Polycystic ovary syndrome and assisted reproduction: splitters versus lumpers

In 2003, the Rotterdam ESHRE/ASRM consensus updated the criteria for diagnosing polycystic ovary syndrome (PCOS), requiring, after the exclusion of other etiologies, at least two of the following: oligo-anovulation, hyperandrogenism, and polycystic ovaries. This change was driven by the awareness that PCOS is a syndrome with a broad spectrum of signs and symptoms of ovarian dysfunction (The Rotterdam PCOS consensus workshop group. Hum Reprod. 2004;19:41-47)

Topical Collection \u201cUpdates in obstetrics and gynecology\u201d: summary of the first year

Updates in obstetrics and gynecolog

Risk of reduced intestinal absorption of myo-inositol caused by D-chiro-inositol or by glucose transporter inhibitors

Background: D-chiro-inositol (DCI) and glucose transporter inhibitors may inhibit myo-inositol (MI) transporters, and the aim is to clinically evaluate their effect on MI absorption. Research design and methods: Fasting 18 healthy volunteers received orally 6000 mg MI, 6000 mg MI with 1000 mg DCI, and 6000 mg MI with SelectSIEVE\uae Apple PCQ and Sorbitol, Maltodextrin and Sucralose (PCQ- SMS), in three different phases with a washout period of 7 days. At each phase, blood samples were collected before administration, and every 60 minutes until 540 minutes after administration. MI plasma levels (\u3bcmol/L) were quantified by gas chromatography-mass spectrometry; maximum plasma concentration (Cmax), time to reach it (Tmax), and the area under the time-concentration curve of MI (AUC 0-540) were evaluated. Results: The Cmax of MI alone (Tmax=180min) was 1.29-fold higher than those of MI with DCI (Tmax=180min) (p<0.001) and 1.69-fold higher than those of MI with PCQ-SMS (Tmax=240min) (p<0.001). The AUC 0-540 was reduced by 19.09% in MI plus DCI (p=0.0118) and of 31.8% in MI plus PCQ-SMS (p<0.001) as compared to MI alone. Conclusions: DCI, glucose transporter inhibitors and sugars, such as sorbitol and maltodextrin, seem to inhibit MI absorption, decreasing MI plasma concentration as compared to MI alone

Role of inositol to improve surfactant functions and reduce IL-6 levels: A potential adjuvant strategy for SARS-CoV-2 pneumonia?

To date, the spread of SARS-CoV-2 infection is increasing worldwide and represents a primary healthcare emergency. Although the infection can be asymptomatic, several cases develop severe pneumonia and acute respiratory distress syndrome (ARDS) characterized by high levels of pro-inflammatory cytokines, primarily interleukin (IL)-6. Based on available data, the severity of ARDS and serum levels of IL-6 are key determinants for the prognosis. In this scenario, available in vitro and in vivo data suggested that myo-inositol is able to increase the synthesis and function of the surfactant phosphatidylinositol, acting on the phosphoinositide 3-kinase (PI3K)-regulated signaling, with amelioration of both immune system and oxygenation at the bronchoalveolar level. In addition, myo-inositol has been found able to decrease the levels of IL-6 in several experimental settings, due to an effect on the inositol-requiring enzyme 1 (IRE1)-X-box-binding protein 1 (XBP1) and on the signal transducer and activator of transcription 3 (STAT3) pathways. In this scenario, treatment with myo-inositol may be able to reduce IL-6 dependent inflammatory response and improve oxygenation in patients with severe ARDS by SARS-CoV-2. In addition, the action of myo-inositol on IRE1 endonuclease activity may also inhibit the replication of SARS-CoV-2, as was reported for the respiratory syncytial virus. Since the available data are extremely limited, if this potential therapeutic approach will be considered valid in the clinical practice, the necessary future investigations should aim to identify the best dose, administration route (oral, intravenous and/or aerosol nebulization), and cluster(s) of patients which may get beneficial effects from this treatment

La patogenesi dell\u2019endometriosi

L\u2019endometriosi \ue8 una malattia ginecologica benigna definita dalla presenza di ghiandole e stro- ma endometriale al di fuori dell\u2019utero. Essa si correla a dolore pelvico ed infertilit\ue0 e pu\uf2 compro- mettere gravemente la qualit\ue0 di vita delle donne affette (1\u20136). Inoltre, in relazione alla possibilit\ue0 di determinare d\u2019anno d\u2019organo pu\uf2 arrivare a richiedere trattamenti chirurgici particolarmente estesi (7,8). Sebbene pochi studi abbiano valutato la prevalenza e l\u2019incidenza dell\u2019endometriosi nella popolazione generale, si stima che il tasso di prevalenza dell\u2019endometriosi sia del 10% con un\u2019incidenza di circa 2-7 donne ogni mille all\u2019anno, e un ulteriore 11% di prevalenza legato a casi non diagnosticati (9\u201311). Comprendere i molteplici meccanismi sottostanti l\u2019eziopatogenesi dell\u2019endometriosi \ue8 di fondamentale importanza per le implicazioni che potrebbe avere nella prevenzione, diagnosi, trattamento e prognosi della malattia stessa (1)

Taglio cesareo demolitore

Taglio cesareo demolitor

Inositol in Polycystic Ovary Syndrome: Restoring Fertility through a Pathophysiology-Based Approach

Myo-inositol (MI) and D-chiro-inositol (DCI) are insulin second messengers, and MI is involved in follicular gonadotropin pathways which orchestrate ovulation. The tissue-specific MI/DCI ratio is modulated by insulin through aromatase and is altered in insulin resistance (IR), with reduced epimerization of MI to DCI in insulin-sensitive tissues. In ovaries, the MI/DCI ratio is 100:1, but is dramatically reduced by insulin-stimulated epimerase in hyperinsulinemic women with polycystic ovary syndrome (PCOS). Inositols have proved to be effective in PCOS, improving metabolic and hormonal state, and restoring spontaneous ovulation. In assisted reproductive technology, inositol improved ovarian stimulation parameters, although data concerning fertility outcomes are conflicting. Given their functions, inositols are an attractive treatment option for PCOS, although well-designed studies on spontaneous and non-spontaneous fertility are needed

Nintedanib for Advanced Epithelial Ovarian Cancer: A Change of Perspective? Summary of Evidence from a Systematic Review

Epithelial ovarian cancer (EOC) is the sixth most commonly diagnosed cancer among women. Results with available therapies are far from being satisfactory and, therefore, current research is focusing on new anticancer drugs to improve the clinical response of these patients. Nintedanib is an oral multiple tyrosine kinases inhibitor, which targets angiogenesis. Considering the current scenario, the aim of this systematic review is to highlight the prevailing knowledge about pharmacokinetics, pharmacodynamics, clinical efficacy, and safety of Nintedanib for the treatment of advanced EOC

Robotic Surgery in Female-To-Male Transition: A Possible Way for Further Improvement

Robotic Surgery in Female-To-Male Transition: A Possible Way for Further Improvemen

Translational animal models for endometriosis research: a long and windy road

endometriosi