We study the ground-state phases of a two-dimensional dipolar supersolid subjected to external periodic confinement by numerically solving the extended Gross--Pitaevskii equation. Focusing on a regime in which the unconfined system forms an intrinsic triangular droplet crystal, we consider triangular, honeycomb, and square optical lattices and classify them into isostructural and heterostructural settings relative to the spontaneous supersolid order. We map out the stationary states as functions of the lattice depth $V_0$ and the commensurability ratio between the intrinsic droplet spacing and the external lattice period. For triangular and honeycomb confinements, the competition between the soft self-organized supersolid lattice and the rigid external potential can generate long-wavelength moiré superstructures in the weak- to intermediate-lattice regime, together with a sequence of reconstructed states including ring-like clusters and stripe-segment configurations. By contrast, the square lattice introduces strong symmetry mismatch between the intrinsic $C_6$ order and the imposed $C_4$ geometry, leading to frustration-induced anisotropic states and symmetry-reduced cluster arrangements. Our results establish dipolar supersolids under periodic confinement as an unconventional route to exploring moiré physics, where moiré superstructures arise from the competition between a self-organized soft lattice and an externally imposed rigid one.
I. A. Zhirnov, K. A. Nazmieva, A. I. Khabibullina
et al.
Introduction. The environment undoubtedly affects the physiological processes in human body, which may be both beneficial and harmful. From 2011 to 2021, the incidence of female infertility in Russia increased by 30 % reaching 789.1 cases per 100,000 women in 2021.Aim: to assess an impact of environmental factors including endocrine disrupting chemicals (EDC) on women's reproductive health by assessing available publications.Materials and Methods. Available studies were searched through the scientific literature databases until April 2024 by revealing 5,732 articles in the PubMed/MEDLINE database, 6,587 in Google Scholar and 2,350 in eLibrary. The publications were selected in accordance with PRISMA recommendations. The current review included 90 publications.Results. Fertility experimental and epidemiological studies showed that environmental factors such as climate, temperature, seasonality, radiation, air pollution, diet and energy balance, working environment, bad habits (e.g. smoking), EDC (plasticizers, heavy metals, parabens, pesticides, industrial chemicals and their by-products, medicines, perfluorochemicals, antibacterial agents) may be associated with impaired female reproductive function.Conclusion. Environmental factors, including EDC, have a significant impact on women's reproductive health and can negatively affect fertility. The main findings of current research confirm a need to raise awareness of the risks associated with exposure to chemicals on women's body.
Acute adhesive small bowel obstruction (AASBO) ranks among the most common indications for emergency abdominal surgery. However, conventional approaches to severity assessment and treatment selection do not incorporate the significant immunological disturbances characteristic of this condition.
Objective. To enhance the diagnosis and management of AASBO through the implementation of a clinical-immunological risk stratification scale and to evaluate the impact of immunotherapy on clinical and immune outcomes.
Materials and Methods. A total of 115 patients with AASBO were enrolled and allocated to a control group (n=56; standard care) or a study group (n=59; standard care plus immunotherapy). Comprehensive clinical, laboratory, radiological, and immunological parameters were analyzed. A prognostic scale incorporating 25 variables was developed. Immune response dynamics and complication rates were rigorously assessed. All procedures were conducted in accordance with the World Medical Association's Declaration of Helsinki (2000 amendments). Statistical analyses were performed using SPSS 22.0 and MedCalc software. Normality was assessed with Shapiro-Wilk test. Between-group comparisons utilized Mann-Whitney U test, Student's t-test, Pearson's chi-square test, and Spearman's correlation analysis. Predictive performance was evaluated through ROC analysis calculating the area under the curve (AUC). Statistical significance was defined as p < 0.05.
Funding: This work was carried out within the framework of the research plan of the Bukhara State Medical Institute (05.2022 DSc.135) entitled “Development of new approaches to early diagnosis, treatment, and prevention of pathological conditions affecting the health of the population of the Bukhara region after COVID-19 (2022–2026)”.
Results. Severe disease progression was significantly associated with CD4⁺ counts < 600 cells/µL, HLA-DR⁺ expression < 30%, IL-6 levels > 30 pg/mL, and TNF-α levels > 25 pg/mL. The study group demonstrated a 3.3-fold reduction in mortality, a 28.1% shorter hospital stay, and a 2.4-fold decrease in Clavien-Dindo grade III-V complications. The integrated prognostic scale exhibited high predictive accuracy (AUC = 0.917).
Conclusion. The incorporation of clinical-immunological stratification and immunotherapy into the management algorithm for AASBO significantly improves treatment outcomes, reduces complication rates, and decreases mortality.
Abstract Background Premature ovarian insufficiency (POI) is a refractory gynecological endocrine disorder. Ningxin-Tongyu-Zishen formula (NTZF), developed based on the ‘simultaneous heart-kidney regulation’ principle, exhibits therapeutic efficacy in treating POI, potentially through regulating proBDNF/mBDNF balance. This study aimed to elucidate the molecular mechanism by which NTZF treats POI via proBDNF/mBDNF modulation. Methods POI rat models were established using cyclophosphamide (CTX). The therapeutic effects of NTZF were evaluated by analyzing estrous cycles, ovarian indices, follicular development, serum sex hormone levels (FSH, E2, AMH), and ovarian granulosa cells (OGCs) apoptosis. Following immunofluorescence staining to localize BDNF receptors, proBDNF/mBDNF protein expression was quantified in brain and ovarian tissues. The active metabolite of CTX, phosphoramide mustard (PM), was employed to induce damage in KGN cells. The regulatory effect of NTZF on proBDNF/mBDNF was investigated and compared with recombinant mBDNF protein. tPA and PAI-1 was screened, and their interactions with NTZF were analyzed. mRNA and protein expression of tPA, PAI-1, and tPA-PAI-1 complexes were assessed via q-PCR and Western Blot. Results NTZF composition was characterized and shown to improve ovarian function in POI rats. Its mechanism involves correcting proBDNF/mBDNF imbalance in both brain and ovarian tissues. NTZF achieved this correction through the PAI-1/tPA signaling pathway, thereby inhibiting apoptosis in damaged KGN cells. Conclusion Our findings demonstrate that NTZF attenuates PAI-1 expression, diminishes tPA-PAI-1 complex formation, and potentiates tPA-dependent proteolysis of proBDNF into mBDNF, thereby restoring their balance. This restores proBDNF/mBDNF balance, suppresses OGCs apoptosis, and ultimately ameliorates POI.
Yu Ando, Nora Jee-Young Park and, Gun Oh Chong
et al.
Screening is critical for prevention and early detection of cervical cancer but it is time-consuming and laborious. Supervised deep convolutional neural networks have been developed to automate pap smear screening and the results are promising. However, the interest in using only normal samples to train deep neural networks has increased owing to class imbalance problems and high-labeling costs that are both prevalent in healthcare. In this study, we introduce a method to learn explainable deep cervical cell representations for pap smear cytology images based on one class classification using variational autoencoders. Findings demonstrate that a score can be calculated for cell abnormality without training models with abnormal samples and localize abnormality to interpret our results with a novel metric based on absolute difference in cross entropy in agglomerative clustering. The best model that discriminates squamous cell carcinoma (SCC) from normals gives 0.908 +- 0.003 area under operating characteristic curve (AUC) and one that discriminates high-grade epithelial lesion (HSIL) 0.920 +- 0.002 AUC. Compared to other clustering methods, our method enhances the V-measure and yields higher homogeneity scores, which more effectively isolate different abnormality regions, aiding in the interpretation of our results. Evaluation using in-house and additional open dataset show that our model can discriminate abnormality without the need of additional training of deep models.
BackgroundWomen's death due to complications of pregnancy and childbirth is still high. Maternity waiting homes are one of the strategies to reduce it. However, there is limited evidence on the effect of using maternity waiting homes on birth outcomes, particularly in this study area. Therefore, this study was aimed to estimate the effect of staying in maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in the Amhara region, Northwest Ethiopia 2018.MethodsInstitutional-based comparative cross-sectional study using both quantitative and qualitative approaches was conducted. Data were collected using structured questionnaire interviews, in-depth interview and chart reviews. Propensity score matching analysis was used to estimate the effect of maternity waiting homes use on birth outcomes. Propensity score matching analysis was used to match potential differences in background characteristics that affect pregnancy outcomes between comparison groups. We used thematic analysis for qualitative data.ResultA total of 548 pregnant mothers (274 stayed in maternity waiting homes 274 did not stay) took part in this study. The proportion of adverse birth outcomes of mothers who stayed in maternity waiting homes were 15(5.5%) which is lower than those who didn't stay 35 (12.8%). After matching with baseline covariates, mean difference of adverse maternal birth outcomes, the difference between didn't use maternity waiting home and used was 10.4%, at (t = 3.78) at 5% level of significance. Similarly, the mean adverse perinatal birth outcomes difference between mothers who didn't use MWHs and used was 11% (t = 4.33).ConclusionsMaternity waiting home showed a significant positive effect on birth outcomes. Mothers who stayed in the maternity waiting homes had low adverse maternal and perinatal birth outcomes compared to non-users. Accommodations and quality health care services were the challenges mothers faced during their stay in the maternity waiting homes. Therefore, all concerned bodies should give attention accordingly to maternity waiting home services to reduce adverse birth outcomes through the strengthening of the quality of health care provided.
Elena S. Silantyeva, Mekan R. Orazov, Marina B. Khamoshina
et al.
Dyspareunia is a condition associated with a wide range of disorders. Pelvic floor dysfunction, manifesting as a myofascial syndrome or pelvic floor muscle hypertonia, may predict dyspareunia in women in different age groups. The review addresses the current view on the dyspareunia pathogenesis associated with pelvic floor muscle dysfunction.
Eman M. Mansory, Lotus Alphonsus, Janine R. Hutson
et al.
Background: Venous thromboembolism (VTE) remains one of the leading causes of morbidity and mortality during pregnancy and the postpartum period. Despite that, the prevention and management of VTEs in pregnant patients is an area of great debate. Objectives: The aim of this systematic review was to evaluate the risk of VTE recurrence during pregnancy for pregnant patients with prior personal history of VTE and the effect of LMWH on such risk. Methods: MEDLINE and EMBASE were searched between January 2000 to December 2022. We included studies that evaluated pregnant patients with previous personal history of VTE and assessed VTE recurrence with or without thromboprophylaxis. A meta-analysis of proportions was done through a Freeman–Tukey transformation using random effect models. Results: 30 studies were included in this systematic review. The studies included 5075 pregnant patients with a previous history of DVT or PE. We found a wide variability in thromboprophylaxis strategies. The estimated pooled proportions of VTE recurrence were 2.5% (95% CI 1.8–3.3) in patients who were consistently on anticoagulation during pregnancy (pre- and post-partum), 4.7% (95% CI 1.8–8.8) in patients who received anticoagulation in the postpartum period only, and 13.6% (95% CI 6.5 to 22.8) in patients who were not on anticoagulation. Conclusions: In patients with a previous VTE history receiving prophylactic anticoagulation (either both pre- and post-partum or post-partum only), the estimates of VTE recurrence were lower than for patients who did not receive prophylaxis, however, a direct comparison was not possible. The optimal thromboprophylaxis strategy remains unknown.
Diseases of the circulatory (Cardiovascular) system
Abstract The biological functions of ubiquitin-conjugating enzymes E2 (UBE2) family members in uterine corpus endometrial carcinoma (UCEC) remains unclear. Our study aimed to systematically analyze the expression patterns, prognostic value, biological functions and molecular regulatory mechanisms of UBE2 family in UCEC. Among nine screened UBE2 family members associated with UCEC, UBE2C was the most significantly overexpressed gene with poor prognosis. High expression levels of UBE2C in UCEC was correlated with stages, histological subtypes, patient’s menopause status and TP53 mutation. Three molecules (CDC20, PTTG1 and AURKA), were identified as the key co-expression proteins of UBE2C. The generic alterations (mutation, amplification) and DNA hypomethylation might contribute to UBE2C’s high expression in UCEC. Furthermore, in vitro experiments showed that the interference of UBE2C inhibited the migration and invasion of endometrial cancer cells, while partially impact cell proliferation and didn’t impact the expression of epithelial-mesenchymal transition (EMT) markers. Using comprehensive bioinformatics analysis and in vitro experiments, our study provided a novel insight into the oncogenic role of UBE2 family, specifically UBE2C in UCEC. UBE2C might serve as an effective biomarker to predict poor prognosis and a potential therapeutic target in clinical practice.
The pervasiveness of the Internet of Things (IoT) has enabled the administration of a large number of intelligent devices. However, IoT is based on centralised models, which introduce a number of problems, such as a single point of failure and security risks. Blockchain may offer a viable option for addressing these concerns. Practically, both blockchain and IoT are complex technologies posing further challenges in assessing application performance. The availability of a reliable simulation environment for Blockchain based IoT applications would be a major aid in the development and evaluation of such applications. Our research has found that currently there are no simulators with a comprehensive set of features, for the development and evaluation of blockchain based IoT applications, which is the main motivation for our work. The purpose of this study is to gather the opinions of experts regarding the creation of a simulation environment for IoT based blockchain applications. To do this, we utilise two separate investigations. First, a questionnaire is developed to ensure that the development of such simulation software would be of significant use. Second, interviews with participants are performed to gain their perspectives on the primary issues they face with blockchain-based IoT applications. In addition, the interviews focused on collecting the perspectives of participants on how blockchain may improve IoT and how to identify blockchain's applicability in IoT. Our findings demonstrate that the participants had a great deal of confidence in blockchain to resolve IoT issues. However, they lack the tools necessary to assess this concept. This highlights their requirement for a simulator to analyse the integration of blockchain and IoT.
Patricia Wollstadt, Daniel L. Rathbun, W. Martin Usrey and
et al.
Studies investigating neural information processing often implicitly ask both, which processing strategy out of several alternatives is used and how this strategy is implemented in neural dynamics. A prime example are studies on predictive coding. These often ask if confirmed predictions about inputs or predictions errors between internal predictions and inputs are passed on in a hierarchical neural system--while at the same time looking for the neural correlates of coding for errors and predictions. If we do not know exactly what a neural system predicts at any given moment, this results in a circular analysis--as has been criticized correctly. To circumvent such circular analysis, we propose to express information processing strategies (such as predictive coding) by local information-theoretic quantities, such that they can be estimated directly from neural data. We demonstrate our approach by investigating two opposing accounts of predictive coding-like processing strategies, where we quantify the building blocks of predictive coding, namely predictability of inputs and transfer of information, by local active information storage and local transfer entropy. We define testable hypotheses on the relationship of both quantities to identify which of the assumed strategies was used. We demonstrate our approach on spiking data from the retinogeniculate synapse of the cat. Applying our local information dynamics framework, we are able to show that the synapse codes for predictable rather than surprising input. To support our findings, we apply measures from partial information decomposition, which allow to differentiate if the transferred information is primarily bottom-up sensory input or information transferred conditionally on the current state of the synapse. Supporting our local information-theoretic results, we find that the synapse preferentially transfers bottom-up information.
Yigermal Bassie, Mohammed Mahmud, and Mulugeta Bekele
A large number of water molecules are each placed on a lattice far apart so that they are very weakly interacting with each other and in contact with a heat bath at temperature $T$. A strong static electric field, $E_{0}$, is applied to these molecules along a $z$-axis causing three level split energy values. A weak AC electric field that acts for a finite time $τ$ applied in the $xy-$plane induces transitions between the three levels. This weak AC field acts as a protocol $ζ(t)$, that is switched on at $t=0$ and switched off at $t=τ$. Through this protocol, the system is taken from an initial thermodynamic equilibrium state $F(T,0)$ to the non-equilibrium state $F_{non-equil}(T, τ)$ recorded right when the AC field is switched off at time $t=τ$. Once again the AC field is switched on and let it act for the same finite amount of time $τ$ and its non-equilibrium state $F_{non-equil}(T, τ)$ recorded right when the AC field is switched off. The same cyclic process is repeated for a large number of times. The data available for this finite-time non-equilibrium process allowed us to extract equilibrium thermodynamic quantities like free energy, which is what we call Jarznski equality and its relation to the second law of thermodynamics. The work distributions of the three-level system in the optimum condition is obtained. Besides, the average work of the system as a function of $ω$ and time around the optimum frequency are evaluated, where $ω$ is the frequency of the AC electric field.
Charles Chapron, Marie-Christine Lafay-Pillet, Pietro Santulli
et al.
Summary: Background: The time between symptoms onset and endometriosis diagnosis is usually long. The negative impacts of delayed endometriosis diagnosis can affect patients and health outcomes. Methods: We conducted a case-control study using clinical symptoms and epidemiological data extracted from a prospective pre-operative patient questionnaire compared between patients with histologically proven endometriosis and patients with no endometriosis at surgical exploration from 2005 to 2018, in a French referral center. We used the beta coefficients of the significant variables introduced in a multiple regression model to devise a score (score 1), evaluated by the area under the curve (or C-index), with three levels, defined by a score between 1 and ≥ 25: (i) highly specific, identifying correctly the patients without the disease; (ii) highly sensitive, identifying the patients with the disease; and (iii) a level maximizing sensitivity and specificity for the best classification of the whole population. To minimize patient self-evaluation of pain, we devised a second score (score 2) with the same method and levels and scores definition, excluding visual analog scale pain scores, except for dysmenorrhea. These scores were validated on an internal and external population. Findings: Score 1 had a C-index of 0.81 (95% CI [0.79–0.83]). Results for the three score 1 levels were: ≥ 25: specificity of 91% (95% CI [89–93]); < 11: sensitivity of 91% (95% CI [89–93]); ≥ 18: specificity of 75% (95% CI [72–78]) and sensitivity of 73% (95% CI [70–76]). Score 2 had a C-index of 0.75 (95% CI [73–77]). The three levels of score 2 were: ≥ 24: specificity of 82% (95% CI [80–85]); < 7: sensitivity of 92% (95% CI [90–94]); ≥ 17: specificity of 62% (95% CI [58–65]) and sensitivity of 78% (95% CI [75–81]). The two scores were internally and externally validated. Interpretation: A score based only on a patient questionnaire could allow identification of a population at high risk of endometriosis. This strategy might help referral to specialized radiologists for a non-surgical endometriosis scan. Funding: None.
Abstract Background Frozen-thawed embryo transfer (FET) is thought to be associated with obstetric and neonatal complications after in vitro fertilization/intracytoplasmic single sperm injection (IVF/ICSI) treatment. The study aimed to determine whether the endometrial preparation protocol is an influencing factor for these complications. Methods We conducted a retrospective cohort study of 3,458 women who had singleton deliveries after IVF/ICSI–FET treatment at the Centre for Reproductive Medicine of Shanghai First Maternity and Infant Hospital between July 2016 and April 2021. The women were divided into three groups according to the endometrial preparation protocols: 2,029 women with programmed cycles, 959 with natural cycles, and 470 with minimal ovarian stimulation cycles. The primary outcomes were the incidence rates of obstetric and neonatal complications, namely, hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), placenta previa, preterm rupture of membranes (PROM), preterm delivery, postpartum haemorrhage, large for gestational age (LGA), small for gestational age (SGA), and macrosomia. Results After adjustments for confounding variables by multivariate logistic regression analysis, the results showed that programmed cycles had an increased risk of HDP (aOR = 1.743; 95% CI, 1.110–2.735; P = 0.016) and LGA (aOR = 1.269; 95% CI, 1.011–1.592; P = 0.040) compared with natural cycles. Moreover, programmed cycles also increased the risk of LGA (aOR = 1.459; 95% CI, 1.083–1.965; P = 0.013) but reduced the risk of SGA (aOR = 0.529; 95% CI, 0.348–0.805; P = 0.003) compared with minimal ovarian stimulation cycles. There were no significant differences between natural cycles and minimal ovarian stimulation cycles. Conclusions During IVF/ICSI–FET treatment, the risk of HDP and LGA was increased in women with programmed cycles. Therefore, for patients with thin endometrium, irregular menstruation or no spontaneous ovulation, minimal ovarian stimulation cycles may be a relatively safer option than programmed cycles.
Tomoka Ishibashi, Kentaro Nakayama, Sultana Razia
et al.
Background: Given that total laparoscopic hysterectomy (TLH) is less invasive than open surgery, its popularity has increased in Japan. The aim of the present study was to determine the most appropriate uterine size for the safe completion of TLH for the treatment of uterine leiomyomas. Methods: This retrospective study included 505 patients who underwent TLH for uterine leiomyomas. Patients were divided into three groups according to the weight of the excised uterus (<500 g, n = 347; 500–1000 g, n = 125; >1000 g, n = 33). TLH procedures were performed by a resident physician under the supervision of an attending physician. Clinical outcomes including blood loss and duration of surgery were collected from patients’ electronic medical records and compared according to uterine size. Magnetic resonance imaging (MRI) was performed prior to TLH for detection, localization, and measurement of the myoma. Results: Mean operation times were shortest (<500 g: 163 min; 500–1000 g: 190 min; >1000 g: 209 min) and the mean volume of blood lost was lowest (<500 g: 116 mL; 500–1000 g: 208 mL; >1000 g: 402 mL) in patients with a uterus weighing less than 500 g. There were no significant differences in operation time or bleeding between those with a uterine weight of 500–1000 g or >1000 g. MRI revealed that myomas tended to be restricted within the sacral promontory in patients with uterine weights <500 g, whereas those in the other two groups tended to extend beyond this region. Conclusions: TLH outcomes are best when the uterine weight is <500 g. The use of MRI prior to TLH may provide insights into uterine size and/or mass and thus allow for improved surgical planning.
Jaymie A. Henry, Angela S. Volk, Sicily K. Kariuki
et al.
While there has been overall progress in addressing the lack of access to surgical care worldwide, untreated surgical conditions in developing countries remain an underprioritized issue. Significant backlogs of advanced surgical disease called neglected surgical diseases (NSDs) result from massive disparities in access to quality surgical care. We aim to discuss a framework for a public health rights-based initiative designed to prevent and eliminate the backlog of NSDs in developing countries. We defined NSDs and set forth six criteria that focused on the applicability and practicality of implementing a program designed to eradicate the backlog of six target NSDs from the list of 44 Disease Control Priorities 3rd edition (DCP3) surgical interventions. The human rights-based approach (HRBA) was used to clarify NSDs role within global health. Literature reviews were conducted to ascertain the global disease burden, estimated global backlog, average cost per treatment, disability-adjusted life-years (DALYs) averted from the treatment, return on investment, and potential gain and economic impact of the NSDs identified. Six index NSDs were identified, including neglected cleft lips and palate, clubfoot, cataracts, hernias and hydroceles, injuries, and obstetric fistula. Global definitions were proposed as a starting point towards the prevention and elimination of the backlog of NSDs. Defining a subset of neglected surgical conditions that illustrates society’s role and responsibility in addressing them provides a framework through the HRBA lens for its eventual eradication.
Nils Fleischhacker, Kasper Green Larsen, and Mark Simkin
Property-preserving hash functions allow for compressing long inputs $x_0$ and $x_1$ into short hashes $h(x_0)$ and $h(x_1)$ in a manner that allows for computing a predicate $P(x_0, x_1)$ given only the two hash values without having access to the original data. Such hash functions are said to be adversarially robust if an adversary that gets to pick $x_0$ and $x_1$ after the hash function has been sampled, cannot find inputs for which the predicate evaluated on the hash values outputs the incorrect result. In this work we construct robust property-preserving hash functions for the hamming-distance predicate which distinguishes inputs with a hamming distance at least some threshold $t$ from those with distance less than $t$. The security of the construction is based on standard lattice hardness assumptions. Our construction has several advantages over the best known previous construction by Fleischhacker and Simkin. Our construction relies on a single well-studied hardness assumption from lattice cryptography whereas the previous work relied on a newly introduced family of computational hardness assumptions. In terms of computational effort, our construction only requires a small number of modular additions per input bit, whereas previously several exponentiations per bit as well as the interpolation and evaluation of high-degree polynomials over large fields were required. An additional benefit of our construction is that the description of the hash function can be compressed to $λ$ bits assuming a random oracle. Previous work has descriptions of length $\mathcal{O}(\ell λ)$ bits for input bit-length $\ell$, which has a secret structure and thus cannot be compressed. We prove a lower bound on the output size of any property-preserving hash function for the hamming distance predicate. The bound shows that the size of our hash value is not far from optimal.
We describe an extremely rare case of a 66-year-old woman with a vaginal epithelioid angiosarcoma. She presented with constitutional symptoms, pelvic pain, vaginal bleeding, and a violaceous vaginal lesion. A thorough gynaecological examination, tissue biopsy and imaging were crucial to establish an accurate diagnosis. With only 3 other cases reported in the literature, epithelioid angiosarcoma of the vagina seem to present late due to their nonspecific presentation and secluded location. Once diagnosed, optimal treatment is difficult to determine and together with the overly aggressive behaviour of these tumours, they are associated with a poor prognosis. To our knowledge, our case study and systematic literature review is the first to compare the management outcomes of epithelioid subtype angiosarcomas of the vagina. The rarity of this pathology contributes to diagnostic difficulties and lack of consensus regarding treatment of angiosarcomas of the vagina.
Gynecology and obstetrics, Neoplasms. Tumors. Oncology. Including cancer and carcinogens