Endometriosis: cannabidiol therapy for symptom relief.

Endometriosis is a common, chronic, incurable condition the hallmark of which is the presence of lesions (tissue resembling endometrium) in sites outside the womb, with symptoms including chronic debilitating pain and fatigue. However, current therapeutic options are limited. Recent advances in our understanding of the mechanisms that contribute to the development of lesions and pain experience in endometriosis as well as surveys of patients have increased interest in testing recently approved formulations containing cannabidiol (CBD) in this patient group.

Transcarotid Artery Revascularization Learning Curves Differ between Surgeon Experience Level.

Background: There has been ensuing interest in adopting transcarotid artery revascularization (TCAR), because of its low perioperative stroke and complication rates. In our study, we aimed to identify the case number at which there is improvement in TCAR technical proficiency. We also assessed how surgeon experience influenced outcomes.

A review of the current recommendations and practices for hemodialysis access monitoring and maintenance procedures.

The growing number of prevalent arteriovenous (AV) accesses has been associated with an increase in the incidence of procedures being performed to maintain patency. To reduce the rate of unnecessary procedures, the 2019 Kidney Disease Outcome Quality Initiative guidelines addended the AV access surveillance recommendations, which includes clinical monitoring and assessment of dialysis adequacy alone. Abnormal clinical findings would necessitate follow-up angiography with or without confirmatory duplex ultrasound.

Outcomes of balloon-assisted maturation with large-diameter balloons.

Objectives: Balloon-assisted maturation (BAM) is a well-established technique for maturation of inadequate arteriovenous fistulas (AVF). The objective of this study was to evaluate outcomes of initial BAM using large-diameter angioplasty balloons.

Methods: Charts of patients who underwent BAM between 2018 and 2021 at a single academic institution were reviewed.

Endometriosis: Improvements and challenges in diagnosis and symptom management.

Endometriosis is a chronic disorder with debilitating symptoms that is difficult to diagnose and treat. Advances in imaging technologies and strategies for the management of symptoms are improving the quality of life of patients by reducing the time taken for diagnosis and offering a more balanced approach to therapy.

Listening deeply to refugee background women to understand experiences of domestic and family violence in their communities to foster engagement with global support systems.

As trauma survivors, women and girls from refugee backgrounds face significant challenges when settling in host countries; the risk of domestic and family violence (DFV) accentuates these difficulties. Reflecting on findings from a seven-year university and industry research partnership, this article explores the etiology of DFV in women from refugee backgrounds living in non-metropolitan Australia. Drawing on action research principles and intersectional and social ecological theoretical frameworks, this study captured diverse women's views about experiences and strategies for addressing DFV in refugee communities.

Incidence and characteristics of vascular trauma at a level 2 trauma center.

Objective: Despite the significant number of trauma patients treated at level 2 trauma centers (L2TCs) in the United States, most of the literature describing vascular trauma is from level 1 trauma centers (L1TCs). Currently, trauma center designation criteria do not require vascular surgery as a necessary component service.

Methods: A retrospective chart review was performed for all trauma patients with a vascular surgery consultation seen at our L2TC between 2013 and 2018.

Effectiveness of laparoscopic removal of isolated superficial peritoneal endometriosis for the management of chronic pelvic pain in women (ESPriT2): protocol for a multi-centre randomised controlled trial.

Background: Endometriosis affects 190 million women and those assigned female at birth worldwide. For some, it is associated with debilitating chronic pelvic pain. Diagnosis of endometriosis is often achieved through diagnostic laparoscopy.

Measurement of changes in uterine and fibroid volume during treatment of heavy menstrual bleeding (HMB).

Study Question: Does application of an unbiased method for analysis of magnetic resonance (MR) images reveal any effect on uterine or fibroid volume from treatment of heavy menstrual bleeding (HMB) with three 12-week courses of the selective progesterone receptor modulator ulipristal acetate (SPRM-UPA)?

Summary Answer: Application of an unbiased method for analysis of MR images showed that treatment of HMB with SPRM-UPA was not associated with a significant reduction in the volume of the uterus or in the volume of uterine fibroids.

What Is Known Already: SPRM-UPA shows therapeutic efficacy for treating HMB. However, the mechanism of action (MoA) is not well understood and there have been mixed reports, using potentially biased methodology, regarding whether SPRM-UPA has an effect on the volume of the uterus and fibroids.

Ulipristal acetate versus levonorgestrel-releasing intrauterine system for heavy menstrual bleeding (UCON): a randomised controlled phase III trial.

Background: Heavy menstrual bleeding affects one in four women and negatively impacts quality of life. Ulipristal acetate is prescribed to treat symptoms associated with uterine fibroids. We compared the effectiveness of ulipristal acetate and the levonorgestrel-releasing intrauterine system at reducing the burden of heavy menstrual bleeding, irrespective of the presence of fibroids.

Comparing inpatient management of chronic pelvic pain flares before and after the COVID-19 pandemic.

Abstract: Patients with chronic pelvic pain (CPP) may experience pain exacerbations requiring hospital admissions. Due to the effects of backlogged elective surgeries and outpatient gynaecology appointments resulting from the COVID-19 pandemic, we hypothesised that there would be an increased number of women admitted with CPP flares. We conducted a retrospective review of all acute gynaecology admissions at the Royal Infirmary of Edinburgh from July to December 2018 (pre-COVID) and 2021 (post-COVID lockdown).

Early (Days 1-4) post-treatment serum hCG level changes predict single-dose methotrexate treatment success in tubal ectopic pregnancy.

Study Question: What is the capacity of the change between Day 1 and Day 4 post-treatment serum human chorionic gonadotropin (hCG) levels for predicting single-dose methotrexate treatment success in tubal ectopic pregnancy?

Summary Answer: Any fall in Days 1-4 serum hCG signified an 85% (95% CI 76.8-90.6) likelihood of treatment success for women with tubal ectopic pregnancy (initial hCG of ≥1000 and ≤5000 IU/l) managed with single-dose methotrexate.

Examination of reporting status of pediatric oncology trials within the national library of medicine's trial database.

Finding safer and more effective treatment options are critical in progressing the field of pediatric oncology. These treatment options are discovered through completion and publication of clinical trials. The primary objective of this study was to assess the overall study characteristics of pediatric oncology clinical trials initiated between 2008 and 2021.

Combination of gefitinib and methotrexate to treat tubal ectopic pregnancy (GEM3): a multicentre, randomised, double-blind, placebo-controlled trial.

Background: Tubal ectopic pregnancies can cause substantial morbidity or even death. Current treatment is with methotrexate or surgery. Methotrexate treatment fails in approximately 30% of women who subsequently require rescue surgery.

Menstruation Dysregulation and Endometriosis Development.

Endometriosis is a common gynecological condition characterized by the growth of endometrial-like tissue outside of the uterus which may cause symptoms such as chronic pelvic pain or subfertility. Several surgical and medical therapies are available to manage symptoms, but a cure has yet to be determined which can be attributed to the incomplete understanding of disease pathogenesis. Sampson's theory of retrograde menstruation is a widely accepted theory describing how shed endometrial tissue can enter the peritoneal cavity, but other factors are likely at play to facilitate the establishment of endometriosis lesions.

Combination GnRH antagonists for endometriosis: Balancing efficacy with side effects.

Endometriosis is a chronic pain condition affecting 1 in 10 women. There is an unmet need for better medical treatments for endometriosis. We spotlight trials of a single preparation combined HRT-GnRH antagonist (Relugolix) by Giudice et al.

What Family Circumstances, During COVID-19, Impact on Parental Mental Health in an Inner City Community in London?

The introduction of lockdown due to a public health emergency in March 2020 marked the beginning of substantial changes to daily life for all families with young children. Here we report the experience of families from London Borough of Tower Hamlets with high rates of poverty and ethnic and linguistic diversity. This inner city community, like communities worldwide, has experienced a reduction or closure in access to education, support services, and in some cases, a change in or loss of income, job, and food security.