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Tsikouras P, Oikonomou E, Bothou A, Kyriakou D, Nalbanti T, Andreou S, Daniilidis A, Peitsidis P, Nikolettos K, Iatrakis G, Nikolettos N. Labor management and neonatal outcomes in cardiotocography categories II and III (Review). Med Int (Lond) 2024; 4:27. [PMID: 38628383 PMCID: PMC11019468 DOI: 10.3892/mi.2024.151] [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] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
The safe care of both mothers and fetuses during labor is a primary goal of all health professionals. The assessment of fetal oxygenation and well-being is a key aspect of perinatal care provided. Fetal heart rate (FHR) auscultation became part of daily obstetric practice in a number of countries during the 20th century and remains a key method of fetal monitoring, particularly in low-risk pregnancies. Cardiotocography (CTG) is the continuous monitoring and recording of the FHR and uterine myometrial activity, making it possible to assess the fetal condition. It therefore plays a critical role in the detection of fetal hypoxia during labor, a condition directly related to short- and long-term complications in the newborn. Herein, particular reference is made to the management of CTG category II and III standards, as well as to the handling of childbirth. In addition, specific FHR patterns are associated with immediate neonatal outcomes based on updated studies conducted worldwide. Finally, the prognostic significance of CTG and its potential as a prospective avenue for further investigation are also highlighted herein. Given that the misinterpretation of CTG findings is the most common cause of medical-legal responsibility, this knowledge field requires more emphasis and attention. The aim of the present review was to further deepen the knowledge on issues that mainly concern the safety and monitoring of pregnant women and fetuses during childbirth.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Efthimios Oikonomou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Anastasia Bothou
- Midwifery Department of Neonatology, University Hospital Alexandra, 11528 Athens, Greece
| | - Dimimitrios Kyriakou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Theopi Nalbanti
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Sotirios Andreou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Angelos Daniilidis
- 1st Department of Obstetrics and Gynecology, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
| | - Panagiotis Peitsidis
- Department of Obstetrics and Gynecology, Helena Venizelou Maternity Hospital, 11521 Athens, Greece
| | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Georgios Iatrakis
- Midwifery Department, University of West Attica, 12243 Athens, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Kontomanolis EN, Symeonidis P, Nikolettos K, Perros P, Rody A, Tsikouras P, Nikolettos N, Giatromanolaki A. ARID1 and BRG1 Expression in Endometrial Cancer. In Vivo 2024; 38:1260-1265. [PMID: 38688602 PMCID: PMC11059895 DOI: 10.21873/invivo.13563] [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] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM Endometrial cancer (EC) is the predominant malignancy among gynecologic cancers and ranks fourth among all types of cancer. Recently, researchers have focused on the development of new prognostic biomarkers. Subunits of the SWI/SNF protein complex, like the ARID1 and BRG1, have been associated with the development of endometrial cancer. The present study aimed to evaluate the expression patterns of ARID1A and BRG1 in a collection of endometrioid adenocarcinomas of the uterus using immunohistochemistry. PATIENTS AND METHODS The study comprised a total of thirty-three individuals diagnosed with stage I endometrioid endometrial cancer, treated with radical hysterectomy. The histological material was then examined to assess the cytoplasmic and nuclear expression of the proteins. RESULTS ARID1A exhibited expression in both the cytoplasm and nucleus of cancer cells, whereas BRG1 was mainly expressed in the nuclei. In addition, ARID1A exhibited a notable decrease in expression in grade 3 histology, with no significant correlation with the depth of myometrial invasion. The reduced expression was highly related to tumor expansion into the endocervix. The findings demonstrated a total absence of ARID1A expression in 27% of endometrioid carcinomas, with a significant reduction in expression in an additional 51% of cancer cells. These findings align with the most recent published data. In contrast, in the current study, BRG1 was rarely down-regulated and was extensively expressed in the majority of endometrioid carcinomas, preventing the possibility of statistical analysis. CONCLUSION In summary, ARID1A expression loss can be used as a biomarker to guide post-operative therapy; however, further investigation is needed, especially for early-stage endometrial cancer.
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Affiliation(s)
- Emmanuel N Kontomanolis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece;
| | - Panagiotis Symeonidis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paraskevas Perros
- 1 Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens 'ALEXANDRA', Athens, Greece;
| | - Achim Rody
- Department of Obstetrics and Gynecology, University Hospital, Schleswig-Holstein, Luebeck, Germany
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
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Tsikouras P, Oikonomou E, Nikolettos K, Andreou S, Kyriakou D, Damaskos C, Garmpis N, Monastiridou V, Nalmpanti T, Bothou A, Iatrakis G, Nikolettos N. The Impact of Periodontal Disease on Preterm Birth and Preeclampsia. J Pers Med 2024; 14:345. [PMID: 38672972 PMCID: PMC11051368 DOI: 10.3390/jpm14040345] [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: 03/12/2024] [Revised: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
This review delves into the possible connection between periodontitis and negative pregnancy outcomes, such as preeclampsia and preterm birth. It highlights the potential influence of an unidentified microbial factor on preeclampsia and the effects of inflammatory responses on the rate of preterm births. Furthermore, it underscores the prevalent occurrence of oral ailments within the populace and their significant repercussions on quality of life. Hormonal fluctuations during pregnancy may exacerbate oral conditions such as pregnancy gingivitis and periodontitis, necessitating bespoke therapeutic approaches that take into account potential fetal ramifications. Periodontal disease, characterized by microbial attack and inflammatory response, results in tissue destruction and tooth loss. The oral cavity's susceptibility to bacterial colonization, which is primarily due to its role as a site for food intake, is highlighted. Furthermore, research indicates a correlation between inflammatory responses and factors such as prostaglandin E2 and IL-1β, and preterm birth. Therapeutic interventions are a focus of international research, with efforts being aimed at optimizing outcomes through larger studies involving pregnant women.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Efthymios Oikonomou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Sotiris Andreou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Dimitrios Kyriakou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Christos Damaskos
- Department of Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece
| | | | - Vassiliki Monastiridou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Theopi Nalmpanti
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
| | - Anastasia Bothou
- Neonatal Department, University Hospital Alexandra, 11528 Athens, Greece;
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - George Iatrakis
- Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 11528 Athens, Greece;
- Department of Obstetrics and Gynecology, Rea Maternity Hospital, 17564 Athens, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (K.N.); (S.A.); (D.K.); (V.M.); (T.N.); (N.N.)
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Nousiopoulou E, Vrettou K, Damaskos C, Garmpis N, Garmpi A, Tsikouras P, Nikolettos N, Nikolettos K, Psilopatis I. The Role of Urothelial Cancer-Associated 1 in Gynecological Cancers. Curr Issues Mol Biol 2024; 46:2772-2797. [PMID: 38534790 DOI: 10.3390/cimb46030174] [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: 02/19/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024] Open
Abstract
Gynecological cancers (GC) represent some of the most frequently diagnosed malignancies in women worldwide. Long-non-coding RNAs (lncRNAs) are regulatory RNAs increasingly being recognized for their role in tumor progression and metastasis in various cancers. Urothelial cancer-associated 1 (UCA1) is a lncRNA, first found deregulated in bladder cancer, and many studies have exposed its oncogenic effects in more tumors since. However, the role of UCA1 in gynecological malignancies is still unclear. This review aims to analyze and define the role of UCA1 in GC, in order to identify its potential use as a diagnostic, prognostic, or therapeutic biomarker of GC. By employing the search terms "UCA1", "breast cancer", "endometrial cancer", "ovarian cancer", "cervical cancer", "vaginal cancer", and "vulvar cancer" in the PubMed database for the literature review, we identified a total of sixty-three relevant research articles published between 2014 and 2024. Although there were some opposing results, UCA1 was predominantly found to be upregulated in most of the breast, endometrial, ovarian, cervical, and vulvar cancer cells, tissue samples, and mouse xenograft models. UCA1 overexpression mainly accounts for enhanced tumor proliferation and increased drug resistance, while also being associated with some clinicopathological features, such as a high histological grade or poor prognosis. Nonetheless, no reviews were identified about the involvement of UCA1 in vaginal carcinogenesis. Therefore, further clinical trials are required to explore the role of UCA1 in these malignancies and, additionally, examine its possible application as a target for upcoming treatments, or as a novel biomarker for GC diagnosis and prognosis.
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Affiliation(s)
- Eleni Nousiopoulou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Kleio Vrettou
- Department of Cytopathology, Sismanogleio General Hospital, 15126 Athens, Greece
| | - Christos Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Nikolaos Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Nikolaos Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panagiotis Tsikouras
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, 68110 Alexandroupolis, Greece
| | - Nikolaos Nikolettos
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, 68110 Alexandroupolis, Greece
| | - Konstantinos Nikolettos
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, 68110 Alexandroupolis, Greece
| | - Iason Psilopatis
- Universitätsklinikum Erlangen-Frauenklinik, Universitätsstraße 21/23, 91054 Erlangen, Germany
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Tsikouras P, Oikonomou E, Bothou A, Chaitidou P, Kyriakou D, Nikolettos K, Andreou S, Gaitatzi F, Nalbanti T, Peitsidis P, Michalopoulos S, Zervoudis S, Iatrakis G, Nikolettos N. The Impact of Endometriosis on Pregnancy. J Pers Med 2024; 14:126. [PMID: 38276248 PMCID: PMC10820275 DOI: 10.3390/jpm14010126] [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: 11/04/2023] [Revised: 12/14/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
Despite the increased frequency of endometriosis, it remains one of the most enigmatic disorders regarding its effects on pregnancy. Endometriosis adversely affects both natural and assisted conception. Impaired folliculogenesis, which causes follicular dysfunction and low egg quality, as well as luteal phase problems, reduced fertilization, and abnormal embryogenesis, are some of the mechanisms advocated to explain reproductive dysfunction. There is a rising need for a comprehensive study of the potential negative consequences of this condition on pregnancy outcomes, including the postpartum period, as more women with a medical history of endometriosis become pregnant. Obstetrical complications (small for gestational age [SGA], cesarean section [CS], miscarriage, hemorrhage, low placental adhesion, and preterm delivery) are statistically elevated in women with endometriosis. Furthermore, ruptured ovarian endometrioma, appendicitis, intestinal perforation, and hemoperitoneum have been described in pregnancy. Obstetricians are largely unfamiliar with these complications, as they have not been thoroughly investigated. The development and pathogenesis of endometriosis is an important field of study and has not yet been fully elucidated. Finding these mechanisms is crucial for the development of new and more effective strategies to treat this condition. Endometriosis can have an impact on obstetric and neonatal outcomes of pregnancy, in addition to its potential effects on conception. To date, no additional monitoring is recommended for pregnancies with a history of endometriosis. However, more studies are urgently needed to assess the need for the tailored pregnancy monitoring of women with endometriosis.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (A.B.); (P.C.); (D.K.); (K.N.); (S.A.); (F.G.); (T.N.); (P.P.); (S.Z.); (G.I.); (N.N.)
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Dragoutsos G, Tsiggalou C, Oikonomou E, Bothou A, Trypsiannis G, Nikolettos K, Damaskos C, Garmpis N, Kyriakou D, Nalbanti T, Iatrakis G, Nikolettos N, Tsikouras P. Association of Anti-Ro/SSA and Anti-La/SSB Autoantibodies With Pregnancy Outcome in the General Population. Mater Sociomed 2024; 36:47-53. [PMID: 38590603 PMCID: PMC10999136 DOI: 10.5455/msm.2024.36.47-53] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
Background Autoimmune diseases encompass a diverse array of disorders that disturb the optimal functioning of the immune system, which is to eliminate the 'foreign or/and dangerous' to mistakenly target the body's own tissues. Objective The aim of this research is to evaluate the most effective approach to managing autoimmune diseases within the framework of pregnancy. Methods The exact causes and etiologies of these diseases are multifactorial and mostly still unclear. Ro/SSA autoantibodies and La/SSB, could be found in Sjögren's disease (SJ), systemic lupus (SLE) and other autoimmune disorders. Smoking, stress, UV exposure, vitamin D deficiency, and other genetic and environmental factors have been identified as risk factors for rheumatic diseases. Results Over the years, an ever-increasing incidence of these diseases has been observed in the general population, with the female sex being at increased risk for their occurrence. This fact raises the question of what should be the management of these pathological entities during pregnancy. Taking into account the very significant impact on the quality of paitients'daily life and the seemingly augmented prevalence of autoimmune diseases, as well as their preference in the female population, the reasonable question arises as to what should be the optimal management of these diseases in the context of pregnancy. Conclusion Given the limited data of the global medical community regarding the etiological factors and mechanisms that trigger the onset of rheumatic diseases, the management of pregnant women is a complex conundrum that health professionals are challenged to face and solve.
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Affiliation(s)
- Georgios Dragoutsos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Christina Tsiggalou
- Department of Medical Micobiology-Immunology Laboratory of Hygiene and Environmental Protection Democritus University of Thrace, Greece
| | - Efthymios Oikonomou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | | | | | - Christos Damaskos
- Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Greece and Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Nikolaos Garmpis
- Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Kyriakou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Theopi Nalbanti
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Georgios Iatrakis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
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Damaskos C, Psilopatis I, Garmpi A, Dimitroulis D, Nikolettos K, Vrettou K, Sarantis P, Koustas E, Kouraklis G, Antoniou EA, Karamouzis MV, Nikolettos N, Tsikouras P, Marinos G, Kontomanolis E, Kontzoglou K, Garmpis N. Evaluation of the Histone Deacetylase 2 (HDAC-2) Expression in Human Breast Cancer. Cancers (Basel) 2024; 16:209. [PMID: 38201636 PMCID: PMC10777907 DOI: 10.3390/cancers16010209] [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: 11/18/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND/AIM Triple negative breast cancer belongs to the most aggressive breast cancer forms. Histone deacetylases (HDACs) constitute a class of enzymes that exhibit a significant role in breast cancer genesis and progression. In this study, we aimed at assessing the clinical importance of HDAC-2 in triple negative breast cancer. MATERIALS AND METHODS A total of 138 breast cancer specimens were examined on an immunohistochemical basis. A statistical analysis was performed in order to examine the association between HDAC-2 and the survival and clinicopathological features of the patients. RESULTS Increased HDAC-2 expression was observed in every fourth case of triple negative breast cancer with positive HDAC-2 staining, whereas only 12 out of 98 non-triple negative breast cancer samples showed high HDAC-2 expression. HDAC-2 overexpression correlated with prolonged overall survival (OS) and disease-free survival (DFS) in triple negative breast cancer. CONCLUSIONS High HDAC-2 levels in triple negative breast cancer seem to positively influence patient survival, disease stage and recurrence.
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Affiliation(s)
- Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (N.G.)
| | - Iason Psilopatis
- Department of Obstetrics and Gynecology, University Erlangen, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Nikolettos
- Department of of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece (N.N.)
| | - Kleio Vrettou
- Department of Cytopathology, Sismanogleio General Hospital, 15126 Athens, Greece
| | - Panagiotis Sarantis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.)
| | - Evangelos Koustas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.)
| | - Gregory Kouraklis
- Department of Surgery, Evgenideio Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Efstathios A. Antoniou
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (N.G.)
- Department of General Surgery and HPB Surgery of Adults and Children, Hygeia Hospital, 15123 Athens, Greece
| | - Michail V. Karamouzis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.)
| | - Nikolaos Nikolettos
- Department of of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece (N.N.)
| | - Panagiotis Tsikouras
- Department of of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece (N.N.)
| | - Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Emmanouil Kontomanolis
- Department of of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece (N.N.)
| | - Konstantinos Kontzoglou
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (N.G.)
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (N.G.)
- Department of General Surgery and HPB Surgery of Adults and Children, Hygeia Hospital, 15123 Athens, Greece
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Tsagias N, Xydias EM, Ziogas AC, Tsikouras P, Patsinakidis N, Daniilidis A, Tsakos E. Hysteroscopic resection as a safe minimally invasive technique for the management of cornual pregnancy: A case report and literature review. Clin Case Rep 2023; 11:e8137. [PMID: 37953899 PMCID: PMC10632553 DOI: 10.1002/ccr3.8137] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/11/2023] [Accepted: 10/21/2023] [Indexed: 11/14/2023] Open
Abstract
Hysteroscopic resection of ectopic cornual pregnancy following MRI imaging is a safe and effective treatment option without significantly impacting fertility potential or increasing the risk of future obstetrical complications.
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Affiliation(s)
| | - Emmanouil M. Xydias
- EmbryoClinic IVFThessalonikiGreece
- Faculty of Medicine, School of Health SciencesUniversity of ThessalyLarissaGreece
| | - Apostolos C. Ziogas
- Faculty of Medicine, School of Health SciencesUniversity of ThessalyLarissaGreece
| | - Panagiotis Tsikouras
- Department of MedicineDemocritus University of ThraceAlexandroupoliGreece
- Department of Obstetrics and GynecologyGeneral University Hospital of AlexandroupoliAlexandroupoliGreece
| | | | - Angelos Daniilidis
- First University Department of Obstetrics and Gynecology, School of MedicinePapageorgiou General Hospital, Aristotle University of ThessalonikiThessalonikiGreece
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Peitsidis P, Iavazzo C, Gkegkes ID, Laganà AS, Makridima S, Tsikouras P. Tranexamic Acid (TXA) for the Hemostatic Treatment of Post-Partum Hemorrhage (PPH): What Key Points Have We Learnt After All These Years? J Clin Med 2023; 12:6385. [PMID: 37835029 PMCID: PMC10573555 DOI: 10.3390/jcm12196385] [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] [Received: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Post-partum bleeding or post-partum hemorrhage (PPH) is often defined as the loss of more than 500 mL of blood after vaginal delivery or 1000 mL of blood after cesarean section following the delivery of a child [...].
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Affiliation(s)
- Panagiotis Peitsidis
- Department of Obstetrics and Gynecology, Helena Venizelou Hospital, 11521 Athens, Greece
| | - Christos Iavazzo
- Gynaecological Oncology Department, Metaxa Cancer Hospital, 18537 Piraeus, Greece;
| | - Ioannis D. Gkegkes
- Athens Colorectal Laboratory, 11528 Athens, Greece
- Department of Colorectal Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter EX2 5DW, UK
| | - 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
| | - Sophia Makridima
- Department of Obstetrics and Gynecology, Helena Venizelou Hospital, 11521 Athens, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, The Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Tsikouras P, Oikonomou E, Tsatsaris G, Bothou A, Kyriakou D, Nikolettos K, Nalmbanti T, Peitsidis P, Trypsanis G, Iatrakis G, Nikolettos N, Souftas V. Our Experience with Hydrogel-Coated Trisacryl Microspheres in Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids and Adenomyosis: A Follow-Up of 11 Years. J Pers Med 2023; 13:1385. [PMID: 37763151 PMCID: PMC10532514 DOI: 10.3390/jpm13091385] [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: 08/22/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Uterine artery embolization (UAE) for the treatment of symptomatic uterine fibroids and non-controllable adenomyosis symptoms is a relatively new procedure for organ-preserving therapy. These benign conditions can become symptomatic in about 30% of women between the ages of 35 and 50. The purpose of the UAE either for fibroids or adenomyosis is the elimination of blood loss, the reduction in pain, and bulky or rectal pressure symptoms. The purpose of this study is to present our experience in UAE with the use of hydrogel-coated tris acryl microspheres for the treatment of symptomatic uterine fibroids and adenomyosis.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Efthymios Oikonomou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - George Tsatsaris
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Dimitrios Kyriakou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Theopi Nalmbanti
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Panagiotis Peitsidis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Grigorios Trypsanis
- Department of Medical Statistics, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - George Iatrakis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (E.O.); (G.T.); (A.B.); (D.K.); (K.N.); (T.N.); (P.P.); (G.I.); (N.N.)
| | - Vasileios Souftas
- Department of Interventional Radiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
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11
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Anthoulaki X, Oikonomou E, Bothou A, Papanikolopoulou S, Nikolettos K, Damaskos C, Garbis N, Kyriakou D, Nalbanti T, Iatrakis G, Nikolettos N, Tsikouras P. Comparison of Gut Microbiome in Neonates Born by Caesarean Section and Vaginal Seeding with Gut Microbiomes of Neonates Born by Caesarean Section Without Vaginal Seeding and Neonates Born by Vaginal Delivery. Mater Sociomed 2023; 35:234-243. [PMID: 37795168 PMCID: PMC10545928 DOI: 10.5455/msm.2023.35.234-243] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/25/2023] [Indexed: 10/06/2023] Open
Abstract
Background Pregnancy is an admirable biological process, resulting in significant changes in many of the body's normal systems so that they can support the development of the fetus. These changes involve hormonal changes, weight gain, immune system regulation, and others that need to be synchronized to maintain both maternal and fetal health. Objective The purpose of this study was to compare gut microbiome in neonates born by caesarean section and vaginal seeding with gut microbiomes of neonates born by caesarean section without vaginal seeding and neonates born by vaginal delivery. Methods In Democritus University of Thrace, from 2019 to 2022, gut microbiomes were compared for three groups of neonates. Group A included 110 neonates born by CS who underwent vaginal seeding, group B included 85 neonates born by CS without vaginal seeding and group C included 95 neonates born by vaginal delivery. Results Vaginal seeding in neonates born with CS resulted in gut microbiome which was similar to the gut microbiome of neonates born by vaginal delivery (including lactobacillus species and bacteroides). On the contrary, gut microbiome of neonates born by CS without vaginal seeding was "limited". Conclusion According to our findings, vaginal seeding alters the gut microbiome of the neonates born with CS. However, there is a need for further investigation to prove its efficacy and its safety for the neonate.
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Affiliation(s)
- Xanthi Anthoulaki
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Efthimios Oikonomou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | | | | | - Christos Damaskos
- Nikolaos Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece and Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Nikolaos Garbis
- Nikolaos Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kyriakou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | | | - Georgios Iatrakis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
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Chalkidou A, Oikonomou E, Lambrinos D, Bothou A, Kyriakou D, Nikolettos K, Marinos G, Iatrakis G, Zervoudis S, Nikolettos N, Tsikouras P. The Comparative Study of the Administration of the Combination Preparation of Isoflavones and Hyaluronic Acid in Menopausal Women for the Treatment of the Symptoms of Menopause, Urogenital Atrophy and Oteoporosis in Relation to Existing Hormone Replacement Therapies. Mater Sociomed 2023; 35:206-214. [PMID: 37795159 PMCID: PMC10545921 DOI: 10.5455/msm.2023.35.206-214] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Background Menopause is characterized by a series of symptoms and effects from the various systems and organs, for which, the decline in estrogen production from the ovaries is considered responsible. Objective The aim of this study was to make comparative study of the administration of the combination preparation of isoflavones and hyaluronic acid in menopausal women for the treatment of the symptoms of menopause, urogenital atrophy and osteoporosis in relation to existing hormone replacement therapies. Methods In this five-year, double-blind, placebo-controlled clinical study, a total of 274 postmenopausal women were enrolled and classified into three groups. Participants in group A, were 96 women who did not receive Hormone Replacement Therapy (HRT), in the second group, 92 received daily treatment with tibolone (2.5 mg) as monotherapy, and in the third group, 86 received treatment with a pharmaceutical formulation of hyaluronic acid 120 mg and isoflavones. MF11RCE 80 mg. Results In the postmenopausal women of our study, a significant reduction of postmenopausal symptoms was found in both groups B and C of participants who received hormone replacement preparations compared to group A who did not receive HRT. Furthermore, no difference in efficacy was observed between the administered preparations of isoflavones and tibolone. Conclusion The combination of isoflavones and hyaluronic acid has the same efficacy as tibolone in menopausal symptoms.
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Affiliation(s)
- Anna Chalkidou
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
| | - Efthimios Oikonomou
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
- Neonatal Intensive Care Unit of University Hospital Alexandroupolis, Greece
| | | | - Anastasia Bothou
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
| | - Dimitrios Kyriakou
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
| | | | - Georgios Marinos
- Georgios Marinos, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Iatrakis
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
| | - Stefanos Zervoudis
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology,Democritus Univesity of Thrace, Greece
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13
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Michalopoulos S, Tsikouras P, Varlami V, Lambrinos D, Bothou A, Nikolettos K, Papanikolopoulou S, Marinos G, Iatrakis G, Nikolettos N. Retrospective Study of the Correlation Between Twin Pregnancies and Perinatal Outcome in Association to the Impact of Preterm Birth. Mater Sociomed 2023; 35:215-221. [PMID: 37795161 PMCID: PMC10545924 DOI: 10.5455/msm.2023.35.215-221] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
Background Twin pregnancies make up 2% to 4% of all births. Incidence of spontaneous twin pregnancies varies around the world, with percentages ranging from 8/1000 to >17/1000 births. The variation in twin pregnancy rates is thought to be due to dizygotic pregnancies, since monozygotic pregnancies have a consistent incidence of 3.5/1000 to 4/1000 births. The incidence of twin pregnancies after the widespread use of assisted reproduction has increased significantly. Objective The purpose of the present study is to investigate factors , who contribute to improve the perinatal outcome in twin pregnancies. Support will be provided by the results of twin pregnancies by the Department of Obstetrics and Gynaecology of Demokrition University of Thrace (Alexandroupolis, Greece) in the last fifteen years. Methods From the above Department, data were collected on the number of twin pregnancies, maternal age, gestational age, mode of delivery (spontaneous delivery or caesarean section), birth weight and rate of twin pregnancies with assisted reproduction. Results The results showed the increasing trend of twin pregnancies and births. A total of 304 twin pregnancies were identified (rate 2.75%). The rate of assisted reproduction was 34.83% in our sample, while the rate of cesarean deliveries was 95.5%, showing a large increase in recent years. In ten cases, normal delivery was successfully performed. The gestational age in twin pregnancies that ended with normal delivery was 37.37 + 3 weeks and the fetuses were both cephalic presentations. The main reason for admission of newborns to the NICU Department was prematurity. Conclusion The constantly improving education of perinatalists and understanding of the pathophysiology may lead to individualization of their treatment, and improvement of their prognosis based on recent scientific data from other international centers.
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Affiliation(s)
| | | | - Vassiliki Varlami
- Neonatal Intensive Care Unit of University Hospital Alexandroupolis, Greece
| | | | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus Univesity of Thrace, Greece
| | | | | | - Georgios Marinos
- Georgios Marinos, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Iatrakis
- Department of Obstetrics and Gynecology, Democritus Univesity of Thrace, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus Univesity of Thrace, Greece
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14
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Nikolettos K, Vlahos N, Pagonopoulou O, Nikolettos N, Zikopoulos K, Tsikouras P, Kontomanolis E, Damaskos C, Garmpis N, Asimakopoulos B. Is There an Association Between Circulating Kisspeptin Levels and Ovarian Reserve in Women of Reproductive Age? In Vivo 2023; 37:2219-2223. [PMID: 37652519 PMCID: PMC10500527 DOI: 10.21873/invivo.13322] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM To investigate the possible association of kisspeptin levels with the ovarian reserves of women of reproductive age. PATIENTS AND METHODS Eighty women aged 19-40 participated after signing an informed consent. Of these, 74 were finally included as in 6 women the blood samples were considered inappropriate due to hemolysis. They were divided into three main groups according to their ovarian reserve patterns: women with adequate ovarian reserves (Group A - AOR) (n=30), women with increased ovarian reserves (Group B - PCOS) (n=31), and women with diminished ovarian reserves (Group C - DOR) (n=13). RESULTS Women with diminished ovarian reserves had statistically significantly increased age and FSH compared to the other two groups. No statistically significant difference was found between the three groups for estradiol and thyroid stimulating hormone. Moreover, body mass index, luteinizing hormone, total testosterone, 17-hydroxyprogesterone, dehydroepiandrosterone, anti-Mullerian hormone (AMH), and antral follicle count (AFC) were increased in group B compared to the other two groups. AMH and AFC were decreased in women with diminished ovarian reserves compared to the other two groups, as expected. The comparison of kisspeptin levels between the three groups showed that kisspeptin levels were increased in women with diminished ovarian reserves, compared to the other two groups, but without a statistically significant difference. However, kisspeptin levels in group C were statistically significantly higher than those in group A. CONCLUSION There are no strong indications that kisspeptin levels are associated with the ovarian reserve in women of reproductive age.
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Affiliation(s)
- Konstantinos Nikolettos
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, Alexandroupolis, Greece;
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, Aretaieion Hospital, Athens, Greece
| | - Olga Pagonopoulou
- Laboratory of Physiology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikos Nikolettos
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Panagiotis Tsikouras
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Emmanouil Kontomanolis
- Obstetric and Gynecologic Clinic, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Byron Asimakopoulos
- Laboratory of Physiology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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15
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Peitsidis P, Iavazzo C, Tsikouras P, Gkegkes ID. Pelvic splenosis: A systematic review of the literature. Clin Ter 2023; 174:379-385. [PMID: 37378510 DOI: 10.7417/ct.2023.2453] [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] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background Splenosis is the presence of ectopic autotransplantation of splenic tissue in various compartments of the human body, occurring after rupture of the splenic parenchyma. Methods A systematic PubMed and Scopus search was conducted. Results The mean age of the patients was 51.7 years. The majority of patients were of female gender. An emergency presentation was noted in 30 out of 85 patients, having abdominal pain as main symptom. The principal reason for splenectomy were traffic accidents. The time span between splenectomy and the initial symptoms ranged between 1 and 57 years. The most frequent symptom at presentation of pelvic splenosis was abdominal pain. Almost a quarter of the included patients were without any symptom. Presence of extrapelvic splenosis was de-scripted in almost half of the included patients. With regards to the type of treatment provided, exploratory laparotomy, laparoscopic surgical exploration / laparoscopy, robotic removal of splenium and watchful waiting, were performed in 35 (41.2%), 32 (37.6%), 3 (3.5%) and 15 (16.3%) patients, respectively. No fatality was reported. Conclusion Pelvic splenosis is a rare clinical condition. It may mimic several clinical conditions and mislead diagnosis. The clinical history of splenectomy for trauma or different other reasons may es-tablish diagnosis and exclude other morbidities. Excision and complete removal of pelvic splenosis nodules is not always necessary and it depends on the clinical symptomatology. Careful imaging and precise assessment with the assistance of nuclear medicine may lead to correct diagnosis and avoid unnecessary surgical interventions.
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Affiliation(s)
- P Peitsidis
- REA Hospital, Athens, Greece
- Department of Midwifery University of West Attica, Athens, Greece
| | - C Iavazzo
- Gynaecological Oncology De-partment, Metaxa Cancer Hospital, Piraeus, Greece
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - I D Gkegkes
- Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- Athens Colorectal Laboratory, Athens, Greece
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Giovannopoulou E, Karakasi MV, Kouroupi M, Giatromanolaki A, Tsikouras P, Pavlidis P. Safety and efficacy of ovarian tissue autotransplantation: A systematic literature review. Folia Med (Plovdiv) 2023; 65:362-370. [PMID: 38351810 DOI: 10.3897/folmed.65.e89198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/16/2022] [Accepted: 09/30/2022] [Indexed: 02/16/2024] Open
Abstract
Ovarian tissue autotransplantation is an innovative fertility preservation technique that has provoked ongoing investigations. The purpose of the present study was to assess the safety and reproductive performance of ovarian tissue autotransplantation. This review is conducted according to PRISMA guidelines. Seven studies met the inclusion criteria. A total of 3427 patients underwent ovarian tissue cryopreservation and 205 received an autotransplantation. Tissue retrieval was mainly performed by laparoscopy and only one major complication occurred. Transplantations were predominantly performed by open procedures and data on safety were insufficient. A total of 295 autotransplantations were analyzed, resulting in 104 pregnancies. Sixty-five pregnancies led to live births, while nine were ongoing at that time. A pregnancy rate (PR) of 50.7% and a live-birth rate (LBR) of 32.7% were observed. Natural conception accounted for 46.3% of live births. No birth deficits were recorded. Ovarian tissue autotransplantation seems to be a safe procedure with acceptable pregnancy rates.
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Affiliation(s)
| | | | - Maria Kouroupi
- General University Hospital of Alexandroupolis, Alexandroupolis, Greece
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Peitsidis P, Tsikouras P, Laganà AS, Laios A, Gkegkes ID, Iavazzo C. A Systematic Review of Systematic Reviews on the Use of Aromatase Inhibitors for the Treatment of Endometriosis: The Evidence to Date. Drug Des Devel Ther 2023; 17:1329-1346. [PMID: 37168488 PMCID: PMC10166210 DOI: 10.2147/dddt.s315726] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023] Open
Abstract
Endometriosis is a chronic gynecologic condition that affects around 6-10% of reproductive age women. This clinical entity is characterized with pelvic pain, dysmenorrhea, dyspareunia, and infertility which are the most often presenting symptoms. Aromatase P450 is the key enzyme for ovarian estrogen biosynthesis and there is evidence that endometriotic lesions express aromatase and are able to synthesize their own estrogens. Aromatase inhibitors (AIs) are potent drugs that suppress the estrogen synthesis via suppression of aromatase. We performed a systematic review of systematic reviews and narrative reviews on the use of aromatase inhibitors in the medical management of endometriosis. We searched: PubMed (1950-2022), Google Scholar (2004-2022), Cochrane Library (2010-2022) and Researchgate (2010-2022). The search included the following medical subject headings (MeSH) or keywords: "Aromatase Inhibitors" AND "Endometriosis" AND "Systematic reviews" OR "Systematic review" AND "Reviews" OR "Reviews" AND "Endometriosis". The electronic database search yielded initially 12,106 studies from the different databases. Further assessment of the studies resulted in exclusion of (n = 12,015) studies due to duplicates and irrelevance; Finally, 24 studies were selected for inclusion, 5 were Systematic reviews and 19 were Narrative reviews. The 5 systematic reviews were assessed by AMSTAR-2 criteria and were found to have low quality. Narrative reviews were assessed with SANRA criteria and were found to have high-quality aromatase inhibitors are potent drugs that can manage the endometriosis-related symptoms in cases where initial medical management has failed to show positive results. However, their use is limited by the adverse effects that are linked with menopausal symptoms. aromatase inhibitors can be administered as an alternative treatment in patients. Future studies with randomized design are required to reach safer conclusions and further investigation. These studies should define the therapeutic dose, new add-back therapy modalities. Future directions should examine the most-appropriate way of administration and the duration of therapy.
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Affiliation(s)
- Panagiotis Peitsidis
- Department of Obstetrics and Gynecology Helena Venizelou Hospital, Athens, Greece
- Correspondence: Panagiotis Peitsidis, Department of Obstetrics and Gynecology, Helena Venizelou Hospital Athens Greece, Helena Venizelou 2 Street, P.C, Athens, 11521, Greece, Tel +306972221553; +302107473793, Email
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology.The Democritus University of Thrace, Alexandroupolis, Greece
| | - 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, Palermo, Italy
| | - Alexandros Laios
- Department of Gynecological Oncology St James Institute of Oncology, Leeds Teaching Hospitals, Leeds, Uk
| | - Ioannis D Gkegkes
- Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation, Devon, UK
| | - Christos Iavazzo
- Gynaecological Oncology Department, Metaxa Cancer Hospital, Piraeus, Greece
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18
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Tsikouras P, Gkaitatzi F, Gerede A, Anthoulaki X, Bothou A, Chalkidou A, Michalopoulos S, Tsirkas I, Gyroglou S, Peitsidis P, Nikolettos K, Alexiou A, Dragoutsos G, Sachnova N, Chloropoulou P, Zervoudis S, Iatrakis G, Rath W, Trypsiannis G, Nikolettos N, Souftas V. Life Quality in Premenopausal Women after Embolization of Uterine Myomas. J Pers Med 2022; 12:jpm12121990. [PMID: 36556210 PMCID: PMC9786225 DOI: 10.3390/jpm12121990] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/01/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: Fibroids cause significant morbidity and are the most common indication for hysterectomies worldwide, delimiting a major public health problem. Uterine artery embolization (UAE) is an alternative therapy to surgical treatment of symptomatic fibroids; it has satisfactory long-time results and is no longer considered investigational for the treatment of symptomatic fibroids. This study was undertaken to evaluate changes in fibroid specific symptom severity and health-related quality of life (HRQOL) after UAE and to optimize the assessment of safety and outcomes measures for participants who receive UAE to objective compare UAE and surgical alternatives for therapy of symptomatic fibroids. Study design: The analysis was based on questionnaires completed by 270 pre-menopausal females with a mean age of 42 years (range, 38-50 years) who underwent UAE for uterine leiomyomas and/or adenomyosis from November 2013 through December 2019. Only symptomatic women were selected whose symptoms were not improving with medication and who did not wish to have children. The primary outcome measure was a change in fibroid symptoms and HRQOL (health related quality of life) after UAE. Secondary outcomes included the decrease in uterine volume after UAE. Results: Questionnaires were completed by 270 women (100%) at a mean of 12.1 months from UAE. The median follow-up period was two years. Uterine fibroid embolization led to a shrinkage at three months for the 90% of the participants. A reduction of bleeding symptoms, pain and bulk-related symptoms was observed in 89.7%, 88.9%, and 89.5% of the patients, respectively. In the long term, there was no significant difference in parameters assessed compared with the midterm follow-up findings. A total of 6 patients (2.3%) underwent fractional curettage an average of 32.1 months after intervention due to necrotic changes in submucosal fibroids. All participants continued to be satisfied with the intervention, and 240 patients (88.9%) answered that they would recommend uterine fibroid embolization to other patients. Conclusions: Women who undergo UAE have a significant decrease in symptom severity and increase in HRQOL which is associated with high levels of satisfaction with the procedure (even when subsequent therapies are pursued).
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
- Correspondence:
| | - Foteini Gkaitatzi
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Aggeliki Gerede
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Xanthoula Anthoulaki
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Anna Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Spyridon Michalopoulos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Ioannis Tsirkas
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Selma Gyroglou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | | | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Alexios Alexiou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - George Dragoutsos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Natalia Sachnova
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Pelagia Chloropoulou
- Department of Anaesthesiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - George Iatrakis
- Rea Maternity Hospital, University of West Attica, 17564 Athens, Greece
| | - Werner Rath
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Grigorios Trypsiannis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandropoulis, Greece
| | - Vasileios Souftas
- Department of Interventional Radiology, Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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19
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Zervoudis S, Iatrakis G, Paulinelli R, Tsikouras P, Dimitrakakis C, Bothou A, Navrozoglou I, Paschopoulos M. Feasibility Study of a Variant Procedure of Radical Breast Ductectomy (Dolichectomy) with a Perinipple Incision. Chirurgia (Bucur) 2022; 117:615-618. [PMID: 36318693 DOI: 10.21614/chirurgia.2783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Papillomatosis and recurrent duct ectasia could be treated with terminal lactiferous ducts excision. In this study we describe a modified miniinvasive procedure of terminal lactiferous ducts excision with a perinipple approach to the lower or upper half of the nipple. This technique avoids the much more extensive periareolar incision and has excellent aesthetic results.
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20
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Rath W, Hellmeyer L, Tsikouras P, Stelzl P. Mechanical Methods for the Induction of Labour After Previous Caesarean Section – An Updated, Evidence-based Review. Geburtshilfe Frauenheilkd 2022; 82:727-735. [PMID: 35815098 PMCID: PMC9262630 DOI: 10.1055/a-1731-7441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/29/2021] [Indexed: 11/04/2022] Open
Abstract
There are currently no up-to-date evidence-based recommendations on the preferred method to induce labour after previous Caesarean section, especially for patients with unripe cervix, as
randomised controlled studies are lacking. Intravenous oxytocin and misoprostol are contraindicated in these women because of the high risk of uterine rupture. In women with ripe cervix
(Bishop Score > 6), intravenous administration of oxytocin is an effective procedure with comparable rates of uterine rupture to those with spontaneous onset of labour. Vaginal
prostaglandin E
2
(PGE
2
) and mechanical methods (balloon catheters, hygroscopic cervical dilators) are effective methods to induce labour in pregnant women with unripe
cervix and previous Caesarean section. According to current guidelines, the administration of PGE
2
is associated with a higher rate of uterine rupture compared to balloon
catheters. Balloon catheters are therefore a suitable alternative to PGE
2
to induce labour after previous Caesarean section, even though this is an off-label use. In addition to
two meta-analyses published in 2016, 12 mostly retrospective cohort/observational studies with low to moderate levels of evidence have been published on mechanical methods of cervical
ripening after previous Caesarean section. But because of the significant heterogeneity of the studies, substantial differences in study design, and insufficient numbers of pregnant women
included in the studies, it is not possible to make any evidence-based recommendations based on these studies. According to a recent meta-analysis, the average rate using balloon catheters
is approximately 53% and the average rate after spontaneous onset of labour is 72%. The uterine rupture rate was 0.2–0.9% for vaginal PGE
2
and 0.56–0.94% for balloon catheters and
is therefore comparable to the uterine rupture rate associated with spontaneous onset of labour. According to the product informations, hygroscopic cervical dilators (Dilapan-S) are
currently the only method which is not contraindicated for cervical ripening/induction of labour in women with previous Caesarean section, although data are insufficient. Well-designed,
randomised, controlled studies with sufficient case numbers comparing balloon catheters and hygroscopic cervical dilators with mechanical methods and vaginal prostaglandin E
2
/oral
misoprostol are therefore necessary to allow proper decision-making.
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Affiliation(s)
- Werner Rath
- Medizinische Fakultät, Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lars Hellmeyer
- Klinik für Gynäkologie und Geburtsmedizin, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Patrick Stelzl
- Universitätsklinik für Gynäkologie, Geburtshilfe und Gynäkologische Endokrinologie, Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Linz, Austria
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21
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Bothou A, Zervoudis S, Iliadou M, Pappou P, Iatrakis G, Tsatsaris G, Peitsidis P, Gerende A, Chalkidou A, Anthoulaki X, Nikolettos N, Tsikouras P. Breastfeeding and Breast Cancer Risk: Our Experience and Mini-review of the Literature. Mater Sociomed 2022; 34:28-32. [PMID: 35801066 PMCID: PMC9229285 DOI: 10.5455/msm.2022.33.28-32] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background: According to data from World Health Organization, breast cancer constitutes the second most common diagnosed malignancy after lung cancer and the second leading cause of death among women in 2020, worldwide. The protective role of breastfeeding in the emergence of breast malignancy has been mentioned in several studies, indicating the important part it can have in the effort of reducing breast cancer’s incidence. Objective: To investigate a possible association between breastfeeding and breast cancer risk in Greek women. Methods: Totally, 391 women participated in our case-control retrospective study. In the case group included 238 women with breast cancer, while in control group 153 women without breast cancer who were enrolled in two breast clinics in Greece. All women were examined clinically and with breast ultrasound, while those older than 40 years old also with bilateral digital mammography. Results: The x2 (chi-square) test found a statistically significant reverse correlation between breast cancer and breastfeeding ⩾12 months (cumulative) (p = 0.001). It was observed that the percentages of patients who breastfed ⩾12 months were lower than those of healthy women. Conclusion: Breastfeeding and particularly the cumulative period of ⩾12 months is related to the maximum of the protection from breast cancer.
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Affiliation(s)
- Anastasia Bothou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
- Neonatal Department, "Alexandra" General Hospital, Athens, Greece
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | | | - Maria Iliadou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
| | - Panagiota Pappou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
| | - Georgios Iatrakis
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
- REA Hospital, Athens, Greece
| | - Georgios Tsatsaris
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - Panagiotis Peitsidis
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
- REA Hospital, Athens, Greece
| | - Aggeliki Gerende
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - Anna Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - Xanthi Anthoulaki
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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22
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Peitsidis P, Vrachnis N, Sifakis S, Katsetos C, Tsikouras P, Antonakopoulos N, Alexopoulos E, Kalmantis K. Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review. Exp Ther Med 2021; 23:36. [PMID: 34849151 PMCID: PMC8613536 DOI: 10.3892/etm.2021.10958] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/18/2021] [Indexed: 11/11/2022] Open
Abstract
Narrow-band imaging (NBI), an on-demand, real-time endoscopic imaging technique, was developed to enhance visualization of the mucosal vascular network and surface texture. The present article provides a systematic review of studies that assessed the use of NBI in gynecological endoscopy. The following electronic databases were searched: PubMed (1950-2020), Google Scholar (2004-2020) and Cochrane Library (2010-2020). In the initial search, 3,836 entries were identified, of which 31 were finally included in the systematic review. Of the selected studies, 10 (32%) were case reports, 19 (61.2%) were prospective studies and 2 (6.4%) were randomized controlled trials with control groups. The selected studies reported on the use of NBI in hysteroscopy, laparoscopy and colposcopy. It was revealed that NBI utilization in hysteroscopy increased the accuracy, sensitivity and specificity in detecting malignant and premalignant lesions. NBI improved the specificity and sensitivity in the detection of endometriotic lesions and cervical lesions. Conventional white light endoscopy in gynecology may be significantly improved by the use of NBI. Further studies with larger cohorts and improved design are required to achieve more reliable results. It is of special interest that utilization of this method requires apparatus which is expensive; concerns are the long training and experience of staff required and the long learning curve.
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Affiliation(s)
- Panagiotis Peitsidis
- National Public Health Organization of Greece, Department of Obstetrics and Gynecology, Tzaneio Hospital, 18536 Piraeus, Greece.,Faculty of Midwifery, University of West Attica, 12243 Athens, Greece
| | - Nikolaos Vrachnis
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, 12462 Athens, Greece.,Department of Vascular Biology, Molecular and Clinical Sciences Research Institute, St. George's University of London, London SW17 0QT, UK
| | - Stavros Sifakis
- Department of Obstetrics and Gynecology, Mitera Hospital, 71202 Heraklion, Greece
| | - Christos Katsetos
- National Public Health Organization of Greece, Department of Obstetrics and Gynecology, Tzaneio Hospital, 18536 Piraeus, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece
| | - Nikolaos Antonakopoulos
- 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, 12462 Athens, Greece
| | - Evaggelos Alexopoulos
- Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, 11528 Athens, Greece
| | - Konstantinos Kalmantis
- Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, 11528 Athens, Greece
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23
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Bothou A, Apostolidi DM, Tsikouras P, Iatrakis G, Sarella A, Iatrakis D, Peitsidis P, Gerente A, Anthoulaki X, Nikolettos N, Zervoudis S. Overview of techniques to manage shoulder dystocia during vaginal birth. Eur J Midwifery 2021; 5:48. [PMID: 34723155 PMCID: PMC8527401 DOI: 10.18332/ejm/142097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/05/2021] [Accepted: 09/09/2021] [Indexed: 01/13/2023] Open
Abstract
Shoulder dystocia is an obstetric emergency which is unpredictable and complicates approximately 0.5-1% of vaginal births. This article discusses the risk factors and the associated fetal and maternal complications, while it is also an overview of techniques and algorithms to handle shoulder dystocia.
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Affiliation(s)
- Anastasia Bothou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.,Department of Obstetrics and Gynecology, Health Sciences School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitra-Maria Apostolidi
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Health Sciences School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Iatrakis
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.,REA Maternity Hospital, Athens, Greece
| | - Aggeliki Sarella
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | | | - Panagiotis Peitsidis
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.,REA Maternity Hospital, Athens, Greece
| | - Aggeliki Gerente
- Department of Obstetrics and Gynecology, Health Sciences School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Xanthoula Anthoulaki
- Department of Obstetrics and Gynecology, Health Sciences School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Health Sciences School, Democritus University of Thrace, Alexandroupolis, Greece
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24
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Tsikouras P, Kourti V, Gerede A, Kiosse E, Panopoulou M, Zervoudis S, Bothou A, Iatrakis G, Gaitatzi F, Vatsidou X, Chalkidou A, Nikolettos K, Alexiou A, Peitsidis P, Lambropoulou M, Michalopoulos S, Nikolettos N, Rafailidis P. Impact of SARS-CoV-2 on pregnancy outcomes (Review). Med Int (Lond) 2021; 1:19. [PMID: 36698529 PMCID: PMC9829087 DOI: 10.3892/mi.2021.19] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/25/2021] [Indexed: 01/28/2023]
Abstract
The impact of the pandemic outbreak associated with coronavirus 2019 disease (COVID-19) on pregnant women is of interest to obstetricians and gynecologists due to the vulnerability of this target group. In pregnant women and their infants, an exceptional clinical management is warranted. Current epidemiological findings provide information regarding the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant patients and potential adverse perinatal outcomes. Overall, these findings are a strong indication that an increased antenatal surveillance for pregnant patients infected with COVID-19 is warranted. The aim of the present narrative review was to summarize the data obtained to date regarding the health of women during pregnancy, as well as that of the fetus associated with the risk of severe infection due to COVID-19. The present review aimed to provide further insight into the effects of this pandemic on pregnancy, also providing the experience of the authors on this matter as an example.
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Affiliation(s)
- Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Vasiliki Kourti
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Aggeliki Gerede
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Eleni Kiosse
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Panopoulou
- Laboratory of Clinical Microbiology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Stefanos Zervoudis
- Technological Educational Institute of Athens and Rea Maternity Hospital, 175 64 Athens, Greece
| | - Anastasia Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - George Iatrakis
- Technological Educational Institute of Athens and Rea Maternity Hospital, 175 64 Athens, Greece
| | - Fotini Gaitatzi
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Xanthi Vatsidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Anna Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Konstantinos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Alexis Alexiou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Panagiotis Peitsidis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Lambropoulou
- Department of Histology and Embryology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Spyridon Michalopoulos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Petros Rafailidis
- Second Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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25
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Bothou A, Zervoudis S, Tsatsaris G, Pappou P, Liadopoulou M, Iatrakis G, Gerende A, Chalkidou A, Nikolettos N, Tsikouras P. Neonatal Birth Weight of the Woman as a Risk Factor for Breast Cancer in her Life: a Case-Control Bicentric Study. Mater Sociomed 2021; 33:119-123. [PMID: 34483740 PMCID: PMC8385737 DOI: 10.5455/msm.2021.33.119-123] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/16/2021] [Indexed: 11/03/2022] Open
Abstract
Background It is a global fact that the birth weight is increasing during the years around the world and for this reason it is very important to be examined as a potential risk factor for breast cancer. According to data from World Health Organization, breast cancer is the second most frequent malignancy across the world, after lung cancer, in Europe including Greece in incidence and mortality for women between the ages 0-85 years old. Objective The aim of this study was to investigate a possible association between neonatal birth weight of the women and breast cancer risk in Greek women. Although that many studies concluded that birth weight is positively related with breast cancer reinforcing the theory that breast cancer may originate in utero, some studies found no association. Moreover, the results from previous studies are inconsistent maybe due to several factors such as the study design and the number of cases. Methods This study was a case-control retrospective bicentric study. The case group included 238 women with breast cancer, while the control group included 153 women without breast cancer who consulted in two breast clinics in Greece. In all women, a clinical examination and breast ultrasound were achieved. Moreover, digital bilateral mammography was performed in patients older than 40 years. Results According to Fisher's exact analysis, there is a statistically significant relationship between the higher women's neonatal birth weight and the risk for breast cancer (p<0.001). More specifically in the group of women with breast cancer, 61% of them had more than 3500 grams birth weight, in contrast with 7.8 % in the control group. In our cohort, women who had birth weight more than 3500 grams are more likely to develop breast cancer in their life. Conclusion Our study trend to show that the increased neonatal birth weight may influence future risk of breast cancer. However, further studies with larger number of participants are needed in order to clarify the role of birth weight as a complementary risk factor of breast cancer.
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Affiliation(s)
- Anastasia Bothou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece.,Neonatal Department, "Alexandra" General Hospital, Athens, Greece.,Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | | | - Georgios Tsatsaris
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Panagiota Pappou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
| | - Maria Liadopoulou
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece
| | - Georgios Iatrakis
- Department of Midwifery, University of West Attica (UniWA), Athens, Greece.,REA Hospital, Athens, Greece
| | - Aggeliki Gerende
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Anna Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece
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26
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Abstract
Dyslipidemia represents a major risk factor for cardiovascular disease. In addition, severe hypertriglyceridemia is an important cause of acute pancreatitis. Accordingly, the increase in serum lipid levels that are observed during pregnancy have potentially important implications. The management of dyslipidemia in pregnancy is further complicated by the lack of safety data during this period for most of the lipid-lowering agents. In the present review, we discuss the most important lipid disorders in pregnant women and their management. Pregnancy is characterized by increases in both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, which might result in severe complications both for the mother and the fetus. Accordingly, LDL-C and triglyceride levels should be monitored during pregnancy, particularly in women with a history of dyslipidemia. Diet is the mainstay of management of dyslipidemia in pregnant women and apheresis can also be considered in patients with homozygous familial hypercholesterolemia or severe hypertriglyceridemia. However, there is a pressing need for studies that with evaluate the safety of lipid-lowering agents during pregnancy.
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Affiliation(s)
- Anastasios Liberis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Stamatis Petousis
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Panagiotis Tsikouras
- Second Department of Obstetrics and Gynecology, Medical School, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece
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27
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Rath W, Tsikouras P, Schlembach D. [Ambulatory and Home Blood Pressure Measurement in Hypertensive Pregnant Women]. Z Geburtshilfe Neonatol 2020; 224:333-338. [PMID: 33276403 DOI: 10.1055/a-1266-7401] [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: 10/22/2022]
Abstract
The prevalence of hypertensive disorders in pregnancy (HDP) is 6-8%. Blood pressure measurement (BPM) remains the cornerstone of diagnosis and should be performed in a standardised manner using automated devices. Office BPM represents only a spotty reading in an "artificial" environment failing to diagnose white coat hypertension (WCH). Ambulatory and home blood pressure measurement (ABPM/HBPM) are recommended for the diagnosis and differentiation of hypertension as well as for blood pressure and therapy control in women with HDP. Patient compliance is crucial for the use of both methods. ABPM is an appropriate method for the early identification of WCH and masked hypertension as well as for differentiating WCH from chronic hypertension < 20 week's gestation. HBPM has been shown to reduce the number of antenatal visits and hospital admissions compared to office blood pressure measurement without compromising maternal and fetal outcomes; it also avoids unnecessary antihypertensive medications and reduces the rate of labour inductions and false diagnosis of "preeclampsia". Problems associated with ABPM are its limited availability and inconvenience to patients due to sleep disturbances. Disadvantages of HBPM are the need for patient training, potential measurement errors, and the lack of evidence-based BP thresholds. The widespread use especially of HBPM may contribute to a reduction in workload of obstetric staff in the hospital and may save hospital expense.
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Affiliation(s)
- Werner Rath
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Komotini, Greece
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Gyroglou S, Babageorgaka I, Tsikouras P. Clinical occurrence and management of abdominal pain in adolescent girls. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718094] [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: 10/23/2022] Open
Affiliation(s)
- S Gyroglou
- Democritus University of Thrace, Department of Obstetrics and Gynecology
| | - I Babageorgaka
- Democritus University of Thrace, Department of Obstetrics and Gynecology
| | - P Tsikouras
- Democritus University of Thrace, Department of Obstetrics and Gynecology
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Anthoulaki X, Deuteraiou D, Tsikouras P. Postnatal colonization of neonatal intestine after vaginal seeding. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717981] [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: 10/23/2022] Open
Affiliation(s)
- X Anthoulaki
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - D Deuteraiou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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Deuteraiou D, Tologos S, Papadatou B, Tsikouras P, Lambropoulou M. Apoptosis and first trimester abortions. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717979] [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: 10/23/2022] Open
Affiliation(s)
- D Deuteraiou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - S Tologos
- Department of Embryology, Democritus University of Thrace
| | - B Papadatou
- Department of Embryology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - M Lambropoulou
- Department of Embryology, Democritus University of Thrace
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Tsirkas I, Tsirkas T, Tsikouras P. Current update of higher education school students in thraki area on contraception and sexually transmitted diseases. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718095] [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: 10/23/2022] Open
Affiliation(s)
- I Tsirkas
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - T Tsirkas
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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Babageorgaka I, Chalkidou A, Bothou A, Tsikouras P. Current update of secondary education school students in thraki area in contraception and sexually transmitted diseases. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718096] [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: 10/23/2022] Open
Affiliation(s)
- I Babageorgaka
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - A Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - A Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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Sibbas T, Kokovidou T, Tsikouras P. Association of STD with abortions and preterm labor. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717980] [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: 10/23/2022] Open
Affiliation(s)
- T Sibbas
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - T Kokovidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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Chalil Bourazan A, Chalkidou A, Bothou A, Tsikouras P. A questionnaire survey on the selection of contraception methods by two students religious groups. Preliminary results. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718097] [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: 10/23/2022] Open
Affiliation(s)
- A Chalil Bourazan
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - A Chalkidou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - A Bothou
- Department of Obstetrics and Gynecology, Democritus University of Thrace
| | - P Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace
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Stanoulov G, Chalil BA, Tsikouras P. Menstruation behavior after use of emergency contraception: Ulipristal acetate versus levonorgestrel in women of reproductive age. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717696] [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: 10/23/2022] Open
Affiliation(s)
- G Stanoulov
- Democritus University of Thrace, Department of Obstetrics and Gynecology
| | - Bourazan A Chalil
- Democritus University of Thrace, Department of Obstetrics and Gynecology
| | - P Tsikouras
- Democritus University of Thrace, Department of Obstetrics and Gynecology
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Koukoulomati A, Tsikouras P. Evaluation of cervical pap smears in a sampling of young women in reproductive age from a family planning center. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718192] [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: 10/23/2022] Open
Affiliation(s)
- A Koukoulomati
- Democritus University of Thrace, Department of Obstetrics and Gynecology
| | - P Tsikouras
- Democritus University of Thrace, Department of Obstetrics and Gynecology
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Zervoudis S, Iatrakis G, Daures JP, Bothou A, Aranitis V, Patralexis X, Tsatsaris G, Navrozoglou I, Tsikouras P, Paschopoulos M. Ductoscopy Coupled to Duct Lavage and Duct Brushing in Pathologic Nipple Discharge: Our Experience. Chirurgia (Bucur) 2020; 115:334-340. [PMID: 32614288 DOI: 10.21614/chirurgia.115.3.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE to present our experience in the management of pathological nipple discharge using the procedure D.DL.DB: "ductoscopy" (D) coupled to "duct lavage" (DL) plus "duct brushing" (DB) for etiologic diagnosis. Also to compare the diagnosis obtained with D.DL.DB to the final histology. MATERIAL AND METHOD Eighty-five patients with organic unilateral nipple discharge were enrolled in two Breast Units. 82 of 85 patients were investigated successfully with D.DL.DB. Results:: The final histological results were: papilloma 46.3%, duct ectasia 36.5%, breast cancer 8.5%, precancer lesions 4.9%, and mixed benign lesions 3.8%. Pyramidectomy and radical ductectomy were performed in 76 and 6 cases respectively. In 80% of the cases, DLDB cytology results were identical to the final histology. (Kappa=0;69 CI=[0.56 -0.82]. The sensitivity of D.DL.DB versus pathology, for cancer or precancer lesions was 81.8% (CI=0.59 -1) and the specificity was 97.1% (CI=0.93 -1). Using Koch scale, the concordance between the two methods D.DL.DB and surgery was high and the sensitivity was in the upper range regarding the literature (58% to 90%). CONCLUSION Our experience confirms the high value of D.DL.DB in the management of organic nipple discharge.
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Rath W, Tsikouras P, Stelzl P. HELLP Syndrome or Acute Fatty Liver of Pregnancy: A Differential Diagnostic Challenge: Common Features and Differences. Geburtshilfe Frauenheilkd 2020; 80:499-507. [PMID: 32435066 PMCID: PMC7234826 DOI: 10.1055/a-1091-8630] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/15/2019] [Accepted: 01/08/2020] [Indexed: 12/17/2022] Open
Abstract
HELLP syndrome and the less common acute fatty liver of pregnancy (AFL) are unpredictable, life-threatening complications of pregnancy. The similarities in their clinical and laboratory presentations are often challenging for the obstetrician when making a differential diagnosis. Both diseases are characterised by microvesicular steatosis of varying degrees of severity. A specific risk profile does not exist for either of the entities. Genetic defects in mitochondrial fatty acid oxidation and multiple pregnancy are considered to be common predisposing factors. The diagnosis of AFL is based on a combination of clinical symptoms and laboratory findings. The Swansea criteria have been proposed as a diagnostic tool for orientation. HELLP syndrome is a laboratory diagnosis based on the triad of haemolysis, elevated aminotransferase levels and a platelet count < 100 G/l. Generalised malaise, nausea, vomiting and abdominal pain are common symptoms of both diseases, making early diagnosis difficult. Clinical differences include a lack of polydipsia/polyuria in HELLP syndrome, while jaundice is more common and more pronounced in AFL, there is a lower incidence of hypertension and proteinuria, and patients with AFL may develop encephalopathy with rapid progression to acute liver failure. In contrast, neurological symptoms such as severe headache and visual disturbances are more prominent in patients with HELLP syndrome. In terms of laboratory findings, AFL can be differentiated from HELLP syndrome by the presence of leucocytosis, hypoglycaemia, more pronounced hyperbilirubinemia, an initial lack of haemolysis and thrombocytopenia < 100 G/l, as well as lower antithrombin levels < 65% and prolonged prothrombin times. While HELLP syndrome has a fluctuating clinical course with rapid exacerbation within hours or transient remissions, AFL rapidly progresses to acute liver failure if the infant is not delivered immediately. The only causal treatment for both diseases is immediate delivery. Expectant management between 24 + 0 and 33 + 6 weeks of gestation is recommended for HELLP syndrome, but only in cases where the mother can be stabilised and there is no evidence of foetal compromise. The maternal mortality rate for HELLP syndrome in developed countries is approximately 1%, while the rate for AFL is 1.8 – 18%. Perinatal mortality rates are 7 – 20% and 15 – 20%, respectively. While data on the long-term impact of AFL on the health of mother and child is still insufficient, HELLP syndrome is associated with an increased risk of developing cardiovascular, metabolic and neurological diseases in later life.
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Affiliation(s)
- Werner Rath
- Medizinische Fakultät, Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Panagiotis Tsikouras
- Democritus University of Thrace, Department of Obstetrics and Gynecology, Alexandroupolis, Greece
| | - Patrick Stelzl
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
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Souftas V, Deuteraiou D, Anthoulaki X, Chalkidou A, Bothou A, Gaidatzi F, Tsypsianis G, Iatrakis G, Zervoudis S, Souftas D, Michalopoulos S, Vogiatzaki T, Galazios G, Nikolettos N, Tsikouras P. Significance of changes in inflammatory parameters following uterine artery embolization in pre-menopausal females. Exp Ther Med 2020; 19:3684-3690. [PMID: 32346432 PMCID: PMC7185183 DOI: 10.3892/etm.2020.8652] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/19/2019] [Indexed: 12/29/2022] Open
Abstract
The purpose of the present study was to describe the course of changes in laboratory inflammatory markers following bilateral uterine artery embolization (UAE) as a treatment for leiomyomas and adenomyosis. The body temperature was measured and blood samples were collected to determine white blood cell (WBC) count and C-reactive protein (CRP) levels in 270 patients on the day prior to UAE and for up to 4 days post-embolization. Aside from a single case with a non-inflammatory complication, none of the other cases had any complications. Post-UAE leukocytosis with a mean maximum value of 10.8±3.5x109/l (range, 5.9-18.6x109/l) was observed one-year post-intervention. The mean leukocyte numbers were indicated to be higher on day 3 post-UAE. The CRP level was also increased post-UAE, with a mean maximum value of 7.75±3.5 mg/dl. Maximum levels were reached in 8 patients on the 2nd and in 11 patients on the 3rd post-operative day. The maximum pain score was ~5.5 and reached its lowest level at the end of the 12th week post-intervention. The present study did not consider an association between the embolic material used or uterus size with the level of treatment success. No complications were observed post-UAE; however, a significant increase in the WBC count was observed within the first 3 days, indicating mild leukocytosis.
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Affiliation(s)
- Vasileios Souftas
- Department of Interventional Radiology and Medical Imaging, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Dorelia Deuteraiou
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Xanthoula Anthoulaki
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Anna Chalkidou
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Anastasia Bothou
- Department of Obstetrics and Mastology, Rea Hospital, Athens 17564, Greece
| | - Fotini Gaidatzi
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Grigorios Tsypsianis
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Georgios Iatrakis
- University of West Attica, Department of Midwifery, Athens 17564, Greece
| | - Stefanos Zervoudis
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Dimitrios Souftas
- Department of Social Administration, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Spyridon Michalopoulos
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Theodosia Vogiatzaki
- Department of Anesthesiology and Pain Treatment, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - George Galazios
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Nikolaos Nikolettos
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Medical Faculty, Democritus University of Thrace, Alexandroupolis 68100, Greece
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Bothou A, Zervoudis S, Tsatsaris G, Iatrakis G, Deuteraiou D, Anthoulaki X, Galazios G, Tsikouras P. Maternal and paternal age at birth and the risk of breast cancer in Greek women: a case-control study. J BUON 2020; 25:662-665. [PMID: 32521850] [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: 06/11/2023]
Abstract
PURPOSE To investigate the possible association between maternal and paternal age and breast cancer in Greek women. METHODS This study enrolled 238 women with breast cancer and 153 healthy women as control group. All participants were examined clinically and with breast ultrasound and those older than 40 years, also with digital mammography. RESULTS A statistically significant positive correlation was observed between the age of the father (x2=52.985, p<0.001) and the mother (x2=34.838, p=0.001). More specifically, in breast cancer patients, the majority of their mothers (45.4%) was over 30 years of age and their fathers' age (48.3%) was over 37 years of age. CONCLUSIONS Our study found that as the age of the father and mother increases, the incidence of breast cancer increases in parallel. Further studies with larger number of patients are necessary in order to clarify the real role of parental age as a risk factor of breast cancer.
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Affiliation(s)
- Anastasia Bothou
- Democritus University of Thrace, Department of Obstetrics and Gynecology, Alexandroupolis, Greece
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Chloropoulou PP, Konstantinou F, Nikitidis N, Tsikouras P, Vogiatzaki T. Anesthetic Management of a Parturient With Cardiac Tamponade due to Heart Perforation by an Atrial Septum Defect Repair Device. A A Pract 2020; 14:116-118. [DOI: 10.1213/xaa.0000000000001161] [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: 11/05/2022]
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42
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Bothou A, Tsikouras P, Zervoudis S, Tsatsaris G, Anastasopoulos G, Iatrakis G, Lykeridou K, Deuteraiou D, Anthoulaki X, Chalkidou A, Galazios G. Blood groups type linked to breast cancer in a Greek cohort of women - a case control study. J BUON 2019; 24:1884-1888. [PMID: 31786851] [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: 06/10/2023]
Abstract
PURPOSE To investigate the possible association between ABO blood types and breast cancer in Greek women. METHODS 202 female patients with breast cancer and 139 healthy women as control group were examined clinically and with breast ultrasound and those older than 40 years, also with bilateral digital mammography. RESULTS In the case-group, 26.7% had blood group O, 5.5% had blood group B, 61.9% had blood group A and 5.9% had blood group AB. In the control-group, 47.5% had blood group O, 13.7% had blood group B, 31.6% had blood group A and 7.2% had blood group AB. Usage of diagrams with the percentages of frequency, the average control, Pearson, Spearman, Student's t-tests analyzed with SPSS statistical software showed a significant correlation between breast cancer and blood group A (p<0.01). CONCLUSIONS Although in the literature it is controversial whether ABO/Rh blood groups have association with breast cancer, the results of our study show a significant correlation between breast cancer and blood group A.
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Affiliation(s)
- Anastasia Bothou
- Democritus University of Thrace, Department of Obstetrics and Gynecology, Alexandroupolis, Greece
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Gyroglou S, Anthoulaki X, Deuteraiou D, Chalkidou A, Manav B, Galazios G, Souftas V, Tsikouras P. Amenorrhea incidence among symptomatic premenopausal women with uterine fibroids after uterine artery embolization (UAE). Our experience. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4952.2019] [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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44
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Zervoudis S, Xepapadakis G, Psarros N, Bothou A, Tsikouras P, Galazios G, Kontogianni P, Papazian M, Navrozoglou I, Iatrakis G, Paschopoulos M. Management of malignant and borderline phyllodes tumors of the breast: our experience. J BUON 2019; 24:1521-1525. [PMID: 31646802] [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: 06/10/2023]
Abstract
PURPOSE Phyllodes breast tumors (PT) range from benign lesions to malignant ones that may give distant metastasis. Preoperative diagnosis is difficult, while the treatment of borderline and malignant disease remains controversial. METHODS Eighteen patients in 3 clinics were included in the study. Lumpectomy with large margins was performed in 15 patients, while mastectomy was performed in 3 patients. Lymph node excision was carried out in 3 patients with malignant tumors. Radiation therapy (RT) was delivered after a second lumpectomy in cases of local recurrence. Chemotherapy was used only in 2 patients with aggressive recurrent tumors. RESULTS Borderline behavior was reported in 4 patients. Lumpectomy was performed in these cases, with local recurrence in 2 of them. Malignant behavior was reported in 14 patients. Lumpectomy was performed in 10 patients and mastectomy in 3. Local recurrence was reported in 5 cases and in 2 patients recurrence after a 2nd operation was also reported. CONCLUSIONS Borderline PT were treated conservatively and the prognosis was excellent, while malignant subtypes needed mastectomy in about 25% of the cases, The local recurrence rate was high, but the disease free survival (DFS) and the overall survival (OS) were also very high (94%).
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Affiliation(s)
- Stefanos Zervoudis
- Rea Hospital, Breast Clinic and Greek-French Breast Unit, Athens, Greece
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Panagiotou E, Tsikouras P, Bothou A, Fotopoulos S, Zervoudis S, Deuteraiou D, Chalil AB, Trypsianis G, Galazios G. A comparative study of the contribution of antenatal corticosteroids administration on improving neonatal respiratory function after elective cesarean section. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4613.2019] [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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46
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Koliakos G, Tsagias N, Kouzi K, Tsikouras P, Kasapi E. Stem cells from follicular fluid present multilineage differentiation capacity and form oocyte-like structures under the influence of FSH hormone. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.481] [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: 10/26/2022]
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47
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Deftereou T, Trypsianis G, Tologkos S, Papadatou V, Tsikouras P, Simopoulou M, Meditskou S, Papamitsou T, Alexiadis T, Lambropoulou M. Immunohistochemical study and evaluation of apoptosis’ role during trophoblast differentiation in normal and abnormal pregnancies. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.317] [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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48
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Wang GL, Tsikouras P, Zuo HQ, Huang MQ, Peng L, Bothou A, Zervoudis S, Tobias Teichmann A. Radioactive seed localization and wire guided localization in breast cancer: A systematic review and meta-analysis. J BUON 2019; 24:48-60. [PMID: 30941951] [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: 06/09/2023]
Abstract
PURPOSE Classically, wire-guided localization (WGL) is used for the localization of non palpable breast lesions. On the other hand, many studies report a newer technique called radioactive seed localization (RSL). The purpose of our study was a systematic review and meta analysis of the two techniques regarding the rate of positive margins and the quantity of excised tissue. METHODS Our study searched publications up to March 24th 2018 in Medline, Embase and Cochrane Library regarding studies comparing the two techniques of localization of subclinical lesions with WGL or RSL using technetium 99m as radioactive agent. The primary target was the rate of positive margins and the second was the rate of second surgery for reexcision. Revman5.3 and STATE12.0 were used for the statistics. RESULTS Five randomized controlled trials (RCTs) and 13 cohort studies comprising 3879 breast cancer patients were included. RSL was significantly superior than WGL both in better margin status (RR=0.72, 95% CI 0.56-0.92, p=0.01) and reduced reoperation rate (RR=0.68, 95% CI 0.52-0.88, p=0.004). Subgroup analysis of RCTs showed no different ability of both techniques in terms of free margin status (RR=0.85, 95% CI 0.55-1.31, p=0.46) and reoperation rate (RR=0.80, 95% CI 0.48-1.32, p=0.38). Further subgroup analysis excluding three studies with different ductal carcinoma in situ (DCIS) proportion exhibited same efficacy in margin negativity (RR=0.83, 95% CI 0.69-1.01, p=0.07) and further operation rate (RR=0.85, 95% CI 0.71-1.01, p=0.07).
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Affiliation(s)
- Gui-Lin Wang
- Department of Breast Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
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Tamiolakis D, Venizelos I, Lambropoulou M, Jivannakis T, Seliniotaki E, Tsikouras P, Limberis V, Tsalkidis A, Papadopoulos N. Gains and Losses of HLA Class II (DR) and CD4 in Atypical Hyperplasia, Carcinoma in situ and Infiltrating Ductal Carcinoma of the Breast. Acta Med (Hradec Kralove, Czech Repub ) 2018. [DOI: 10.14712/18059694.2018.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: Breast cancer is a frequent cause of death among women with gynaecologic malignancies despite the introduction of combination chemotherapy. There is therefore a need for new therapeutic strategies for patients with breast cancer, such as cellular immunotherapy. In this immunohistochemical study we analyzed the epithelial expression of major histocompatibility complex (MHC) class II (HLA-DR) on atypical and malignant primary mammary epithelial cells, as well as the magnitude of the stromal T lymphocytes (T4 subset) at the tumor site. Experimental design: The study was carried out retrospectively in tumor tissue from 82 patients with mammary lesions (31 cases of atypical ductal hyperplasia -ADH-, 12 cases of ductal carcinoma in situ –DCIS- and 39 cases of infiltrating ductal carcinoma not otherwise specified -IDC-NOS). Medullary carcinomas were not included in our investigation. Material used had been formalin fixed and paraffin embedded. Results: HLA class II (DR) was expressed in 20 of 31 ADHs (64.5%), in 4 of 12 DCISs (33.3%), and in 10 of 39 IDC-NOSs (25.6%). CD4 was expressed in 9 of 31 ADHs (29%), in 5 of 12 DCISs (42%), and in 26 of 39 IDCNOSs (67%). Conclusions: The results showed decreased epithelial expression of HLA class II (DR) and increased stromal expression of CD4, as the lesion progressed to malignancy. Gradual loss of epithelial HLA class II expression might be a manifestation of cellular differentiation from the atypical form versus the malignant one, signaling simultaneously a selective effect on the response capacity of the immune system.
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Affiliation(s)
- Werner Rath
- Faculty of Medicine, Obstetrics and Gynecology, University Hospital
Schleswig–Holstein, Kiel, Germany
- Werner Rath, Faculty of Medicine, Obstetrics and
Gynecology, University Hospital Schleswig–Holstein, Campus Kiel, Arnold-Heller-Str 3,
D-24105 Kiel, Germany.
| | | | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Democritus University of Thrace,
Alexandroupolis, Greece
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