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Objective: This guideline reviews the etiology, diagnosis, evaluation, and treatment of hirsutism.
Target Population: Women with hirsutism.
Options: Three approaches to management include: 1) mechanical hair removal; 2) suppression of androgen production; and 3) androgen receptor blockade.
Outcomes: The main limitations of the management options include the adverse effects, costs, and duration of treatment.
Benefits, Harms, And Costs: Implementation of the recommendations in this guideline may improve the management of hirsutism in women with this condition. Adverse effects and a potential long duration of treatment are the main drawbacks to initiating treatment, as is the possibility of significant financial costs for certain treatments.
Evidence: A comprehensive literature review was updated to April 2022, following the same methods as for the prior Society of Obstetricians and Gynaecologists of Canada (SOGC) Hirsutism guidelines. Results were restricted to systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies. There were no date limits, but results were limited to English- or French-language materials.
Validation Methods: The authors rated the quality of evidence and strength of recommendations using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, along with the option of designating a recommendation as a "good practice point." See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).
Intended Audience: Primary care providers, family medicine physicians, obstetricians and gynaecologists, reproductive endocrinologists and others who manage the care of patients with hirsutism.
Tweetable Abstract: Management of hirsutism involves a 3-pronged approach of mechanical hair removal, suppression of androgen production, and androgen receptor blockade.
Summary Statements: RECOMMENDATIONS.
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http://dx.doi.org/10.1016/j.jogc.2023.102272 | DOI Listing |
Clin Endosc
November 2024
Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
Background/aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding.
View Article and Find Full Text PDFClin Endosc
December 2024
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Background/aims: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is an essential tool for tissue acquisition in solid pancreatic tumors. Rapid on-site evaluation (ROSE) by cytologists ensures diagnostic accuracy. However, the universal application of the ROSE is limited by its availability.
View Article and Find Full Text PDFTissue Barriers
December 2024
Department of General and Special Pathology, Saarland University (USAAR) and Saarland University Medical Center (UKS), Homburg, Germany.
The immunohistochemical expression of various members of the claudin family has already been studied in pathological affections of the vulva whether to differentiate precancerous lesions from vulvar squamous cell carcinoma or in inflammatory conditions such as lichen sclerosus. From an oncological perspective, however, immunohistochemical analysis of claudin 18.2 protein expression has become increasingly clinically relevant nowadays since the impressive therapeutic benefits of the claudin 18.
View Article and Find Full Text PDFPulm Ther
December 2024
Eli Lilly and Company, Indianapolis, IN, USA.
Introduction: This real-world study assessed the effectiveness of bebtelovimab (BEB) versus nirmatrelvir/ritonavir (NR) among outpatients with COVID-19 during the Omicron variant era.
Methods: We conducted a cohort study evaluating patients treated with BEB or NR from February to August 2022 (study period). Follow-up began the day after treatment and continued for 30 days.
Indian J Pediatr
December 2024
Division of Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Objectives: To present cases of rapid onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) and discuss management insights.
Methods: Case records of patients fulfilling the criteria for ROHHAD and presenting to the Pediatric Endocrinology Division of All India Institute of Medical Sciences, New Delhi, between July 2019 and June 2024 were reviewed for clinical features, treatments, and outcomes.
Results: Five patients (4 boys, 1 girl) presented at a median age of 4 y (range 3.
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