Publications by authors named "Nappi R"

Background: Compared to male patients, sexual health remains poorly studied in women and sexual gender minority (SGM) patients with cancers.

Material And Methods: An online survey was developed by a multidisciplinary team to assess the awareness and attitude of Italian oncological providers facing sexual health during or after cancer treatment. On behalf of the respective scientific committees, the questionnaire was sent to Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies group (MITO) and to Italian Association of Radiation Oncology (AIRO) Group.

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Introduction: This study evaluated the safety and tolerability of fezolinetant in women with vasomotor symptoms (VMS) due to menopause in a pooled analysis of data from three 52-week phase 3 studies (SKYLIGHT 1, 2, and 4).

Methods: SKYLIGHT 1 and 2 were double-blind, placebo-controlled studies where women (≥ 40 to ≤ 65 years), with moderate to severe VMS (minimum average ≥ 7 hot flashes/day) were randomized to once-daily placebo, fezolinetant 30 mg or 45 mg. After 12 weeks, those on placebo were re-randomized to fezolinetant 30 mg or 45 mg, while those on fezolinetant continued on their assigned dose for 40 weeks.

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Purpose: Multiple sclerosis (MS) is often diagnosed in people of reproductive age. However, family planning counselling is not always integrated within MS care. Decisions on family planning can be further complicated by potential side effects associated with several disease-modifying therapies.

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Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae, and treatment of POI.

What Is Known Already: Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life; fertility; and bone, cardiovascular, and cognitive health.

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Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.

What Is Known Already: Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life; fertility; and bone, cardiovascular and cognitive health.

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Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.

What Is Known Already: POI presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life, on fertility and on bone, cardiovascular and cognitive health.

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Sexual health is multidimensional across the lifespan. At midlife, women may face challenges to sexuality, often requiring intervention. Menopause-related and age-related hormonal changes intermingle with common medical conditions and contribute to biological substrates less favorable to a healthy sexual response.

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Vestibulodynia (VBD) represents a summation and overlapping of trigger factors (infections, hormonal disturbances, allergies, genetic aspects, psychological vulnerability, and others) with broad individual variability. As there are no standard treatment options for VBD, the disease is still in need of appropriate therapeutic tools. : A prospective observational trial was performed to confirm the efficacy of a topical gel containing a spermidine-hyaluronate complex (UBIGEL donna™) as either a stand-alone or companion treatment through a multicenter study on a large sample population.

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Objectives: To assess the efficacy and safety of the non-hormonal, neurokinin 3 receptor antagonist, fezolinetant, to treat moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy.

Design: Phase 3b randomised controlled trial.

Setting: 16 countries.

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Article Synopsis
  • - This study aimed to evaluate how much pregnant women and hospital staff know about umbilical cord blood (UCB) donation and storage, revealing key insights into their views and practices.
  • - A total of 19 studies involving nearly 20,000 pregnant women and over 1,200 hospital staff showed that awareness of UCB was 61% for both groups, with 57% of pregnant women having a positive attitude toward UCB donation.
  • - The findings indicated a strong preference for public UCB banking over private options, with 51% of pregnant women favoring public storage compared to only 12% for private storage.
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Purpose: To assess oocyte competence and embryo chromosomal constitution in phenotype-D PCOS women undergoing ICSI for PGT-A at the blastocyst stage.

Methods: Retrospective study at a private IVF center. In the period 2013-2021, 58 naïve phenotype-D PCOS women (i.

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Objective: Oral, low-dose and ultra-low-dose continuous combined 17β-estradiol (E) plus dydrogesterone (D) reduce vasomotor symptoms (VMS) in postmenopausal women.

Methods: Two phase 3, double-blind studies were included. In the European study, postmenopausal women were randomized 2:1:2 to receive E0.

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Objective: This study aimed to evaluate physician-patient alignment on menopausal symptom burden and impact for women experiencing natural vasomotor symptoms (nVMS) or VMS induced by endocrine therapy for breast cancer (iVMS).

Methods: For this real-world, cross-sectional survey, physicians from the USA and five European countries provided data for consulting patients experiencing nVMS/iVMS; patients optionally self-reported their experiences. Alignment between physician and patient responses was assessed using weighted Cohen's analysis.

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Article Synopsis
  • Vasomotor symptoms (VMS) affect many menopausal women and can negatively impact their quality of life, with available treatments like menopausal hormone therapy (MHT) posing risks for some.
  • Fezolinetant is a newly approved oral non-hormonal drug that targets neurokinin 3 receptors to help alleviate moderate to severe VMS and has demonstrated effectiveness in clinical trials.
  • The drug appears to improve VMS-related issues such as sleep and overall quality of life while maintaining a safe profile, highlighting its potential as a key option for women unable to use hormone therapy, although further research is needed.
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  • There is growing recognition that endometriosis can affect postmenopausal women, but there is still limited information available on its prevalence and clinical management in this demographic.
  • Symptoms of endometriosis in menopausal patients can be vague and may appear at any stage, making accurate diagnosis challenging.
  • Surgical excision remains the main treatment for symptomatic postmenopausal endometriosis, though there's ongoing debate about the use of hormone therapy due to potential risks, highlighting the need for more research in this area.
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Despite the benefits of exercise on mental and physical health, excessive training loads can lead to health problems in the long term, including a wide spectrum of menstrual dysfunction (MD). This narrative review aims to analyze the relationship between physical exercise and MD in adolescent female athletes to support regular menstrual health monitoring and promote educational programs on reproductive risks. When dealing with MD in young athletes, several factors entangled with maturation of the hypothalamus-pituitary-ovarian axis should be considered.

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Objectives: Evidence suggests ethnicity-specific differences in postmenopausal symptoms, highlighting the need for therapies that are efficacious across different ethnicities. We evaluated the efficacy of an ultra-low dose combination of 0.5 mg estradiol and 0.

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Estetrol (E4) is a natural estrogen that has recently emerged as new option for contraception and hormone replacement therapy (HRT). Unlike other estrogens, E4 primarily stimulates nuclear estrogen receptor alpha (ERα) and does not activate membrane ERα. For this reason, this novel estrogen has tissue-specific effects across various organs such as liver, vascular endothelium, mammary glands, brain, vagina, and uterus.

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The vision of the International Menopause Society (IMS) is that all women across the world will have easy and equitable access to evidence-based knowledge and health care, empowering them to make fully informed midlife health choices. The aim of this White Paper is to provide a well-balanced educational narrative of the menopause and menopause hormone therapy (MHT) from IMS experts, leading into World Menopause Day 2024. This is achieved by exploring the anthropology and history of menopause, the principles and controversies of prescribing MHT, and by placing this into regulatory and menopause society contexts.

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Article Synopsis
  • - Functional hypothalamic amenorrhea (FHA) is a condition causing missed periods and chronic anovulation in young women, often due to issues like calorie restriction, excessive exercise, and stress, which disrupt hormone secretion.
  • - Recent research suggests a genetic component to FHA, indicating some women may be more susceptible to stress-related triggers, with rare gene variants linked to this condition.
  • - The review proposes that FHA is influenced by a mix of genetics, environmental factors, and epigenetic changes, and hints at the possibility of a similar condition in men, highlighting the need for more research in this area.
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Objectives: Despite the profound impact of menopausal symptoms on women, treatment utilization is low, and many seek alternative therapies. The REALISE study aimed to evaluate the treatment landscape - that is, pharmacological treatment, lifestyle changes (LC), and use of over-the-counter (OTC) products - for women from six high-income countries experiencing vasomotor symptoms (VMS) and receiving healthcare.

Study Design: Analysis of a secondary dataset, the Adelphi Real World Disease Specific Programme™, a large, cross-sectional, point-in-time survey conducted in the United States and five European countries (February-October 2020).

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Objective: This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.

Methods: In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined.

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Importance: Safe and effective nonhormonal treatments for menopausal vasomotor symptoms (VMS) are needed.

Objective: To evaluate the efficacy and safety of elinzanetant, a selective neurokinin-1,3 receptor antagonist, for the treatment of moderate to severe menopausal vasomotor symptoms.

Design, Setting, And Participants: Two randomized double-blind phase 3 trials (OASIS 1 and 2) included postmenopausal participants aged 40 to 65 years experiencing moderate to severe vasomotor symptoms (OASIS 1: 77 sites in the US, Europe, and Israel from August 27, 2021, to November 27, 2023, and OASIS 2: 77 sites in the US, Canada, and Europe from October 29, 2021, to October 10, 2023).

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Aims: Little research has investigated how sex may affect the prognosis of patients with chronic heart failure (HF). The present study was aimed at exploring sex-specific differences in prognosis in a cohort of patients with chronic HF, categorized according to severity of left ventricular dysfunction (HFrEF, HFmrEF and HFpEF), right ventricular (RV) dysfunction and ischemic (IHD) or nonischemic (no-IHD) etiology.

Methods: This retrospective analysis included 1640 HF patients of whom 24% were females, 759 patients had IHD, 1110 patients had HFrEF, 147 patients had HFmrEF and 383 patients had HFpEF.

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