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Mikuš M, Šprem Goldštajn M, Laganà AS, Vukorepa F, Ćorić M. Clinical Efficacy, Pharmacokinetics, and Safety of the Available Medical Options in the Treatment of Endometriosis-Related Pelvic Pain: A Scoping Review. Pharmaceuticals (Basel) 2023; 16:1315. [PMID: 37765123 PMCID: PMC10537015 DOI: 10.3390/ph16091315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/17/2023] [Revised: 09/10/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND In this scoping review, we sought to identify published studies evaluating the drugs currently used in the treatment of endometriosis-related pelvic pain, with reflection on their chemical properties, pharmacokinetics, safety profile, and clinical efficacy. METHODS A literature search was conducted with the use of the PubMed and EMBASE electronic databases, focusing on identifying articles published in English between January 1990 and 2023. RESULTS Based on the included studies, current therapy options for the treatment of endometriosis-related pain identified and reviewed in this article were: (1) non-steroidal anti-inflammatory drugs; (2) combined oral contraceptive (COCs); (3) progestins; (4) gonadotropin-releasing hormone agonists and antagonists; (5) aromatase inhibitors (AIs); (6) selective estrogen and progesterone receptor modulators; and (7) levonorgestrel-intrauterine device. CONCLUSIONS Based on the published evidence, clinicians should consider NSAIDs, COCs, and progestins as the first-line medical therapies. Compared with second-line options, such as GnRH agonists/antagonists or AIs, the abovementioned first-line options are well tolerated, efficacious, and exhibit lower overall price. Future research priorities should be to identify novel target therapies and to evaluate the effects of available drugs through different routes of administration.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia; (M.Š.G.); (F.V.); (M.Ć.)
| | - Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia; (M.Š.G.); (F.V.); (M.Ć.)
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Franka Vukorepa
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia; (M.Š.G.); (F.V.); (M.Ć.)
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia; (M.Š.G.); (F.V.); (M.Ć.)
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Matak L, Mikuš M, Ćorić M, Spagnol G, Matak M, Vujić G. Comparison end-to-end anastomosis with ostomy after secondary surgical cytoreduction for recurrent high-grade serous ovarian cancer: observational single-center study. Arch Gynecol Obstet 2023; 308:231-237. [PMID: 36680573 DOI: 10.1007/s00404-023-06918-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/17/2022] [Accepted: 01/08/2023] [Indexed: 01/22/2023]
Abstract
We conducted an observational single-center cohort study on patients with recurrent high-grade serous ovarian carcinoma that underwent secondary surgical cytoreduction with extent of partial ileectomy and/or colectomy, followed by adjuvant chemotherapy (Paclitaxel-Carboplatin). All patients performed previously primary debulking surgery without residual disease, followed by three cycles of adjuvant chemotherapy. The aim of this study was to compare survival in patients with ostomy or end-to-end anastomosis that underwent secondary cytoreduction. Furthermore, we investigated the morbidity, the rate, timing and complications of the ostomy or end-to-end anastomosis after secondary cyto-reduction.
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Affiliation(s)
- Luka Matak
- Department of Obstetrics and Gynecology, General Hospital Zadar, Bože Peričića 5, 23000, Zadar, Croatia.
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Giulia Spagnol
- Department of Women and Children's Health, Clinic of Gynecology and Obstetrics, University of Padua, Padua, Italy
| | - Magdalena Matak
- Department of Dermatovenearology, General Hospital Zadar, Zadar, Croatia
| | - Goran Vujić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
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Mikuš M, Matak L, Vujić G, Škegro B, Škegro I, Augustin G, Lagana AS, Ćorić M. The short form endometriosis health profile questionnaire (EHP-5): psychometric validity assessment of a Croatian version. Arch Gynecol Obstet 2023; 307:87-92. [PMID: 35819491 DOI: 10.1007/s00404-022-06691-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 05/06/2022] [Accepted: 06/26/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To translate, adapt and validate the Endometriosis Health Profile-5 (EHP-5) in Croatian population. METHODS This validation study is a part of a prospective, observational study (EHP-5 CRO) with aim of implementation of EHP-5 and to provide better insight in quality of life consideration of women with endometriosis in Croatian clinical practice. A 150 consecutive patients with surgically proven endometriosis were enrolled. The translation to Croatian followed standardized procedure. Cronbach's Alpha was calculated to calculate internal consistency reliability of EHP-5. The test-retest reliability was calculated using intraclass correlation coefficient (ICC). The t test for independent samples was used to assess known-groups validity. RESULTS Both EHP-5 core and EHP-5 modular parts of the questionnaire had good internal consistency, assessed by the Cronbach's Alpha coefficient (α = 0.793 and α = 0.842, respectively). Obtained results indicate very good reliability for core as well as for modular part of EHP-5 questionnaire (ICC = 0.896 and 0.936, respectively). The independent t test showed that women who reported their pain with VAS scale 7 or more had significantly higher results (p < 0.001) on EHP-5 (M = 50.63) compared with women who reported their pain 6 or less (M = 26.91). Furthermore, we found statistically significant difference between women who are infertile with women who are fertile (p < 0.001), whereby infertile women had higher average result on EHP-5 (M = 49.55) compared with fertile women (M = 34.36). CONCLUSIONS The Croatian version of the EHP-5 have very good psychometric characteristics and can be used as a reliable tool for assessing patients with endometriosis in everyday clinical practice.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
| | - Luka Matak
- Department of Obstetrics and Gynecology, General Hospital, Zadar, Croatia.
| | - Goran Vujić
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
| | - Bernarda Škegro
- Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, University Hospital Center, Zagreb, Croatia
| | - Goran Augustin
- Department of Surgery, University Hospital Center, Zagreb, Croatia
| | - Antonio Simone Lagana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Gynecology Oncology, University of Palermo, Palermo, Italy
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center, Zagreb, Croatia
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Todorić Z, Majdandžić I, Keretić Kregar T, Herljević Z, Ćorić M, Lešin J, Kuliš T, Mareković I. Increasing trend in enterococcal bacteraemia and vancomycin resistance in a tertiary care hospital in Croatia, 2017-2021. Infect Dis (Lond) 2023; 55:9-16. [PMID: 36240424 DOI: 10.1080/23744235.2022.2131901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The epidemiology of enterococcal bacteraemia has changed worldwide and vancomycin-resistant enterococci increasingly cause healthcare-associated infections) with limited treatment options. Studies show heterogeneity among countries, regions and individual hospitals. METHODS We retrospectively analysed enterococcal bacteraemia with Enterococcus faecalis and E. faecium at the largest hospital in Croatia, University Hospital Centre Zagreb from January 2017 to December 2021. RESULTS A total of 432 cases of enterococcal bacteraemia were identified with 256 (59.3%) due to E. faecalis and 176 (40.7%) to E. faecium. Enterococcal bacteraemia occurred more frequently in men (n = 270; 62.5%) and the median age of all patients was 62 years (IQR: 0-92). We found statistically significant increase in the incidence trend of bacteraemic episodes with an annual percent change of 20.9% (95% confidence interval 14.3 to 27.8; p = .002) predominantly due to an increase of E. faecalis bacteraemia. The majority of patients (362/432; 83.8%) had healthcare-associated infections and 38.0% (165/432) of patients were in the intensive care unit. The proportion of vancomycin-resistant enterococcal bacteraemia increased from 12.7% (n = 8/63) in 2017 to 25.7% (n = 29/113) in 2021, statistically significant increasing trend (p = .0455), mainly due to an increased proportion of vancomycin-resistant E. faecium (p = .0169). CONCLUSIONS This is the first study describing the trends in enterococcal bacteraemia and vancomycin-resistance in enterococci in Croatia. We found a rising trend in enterococcal bacteraemia and in the proportion of vancomycin resistance and identified the most vulnerable patient groups, notably intensive care unit patients.
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Affiliation(s)
- Zrinka Todorić
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Ivana Majdandžić
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Tea Keretić Kregar
- Institute of Public Health of Varaždin County, Ivana Meštrovića bb, Varaždin, Croatia
| | - Zoran Herljević
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- Department of Obstetrics and Gynaecology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Joško Lešin
- Department of Obstetrics and Gynaecology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Tomislav Kuliš
- Department of Urology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
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Mikuš M, Kalafatić D, Vrbanić A, Šprem Goldštajn M, Herman M, Živković Njavro M, Živković K, Marić G, Ćorić M. Efficacy Comparison between Kegel Exercises and Extracorporeal Magnetic Innervation in Treatment of Female Stress Urinary Incontinence: A Randomized Clinical Trial. Medicina (Kaunas) 2022; 58:medicina58121863. [PMID: 36557065 PMCID: PMC9784675 DOI: 10.3390/medicina58121863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: To estimate the effectiveness of Kegel exercises versus extracorporeal magnetic innervation (EMI) in the treatment of stress urinary incontinence (SUI). Materials and Methods: A parallel group, randomized clinical trial was conducted in the Department of Obstetrics and Gynecology, Clinical Hospital Centre Zagreb, Croatia. After assessing the inclusion/exclusion criteria, each eligible participant was randomized to one of the two observed groups by flipping a coin: the first group underwent treatment with Kegel exercises for 8 weeks, while the second group underwent EMI during the same time interval. The primary outcome was the effectiveness of treatment as measured by the ICIQ-UI-SF overall score, eight weeks after the commencement of treatment. Results: During the study period, 117 consecutive patients with SUI symptoms were assessed for eligibility. A total of 94 women constituted the study population, randomized into two groups: Group Kegel (N = 48) and Group EMI (N = 46). After 8 weeks of follow-up, intravaginal pressure values in the EMI group were 30.45 cmH2O vs. the Kegel group, whose values were 23.50 cmH2O (p = 0.001). After 3 months of follow-up, the difference was still observed between the groups (p = 0.001). After the end of treatment and 3 months of follow-up, the values of the ICIQ-UI SF and ICIQ-LUTSqol questionnaires in the EMI group were lower than in the Kegel group (p < 0.001). Treatment satisfaction was overall better in the EMI group than in the Kegel group (p < 0.001). Conclusions: Patients treated with EMI had a lower number of incontinence episodes, a better quality of life, and higher overall satisfaction with treatment than patients who performed Kegel exercises.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-99-400-6639
| | - Držislav Kalafatić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Adam Vrbanić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Mislav Herman
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | | | - Klara Živković
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Goran Marić
- Faculty of Humanities and Social Sciences, University of Zagreb, 10000 Zagreb, Croatia
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
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Mikuš M, Vitale SG, Ćorić M, Zajec V, Ciebiera M, Carugno J, D'alterio MN, Herman M, Puževski T, Angioni S. State of the art, new treatment strategies, and emerging drugs for non-hormonal treatment of endometriosis: a systematic review of randomized control trials. Gynecol Endocrinol 2022; 38:911-917. [PMID: 36237165 DOI: 10.1080/09513590.2022.2133105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/18/2023] Open
Abstract
Objective: The aim of this systematic review is to recap the data obtained from randomized controlled trials looking at new pharmacologic treatments for endometriosis published over the last decade with a focus on non-hormonal therapeutic options alleviating endometriosis-associated pelvic pain.Methods: We identified relevant original studies in the English language through a search of the MEDLINE, Scopus, and EMBASE (2012 to present) databases using the appropriate MeSH terms and applying the article type filter 'randomized controlled trials'. A total of 179 records were found during the electronic search. After a detailed evaluation and review of the manuscripts, seven primary articles met the inclusion criteria. A systematic review of the data was conducted.Results: This review included several, non-hormonal emerging drug therapies for endometriosis-associated pelvic pain. Based on our results, we divided well-founded studies into three subgroups: antiangiogenic agents, immunomodulators, and natural components. Randomized control trials showed promising results with dopamine agonists (cabergoline, quinagolide, and bromocriptine), and the immunomodulatory JNK inhibitor bentamapimod. Agents that have not been represented in randomized control trials or have failed to demonstrate efficacy include statins and TNF-α inhibitors.Conclusion: Although there are substantial improvements in non-hormonal therapy options, majority of the currently available treatment options are supressive rather than curative and do not present a final solution for patients. Future research priorities should be to identify novel target therapies and to evalute the effects of available drugs through different routes of administration.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Salvatore Giovanni Vitale
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Vendy Zajec
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Sciences Department, Minimally Invasive Gynecology Unit, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Maurizio Nicola D'alterio
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Mislav Herman
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Tomislav Puževski
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Stefano Angioni
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Mikuš M, Goldštajn MŠ, Brlečić I, Dumančić S, Laganà AS, Chiantera V, Vujić G, Ćorić M. CTLA4-Linked Autoimmunity in the Pathogenesis of Endometriosis and Related Infertility: A Systematic Review. Int J Mol Sci 2022; 23:ijms231810902. [PMID: 36142815 PMCID: PMC9504308 DOI: 10.3390/ijms231810902] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
Several studies, although with conflicting results, have sought to determine the concentration of soluble CTLA4 antigens in peripheral blood plasma and peritoneal fluid in patients with endometriosis-related infertility. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) through a search of the following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database and Web of Science, and Clinical Trials research register. We included observational or prospective human and animal studies with any features related to endometriosis and/or infertility studies involving CTLA4-related pathogenesis published in English. The results of studies in which the size and characteristics of the observed groups were not stated were excluded. From the initial pool of 73 publications identified and screened, we finally included 5 articles to summarize the most recent knowledge about CTLA4-linked autoimmunity in the pathogenesis of endometriosis and related infertility. Evidence from clinical studies shows that CTLA4-based autoimmunity is involved in the maintenance of chronic inflammation in the peritoneal environment, with pre-clinical evidence of anti-CTLA antibodies as a potential novel target therapy for endometriosis. However, CTLA4 gene analyses do not support findings of CTLA4-linked autoimmunity as a primary determinant of the pathogenesis of endometriosis. These findings underlie the role of complex interactions within the family of immune checkpoint molecules involved. Further studies are needed to investigate the clinical relevance of anti-CTLA target therapy, taking into account the potential adverse events and repercussions of novel immunologic therapy modalities. However, with the general scarcity of studies investigating this topic, the clinical importance of CTLA4 autoimmunity still remains unclear.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
- Correspondence: (M.M.); (A.S.L.); Tel.: +385-99-400-6639 (M.M. & A.S.L.)
| | - Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Ivan Brlečić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Stipe Dumančić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Split, 21000 Split, Croatia
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
- Correspondence: (M.M.); (A.S.L.); Tel.: +385-99-400-6639 (M.M. & A.S.L.)
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Goran Vujić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
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Zajec V, Mikuš M, Vitale SG, D'alterio MN, Gregov M, Šarić MJ, Carugno J, Angioni S, Ćorić M. Current status and challenges of drug development for hormonal treatment of endometriosis: a systematic review of randomized control trials. Gynecol Endocrinol 2022; 38:713-720. [PMID: 35971323 DOI: 10.1080/09513590.2022.2109145] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/15/2022] Open
Abstract
OBJECTIVE The aim of this systematic review is to summarize the data obtained from randomized controlled trials looking at new pharmacologic treatments for endometriosis published over the last decade with a focus on hormonal therapeutic options for endometriosis-associated pelvic pain (EAPP), excluding studies focusing on fertility. METHODS We identified relevant original studies in the English language through a search of the MEDLINE, Scopus, and EMBASE (2012 to present) databases using the appropriate MeSH terms and applying the article type filter 'randomized controlled trials'. A total of 219 records were found during the electronic search. After a detailed evaluation and review of the manuscripts, 11 primary articles met the inclusion criteria. A systematic review of the data was conducted. RESULTS This review included several emerging drug therapies for EAPP. Randomized control trials showed promising results with several oral gonadotropin-releasing hormone antagonists (elagolix, relugolix, ASP1707, linzagolix). However, studies of other hormonal agents such as aromatase inhibitors and selective progesterone receptor modulators have not yielded significant or new advantages. Selective estrogen receptor modulators have not been represented in randomized control trials and have failed to demonstrate clinical efficacy. CONCLUSION Although numerous novel agents are being investigated for the treatment of endometriosis, there is still no significant progress in the development of curative rather than suppressive drugs. Therefore, further efforts are needed to develop an effective and hopefully curative treatment for this chronic, costly, and overwhelming disease.
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Affiliation(s)
- Vendy Zajec
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Salvatore Giovanni Vitale
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Maurizio Nicola D'alterio
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Marija Gregov
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marko Jakov Šarić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Sciences Department, Minimally Invasive Gynecology Unit, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Stefano Angioni
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
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Knežević T, Padjen I, Ivković V, Bulimbašić S, Ćorić M, Jezic I, Biloglav Z, Laganović M, Anic B. AB0575 MESANGIAL C1Q DEPOSITION, BUT NOT C3 AND C1Q DEPOSITION IN OTHER RENAL COMPARTMENTS, IS A PREDICTOR OF RENAL OUTCOME IN LUPUS NEPHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundComplement activation is an important pathophysiological process in the pathogenesis and development of systemic lupus erythematosus and lupus nephritis (LN). However, the prognostic value of complement factors deposition in different kidney compartments has received little attention and, to the best of our knowledge, no study examined its association with renal outcomes in LN.ObjectivesTo evaluate prognostic significance of C1q and C3 complement factors in renal tissue compartments.MethodsWe have conducted a retrospective cohort study and collected data on demographics, clinical and laboratory parameters and histopathology (light, immunofluorescent and electron microsopy) at the time of biopsy and after long-term follow-up. C1q and C3 expression graded in different kidney compartments (mesangium, glomerular basement membrane (GBM), tubular basement membrane (TBM) and blood vessel wall) and dichotomized into no or low (grades 0 and 1) and high expression (grades 2 and 3). Remission (defined as complete or partial remission) was defined as per EULAR 2019 guidelines.ResultsA total of 51 patients with biopsy-proven LN were followed up for 4.5±2.9 years (80% women, mean age at biopsy 38±14). A total of 29 (71%) achieved complete or partial remission. Complement expression in different kidney compartments was as follows: mesangium (C1q 54%, C3 59%), GBM (C1q 34%, C3 41%), TBM (C1q 5%, C3 5%) and blood vessel wall (C1q 0%, C3 5%). Patients with proliferative lupus had more frequently C1q and C3 deposition in the mesangium (69% vs. 14%, p<0.001 and 72% vs. 29%, p=0.005, respectively), while there were no differences between proliferative and non-proliferative LN in other renal compartments (all p>0.05). Subjects who achieved remission more frequently had C1q deposition in the mesangium (64% vs. 31%, p=0.045), but there was no association between remission and deposition of C1q or C3 in other renal compartments (all p>0.05). Interestingly, the association between C1q mesangial deposition and renal outcome was significant even after adjustment for age at biopsy, gender and lupus type (proliferative vs. non-proliferative) (OR 0.13 [0.02, 0.98], p=0.047).ConclusionC1q deposition in the mesangium might be an important prognostic factor in LN and more aggressive treatment of these patients may explain the better outcomes of these patients.Disclosure of InterestsNone declared
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Jurić I, Bošnjak Z, Ćorić M, Lešin J, Mareković I. In vitro susceptibility of carbapenem-resistant Enterobacterales to eravacycline - the first report from Croatia. J Chemother 2021; 34:67-70. [PMID: 34402411 DOI: 10.1080/1120009x.2021.1965335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/20/2022]
Abstract
The main obstacle in treatment of infections caused by carbapenem-resistant Enterobacterales (CRE) are limited treatment options. The novel antimicrobial agents other than β-lactams with activity not being dependent on β-lactamase class are especially important. Eravacycline (ERV) is the first fully synthetic fluorocycline indicated for the treatment of complicated intra-abdominal infections in adults. Eighty CRE isolates at the University Hospital Centre Zagreb, Croatia were examined for susceptibility to ERV by disc diffusion method and minimal inhibitory concentration (MIC). Total of 54 (54/80; 67.5%) isolates were susceptible to ERV with MIC50 of ≤0.5 μg/mL and MIC90 of 4 μg/mL. Susceptibility of OXA-48 positive isolates was not significantly higher in comparison with NDM positive (P = 0.539) and VIM positive (P = 0.7805) isolates. ERV is possible alternative to novel β-lactamase inhibitor combinations for treatment of CRE infections with antimicrobial susceptibility testing of CRE isolate to ERV in particular patient as condicio sine qua non before administration.
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Affiliation(s)
- Ivana Jurić
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zrinka Bošnjak
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Gynaecology and Obstetrics, University Hospital Centre Zagre, Zagreb, Croatia
| | - Joško Lešin
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Gynaecology and Obstetrics, University Hospital Centre Zagre, Zagreb, Croatia
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Knežević T, Padjen I, Bulimbašić S, Ćorić M, Ivković V, Laganović M, Anić B. AB0349 NEUTROPHIL-TO-LYMPHOCYTE RATIO, PLATELET-TO-LYMPHOCYTE RATIO AND MEAN PLATELET VOLUME IN LUPUS NEPHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A number of blood count parameters are associated with inflammatory and autoimmune diseases. There is discordant evidence whether neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) might reflect inflammatory response and have prognostic value in SLE patients. However, the studies examining the potential role of these markers in LN are missing.Objectives:To examine NLR, PLR and MPV at the time of biopsy in patients with LN and evaluate their association with prognosis.Methods:In this retrospective study we analyzed the demographic, histologic, laboratory and clinical characteristics of patients with biopsy-proven LN diagnosed between 2011 and 2020. All patients met the 1997 revised American College of Rheumatology classification criteria for SLE. Complete remission was defined as proteinuria <0.5 g/day and serum creatinine within 10% from baseline, and partial remission as more than 50% reduction in proteinuria to sub-nephrotic levels and serum creatinine within 10% from baseline.Results:We have included 55 patients (80% women) with biopsy-proven LN (age at biopsy 38±13 years). On renal histology, one patient was class I LN, two patients were class II, 7 were class III, 5 were class III+V, 23 were class IV, two were class IV+V, 11 class VI and 4 had other features. Median baseline NLR was 3.64 (IQR: 1.85, 6.93), PLR was 167 (IQR: 116, 300) and MPV was 10.0 (IQR: 9.2, 10.8). There were no differences in any of the three parameters between different classess of LN (all p>0.05). Eighteen patients achieved complete remission (CR), 16 partial remission and 21 did not achieve remission. None progressed to ESRD and two patients died, both from sepsis. There no differences in NLR, PLR and MPV at the time of biopsy between group which achieved CR/PR vs. no remission (all p>0.05; Figure 1). We constructed a thorough multivariate regression model which showed that neither NLR, PLR or MPV are predictors of renal remission in LN.Conclusion:NLR, PLR and MPV are not useful prognostic markers in predicting renal remission in LN.References:[1]Hartmann LT, et al. Open Rheumatol J. 2018 Aug 31;12:129-138.[2]Chen SY, et al. J Res Med Sci. 2018 May 30;23:48.[3]Zhao CN, et al. Rheumatol Int. 2018 Sep;38(9):1635-1641.Disclosure of Interests:None declared
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Knežević T, Padjen I, Bulimbašić S, Ćorić M, Ivković V, Laganović M, Anić B. AB0348 ALBUMIN-TO-GLOBULIN RATIO AS A POTENTIAL PREDICTOR OF RENAL REMISSION IN LUPUS NEPHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Optimal prognostic predictors in lupus nephritis (LN) are still not clearly defined. Studies have recently shown that albumin-to-globulin ratio (A/G) is not only a good predictor of outcomes in malignancy, infection and renal disease, but is also a potential marker of increased immunoglobulin synthesis and LN activity and might be useful as a predictor of the development of LN in SLE patients. Studies on the role of A/G in predicting outcomes in LN are, however, lacking.Objectives:To assess a potential prognostic value of A/G at renal biopsy in predicting outcomes in LN.Methods:In this retrospective study we analyzed the demographic, histologic, laboratory and clinical characteristics of patients with biopsy-proven LN diagnosed between 2011 and 2020. All patients met the 1997 revised American College of Rheumatology classification criteria for SLE. Complete remission was defined as proteinuria <0.5 g/day and serum creatinine within 10% from baseline, and partial remission as more than 50% reduction in proteinuria to sub-nephrotic levels and serum creatinine within 10% from baseline.Results:We have included 55 patients (80% women) with biopsy-proven LN (age at biopsy 38±13 years). On renal histology, one patient was class I LN, two patients were class II, 7 were class III, 5 were class III+V, 23 were class IV, two were class IV+V, 11 class VI and 4 had other features. Median eGFR and proteinuria at biopsy were 69 (IQR: 44, 100) mL/min/1.73 m2 and 3.5 (2.3, 5.6) g/day, respectively. Baseline mean A/G was 1.12±0.29 and did not differ between LN classes (p=0.91). At one-year follow-up eGFR increased non-significantly (69 vs. 82 mL/min/1.73 m2, p=0.13) and proteinuria decreased (3.5 vs. 0.6 g/day, p<0.001). Eighteen patients achieved complete remission (CR), 16 partial remission and 21 did not achieve remission. None progressed to ESRD and two patients died, both from sepsis. A/G at the time of biopsy did not differ between group which achieved CR/PR vs. no remission (p>0.05; Figure 1) and was not a significant predictor of remission in a multivariate regression model (OR 5.9, 95% CI 0.6, 63.2).Conclusion:While being a potential marker for transition of SLE to LN, A/G was not showed to be a predictor of renal remission in LN.References:[1]Liu XR, et al. Lupus. 2021 Jan 6:961203320981139.[2]Kwon OC, et al. Semin Arthritis Rheum. 2018 Dec;48(3):462-466ckDisclosure of Interests:None declared
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Šprem Goldštajn M, Mikuš M, Ćorić M, Orešković S, Dumančić S, Noventa M, Buzzaccarini G, Andrisani A, Laganà AS. The pharmacoeconomic impact of follitropin alpha biosimilars in IVF therapy in Europe: a report of the literature. Expert Rev Pharmacoecon Outcomes Res 2021; 21:553-558. [PMID: 33784935 DOI: 10.1080/14737167.2021.1910026] [Citation(s) in RCA: 1] [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: 10/21/2022]
Abstract
Introduction: To study the impact of biosimilars in assisted reproductive treatments, we performed a review of the literature. Biosimilars are a bioequivalent chemical drug referred to the original. Their production is strongly requested in order to reduce drug cost and reduce health economic impact on national health system. In assisted reproductive treatments different gonadotropin biosimilars are being produced.Areas covered: For this reason, we performed a review of the literature on follitropin alfa Gonal-F biosimilar, Ovaleap and Bemfola, to assess their cost efficacy in national health system. Cost effective (CE) analysis and incremental cost-effectiveness ratio (ICER) were used as parameters for biosimilar impact evaluation in the national health system economy. In particular, they had only slight impact on cost reduction of recombinant follitropin alfa products in Europe.Expert opinion: considering cost-effective analysis, Gonal-F remains the first choice for national health systems. However, well-designed powered methods are strongly needed to assess biosimilars cost-effectiveness.
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Affiliation(s)
- Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Slavko Orešković
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Stipe Dumančić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marco Noventa
- Department of Women and Children's Health, University of Padua, Padua, Italy
| | | | | | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
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Karadža M, Židovec Lepej S, Planinić A, Grgić I, Ćorušić A, Planinić P, Ćorić M, Hošnjak L, Fujs Komloš K, Poljak M, Vince A. Distribution of human papillomavirus genotypes in women with high-grade cervical intraepithelial lesions and cervical carcinoma and analysis of human papillomavirus-16 genomic variants. Croat Med J 2021. [PMID: 33660963 PMCID: PMC7976879 DOI: 10.3325/cmj.2021.62.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Škegro B, Bjedov S, Mikuš M, Mustač F, Lešin J, Matijević V, Ćorić M, Elveđi Gašparović V, Medić F, Sokol Karadjole V. Endometriosis, Pain and Mental Health. Psychiatr Danub 2021; 33:632-636. [PMID: 34718292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Endometriosis is a chronic and progressive disease which can significantly affect a woman's personal, as well as intimate and professional aspects of life. The aim of this study was to asses health-related quality of life and mental health status in patients with endometriosis, investigating also their relationship with endometriosis-related comorbid symptoms and conditions, such as pain and infertility. SUBJECTS AND METHODS An observational cross-sectional study involved 79 women with endometriosis. All patients filled the Endometriosis Health Profile (EHP-5), the Depression Anxiety Stress Scales (DASS-21) and the Visual Analogue Scale (VAS). Their medical data were retrieved from medical records. Data was analyzed using the SPSS 23.0 (IBM Corp., Armonk, NY). RESULTS Of all the patients evaluated in our study, 44.3% presented depressive symptoms and 25.3% presented anxiety, while 31.7% reported stress symptoms. Moderate correlations were found between results on EHP-5 and depression (r=0.515), stress (r=0.558) and VAS score (r=0.565). Furthermore, weak positive relationship was observed between EHP-5 and anxiety (r=0.295) and infertility (r=0.267). Additionally, moderate correlation was found between depression and infertility (r=0.519), while there was weak association between VAS score and stress (r=0.236). CONCLUSIONS This study showed complex relationships between symptoms and conditions manifesting in patients with endometriosis. Due to diversity of symptoms, potentially including mental health issues, it is important to emphasize the need for combined personalized treatment for these patients, taking into account both physical and psychological aspect of the disease.
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Affiliation(s)
- Bernarda Škegro
- Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center Sestre milosrdnice, Zagreb, Croatia
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Mikuš M, Ćorić M, Matak L, Škegro B, Vujić G, Banović V. Validation of the UDI-6 and the ICIQ-UI SF - Croatian version. Int Urogynecol J 2020; 31:2625-2630. [PMID: 32821964 DOI: 10.1007/s00192-020-04500-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/13/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Despite the widespread use of UDI-6 and ICIQ-UI SF in Croatia, it remains unknown whether a realiable and valid measure for the population of interest is used. Thus, the aim of this study was to translate, adapt and validate the UDI-6 and the ICIQ-UI SF in Croatia. METHODS The study included a total of 232 consecutive patients with urinary incontinence symptoms. The translation to Croatian followed standardized procedure. All participants underwent urodynamic assesment and completed UDI-6 and ICIQ-UI SF questionnaires at inclusion and 2 weeks after to assess test-retest reliability. Cronbach α coefficient was calculated in order to assess internal consistency. RESULTS Both questionnaires had high internal consistency (Cronbach α for UDI-6 and ICIQ-UI SF was .83 and .85, respectively) and high test-retest reliability (intraclass correlation coefficient .99 for instruments). Strong correlation was found between urodynamic findings and total scores in UDI-6 and ICIQ-UI SF (ρ = 0.88 and 0.89, respectively). Women with stress urinary incontinence (SUI) and detrusor overactivity (DOA) group had significantly higher scores on UDI-6 (Mdn = 33.33 and Mdn = 50, respectively) compared to women with no urodynamic abnormality (Mdn = 0; p < 0.001). Women with no urodynamic abnormality scored significantly lower on ICIQ-UI SF (Mdn = 0; p < 0.001) compared to women with SUI (Mdn = 14) and DOA (Mdn = 16). Women with DOA scored worse on Irritative and Obstructive symptoms when comparing with two other groups (p < 0.001), while women with SUI had significantly worse score on Stress symptoms subscale (p < 0.001). CONCLUSIONS The UDI-6 and ICIQ-UI SF have very good psychometric characteristics and can be used in Croatian urogynecology practice.
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Affiliation(s)
- Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Petrova 13, 10000, Zagreb, Croatia. .,School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Mario Ćorić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Petrova 13, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luka Matak
- Department of Obstetrics and Gynecology, General Hospital Zadar, Zadar, Croatia
| | - Bernarda Škegro
- Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Goran Vujić
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Petrova 13, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vladimir Banović
- Department of Obstetrics and Gynecology, University Hospital Center Zagreb, Petrova 13, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Ćorić M, Gregov M, Šarić MJ, Mikuš M, Grgić F, Knežević N, Matošević P, Brozović I. One-stage, radical laparoscopic endometriosis excision involving three different organ systems: A case report from tertiary referral center. Journal of Endometriosis and Pelvic Pain Disorders 2020. [DOI: 10.1177/2284026520928246] [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: 11/16/2022]
Abstract
Introduction: We present a case of an extensive endometriosis involving left paracolpium and left parametrium, rectovaginal septum, urinary bladder, left interiliac region between artery and vein, left ureter and rectum, presenting as dysmenorrhoea, alternating bouts of diarrhea and constipation and hydronephrosis. Methods: Laparoscopic surgery made by a multidisciplinary team consist of gynecologic, abdominal surgeon and urologist. Results: Successfully managed deep infiltrated endometriosis. Conclusion: The aim of this report is to demonstrate benefit of one-stage, minimally invasive radical surgical procedure performed in a tertiary referral center. To the best of our knowledge, this report presents an extremely complex case because we successfully managed deep infiltrating endometriosis in three different organ systems at the same time, using minimally invasive nerve-sparing technique. A case with the same constellation has not been published yet since reported cases of extrapelvic endometriosis chiefly address one organ system involvement.
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Affiliation(s)
- Mario Ćorić
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marija Gregov
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Mislav Mikuš
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Franjo Grgić
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | - Ivo Brozović
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Šimičević M, Juras J, Lovrić Gršić H, Mikuš M, Planinić P, Ćorić M. Comparison of laparoscopic and laparotomic approach in lymphadenectomy in women with gynaecological cancer. J OBSTET GYNAECOL 2020; 41:329-330. [PMID: 32148157 DOI: 10.1080/01443615.2020.1716312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Maša Šimičević
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Josip Juras
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Helena Lovrić Gršić
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mislav Mikuš
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Pavao Planinić
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- Department of Gynaecological Surgery, University Hospital Center Zagreb, Zagreb, Croatia
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Mareković I, Bošnjak Z, Jurić K, Ćorić M, Popović-Grle S. Susceptibility of Escherichia coli to nitroxoline, an option for uncomplicated urinary tract infections – the first report from Croatia. J Chemother 2018; 30:189-191. [DOI: 10.1080/1120009x.2018.1452585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ivana Mareković
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zrinka Bošnjak
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Karla Jurić
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mario Ćorić
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Gynaecology and Obstetrics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sanja Popović-Grle
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Pulmonary Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia
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