Publications by authors named "Romualdi D"
Article Synopsis
- The 2024 Australian evidence-based guideline offers recommendations for diagnosing and treating unexplained infertility in couples, tailored specifically for the Australian healthcare context and approved by national health authorities.
- The guideline contains 40 evidence-based recommendations, addressing areas such as defining infertility, diagnosing various factors contributing to infertility, and treatment options, with a focus on improving patient care.
- Key updates include a refined definition of unexplained infertility and a more comprehensive assessment process, integrating considerations of evidence quality, safety, and practicality for implementing these guidelines in Australia.
Article Synopsis
- * In a 12-month analysis of 2,268 women, the majority were classified as having benign tumors, while a small percentage were diagnosed with malignancies, highlighting the algorithm's effectiveness in identifying risk factors such as patient age and tumor size.
- * A new risk classification system was developed, enabling better stratification of patients based on the likelihood of malignancy, achieving a high predictive accuracy (area under the curve of 0.87).
Article Synopsis
- The study reviews whether polycystic ovary syndrome (PCOS) affects birth outcomes for the children of women with the condition by analyzing data from 73 studies involving nearly 93,000 offspring.
- It finds that mothers with PCOS tend to be younger, have a higher body mass index (BMI), and experience greater weight gain during pregnancy, which may influence birth outcomes.
- The study concludes that PCOS is linked to higher risks of preterm birth, fetal growth issues, and lower birth weights, suggesting the need to consider PCOS status during pregnancy to improve outcomes for affected offspring.*
Article Synopsis
- * Factors like younger age and higher body mass index (BMI) contribute to these complications, but even when accounting for age and BMI, PCOS still poses significant risks.
- * The findings support the need for PCOS screening in antenatal care, as highlighted in the 2023 guidelines, aiming to improve outcomes for women planning to become pregnant or who are already pregnant.
Importance: Hirsutism represents a significant concern for women with polycystic ovary syndrome (PCOS), with deleterious psychological effects warranting acknowledgment and a clear imperative to provide effective management. To our knowledge, this is the first review to exclusively examine the effectiveness of laser and light-based therapies in addressing hirsutism in women with PCOS.
Objective: To synthesize the existing literature regarding the effectiveness of laser and light hair reduction therapies, either as stand-alone treatments or in combination with systemic agents, in treating hirsutism for women with PCOS.
Spondylodiscitis after sacral colpopexy: diagnose early to treat earlier.
Int J Clin Exp Pathol
March 2024
Article Synopsis
- Spondylodiscitis is a rare but serious complication that can occur after sacral colpopexy surgery for Pelvic Organ Prolapse, resulting in severe consequences if not promptly identified and treated.
- A review of literature from 2000 to 2022 emphasizes that poor surgical techniques and site infections can lead to this condition, requiring advanced imaging and timely surgical intervention.
- A case study of a 68-year-old woman illustrates the diagnosis and successful laparoscopic treatment of sacral spondylodiscitis, as her symptoms and radiological issues resolved two weeks after surgery.
Objective: Characteristic features of polycystic ovary syndrome (PCOS) include insulin resistance and an increased risk for type 2 diabetes. To promote improved insulin sensitivity, insulin sensitisers have been used in PCOS. However, direct comparisons across these agents are limited.
View Article and Find Full Text PDFStudy Question: What is the recommended management for couples presenting with unexplained infertility (UI), based on the best available evidence in the literature?
Summary Answer: The evidence-based guideline on UI makes 52 recommendations on the definition, diagnosis, and treatment of UI.
What Is Known Already: UI is diagnosed in the absence of any abnormalities of the female and male reproductive systems after 'standard' investigations. However, a consensual standardization of the diagnostic work-up is still lacking.
Background: Anti-androgens and combined oral contraceptive pills (COCPs) may mitigate hyperandrogenism-related symptoms of polycystic ovary syndrome (PCOS). However, their efficacy and safety in PCOS remain unclear as previous reviews have focused on non-PCOS populations. To inform the 2023 International Evidence-based Guideline in PCOS, we conducted the first systematic review and meta-analysis investigating the efficacy and safety of anti-androgens in the management of hormonal and clinical features of PCOS.
View Article and Find Full Text PDFContext: Polycystic ovary syndrome (PCOS) affects more than 1 in 10 women.
Objective: As part of the 2023 International PCOS Guidelines update, comparisons between combined oral contraceptive pills (COCP), metformin, and combination treatment were evaluated.
Data Sources: Ovid Medline, Embase, PsycINFO, All EBM, and CINAHL were searched.
Article Synopsis
- Metformin has been found to improve insulin sensitivity and help with weight management in women with polycystic ovary syndrome (PCOS), but more research is needed to fully understand its effects.
- A systematic review of clinical studies showed that metformin leads to greater reductions in body mass index (BMI), insulin resistance, and fasting glucose levels compared to placebo, although it may cause mild gastrointestinal side effects.
- The findings suggest that metformin, combined with lifestyle changes, is effective for managing PCOS, particularly in those who are overweight or obese.
Context: The mountain pine beetle (MPB; ) is a native bark beetle whose outbreaks leads to widespread conifer forest mortality. Of particular concern to forest and wildfire managers is the influence of MPB outbreaks on wildfire via spatial legacies left in impacted forest stands. There is, however, limited consensus in the literature regarding how MPB outbreaks affect wildfire across western North America.
View Article and Find Full Text PDFObjective: To compare between different combined oral contraceptive pills (COCPs) as part of the update of the International Evidence-Based Guidelines on the Assessment and Management of polycystic ovary syndrome (PCOS).
Design: A systematic review and meta-analysis was performed, Prospero CRD42022345640.
Methods: MEDLINE, EMBASE, All EBM, CINAHL, and PsycINFO was searched on July, 8, 2022, for studies including women with PCOS, comparing 2 different COCPs in randomized controlled trials.
Objective: As part of the update of the International Evidence-Based Guidelines for the Assessment and Management of polycystic ovary syndrome (PCOS), a systematic review was performed to inform evidence-based recommendations.
Design: Systematic review. Only randomised controlled trial were included.
Recurrent cystitis (RC) is a common disease, especially in females. Anatomical, behavioral and genetic predisposing factors are associated with the ascending retrograde route, which often causes bladder infections. RC seems to be mainly caused by agents derived from the intestinal microbiota, and most frequently by .
View Article and Find Full Text PDFPurpose: The aim was to compare a protocol of uterine artery embolization (UAE) consisting in three digital subtraction angiographies (DSAs)-Group A, with a protocol based on a single DSA-Group B.
Materials And Methods: This is a single-center prospective randomized study enrolling 20 women (mean age 41 years, range 22-55 years) with uterine fibroids treated with UAE, from January 2015 to February 2016. All UAEs were performed by two interventional radiologists using the same angiography machine.
Background: Studies on immunological infertility after inguinal hernia correction are few and not very representative. Anti-sperm antibodies have been shown to reduce male fertility. Although the extent of infertility due to anti-sperm antibodies alone is not very clear, data indicates that about 8%-10% of infertile patients have immunological infertility DESIGN: This retrospective study includes all infertile male patients (n = 2258) who underwent mixed antiglobulin reaction tests and urologic examination from 2000 to 2020.
View Article and Find Full Text PDFStudy Question: Is it possible to define a set of performance indicators (PIs) for clinical work in ART, which can create competency profiles for clinicians and for specific clinical process steps?
Summary Answer: The current paper recommends six PIs to be used for monitoring clinical work in ovarian stimulation for ART, embryo transfer, and pregnancy achievement: cycle cancellation rate (before oocyte pick-up (OPU)) (%CCR), rate of cycles with moderate/severe ovarian hyperstimulation syndrome (OHSS) (%mosOHSS), the proportion of mature (MII) oocytes at ICSI (%MII), complication rate after OPU (%CoOPU), clinical pregnancy rate (%CPR), and multiple pregnancy rate (%MPR).
What Is Known Already: PIs are objective measures for evaluating critical healthcare domains. In 2017, ART laboratory key PIs (KPIs) were defined.
Investing in clinical research and evidence-based medicine has helped to improve the care for women with polycystic ovary syndrome (PCOS). However, several important questions remain unanswered on the optimal prevention and management strategies for PCOS. Addressing this uncertainty is often hindered by suboptimal research conduct leading to inefficient evidence synthesis and research wastage.
View Article and Find Full Text PDFWhat is new in the landscape of insulin-sensitizing agents for polycystic ovary syndrome treatment.
Ther Adv Reprod Health
February 2020
Polycystic ovary syndrome, the most common gynecological endocrinopathy, is burdened with a state of hyperinsulinemia and insulin resistance in 50-80% of affected women. Wherever the origin of these metabolic abnormalities lies, their pathogenetic role in determining, perpetuating, and worsening the clinical traits of the syndrome is ascertained. Many studies have already highlighted possible mechanisms: hyperinsulinemia and insulin resistance may contribute to hyperandrogenemia, chronic anovulation, and other comorbidities of the syndrome by differentially affecting the endocrine glands (ovaries, adrenals, and pituitary) and peripheral tissues (fat mass and skeletal muscle).
View Article and Find Full Text PDFStudy Question: What are the key core outcomes to be reported in studies on polycystic ovary syndrome (PCOS)?
Summary Answer: We identified 3 generic and 30 specific core outcomes in 6 specialist domains: metabolic (8), reproductive (7), pregnancy (10), oncological (1), psychological (1) and long-term outcomes (1).
What Is Known Already: Research reporting PCOS is heterogeneous with high variation in outcome selection, definition and quality.
Study Design, Size, Duration: Evidence synthesis and a modified Delphi method with e-surveys were used as well as a consultation meeting.