In-office hysteroscopy is considered the standard technique for visualization of the uterine cavity and the diagnosis of intrauterine pathologies. Moreover, nowadays, it is possible to treat a vast ...number of intracavitary diseases in the office, without the need for the inpatient setting. However, in some cases, pain might occur, and this is the most common reason for not completing the procedure. Over the last 20 years, many efforts have been carried out to miniaturize the instrumentation and to improve the techniques in order to avoid discomfort. Nonetheless, hysteroscopy still provokes distress for many patients. For this reason, pharmacological and non-pharmacological treatments for intraoperative and postoperative pain relief have been widely used for in-office hysteroscopy, with different results in various groups of women. The purpose of this review was to analyze the current literature on pharmacological aids (non-steroidal anti inflammatory drugs, cyclooxygenase-2 inhibitors, antispasmodics, local anesthetics, prostaglandins, opioids) and non-pharmacological interventions (transcutaneous electrical nerve stimulation, uterine stretching, uterine pressure, warming of distension medium, hypnosis, music, vocal-local) and to evaluate their impact on the relief from pain experienced during in-office hysteroscopy.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Purpose
The aim of the study was to evaluate the effects of dienogest (DNG) on quality of life (QoL) and sexual function of women affected by endometriosis pain.
Methods
Fifty-four women constituted ...the study group and were given 2 mg/daily DNG; 48 women were given non-steroidal anti-inflammatory drugs and constitut ed the control group. To define the endometriosis-associated pelvic pain, the Visual Analogic Scale (VAS) was used. The Short Form-36 (SF-36), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to assess the QoL, the sexual function and the sexual distress, respectively. The study included two follow-ups at 3 and 6 months.
Results
Pain improvement was observed in the study group at 3 (
p
< 0.05) and 6 months (
p
< 0.001) of treatment. At the 1st follow-up, women reported QoL improvements in some functions (
p
< 0.05); at the 2nd follow-up, they reported improvement in all categories (
p
< 0.001). The FSFI score did not change at the 1st follow-up (
p
= NS). On the contrary, at the 2nd follow-up, it improved with respect to the baseline (
p
< 0.05). At the 2nd follow-up, the FSFI score had risen to 27.8 (
p
< 0.001) and the FSDS score had dropped to 11.3 (
p
< 0.001). No change was observed in the control group (
p
= NS).
Conclusions
The progressive reduction of the pain syndrome reported by women over the treatment period could contribute to improve the QoL and sexual life of women on DNG.
Lakes are classified by thermal mixing regimes, with shallow waterbodies historically categorized as continuously mixing systems. Yet, recent studies demonstrate extended summertime stratification in ...ponds, underscoring the need to reassess thermal classifications for shallow waterbodies. In this study, we examined the summertime thermal dynamics of 34 ponds and shallow lakes across temperate North America and Europe to categorize and identify the drivers of different mixing regimes. We identified three mixing regimes: rarely (n = 18), intermittently (n = 10), and often (n = 6) mixed, where waterbodies mixed an average of 2%, 26%, and 75% of the study period, respectively. Waterbodies in the often mixed category were larger (≥4.17 ha) and stratification weakened with increased wind shear stress, characteristic of “shallow lakes.” In contrast, smaller waterbodies, or “ponds,” mixed less frequently, and stratification strengthened with increased shortwave radiation. Shallow ponds (<0.74 m) mixed intermittently, with daytime stratification often breaking down overnight due to convective cooling. Ponds ≥0.74 m deep were rarely or never mixed, likely due to limited wind energy relative to the larger density gradients associated with slightly deeper water columns. Precipitation events weakened stratification, even causing short‐term mixing (hours to days) in some sites. By examining a broad set of shallow waterbodies, we show that mixing regimes are highly sensitive to very small differences in size and depth, with potential implications for ecological and biogeochemical processes. Ultimately, we propose a new framework to characterize the variable mixing regimes of ponds and shallow lakes.
Key Points
Shallow lakes and ponds are assumed to be well mixed, yet we identified three mixing regimes: rarely, intermittently, or often mixed
Across 34 temperate shallow lakes and ponds, mixing regimes were primarily regulated by surface area and depth
Small, shallow waters mix due to shortwave radiation and convection; large, shallow waters mix due to wind
Purpose
To evaluate the effects of a continuous regimen combined oral contraceptive (COC) containing 2 mg dienogest and 30 µg ethinyl estradiol (DNG/EE) compared to a 21/7 regimen on the quality of ...life (QoL) and sexual function in women affected by endometriosis-associated pelvic pain.
Methods
Sixty-three women constituted the Study group treated with DNG/EE COC continuous regimen; 33 women were given DNG/EE COC in a 21/7 regimen. To define the endometriosis-associated pelvic pain, the Visual Analogic Scale was used. The Short Form-36, Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to assess QoL, sexual function and sexual distress, respectively. The study included two follow-ups.
Results
At 3 and 6 months of treatment there was an improvement in pain of the Study group (
p
< 0.001). The Control group underwent pain improvement at the second follow-up (
p
< 0.05). At the first and the second follow-ups, the Study group reported QoL improvements in all categories (
p
< 0.001). The Control group reported QoL improvements in all categories at the second follow-up (
p
< 0.05). At the first and the second follow-ups of the Study group, the FSFI total score had risen (
p
< 0.001), and the FSDS score had dropped (
p
< 0.001). An improvement of the FSFI score and a reduction of the FSDS score of the Control group was observed at the second follow-up (
p
< 0.001), but not at the first follow-up (
p
= NS).
Conclusions
Women on DNG/EE COC continuous regimen reported a reduction of endometriosis-associated pelvic pain and there was an improvement of their sexual activity and their QoL that was better than the DNG/EE 21/7 conventional regimen.
Largemouth bass (LMB, 265–475 mm) were collected to document whether changes in fish condition and reproductive status influenced the concentration of total mercury (Hg) and selenium (Se) in axial ...muscle by season and sex. The fatty acid (FA) composition of fish was also examined to describe seasonal and sexual differences and identify whether arachidonic acid (ARA) could be used as a biomarker of Hg toxicity. There was a trend for females to have lower (
p
< 0.062) Se concentrations than males. The concentration of Se for females during spring (mean ± SD, 686 ± 51 ng/g dw) was 15% lower than males (806 ± 67 ng/g dw). Lower Se concentrations in females than males continued through summer and fall. Concentration of Hg for females during spring (152 ± 39 ng/g ww) was also 59% lower than males (373 ± 303 ng/g ww), but the difference was not significant (
p
> 0.2). The percent of lipids was greatest in fall and winter (3%) and comprised primarily of omega-3 fatty acids (35 g/100 g lipid). Fish condition as measured by percent lipids and relative weight was negatively (
p
< 0.02) related to Hg concentration for females and males. Lipid content for both sexes was also positively (
p
< 0.05) related to the Se:Hg ratio. Relative weight was positively related to the Se:Hg ratio for females during all seasons (
p
= 0.014), but only during spring and summer for males (
p
< 0.007). A low Se:Hg value was associated with an elevation in ARA for both sexes and a reduced hepatosomatic index in males. Data suggested that females transferred muscle stores of Se and Hg to developing oocytes during spring. This study generates hypotheses regarding the physiological drivers of seasonal and sexual variability in Hg, Se, and FA in LMB that may be applicable to other species and have implications for fisheries health and management.
Purpose
The aim of the study was to evaluate the effects of nutraceuticals containing Equol, Resveratrol, Quecitine and Passiflora (Zemiar
®
, Avantgarde, Pomezia, Rome, Italy) on quality of life ...(QoL) and sexual function in perimenopausal women.
Methods
Sixty perimenopausal women having vasomotor symptoms and being in the −1, +1a of the STRAW system (amenorrhea for longer than 60 days and FSH < 20 UI/L) were enrolled. The modified Kupperman Index (KI) was used to evaluate menopause symptoms. The Short Form-36 (SF-36), Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to assess QoL, sexual function and sexual distress, respectively. The study had two follow-ups at 3 and 6 months.
Results
The women reported an improvement in the KI total score from the baseline (35 ± 4) to the 1st (21 ± 3,
p
< 0.05) and the 2nd (18 ± 2,
p
< 0.01) follow-ups. At the 1st follow-up, the women reported QoL improvements in some functions (
p
< 0.05); at the 2nd follow-up, they reported improvements in all categories (
p
< 0.001). At baseline, the total FSFI score was 23.1 ± 1.2 and the FSDS score was 18.1 ± 1.4, both indicating sexual dysfunction with sexual distress. FSFI and FSDS total scores did not change at the 1st follow-up (
p
= NS). On the contrary, at the 2nd follow-up, the FSFI score had risen to (27.6 ± 1.5) (
p
< 0.001) and the FSDS score had dropped to (11.3 ± 1.2) (
p
< 0.001).
Conclusions
Nutraceuticals can be effective in modulating the perimenopausal symptoms in women. The progressive reduction of the vasomotor symptoms reported by women over the nutraceutical usage could contribute to improve their QoL and sexual life.
Understanding attributes of phenology beyond the mean date of a life history event, such as variability among individuals within a population, is critical to predict how climate‐induced phenological ...shifts may alter population dynamics. Identifying how phenological variability impacts organisms is especially needed to better understand how phenological shifts affect trophic dynamics (e.g., shifts in variability of top predators affecting primary production). To better understand the effects of phenological variability on both populations and communities, we examined how variation in egg hatching synchrony of predatory marbled salamanders (Ambystoma opacum) impacted intraspecific interactions at the larval stage, ultimately affecting demographic traits and survival through metamorphosis. We also examined how hatching synchrony affected overall trophic dynamics (e.g., primary consumers and producers) in pond food webs. We experimentally manipulated the degree of hatching synchrony of embryonic A. opacum and subsequently reared larvae in outdoor mesocosms. We monitored demographic traits such as larval growth, size at and time to metamorphosis, and survival. To assess trophic dynamics, we monitored zooplankton abundance and phytoplankton biomass during the experiment. Larvae exhibited greater variability in body size in medium and low hatching synchrony treatments compared to high synchrony treatments. Larval body size variation diminished over time to ultimately result in no differences in most life history traits at metamorphosis or survival among hatching synchrony treatments. We also found no differences among treatments in zooplankton abundance or phytoplankton biomass, likely because of minimal variation in A. opacum survival among treatments that would induce top‐down changes. Overall, we found that phenological variation may be context dependent in its influence on demography and overall community structure. Because of concerns for how phenological shifts will affect species interactions, greater scrutiny into conditions that would promote changes in population and community dynamics is needed.
The Italian Society of Contraception identified as one of its priorities the need to give recommendations on management of contraception during Coronavirus-Covid 19 pandemia
A concise communication ...was produced which summarises in an easy-to-read format suitable for clinicians the management of the different contraceptives mostly used. Information how to manage contraception in different conditions is presented.
Women may, in general, continue to use either intrauterine and or hormonal contraceptives. The use of condom should be added to any hormonal contraceptive, when the contraceptive efficacy is reduced or when women stop the contraceptive method.
At the present time, during the Coronavirus-Covid 19 pandemia, no data contraindicate the use of intrauterine or hormonal contraceptives. Conversely the use of an appropriate contraception is advocate to prevent unintended pregnancies.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PDF
