Explore the vast range of titles available.

Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is acknowledged that vulnerable people can suffer from mortal complications of COVID-19. Therefore, strengthening the immune system particularly in the most fragile people could help to protect them from infection. First, general nutritional status and food consumption patterns of everyone affect the effectiveness of each immune system. The effects of nutrition could impact the level of intestinal and genital microbiota, the adaptive immune system, and the innate immune system. Indeed, immune system cells and mediators, which are crucial to inflammatory reaction, are in the structures of fats, carbohydrates, and proteins and are activated through vitamins (vit) and minerals. Therefore, the association of malnutrition and infection could damage the immune response, reducing the immune cells and amplifying inflammatory mediators. Both amount and type of dietary fat impact on cytokine biology, that consequently assumes a crucial role in inflammatory disease. This review explores the power of nutrition in the immune response against COVID-19 infection, since a specific diet could modify the cytokine storm during the infection phase. This can be of vital importance in the most vulnerable subjects such as pregnant women or cancer patients to whom we have deemed it necessary to dedicate personalized indications.

The most common effects reported by the Italian Medicine Agency following administration of SARS-CoV-2 vaccine are myalgia, soreness to the arm of inoculation, fever, and asthenia. To date, there are no specific and official reports registered by the Italian Medicine Agency on possible alterations of the menstrual cycle, or of the female reproductive system, following the vaccine. Actually, clinical experience showed a spread of transient adverse drug reactions of the menstrual cycle, following the administration of all COVID-19 vaccine types, both mRNA and Adenovirus vectored ones. In this work, we conducted the first retrospective study on Italian patients vaccinated for SARS-CoV-2 in the period between April 2021 and April 2022, to report the onset of menstrual changes after the vaccine in order to understand: etiology, duration of possible adverse effects, and the extent of the phenomenon. We recruited 100 women aged 18–45, vaccinated for SARS-CoV-2, who were asked to complete a questionnaire consisting of 12 multiple choice questions about the effects of the vaccine on the reproductive system. Thirty-seven of them received three doses of the vaccine, while the remaining 63 received two doses. Symptoms such as delayed menstruation and abnormal uterine bleeding (metrorrhagia, menometrorrhagia, and menorrhagia) were generally reported within the first three weeks of vaccination, especially after the second dose, with a percentage of 23% and 77%, respectively. These preliminary data suggest that this problem may be broader and deserving of further investigation in the future.

Background Recent studies have shown the importance of the microbiota in women's health. Indeed, the persistence of Human Papilloma Virus (HPV)-related lesions in patients with dysbiosis can be the antechamber to cervical cancer. The aim of this study was to evaluate whether long term administration of oral Lactobacillus crispatus can restore eubiosis in women with HPV infections and hence achieve viral clearance. Methods In total, 160 women affected by HPV infections were enrolled at the Department of Gynecological Obstetrics of “San Paolo” Hospital, Italy between February 2021 and February 2022. The women were randomly assigned to two groups, one in treatment with oral Lactobacillus crispatus M247 (group 1, n = 80) versus the control group, that hence only in follow-up (Group 2, n = 80). Results After a median follow-up of 12 months (range 10–30 months), the likelihood of resolving HPV-related cytological anomalies was higher in patients in treatment with the long term oral probiotic (group 1) versus the group that perfom only follow-up (group 2) (60.5% vs. 41.3%, p  = 0.05). Total HPV clearance was shown in 9.3% of patients undergoing only follow-up compared to 15.3% of patients in the group taking long term oral Lactobacillus crispatus M247 ( p  = 0.34). However, the percentage of HPV-negative patients, assessed with the HPV-DNA test, documented at the end of the study period was not significantly different from the control group. Conclusions Despite the limitations of our analysis, we found a higher percentage of clearance of PAP-smear abnormalities in patients who took long term oral Lactobacillus crispatus M247 than in the control group. Larger studies are warranted, but we believe that future research should be aimed in this direction. Trial registration This study is retrospectively registered.

The heterogeneity of the cervico-vaginal microbiota can be appreciated in various conditions, both pathological and non-pathological, and can vary according to biological and environmental factors. Attempts are still in course to define the interaction and role of the various factors that constitute this community of commensals in immune protection, inflammatory processes, and the onset of precancerous lesions of the cervical epithelium. Despite the many studies on the relationship between microbiota, immunity, and HPV-related cervical tumors, further aspects still need to be probed. In this review article, we will examine the principal characteristics of microorganisms commonly found in cervico-vaginal specimens (i) the factors that notoriously condition the diversity and composition of microbiota, (ii) the role that some families of organisms may play in the onset of HPV-dysplastic lesions and in neoplastic progression, and (iii) possible diagnostic-therapeutic approaches.

Introduction/BackgroundThe principal International scientific societies of oncology recommend that Long-term Survivors of Lymphoma join fertility programs. Therefore, we conducted a prospective observational controlled study, with the aim to assess the effects of oral supplementation with Myo-Inositol and D-Chiro-Inositol (MIC) on ovarian function parameters in Long-term Survivors of LymphomaMethodologyBetween January 2020 and January 2021, 90 female patients, long-term Survivors of Lymphoma with an average age of 34 years (range 25–44), were considered eligible and enrolled in the study (figure 1). The study was registered on ClinicalTrials.gov (ID: NCT05410314). We conducted this study on two groups: the first one (A group) underwent oral supplementation with MIC for 12 months, and the second group (B group) underwent follow-up without any nutritional supplement for 12 months. Statistical analysis: The level of statistical significance was set at p ≤ 0.05. Analysis was conducted with STATA/SE 15.0.ResultsIn group A a significant reduction after 12 months was observed for follicle-stimulating hormone (FSH), luteinizing hormone (LH), oligomenorrhea and a reduction to the limits of statistical significance for the progesterone (PG) (table 1).Abstract 2022-RA-1040-ESGO Figure 1Flow-chart for inclusion and treatment of Long-term Survivors of Lymphoma in the studyAbstract 2022-RA-1040-ESGO Table 1Comparison of ovarian function parameters in long-term survivors of Lymphoma patients between baseline (T0) and after 12 months of oral supplementation with Myo-Inositol and D-Chiro-Inositol combined therapy (T12, Group A) abd between baseline (T0) and after 12 months of follow-up without any nutritional supplement (T12; Group B). AMH: anti Müllerian hormone; FSH: follicle-stimulating hormone; LH: luteinizing hormone; PG: progesterone; AFC: antral follicle countConclusionIn our data analysis, comparing ovarian function parameters in group A women between baseline (T0) and after 12 months of oral supplementation with MIC, a significant reduction in FSH and an increase in PG and antral follicle count (AFC) of the right ovary resulted. This result could be due, at least in part, to the known MIC effect on ovulation improvement that contrasts with luteal insufficiency, typical in these patients. The limitations of our study should also be considered, such as the lack of previous similar studies, thus not allowing a direct comparison with other clinical experiences, and the low number of enrolled women. Therefore, further studies are needed to confirm our preliminary findings in a larger setting.

Human papilloma virus (HPV) infection could be considered a social disease, both for its high incidence, especially in younger subjects, and for the risk of neoplastic evolution linked to viral infection. Therefore, the National Health System, in collaboration with the state, must help women to understand the oncological risk of HPV and suitable methods of prevention. We conducted an Italian monocentric survey on HPV risk information as part of cervical cancer screening. An anonymous questionnaire was administered to 200 women with high-risk positive HPV and low-grade cervical lesions during second-level cervical cancer screening at the Gynecology and Obstetrics Unit of the “San Paolo” Hospital. From this survey, the need to improve communication for patients has emerged, as currently it is not exhaustive. In response to this need, organizational changes have been implemented to centralize the moment of counseling in the second levels of screening and to improve the training of health workers in level I as well as family doctors. In addition, psychological support was also proposed to patients who requested it, as was the dissemination of material such as that produced by GISCI (Italian Cervico-Carcinoma Screening Group) and updated in May 2018, which provides 100 answers to questions on HPV in order to achieve effective and comprehensive communication. This investigation requires further development, and the expansion of this investigation to the multicenter level is already underway. Therefore, this survey will represent a cornerstone for further discussion on the topic considering the necessity of appropriate communication in the oncological context.

The progressive improvement of lymphoma treatment has led to an important prolongation of patient survival and life expectancy. The principal international scientific societies of oncology now therefore recommend that long-term survivors of lymphoma join fertility programs. Specifically, fertile-age patients should be assisted by a multidisciplinary team, including specialists dedicated to fertility preservation in oncology, in order to support the completion of their reproductive project. In the general population, the use of Myo-Inositol and D-Chiro-Inositol (MI/DCI) has been demonstrated to be an effective choice to treat ovarian dysfunctions, with a consequent improvement in reproductive outcomes, so it may represent an adjuvant strategy for this purpose. We therefore conducted a pilot prospective case–control study to evaluate the potentialities of this nutritional supplement, with the aim of optimizing reproductive function in female long-term survivors of lymphoma. One group underwent oral supplementation with MI 1200 mg and DCI 135 mg per day for 12 months, compared with controls who underwent no treatment in the same period. After 12 months, FSH, LH, and progesterone levels, as well as oligomenorrhea and antral follicle count (AFC), were significantly improved in the MI/DCI group. In addition, a significantly higher mean value in FSH and LH and a significantly lower mean AFC value in the right ovary were observed in controls compared to the MI/DCI group. Despite the need for further investigation, MI/DCI could be considered a potential adjuvant strategy to restore ovarian function in female long-term survivors of lymphoma.

The aim of our study was to investigate preoperative serum CA 125 as a prognostic factor in patients with ovarian carcinoma. A retrospective analysis was conducted on 82 patients with ovarian carcinoma treated at our Unit between 1998 and 2000 who had a serum CA 125, evaluated by a commercially available radioimmunoassay, prior to cytoreductive surgery. We looked for an association between preoperative CA 125 and known prognostic factors of ovarian cancer. We compared outcomes of patients with preoperative CA 125 at or below to 500 U/ml with outcomes of patients with preoperative CA 125 above 500 U/ml. A significant ( p<0.002) correlation between stage and CA 125 serum levels was found as 16 out of 18 stage I-II patients (89%) had CA 125 level 500 U/ml. Among stage III and IV patients there was nonstatistically significant relation between serum CA 125 and histologic grade (G1+G2 vs. G3) and residual disease (<1 cm vs. >1 cm) after primary cytoreductive surgery. Preoperative serum CA-125 level did not predict either recurrences or disease free interval. Preoperative CA 125 correlated well with FIGO stage but not with age, grade, residual disease after primary surgery, relapse and disease free interval.

Breast involvement in ovarian cancer is extremely rare. We report a case of solitary breast metastasis from ovarian carcinoma in a 43-year-old white woman, 3 months following diagnosis of ovarian cancer. The diagnostic, therapeutic and prognostic aspects as well as a review of the literature of this uncommon site of metastasis are discussed.