Πιλοτική μελέτη διερεύνησης της έκφρασης δεικτών πολυδυναμικότητας στο τραχηλικό επίχρισμα και πρόωρος τοκετός

Ο πρόωρος τοκετός αποτελεί την κυριότερη αιτία νεογνικής νοσηρότητας και θνησιμότητας και αφορά περίπου το 10% των κυήσεων. Παρότι η επίπτωση του έχει σαφώς μειωθεί την τελευταία δεκαετία, τα ποσοστά του συνεχίζουν να παραμένουν σε υψηλά επίπεδα, με την επίπτωση να είναι ιδιαίτερα αυξημένη στις αναπτυσσόμενες χώρες. Τα πρόωρα νεογνά εμφανίζουν αυξημένα ποσοστά αναπνευστικής δυσχέρειας, λοιμώξεων, άπνοιας, υπογλυκαιμίας, επιληπτικών κρίσεων, ίκτερου, πυρηνικού ίκτερου, προβλημάτων διατροφής, νεκρωτικής εντεροκολίτιδας, περικοιλιακής λευκομαλακίας ενώ παράλληλα έχουν ανάγκη παρατεταμένης νοσηλείας σε τριτοβάθμια νοσοκομεία, επιβαρύνοντας σημαντικά τα δημόσια συστήματα υγείας. Καθίσταται λοιπόν επιτακτική η ανάγκη για τη μείωση της συχνότητας του πρόωρου τοκετού. Τα τελευταία χρόνια η έρευνα έχει επικεντρωθεί στο πεδίο της πρωτεϊνικής έκφρασης διαφόρων παραγόντων, οι οποίοι φαίνεται ότι συμμετέχουν στην αλλαγή της ιστολογικής μορφολογίας του τραχήλου, οδηγώντας σε ανεπάρκεια του τραχήλου, ενός από τους σημαντικότερους προδιαθεσικούς παράγοντες μη ιατρογενούς πρόωρου τοκετού. Η θεωρία των αρχέγονων πολυδύναμων κυττάρων έχει διατυπωθεί σε πολυάριθμα ερευνητικά πεδία συμπεριλαμβανομένης της γυναικολογικής ογκολογίας και συγκεκριμένα στον καρκίνο του τραχήλου της μήτρας, όπου φαίνεται πως η παρουσία τους επηρεάζει τόσο την πρόγνωση, όσο και την ανταπόκριση στη θεραπεία. Η υπόθεση της παρούσας μελέτης βασίζεται στην πιθανή συμμετοχή των αρχέγονων πολυδύναμων κυττάρων στην ιστική αναδιαμόρφωση του τραχήλου, που παρατηρείται σε γυναίκες με ανεπάρκεια τραχήλου. Σκοπός λοιπόν της μελέτης είναι να διερευνηθεί η έκφραση δεικτών πολυδυναμικότητας σε κυτταρολογικό υλικό τραχηλικού επιχρίσματος σε γυναίκες με ανεπάρκεια του τραχήλου της μήτρας και να συγκριθεί με αυτό υγιών μαρτύρων οι οποίες έχουν φυσιολογικό μήκος τραχήλου. Τα δείγματα θα λαμβάνονται από τον εξωτράχηλο γυναικών κατά τη διάρκεια της 20ης – 24ης εβδομάδας κύησης και είναι αντίστοιχα με αυτά της κυτταρολογίας υγρής φάσης που χρησιμοποιούνται για τη ανίχνευση παθολογίας του τραχήλου της μήτρας.Premature birth is the leading cause of neonatal morbidity and mortality with an estimated incidence of about 10%. Although its incidence has clearly decreased over the last decade, its rates continue to be high, especially in developing countries. Premature infants show increased rates of respiratory distress syndrome, infections, apnea, hypoglycemia, seizures, jaundice, nuclear jaundice, nutritional problems, necrotizing enterocolitis, and periventricular leukomalacia. As a result, they need prolonged hospitalization, having a serious economic impact on healthcare. Therefore, the need of reducing the frequency of preterm birth is becoming urgent. In recent years, research has focused on protein expression of several factors, which seem to be involved in the histological change of the cervix, leading to cervical insufficiency, one of the most important predisposing factors for non-iatrogenic preterm birth. The theory of pluripotent stem cells has been formulated in numerous research fields, including gynecologic oncology and specifically in cervical cancer, where their presence appears to affect both prognosis and response to treatment. The hypothesis of the present study is based on the possible involvement of pluripotent stem cells in cervical tissue remodeling, observed in women with cervical insufficiency. The aim of the study is to investigate the expression of stemness markers in cervical smear in women with cervical insufficiency and to compare it with that of healthy controls who have normal cervical size. The samples will be taken from women's cervix during the 20th - 24th week of pregnancy and are similar to those of liquid phase cytology used to detect cervical pathology

Cancer Treatment and Immunotherapy during Pregnancy

Background/aim: Immunotherapy has, in recent years, witnessed an expansion in its indications for the treatment of cancer. Coupled with the fact that, nowadays, even more women choose to postpone parenthood, thus increasing their chances of having some kind of malignancy during pregnancy, more and more women are eligible for receiving immunotherapy during this period of their lives. The cases of cancer diagnosed during pregnancy is an ever-increasing trend nowadays. Materials and methods: The oncologists and clinicians treating women often face a range of ethical and therapeutic dilemmas due to the particularity of the patient’s conditions. The primary concern is the protection of the mother, firstly, and then the fetus (through adjustments to the various treatment regimens) if possible. Results and conclusions: Oncological drugs, radiation therapy, surgery, or a combination of all the above methods are selected, depending on the case. In this project, we studied the oncology drugs used for various types of gestational cancer, their appropriateness and timing, as well as their possible effects on the parent and embryo upon their administration. Various studies have shown that the administration of oncological drugs should be postponed until at least after the first trimester of pregnancy

Pregnancy and COVID-19

Evidence indicates that SARS-CoV-2 infection increases the likelihood of adverse pregnancy outcomes. Modifications in the circulatory, pulmonary, hormonal, and immunological pathways induced by pregnancy render pregnant women as a high-risk group. A growing body of research shows that SARS-CoV-2 infection during pregnancy is connected to a number of maternal complications, including pneumonia and intensive care unit (ICU) hospitalization. Miscarriages, stillbirth, preterm labor, as well as pre-eclampsia and intrauterine growth restriction are also among the most often documented fetal implications, particularly among expecting women who have significant COVID-19 symptoms, often affecting the timing and route of delivery. Thus, prevention of infection and pharmacological treatment options should aim to minimize the aforementioned risks and ameliorate maternal, obstetric and fetal/neonatal outcomes

Advantages and Limitations of Ultrasound as a Screening Test for Ovarian Cancer

Ovarian cancer (OC) is the seventh most common malignancy diagnosed among women, the eighth leading cause of cancer mortality globally, and the most common cause of death among all gynecological cancers. Even though recent advances in technology have allowed for more accurate radiological and laboratory diagnostic tests, approximately 60% of OC cases are diagnosed at an advanced stage. Given the high mortality rate of advanced stages of OC, early diagnosis remains the main prognostic factor. Our aim is to focus on the sonographic challenges in ovarian cancer screening and to highlight the importance of sonographic evaluation, the crucial role of the operator΄s experience, possible limitations in visibility, emphasizing the importance and the necessity of quality assurance protocols that health workers have to follow and finally increasing the positive predictive value. We also analyzed how ultrasound can be combined with biomarkers (ex. CA-125) so as to increase the sensitivity of early-stage OC detection or, in addition to the gold standard examination, the CT (Computed tomography) scan in OC follow–up. Improvements in the performance and consistency of ultrasound screening could reduce the need for repeated examinations and, mainly, ensure diagnostic accuracy. Finally, we refer to new very promising techniques such as liquid biopsies. Future attempts in order to improve screening should focus on the identification of features that are unique to OC and that are present in early-stage tumors