Soheila Aminimoghaddam; Nastaran Abolghasem
Volume 4, Issue 1 , March and April 2019, , Pages 5-11
Abstract
Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer ...
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Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer from hot flashes at some point during their perimenopausal years. A decline in oestrogen levels during menopause seems to be responsible for the appearance of hot flashes. This decline increases norepinephrine levels, leading to an up-regulation of serotonin receptors in the hypothalamus, which are involved in temperature regulation. The outcome of the activation of this norepinephrine serotonin pathway is believed to be the narrower thermoregulation zone, which in turn results in a greater risk of crossing the upper and lower thresholds of the thermoregulatory zone. Thus, it causes sweats and chills in this group of women. The most known effective treatment of hot flashes is hormone replacement therapy (HRT); however, in recent years, other non-hormonal options have become available for those women who cannot or do not want to take HRT.
Soheila Aminimoghaddam; Nastaran Abolghasem; Tahereh Ashraf- Ganjooie
Volume 3, Issue 3 , September and October 2018, , Pages 123-128
Abstract
Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients ...
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Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.