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Contains fulltext : 233788.pdf (Publisher’s version ) (Open Access), 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).

Contains fulltext : 238753.pdf (Publisher’s version ) (Open Access), Premature ovarian insufficiency (POI) is an increasing public health problem with a prevalence now approaching 4%. POI results in adverse effects on the skeleton and central nervous system as well as disturbances of metabolic and cardiological factors that predispose to a major increased risk of cardiovascular disease (CVD). This article reviews the effects of the premature loss of ovarian function on lipids and lipoproteins, glucose and insulin metabolism, body composition, hemostasis and blood pressure, together with effects on the development of metabolic syndrome and diabetes mellitus. The article examines the effects of POI on vascular endothelial function and inflammation that result in arterial disease, and reviews the effects of hormone replacement therapy (HRT) on these various metabolic processes and on cardiovascular outcomes. It is essential that women with POI receive hormonal treatment to help prevent the development of CVD, and that this treatment is continued at least until the normal age of menopause. It appears that HRT has a more favorable effect than the combined oral contraceptive, but larger clinical trials are needed to establish the optimal treatment. Other therapeutic measures may need to be added to correct existing metabolic abnormalities and, in particular, attention to lifestyle factors such as diet and exercise must be encouraged.

Contains fulltext : 238753.pdf (Publisher’s version ) (Open Access), Premature ovarian insufficiency (POI) is an increasing public health problem with a prevalence now approaching 4%. POI results in adverse effects on the skeleton and central nervous system as well as disturbances of metabolic and cardiological factors that predispose to a major increased risk of cardiovascular disease (CVD). This article reviews the effects of the premature loss of ovarian function on lipids and lipoproteins, glucose and insulin metabolism, body composition, hemostasis and blood pressure, together with effects on the development of metabolic syndrome and diabetes mellitus. The article examines the effects of POI on vascular endothelial function and inflammation that result in arterial disease, and reviews the effects of hormone replacement therapy (HRT) on these various metabolic processes and on cardiovascular outcomes. It is essential that women with POI receive hormonal treatment to help prevent the development of CVD, and that this treatment is continued at least until the normal age of menopause. It appears that HRT has a more favorable effect than the combined oral contraceptive, but larger clinical trials are needed to establish the optimal treatment. Other therapeutic measures may need to be added to correct existing metabolic abnormalities and, in particular, attention to lifestyle factors such as diet and exercise must be encouraged.

Contains fulltext : 233788.pdf (Publisher’s version ) (Open Access), 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).

Contains fulltext : 238753.pdf (Publisher’s version ) (Open Access), Premature ovarian insufficiency (POI) is an increasing public health problem with a prevalence now approaching 4%. POI results in adverse effects on the skeleton and central nervous system as well as disturbances of metabolic and cardiological factors that predispose to a major increased risk of cardiovascular disease (CVD). This article reviews the effects of the premature loss of ovarian function on lipids and lipoproteins, glucose and insulin metabolism, body composition, hemostasis and blood pressure, together with effects on the development of metabolic syndrome and diabetes mellitus. The article examines the effects of POI on vascular endothelial function and inflammation that result in arterial disease, and reviews the effects of hormone replacement therapy (HRT) on these various metabolic processes and on cardiovascular outcomes. It is essential that women with POI receive hormonal treatment to help prevent the development of CVD, and that this treatment is continued at least until the normal age of menopause. It appears that HRT has a more favorable effect than the combined oral contraceptive, but larger clinical trials are needed to establish the optimal treatment. Other therapeutic measures may need to be added to correct existing metabolic abnormalities and, in particular, attention to lifestyle factors such as diet and exercise must be encouraged.

Contains fulltext : 233788.pdf (Publisher’s version ) (Open Access), 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).

Objective: To compare the cumulative pregnancy rate (CPR) for experienced clinicians and trainees naive to the skill of embryo transfer (ET) during an assisted reproductive treatment (ART) cycle. To establish the minimum number of procedures required to achieve consistent outcomes.Method: A non-interventional retrospective observational cohort study looking at all consecutive ETs undertaken over a 5-year study period. The CPR was determined by a self-reported urinary home pregnancy test undertaken 16 days after oocyte retrieval.Results: The CPR did not differ between an experienced clinician (39%) and trainee (45%) for the first 50 (p=0.41) and last 50 (40.7% versus 42.7%) (p=0.81) ET procedures. The CPR for the individuals remained consistent with their peaks and troughs mirroring the overall success rate of the unit. This pattern continued when the data was further stratified for co-variables (age [<=37 years of age], catheter type [soft] and embryo quality [expanded blastocyst of grade >=2]): CPRs for experienced clinicians was 65.7% (first 50 transfers) and 40.9% (last 50 transfers); CPR for trainees was 66.7% (first 50 transfers) and 53.6% (last 50 transfers); p=0.95 and p=0.37, respectively. The trainees, however, were more likely to use a stylet catheter with a 2-step transfer technique, with a cost over clinical implication. Furthermore, patients expressed a preference for an experienced clinician to perform their procedure, despite being informed that the grade of the clinician had no impact on the cycle outcome after an analysis of the unit's data.Conclusion: The clinician's grade and duration of service have not been shown to significantly impact the outcome of the ART cycle. The findings, however, should be interpreted with caution, as they reflect the culture of training in the unit, where there is a strong emphasis on adequate direct and indirect supervision. Furthermore, the relationship between the volume of work and outcomes is established in postgr, Hintergrund: Embryotransfer (ET) ist die letzte kritische Phase innerhalb des assistierten reproduktiven Behandlungszyklus (ART). Es wird zunehmend deutlich, dass ein atraumatisches Verfahren wichtig für das Erzielen eines erfolgreichen Ergebnisses ist, und somit sollten theoretisch die Erfolgsraten zwischen Kliniksärzten variieren, basierend auf ihrer Position und ihrem Dienstalter, die beide Maßeinheiten klinischer Erfahrung sind. Diese Studie vergleicht die kumulative Schwangerschaftsrate (CPR) erfahrener Kliniker mit der von Ärzten in der Ausbildung, die mit den Fertigkeiten des ET nicht vertraut sind.Methode: Nicht-interventionelle retrospektive beobachtende Kohortenstudie, die über einen 5-Jahres-Zeitraum alle durchgeführten konsekutiven ETs untersucht. Die CPR wurde durch einen Urinschwangerschaftstest festgestellt, der 16 Tage nach der Gewinnung der Oozyte durchgeführt wurde.Ergebnisse: Die CPR zeigte keine Unterschiede zwischen erfahrenen Kliniksärzten (39%) und Ärzten in der Ausbildung (45%) bei den ersten 50 (p=0,41) und den letzten 50 Verfahren (40,7% versus 42,7%) (p=0,81). Die CPR blieb für diese Personen konsistent hinsichtlich Spitzen und Tiefpunkten, die die Erfolgsrate der Abteilung widerspiegelten. Dieses Muster setzte sich fort, als nach Co-Variablen stratifiziert wurde (Alter [<=37 Jahre], Kathetertyp [weich] und Embryoqualität [ausgedehnte Blastozysten von Grad >=2]): die CPR für erfahrene Kliniker lag bei 65,7% (erste 50 Transfers) und 40,9% (letzte 50 Transfers); die CPR für Ärzte in der Ausbildung lag bei 66,7% bzw. 53,6%; p=0,95 bzw. p=0,37. Ärzte in der Ausbildung neigten eher dazu, einen Mandrinkatheter mit 2-stufiger Transfertechnik zu verwenden mit klinischen Auswirkungen bzgl. Mehrkosten. Darüber hinaus präferierten die Patienten, das ein erfahrener Kliniker bei ihnen das Verfahren durchführen sollte, obwohl sie darüber informiert worden waren, dass nach Analyse der Daten die Dienstposition keinen Einfluss auf das Zyklusergebnis hat.Sc