Article
Obstetrics & Gynecology
Yutaka Osuga, Yasuaki Nakano, Yuji Yamauchi, Masaya Takanashi
Summary: The study evaluated the efficacy and safety of ulipristal acetate (UPA) for uterine fibroids (UFs), finding it to be noninferior to leuprorelin (LEU) in inducing amenorrhea for 35 days. The results demonstrate the clinical utility of UPA for Asians, with comparable effects on heavy menstrual bleeding as LEU.
FERTILITY AND STERILITY
(2021)
Article
Medicine, General & Internal
Iwona Szydlowska, Marta Grabowska, Jolanta Nawrocka-Rutkowska, Malgorzata Piasecka, Andrzej Starczewski
Summary: The results of the study suggest that a good response to UPA treatment in fibroids may be associated with a decrease in fibrosis, ER/PR and PCNA and Ki67 immunoexpression, as well as an increase in cell apoptosis.
JOURNAL OF CLINICAL MEDICINE
(2021)
Editorial Material
Obstetrics & Gynecology
Mei-An Middelkoop, Maria E. de Lange, T. Justin Clark, Ben Willem J. Mol, Pierre M. Bet, Judith A. F. Huirne, Wouter J. K. Hehenkamp
Summary: This paper reviews the marketing authorization and implementation process of UPA, highlighting its limitations in terms of study population representativeness, lack of surgical outcome evaluation, and absence of comparative groups for intermittent treatment. The paper emphasizes the need for regulatory measures to ensure the generation of necessary evidence before widespread prescription of new drugs.
HUMAN REPRODUCTION
(2022)
Article
Oncology
Hanxiao Zhu, Xiaoli Lai, Jinhong Wu, Chenan Guan, Junhui Yu
Summary: This article provides an overview of the common symptoms, treatment options, and novel techniques for uterine fibroids. The implementation of GnRH antagonist-based methodology is proven to be an effective approach for the removal of fibroids and alleviation of symptoms.
JOURNAL OF ONCOLOGY
(2022)
Article
Multidisciplinary Sciences
Md Soriful Islam, Maclaine Parish, Joshua T. Brennan, Briana L. Winer, James H. Segars
Summary: Fibrosis in uterine fibroids can be restricted by inhibiting fibrotic processes, and Epigallocatechin gallate (EGCG) has shown promise as a drug for uterine fibroids. This study investigates the effects and mechanisms of EGCG on fibroid cell fibrosis and finds that EGCG reduces the expression of fibrotic proteins and regulates key signaling pathways. Furthermore, EGCG exhibits greater anti-fibrotic effects compared to synthetic inhibitors.
SCIENTIFIC REPORTS
(2023)
Article
Oncology
Oukseub Lee, Maarten C. Bosland, Minhua Wang, Ali Shidfar, Omid Hosseini, Xiaoling Xuei, Priyam Patel, Matthew J. Schipma, Irene Helenowski, J. Julie Kim, Susan E. Clare, Seema A. Khan
Summary: Results show that ulipristal acetate is the most effective among the selective progesterone receptor modulators studied, while mifepristone is ineffective and telapristone acetate is less effective. Ulipristal acetate reduces tumor incidence and delays tumor onset, and also affects gene expression in benign mammary glands.
Review
Pharmacology & Pharmacy
Stefano Angioni, Maurizio N. D'Alterio, Angelos Daniilidis
Summary: Uterine fibroids are common benign tumors in women, often causing heavy menstrual bleeding and various symptoms. Treatment options for uterine fibroids include surgery and medical therapy, each with its own advantages and disadvantages.
CURRENT PHARMACEUTICAL DESIGN
(2021)
Review
Cell Biology
Mohamed Ali, Michal Ciebiera, Somayeh Vafaei, Samar Alkhrait, Hsin-Yuan Chen, Yi-Fen Chiang, Ko-Chieh Huang, Stepan Feduniw, Shih-Min Hsia, Ayman Al-Hendy
Summary: Uterine fibroids are a significant benign neoplastic threat to women's health globally, affecting up to 80% of premenopausal women and causing symptoms such as heavy menstrual bleeding, pain, and infertility. Progesterone signaling is crucial for the development and growth of uterine fibroids, promoting cell proliferation through genetic and epigenetic pathways. This review discusses the role of progesterone signaling in uterine fibroid pathogenesis and explores the therapeutic potential of compounds that modulate progesterone signaling, including selective progesterone receptor modulator drugs and natural compounds. Further research is needed to ensure safety and understand the exact molecular mechanisms of selective progesterone receptor modulator drugs, while clinical trials are necessary to confirm the effectiveness of natural compounds as a potential long-term treatment option, particularly for women planning pregnancy.
Review
Pharmacology & Pharmacy
Mohamed Ali, Michal Ciebiera, Marta Wlodarczyk, Samar Alkhrait, Elise Maajid, Qiwei Yang, Shih-Min Hsia, Ayman Al-Hendy
Summary: Uterine fibroids are the most common benign neoplasm in reproductive age women, and current treatment options have limitations. There is an urgent need for safe and effective non-surgical treatments.
Article
Medicine, General & Internal
Jung Yoon Park, Boah Chae, Mee-Ran Kim
Summary: This study evaluated the expression of various growth factors in uterine leiomyoma and compared the effects of existing medication and specific growth factor inhibitors on leiomyoma and normal myometrium. TGF-beta and VEGF inhibitors showed stronger therapeutic effects than the conventional drug UPA for treating uterine leiomyoma.
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
(2022)
Article
Medicine, Research & Experimental
Jae Ryoung Hwang, Young-Jae Cho, Ji-Yoon Ryu, Ju-Yeon Choi, Jung-Joo Choi, Jason K. Sa, Hyun-Soo Kim, Jeong-Won Lee
Summary: This study found that ulipristal acetate (UPA) has inhibitory effects on uterine sarcoma in in vitro and in vivo experiments. UPA showed significant anti-tumor effects in uterine sarcoma through the inhibition of the STAT3/CCL2 signaling pathway and could be a potential therapeutic agent for treating this disease.
BIOMEDICINE & PHARMACOTHERAPY
(2023)
Article
Obstetrics & Gynecology
Rohan R. Chodankar, Alison Murray, Moira Nicol, H. R. Whitaker, Alistair R. W. Williams, Hilary O. D. Critchley
Summary: This study investigated the impact of the progesterone receptor modulator ulipristal acetate (UPA) on endometrial morphology and function. The results showed that the effects on hormone receptors, cell proliferation, and progesterone-regulated genes were reversible after cessation of treatment.
FERTILITY AND STERILITY
(2021)
Article
Multidisciplinary Sciences
Mary C. Peavey, San-Pin Wu, Rong Li, Jian Liu, Olivia M. Emery, Tianyuan Wang, Lecong Zhou, Margeaux Wetendorf, Chandra Yallampalli, William E. Gibbons, John P. Lydon, Francesco J. DeMayo
Summary: The study revealed that overexpression of progesterone receptor PGR-B leads to relaxation of uterine muscles, prolonged gestational length, and increased incidence of labor dystocia, while overexpression of PGR-A increases uterine muscle contraction without affecting gestational length.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2021)
Article
Medicine, General & Internal
Iwona Szydlowska, Marta Grabowska, Jolanta Nawrocka-Rutkowska, Andrzej Kram, Malgorzata Piasecka, Andrzej Starczewski
Summary: This study found that a good response to UPA treatment may be associated with a decrease of inflammatory markers, but it does not influence myoma vascularization.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Obstetrics & Gynecology
Yutaka Osuga, Yasuaki Nakano, Yuji Yamauchi, Hitoshi Murakawa
Summary: The long-term intermittent administration of 10-mg UPA has been proven effective in reducing symptoms associated with uterine fibroids in Japanese women. During the treatment, patients experienced high rates of amenorrhea and normalization of uterine bleeding, leading to sustained improvements in anemia, pain, and quality of life.
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
(2021)
Article
Obstetrics & Gynecology
Bahadir Yazicioglu, Nazan Yurtcu, Huri Guvey, Canan Soyer Caliskan, Samettin Celik, Andrea Tinelli
Summary: This study aims to draw attention to the outcomes of adolescent pregnancies. It was found that adolescent pregnant women have poor overall neonatal outcomes, small neonatal head circumference, and are more likely to experience neonatal hypoglycemia, the need for Neonatal Intensive Care Unit and late-onset neonatal sepsis. Therefore, it is important to focus on the outcomes of adolescent pregnancies and provide family planning and baby care social trainings.
GINEKOLOGIA POLSKA
(2023)
Article
Urology & Nephrology
Andrea Morciano, Alfredo Ercoli, Dario Caliandro, Giuseppe Campagna, Giovanni Panico, Alessia Giaquinto, Marzio Angelo Zullo, Andrea Tinelli, Giovanni Scambia, Giuseppe Marzo, Mauro Cervigni
Summary: This study conducted a randomized clinical trial to investigate a new laparoscopic approach for treating severe posterior vaginal prolapse. The results suggest that this technique is effective in improving objective and subjective outcomes in patients with severe posterior vaginal prolapse, with minimal complications.
NEUROUROLOGY AND URODYNAMICS
(2023)
Article
Obstetrics & Gynecology
Oleksandra Kozyra, Mykhailo Medvediev, Andrea Tinelli
Summary: This study examined the predictive value of endometrial receptivity and pregnancy outcomes using pipelle biopsy examination during the luteal phase in infertile women. The results showed that a unique implantation window was one of the underlying causes of implantation failures. Personalizing the endometrial preparation protocol is a method to improve IVF outcomes.
CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY
(2023)
Editorial Material
Obstetrics & Gynecology
Andrea Tinelli
Summary: This editorial article discusses the application of modern concepts in gynecology, including endoscopic surgery, imaging, minimally invasive technology, and therapy.
CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY
(2023)
Article
Obstetrics & Gynecology
Pinar Birol Ilter, Murat Yassa, Hakan Timur, Ozan Dogan, Arzu Bilge Tekin, Ahmad Haydar, Cagri Gulumser, Niyazi Tug, Antonio Malvasi, Andrea Tinelli
Summary: The study aimed to investigate the role of intrapartum ultrasound in diagnosing asynclitism and the importance of the degree of asynclitism in labor outcomes. A cohort study was conducted on 41 low-risk pregnant women with singleton-vertex fetus. Severe and moderate asynclitism was observed in 41.7% and 58.8% of women, respectively. Severe asynclitism was associated with increased operative birth and maternal-fetal complications. Detection of asynclitism degree by intrapartum ultrasound could be useful in alerting the obstetrics team to potential perinatal problems during delivery.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2023)
Article
Biochemistry & Molecular Biology
Antonio Malvasi, Ettore Cicinelli, Giorgio Maria Baldini, Antonella Vimercati, Renata Beck, Miriam Dellino, Gianluca Raffaello Damiani, Gerardo Cazzato, Eliano Cascardi, Andrea Tinelli
Summary: The investigation studied the reduction of enkephalinergic neuro fibers (En) in the Lower Uterine Segment (LUS) during prolonged dystocic labor (PDL) with Labor Neuraxial Analgesia (LNA). The study compared LUS samples obtained from emergency cesarean section (CS) cases of 38 patients with PDL to elective CS cases of 37 patients. The results showed a significant reduction in En in the LUS of the PDL group, indicating that the drugs used during LNA may not effectively control the dystocic pain.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Surgery
Andrea Morciano, Giuseppe Marzo, Dario Caliandro, Michele Carlo Schiavi, Alessia Giaquinto, Carlo Rappa, Marzio Angelo Zullo, Andrea Tinelli, Giovanni Scambia, Mauro Cervigni
Summary: The aim of this study was to verify the efficacy and safety of local anesthesia during Altis (R) single incision placement for stress urinary incontinence. The results showed that local anesthesia had a good objective and subjective cure rate, with shorter operative time compared to spinal anesthesia. There were no significant differences in cure rate and postoperative complications between the two anesthesia methods. Therefore, local anesthesia may be considered a safe alternative to spinal anesthesia for Altis (R) implantation, allowing for outpatient procedures.
MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES
(2023)
Review
Obstetrics & Gynecology
Michael Stark, Ospan Mynbaev, Antonio Malvasi, Andrea Tinelli
Summary: This article discusses the choice of birthing position for parturients, emphasizing the role of gravity in the childbirth process. The author suggests informing parturients about the risks and benefits of each birthing option, allowing them to decide which position suits them.
INTERNATIONAL JOURNAL OF WOMENS HEALTH
(2023)
Article
Obstetrics & Gynecology
Andrea Tinelli, Ioannis Kosmas, Mykhailo V. Medvediev, Antonio Malvasi, Andrea Morciano, Radmila Sparic, Ospan A. Mynbaev
Summary: This observational prospective study aimed to determine whether performing myomectomy in patients over 40 years old with symptomatic uterine fibroids and desiring future fertility would have better surgical and reproductive outcomes. The study included laparoscopic intracapsular myomectomy (LIM), open laparotomy (OIM), and non-surgical management as a control group. The results showed that there were no significant differences in reproductive outcomes between operated and non-operated patients, indicating that myomectomy in patients over 40 years old did not have a detrimental effect on future pregnancy rates compared to expectant management.
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
(2023)
Article
Biochemistry & Molecular Biology
S. Tacconi, S. Longo, F. Guerra, C. Moliteni, M. Friuli, A. Romano, S. Gaetani, V. M. Paradiso, G. Difonzo, F. Caponio, D. Lofrumento, D. Vergara, C. Bucci, L. Dini, A. M. Giudetti
Summary: In this study, a green olive leaf extract obtained by water ultrasound-assisted extraction procedure (OLE) showed antioxidant and lipid-lowering effects on human hepatic HuH7 cells treated with high concentrations of free fatty acids (FFA). OLE reduced lipid accumulation, oxidative stress, and improved mitochondrial membrane potential and hepatic parameters by restoring the expression of enzymes involved in insulin signaling and lipid metabolism.
Review
Obstetrics & Gynecology
Radmila Sparic, Mladen Andjic, Daniele Vergara, Andrea Morciano, Ottavia D'Oria, Giorgio Maria Baldini, Antonio Malvasi, Andrea Tinelli
Summary: There is a reported association between low vitamin D levels and PCOS as well as insulin resistance, metabolic syndrome, hyperandrogenemia, metabolic and endocrine disorders, oxidative stress, and pro-inflammatory milieu in PCOS women.
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
(2023)
Article
Obstetrics & Gynecology
Antonio Malvasi, Gianluca Raffaello Damiani, Amerigo Vitagliano, Miriam Dellino, Reuven Achiron, Kosmas Ioannis, Antonella Vimercati, Maria Gaetani, Ettore Cicinelli, Marina Vinciguerra, Ilaria Ricci, Andrea Tinelli, Giorgio Maria Baldini, Giuseppe Trojano
Summary: The aim of this study was to evaluate the acceptance of both translabial and transabdominal intrapartum ultrasound (IU) in the delivery ward. The results showed that IU was well accepted by most patients, as it reassured them about their fetal condition and allowed them to see the fetus on the screen.
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY-X
(2023)