63 research outputs found
Η σημασία της συνδυασμένης εκτίμησης του καρκινοεμβρυικού αντιγόνου (CEA) και της αλφαεμβρυικής πρωτεΐνης (α - FP) στη διαφορική διάγνωση των πρωτοπαθών από τα μεταστατικά καρκινώματα του ήπατος
Is There a Role of Elevated CA 19-9 Levels in the Evaluation of Clinical Characteristics of Mature Cystic Ovarian Teratomas? A Systematic Review and Meta-analysis
The role of preoperative CA 19-9 levels in patients with ovarian mature
cystic teratoma (MCT) and the association of elevated levels of the
biomarker with patients' and tumor characteristics were evaluated. Four
electronic databases were searched for articles published up to
September 2019. Trials that evaluated the significance of elevated CA
19-9 in patients with ovarian MCTs and publications with > 20 patients
were considered eligible for inclusion. Seven studies that included 995
patients with an ovarian MCT who were evaluated with elevated (n = 364)
or normal (n = 631) CA 19-9 levels were included. Mean tumor size was
significantly increased in patients with elevated CA 19-9 levels (p =
0.038). The rate of ovarian torsion was significantly increased in the
elevated CA 19-9 group (p = 0.04). The present study highlights the
importance of CA 19-9 as a marker in the diagnosis of MCT, and a
meta-analysis supports that it could raise a high degree of clinical
suspicion of early recognition of torsion and early surgical management
due to complications related to increased size. Nonetheless, the
diagnostic value of CA 19-9 is still limited and CA 19-9 can still serve
only as a supplementary diagnostic tool in patients with MCTs
Post-Traumatic Pelvic Splenosis Diagnosed With a Combination of Laparoscopy and Technetium 99m Red Blood Cell Scintigraphy
Human Chorionic Gonadotropin: The Pregnancy Hormone and More
To thoroughly review the uses of human chorionic gonadotropin (hCG) related to the process of reproduction and also assess new, non-traditional theories. Review of the international literature and research studies. hCG and its receptor, LH/CGR, are expressed in numerous sites of the reproductive tract, both in gonadal and extra-goanadal tissues, promoting oocyte maturation, fertilization, implantation and early embryo development. Moreover, hCG seems to have a potential role as an anti-rejection agent in solid organ transplantation. Future research needs to focus extensively on the functions of hCG and its receptor LH/CGR, in an effort to reveal known, as well as unknown clinical potentials
The Impact of Genetics Profile (Gene Polymorphisms) in Obese Non-PCOS Women Entering an IVF/ICSI Program
Data concerning the effects of increased body mass index (BMI) on
ovarian and pregnancy outcome are rich, but the results are rather
controversial. Regarding pharmacogenetics, gene polymorphisms of
hormonal receptor genes, such as Estrogen Receptor alpha (ESR1),
Estrogen Receptor beta (ESR2) and FSH receptor (FSHR) genes, are
associated with ovarian stimulation and pregnancy outcome and may
constitute a useful tool for ART experts for the prediction of this
outcome. The aim of this study is to track differences in the
distribution of gene polymorphisms among obese non-PCOS and non-obese
patients concerning three distinct genes which are involved in the
ovarian stimulation mechanism: PvuII polymorphism of ESR1 gene, RsaI
polymorphism of ESR2 gene and Ser680Asn variation of FSHR gene, using
restriction fragment length polymorphism analysis and real-time
polymerase chain reaction. A total of 151 normally ovulating female
patients underwent IVF or ICSI. Interestingly, the pregnancy rate in the
BMI >= 30 kg/m(2) group was higher in a statistically significant way
(40.9% versus 17.8%, p=0.023). The obese patients of this study were
in need of increased total FSH dose in order to achieve a satisfactory
oocyte number (p<0.001) and needed more days of stimulation (p=0.002),
but also presented lower basal FSH levels (p=0.032), which may explain,
to an extend, the better pregnancy outcome. Concerning the polymorphisms
of ESR1, ESR2 and FSHR genes, we did not observe differences in the
genotype distribution when we compared the obese non-PCOS population
with the non-obese population. Thus, obesity does not constitute an
additional indication to perform a genetic analysis before entering an
IVF/ICSI program
A Genetic study in assisted reproduction and the risk of congenital anomalies
In vitro fertilization is one of the most common and effective procedure for thousands of couples worldwide who want to have a child and are unable to do so for various reasons. Diverse studies show that couples who conceive naturally after one year of trying had newborns with an increased risk of prematurity and low birth weight, compared with couples who conceived before completing one year of trying. Children from assisted reproduction (AR), have a 30% increased risk of prematurity and low birth weight, compared with children from infertile fathers. Regarding the conflicting results the present study aimed to record the frequency of genetic, congenital anomalies in children and adolescents who had examined in the last decade to the Clinical Genetics Clinic of the National and Kapodistrian University of Athens whose mothers had undergone assisted reproduction. The research process was conducted at the "Aghia Sofia" Children's Hospital based in Athens. However, the cases that were studied came from all over Greece. Initially, the researcher recorded the cases that came to the clinic of Clinical Genetics and whose conception occurred after technical assisted reproduction. After telephone communication and the consent of the parents, a live appointment was scheduled. In this meeting-interview all the provisions of the investigation and the protocol were asked and some elements of the medical history of the cases were confirmed. The total sample included 230 children and adolescents. The resulting data were recorded on a printed form/questionnaire. Then, they were registered electronically in the program SPSS 25.0 (Statistical Package for Social Sciences) with a specific unit code for each case/patient, followed by the processing and statistical analysis of the data as well as the recording of the results. The gender of the participants was male for 118 participants (51.3%) and 112 females (48.7%). Mean and standard deviation (SD) of maternal, paternal (at the time of delivery) age was equal to 36.38 (5.94) and 39.94 (6.58) respectively. The observed abdormalities were 35.53% psychomotor retardation, 23.68% facial abnormalities, 23.68% spinal cord abnormalities, 21.05% morphological abnormalities, 20.61% short stature, 19.74% developmental disorders, 19.30% heart disease, 16.67% neurological diseases, 14.47% genetic syndromes, 11.40% genital abnormalities, 8.33% limb abnormalities, 7.46% dermatological abnormalities, 6.14% eye abnormalities, 6.14% hypothyroidism, 5.70% endocrine disorders, 5.26%otolaryngology abnormalities, 2.63% disease of kidney, intestine, 2.19% vascular malformations. Regarding the karyotype chromosome analysis by G-banding technique, from the 230 children in: 24 (10.43%) a pathological result was found, in 158 children (68.70%) it was found normal (46, XX or 46, XY by case) without other findings, while in 48 children (20.87%) the test was not performed for various reasons. Regarding the results of molecular analysis (DNA) from the 230 children, in 50 (21.74%) a pathological finding was found, in 56 children (24.35%) no abnormalities were found and in 124 children (53.91%) no molecular analysis was performed for various reasons. In conclusion, the sample of this descriptive study is characterized as uniform in terms of the method of assisted reproduction since 96.24% had followed the classic IVF. Full-term pregnancy was associated with the appearance of malignancy and head morphological abnormalities (64.6%), normal pregnancy was associated with genetic syndromes (18.2%) and facial abnormalities (11.1%). It is recommended the screening oocyte and sperm donors in order to help protect the safety and health of donors, recipients, and future offspring. The present study confirms the association of the presence of congenital anomalies after in vitro fertilization (IVF). However, the absolute risk of developing severe dysplasias after an IVF procedure is limited
Three Dimensional Power Doppler evaluation of human endometrium after administration of oxytocine receptor antagonist (OTRa) in an IVF program
Purpose To compare endometrial and subendometrial morphological changes
and vascularity as measured by 3D Power Doppler sonography, based on a
specific scoring system between women subjected or not to oxytocine
receptor antagonist (OTRa) during IVF cycles.
Methods Twenty-six women were divided into groups according to OTRa
(Atosiban tractocide) administration. The first group (control n = 13
women) was examined with 3D Power Doppler 3 days after embryo transfer.
The second group (n = 13 women) was administered 7.5 mg intravenous
tractocide 2 days after embryo transfer and a 3D Power Doppler was
performed after a day.
Results The control group presented the following ultrasonographic
characteristics: (a) echogenic endometrium in all cases, (b) endometrial
thickness >7 mm in all cases (84.6%), (c) endometrial volume >2.31
cm(3) in 5 cases (38.5%), (d) abnormal sub-endometrial halo in 3 cases
(23.1%), (e) endometrial blood flow in 6 cases (46.2%) and (f) complex
vessel’s architecture in 2 cases (15.4%). In women who underwent OTRa
administration were observed: (a) echogenic endometrium in 1 case
(7.7%), triple line endometrium in 12 cases (92.3%), (b) endometrial
thickness >7 mm in all cases, (c) endometrial volume >2.31 cm(3) in 11
cases (84.6%), (d) abnormal sub-endometrial halo in 3 cases (23.1%),
(e) endometrial blood flow in 11 cases (84.6%) and (f) complex vessel’s
architecture in 6 cases (46.2%).
Conclusions Women who have taken OTRa presented an endometrium with
characteristics more predictive of implantation
Occupational social class, coping responses and infertility-related stress of women undergoing infertility treatment
Aim and objectives. The aims of this study were to examine the
association between (1) occupational social class and coping responses,
(2) coping responses and infertility-related stress and (3) occupational
social class and infertility-related distress.
Background. The coping strategies that individuals use in most of the
stressful situations vary according to certain factors, such as, the
appraised characteristics of the stressful condition, personality
dispositions and social resources.
Design. This study was a cross-sectional survey.
Methods. The study involved 404 women undergoing infertility treatment
at a public clinic in Athens, Greece. State and trait anxiety
(State-Trait Anxiety Inventory), infertility-related stress (Copenhagen
Multi-centre Psychosocial Infertility) and coping strategies (Copenhagen
Multi-centre Psychosocial Infertility) were measured.
Results. Women of low/very low social class reported higher levels of
active-confronting coping compared with women of higher social class (p
< 0.001). A positive correlation between active-avoidance coping and
both state and trait anxiety (r = 0.278 and 0.233, respectively, p <
0.01) was observed. The passive-avoidance coping scale was positively
correlated with marital and personal stress (r = 0.186 and 0.146,
respectively, p < 0.01). All three kinds of stress (marital, personal
and social) were positively correlated with both active-avoidance (r =
0.302, 0.423 and 0.211, respectively, p < 0.01) and active-confronting
scale (r = 0.150, 0.211 and 0.141, respectively, p < 0.01).
Conclusions. Infertile women of the lowest social class used more
active-confronting coping and more passive-avoidance coping than women
of the highest social class. Factors such as low social class and
maladaptive coping strategies might contribute to infertility-related
stress and anxiety.
Relevance to clinical practice. Nurses and midwives who work in
infertility clinics should aim to identify individuals who are at high
risk for infertility stress and adjustment difficulties and they should
minimise the identified risk factors for infertility-related stress and
strengthen the protective factors
Recurrent benign leiomyomas after total abdominal hysterectomy. Rich or poor estrogenic environment may lead to their recurrence?
INTRODUCTION: Benign metastasizing leiomyomas represent benign lesions
consisted by leiomatosous tissue and could be observed in positions away
from their usual localization, the human uterus. They commonly affect
women that have undergone total hysterectomy. Approximately 100 similar
cases have been reported in the literature, so the case we present is
rare and reviewing the literature and needs to be reported.
PRESENTATION OF CASE: We report a case of a 55 year old Greek woman,
gravida five and para three, who attended our unit 3 years ago
complaining of occasionally lower abdominal pain and irritation the last
months. Fourteen years ago she underwent abdominal hysterectomy and left
salpingo-oophorectomy due to a 13 cm uterine leiomyoma. In the meantime
she underwent two surgical procedures for recurrent benign leiomyomas.
DISCUSSION: When patient was admitted at this time, clinical examination
revealed a palpable mass of 5 cm. The transvaginal ultrasonography
revealed 3 masses in the lower pelvis of unknown origin. The patient
underwent a new laparotomy revealing three masses of benign leiomyomas
with low mitotic activity.
CONCLUSION: Our case supports the recurrent appearance of leiomyomas in
pelvis after total abdominal hysterectomy and is one of few reports in
literature where the tumors appear in the same patient both in estrogen
rich and estrogen poor environment. Additionally, we show the importance
of transvaginal ultrasonography and 3 dimensional power Doppler in the
differential diagnosis of pelvic masses. Thus, transvaginal
ultrasonography seems to be a pivotal tool for the diagnosis and follow
up of these challenging lesions. (C) 2018 The Authors. Published by
Elsevier Ltd on behalf of IJS Publishing Group Ltd
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