Poziom surowiczego czynnika wzrostu związanego z angiopoetyną (AGF) jest podwyższony w cukrzycy ciążowej i związany z insulinoopornością

Objective: Angiopoietin-related growth factor (AGF) is associated with angiogenesis but it can also affect glucose and energy metabolism. The aim of the study was to determine AGF levels in gestational diabetes mellitus (GDM). Materials and Methods: The study included 44 patients with GDM (GDM group) and 33 non-diabetic, healthy, women in the third trimester of pregnancy (control group). We analyzed serum levels of AGF and other biochemical and anthropometric markers in all subjects. Results: The study revealed that serum AGF levels were significantly higher in patients with GDM (113.30+/-69.92 ng/ml) than in controls (52.30+/-35.59 ng/ml), (p-valueCel: Czynnik wzrostu związany z angiopoetyną (AGF) jest odpowiedzialny za angiogenezy ale może też wpływać na metabolizm glukozy i energii. Celem tego badania była ocena poziomu AGF w cukrzycy ciążowej (GDM). Materiał i metoda: Do badania włączono 44 pacjentki z GDM (tzw. grupa GDM) i 33 zdrowe ciężarne w trzecim trymestrze ciąży (grupa kontrolna). Zbadano poziom surowiczego AGF oraz inne biochemiczne i antropometryczne markery u wszystkich pacjentek. Wyniki: Wykazano, że poziom surowiczego AGF był istotnie wyższy u pacjentek z cukrzycą ciążową (113,3+/-69,92 ng/ml) niż w grupie kontrolnej (52,3+/-35,59 ng/ml), (

Purse-string suture technique using a mini-Pfannenstiel incision to treat large dermoid cysts

This study describes the purse-string suture technique using a mini-Pfannenstiel incision for the surgical treatment of large ovarian dermoid cysts. We investigated intra and postoperative outcomes in 24 patients who underwent removal of large ovarian dermoid cysts through a mini-Pfannenstiel incision using the purse-string suture technique. The surgical procedure was performed by two experienced surgeons. The mean diameter of the cysts was 11.9 cm. The mean operation time was 46 min and the intraoperative rupture rate was 8.3%. No patient developed chemical peritonitis. The length of hospitalisation was 36 h. The recurrence rate was 8.3% in the same ovary at 1-year follow-up. In conclusion, ovarian dermoid cysts measuring >8 cm in diameter can be effectively treated through a mini-Pfannenstiel incision using the purse-string suture technique.Impact Statement What is already known on this subject? Dermoid cysts are the most common ovarian germ cell tumours occurring in the second and third decades of life, and these tumours are usually treated surgically. There is a lack of consensus among gynaecologists regarding the optimal surgical treatment modalities for ovarian dermoid cysts; however, laparoscopic cystectomy is the gold standard for the surgical treatment of dermoid cysts. Notably, aspiration of dense cystic contents may be difficult during laparoscopic cystectomy. What do the results of this study add? Our technique enables easy removal of dense cystic materials including hair and bone fragments. The short operation time, low recurrence rate and the minimal incisional scar serve as advantages of our novel method. What are the implications of these findings for clinical practice and/or further research? This surgical technique can be successfully used in clinical settings with limited facilities for laparoscopic surgery

The effects of sclerotherapy with 5% trichloroacetic acid on the cyst diameter and ovarian tissue in the rat ovarian cyst model

The aim of this study was to compare the effects of only aspiration with aspiration and 5% trichloroacetic acid (TCA) application on ovarian cyst size and ovarian reserve. The ovarian cysts of 14 rats that were divided into two groups randomly were investigated after total salpingectomy procedure. G1 was the group of saline application after cyst aspiration, while in G2, after aspiration 5% TCA at half amount of aspiration volume was injected into the cyst and re-aspirated after five minutes. The abdomens of the rats were closed and re-explored after 1 month. The cyst diameters of the rats in each group were measured. Ovaries were removed for histopathological examination. There was no significant difference in cyst diameter in G1 before and after aspiration. In G2, there was a significant decrease in cyst size after TCA application. Ovarian follicle counts were not significantly different between the two groups. In conclusion, application of 5% TCA to the ovarian cysts for five minutes significantly reduces the cyst size.Impact Statement What is already known on this subject: Minimally invasive therapies come into prominence to avoid surgical complications and diminished fertility in the treatment of ovarian cysts. USG-guided aspiration and sclerosis has been reported as cost-efficient and effective treatment methods for localised benign cysts in other organs such as the thyroid, parathyroid, liver, kidney and spleen. It has been shown that sclerotherapy applied to infertile women with ovarian cysts reduces pelvic pain without affecting the number of follicles, term pregnancy and abortion rates, extracted oocytes, embryo quality or hormonal levels when compared to non-ovarian cystic infertile women. TCA is a chemical agent that is topically applied, not systemically absorptive, which causes denaturation of proteins and structural cell death, resulting in coagulation necrosis after chemical cauterisation. For this reason, we used 5% TCA to treat simple ovarian cysts on a rat model. What the results of this study add: In this experimental study, we showed that the application of 5% TCA into the cyst for five minutes – then aspirated – significantly reduced the size of the ovarian cysts. Five percent TCA application did not affect the ovarian reserve. What the implications are of these findings for clinical practice and/or further research: Our study is original because of the fact that to the best of our knowledge, this is the first study about the use of 5% TCA in treatment of ovarian cysts in the literature

What is the impact of short- and long-term supplementation of either cabergoline or clarithromycin on resolving rat ovarian hyperstimulation syndrome (OHSS) model?

This study aimed to evaluate the effects of coasting, cabergoline and clarithromycin in a rat ovarian hyperstimulation syndrome (OHSS) model. The 42 female Wistar rats were divided into seven groups: control, OHSS (was given 10 IU of pregnant mare serum gonadotropin for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS ), coasting (hCG was applied on the 27th day after gonadotropin injections and the rats were decapitated on the 28th day), Cabergoline (100 mg/kg/d) and clarithromycin (100 mg/kg/d) were given (on the 26th day) with a short-term supplementation (on the 26th day) and long-term supplementation (from the 22nd to the 26th day) groups. The rats were decapitated on the 27th day. Cabergoline and clarithromycin significantly lowered VEGF-2 levels. Clarithromycin significantly reduced IL-1b and TNF-a and significantly increased IL-10 levels. Clarithromycin may be an effective drug for the treatment of OHSS. Impact statement What is already known on this subject? Ovarian hyper-stimulation syndrome (OHSS) is a self-limited disease, in which vascular endothelial growth factor (VEGF) plays the most important role and has a large clinical spectrum related with increased capillary permeability and fluid retention. Some treatment methods that block VEGF over-expression are used in treatment of OHSS. Clarithromycin is known to suppress the production of some pro-inflammatory molecules such as VEGF, IL-8, IL-1, IL-6 and TNF-a. In our study, we compared the efficacy of coasting, short- and long-term supplementation of clarithromycin and cabergoline on correcting OHSS parameters in an experimental study. What do the results of this study add? As a result of our study, we found that OHSS parameters improved better in early prophylactic treatment regimens. We have shown that clarithromycin may be a more effective treatment agent than coasting and cabergoline. What are the implications of these findings for clinical practice and/or further research? Although our study is important in that it is the first pilot study to show that clarithromycin is effective in the treatment of OHSS, there is a need for larger clinical trials

Comparison of results of Bakri balloon tamponade and caesarean hysterectomy in management of placenta accreta and increta: a retrospective study

The aim of this study was to compare the postoperative results of the patients who were treated with Bakri balloon tamponade or hysterectomy for placenta accreta and increta. Patients who were diagnosed with placenta accreta or increta preoperatively and intraoperatively and treated with Bakri balloon tamponade (Group 1) or caesarean hysterectomy (Group 2) were compared in regards to the postoperative results. Among the 36 patients diagnosed with placenta accreta or increta, 19 patients were treated with Bakri balloon tamponade while 17 cases were treated with hysterectomy. Intraoperative blood loss amount was 1794 ± 725 ml in G1, which was lower than that in G2 (2694 ± 893 ml). Blood transfusion amount was 2.7 ± 2.6 units in G1, lower than that in G2 (5.7 ± 2.4 units), too. Operation time was 64.5 ± 29 min and 140 ± 51 min in G1 and G2, respectively, showing significant differences between two groups. The success rate of Bakri balloon was determined as 84.21%. In conclusion, cases with placenta accreta/increta, with predicted placental detachment who are willing to preserve fertility, application of uterine balloon tamponade devices before the hysterectomy is encouraging with its advantages compared with the hysterectomy.Impact statement What is already known on this subject: Invasive placental anomalies are the most common indication of postpartum hysterectomy. Recently, uterine balloon tamponade was also included in the treatment modalities of postpartum haemorrhage.This study aimed to compare the postoperative results of UBT or hysterectomy for patients with placenta accreta and increta. What the results of this study add: In this study, the total amount of blood loss was higher in the caesarean hysterectomy group when compared with the Bakri balloon tamponade group. The mean transfusion requirement, mean operation time and hospitalisation period was significantly longer in the caesarean hysterectomy group. The success rate of the Bakri balloon was determined as 84.21%. Two patients who were treated with balloon application had a successful pregnancy and delivery later. Maternal mortality was reported in neither balloon nor hysterectomy groups. What the implications are of these findings for clinical practice and/or further research: In conclusion, patients diagnosed with placenta accreta/increta with ultrasound should be taken into the operation in elective conditions, if possible, on lithotomy position. In cases with predicted placental detachment that are willing to preserve fertility, application of uterine balloon tamponade devices before the hysterectomy has advantages compared with the hysterectomy