After the first case of COVID-19 pneumonia was reported in Wuhan, Hubei Province, China, in December 2019, the infection quickly spread to the rest of China and then to the wider world. The available information on pregnant women infected with COVID-19 is now significantly greater. There are now several case series and systematic reviews of cohorts, some of which include more than 100 cases. This review evaluates the scientific literature available until May 1, 2020 and discusses common questions about COVID-19 in the context of pregnancy and the postpartum period.
Purpose
Human papillomavirus (HPV) can cause condylomata acuminata, also known as genital warts. Our aim was to evaluate the long-term recurrence of genital warts after primary carbon dioxide laser treatment before the introduction of the vaccination against HPV.
Methods
Recurrence rate and localization of genital warts were analysed in a retrospective study in 1798 women presenting with a new diagnosis of genital warts from 1992 to 2009 at a University hospital and had received laser treatment. Additionally, data on topography, pregnancy status, and cervical smear were available for women treated from 2003 to 2009 (
n
= 825, data subset 1) and systematic follow-up data for women treated in 2006 and 2007 (
n
= 242, data subset 2).
Results
Median time from laser treatment to first recurrence was 14.6 weeks (data subset 2). The site most affected was the vulva (90.7%) followed by the perineum/perianal region (59.3%) and the vagina (47.3%). Abnormal Pap smear was observed in 22.6%. Systematic follow-up with a median follow-up time of 3.1 years revealed at least one recurrence in 68 (28.1%) of 242 women. Women with multifocal genital warts had a 2.9 times increased risk for recurrence compared to women with unifocal lesions (
p
= 0.01).
Conclusions
Nearly 30% of women presenting with genital warts experienced at least one recurrence after treatment with carbon dioxide laser. Multifocal lesions are the strongest indicator of recurrence. These data provide an important insight to recurrence rates of genital warts before HPV vaccination and underline the significance of a long-term follow-up and HPV vaccination.
Introduction
Poor genital self-image is a common phenomenon leading to an increasing interest in female genital surgery over the last years.
Aim
The aim was to correlate objective measurements of the labia minora with the individual subjective perception of the labial size.
Methods
In a cross-sectional study with 200 premenopausal women (median age 33.5 years) presenting for gynecological issues other than vulvar diseases, labial width and length were measured, and psychological and physical complaints were assessed. Multivariable logistic regression analyses were performed to identify factors that influenced self-reported complaints and subjective perception of labia size.
Main Outcome Measure
The main outcome measure was labial appearance (width and length in mm, color), subjective perception of the labial size, and complaints.
Results
The median width of the labia minora was 19.0 mm (interquartile range = 12.6–27.5), and the median length was 35.5 mm (interquartile range = 27.8–48.9). The objective size of the labia was significantly associated with womens' subjective perception of the labial size, but not with self-reported complaints. Nearly one-third of the women (n = 53, 27%) reported complaints of their labia minora which were mainly physical (n = 41, 77%) or a combination of physical and psychological problems (n = 9, 17%), while only a small group reported experiencing only psychological complaints (n = 3, 6%). Predictors of complaints were previous cosmetic surgery and the subjective perception of the labia size. The latter was significantly associated with discomfort during intercourse and when visiting a sauna and by labia minora that protruded over the labia majora.
Clinical Implications
Cutoff values to define labial hypertrophy and to justify labial reduction surgery should be avoided.
Strength & Limitations
This is a large sample of labial measurements in women not seeking labiaplasty. Standardized and validated questions regarding quality of life, sexuality, and body image could have provided more insight into psychological aspects.
Conclusion
These data demonstrate the variability of labial anatomy and its perception.
Our data compare favorably to a theoretical cohort suggesting a clinically reasonable cut-off of > 11 mm endometrial thickness to discriminate between "normal" and "pathological". The data regarding "risk for endometrial cancer" can be used for counseling affected women.
pathway through increased phosphorylation of CHK1 on serine 345 in PEO1 olaparib-sensitive cells. Targeting PARP in combination with ATRi or CHK1i is also synergistic in olaparib-resistant OC cells. However, pCHK1 was upregulated after treatment with CHK1i and PARPi/CHK1i in PEO1-OR cells. PARPi-resistance is associated with increased expression of PARP1, but not P-glycoprotein. Conclusion* Our results show that olaparib in combination with ATRi or CHK1i prompts cell death of OC line sensitive and resistant to olaparib on the path of synthetic lethality.
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