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Although the history of polycystic ovary syndrome (PCOS) was discussed in detail in Chapter 1, a brief review here is warranted. Stein and Leventhal were not only the first to describe the condition in 1934/5; they also reported on a surgical treatment for anovulation, which resulted in two pregnancies. By 1964, Stein reported on a successful series of 108 anovulatory PCOS women treated by bilateral ovarian wedge resection (BOWR).
Although the modern history of polycystic ovary syndrome (PCOS) started with the pivotal paper by Stein and Leventhal in 1935, there are suggestions that the “syndrome” was referred to as early as in the time of Hippocrates (ca. 460–377 BC). Medical notes at the time referred to women “whose menstruation is less than three days or is meager, are robust, with a healthy complexion and a masculine appearance; yet they are not concerned about bearing children nor do they become pregnant” and suggest that they may have been describing women with PCOS.
Polycystic ovary syndrome (PCOS) is one of the most common reproductive health problems of women, causing irregular periods and potential infertility amongst other challenging symptoms. Effective treatment remains a significant challenge and is largely achieved through hormonal medication and lifestyle changes. This third edition covers the aetiology, pathology, impact on fertility and effective medical and surgical management. The content has been thoroughly revised in line with updated guidelines and research developments in the field. A new chapter on the patient's perspective has been included, bringing valuable insight into the lived experience of the condition. Mood disorders and the psychological aspects of PCOS are also covered for the first time. This is a key reference for all clinicians involved in the care of patients with PCOS, including gynaecologists, IVF specialists and reproductive endocrinologists.
The term “polycystic ovary syndrome” (PCOS) has replaced the term Stein–Leventhal syndrome. Stein and Leventhal not only were the first to describe the condition but also developed and reported on a treatment, reporting on a successful series of 108 women treated by “wedge resection” . In fact until the availability of clomiphene (clomifene) citrate (CC) in 1961 , this was the only option available to treat the infertility of women with this condition; characterized by obesity, oligomenorrhea, and anovulation. However, as treatment required laparotomy, and often resulted in periovarian adhesion formation, once medical treatment was available, initially CC, then human pituitary gonadotropins (hPG) , then urinary human menopausal gonadotropin (hMG) , wedge resection lost popularity, unless it was performed in conjunction with another surgical procedure that already required laparotomy.
Coronavirus disease 2019 (COVID-19) is associated with autoimmunity and systemic inflammation. Patients with autoimmune rheumatic and musculoskeletal disease (RMD) may be at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, based on evidence from the literature, as well as international scientific recommendations, we review the relationships between COVID-19, autoimmunity and patients with autoimmune RMDs, as well as the basics of a multisystemic inflammatory syndrome associated with COVID-19. We discuss the repurposing of pharmaceutics used to treat RMDs, the principles for the treatment of patients with autoimmune RMDs during the pandemic and the main aspects of vaccination against SARS-CoV-2 in autoimmune RMD patients.
We present novel methods for detecting lexical entailment in a fully rule-based and explainable fashion, by automatic construction of semantic graphs, in any language for which a crowd-sourced dictionary with sufficient coverage and a dependency parser of sufficient accuracy are available. We experiment and evaluate on both the Semeval-2020 lexical entailment task (Glavaš et al. (2020). Proceedings of the Fourteenth Workshop on Semantic Evaluation, pp. 24–35) and the SherLIiC lexical inference dataset of typed predicates (Schmitt and Schütze (2019). Proceedings of the 57th Annual Meeting of the Association for Computational Linguistics, pp. 902–914). Combined with top-performing systems, our method achieves improvements over the previous state-of-the-art on both benchmarks. As a standalone system, it offers a fully interpretable model of lexical entailment that makes detailed error analysis possible, uncovering future directions for improving both the semantic parsing method and the inference process on semantic graphs. We release all components of our system as open source software.
In the Transdanubian Range, Pannonian Basin, Hungary, karstic sinkholes on a planation surface of Triassic carbonates are filled by grey clayey–silty kaolin deposits. The provenance and accumulation age of these strongly altered terrestrial karst-filling sediments are constrained by X-ray powder diffraction, heavy mineral analysis and zircon U–Pb dating. The heavy minerals of the Southern Bakony Mountains samples are dominated by the ultra-stable zircon–rutile–tourmaline association. Zircon U–Pb data indicate accumulation between 20 and 16 Ma. Furthermore, Archaean to Palaeogene grains were also determined, reflecting the principally fluvial recycling of Eocene bauxites and their cover sequences. In contrast, the sample from the Keszthely Hills consists almost exclusively of airborne material including zircons of 18–14 Ma, reflecting a dominant contribution from the Carpathian–Pannonian Neogene volcanism. The shift in the Miocene age components is inferred to have been caused by the landscape evolution and burial history of the planation surface remnants controlled by local block tectonics.
With up to 60 per cent of women experiencing both physical and emotional symptoms during the menopause, including hot flushes, mood swings and loss of libido, managing these symptoms can be a complex task. Managing the Menopause is a highly practical, evidence-based reference, covering all forms of management in detail. Providing guidance on prescribing, as well as the advantages and disadvantages of various products and therapies, particular emphasis is given to addressing concerns over the long-term complications of Menopausal Hormone Therapy (MHT) use. The book contains new chapters on nutrition, ovarian tissue cryopreservation and migraine in the menopause and previous chapters have been fully updated to inform readers of the latest research. Treatment plans are included in the text, helping clinicians to support their patients quickly and effectively. A comprehensive review of the menopause that is easily understood at all levels, this is an essential guide for clinicians.
Male factor infertility is receiving greater emphasis in IVF programs. This book reviews the scientific evidence for various medical, environmental and lifestyle factors that can affect male fertility, such as chromosome abnormalities, age, anti-sperm antibodies and endocrine disruptors. Part of a four-book series on improving IVF success, this volume subsequently explores a range of treatments and strategies to improve sperm quality, including FSH treatment and antioxidants. It also discusses methods to prevent male infertility from childhood through to adulthood. Concise, practical and evidence-based - and with insights from global experts in the field - this text will enable gynecologists, urologists and andrologists to make evidence-based decisions that can influence the success rate of fertilization in subsequent IVF cycles.