Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interd...Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer treatment and to facilitate fertility preservation, including oocyte and ovarian tissue cryopreservation. These fertility issues are often inadequately addressed, and referral rates to oncofertility centers are low. The aim of this study was to report the 3-year experience of the San Raffaele Oncofertility Unit. A total of 96 patients were referred to the Oncofertility Unit for evaluation after the diagnosis of cancer and before gonadotoxic treatment between April 2011 and June 2014. Of the 96 patients, 30(31.2%) were affected by breast cancers, 20(20.8%) by sarcomas, 28(29.2%) by hematologic malignancies, 13(13.5%) by central nervous system cancers, 3(3.1%) by bowel tumors, 1(1.0%) by Wilms' tumor, and 1(1.0%) by a thyroid tumor; 47(49.0%) were referred for oocyte cryopreservation before starting chemotherapy, 20(20.8%) were referred for ovarian tissue cryopreservation, and 29(30.2%) were not recruited. The mean time between the patients' counseling and oocyte retrieval was 15 days(range, 2–37 days). The mean time between the laparoscopic surgery and the beginning of treatment was 4 days(range, 2–10 days). The number of patients who were referred increased over time, whereas the rate of patients who were not recruited decreased, showing an improvement in referrals to the Oncofertility Unit and in the patients' counseling and understanding. Our results indicate that an effective multidisciplinary oncofertility team is necessary for prompt referrals and treatment.展开更多
Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous ...Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous studies have only described small cohorts or inhomogeneous population.Consequently,we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA,and compared testicular sperm extraction(TESE)outcomes between men with bilateral versus unilateral cryptorchidism.Our results show no difference in follicle-stimulating hormone(FSH)levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism(median:21.3 IU I^-1 vs 19.3 IU I^-1,P=0.306;and 7.2 ml vs 7.9 ml,P=0.543,respectively).In addition,sperm retrieval rates were similar(66.2%vs 60.0%,P=0.353).Using multivariate analysis,we have found that only a low inhibin B level(above the assay's detection limit)was positively associated with successful sperm retrieval(P<0.05).Regarding intracytoplasmic sperm injection outcomes,we found that cumulative pregnancy rate and live birth rate per cycle were not statistically different between the two groups(17.4%vs 27.8%,P=0.070;and 16.1%vs 26.4%,P=0.067,respectively).Unexpectedly,there was no significant difference in hormonal profiles(FSH,luteinizing hormone[LH],testosterone,and inhibin B levels)and TESE outcomes between unilateral versus bilateral cryptorchidism.This suggests that a history of unilateral cryptorchidism could reflect a bilateral testicular impairment.Interestingly,inhibin B level might be a predictor of successful TESE.展开更多
Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at t...Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.展开更多
Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University Colleg...Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.展开更多
Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influ...Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual risk-related beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 - 17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3-month follow-up. Results: Mothers’ and daughters’ scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p r = 0.27, p r = 0.427, p r = 0.146, p = 0.008). A two-factor structure was identified, although the second factor showed a lower eigen-value than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.展开更多
文摘Advances in cancer treatment allow women to be cured and live longer. However, the necessary chemotherapy and radiotherapy regimens have a negative impact on future fertility. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer treatment and to facilitate fertility preservation, including oocyte and ovarian tissue cryopreservation. These fertility issues are often inadequately addressed, and referral rates to oncofertility centers are low. The aim of this study was to report the 3-year experience of the San Raffaele Oncofertility Unit. A total of 96 patients were referred to the Oncofertility Unit for evaluation after the diagnosis of cancer and before gonadotoxic treatment between April 2011 and June 2014. Of the 96 patients, 30(31.2%) were affected by breast cancers, 20(20.8%) by sarcomas, 28(29.2%) by hematologic malignancies, 13(13.5%) by central nervous system cancers, 3(3.1%) by bowel tumors, 1(1.0%) by Wilms' tumor, and 1(1.0%) by a thyroid tumor; 47(49.0%) were referred for oocyte cryopreservation before starting chemotherapy, 20(20.8%) were referred for ovarian tissue cryopreservation, and 29(30.2%) were not recruited. The mean time between the patients' counseling and oocyte retrieval was 15 days(range, 2–37 days). The mean time between the laparoscopic surgery and the beginning of treatment was 4 days(range, 2–10 days). The number of patients who were referred increased over time, whereas the rate of patients who were not recruited decreased, showing an improvement in referrals to the Oncofertility Unit and in the patients' counseling and understanding. Our results indicate that an effective multidisciplinary oncofertility team is necessary for prompt referrals and treatment.
文摘Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous studies have only described small cohorts or inhomogeneous population.Consequently,we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA,and compared testicular sperm extraction(TESE)outcomes between men with bilateral versus unilateral cryptorchidism.Our results show no difference in follicle-stimulating hormone(FSH)levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism(median:21.3 IU I^-1 vs 19.3 IU I^-1,P=0.306;and 7.2 ml vs 7.9 ml,P=0.543,respectively).In addition,sperm retrieval rates were similar(66.2%vs 60.0%,P=0.353).Using multivariate analysis,we have found that only a low inhibin B level(above the assay's detection limit)was positively associated with successful sperm retrieval(P<0.05).Regarding intracytoplasmic sperm injection outcomes,we found that cumulative pregnancy rate and live birth rate per cycle were not statistically different between the two groups(17.4%vs 27.8%,P=0.070;and 16.1%vs 26.4%,P=0.067,respectively).Unexpectedly,there was no significant difference in hormonal profiles(FSH,luteinizing hormone[LH],testosterone,and inhibin B levels)and TESE outcomes between unilateral versus bilateral cryptorchidism.This suggests that a history of unilateral cryptorchidism could reflect a bilateral testicular impairment.Interestingly,inhibin B level might be a predictor of successful TESE.
文摘Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.
文摘Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.
文摘Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual risk-related beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 - 17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3-month follow-up. Results: Mothers’ and daughters’ scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p r = 0.27, p r = 0.427, p r = 0.146, p = 0.008). A two-factor structure was identified, although the second factor showed a lower eigen-value than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.
