the cysts. Twenty-four women with endometriosis-related symptoms, increased values of CA-125 and transvaginal ultrasonography showing endometriomas >3 cm who were initially sent to us for laparotomy and conservative surgery for endometriosis were included. Main outcome measures were severity of symptoms, size and percentage of echographical reduction of endometriomas and CA-125 levels after 2 menses post-GnRH analogues.