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Bakas P, Creatsa M, Panagopoulos P, Vlahos N, Papadakis E, Simopoulou M. Outcome and recurrence risk of premature progesterone rise in IVF/ICSI cycles using GnRH antagonists for pituitary down-regulation. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog3704.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Lambrinoudaki I, Armeni E, Pliatsika P, Rizos D, Kaparos G, Augoulea A, Alexandrou A, Flokatoula M, Creatsa M, Panoulis C, Triantafyllou N, Papacharalambous X. Thyroid function and autoimmunity are associated with the risk of vertebral fractures in postmenopausal women. J Bone Miner Metab 2017; 35:227-233. [PMID: 27023333 DOI: 10.1007/s00774-016-0752-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 02/22/2016] [Indexed: 01/12/2023]
Abstract
Overt or subclinical thyroid dysfunction may affect the risk of fragility fractures. The aim of the present study was to assess the association of thyroid function and autoimmunity with vertebral fractures (VF) in a large sample of Greek postmenopausal women. This cross-sectional study recruited 335 euthyroid postmenopausal women, aged 35-79 years. Euthyroidism was verified by serum thyroid-stimulating hormone (TSH) within the laboratory reference range (0.4-4.5 μIU/mL). VFs were diagnosed by lumbar spine lateral radiographs, according to quantitative procedures. Serum free triiodothyronine (FT3), free thyroxine (FT4), TSH, as well as levels of anti-thyroglobulin (anti-TG) and thyroid peroxidase antibodies (anti-TPO) were compared according to the presence of VFs. Multivariate logistic regression showed that the presence of VFs was predicted independently by ln-TSH levels (OR = 0.290, p = 0.037) and positive anti-TG antibodies (OR = 3.308, p = 0.026) in models adjusted for age, menopausal age, and ln-HOMA-IR. Stepwise logistic regression analysis showed that the presence of VFs was predicted by menopausal age (OR = 1.120, p = 0.001), ln-TSH (OR = 0.312, p = 0.052), and thyroid autoimmunity (anti-TG and anti-TPO positive: OR = 6.637, p = 0.007) in a model that also included age and ln-HOMA-IR. Women with lower circulating TSH had higher risk of having a VF, independently of age, menopausal age, and insulin resistance. The presence of positive anti-TG/anti-TPO antibodies also indicated an elevated risk of fracture. Levels of thyroid hormones had no apparent effect on the risk of fracture. Further studies are necessary to establish the significance of our findings.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Paraskevi Pliatsika
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Demetrios Rizos
- Hormonal and Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece
| | - George Kaparos
- Hormonal and Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Andreas Alexandrou
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Maria Flokatoula
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Maria Creatsa
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
| | - Constantinos Panoulis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece
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Bakas P, Tzouma C, Creatsa M, Boutas I, Hassiakos D. Maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of human chorionic gonadotropin: a case report. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2103.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Bakas P, Tzouma C, Creatsa M, Boutas I, Hassiakos D. Maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of human chorionic gonadotropin: a case report. CLIN EXP OBSTET GYN 2016; 43:446-447. [PMID: 27328512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE OF INVESTIGATION To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. MATERIALS AND METHODS A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. RESULTS All signs of hyperthyroidism resolved and the results of thyroid function tests returned to normal without any medication after embryo meiosis. CONCLUSIONS De novo maternal hyperthyroidism may develop during pregnancy as a result of pathological stimulation of the thyroid gland from the high levels of hCG hormone that can be seen in multiple pregnancies. The risk of hyperthyroidism is related to the number of fetuses. Reversibility of symptomatology can be seen after fetal reduction of multiple pregnancies.
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Bakas P, Chados N, Hassiakos D, Creatsa M, Liapis A, Creatsas G. Secondary hypoparathyroidism during pregnancy – A case report and review of the literature. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1984.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Panoulis K, Armeni E, Christantoni E, Pliatsika P, Anagnostis P, Goulis DG, Kondi-Pafiti A, Augoulea A, Triantafyllou N, Creatsa M, Lambrinoudaki I. The development of malignant or benign endometrial pathology is associated with the expression of gonadal steroid receptors in postmenopausal ovaries. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lambrinoudaki I, Dafnios N, Kondi-Pafiti A, Triantafyllou N, Karopoulou E, Papageorgiou A, Augoulea A, Armeni E, Creatsa M, Vlahos N. A case of postmenopausal androgen excess. Gynecol Endocrinol 2015; 31:760-4. [PMID: 26287476 DOI: 10.3109/09513590.2015.1075500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ovarian steroid cell tumors are very rare but potentially life-threatening neoplasms. They represent less than 0.1% of all ovarian tumors, typically present in premenopausal women and frequently manifest with virilization. Signs of hyperandrogenism may appear in postmenopausal women due to tumorοus and non-tumorοus adrenal and ovarian causes as well due to the normal aging process. In any case, steroid cell tumor should be suspected in postmenopausal women who present with rapid progressive androgen excess symptoms. This report describes a case of a 67-year-old postmenopausal woman with signs of hyperandrogenism, where an ovarian steroid cell tumor was diagnosed and treated by laparoscopic bilateral salpingo-oophorectomy and synchronous hysterectomy.
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Affiliation(s)
| | - Nikos Dafnios
- b 2nd Department of Surgery , National and Kapodistrian University of Athens, Aretaieio Hospital , Athens , Greece , and
| | | | - Nikos Triantafyllou
- c First Neurology Department , National and Kapodistrian University of Athens, Aiginiteion Hospital , Athens , Greece
| | | | | | | | - Eleni Armeni
- a 2nd Department of Obstetrics and Gynecology and
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Bakas P, Boutas I, Creatsa M, Vlahos N, Gregoriou O, Creatsas G, Hassiakos D. Can anti-Mullerian hormone (AMH) predict the outcome of intrauterine insemination with controlled ovarian stimulation? Gynecol Endocrinol 2015; 31:765-8. [PMID: 26288100 DOI: 10.3109/09513590.2015.1025381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess whether the levels of anti-Mullerian hormone (AMH) are related to outcome of intrauterine insemination (IUI) in patients treated with gonadotropins. INTERVENTION(S) A total of 195 patients underwent controlled ovarian stimulation (COS) with recombinant follicle stimulating hormone (rFSH) (50-150 IU/d). All patients were submitted upto three cycles of IUI. OUTCOME Primary outcome was the ability of AMH levels to predict clinical pregnancy at first attempt and the cumulative clinical pregnancy probability of upto three IUI cycles. Secondary outcomes were the relation of AMH, LH, FSH, BMI, age, parity and basic estradiol levels with each other and the outcome of IUI. RESULTS The area under the receiver operating characteristic (ROC) curve in predicting clinical pregnancy for AMH at first attempt was 0.53 and for cumulative clinical pregnancy was 0.76. AMH levels were positively correlated with clinical pregnancy rate at first attempt and with cumulative clinical pregnancy rate, but negatively correlated with patient's age and FSH levels. Patient's FSH, LH levels were negatively correlated with cumulative clinical pregnancy rate. CONCLUSIONS AMH levels seem to have a positive correlation and patient's age and LH levels had a negative correlation with the outcome of IUI and COS with gonadotropins. AMH concentration was significantly higher and LH was significantly lower in patients with a clinical pregnancy after three cycles of IUI treatment compared with those who did not achieve pregnancy.
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Affiliation(s)
- Panagiotis Bakas
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - Ioannis Boutas
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - Maria Creatsa
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - Nicos Vlahos
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - Odysseas Gregoriou
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - George Creatsas
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
| | - Dimitrios Hassiakos
- a 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, University of Athens , Athens , Greece
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Triantafyllou N, Thoda P, Armeni E, Rizos D, Kaparos G, Augoulea A, Alexandrou A, Creatsa M, Tsivgoulis G, Artemiades A, Panoulis C, Lambrinoudaki I. Association of sex hormones and glucose metabolism with the severity of multiple sclerosis. Int J Neurosci 2015; 126:797-804. [PMID: 26407165 DOI: 10.3109/00207454.2015.1069825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE/AIM OF THE STUDY We evaluated possible associations between the severity of multiple sclerosis (MS) and levels of sex hormones as well as biochemical parameters in a sample of ambulatory patients. MATERIAL AND METHODS This cross-sectional study recruited 133 adults (52 men, 66 premenopausal and 15 postmenopausal women), with relapsing-remitting MS. Fasting venous blood samples were drawn for biochemical and hormonal evaluation. These parameters were tested for possible associations with MS severity, assessed using the Expanded Disability Status Scale (EDSS)-scores. RESULTS Follicle-stimulating hormone correlated with mean EDSS scores (r = -0.369, p = 0.038) in the premenopausal subgroup. However, this association became non-significant in the age-adjusted multivariate analysis (p = 0.141; power = 67%, type α error 0.10). Free androgen exhibited a borderline negative effect on EDSS-scores in the subgroup of men (r = -0.367, p = 0.093), which was lost after adjusting for age and duration of disease (p = 0.192; statistical power = 93%, type α error 0.05). Levels of estradiol tended to affect disability status of postmenopausal women (normal-mild vs. severe impairment: 23.33 ± 11.73pg/mL vs. 14.74 ± 6.30pg/mL, p = 0.095). Levels of sex hormones or indices of glycemic metabolism did not differ between patients presenting with EDSS scores higher or lower than the median value. CONCLUSION Sex hormones and indices of glucose metabolism exhibited only a middle effect on EDSS scoring, which was not independent from the presence of confounders like age and duration of MS. The present study highlights the need for additional research, in order to elucidate the role of sex hormones and insulin resistance in the course of MS.
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Affiliation(s)
- Nikolaos Triantafyllou
- a 1 1st Department of Neurology , University of Athens , Aiginiteio Hospital, Athens , Greece
| | - Pinelopi Thoda
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Eleni Armeni
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Demetrios Rizos
- c 3 Hormonal and Biochemical Laboratory , University of Athens , Aretaieio Hospital, Athens , Greece
| | - George Kaparos
- c 3 Hormonal and Biochemical Laboratory , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Areti Augoulea
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Andreas Alexandrou
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Maria Creatsa
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Georgios Tsivgoulis
- d 4 2nd Department of Neurology , University of Athens , Attiko Hospital, Athens , Greece
| | - Artemios Artemiades
- a 1 1st Department of Neurology , University of Athens , Aiginiteio Hospital, Athens , Greece
| | - Constantinos Panoulis
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
| | - Irene Lambrinoudaki
- b 2 2nd Department of Obstetrics and Gynecology , University of Athens , Aretaieio Hospital, Athens , Greece
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Augoulea A, Sioutis D, Rizos D, Panoulis C, Triantafyllou N, Armeni E, Deligeoroglou E, Chrelias C, Creatsa M, Liapis A, Lambrinoudaki I. Stress urinary incontinence and endogenous sex steroids in postmenopausal women. Neurourol Urodyn 2015; 36:121-125. [PMID: 26380958 DOI: 10.1002/nau.22885] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/28/2015] [Indexed: 11/09/2022]
Abstract
AIMS Urinary incontinence in general is a major cause of quality of life impairment, morbidity and hospitalization. Its onset is strongly linked to the menopause. Our study aimed to elucidate the possible relationship between endogenous circulating estrogens and the onset and development of stress urinary incontinence (SUI). METHODS One hundred and thirty eight peri- and postmenopausal women with SUI were matched 1:1 with continent women based on age and BMI. Morning fasting blood samples were drawn from all subjects for assessment of estradiol (E2), FSH, LH, Testosterone, Δ4-Androstendione (Δ4Α), DHEAS, prolactin, SBHG as well as a biochemical profile (glucose, insulin, triglycerides, cholesterol, HDL, LDL, ApoA1, ApoB). Hormone and biochemical parameters were compared between continent and incontinent women. RESULTS Incontinent women had significantly lower serum estradiol levels compared to those in the control group (17.30 ± 8.16 vs. 24.22 ± 8.99, P < 0.001). Furthermore, the same association was observed for serum Δ4Α (146.07 ± 52.63 vs. 159.99 ± 42.62, P = 0.017). These associations remained significant after controlling for age, menopausal age, BMI, and number of deliveries. CONCLUSIONS These results may indicate that within the postmenopausal range, endogenous sex hormones may be associated with the presence of SUI in women not on menopausal hormone therapy. Neurourol. Urodynam. 36:121-125, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Areti Augoulea
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Dimos Sioutis
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Demetrios Rizos
- Hormonal Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Constantinos Panoulis
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Nikolaos Triantafyllou
- First Department of Neurology, University of Athens, Aiginiteio Hospital, Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Efthymios Deligeoroglou
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Charalambos Chrelias
- Third Department of Obstetrics and Gynecology, University of Athens, Attico Hospital, Athens, Greece
| | - Maria Creatsa
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Angelos Liapis
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
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Lambrinoudaki I, Armeni E, Rizos D, Georgiopoulos G, Athanasouli F, Triantafyllou N, Panoulis K, Augoulea A, Creatsa M, Alexandrou A, Alevizaki M, Stamatelopoulos K. Indices of adiposity and thyroid hormones in euthyroid postmenopausal women. Eur J Endocrinol 2015; 173:237-45. [PMID: 26142102 DOI: 10.1530/eje-15-0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We aimed to evaluate the association between thyroid hormones and indices of obesity in a sample of euthyroid postmenopausal women. DESIGN Cross-sectional study. METHODS Serum levels of TSH, free triiodothyronine (FT3), and free thyroxine (FT4) as well as BMI and waist:hip ratio (WHR) were evaluated in 194 healthy euthyroid postmenopausal women. Ultrasonography was used to assess abdominal fat layers (subcutaneous fat (SF), preperitoneal fat (PF), and SF:PF ratio). Indices of adiposity were defined as high vs low depending on the median value of the assessed parameters. RESULTS After multivariate adjustment for traditional risk factors, lower FT4 levels and a higher FT3:FT4 ratio predicted higher SF mass (FT4, Exp(β)=0.035, P=0.020 and FT3:FT4, Exp(β)=2.374, P=0.018), whereas higher FT3 predicted higher PF mass (Exp(β)=2.815, P=0.032). Women with FT3:FT4 above the highest quartile had a significantly higher SF mass as compared to women in the lowest quartile (1.81 ± 0.62 cm vs 1.54 ± 0.46 cm, P=0.027). BMI had a positive independent association with TSH (Exp(β)=1.829, P=0.018). Finally, FT3 was significantly associated with SF mass among women with higher BMI (FT3, β=0.259, P=0.040) and women with higher WHR (β=0.309, P=0.020) but not among women with lower BMI or WHR values. CONCLUSION Thyroid hormone levels, and in particular FT3, were independently associated with SF and PF in euthyroid postmenopausal women, and this association was mainly evident in women with higher BMIs. On the other hand, among traditional indices of adiposity, only TSH was positively associated with BMI. Larger prospective studies are needed to evaluate the significance of the present findings.
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Affiliation(s)
- Irene Lambrinoudaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Demetrios Rizos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Georgios Georgiopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Foteini Athanasouli
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Nikolaos Triantafyllou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Creatsa
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Maria Alevizaki
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Second Department of Obstetrics and GynecologyHormonal LaboratoryAretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of TherapeuticsAlexandra Hospital, University of Athens, 80 Vas. Sofias Avenue, GR-11528 Athens, GreeceDepartment of NeurologyAiginiteion Hospital, University of Athens, 72-74 Vas. Sofias Avenue, GR-11528 Athens, Greece
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Armeni E, Bouziou G, Spyropoulou A, Koundi K, Rizos D, Augoulea A, Alexandrou A, Creatsa M, Panoulis C, Dendrinos S, Leonadrou A, Zervas I, Lambrinoudaki I. The development of mood disturbances is associated with levels of circulating androgen in young postmenopausal women. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Armeni E, Flokatoula M, Pliatsika P, Antoniou A, Augoulea A, Alexandrou A, Creatsa M, Panoulis C, Papacharalambous X, Lambrinoudaki I. Vertebral fracture prevalence among Greek healthy middle-aged postmenopausal women: association with demographics, anthropometric parameters and bone mineral density. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lambrinoudaki I, Bouziou G, Armeni E, Spyropoulou A, Koundi K, Rizos D, Augoulea A, Alexandrou A, Creatsa M, Panoulis C, Dendrinos S, Leonadrou AA, Zervas IM. Circulating androgens are associated with mood disturbances in young postmenopausal women. Climacteric 2015; 18:205-13. [DOI: 10.3109/13697137.2014.984674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Panoulis K, Christantoni E, Pliatsika P, Anagnostis P, Goulis DG, Kondi-Pafiti A, Armeni E, Augoulea A, Triantafyllou N, Creatsa M, Lambrinoudaki I. Expression of gonadal steroid receptors in the ovaries of post-menopausal women with malignant or benign endometrial pathology: a pilot study. Gynecol Endocrinol 2015; 31:613-7. [PMID: 26036714 DOI: 10.3109/09513590.2015.1021324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This pilot study aimed to investigate the expression of estrogen (ER) and progesterone receptors (PR), as well as their subtypes [alpha (ERα), beta (ERβ)], in the ovaries of postmenopausal women with benign or malignant endometrial pathology. Twenty postmenopausal women (age 66.2 ± 7.4 years) were included, diagnosed with benign (n = 10) or malignant [(serous/papillary (n = 4), endometrioid (n = 6)] endometrial lesions. Higher ERβ and PR ovarian expressions were observed comparing women with endometrioid versus non-endometrioid endometrial carcinoma (p = 0.022 and p = 0.029, respectively). Age, age at menarche and presence of hypertension were negatively associated with ERs and PR expression. The expression of ERα and ERβ was inversely correlated with menopausal age, which was not verified for PR. No significant association was observed between ERs or PR expression and benign or malignant endometrial pathology. Higher expression of ERβ and PR in the postmenopausal ovary is associated with the presence of a less aggressive type of endometrial cancer, comparing women with endometrioid versus non-endometrioid lesions. The expression pattern of ovarian receptors did not differ regarding the development of benign or malignant endometrial lesions. Larger observational studies are necessary to confirm the significance of our findings.
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Affiliation(s)
- Konstantinos Panoulis
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Evanthia Christantoni
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Paraskevi Pliatsika
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Panagiotis Anagnostis
- b Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece , and
| | - Dimitrios G Goulis
- b Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece , and
| | - Agathi Kondi-Pafiti
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Eleni Armeni
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Areti Augoulea
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Nikolaos Triantafyllou
- c First Neurology Department , Aiginiteion Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Maria Creatsa
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Irene Lambrinoudaki
- a Second Department of Obstetrics and Gynecology , Aretaieio Hospital, National and Kapodistrian University of Athens , Athens , Greece
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Bakas P, Chados N, Hassiakos D, Creatsa M, Liapis A, Creatsas G. Secondary hypoparathyroidism during pregnancy--a case report and review of the literature. CLIN EXP OBSTET GYN 2015; 42:825-826. [PMID: 26753497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Secondary hypoparathyroidism is seldom seen during pregnancy. Usually, it presents with hypocalcemia. Even if there is no established therapeutic treatment, vitamin D or its analogues are required. In the present case, a 36-year-old, second gravida, with known hypoparathyroidism for the last ten years, was admitted in the prenatal clinic of "Aretaieion" University Hospital in Athens at her 39 weeks of pregnancy. She was treated with calcitriol and calcium and she was monitored monthly. She had a cesarian section and delivered a healthy female baby of 3,380 gr at 39 weeks and 1 day.
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Lambrinoudaki I, Flokatoula M, Armeni E, Pliatsika P, Augoulea A, Antoniou A, Alexandrou A, Creatsa M, Panoulis C, Dendrinos S, Papacharalambous X. Vertebral fracture prevalence among Greek healthy middle-aged postmenopausal women: association with demographics, anthropometric parameters, and bone mineral density. Spine J 2015; 15:86-94. [PMID: 25106754 DOI: 10.1016/j.spinee.2014.07.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 07/29/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The prevalence of skeletal fractures shows a marked geographic variability; however, data regarding the Greek population remain limited. PURPOSE To evaluate the frequency of asymptomatic vertebral fractures (VFs), and potential risk factors, in a large sample of Greek postmenopausal women. STUDY DESIGN A cross-sectional study at the University Menopause Clinic. PATIENT SAMPLE Four hundred fifty-four postmenopausal women aged 35 to 80 years, with an average menopausal age of 9.2±7.1 years. OUTCOME MEASURES They included medical history, anthropometric and biochemical parameters, bone mineral density (BMD) at lumbar spine (LS) and femoral neck (FN), and LS lateral radiographs. METHODS Lumbar spine lateral radiographs were evaluated according to quantitative procedures, aiming to identify VFs. Anthropometric and biochemical parameters and values of BMD were compared according to the presence of VFs. RESULTS A total of 37 (8.15%) women had at least one VF. Lumbar spine and FN-osteoporosis was identified in up to 23.1% and 40.9% subjects with prevalent VFs, respectively. The prevalence of VFs was largely associated with age, with women aged 60 years or more presenting an up to fourfold risk compared with younger women. Moreover, the presence of VFs was associated with higher menopausal age, advanced age at menarche, a history of early menopause, and prolonged lactation. Lower LS-BMD and, especially, FN-BMD were negatively associated with VF prevalence (prevalent VF vs. no VF: LS-BMD, 0.89±0.16 g/cm(2) vs. 0.98±0.16 g/cm(2), p=.010; FN-BMD, 0.72±0.10 g/cm(2) vs. 0.81±0.12 g/cm(2), p=.008). CONCLUSIONS Asymptomatic VFs are common among Greek healthy middle-aged postmenopausal women. More than 50% subjects with prevalent VFs present with normal BMD or osteopenia. Age and bone density classification at the FN presented the strongest association with the prevalence of VFs.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece.
| | - Maria Flokatoula
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Paraskevi Pliatsika
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Aris Antoniou
- 1st Department of Radiology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Andreas Alexandrou
- 1st Department of Surgery, University of Athens, Laiko Athens General Hospital, 17 Agiou Thoma St, GR-11527 Athens, Greece
| | - Maria Creatsa
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Constantinos Panoulis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Spyridon Dendrinos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
| | - Xenofon Papacharalambous
- 1st Department of Radiology, University of Athens, Aretaieio Hospital, 76 Vas. Sofias Ave., GR-11528, Athens, Greece
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Alexandrou A, Armeni E, Kaparos G, Rizos D, Tsoka E, Deligeoroglou E, Creatsa M, Augoulea A, Diamantis T, Lambrinoudaki I. Bsm1 Vitamin D Receptor Polymorphism and Calcium Homeostasis Following Bariatric Surgery. J INVEST SURG 2014; 28:8-17. [DOI: 10.3109/08941939.2014.943857] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kokras N, Papadopoulos L, Zervas IM, Spyropoulou A, Stamatelopoulos K, Rizos D, Creatsa M, Augoulea A, Papadimitriou GN, Lambrinoudaki I. Psychological but not vasomotor symptoms are associated with temperament and character traits. Climacteric 2014; 17:500-9. [DOI: 10.3109/13697137.2014.890180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Askoxylaki M, Siristatidis C, Chrelias C, Vogiatzi P, Creatsa M, Salamalekis G, Vrantza T, Vrachnis N, Kassanos D. Reactive oxygen species in the follicular fluid of subfertile women undergoing In Vitro Fertilization: a short narrative review. J Endocrinol Invest 2013; 36:1117-20. [PMID: 24081166 DOI: 10.3275/9097] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reactive Oxygen Species (ROS) are produced as a normal product of aerobic metabolism. Naturally, there is an array of protective mechanisms that neutralize ROS, while any potential imbalance between ROS and antioxidants results in oxidative stress. In an In Vitro Fertilization (IVF) setting, existing literature suggests a favorable outcome in terms of oocyte quality/maturation and fertilization rate with increased ROS levels, while other study groups have presented significant data on the detrimental effect of increased ROS concentration in the quality of embryos exposed and their potential to advance. In this study, we examine the conflicting views of the role of ROS in fertilization and embryo quality, especially through their concentration in the follicular fluid of subfertile women undergoing IVF. The current debate could possibly be attributed to the different assay methods and end-point outcomes employed by each research group, along with the noted limited number of the relevant studies published on the subject. Properly conducted studies can further validate and elicit the exact role of ROS as well as their association to female reproduction, and especially to women undergoing IVF.
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Affiliation(s)
- M Askoxylaki
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, Attikon Hospital, University of Athens, Rimini 1, Chaidari, Athens, Greece, 12642.
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Vogiatzi P, Chrelias C, Cahill DJ, Creatsa M, Vrachnis N, Iliodromiti Z, Kassanos D, Siristatidis C. Hemizona assay and sperm penetration assay in the prediction of IVF outcome: a systematic review. Biomed Res Int 2013; 2013:945825. [PMID: 24228261 PMCID: PMC3818817 DOI: 10.1155/2013/945825] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/01/2013] [Indexed: 11/17/2022]
Abstract
The limited predictive value of semen analysis in achieving natural conception or in IVF outcome confirms the need for sperm function tests to determine optimal management. We reviewed HZA and SPA predictive power in IVF outcome, with statistical significance of diagnostic power of the assays. HZA was readily efficient in predicting IVF outcome, while evident inconsistency among the studies analysed framed the SPA's role in male fertility evaluation. Considerable variation was noted in the diagnostic accuracy values of SPA with wide sensitivity (52-100%), specificity (0-100%), and PPV (18-100%) and NPV (0-100%) together with fluctuation and notable differentiation in methodology and cutoff values employed by each group. HZA methodology was overall consistent with minor variation in cutoff values and oocyte source, while data analysis reported strong correlation between HZA results with IVF outcome, high sensitivity (75-100%), good specificity (57-100%), and high PPV (79-100%) and NPV (68-100%). HZA correlated well with IVF outcome and demonstrated better sensitivity/specificity and positive/negative predictive power. Males with normal or slightly abnormal semen profiles could benefit by this intervention and could be evaluated prior to referral to assisted reproduction. HZA should be used in a sequential fashion with semen analysis and potentially other bioassays in an IVF setting.
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Affiliation(s)
- Paraskevi Vogiatzi
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Charalampos Chrelias
- 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
| | - David J. Cahill
- School of Clinical Sciences, University of Bristol, Level D, St Michael's Hospital, Bristol BS2 8EG, UK
| | - Maria Creatsa
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Nikos Vrachnis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Vasilissis Sofias 76, 11528 Athens, Greece
| | - Zoe Iliodromiti
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Vasilissis Sofias 76, 11528 Athens, Greece
| | - Demetrios Kassanos
- 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Charalampos Siristatidis
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
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Siristatidis CS, Vrachnis N, Creatsa M, Maheshwari A, Bhattacharya S. In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction. Cochrane Database Syst Rev 2013:CD006606. [PMID: 24101529 DOI: 10.1002/14651858.cd006606.pub3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 50% of women presenting with subfertility. Subfertility affects 15% to 20% of couples trying to conceive. A significant proportion of these women ultimately need assisted reproductive technology (ART). In vitro fertilisation (IVF) is one of the assisted reproduction techniques employed to raise the chances of achieving a pregnancy. For the standard IVF technique, stimulating follicle development and growth before oocyte retrieval is essential, for which a large number of different methods combining gonadotrophins with a gonadotrophin-releasing hormone (GnRH) agonist or antagonist are used. In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response, characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially effective intervention for women with PCOS-related subfertility involves earlier retrieval of immature oocytes at the germinal-vesicle stage followed by in vitro maturation (IVM). So far, the only data available have derived from observational studies and non-randomised clinical trials. OBJECTIVES To compare outcomes associated with in vitro maturation (IVM) followed by vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) versus conventional IVF or ICSI, among women with polycystic ovarian syndrome (PCOS) undergoing assisted reproductive technologies (ART). SEARCH METHODS We searched the Menstrual Disorders and Subfertility Group (MDSG) Specialised Register of controlled trials to May 2013 for any relevant trials identified from the title, abstract, or keyword sections. This was followed by a search of the electronic database MEDLINE, EMBASE, LILACS and CINAHL, without language restriction. We also performed a manual search of the references of all retrieved articles; sought unpublished papers and abstracts submitted to international conferences, searched the clinicaltrials.gov and WHO portal registries for submitted protocols of clinical trials, and contacted experts. In addition, we examined the National Institute of Clinical Excellence (NICE) fertility assessment and treatment guidelines and handsearched reference lists of relevant articles (from 1970 to May 2013). SELECTION CRITERIA All randomised trials (RCTs) on the intention to perform IVM before IVF or ICSI compared with conventional IVF or ICSI for subfertile women with PCOS. DATA COLLECTION AND ANALYSIS Three review authors (CS, MK and NV) independently assessed eligibility and quality of trials. Primary outcome measure was live birth rate per randomised woman. MAIN RESULTS There were no RCTs suitable for inclusion in the review, although there are currently three ongoing trials that have not yet reported results. AUTHORS' CONCLUSIONS Though promising data on the IVM technique have been published, unfortunately there is still no evidence from RCTs upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. Meanwhile, the results of the above-mentioned ongoing trials are awaited and, of course, further evidence from good quality trials in the field is eagerly anticipated.
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Affiliation(s)
- Charalampos S Siristatidis
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital,, Rimini 1, Athens, Chaidari, Greece, 12462
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Grigoriadis C, Tympa A, Creatsa M, Bakas P, Liapis A, Kondi-Pafiti A, Creatsas G. Hofbauer cells morphology and density in placentas from normal and pathological gestations. Rev Bras Ginecol Obstet 2013; 35:407-12. [DOI: 10.1590/s0100-72032013000900005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/25/2013] [Indexed: 11/21/2022] Open
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Grigoriadis C, Bakas P, Derpapas A, Creatsa M, Liapis A. Tension-free vaginal tape obturator versus Ajust adjustable single incision sling procedure in women with urodynamic stress urinary incontinence. Eur J Obstet Gynecol Reprod Biol 2013; 170:563-6. [PMID: 23972452 DOI: 10.1016/j.ejogrb.2013.07.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 06/17/2013] [Accepted: 07/29/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the efficacy and complications of inside-out transobturator tension-free vaginal tape (TVT-O) in comparison with a single incision sling procedure (Ajust) for the treatment of urodynamic stress urinary incontinence. STUDY DESIGN Prospective closely matched controlled study. In total, 171 patients were included in the study: 86 women underwent the TVT-O procedure, while in other 85 cases the Ajust procedure was performed. Subjective and objective cure, improvement and failure rates, mean operative time, hospital stay and incidence of complications were assessed. RESULTS There was no statistically significant difference between the two groups for age, body mass index, parity, menopausal status and severity of prolapse. No major intraoperative complications occurred. There was no significant difference in the mean operative time and the duration of hospital stay between the two groups. The mean follow-up time of the study was 22.3 months (range 12-36 months). For the TVT-O group the objective cure rate was 86%, the improvement rate was 5.9% and the failure rate was 8.1%, while the subjective cure rate was 82.6%. For the Ajust group the objective cure rate was 84.7%, the improvement rate was 4.7%, 10.6% of patients showed no change in their symptoms and the subjective cure rate was 81.2%. CONCLUSIONS The Ajust sling procedure presents success rates, at 22 months' mean follow up, comparable to the TVT-O method. Both techniques seem to be safe and effective for the treatment of urodynamic stress urinary incontinence.
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Affiliation(s)
- C Grigoriadis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Greece.
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Siristatidis C, Chrelias C, Creatsa M, Varounis C, Vrachnis N, Iliodromiti Z, Kassanos D. Addition of prednisolone and heparin in patients with failed IVF/ICSI cycles: a preliminary report of a clinical trial. HUM FERTIL 2013; 16:207-10. [DOI: 10.3109/14647273.2013.803608] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Labos G, Trakakis E, Pliatsika P, Augoulea A, Vaggopoulos V, Basios G, Simeonidis G, Creatsa M, Alexandrou A, Iliodromiti Z, Kassanos D, Lambrinoudaki I. Efficacy and safety of DT56a compared to hormone therapy in Greek post-menopausal women. J Endocrinol Invest 2013; 36:521-6. [PMID: 23563111 DOI: 10.3275/8926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hormone therapy (HT) is the treatment of choice for the alleviation of menopausal symptoms; concerns, however, about its concomitant long-term health risks have limited its use. DT56a is a unique enzymatic isolate of soybeans. The purpose of our study was to evaluate the efficacy and safety of DT56a, compared to HT, in symptomatic post-menopausal women. SUBJECTS AND METHODS Eighty-nine post-menopausal women were studied prospectively. Women with climacteric symptoms were randomly assigned to receive eitherDT56a (no.=27) or oral low dose continuous combined HT (no.=26). Symptomatic women not wishing to receive any treatment served as controls (no.=36). Menopausal symptoms as assessed through the Kupperman index, serum lipids and lipoproteins, calcium, as well as bone mineral density (BMD), endometrial thickness, and mammography were assessed at baseline and at 12 months. RESULTS Patients receiving HT and DT56a showed a significant and independent decrease in menopausal symptoms (mean difference in Kupperman score, DT56a group: -3.98, HT group -5.601, no treatment group +1.76, p-value <0.001). Lumbar spine BMD T-score was significantly lower in women receiving no treatment, as opposed to the two treatment arms which showed no significant change (No treatment, baseline: -0.60, final: -0.85, p=0.001; HT, baseline: -84, final -0.99, p=0.79; DT56a, baseline -0.51, final: -0.76, p=0.75). No differences in femoral bone density, ET or mammography classification were detected in any of the treatment arms. Likewise, serum lipids or lipoproteins did not differ between the three groups. CONCLUSIONS DT56a decreased menopausal symptoms significantly and in the same degree as HT.
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Affiliation(s)
- G Labos
- 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Athens, Greece
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Siristatidis C, Vogiatzi P, Salamalekis G, Creatsa M, Vrachnis N, Glujovsky D, Iliodromiti Z, Chrelias C. Granulocyte macrophage colony stimulating factor supplementation in culture media for subfertile women undergoing assisted reproduction technologies: a systematic review. Int J Endocrinol 2013; 2013:704967. [PMID: 23509457 PMCID: PMC3594979 DOI: 10.1155/2013/704967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/09/2013] [Accepted: 01/26/2013] [Indexed: 11/17/2022] Open
Abstract
Granulocyte macrophage colony stimulating factor (GM-CSF) is a cytokine/growth factor produced by epithelial cells that exerts embryotrophic effects during the early stages of embryo development. We performed a systematic review, and six studies that were performed in humans undergoing assisted reproduction technologies (ART) were located. We wanted to evaluate if embryo culture media supplementation with GM-CSF could improve success rates. As the type of studies and the outcome parameters investigated were heterogeneous, we decided not to perform a meta-analysis. Most of them had a trend favoring the supplementation with GM-CSF, when outcomes were measured in terms of increased percentage of good-quality embryos reaching the blastocyst stage, improved hatching initiation and number of cells in the blastocyst, and reduction of cell death. However, no statistically significant differences were found in implantation and pregnancy rates in all apart from one large multicenter trial, which reported favorable outcomes, in terms of implantation and live birth rates. We propose properly conducted and adequately powered randomized controlled trials (RCTs) to further validate and extrapolate the current findings with the live birth rate to be the primary outcome measure.
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Affiliation(s)
- Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Paraskevi Vogiatzi
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece
| | - George Salamalekis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Maria Creatsa
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece
| | - Nikos Vrachnis
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Vas Sofias 76, 11528 Athens, Greece
| | - Demián Glujovsky
- Médico Especialista en Medicina Reproductiva (SAMeR), Especialista Universitario en Ginecología y Obstetricia, Magíster en Efectividad Clínica, Viamonte 1432, Buenos Aires, Argentina
| | - Zoe Iliodromiti
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Vas Sofias 76, 11528 Athens, Greece
| | - Charalampos Chrelias
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
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Lambrinoudaki I, Tsouvalas E, Vakaki M, Kaparos G, Stamatelopoulos K, Augoulea A, Pliatsika P, Alexandrou A, Creatsa M, Karavanaki K. Osteoprotegerin, Soluble Receptor Activator of Nuclear Factor- κ B Ligand, and Subclinical Atherosclerosis in Children and Adolescents with Type 1 Diabetes Mellitus. Int J Endocrinol 2013; 2013:102120. [PMID: 24288529 PMCID: PMC3833004 DOI: 10.1155/2013/102120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/31/2013] [Accepted: 09/03/2013] [Indexed: 12/28/2022] Open
Abstract
Aims. To evaluate carotid intima-media thickness (cIMT) and biomarkers of the osteoprotegerin/receptor activator of nuclear factor- κ B ligand (OPG/RANKL) system in type 1 diabetes (T1DM) children and adolescents and controls. Subjects and Methods. Fifty six T1DM patients (mean ± SD age: 12.0 ± 2.7 years, diabetes duration: 5.42 ± 2.87 years and HbA1c: 8.0 ± 1.5%) and 28 healthy matched controls, were studied with anthropometric and laboratory measurements, including serum OPG, soluble RANKL (sRANKL) and cIMT. Results. Anthropometric, laboratory, and cIMT measurements were similar between T1DM youngsters and controls. However patients with longer diabetes duration (>/7.0 years) had indicatively higher cIMT (cIMT = 0.49 vs 0.44 mm, P 0.072) and triglyceride levels than the rest of the patients (93.7 vs 64.6 mg/dl, P 0.025). Both in the total study population (β 0.418, P 0.027) and among T1DM patients separately (β 0.604, P 0.013), BMI was the only factor associated with cIMT. BMI was further associated with OPG in both groups (β -0.335, P 0.003 and β -0.356, P 0.008 respectively), while sRANKL levels were not associated with any factor. Conclusions. BMI was the strongest independent predictor of cIMT among the whole population, and especially in diabetics, suggesting a possible synergistic effect of diabetes and adiposity on atherosclerotic burden. BMI was overall strongly associated with circulating OPG, but the causes of this association remain unclear.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Emmanouil Tsouvalas
- 2nd Department of Pediatrics, Diabetes & Metabolism Clinic, University of Athens, “P&A Kyriakou” Children's Hospital, Athens, Greece
| | - Marina Vakaki
- Radiology Department, “P&A Kyriakou” Children's Hospital, Athens, Greece
| | - George Kaparos
- Hormonal Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Kimon Stamatelopoulos
- Department of Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
- *Areti Augoulea:
| | - Paraskevi Pliatsika
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Andreas Alexandrou
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Maria Creatsa
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Kyriaki Karavanaki
- 2nd Department of Pediatrics, Diabetes & Metabolism Clinic, University of Athens, “P&A Kyriakou” Children's Hospital, Athens, Greece
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Lambrinoudaki I, Papadimitriou D, Kaparos G, Rizos D, Panoulis C, Deligeoroglou E, Alexandrou A, Auguolea A, Apostolakis M, Creatsa M, Kouskouni E. MTHFR C677T polymorphism modifies the effect of HRT on metabolic parameters in postmenopausal women. Climacteric 2012; 16:568-75. [PMID: 23145891 DOI: 10.3109/13697137.2012.738722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the interaction of the MTHFR C677T polymorphism with changes in lipid and glucose metabolism effected by oral hormone replacement therapy (HRT) in postmenopausal women. METHODS In this open-label, prospective, interventional study, parameters of lipid and glucose metabolism, as well as homocysteine, were assessed in 97 postmenopausal women at baseline and 1 year after the initiation of HRT. Participants were stratified into three subgroups, according to the MTHFR C677T polymorphism (wild-type: CC genotype; heterozygous: CT genotype; homozygous for the mutant variable: TT genotype). RESULTS The TT genotype was associated with an elevation of total and low density lipoprotein (LDL) cholesterol, while CT and CC genotypes were associated with a reduction of total cholesterol and LDL cholesterol after 1 year of HRT (p = 0.032 for total cholesterol and p = 0.002 for LDL cholesterol). Women with the TT genotype had higher glucose levels in contrast to women with the CC genotype who had lower glucose levels after 1 year of HRT (p = 0.011). Additionally, CC carriers under HRT had a significant elevation of apolipoprotein A1 levels (p = 0.018), contrarily to CT and TT genotypes. CONCLUSION While HRT was associated with favorable changes in lipid and metabolic parameters in carriers of the CC genotype, this effect was not evident in carriers of the T allele. The MTHFR C677T polymorphism may modify the effect of HRT on lipid and metabolic parameters in postmenopausal women.
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Affiliation(s)
- I Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens , Aretaieio Hospital, Athens
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Trakakis E, Basios G, Peppa M, Simeonidis G, Labos G, Creatsa M, Misailidou M, Boutati E, Vaggopoulos V, Panagopoulos P, Dimitriades G, Kassanos D. The prevalence of glucose metabolism abnormalities in Greek women with polycystic ovary syndrome. Gynecol Endocrinol 2012; 28:867-70. [PMID: 22571176 DOI: 10.3109/09513590.2012.683058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The prevalence of glucose metabolism abnormalities in PCOS women worldwide varies between 10 and 40% but there are no data in Greek PCOS women. In this retrospective study the prevalence of glucose abnormalities and the indices of insulin resistance (IR) and whole-body insulin sensitivity were estimated in a Greek population with PCOS. Impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and type 2 diabetes mellitus (t2DM) were calculated. The prevalence of IGT, IFG and t2DM in our PCOS population was 7.6, 5.1 and 1.7%, respectively. The total prevalence of glucose abnormalities was estimated as 14.1%. The prevalence of t2DM was three- to four-fold higher than in the general Greek female population of the same age as this was estimated by 2, recently published studies. PCOS women with increased BMI and waist circumference and age greater than 30 years, present more severe IR and decreased whole-body insulin sensitivity. Our data indicates a relatively high prevalence of glucose intolerance and t2DM in a Greek population with PCOS. Obese women with PCOS are in higher risk to develop glucose abnormalities and probably t2DM later in life and therefore every woman diagnosed with PCOS should undergo a 2-h post load OGTT.
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Affiliation(s)
- Eftihios Trakakis
- Third Department of Obstetrics and Gynecology University of Athens, Attikon University Hospital, Athens, Greece.
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Gregoriou O, Bakas P, Grigoriadis C, Creatsa M, Sofoudis C, Creatsas G. Antibiotic prophylaxis in diagnostic hysteroscopy: is it necessary or not? Eur J Obstet Gynecol Reprod Biol 2012; 163:190-2. [DOI: 10.1016/j.ejogrb.2012.03.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/13/2012] [Accepted: 03/21/2012] [Indexed: 11/28/2022]
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Pliatsika P, Antoniou A, Alexandrou A, Panoulis C, Kouskouni E, Augoulea A, Dendrinos S, Aravantinos L, Creatsa M, Lambrinoudaki I. Serum lipid levels and bone mineral density in Greek postmenopausal women. Gynecol Endocrinol 2012; 28:655-60. [PMID: 22324476 DOI: 10.3109/09513590.2011.650766] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Contradictory results have been reported regarding a relationship between serum lipid levels and bone mineral density. The purpose of this study was to further investigate a possible relationship between those parameters in Greek postmenopausal women. A total of 591 patients followed at a tertiary hospital were examined for seven different lipid factors in relation to dual-emission X-ray absorptiometry measurements at the lumbar spine. Lipoprotein-a was the only lipid measurement that univariately showed an almost significant trend of association with bone mass category (analysis of variance [ANOVA] p value 0.062 for Ln(Lipoprotein-a)). In multiple regression, it was noted that a non-significant negative trend of association of high density lipoprotein (HDL) cholesterol and Apolipoprotein AI with lumbar T-score (p value 0.058 and 0.075, respectively). In age subgroup analysis, Lipoprotein-a and Ln(Lipoprotein-a) presented a negative correlation with lumbar T-score for women with age ≥ 53 years (p value 0.043 and 0.070, respectively), while a negative correlation of HDL and Apolipoprotein AI levels with lumbar T-score remained in women with age < 53 years (p value 0.039 and 0.052, respectively). The findings do not support a strong relationship between lipid levels and bone mass measurements.
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Affiliation(s)
- Paraskevi Pliatsika
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
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Lambrinoudaki I, Karaflou M, Kaparos G, Alexandrou A, Creatsa M, Aravantinos L, Augoulea A, Kouskouni E. Effect of tibolone and raloxifene on serum markers of apoptosis in postmenopausal women. Climacteric 2012; 16:258-64. [DOI: 10.3109/13697137.2012.668251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Gregoriou O, Bakas P, Grigoriadis C, Creatsa M, Hassiakos D, Creatsas G. Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios. Fertil Steril 2012; 98:48-51. [PMID: 22579129 DOI: 10.1016/j.fertnstert.2012.04.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 04/04/2012] [Accepted: 04/04/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare the effects of 2.5 mg letrozole with those of 1 mg anastrazole daily on the hormonal and semen profiles of a subset of infertile men with low T/E(2) ratios. DESIGN Prospective, nonrandomized study. SETTING Reproductive medicine clinic. PATIENT(S) The study group consisted of 29 infertile men with a low serum T/E(2) ratio (<10). INTERVENTION(S) Patients were divided into two groups. Group A included 15 patients treated with 2.5 mg letrozole orally once daily for 6 months, and Group B consisted of 14 patients treated with 1 mg anastrazole orally every day for 6 months. MAIN OUTCOME MEASURE(S) Hormonal evaluation included measurement of serum FSH, LH, PRL, T, and E(2). In all sperm analyses pretreatment and posttreatment total motile sperm counts (ejaculate volume × concentration × motile fraction) were evaluated. RESULT(S) The use of aromatase inhibitors (either letrozole or anastrazole) in cases of infertile men with low T/E(2) ratios improved both hormonal and semen parameters. CONCLUSION(S) This study suggests that some men with severe oligospermia, low T levels, and normal gonadotropin concentration may have a treatable endocrinopathy.
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Affiliation(s)
- Odysseas Gregoriou
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece.
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Augoulea A, Alexandrou A, Creatsa M, Vrachnis N, Lambrinoudaki I. Pathogenesis of endometriosis: the role of genetics, inflammation and oxidative stress. Arch Gynecol Obstet 2012; 286:99-103. [PMID: 22546953 DOI: 10.1007/s00404-012-2357-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 04/19/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. MATERIALS AND METHODS The etiology of this multifactorial disease is still unresolved and an increasing number of studies suggest that genetic, hormonal, environmental, immunological and oxidative factors may all play an important role in the pathogenesis of this disorder. CONCLUSIONS In this literature review, inflammatory activity, oxidative stress as well as genetic abnormalities and mutations have been studied in an effort to identify factors predisposing to endometriosis.
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Affiliation(s)
- A Augoulea
- 2nd Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.
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Stamatelopoulos KS, Armeni E, Georgiopoulos G, Kazani M, Kyrkou K, Stellos K, Koliviras A, Alexandrou A, Creatsa M, Papamichael C, Lambrinoudaki I. Recently postmenopausal women have the same prevalence of subclinical carotid atherosclerosis as age and traditional risk factor matched men. Atherosclerosis 2012; 221:508-13. [DOI: 10.1016/j.atherosclerosis.2011.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 10/21/2011] [Accepted: 12/03/2011] [Indexed: 01/17/2023]
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Lambrinoudaki I, Augoulea A, Armeni E, Rizos D, Alexandrou A, Creatsa M, Kazani M, Georgiopoulos G, Apostolakis M, Panoulis K, Stamatelopoulos K. 30 CLIMACTERIC SYMPTOMS AND SUBCLINICAL ATHEROSCLEROSIS IN POSTMENOPAUSAL WOMEN. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Giannouli P, Zervas I, Spiropoulou A, Creatsa M, Augoulea A, Kazani A, Panoulis K, Aravantinos L, Lambrinoudaki E. 131 VALIDATION OF UTIAN QUALITY OF LIFE SCALE IN GREEK POPULATION. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70242-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Armeni E, Stamatelopoulos K, Georgiopoulos G, Kazani M, Kouskouni E, Creatsa M, Alexandrou A, Papamichael C, Lambrinoudaki I. 27 PREDICTORS OF SUBCLINICAL ATHEROSCLEROSIS IN POSTMENOPAUSAL WOMEN. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70138-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Armeni E, Stamatelopoulos K, Creatsa M, Rizos D, Georgiopoulos G, Kazani M, Alexandrou A, Papamichael C, Lambrinoudaki I. 10 SUBCLINICAL ATHEROSCLEROSIS AND ARTERIAL STIFFNESS ASSOCIATE WITH CIRCULATING ANDROGEN LEVELS IN HEALTHY RECENTLY MENOPAUSAL WOMEN. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Armeni E, Giannouli P, Zervas I, Koundi K, Spyropoulou A, Alexandrou A, Kazani A, Augoulea A, Creatsa M, Lambrinoudaki I. 123 PREDICTORS OF QUALITY OF LIFE IN GREEK MIDDLE-AGE WOMEN: A POPULATION SURVEY. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70234-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Armeni E, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Alexandrou A, Deligeoroglou E, Creatsa M, Bouboulis G, Alevizaki M, Lambrinoudaki I. 29 ARTERIAL STIFFNESS IS ASSOCIATED WITH HIGH NORMAL TSH IN HEALTHY POSTMENOPAUSAL WOMEN. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Giannouli P, Zervas I, Armeni E, Koundi K, Spyropoulou A, Alexandrou A, Kazani A, Areti A, Creatsa M, Lambrinoudaki I. Determinants of quality of life in Greek middle-age women: A population survey. Maturitas 2012; 71:154-61. [DOI: 10.1016/j.maturitas.2011.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 11/14/2011] [Accepted: 11/15/2011] [Indexed: 10/14/2022]
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Creatsa M, Armeni E, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Alexandrou A, Dendrinos S, Augoulea A, Papamichael C, Lambrinoudaki I. Circulating androgen levels are associated with subclinical atherosclerosis and arterial stiffness in healthy recently menopausal women. Metabolism 2012; 61:193-201. [PMID: 21820132 DOI: 10.1016/j.metabol.2011.06.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 06/03/2011] [Accepted: 06/05/2011] [Indexed: 01/09/2023]
Abstract
Although increasing evidence supports an association between endogenous sex hormones and cardiovascular disease, the results still remain controversial. This study aims to examine the association between endogenous sex hormones and indices of vascular function and structure. Serum follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate (DHEAS), and Δ4-androstenedione were measured in 120 healthy postmenopausal women aged 41 to 60 years. Possible associations with surrogate markers of subclinical atherosclerosis, arterial stiffness, and endothelial function were investigated. Indices of arterial structure included carotid and femoral intima-media thickness and atheromatous plaques presence. Indices of arterial function included flow-mediated dilation of the brachial artery, carotid-femoral pulse wave velocity (PWV), and augmentation index. Total testosterone and free androgen index (FAI) were the most important predictors of common carotid artery intima-media thickness (β = 0.376 and β = 0.236, P < .001 and P = .014, respectively). Similarly, FAI was the only significant independent predictor of PWV (β = 0.254, P = .027) after adjusting for age, smoking, body mass index, homeostasis model assessment of insulin resistance, and blood lipids. Free estrogen index showed a positive association with PWV, independently of age, smoking, and body mass index, but not of homeostasis model assessment of insulin resistance and blood lipids. Age-adjusted levels of DHEAS exhibited a significant independent negative association with measures of augmentation index. Follicle-stimulating hormone, luteinizing hormone, estradiol, sex hormone-binding globulin, and Δ4-androstenedione were not associated with any of the vascular parameters independently of traditional cardiovascular risk factors. Higher serum testosterone and FAI are associated with subclinical atherosclerosis in healthy recently menopausal women. This association is independent of traditional cardiovascular risk factors or insulin resistance. On the contrary, serum DHEAS exhibits a negative association with arterial stiffness.
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Affiliation(s)
- Maria Creatsa
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GR-11528, Athens, Greece
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Bakas P, Hassiakos D, Liapis A, Creatsa M, Konidaris S, Gregoriou O. Misoprostol for cervical ripening before diagnostic hysteroscopy in nulliparous women. Int J Gynaecol Obstet 2011; 116:263-4. [PMID: 22169042 DOI: 10.1016/j.ijgo.2011.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/27/2011] [Accepted: 11/21/2011] [Indexed: 11/18/2022]
Affiliation(s)
- Panagiotis Bakas
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, LHTO Maternity Hospital, Athens, Greece.
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Lambrinoudaki I, Augoulea A, Armeni E, Rizos D, Alexandrou A, Creatsa M, Kazani M, Georgiopoulos G, Livada A, Exarchakou A, Stamatelopoulos K. Menopausal symptoms are associated with subclinical atherosclerosis in healthy recently postmenopausal women. Climacteric 2011; 15:350-7. [DOI: 10.3109/13697137.2011.618564] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Siristatidis C, Kassanos D, Salamalekis G, Creatsa M, Chrelias C, Creatsas G. Cardiotocography alone versus cardiotocography plus Doppler evaluation of the fetal middle cerebral and umbilical artery for intrapartum fetal monitoring: a Greek prospective controlled trial. J Matern Fetal Neonatal Med 2011; 25:1183-7. [DOI: 10.3109/14767058.2011.622000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sioulas VD, Politi E, Rizos D, Augoulea A, Kyroudi A, Sergentanis TN, Panoulis C, Aravantinos L, Creatsa M, Lambrinoudaki I. Does hormone therapy, tibolone or raloxifene modify VEGF expression in cervical epithelial cells? Climacteric 2011; 15:181-5. [PMID: 22066937 DOI: 10.3109/13697137.2011.604144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM Vascular endothelial growth factor (VEGF) seems to be a critical molecule in cervical carcinogenesis. We aimed to investigate the possible associations between hormonal factors and VEGF expression in cervical epithelial cells from postmenopausal women. METHOD A total of 105 healthy postmenopausal women (aged 45-68 years old) attending a university menopause clinic were enrolled in this cross-sectional study. Pap smears were derived from current users of 17β-estradiol 1 mg + norethisterone acetate 0.5 mg (n = 28), tibolone 2.5 mg (n = 23), raloxifene HCl 60 mg (n = 21) and women not receiving treatment (n = 33). VEGF immunostaining was evaluated in squamous, glandular and metaplastic cells, using a semiquantitative method (rating scale: 0-3). RESULTS Concerning endogenous hormones, higher Δ4-androstenedione levels were associated with more intense VEGF immunostaining in glandular (p = 0.041) and metaplastic cells (p = 0.004). Hormone therapy and raloxifene did not induce any changes in VEGF immunoreactivity in the examined cells. In contrast, tibolone administration was accompanied by diminished VEGF presence in metaplastic cells (p = 0.016 vs. controls). CONCLUSION Our findings may in part reflect the molecular processes contributing to the safe profile of hormone therapy, tibolone and raloxifene in cervical carcinogenesis.
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Affiliation(s)
- V D Sioulas
- Menopause Clinic, 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 33 Metonos Street, Holargos, Athens, Greece
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Chatzicharalampous C, Rizos D, Pliatsika P, Leonardou A, Hasiakos D, Zervas I, Alexandrou A, Creatsa M, Konidaris S, Lambrinoudaki I. Reproductive hormones and postpartum mood disturbances in Greek women. Gynecol Endocrinol 2011; 27:543-50. [PMID: 20653338 DOI: 10.3109/09513590.2010.501886] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Postpartum mood disturbances are common among Greek women, with postpartum depression (PPD) being as high as 19%. This study aimed to investigate whether sex steroid hormone levels affect the incidence of postpartum mood disturbances. MATERIALS AND METHODS Fifty-seven women were evaluated for postpartum mood disturbances using the Postpartum Blues Questionnaire and the Edinburgh Postnatal Depression Scale on the 1st and 6th week. Serum estradiol, progesterone and testosterone concentrations were measured upon admission for delivery and daily until the fourth postpartum day. We then studied the association between hormone levels and the scores in the two psychometric scales. RESULTS Testosterone was the only hormone that was marginally associated with psychometric scoring in simple regression analysis. (Postpartum Blues during days 1-4: b = 4.291, 95% C.I. -0.796 to 9.377 and p-value = 0.096). Women with lower testosterone drops had higher scores in Postpartum Blues Questionnaire. This association, however, lost statistical significance in the multivariable analysis after adjusting for pregnancy duration. In multiple regression analysis, only pregnancy duration had the most constant adverse effect on psychometric scores: The shorter the duration of pregnancy, the higher the scores for Postpartum Blues. (r = -0.39, p < 0.01). CONCLUSIONS Our findings do not indicate an association between the occurrence of postpartum mood disorders and sex steroid hormone levels. Preterm labour may be associated with a higher risk of postpartum mood disturbances.
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Lambrinoudaki I, Armeni E, Georgiopoulos G, Kazani M, Kouskouni E, Creatsa M, Alexandrou A, Fotiou S, Papamichael C, Stamatelopoulos K. Subclinical atherosclerosis in menopausal women with low to medium calculated cardiovascular risk. Int J Cardiol 2011; 164:70-6. [PMID: 21737156 DOI: 10.1016/j.ijcard.2011.06.063] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/08/2011] [Accepted: 06/10/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The menopausal status is closely related with cardiovascular disease (CVD). Nevertheless, it is still not included in risk stratification by total cardiovascular risk estimation systems. The present study aimed to evaluate the extent of subclinical vascular disorders in young healthy postmenopausal women. METHODS This cross-sectional study consecutively recruited 120 healthy postmenopausal women without clinically overt CVD or diabetes, aged 41-60 years and classified as not high-risk by the Heartscore (<5%). In addition to risk factors used for Heartscore calculations, years since menopause and associated risk factors (triglycerides (range 37-278 mg/dl), waist circumference (62-114 cm), fasting blood glucose (69-114 mg/dl) and HOMA-IR (0.44-5)) were also assessed. Carotid-femoral pulse wave velocity, carotid and femoral intima-media thickness in the abnormal range as well as atheromatous plaques both in carotid and femoral arteries were used to define the presence of subclinical atherosclerosis. RESULTS Subclinical atherosclerosis and the presence of at least one plaque were identified in 55% and 28% of women, respectively. Subjects with subclinical atherosclerosis had higher age, years since menopause, HOMA-IR and blood pressure. By multivariate analysis years since menopause and systolic blood pressure independently determined subclinical atherosclerosis while 79% of intermediate-risk women (Heartscore 2-4.9%) being in menopause for at least 4 years would be reclassified to a higher risk for the presence of atherosclerosis. CONCLUSION Subclinical atherosclerosis was highly prevalent in postmenopausal women with low to medium Heartscore. Thus our data suggest that menopausal status and associated risk factors should be additionally weighted in risk calculations, regarding primary prevention strategies in this population.
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Affiliation(s)
- Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, 76 Vas. Sofias Ave., University of Athens, Aretaieio Hospital, Athens, Greece
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