The role of biological markers in predicting infertility associated with non-obstructive endometriosis

Objectives: Our study evaluates if the use of biological markers can predict the infertility in women with non-obstructiveendometriosis.Material and methods: Two prospective, non-randomised studies were conducted to identify if CA-125, IL-6 and IL-8 can beused as predictive markers for infertility in women with non-obstructive endometriosis. Peripheral levels of CA-125, IL-6 andIL-8 were measured before laparoscopy in all patients.Results: We found a total number of 152 patients with non-obstructive endometriosis, we divided them in two groups: fertileand infertile women. There was a statistically significant difference of the mean of CA-125 values between the two groups(p = 0.00). The patients with infertility had a significantly higher IL-6 serum values than the fertile patients (p = 0.00). Regardingthe IL-8 serum values, there was no statistically significant difference between the two groups fertile vs infertile, (p = 0.06).Conclusions: The elevated serum levels of CA-125 and IL-6 was associated with an increased probability of being diagnosedwith infertility. The IL-8 had no value in predicting infertility associated with non-obstructive endometriosis

The social and the psychological impact of endometriosis on the Romanian urban population

Objectives. Our study assesses the social and psychological impact of the symptoms of endometriosis. Materials and methods. This crosssectional study was conducted from January 2014 to January 2016. The research involved two groups. The study instrument, the EHP-5 questionnaire, was completed by the respondents on the admission date or on the routine gynecological visit day. Results. Endometriosis has a negative social and psychological impact on women’s life, the most affected areas being work, fertility and sexual activity. Moreover, pain and the negative perception of self-image are major sources of distress. Conclusion. The symptoms and effects of endometriosis, especially chronic pelvic pain, mood changes and infertility, are significant negative factors in women’s life. The authors further conclude that the EHP-5 questionnaire can be more widely used to help select women who may need special attention in terms of their quality of life, thus helping gynecologists refer affected women to a health care professional

Corpus luteum in ectopic ovarian tissue miming tubal pregnancy

We report an extraordinarily rare case of a pregnant patient with history of multiple ovarian cyst surgery. The corpus luteum developed on an ectopic ovarian tissue, miming an tubal pregnancy. One week later after the diagnostic laparoscopy an intrauterine pregnancy was visualised. Therefore, ectopic ovarian tissue with normal follicular activity may appear after multiple ovarian surgery

Pregnancy after miscarriage: Psychological implications and emotional care

This article propose a review of the most important medical and psychological aspects regarding pregnancy after miscarriage. We highlighted the results of studies that reflect the importance of psychological implications and emotional care. This paper is a review based on information from the literature. The analysis was limited to articles and guides in English published between January 1, 2010 and June 1, 2021 on PubMed, ScienceDirect and Google Scholar using the following keywords: miscarriage, pregnancy after miscarriage, psychological counseling, psychological interventions. In this review we discuss the medical and psychological characteristics of this research area. We focus on the emotional aspects involved, the emotional and mental states that appear and the ways to deal with this difficulty in life. Psychotherapy, psychological counseling and care practices influences the wellbeing of women and represents a real support in mental recovery after miscarriange

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Microduplication 3p26.3p24.3 and 4q34.3q35.2 Microdeletion Identified in a Patient with Developmental Delay Associated with Brain Malformation

Microdeletions and microduplications are involved in many of prenatal and postnatal cases of multiple congenital malformations (MCM), developmental delay/intellectual disability (DD/ID), and autism spectrum disorders (ASD). Molecular karyotyping analysis (MCA), performed by DNA microarray technology, is a valuable method used to elucidate the ethology of these clinical expressions, essentially contributing to the diagnosis of rare genetic diseases produced by DNA copy number variations (CNVs). MCA is frequently used as the first-tier cytogenetic diagnostic test for patients with MCM, DD/ID, or ASD due to its much higher resolution (≥10×) for detecting microdeletions and microduplications than classic cytogenetic analysis by G-banded karyotyping. Therefore, MCA can detect about 10% pathogenic genomic imbalances more than G-banded karyotyping alone. In addition, MCA using the Single Nucleotide Polymorphism-array (SNP-array) method also allows highlighting the regions of loss of heterozygosity and uniparental disomy, which are the basis of some genetic syndromes. We presented a case of a five-year-old patient, with global development delay, bilateral fronto-parietal lysencephaly, and pachygyria, for which MCA through SNP-Array led to the detection of the genetic changes, such as 3p26.3p24.3 microduplication and 4q34.3q35.2 microdeletion, which were the basis of the patient’s phenotype and to the precise establishment of the diagnosis

Emotional disorders, marital adaptation and the moderating role of social support for couples under treatment for infertility

Objectives: Over the last few years, the impact of infertility on the psychological well-being of couples has been well recognised. Men and women with infertility experience stress, anxiety and depression and their relationship might be under pressure. Material and methods: We conducted a non-experimental correlational descriptive study where transversal analysis using questionnaires and quantitative data was performed for 76 couples with diagnosed infertility under the care of various reproductive medicine clinics in Romania between 2018 to 2019. Participants were asked to fill, via internet or in person, a set of tests including data on socio-demographic and infertility characteristics along with five psychological tests: The Fertility Problem Inventory (FPI), State-Trait Anxiety Inventory, Beck’s Depression Inventory (BDI), Dyadic Adjustment Scale and Interpersonal Support Evaluation List-12. The aim of the study was to explore how couples with infertility respond and adapt to this diagnosis and to assess the relationship between emotional disorders, marital adjustment and social support. Results: Mean age of females was 34.2 and of males 36.7 and 38.2% of the couples were experiencing infertility for > 6 years. Women had worse scores on infertility-related distress (FPI) (t = –4.35, p = 0.01), on the BDI depression scale (t = –5.43, p = 0.01) and on anxiety scales (t = –5.48, p = 0.01). Participants with a longer duration of infertility scored significantly higher on infertility-related distress than those with more recent difficulties. Marital adjustment scores correlated negatively with emotional disorders. Both appraisal social support and belonging support moderated the relationship between state-anxiety and marital adjustment. Conclusions: Infertility carries a significant psychological burden for the couple and the longer its duration, the higher the distress level. Women seem to be more vulnerable to its psychological consequences. Marital adjustment correlates negatively with the degree of emotional disorders. In couples with high levels of social support, the relationship between state-anxiety and marital adjustment was negatively correlated

Severe Neonatal Anemia Due to Spontaneous Massive Fetomaternal Hemorrhage at Term: An Illustrative Case with Suspected Antenatal Diagnosis and Brief Review of Current Knowledge

Fetomaternal hemorrhage is defined as transfer of fetal blood into placental circulation and therefore into maternal circulation during pregnancy, and represents an important contributor to intrauterine fetal demise and neonatal death. The condition is rarely diagnosed prenatally because clinical findings are often nonspecific, and it is unpredictable. In this paper we present an illustrative case of massive spontaneous fetomaternal hemorrhage where the diagnosis was highly suspected antenatally based on maternal reported reduced fetal movements, abnormal suggestive cardiotocographic trace, and increased peak systolic velocity in the fetal middle cerebral artery. We discuss obstetrical and neonatal management and review the current knowledge in the literature. Maintaining a high index of suspicion for this condition allows the obstetrician to plan for adequate diagnostic tests, arrange intrauterine treatment or delivery, and prepare the neonatal team