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Ethanol sclerotherapy (EST) has gained attention as a minimally invasive treatment option for ovarian endometriomas, particularly in infertile women with endometrioma undergoing in vitro fertilization (IVF). Endometriomas are associated with decreased ovarian reserve and impaired fertility outcomes, and traditional surgical approaches, such as cystectomy, often lead to further reductions in ovarian reserve. Ethanol sclerotherapy offers a potential alternative that preserves ovarian function while effectively managing endometriomas. This review examines the safety, efficacy, and impact of EST on ovarian reserve, IVF outcomes, and recurrence rates. Comparative studies suggest that pregnancy rates following EST are similar to or better than those after cystectomy, with the added benefit of more oocytes retrieved, which may lead to higher cumulative live birth rates. Despite these promising results, challenges such as recurrence and complications, particularly with prolonged ethanol exposure, remain. The use of transvaginal versus laparoscopic approaches and optimal ethanol exposure protocols are areas of ongoing research. The need for further large-scale, prospective studies is highlighted to refine the EST protocol and better understand the long-term outcomes. Sclerotherapy presents a feasible option for preserving fertility in women with endometriomas, with positive implications for IVF success and ovarian reserve preservation. [ABSTRACT FROM AUTHOR]

Background: Endometriosis and adenomyosis are two closely related, estrogen-dependent, benign gynecological diseases. The available evidence on their common pathogenesis and association is limited and often does not address the heterogeneity of both entities. The aim of our study is to investigate the association between different types and localizations of adenomyosis and endometriosis phenotypes, using magnetic resonance imaging (MRI) and laparoscopic findings. Methods: We performed a retrospective observational study involving premenopausal women over 18 years old who underwent laparoscopic surgery for endometriosis and were pre-operatively diagnosed with adenomyosis through MRI examination at the Cantonal Hospital of Schaffhausen, Switzerland between 2011 and 2022. Results: Of 130 patients with adenomyosis, 23 (17.7%) women had adenomyosis only in the anterior wall (group 1), 38 (29.2%) only in the posterior wall (group 2), and 69 (53.1%) in both the anterior and posterior wall (group 3). Women in group 1 experienced significantly more dysuria compared to the two other groups (p = 0.018), while the prevalence of other pain symptoms (dysmenorrhea, dyspareunia, dyschesia) was comparable between the groups. Women in group 3 had significantly thicker anterior and posterior myometrium compared to groups 1 and 2 (p < 0.001). Co-existence of deep rectal endometriosis was more frequent in women from group 3 compared to groups 1 and 2 (p = 0.039) and in women with adenomyosis in the outer (extrinsic) compared to adenomyosis in the inner myometrium (intrinsic) (p < 0.001). Conclusions: This study provides evidence of an association between the localization of adenomyosis and the distribution of concomitant endometriosis. Specifically, adenomyosis localized in both the anterior and posterior wall appears to be more proliferative compared to adenomyosis found only in the anterior or posterior wall. This is indicated by its association with higher uterine volume, thicker posterior junctional zone, and greater myometrial thickness and with a higher co-existence with deep rectal endometriosis. These findings support an association between the development of specific subtypes of both entities, which represents a valuable resource for the identification of future targets for the treatment and clinical management of adenomyosis and endometriosis. [ABSTRACT FROM AUTHOR]

To present a standardized and reproducible approach for the surgical excision of deep endometriosis in the rectovaginal septum, represented by #ENZIAN A. Surgical video article. A tertiary referral center. The case of a patient with an isolated endometriotic nodule in the rectovaginal septum was used to illustrate the surgical technique, also referred to as the butterfly method. An Intuitive Xi DaVinci system was used at the tertiary referral center, IFEMEndo in Bordeaux, France. Patient consent was obtained. Step-by-step approach for the excision of endometriosis in the rectovaginal septum. This educational film presents a systematic approach dividing the surgical procedure into following six steps: 1. Adhesiolysis and identification of the decisive structures such as the sacrouterine ligament, ureter, and nervus hypogastricus on both sides. 2. Dissection of the Okabayashi pararectal space with preservation of the plexus hypogastricus. 3. Incision of the pararectal space medial to the sacrouterine ligament. 4. Dissection of the rectovaginal septum and detachment of the rectum in a caudal direction. 5. Resection of the entire endometriotic nodule, depending on the depth of invasion. 6. Closure by suturing when transvaginal resection was performed. We used the metaphor of the butterfly because it comprehensively and pictorially reflects the resection line of the endometriotic nodule in the rectovaginal septum. Surgical management of rectovaginal endometriosis can be challenging and requires as much as possible the preservation of autonomic nerves. A systematic approach enables the endoscopists to perform a safe and complete removal of the lesion. [ABSTRACT FROM AUTHOR]

Both endometriosis and ovarian dermoid cysts are benign conditions characterized by the presence of well-differentiated tissues in ectopic locations. The presence and surgical excision of these entities can potentially impact ovarian reserves, contributing to reduced chances of future pregnancy. The objective of our study is to investigate the bidirectional association between endometriosis and ovarian dermoid cysts, as well as to analyze the clinical characteristics of patients diagnosed with both conditions. A retrospective cohort study was conducted, including women who underwent laparoscopy and received histological diagnoses of endometriosis and/or dermoid cysts between 2011 and 2019 at the Cantonal Hospital of Schaffhausen. We identified 985 women with endometriosis and 83 women with ovarian dermoid cysts. Among these groups, 22 women presented with both endometriosis and ovarian dermoid cysts. The majority of the above patients had endometriosis stage rASRM I-II (72.7%), with peritoneal endometriosis being the most common phenotype of endometriosis (77.2%). Out of the 14 patients with a desire for future pregnancy, the majority (11/14, 78.5%) had an EFI score of 7–8. The prevalence of bilateral ovarian dermoid cysts was higher in women with both ovarian dermoid cysts and endometriosis in comparison to women with ovarian dermoid cysts without endometriosis (18% vs. 6.5%). Our study revealed that 26.5% of women with ovarian dermoid cysts also had endometriosis, a notably higher prevalence than observed in the general population. Clinicians should be aware of this co-existence, and preoperative counseling should be an integral part of the care plan for affected individuals, where the potential risks and the available options for fertility preservation should be discussed in detail. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting many women of reproductive age. Although its physiology is poorly understood, hyperandrogenemia and insulin resistance play a pivotal role in this complex syndrome, predisposing patients to a variety of cardiovascular and metabolic modalities. Current therapeutic options, including lifestyle modifications and medications, often do not satisfactorily improve clinical outcomes. SGLT2 inhibitors (SGLT‐2i) are a novel option which can potentially improve many hormonal and metabolic parameters for patients with PCOS, though the net cardiovascular effects remain under investigation in this population of patients with PCOS. Overall, the use of SGLT‐2i may be associated with beneficial somatometric, metabolic and hormonal outcomes of PCOS. To date, all available studies have recorded body mass index, waist and hip circumference, and fat mass reductions, improved insulin and androgen levels, and reduced blood pressure. The aim of the present review is to summarise PCOS‐related manifestations and mechanisms leading to cardiovascular disease, to explore the cardiometabolic impact of SGLT2i on PCOS, and to critically analyse the cardiometabolic and hormonal outcomes of the recent studies on the use of SGLT2i in women with PCOS. [ABSTRACT FROM AUTHOR]

Ovarian endometriomas have a negative impact on a patient's reproductive potential and are likely to cause a reduction in ovarian reserve. The most commonly employed ovarian reserve parameters are anti-Müllerian hormone (AMH) and antral follicular count (AFC). Surgical management options of endometrioma include cystectomy, ablative methods, ethanol sclerotherapy and combined techniques. The optimal surgical approach remains a matter of debate. Our review aimed to summarize the literature on the impact of surgical management of endometrioma on AMH, AFC and fertility outcomes. Cystectomy may reduce recurrence rates and increase chances of spontaneous conception. However, a postoperative reduction in AMH is to be anticipated, despite there being evidence of recovery during follow-up. The reduction in ovarian reserve is likely multi-factorial. Cystectomy does not appear to significantly reduce, and may even increase, AFC. Ablative methods achieve an ovarian-tissue-sparing effect, and improved ovarian reserve, compared to cystectomy, has been demonstrated. A single study reported on AMH and AFC post sclerotherapy, and both were significantly reduced. AMH levels may be useful in predicting the chances of conception postoperatively. None of the aforementioned approaches has a clearly demonstrated superiority in terms of overall chances of conception. Surgical management of endometrioma may, overall, improve the probability of pregnancy. Evidence on its value before medically assisted reproduction (MAR) is conflicting; however, a combination of surgery followed by MAR may achieve the optimal fertility outcome. In view of the complexity of available evidence, individualization of care, combined with optimal surgical technique, is highly recommended. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is a serious medical condition that can lead to severe morbidity and mortality, making it a significant public health concern. VTE is a multifactorial condition that results from the interaction of genetic, acquired, and environmental factors. Physiological changes during pregnancy increase the risk of VTE as they express Virchow's triad (increased coagulation factors, decreased fibrinolysis, trauma, and venous stasis). Moreover, pregnancy-related risk factors, such as advanced maternal age, obesity, multiple gestations, and cesarean delivery, further increase the risk of VTE. Managing VTE in pregnancy is challenging due to the complexity of balancing the risks and benefits of anticoagulant therapy for both the mother and the fetus. A multidisciplinary approach involving obstetricians, hematologists, and neonatologists, is necessary to ensure optimal outcomes for both the mother and baby. This review aims to discuss the current challenges associated with VTE in pregnancy and identify potential solutions for improving outcomes for pregnant women at risk for VTE. [ABSTRACT FROM AUTHOR]

BACKGROUND Sexuality has a key impact on quality of life and on reproductive health. Infertility often results in sexual dysfunction. Despite this close association, addressing sexuality is not a standard component of infertility counselling, especially since in most countries sexual medicine is not a core element of specialist training. Even today, many doctors and patients consider discussing sexuality to be more challenging than other aspects of reproductive medicine. The present review addresses the complex consequences of infertility on sexuality. OBJECTIVE AND RATIONALE Our goals were: (i) to identify the prevalence of sexual problems resulting from infertility, (ii) to evaluate characteristics of sexual difficulties and disorders resulting from infertility and (iii) to analyse factors involved in the complex association between sexual problems and infertility. SEARCH METHODS A systematic search for publications containing keywords related to sexual disorders and infertility was performed via PubMed, Web of Science and Psyndex. A total of 170 manuscripts published between January 1966 and April 2021 were identified after verification of inclusion and exclusion criteria. The reference lists in these manuscripts were searched for further relevant literature. Studies were reviewed for quality-related methodological details. OUTCOMES Couples diagnosed with infertility have an increased risk of sexual disorders. Loss of sexual desire and erectile dysfunction are among the most frequent sexual disorders resulting from infertility. Currently available literature reflects only fragmentarily the complexity of the diverse interactions. Sexuality plays out against the backdrop of interactions among personal, cultural, infertility-related and sexuality-related factors. Considering this complexity, it is crucial to evaluate individual profiles as well as partnership interactions to avoid a negative impact of infertility on a couple's sexual life. WIDER IMPLICATIONS Identifying sexual disorders as relevant considerations in the context of infertility and exploring their impact during the entire course of diagnosis and treatment constitute an important contribution to comprehensively care for the couples concerned. Counselling should focus on preventing the onset and aggravation of sexual disorders. As sexuality represents a major component of quality of life and of partnership, such support may improve not only the current overall wellbeing but also the chances of a satisfactory long-term partnership and family life. [ABSTRACT FROM AUTHOR]

Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a significant association with gynecologic malignancies, many underlying principles remain unclear. This work aimed to systematically describe the intraoperative appearance of endosalpingiosis. Methods: Data and intraoperative videos of patients with histologically verified endosalpingiosis were retrospectively reviewed. The main outcome measures were macroscopic phenotype and anatomical distribution. Additionally, a systematic review searching PubMed (Medline) and Embase was conducted. Results: In the study population (n = 77, mean age 40.2 years (SD 16.4)), the mean size of lesions was 3.6 mm and the main visual pattern was vesicular (62%). The most frequent localization was the sacrouterine ligaments (24.7%). In the systematic review population (n = 1174 (210 included studies overall), mean age 45.7 years (SD 14.4)), there were 99 patients in 90 different studies with adequate data to assess the appearance of the lesions. The mean size of the lesions was 48.5 mm, mainly with a cystic visual pattern (49.5%). The majority of the lesions affected the ovaries (23.2%), fallopian tubes (20.4%), or lymph nodes (18.5%). Comparing this study to the literature population, the main differences concerned the size (p < 0.001) and main visual patterns (p < 0.001) of lesions. Conclusions: The usual intraoperative findings of endosalpingiosis appeared less impressive than described in the literature. In our study population, lesions of a few millimeters in size with a vesicular appearance were mostly seen, most frequently in the sacrouterine ligament area. Intraoperative recognition by the gynecologic surgeon and histologic diagnosis should play an important role in further understanding this entity, scientifically and clinically. [ABSTRACT FROM AUTHOR]

Author(s): Richard Redon [1]; Shumpei Ishikawa [2, 3]; Karen R. Fitch [4]; Lars Feuk [5, 6]; George H. Perry [7]; T. Daniel Andrews [1]; Heike Fiegler [1]; Michael H. Shapero [...]

Endosalpingiosis refers to the ectopic presence of tubal epithelium. However, this incidental finding received little attention, although it is the second most common benign peritoneal pathology in women following endometriosis. In contrast to endometriosis, endosalpingiosis shows an increase in prevalence with age beyond the menopause. Furthermore, it does not appear to be chronically inflammatory and, according to research to this date, does not cause chronic pain or infertility. Recent epidemiological and molecular pathological studies show a significantly higher incidence of ovarian and endometrial tumors in women with endosalpingiosis. These correlations have not been conclusively clarified. Generally accepted clinical recommendations for the detection of endosalpingiosis do not yet exist. In order to better understand the disease value of endosalpingiosis and its oncological correlations, this entity should be brought to the attention of surgical gynecology and involved pathology. [ABSTRACT FROM AUTHOR]

Background: Methamphetamine hydrochloride is 1 of the most widespread psycho-stimulants in the world. Nevertheless, its effect on pregnant women and their neonates has not been investigated extensively. Objective: To systematically review the literature for the effect of methamphetamine exposure during pregnancy to neonatal and pregnancy outcomes. Materials and methods: A meta-analysis of retrospective, case-control studies was conducted. Inclusion criteria were women who have used methamphetamine during pregnancy, determined by self-report, maternal or neonatal urine test, and/or meconium toxicology, compared with control women not taking methamphetamine. Main study outcomes were gestational age at birth, neonatal characteristics (birth weight, head circumference, body length), and prevalence of gestational hypertensive disorders. Results: Eight studies involving 626 women taking methamphetamine during pregnancy and 2626 controls were included in the meta-analysis. Pregnancies complicated by the use of methamphetamine resulted in younger gestational age at birth (mean difference [MD] -0.90 weeks, 95% confidence interval [CI] -0.11, -1.69), lower birth weight (MD -245 g, 95% CI -137, -353), head circumference (MD -0.88 cm, 95% CI -0.48, -1.28), body length (MD -0.94 cm, 95% CI -0.55, -1.32), and Apgar score (MD -0.94, 95% CI -0.33, -1.54) compared with control pregnancies. On the contrary, there was no statistical difference on the incidence of pre-eclampsia (risk ratio [RR] 1.77, 95% CI 0.75, 4.14) and hypertensive complications (RR 1.62, 95% CI 0.37, 7.06). Conclusions: Use of methamphetamine during pregnancy results in a deterioration of neonatal somatometric characteristics (birth weight, head circumference, body length), but not in excessive pregnancy complications (hypertension). [ABSTRACT FROM AUTHOR]

Superficial papilloma of the ovary is a rare benign ovarian finding, which was first described back in 1895. Here, we present the intraoperative and histological findings of a superficial papilloma of the ovary in a 59‐year‐old patient. [ABSTRACT FROM AUTHOR]

The article "Colorectal surgery for endometriosis: A comprehensive step-by-step approach of the disc excision technique—a video vignette" presents a systematic and educational approach to disc excision for patients with colorectal infiltration of endometriosis. The case study involves a 27-year-old woman with dyschezia and dyspareunia, who underwent a discoid resection for a 3 cm endometriotic nodule in the rectosigmoid colon. The technique showcased in the video vignette offers favorable functional outcomes and symptom reduction, with comparable complication rates to segmental resection. [Extracted from the article]

In this paper we present DockFlow, a prototypic version of a PharmaGrid. DockFlow is supporting pharmaceutical research through enabling virtual screening on the Grid. The system was developed in the course of the BRIDGE project funded by the European Commission. Grids have been used before to run compute- and data-intensive virtual screening experiments, like in the WISDOM project. With DockFlow, however, we addressed a variety of problems yet unsolved, like the diversity of results produced by different docking tools. We also addressed the problem of analysing the data produced in a distributed virtual screening system applying a combinatorial docking approach. In DockFlow we worked on a grid-based problem solving environment for virtual screening with the following major features: execution of four different docking services (FlexX, AutoDock, DOCK and GAsDock) at locations in Europe and China remotely from a common workflow, storage of the results in a common Docking Database providing a shared analysis platform for the collaboration partners and combination of the results. The DockFlow prototype is evaluated on two scientific case studies: malaria and avian flu. [ABSTRACT FROM AUTHOR]

Recently, the application of array-based comparative genomic hybridization (array CGH) has improved rates of detection of chromosomal imbalances in individuals with mental retardation and dysmorphic features. Here, we describe three individuals with learning disability and a heterozygous deletion at chromosome 17q21.3, detected in each case by array CGH. FISH analysis demonstrated that the deletions occurred as de novo events in each individual and were between 500 kb and 650 kb in size. A recently described 900-kb inversion that suppresses recombination between ancestral H1 and H2 haplotypes encompasses the deletion. We show that, in each trio, the parent of origin of the deleted chromosome 17 carries at least one H2 chromosome. This region of 17q21.3 shows complex genomic architecture with well-described low-copy repeats (LCRs). The orientation of LCRs flanking the deleted segment in inversion heterozygotes is likely to facilitate the generation of this microdeletion by means of non-allelic homologous recombination. [ABSTRACT FROM AUTHOR]

Provides information on the Discovery Net architecture used for building grid-based knowledge discovery applications. Result from the emergence of distributed resources and grid technologies; Focus of the effort of the high performance community; Capabilities of the architecture.

The article discusses several studies on the pathology of gynaecological cancers, published in various periodicals from September 30, 2019 to March 31, 2020. Topics covered include molecular classification of epithelial ovarian cancer based on methylation profiling, and clinicopathological and molecular characteristics of endometrial cancer in "Clinical Cancer Research," and immunogenomic profiling in ovarian cancer in "Nature Communications."

This study describes a new tool for accurate and reliable high-throughput detection of copy number variation in the human genome. We have constructed a large-insert clone DNA microarray covering the entire human genome in tiling path resolution that we have used to identify copy number variation in human populations. Crucial to this study has been the development of a robust array platform and analytic process for the automated identification of copy number variants (CNVs). The array consists of 26,574 clones covering 93.7% of euchromatic regions. Clones were selected primarily from the published "Golden Path," and mapping was confirmed by fingerprinting and BAC-end sequencing. Array performance was extensively tested by a series of validation assays. These included determining the hybridization characteristics of each individual clone on the array by chromosome-specific add-in experiments. Estimation of data reproducibility and false-positive/negative rates was carried out using self--self hybridizations, replicate experiments, and independent validations of CNVs. Based on these studies, we developed a variance-based automatic copy number detection analysis process (CNVfinder) and have demonstrated its robustness by comparison with the SW-ARRAY method. [ABSTRACT FROM AUTHOR]

Accurate diagnosis and assessment of endometriosis by transvaginal ultrasound scan (TVS) can be challenging. We performed an online survey of specialist gynecologists who perform TVS on a regular basis regarding their views as well as clinical experience on the use of TVS in the diagnosis of endometrioma and deep endometriosis (DE). We collected 64 responses. Sixty-one participants (95.31%) answered that they can confidently diagnose endometrioma by TVS "always" or "most of the time". With the exception of DE of the recto-vaginal septum/posterior vaginal vault, for all other DE locations, more than 50% of participants felt that they can "rarely" or "never" diagnose it by TVS in their own clinical practice. Forty-two participants (65.6%) stated that additional, specialized training is required for the diagnosis of endometrioma. When asked about a diagnosis of DE, 58 participants (90.6%) felt that the same is required. The only statistically significant association was between the number of TVSs performed per year and the clinician's ability to diagnose bowel DE in their practice. The answers to all other questions did not differ significantly based on professional status, years of experience post-residency, or number of TVSs per year. Our results demonstrate the delayed adoption of novel diagnostic approaches in endometriosis and confirm the urgent need for specialized ultrasound training., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2023, Grigoriadis et al.)

Objectives Mental health during pregnancy is a very important public health issue with negative effects on both maternal and child outcomes. The aim of our study is to examine the possible association between conception via in vitro fertilization (IVF) and anxiety or depression during the third pregnancy trimester in the Greek population during the years of financial crisis. Materials and Methods This single-center prospective cohort study was conducted in a tertiary university hospital during the period 2017-2018. Pregnant women attending the Antenatal Care Program between 30th-32nd gestational week were asked to complete Hamilton Anxiety Rating Scale (HAM-A) and Beck Depression Inventory (BDI). A propensity score match for 10 variables was conducted in a 1:3 ratio. Results Of the 521 eligible patients, 446 women were included in our study. Four hundred fourteen of them conceived spontaneously, and 32 via IVF. After propensity score matching, 76 remained in the analysis, of whom 57 conceived spontaneously and 19 with IVF. The IVF group had a higher rate of anxiety (18.8%) and a lower rate of depression (9.4%) than the spontaneous conception group (13.5% and 13.5%, respectively), but the differences were not statistically significant before and after propensity score matching.  Conclusion Our study showed that pregnancies after IVF had a higher incidence of antenatal anxiety and a lower incidence of antenatal depression in comparison to pregnancies that were conceived naturally, although the differences did not reach statistical significance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Arvanitidou et al.)

Background: Social media platforms, such as Facebook and Instagram, are increasingly being used to share health-related information by "influencers," regular users, and institutions alike. While patients may benefit in various ways from these interactions, little is known about the types of endometriosis-related information published on social media. As digital opinion leaders influence the perceptions of their followers, physicians need to be aware about ideas and beliefs that are available online, in order to address possible misconceptions and provide optimal patient care., Objective: The aim of this study was to identify and analyze frequent endometriosis-related discussion topics on social media in order to offer caregivers insight into commonly discussed subject matter and aspects., Methods: We performed a systematic search using predefined parameters. Using the term "endometriosis" in Facebook's search function and a social media search engine, a list of Facebook pages was generated. A list of Instagram accounts was generated using the terms "endometriosis" and "endo" in Instagram's search function. Pages and accounts in English with 5000 or more followers or likes were included. Nonpublic, unrelated, or inactive pages and accounts were excluded. For each account, the most recent 10 posts were identified and categorized by two independent examiners using qualitative content analysis. User engagement was calculated using the numbers of interactions (ie, shares, likes, and comments) for each post, stratified by the number of followers., Results: A total of 39 Facebook pages and 43 Instagram accounts with approximately 1.4 million followers were identified. Hospitals and medical centers made up 15% (6/39) of the Facebook pages and 5% (2/43) of the Instagram accounts. Top accounts had up to 111,600 (Facebook) and 41,400 (Instagram) followers. A total of 820 posts were analyzed. On Facebook, most posts were categorized as "awareness" (101/390, 25.9% of posts), "education and research" (71/390, 18.2%), and "promotion" (64/390, 16.4%). On Instagram, the top categories were "inspiration and support" (120/430, 27.9% of posts), "awareness" (72/430, 16.7%), and "personal story" (72/430, 16.7%). The frequency of most categories differed significantly between platforms. User engagement was higher on Instagram than on Facebook (3.20% vs 0.97% of followers per post). On Instagram, the highest percentage of users engaged with posts categorized as "humor" (mean 4.19%, SD 4.53%), "personal story" (mean 3.02%, SD 4.95%), and "inspiration and support" (mean 2.83%, SD 3.08%). On Facebook, posts in the categories "awareness" (mean 2.05%, SD 15.56%), "humor" (mean 0.91%, SD 1.07%), and "inspiration and support" (mean 0.56%, SD 1.37%) induced the most user engagement. Posts made by hospitals and medical centers generated higher user engagement than posts by regular accounts on Facebook (mean 1.44%, SD 1.11% vs mean 0.88%, SD 2.71% of followers per post) and Instagram (mean 3.33%, SD 1.21% vs mean 3.19%, SD 2.52% of followers per post)., Conclusions: Facebook and Instagram are widely used to share endometriosis-related information among a large number of users. Most posts offer inspiration or support, spread awareness about the disease, or cover personal issues. Followers mostly engage with posts with a humoristic, supportive, and awareness-generating nature. Health care providers should be aware about the topics discussed online, as this may lead to an increased understanding of the needs and demands of digitally proficient patients with endometriosis., (©Julian Matthias Metzler, Dimitrios Rafail Kalaitzopoulos, Laurin Burla, Gabriel Schaer, Patrick Imesch. Originally published in JMIR Formative Research (https://formative.jmir.org), 18.03.2022.)

Endometriosis is a benign gynecologic condition affecting up to one woman out of ten of reproductive age. It is defined by the presence of endometrial-like tissue in localizations outside of the uterine cavity. It often causes symptoms such as chronic pain, most frequently associated with the menstrual cycle, and infertility, but may also be oligo- or asymptomatic. There is evidence that some ovarian carcinoma (OC) histotypes, mainly the ovarian clear cell (OCCC) and endometrioid (EnOC) carcinoma, may arise from endometriosis. The most frequent genomic alterations in these carcinomas are mutations in the AT-rich interacting domain containing protein 1A ( ARID1A ) gene, a subunit of the SWI/SNF chromatin remodeling complex, and alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT/mTOR pathway, which frequently co-occur. In ARID1A deficient cancers preclinical experimental data suggest different targetable mechanisms including epigenetic regulation, cell cycle, genomic instability, the PI3K/AKT/mTOR pathway, inflammatory pathways, immune modulation, or metabolic alterations as potential precision oncology approaches. Most of these strategies are relying on the concept of synthetic lethality in which tumors deficient in ARID1A are more sensitive to the different compounds. Some of these approaches are currently being or have recently been investigated in early clinical trials. The remarkably frequent occurrence of these mutations in endometriosis-associated ovarian cancer, the occurrence in a relatively young population, and the high proportion of platinum-resistant disease certainly warrants further investigation of precision oncology opportunities in this population. Furthermore, advanced knowledge about oncogenic mutations involved in endometriosis-associated ovarian carcinomas may be potentially useful for early cancer detection. However, this approach may be complicated by the frequent occurrence of somatic mutations in benign endometriotic tissue as recent studies suggest. In this narrative review of the current literature, we will discuss the data available on endometriosis-associated ovarian carcinoma, with special emphasis on epidemiology, diagnosis and molecular changes that could have therapeutic implications and clinical applicability in the future., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-3022a). The series “Ovarian Cancer: State of the Art and Perspectives of Clinical Research” was commissioned by the editorial office without any funding or sponsorship. SB served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Annals of Translational Medicine from Nov 2019 to Oct 2021. Dr. SILG reports personal fees from AstraZeneca, grants from Novimmune, outside the submitted work. Dr. JAPF reports grants from Mutua Madrileña, grants from Sociedad Española de Oncologia Medica (Spanish Society of Medical Oncology), during the conduct of the study; personal fees from AstraZeneca, personal fees from GSK - Tesaro, personal fees from Clovis, personal fees from Roche, personal fees from Amgen, personal fees from Pfizer, personal fees from Pharmamar, outside the submitted work; in addition, Dr. JAPF has a patent Predictive signature for neoadjuvant chemotherapy in breast cancer pending. The authors have no other conflicts of interest to declare., (2020 Annals of Translational Medicine. All rights reserved.)

Torsion of the fallopian tube is when the tube twists on the axis created between the infundibulopelvic ligament and the utero-ovarian ligament. It most commonly presents with appendicitis-like symptoms, such as abdominal pain, nausea and vomiting. Because of its rarity and non-specific symptoms, it is usually misdiagnosed initially, which delays therapy, at the expense of the preservation of fertility. This case report of a 16-year-old girl who had never had sexual intercourse presents an example of the misdiagnosis of fallopian tube torsion. The definitive diagnosis was based on laparoscopy. We summarize our experience and provide our conclusions after reviewing the literature., Competing Interests: The authors declare that they have no conflict of interest regarding the publication of this case report.