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Pascoal DB, Araujo IMD, Lopes LP, Cruz CMD. Analysis of the Role of Female Hormones During Infection by COVID-19. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:940-948. [PMID: 34933388 PMCID: PMC10183921 DOI: 10.1055/s-0041-1740208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Women have metabolic, immunological, and genetic variables that ensure more protection from coronavirus infection. However, the indication of treatment for several pathologies and contraception is determined by hormones that have adverse effects and raise doubts about their use during the COVID-19 pandemic. Therefore, the present study searches women specificities and the relation between female sexual hormones and COVID-19, and reports the main recommendations in this background. To this end, a review of the literature was conducted in the main databases, auxiliary data sources, and official websites. Therefore, considering the hypercoagulability status of COVID-19, the debate about the use of contraceptives due to the relative risk of thromboembolic effects that they impose arises. However, the current available evidence, as well as the recommendations of main health organs around the world, demonstrate that the use of hormonal contraceptives must be maintained during the pandemic.
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Affiliation(s)
| | | | - Lorenna Peixoto Lopes
- Department of Gynecology and Obstetrics, Universidade Federal de Alagoas, Maceió, AL, Brazil.,Department of Medicine, UNIT University Center, Maceió, AL, Brazil
| | - Cristiane Monteiro da Cruz
- Department of Medicine, Centro Universitário Cesmac, Maceió, AL, Brazil.,Department of Medicine, UNIT University Center, Maceió, AL, Brazil
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Masmejan S, Guex-Crosier Y, Diserens C, Vouga M, Clottu AS, Ribi C, Mathevet P, Jacot-Guillarmod M. When obstetrics-gynecology specialists need to call an ophthalmologist urgently: a case report. J Med Case Rep 2021; 15:517. [PMID: 34670612 PMCID: PMC8529822 DOI: 10.1186/s13256-021-03087-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/31/2021] [Indexed: 12/04/2022] Open
Abstract
Background We report here a case of a healthy 23-year-old female patient who was assessed at the gynecology emergency department for genital ulcers, fever, and blurred vision. After suspicion of herpes simplex virus-2 lesions, the diagnosis of Behçet’s disease was made. We report this case with the aim of including Behçet’s disease in the differential diagnosis of genital ulcers, and emphasize the emergency of the vision loss that can be irreversible. Case presentation A healthy 23-year-old European female patient was assessed by gynecology in the emergency department for genital lesions associated with fever and blurred vision. At first, these lesions were suspected to be primary herpes simplex virus-2 infection One day later, she experienced decreased visual acuity in both eyes. After 4 days of worsening genital ulcers and persistent blurred vision, the patient was referred to the ophthalmology department. Fundoscopic examination showed retinal hemorrhages that were consistent with the first presentation of Behçet’s disease. Conclusions This case demonstrates that genital ulcers can be the very initial symptom of this ophthalmologic emergency. The differential diagnosis of genital ulcers is challenging. Behçet’s disease should be included, especially when associated with systemic or ocular manifestations, and should be considered an emergency for the gynecologist to prevent long-term vision loss.
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Affiliation(s)
- S Masmejan
- Service de Gynécologie et Obstétrique, Département Femme-Mère-Enfant, Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland
| | - Y Guex-Crosier
- Jules-Gonin Eye Hospital, Ophthalmogy Department, FAA, University of Lausanne, Lausanne, Switzerland
| | - C Diserens
- Service de Gynécologie et Obstétrique, Département Femme-Mère-Enfant, Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland
| | - M Vouga
- Service de Gynécologie et Obstétrique, Département Femme-Mère-Enfant, Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland
| | - A S Clottu
- Service d'immunologie et d'allergie, Département de Médecine, Centre Hospitalier Universitaire Vaudois, CHUV, 1011 Lausanne, Switzerland
| | - C Ribi
- Service d'immunologie et d'allergie, Département de Médecine, Centre Hospitalier Universitaire Vaudois, CHUV, 1011 Lausanne, Switzerland
| | - P Mathevet
- Service de Gynécologie et Obstétrique, Département Femme-Mère-Enfant, Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland
| | - M Jacot-Guillarmod
- Service de Gynécologie et Obstétrique, Département Femme-Mère-Enfant, Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland.
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Maas AHEM, Rosano G, Cifkova R, Chieffo A, van Dijken D, Hamoda H, Kunadian V, Laan E, Lambrinoudaki I, Maclaran K, Panay N, Stevenson JC, van Trotsenburg M, Collins P. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur Heart J 2021; 42:967-984. [PMID: 33495787 PMCID: PMC7947184 DOI: 10.1093/eurheartj/ehaa1044] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022] Open
Abstract
Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age. Hypertensive pregnancy disorders and gestational diabetes are associated with a higher risk in younger women. Menopause transition has an additional adverse effect to ageing that may demand specific attention to ensure optimal cardiovascular risk profile and quality of life. In this position paper, we provide an update of gynaecological and obstetric conditions that interact with cardiovascular risk in women. Practice points for clinical use are given according to the latest standards from various related disciplines (Figure 1).
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Affiliation(s)
- Angela H E M Maas
- Department of Cardiology, Director Women's Cardiac Health Program, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Route 616, 6525GA Nijmegen, The Netherlands
| | - Giuseppe Rosano
- St George's Hospitals NHS Trust University of London, Cranmer Terrace, London SW17 0RE, UK.,Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, via della Pisana, 235 Rome, Italy
| | - Renata Cifkova
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Vídeňská 800, 140 59 Prague 4, Czech Republic.,Department of Internal Cardiovascular Medicine, First Medical Faculty, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132 Milan (Milan), Italy
| | - Dorenda van Dijken
- Department of Obstetrics and Gynaecology, OLVG location West, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands
| | - Haitham Hamoda
- Department Gynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, M4:146 4th Floor William Leech Building, Newcastle upon Tyne NE2 4HH, UK
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Irene Lambrinoudaki
- Menopause Clinic, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, 30 Panepistimiou Str., 10679 Athens, Greece
| | - Kate Maclaran
- Department Gynaecology, Chelsea and Westminster Hospital, NHS Foundation Trust, 69 Fulham Road London SW10 9NH, UK
| | - Nick Panay
- Department of Gynaecology, Queen Charlotte's & Chelsea and Westminster Hospitals, Imperial College, Du Cane Road, London W12 0HS, UK
| | - John C Stevenson
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - Mick van Trotsenburg
- Bureau Gender PRO Vienna and Department of Obstetrics and Gynaecology, University Hospital St. Poelten-Lilienfeld, Probst Führer Straße 4 · 3100 St. Pölten, Austria
| | - Peter Collins
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
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Scott RM, Smith ER. Transition to Adulthood for Pediatric Moyamoya Patients. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0040-1715500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractMoyamoya is a progressive arteriopathy of the intracranial vasculature, predominantly affecting the terminal branches of the internal carotid artery. Treatment is predicated on surgical revascularization to reduce the risk of stroke. For patients diagnosed and treated as children, it is important to recognize the long-term implications of the disease, for example, that moyamoya is treatable, but not curable. Pediatric moyamoya patients face unique challenges as they transition to adulthood as a consequence of the chronic nature of this disorder. Successful long-term care requires a strategy that incorporates ongoing longitudinal disease monitoring, coordination of care between physician teams, and anticipation of socioeconomic factors that change over time. This article provides an approach to transition care to adult caregivers for pediatric moyamoya patients with a specific focus on the three key stakeholders in the process: the neurosurgeon, the primary care physician, and the individual patient.
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Affiliation(s)
- R Michael Scott
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Edward R. Smith
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
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