Search

Background and Clinical Significance: Retrorectal cystic hamartomas ("Tailgut cysts") are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. Case Presentation: We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms, were not associated. During a period of 3 years, she underwent several surgical procedures for ovarian cysts, without relieving the symptomatology. A computed tomography (CT) scan showed a presacral tumor with a right pararectal development. A surgical resection of the lesion using an anterior approach was performed, with the final pathological diagnosis of a retrorectal cystic hamartoma ("tailgut cyst"). Conclusions: This case underlines the fact that retrorectal masses can be challenging to diagnose, and tailgut cysts must be taken into consideration in cases of perirectal tumors in patients with a history of multiple failed procedures and surgeries. [ABSTRACT FROM AUTHOR]

Endometriosis, a chronic hormone-dependent condition affecting 10% of women globally, impacts pelvic organs and occasionally distant sites, causing pain, infertility, and sexual dysfunction. Biomarkers such as IL-8, IL-10, and BDNF influence inflammation, nerve sensitization, and pain. This study investigates their relationship with sexual quality of life, focusing on dyspareunia and related dysfunctions, as assessed using the Female Sexual Function Index (FSFI). Dyspareunia, a prominent symptom of endometriosis, is linked to lower FSFI scores in domains such as desire (mean 3.38), satisfaction (mean 3.28), and pain (mean 3.07). Elevated IL-8 tissue levels negatively correlated with desire (r = −0.649, p < 0.05) and satisfaction (r = −0.813, p < 0.01). Similarly, higher BDNF tissue levels were associated with increased pain (r = −0.435, p < 0.01) and reduced satisfaction (r = −0.252, p < 0.05). Patient factors such as higher endometriosis severity scores (mean 26.3, p < 0.05) and surgical history correlated with lower desire and satisfaction. Conversely, physical activity improved pain scores (p < 0.01) and enhanced desire and lubrication (p < 0.05), likely through reduced inflammation and better circulation. These findings highlight the complex interplay between biomarkers, individual factors, and sexual dysfunction in endometriosis, underscoring the need for personalized therapeutic approaches. [ABSTRACT FROM AUTHOR]

Parvovirus B19 (B19V) infection is the cause of erythema infectiosum, or the "fifth disease", a widespread infection, potentially affecting 1–5% of pregnant women, in most cases without significant damage to the pregnancy or fetus. It follows a seasonal variation, with a higher prevalence in temperate climates, mainly in late winter and early spring. Women at increased risk include mothers of preschool and school-age children, and those working in nurseries, kindergartens, and schools. Vertical transmission occurs in 33% to 51% of cases of maternal infection. Parvovirus infection is an important cause of fetal perinatal infection resulting in increased morbidity through the development of fetal anemia, heart failure, and non-immune hydrops. A comprehensive literature review was conducted using PubMed, Cochrane Library, and Google Scholar, focusing on publications from the last 10 years and prioritizing studies related to parvovirus B19 infection in pregnancy. We summarized the existing data in the literature on the effects of parvovirus B19 infection during pregnancy and weighed if there is a need for screening in pregnant patients. Routine screening for parvovirus B19 infection can be considered in communities where infection is common, there is occupational exposure, or during endemic periods, with the reason being that accurate identification and treatment of fetuses affected by congenital B19V infection have been shown to improve perinatal outcomes. [ABSTRACT FROM AUTHOR]

Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP) is a rare uterine tumor primarily affecting perimenopausal and postmenopausal women, typically aged between 45 and 55 years. Characterized by ambiguous histological features, STUMPs present diagnostic challenges as they cannot be definitively classified as benign or malignant based on morphology alone. This systematic review aims to elucidate the clinical, pathological, immunohistochemical, and treatment-related characteristics of STUMPs through an analysis of the literature from the past 20 years. The study follows PRISMA guidelines, utilizing comprehensive searches of PubMed and Scopus databases, yielding 32 studies that meet the inclusion criteria. From the analysis of these studies, it was revealed that the clinical presentations vary from common symptoms such as abnormal uterine bleeding and pelvic pain to incidental detection of uterine mass. Histologically, STUMPs demonstrate features overlapping with both leiomyomas and leiomyosarcomas, including mild nuclear atypia, low mitotic indices, and focal necrosis. Immunohistochemical markers such as p16 and p53 have been investigated for prognostic significance. Elevated p16 expression, often associated with aggressive behavior, was observed in a subset of STUMPs. Surgical management, typically involving hysterectomy or tumorectomy, is the primary treatment, though the extent of resection is variable. Adjuvant therapies are not routinely recommended, but long-term surveillance is advised, especially for high-risk patients. Recurrence rates for STUMPs are approximately 12%, with factors such as high mitotic counts and coagulative necrosis indicating higher risk. This review highlights the complexity of STUMP diagnosis and management, emphasizing the need for more precise diagnostic criteria and individualized treatment strategies. Understanding the morphological, immunohistochemical, and clinical behavior of STUMPs can improve patient outcomes and guide future research in this diagnostically challenging area. [ABSTRACT FROM AUTHOR]

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain, and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis. [ABSTRACT FROM AUTHOR]

Disseminated peritoneal leiomyomatosis (DPL) is a rare condition marked by multiple leiomyomas in the peritoneal cavity, predominantly affecting women of reproductive age. Although typically benign, DPL can present significant diagnostic challenges and, in rare cases, may progress to malignancy. A primary contributing factor to DPL is iatrogenic, particularly due to surgical interventions such as morcellation during myomectomy. This scoping review explores the pathogenesis, epidemiology, diagnosis, and management of DPL, highlighting the crucial role of hormonal influences and iatrogenic factors. Diagnostic methods include computed tomography, ultrasound, magnetic resonance imaging, and histopathological evaluation, which are essential for assessing disease extent and guiding treatment. Management strategies encompass surgical intervention—with a focus on minimizing iatrogenic risks—conservative approaches for asymptomatic patients, and advancements in hormonal treatments. Emphasis is placed on preventing iatrogenic dissemination through refined surgical techniques and patient education. Despite its rarity, with fewer than 200 cases reported globally, understanding DPL's clinical presentation and iatrogenic origins is vital for optimal patient outcomes. This review underscores the importance of early diagnosis, personalized treatment plans, and ongoing research to address the challenges associated with DPL. [ABSTRACT FROM AUTHOR]

Abdominal cystic masses are diagnosed during the intrauterine period and have a relatively low incidence. Fetal ovarian cysts are the most common form diagnosed prenatally or immediately after birth. The pathophysiology of the development of these types of tumors is not fully elucidated, with ovarian hyperstimulation caused by maternal and placental hormones being the most accepted hypothesis. During intrauterine development, the diagnosis of fetal ovarian cysts is most often made accidentally during usual check-up ultrasounds corresponding to the first, second, and third trimesters of pregnancy. We conducted a scoping review with the aim to map the current knowledge regarding the treatment of fetal ovarian cysts diagnosed in the intrauterine period. Focusing on the articles published in the last 10 years in the specialized literature, we tried to identify a conceptualization regarding the surveillance and treatment of these anomalies. [ABSTRACT FROM AUTHOR]

A fetus identified to be at risk for chromosomal abnormalities may benefit from identification of genetic defects through amniocentesis. Although the risks associated with amniocentesis are considered to be minimal, being an invasive procedure it is not completely without complications. Background and Objectives: The current study aims to identify correlations between blood contamination of samples collected during amniocentesis and certain factors dependent on the instruments used (thickness of the needle used to aspirate the fluid), the location of the placenta, and uterine vascularity (more pronounced in multiparous patients). Materials and Methods: The study included 190 patients in the second trimester of pregnancy who met one of the criteria for invasive prenatal diagnosis (age over 35 years, high risk in first trimester screening, history of pregnancies with genetic abnormalities, etc.). The amniotic fluid samples collected from these patients were analyzed in terms of blood contamination of the amniotic fluid aspirated with maternal cells Results: Of the patients in whom the procedure was performed using 21 G size needles, 16 samples (13.33% of the total) were contaminated. None of the samples collected from patients where a 20 G needle was used were contaminated. There was a statistically significant association between the lack of contamination and the use of Doppler ultrasound in multiparous patients with anterior placenta in whom a 21-gauge needle was used for amniocentesis. Conclusions: There is an increased rate of sample contamination (statistically significant) when using 21 G needle sizes and a significant difference in contamination between primiparous and multiparous patients, with contamination being more frequent in multiparous patients. The use of Doppler ultrasonography may benefit the procedure, as the contamination rate was significantly reduced when used during amniocentesis. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is one of the most common malignancies in women in terms of prevalence and mortality. Cervical cancer has some particularities that distinguish it from any other oncologic pathology: first, it is completely preventable by prompt detection of its precursor, cervical intraepithelial neoplasia (CIN); second, the Human Papillomavirus (HPV) infection is a known etiological agent; third, the mean age at diagnosis is much lower than in other oncologic conditions, as a consequence of the sexually-transmitted HPV. Methods: We evaluated the expression level of several long noncoding RNAs and a microRNA in samples from 30 patients with CIN, 9 with cervical cancer and 38 normal samples using qRT-PCR technology. Results: We observed higher expression levels for MEG3, DAPK1, MLH1 and MALAT1 in CIN samples than in normal samples, whereas TIMP3 and SOX1 had lower expression levels. For cancer samples, DAPK1, MLH1 and MALAT1 had higher expression, and MEG3, TIMP3 and SOX1 had lower expression when compared to normal samples. In the case of CIN versus cancer samples, only MEG3 gene showed a statistically significant difference. The expression of miR-205-5p was lower in both CIN and cancer samples compared to normal samples. Conclusion: Decreased MEG3 expression could be considered an alarm signal in the transition from a premalignant cervical lesion to invasive cancer, while altered expression levels of TIMP3, SOX1, MLH1, MALAT1 and miR-205-5p could serve as early biomarkers in the diagnosis of premalignant cervical lesions. Future studies, including a larger number of patients with CIN, will be of particular importance in validating these observations. [ABSTRACT FROM AUTHOR]

Purpose: Endometriosis has an incidence reaching up to 50% in infertile women. Cytokine-mediated immune responses seem to play an important role in endometriosis pathogenesis, but still the etiology and pathophysiology remain unclear. In the current study we tried to investigate whether there is a relationship between IL-10 genetic polymorphism, serum levels of IL-10 and the presence of advanced endometriosis.Methods: The presence of IL-10 592C/A, 819T/C, 1082G/A promoter polymorphisms and IL-10 serum levels were investigated in advanced endometriosis patients compared to healthy controls. Genomic DNA was extracted from peripheral blood leukocytes and further analyzed by PCR.Results: IL-10 serum levels were higher in endometriosis group compared to controls (1.48, 0.68, p < 0.001). We have observed an association between IL-10 592C/C and 819C/C genotypes, presence of C alleles and an increased risk of endometriosis. No difference was observed in IL-10 serum levels corresponding to different alleles or genotypes.Conclusion: Our results suggest that IL-10 592A/C and 819T/C promoter polymorphisms confer susceptibility to advanced endometriosis. No associations were found between the IL-10 1082A/G polymorphism and susceptibility to advanced endometriosis. [ABSTRACT FROM AUTHOR]

Background and aims. Endometriosis is a commonly encountered disorder in women of reproductive age, consisting of the presence of active ectopic endometrial tissue outside the endometrial cavity. Surgical scar endometriosis is a rare condition representing about 2% of all endometriosis cases. The purpose of this study was to assess the main characteristics, diagnostic tools and therapeutic options in abdominal wall endometriosis (AWE). Methods. We have reviewed a series of fourteen cases with histopathological confirmation of AWE that were managed in our institution. Results. The main characteristic of AWE were emphasized, showing that 78.57% of the patients had at least one previous caesarian section and that in only 57.14% of all cases an accurate diagnosis of AWE was established preoperatively. Conclusion. A direct relationship between gynecological and obstetrical surgery and AWE is well established and as the caesarian section rates increase constantly, the awareness regarding AWE should also be increased. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess the histological changes occurring in the vagina and vulva in ovariectomised female rats, as well as the response to the administration of injectable oestrogens.Material and Methods: We used 30 female Wistar white rats, distributed as follows: group 1 - the control group, group 2 - the operated but untreated rats, and groups 3, 4 and 5 - operated rats, to which oestrogenic treatment was administered (Estradiol, Estradurin, Sintofolin) at a dosage of 0.2 mg/rat/day. After 14 days of treatment, all animals were sacrificed and vaginal and vulvar biopsies were taken from all groups.Results: In group 2, we encountered structural changes of the vaginal mucosa, with severe atrophy and alterations in the thickness of the vagina and vulva. In groups 3, 4 and 5 we found marked hyperplasia of the vaginal and vulvar epithelium, eosinophilic and mast cell infiltration in the chorion.Conclusions: Our study proves that the histopathological changes during anoestrus after administration of oestrogens are cell hyperplasia, thickening of the superficial mucosal layer, eosinophilic and mast cells infiltrations, and chorionic congestion. Furthermore, we demonstrated that Estradiol therapy induces the most evident histological changes when compared to synthetic oestrogens such as Estradurin or Sintofolin. [ABSTRACT FROM AUTHOR]

Embryonic demise is the most common event in the lives of women during theirs reproductive time with a rate of about 25%. The aim of this review is to outline the most important paraclinic and biological prognostic parameters. English language articles containing keywords like "embryonic demise", "predictive factors" which were searched using Medline and Pubmed. Systematic reviews, retrospective and prospective studies, clinical trials focused on this subject were selected. Informative value of the references of selected articles was used as base for further relevant headlines. Among the most significant reported predictive factors are the distance between the yolk sac (YS) and embryo, also known as the yalk stalk sign, the progesterone and β human chorionic gonadotropine levels. Low levels of biomarkers and abnormal appearance of gestational sac, crown-rump length and YS are considered worst prognostic factors and may lead to a poor outcome. [ABSTRACT FROM AUTHOR]

Aim of the study was to investigate interleukin (IL)-4 serum levels in patients with advanced endometriosis and whether IL-4 promoter region (-590C/T) genetic polymorphism is involved in genetic susceptibility to endometriosis. Material and methods: IL-4 serum levels and IL-4 -590C/T genetic polymorphism were determined for 80 patients with advanced endometriosis and 85 healthy fertile women using a multiplex cytokine kit, with a Luminex 200 system; high molecular weight genomic DNA was extracted from peripheral blood leukocytes, and further analyzed by PCR amplification and restriction fragment length polymorphism (PCR-PFLP). The relationship between IL-4 serum levels, genotypes and haplotypes and the presence of endometriosis was explored. Results: Interleukin 4 serum levels were significantly higher in the endometriosis group compared to controls (138,459 compared to 84,710, p < 0.001). No significant difference was observed in IL -4 serum levels between genotypes. There were no differences in IL -4 -590C/T genotypes and allele frequencies between control women and patients with endometriosis (2 = 0.496, and 2 = 0.928, OR = 1.3636, CI: 0.725-2.564). Conclusions: The results suggest that in patients with advanced stages of endometriosis there is a higher serum level of IL-4, and that this value, or the presence of the disease, is not influenced by the presence of IL-4 -590C/T genetic polymorphism. [ABSTRACT FROM AUTHOR]

Aims. To characterize the vascularity of endometriotic cysts using color Doppler ultrasound and to differentiate more accurately between endometriotic cysts and other pelvic cyst masses. Methods. Two prospective studies were initiated: the first included 50 patients diagnosed with ovarian endometriotic cysts and 50 patients without gynecological pathology, in whom the resistance index (RI) of the uterine artery, ovarian artery and endometrial arcuate arteries in the early secretory phase was determined by endovaginal Doppler ultrasound; the second study included 50 patients diagnosed with ovarian endometriotic cysts, in whom the RI of the uterine artery, ovarian artery and cyst wall arteries in the late proliferative phase and in the late secretory phase was determined. Results. In the early secretory phase, the vascular flow through the uterine artery was significantly higher in patients with ovarian endometrioma. These patients had increased endometrial vascularity in the early secretory phase compared to the control group. In the late secretory phase, the vascular flow through the ovarian artery was higher compared to the late proliferative phase in patients with ovarian endometrioma. The vascularization of the ovarian endometrioma wall was significantly increased in the late secretory phase compared to the late proliferative phase. Conclusions. Vascularization, described through the arrangement of vessels, vascular density and vascular resistance, is an important factor in the evaluation of ovarian endometrioma. [ABSTRACT FROM AUTHOR]

Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). We report on the case of a33-year-old female with a biamniotic monochorionic twin pregnancy complicated with TRAP sequence and polyhydramnios. The patient underwent fetoscopic termination of the acardiac twin and at 34 gestational weeks (GW) was readmitted with aretroplacental hematoma. The patient gave birth through caesarean section to a living female fetus, weighing 1480 g. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacental hematoma. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the serum pro-inflammatory cytokine profile in patients with diagnosed endometriosis. Material and methods: The study included 160 women, who were divided in two study groups (Group I - endometriosis; Group 2 - healthy). We evaluated the serum levels of interleukin (IL)-lß, lL-5, IL-6, IL-7, and IL-12, and of tumour necrosis factor a (TNF-a) with the use of Human Multiplex Cytokine Panels. Conclusions: Women with endometriosis have elevated levels of key pro-inflammatory cytokines, i.e. IL-1β, IL-6, and TNF-a. At the same time, IL-1ß and IL-6 could be used as predictors for endometriosis. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine menopause-related changes in serum levels of main proinflammatory and anti-inflammatory cytokines. Material and methods: The study included 175 women, who were divided into 5 study groups (group 1 - fertile women; group 2 - pre- and perimenopausal women; group 3 - postmenopausal women; group 4 - surgically induced menopausal women; group 5 - women with chronic inflammatory pathology). We evaluated the serum levels of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-20 and of the tumour necrosis factor (TNF)α with the use of two multiplex cytokine kits. We also determined the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (17β-E2), progesterone (P), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) using sandwich ELISA. Results: The serum level of IL-1β, IL-8 and TNF-α in women with natural menopause and in women with surgically induced menopause is significantly higher than in fertile women in the control group. In patients with surgically induced menopause and in women with natural menopause, IL-8 serum levels are similar to those seen in patients with chronic inflammatory diseases. There is a statistically significant decrease in serum levels of IL-20 in women with natural or surgical menopause than in fertile and premenopausal women. Conclusions: Women in menopause have elevated levels of the key proinflammatory cytokines, i.e. IL-1β, IL-8 and TNF-α and low serum levels of IL-20 in comparison with fertile women. [ABSTRACT FROM AUTHOR]

Twin reversed arterial perfusion (TRAP) sequence is a rare (1/35.000 pregnancies) and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). The normal twin has a high mortality rate (50- 70%), especially due to congestive heart failure. We report on the case of a IIG IIIP 33 year-old patient who was referred to our institution form another service with the initial diagnosis of multiple pregnancy with one dead twin. Ultrasound revealed 24 gestational weeks intrauterine biamniotic monochorionic twin pregnancy with TRAP sequence and polyhydramnios. Therapeutic amniocentesis was performed for polyhydramnios, evacuating 500 ml of amniotic fluid. A fetoscopic intervention was decided, with the occlusion of the umbilical cord of the acardiac twin, followed by the evacuation of another 700 ml amniotic fluid. The patient was readmitted to our institution at 34 gestational weeks for preterm premature rupture of membranes and vaginal bleeding. Ultrasound revealed intrauterine growth restriction of the living twin, corresponding to 30 gestational weeks and retroplacentar hematoma, reaching 8,5/5 cm. The patient gave birth through cesarean section to a living female fetus, weighing 1480 g, Apgar score 6, 7, 8 at 1, 2 and respectively 5 minutes. In conclusion, TRAP sequence is a rare entity, requiring early diagnosis and careful ultrasound monitoring, in order to select the best management option for the pump twin. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacentar hematoma. [ABSTRACT FROM AUTHOR]

Copyright of Ginecologia.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To revise the current literature about the usefulness of elastography in cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), from methods and technical limitations, to diagnosis, staging and the ability of predicting the response to oncologic treatment.Methods: An electronic database search was performed (PubMed, EMBASE, Web of Science) with the data range from January 2000 until May 2020. All studies, fully-available in English, assessing elastography of the uterine cervix in CC and CIN were selected. Studies were reviewed and discussed according to the elastographic technique and to the purpose of the research.Results: Twenty-three articles were found: 11 articles regarding strain elastography, 4 articles assessing shear wave elastography and 8 papers with matter-related information. Elastography was used in the study of normal variants of the uterine cervix as well as: the positive diagnosis of CC and CIN, clinical staging and the prediction of therapeutic response in CC. Comparison of the elastographic techniques was also performed.Conclusions: Elastography has multiple applications in the gynecological pathology of the cervix. The methods used to assess the cervix are diverse, and none have become universally accepted. With regard to CC and CIN, elastography is still an ongoing research field. [ABSTRACT FROM AUTHOR]

Aims: To assess the usefulness of real time elastography (RTE) strain ratio (SR) in diagnosing cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), using a synthetic experimental device (ED) as reference material.Material and Methods: Seventy-nine participants were enrolled, divided in three groups: Group 1 - benign cervix (n=39); Group 2 - CIN (n=32); Group 3 - CC (n=8). Transvaginal RTE was performed, with SR determination, as the ratio between the ED and the cervical tissue. Mean SR values of the groups were compared; diagnostic performance was assessed by tracing the receiver operating characteristic (ROC) curve. Area under the curve (AUC) was analyzed. Cut-off values were established. Pathological results were considered as reference for data interpretation.Results: SR means significantly differed in Group 1 as compared to Groups 2 and 3 (p=0.001). Excluding 2 aberrant values in Group 3, assigned to cases complicated by hemorrhagic necrosis, statistical difference was also noted between Groups 2 and 3 (p=0.02). For Groups 1 and 3, AUC was 0.966 with a 95%CI (0.914-1.000); the cut-off point of SR was 1.42, with a sensitivity of 100% and a specificity of 94.9%. AUC was 0.752 with a 95%CI (0.629-0.876) for Groups 1 and 2. For the cut-off value of 1.03, sensitivity and specificity were 75% and 74%, respectively.Conclusion: RTE SR, performed with a synthetic reference material, seems a reliable method for distinguishing between benign uterine cervix and malignancy, with promising results as a complementary investigation in diagnosing CIN. However, SR becomes inoperant in cases of cancer complicated with hemorrhagic necrosis. [ABSTRACT FROM AUTHOR]

Aims: Embryonic demise is a frequent complication of the first trimester pregnancy. The purpose of this study was to evaluate the correlation between a serum biomarker, the soluble form of the vasculo-endothelial growth factor (sFlt-1) and the distance between the yolk sac (YS) and embryo (DYSE), determined by ultrasonography.Material and Methods: The study was a prospective case-control study that included 2 groups of patients - the control group with 81 first-trimester pregnancies in evolution and the case group with 89 first-trimester pregnancies with a potentially reserved evolutivity.Results: A correlation between the serum level of sFlt-1 and DYSE in embryos with crown-rump length (CRL) greater than 5 mm was identified, showing that a DYSE ≤3 mm correlates with a low level of sFlt-1 (p<0.05) and a DYSE> 4 mm correlates with an increased level of sFlt-1 (p<0.05).Conclusions: A low level of sFlt-1 associated with a distance between the embryo and yolk sac of small dimensions, respectively <3 mm, correlates with an increased rate of non-viable embryos. This correlation between an ultrasound and a serum parameter is of great value and brings important information about the viability of firsttrimester pregnancies. [ABSTRACT FROM AUTHOR]

Objective The study aims to evaluate the presence of a correlation between visceral fat assessed by ultrasonography and the plasmatic level of lipocalin in patients diagnosed with endometrial cancer. Material and Method The study is a case-control analysis including 2 groups of patients: group I - 44 patients diagnosed with endometrial cancer, group II - 44 patients without gynecological pathology or inflammatory disorders. After the clinical examination and anthropometric measurements, these patients underwent ultrasonography (US) examination, in view of determining the visceral fat. At the patients included in this study, we also determined the plasmatic levels for lipocalin. Results At the patients diagnosed with endometrial cancer, the intraabdominal fat area evaluated by US and the plasmatic level of lipocalin is significantly larger (p<0.0001) compared to the control group. A correlation was also found between the intraperitoneal fat area evaluated by US and the plasmatic level of lipocalin. Conclusions The measurement of the intraperitoneal fat by US in correlation with the plasmatic level of lipocalin can be a screening method for endometrial cancer in obese patients. [ABSTRACT FROM AUTHOR]

Background: Transvaginal and transabdominal ultrasonography has become a widely used investigative method in the diagnostic workup of endometriosis, as well as for the postoperative follow-up. The variety of lesions, the distorted anatomy caused by adhesions and the fibrosis process represent the main challenges of the ultrasound evaluation. Regarding the recurrence of endometriosis, the diagnostic criteria are being imprecise, being adjusted according to the development of ultrasound techniques., Objective and Methods: To this study, extensive research has been performed interrogating PubMed, Embase and Web of Science databases to identify published research including patients with endometriosis who underwent surgery. Included patients had postoperative ultrasound investigations to detect evidence of endometriosis recurrence. The selected timeframe was 5 years. We conducted a literature review on ultrasound markers of endometriosis recurrence., Results: In this analysis, 2023 patients from 9 studies were included. The recurrence rate detected was 17.26%. The postoperative treatment was different in the selected studies and they include the administration of progesterone, oral combined contraceptives, GnRh antagonists, aromatase inhibitors and intrauterine devices with prolonged release of progesterone., Discussion: The recurrence rate is different in the selected studies as a result of the recurrence definition used by each author and the minimum dimension of the lesions, in case of the cystic pattern. Innovative techniques of differential diagnosis by ultrasound are proposed, one of them being the textural analysis performed by computer-aided diagnosis – CAD. In order to standardize the recommendations regarding imaging techniques, we propose an algorithm for following up with patients in the postoperative period., Conclusion: The transabdominal or endovaginal ultrasound performed regularly represents a key factor to determine the recurrence of endometriosis in the postoperative period and the imaging reassessment is recommended to be performed at a 6-month interval., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective:  The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of the present study is to evaluate the correlation between a serum biomarker, progesterone, and an ultrasonographic parameter, the distance between yolk sac and embryo (DYSE) in assessing the prognosis of pregnancy outcome in the 1 st trimester., Methods:  The present study is a prospective case-control analysis that includes 2 groups of patients: 81 patients with first-trimester normal evolutive pregnancy and 89 patients with embryonic demise, all of the patients having between 6 and 11 weeks of amenorrhea. Endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for progesterone serum level measurement., Results:  Regarding the DYSE in the case group, lower values were observed compared with the control group, the difference being statistically significant. In the statistical analysis of serum progesterone values, statistically significant differences were observed between the 2 groups ( p  < 0.05)., Conclusion:  The DYSE has a high positive predictive value in identifying pregnancies with potentially reserved outcome, with the present study demonstrating that a DYSE < 3 mm causes an unfavorable evolution of the pregnancy. Low serum levels of progesterone are associated with an increased rate of nonviable embryos. The correlation between these two parameters increases the effectiveness of screening methods in prenatal monitoring and improves the diagnostic methods for the first-trimester pregnancies whose outcome potential can be reserved., Competing Interests: The authors have no conflicts of interests to declare., (Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.)

Background: The association of obesity with endometrial cancer is supported by the presence of endoplasmic reticulum (ER) stress in the adipocyte. Glucose-regulated protein 78 (GRP78) is a marker for ER stress. This protein is a central regulator of ER stress due to its major anti-apoptotic role. It plays an important role in tumor development, progression and chemoresistance., Aim: To look for an association between android and gynoid obesity, plasma GRP78 levels and endometrial cancer., Material and Methods: Forty four patients with endometrial cancer aged 72 ± 6 years and 44 healthy women aged 55 ± 9 years were studied. Android and gynoid fat distribution were determined by dual X-ray absorptiometry and plasma GRP78 levels were measured., Results: GRP78 plasma levels were significantly higher in patients with endometrial cancer as compared to the control group. Android fat distribution had a positive correlation with plasma GRP78 levels (p<0.01). Gynoid fat had a negative correlation with plasma GRP78 levels (p<0.01)., Conclusions: GRP78 levels are associated with the distribution of adipose tissue and are higher in patients with endometrial cancer.