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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]

Background/Objectives: The rapidly increasing rate of obesity has become an extremely important public health problem, particularly in developed countries. Obesity is associated with a range of health problems, often referred to as the metabolic syndrome. Adipose tissue is now regarded as an endocrine organ responsible for the hormonal secretion of adipokines, which are cytokines involved in various physiological processes. It has been established that adipokines play a key role in the regulation of many processes in the human body. The aim of the current study was to use an animal model to investigate the possible influence of obesity and adipokines on the gestational period, on the development of offspring, and to assess whether these changes are influenced by the administration of antioxidant agents and flavonoids. Methods: The present study was performed using 5 groups of 7 female Wistar albino rats. A control group was used to which a 5% lipid diet was administered, and the other 4 groups were fed an obesogenic 65% lipid diet. From the 4 groups that received obesogenic diet one group received no supplement, and the rest of 3 received Detralex, Sel-E-Vit and Rutin (antioxidants and flavonoids). Study times for both pregnant groups and offsprings: on day 15 of gestation, venous blood was drawn to determine adipokine (leptin and visfatin) levels; on days 18–22 ultrasound examination was performed to measure the thickness of adipose tissue in the abdominal wall; for each batch a number of 10 offspring were selected for the measurements (pup weight, brain weight, head length, head width, spine length, width between shoulder blades, coxal bone length), adipokine levels in the offspring (from brain tissue) were also determined, as well as the existence of changes in the brain tissue of the offspring identified by electron microscopy. Results: The results of the study showed that the high-fat diet (HFD) led to a significant increase in body weight and abdominal wall thickness in pregnant females compared to the control group. The levels of leptin and visfatin were also affected by the HFD, with leptin levels being significantly higher in the HFD group and visfatin levels being lower. In the offspring, the HFD group had a significantly higher body mass and brain weight compared to the control group. The anthropometric measurements of the offspring were also affected by the maternal diet, with the HFD group having larger dimensions overall. Interestingly, the offspring of the groups that received flavonoids in addition to the HFD had significantly smaller dimensions compared to both the HFD group and the control group. Conclusions: The results of this experimental study reinforce what is already known about the effects of obesity on the gestation period and offspring and at the same time, the current study highlights the existence of possible adverse effects of flavonoid compounds on the development of pregnancy and offspring, opening the way for future studies on the benefits and risks of using these compounds during gestational period. [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]

Obesity, characterized by an excess of adipose tissue, has become a significant global health issue. The prevalence of obesity has increased markedly in recent decades worldwide, with a sharp rise also observed in developing countries, particularly in urban areas. Addressing obesity during pregnancy is crucial for several reasons and presents challenges for specialists in obstetrics and gynecology. Objectives: The aim of the present study was to investigate the correlation between obesity and its implications for childbirth. Materials and Methods: We conducted a retrospective study involving 1513 patients, grouped into normal-weight, overweight, and obese categories using corrected BMI values. We performed comparative analyses to explore the association between BMI and various outcomes: the method of delivery, the Apgar score at birth, the incidence of fetal distress, fetal birth weight, the presence of pregnancy-associated pathologies, and the occurrence of postpartum hemorrhage. Descriptive statistical analysis was utilized to characterize the demographic and clinical features of the patients and newborns. Results: By examining variables such as the occurrence of fetal distress during labor, the Apgar score at delivery, and the mode of delivery, we identified an association between increasing BMI and complications during labor and delivery. The results indicate that a higher BMI is linked with increased complications and variations in the mode of delivery. Conclusions: Obesity is the most common health issue among women of reproductive age and requires long-term care. It can contribute to numerous pregnancy-associated pathologies and affect both mother and child during labor and delivery. Obesity is associated with lower Apgar scores, the increased incidence of fetal distress, and a higher rate of cesarean section deliveries. Although the absolute risk of serious complications for mother, fetus, and newborn is low among women with obesity, adopting healthy eating and exercise behaviors prior to pregnancy, ideally, or as early in pregnancy as possible, can help minimize excessive weight gain during pregnancy. [ABSTRACT FROM AUTHOR]

Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes. [ABSTRACT FROM AUTHOR]

For SMEs, innovation should be embedded it in the organisational culture in order to enable the creation and integration of the physical and virtual worlds, for an enriched customer experience tailored to their needs. There is a myriad of innovation typologies and levels of analysis present in the literature emanating from many disciplines such as management, psychology, economics, sociology and science (Kristiansen 2012). This article focuses on innovation in order to identify and analyse the types and sources of innovation encountered for SMEs by applying different frameworks and perspectives.

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.

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]

The article discusses the study aimed at comparing maternal and neonatal outcomes associated with delivery techniques via cesarean section. The results suggest that in the absence of robust evidence to support the use of a specific technique, the choice of the obstetrician should be based on the best available evidence. The study indicates that the "pull" and "Patwardhan" techniques represent safe options for delivering an impacted fetal head.

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Aims: In overactive bladder (OAB) research, different biomarkers have been proposed as diagnostic tools and may be used to create individual patient profiles. Assessing the diagnostic performance of biomarkers would better outline their utility. Therefore, our aim was to investigate the diagnostic value of four urinary biomarkers: human brain derived neurotrophic factor (hBDNF), malondialdehyde (MDA), h nerve growth factor (hNGF) and h 8‐hydroxydeoxyguanosine in women with OAB. These are neurotrophins/oxidative stress markers that have been linked to lower urinary tract symptoms. Methods: A total of 105 women were included in the study and distributed in two groups: a group with OAB (n = 53) and a control group (n = 50). The levels of the biomarkers were determined using enzyme‐linked immunosorbent assay technique and they were compared between the groups. If the Mann‐Whitney test demonstrated a statistically significant difference, receiver operating curves (ROC) analysis was undertaken. Results: When normalized to urinary creatinine, hBDNF, MDA, and hNGF showed significantly increased values in women with OAB as compared to controls, whereas 8‐OHdG showed no significant difference. The diagnostic performance of these biomarkers was analyzed based on the area under the ROC curve (AUC). MDA had the highest AUC (0.75), followed by hNGF (0.69) and hBDNF (0.67). Conclusions: Our findings suggest that MDA, a relatively novel biomarker in OAB research, has a fair performance as a diagnostic tool for OAB. Moreover, urinary neurotrophins (NGF and BDNF) as biomarkers may have a role in the diagnostic pathways of women with OAB symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Oncolog-Hematolog 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.)

Copyright of Obstetrică şi Ginecologie 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.)

Introduction. Conjoined twins, also known as Siamese twins, represent one of the rarest anomalies of monozygotic pregnancies that have fascinated both medical world and the general public. The incidence of this anomaly varies between 1:50.000 and 1:100.000 births, and there is a higher predisposition toward female gender, with a ratio of 3:1. Conjoined twins appear from abnormal embryogenesis, the two main theories proposed for explaining the occurrence of this anomaly being fusion and fission. Conjoined twins were classified by Spencer (1996), and are named according to the most prominent site of fusion. The conjoined site may be in the ventral, dorsal or lateral groups. The extent of organ sharing, especially the heart, determines the possibility and prognosis of a separation procedure. Materials and method. The aim of this paper is to offer an overview of the literature regarding this rare anomaly of monoamniotic monochorionic twin pregnancy and to present the case of a 35-year-old multiparous patient (six previous pregnancies) who was referred to our hospital for the confirmation of the thoracopagus conjoined twins diagnosis and for management. Results. With the current findings, the diagnosis of thoracopagus twin pregnancy was established. The family was informed and counseled on the various management options. Due to the presence of a common heart, the termination option was offered and the family accepted. The termination of pregnancy was made through caesarean section, resulting two female twins of approximately 500 g in total which were sent to the pathologist. Conclusions. Conjoined twin pregnancy is a rare finding. Establishing a diagnosis using ultrasound examination early during pregnancy offers the possibility of assessing the prognosis of the pregnancy, based on the organs that are shared by the fetuses, to offer the patient and her family a prognostic and, if possible, the treatment options. [ABSTRACT FROM AUTHOR]

Introduction. The evaluation of fetal long bone measurements, particularly femur length, is essential in assessing fetal biometry, gestational age, size, growth, and in identifying various abnormalities. This study explores the diagnostic value of long bones length in detecting conditions such as Down syndrome and skeletal dysplasia. A femur length below the 10th percentile for gestational age is consistently associated with Down syndrome, while an extremely short femur length often indicates skeletal dysplasia. Humeral length, particularly when small compared to the biparietal diameter, serves as an additional marker for Down syndrome risk. The accurate diagnosis requires measuring all long bone segments, while the femur/abdominal circumference ratio serves as a discriminator for lethal skeletal dysplasia. Complete fetal anatomic evaluation is crucial in the presence of a short femur. This poster presents the current state of the art in the ultrasonography of fetal long bone evaluation. Materials and method. The present paper was realized by synthesizing the data published in the last 30 years regarding fetal long bones ultrasound assessment found on Google Scholar and PubMed, using for filtering the keywords: “femur length”, “humerus length”, “ultrasound”, “trisomy”, and “skeletal dysplasia”. Results. Femur length is a standard parameter measured during fetal biometry assessment. A shortened femur for gestational age may raise the suspicion for fetal growth restriction, trisomy 21 or skeletal dysplasia. In certain cases, it may be the first hint for aneuploidies or skeletal dysplasia. Femur and humerus length can be used to adjust the risk for trisomy 21. When facing a shortened femur, a complete survey of all fetal long bones is mandatory, as it may unveil a potentially severe skeletal anomaly. Conclusions. Ultrasound measurement of fetal long bones and the ratio between different skeletal measurements can be the key for the prenatal diagnosis of fetal skeletal dysplasia or can rise the suspicion of a fetal aneuploidy that can determine further investigations for establishing or excluding such a condition of the fetus. [ABSTRACT FROM AUTHOR]

Introduction. Cervical incompetence (cervical insufficiency) is the inability of the uterine cervix to retain a pregnancy in the absence of uterine contractions. It typically presents as acute, painless dilatation of the cervix, which can lead to a midtrimester pregnancy loss. Transvaginal ultrasound can be used as a diagnostic tool and to monitor cervical changes in cases of cervical incompetence. Materials and method. We have searched the literature on articles published on this aspect on PubMed, Google Scholar and Cochrane, by using the following keywords: “cervical incompetence”, “cervical shortening”, “ultrasound measurements”. We found that some of the ultrasound aspects used in the evaluation of cervical incompetence are: cervical length measurement, funneling assessment and bulging of the fetal membranes into a widened internal os. Conclusions. Cervical shortening is a prognostic indicator for the risk of preterm labor progressing into preterm delivery. [ABSTRACT FROM AUTHOR]

Introduction. The choroid plexus, or plica choroidea, is a plexus of cells that arise from tela choroidea in each of the ventricles of the brain. Regions of the choroid plexus produce and secrete most of the cerebrospinal fluid of the central nervous system. The prevalence of choroid plexus cyst (CPC) is 1:50 fetuses at 20 weeks of gestation and more than 90% resolve by 26 weeks, usually being asymptomatic, but large cysts can cause hydrocephalus. Ultrasound diagnosis is characterized by single or multiple cystic areas (>2 mm in diameter) in one or both choroid plexuses of the lateral cerebral ventricles in biparietal diameter section. The differential diagnosis should exclude an intraventricular hemorrhage penetrating into the choroid plexus and other rare types of cysts like colloid or ependymal cysts. Methodology. We compared two cases of fetuses with CPC, the first one being a fetus with aneuploidy and a series of anomalies detected at the ultrasound examination (intracardiac echogenic focus, increased nuchal fold and absent nasal bone), and the second one being a fetus with normal karyotype where CPC represented a transitory factor. Results. Choroid plexus cysts, also called “soft signs”, are associated with a risk for trisomy 18 and, possibly, trisomy 21. When they are isolated, the risk for aneuploidy is low. If they are present, a detailed ultrasound examination should be performed, with particular attention to the heart, brain and hands. If the ultrasound is abnormal, the next step should be a noninvasive prenatal test (NIPT) to determine the fetal karyotype. Conclusions. In the vast majority of cases, CPC are benign transient variants of normal intracranial anatomy. Chromosomal studies are strongly recommended whenever associated anatomic abnormalities are detected and when choroid plexus cysts are large, bilateral and persistent. [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]

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 hypotheses. 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. We describe the case of a 38-year-old patient, in her second pregnancy, with a physiological course of pregnancy until 29 weeks of gestation, when a cystic mass of 52/48 mm was detected in the abdomen during the routine ultrasound examination. The most likely origin was established to be the right ovary. Applying the diagnostic criteria described by Nussbaum, the detected cystic mass was of a simple type, with a thin wall, transonic content, without the presence of septa, vegetations or the appearance of intracystic hemorrhage. We observed a linear growth trend from the time of diagnosis when the diameter measured 52 mm, until 38 weeks of gestation when it reached 76 mm. A female fetus was born, weighing 3570 g, with an Apgar score of 10, with a good postnatal adaptation. On the eighth day of life, the newborn was transferred to the pediatric surgery unit where ovarian cystectomy was performed. Intraoperatively, a cystic mass was found belonging to the right ovary, with a size of 80/70/70 mm. Ovarian cystectomy was performed, with the successful preservation of ovarian tissue. The postoperative recovery had a favorable outcome. [ABSTRACT FROM AUTHOR]

Background/aim: The aim of the study was to evaluate the serum concentration of main chemokines and interferons in patients with diagnosed endometriosis. Materials and methods: A total of 160 women were divided in two study groups (group 1 - endometriosis; group 2 - healthy women). Serum levels of IFN-α, IFN-γ, MCP-1, MIP-1α, MIP-1β, RANTES, eotaxin, IL-8, MIG, IP-10, and IL-17A were measured with Human Multiplex Cytokine Panels. Results. Serum levels of IFN-γ, MCP-1, and IL-8 were significantly higher (mean 14.03, 57.24, and 534.24, respectively, compared to 0.58, 20.51, and 259.82, respectively), and serum levels of IP-10 and eotaxin were significantly lower in women with endometriosis compared to the controls (mean 1.15 and 1.01, respectively, compared to 3.90 and 3.22, respectively). Conclusions. According to our results women with endometriosis have elevated levels IFN-γ, MCP-1, and IL-8, and lower serum levels of IP-10 and eotaxin, indicating unbalanced immune activity in endometriosis. [ABSTRACT FROM AUTHOR]

Introduction. The identification of biological markers that indicate an increased risk for the development or recurrence of endometrial cancer (EC) in obese women might be useful for decreasing EC mortality and morbidity. Glucose-regulated protein 78 (GRP78) is a major protein of the endoplasmic reticulum expressed in all normal cells. Overexpression of GRP78 has been reported to be a tumoral biomarker. Increased detection of GRP78 is positively correlated with the tumoral stage and prognosis. This study aimed to identify a correlation between intraperitoneal fat, plasma GRP78 levels, and EC. Materials and Methods. Two groups of patients were included in the study: group I, 44 patients diagnosed with EC, and group II, 44 patients without gynecological pathology or inflammatory disorders. Visceral fat was determined by ultrasound and plasma GRP78 levels were measured. Results. Plasma GRP78 levels were significantly higher in patients with EC compared to the control group. Intraperitoneal fat was in a positive linear correlation with the plasma GRP78 level (p<0.0001). Conclusion. The measurement of the GRP78 level associated with the determination of intraperitoneal fat can be a useful predictor for EC. [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]

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]

Urinary incontinence (UI) represents a condition that, although not vital, has a significant impact that can interfere with the quality of life in a meaningful way for many women, its overall prevalence being of approximately 40%. Since 1920, urogynecologists showed an increasing interest in imaging techniques of the pelvic floor, ultrasound being the method of examination most frequently used with benefits that result from easy accessibility and reduced costs. At the beginning, B-mode ultrasound via transvaginal or transperineal route, was used to describe the urinary bladder and the anterior compartment and only later, the other pelvic compartments. Pelvic floor dysfunctions include several conditions among which UI. The main indications for transperineal ultrasound are: recurrent urinary tract infections, urgency-, frequency-, stress-UI, dysuria, prolapse of pelvic organs, dyspareunia, fecal incontinence, pelvic masses. This method proves its utility in assessing parameters like: residual urine, detrusor wall thickness, mobility of the bladder neck, anterior and posterior urethrovesical angle, urethral integrity. Stress UI may be highlighted by Color Doppler. Studying the pelvic floor during contractions or Valsalva maneuvre allows the assessment of the functional anatomy, keypoint for understanding the UI pathophysiology. The assessment of these specific objective and reproducible parameters is complementary to the diagnosis of UI and puts several therapeutic options in a different light. The progress in imaging permanently contributes to the improvement of therapeutic management either refining existing techniques or supporting the development of new procedures in urogynecology. [ABSTRACT FROM AUTHOR]

Ultrasound is the reference imaging procedure used for the exploration of endometrial pathology. As medical procedures improve and the requirements of modern medicine become more demanding, grayscale ultrasound is insufficient in establishing gynecological diagnosis. Thus, more complex examination techniques are required: Doppler ultrasound, contrast-enhanced ultrasound (CEUS), 3D ultrasound, etc. Contrast-enhanced ultrasound is a special examination technique that gains more and more ground. This allows a detailed real-time evaluation of microcirculation in a certain territory, which is impossible to perform by Doppler ultrasound. The aim of this review is to synthesize current knowledge regarding CEUS applications in endometrial pathology, to detail the technical aspects of endometrial CEUS and the physical properties of the equipment and contrast agents used, as well as to identify the limitations of the method. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is a frequent gynecologic disease with a severe impact on the quality of life in the affected women; its pathogenesis is yet to be fully understood, with an altered immunity as a possible key factor. The present study aimed to investigate the serum anti-inflammatory cytokine profile in the patients with endometriosis compared with the healthy controls. Materials and Methods: One hundred and sixty women were included, divided into two study groups (Group I -- endometriosis; Group 2 -- healthy women). We evaluated the serum levels of interleukin-1 receptor antagonist (IL-1Ra), IL-2, IL-2R, IL-4, IL-10, IL-13, and IL-15 with the use of Human multiplex cytokine panels. Statistical analyses (normality distribution analysis, independent t-test, Mann--Whitney U-test) were performed using IBM SPSS software (version 22.0) and GraphPad Prism (version 5.00); receiver operating characteristic curve were used to demonstrate the diagnostic performance of the studied markers. Results: The mean serum level of IL-1Ra, IL-4, and IL-10 were significantly higher in women with endometriosis compared to women free of disease from the control group (30.155, 138.459, and 1.489, respectively, compared to 14.109, 84.710, and 0.688, respectively; P < 0.001, P < 0.001, and P = 0.002, respectively.). No significant differences in the mean serum levels of IL-2, IL-13, and IL-15 were observed between the studied groups and IL-2R had a very low detection rate. Conclusion: Endometriosis is associated with elevated levels of anti-inflammatory cytokines, IL-1Ra, IL-4, and IL-10, markers that have a potential role as a prognostic factor for endometriosis. [ABSTRACT FROM AUTHOR]

Smoke resulting from the burning of a cigarette contains up to 4000 chemical compounds, of which at least 50 are carcinogenic. The main chemical substances released after absorption in the respiratory system are nicotine, carbon monoxide and hydrocyanic acid. Smoking is a risk factor for the development of respiratory, cardiovascular, muscle, bone, immune system diseases, as well as cancer. Exercise capacity represents the capacity of the circulatory, respiratory and muscular system to provide oxygen during sustained physical activity. Smoking is associated with a reduction of aerobic exercise capacity due to low oxygen supply and an impaired heart rate response (negative chronotropic effect), both of which represent important predictive factors of mortality. Nicotine induces the release of catecholamines, aggravates sleep disorders and difficulties falling asleep, and has a negative influence on overall performance capacity. Resistance to infectious bronchial and catarrhal diseases is crucial for smoking athletes, because optimal health is a basic requirement for sports training or the improvement of performance. [ABSTRACT FROM AUTHOR]

Introduction. It is well known that severe obstetric lacerations are associated with anxiety disorders or even with postpartum depression among women. Very few studies investigated the levels of intrapartum anxiety caused by the eventuality of childbirth perineal trauma. This study aimed to evaluate maternal anxiety scores, intrapartum or during the first two hours postpartum, in different patient groups. Methodology. In March 2022, 44 consecutive primiparous women completed an anxiety visual scale, from 1 to 10, intrapartum or during the first two hours postpartum, reflecting their anxiety associated with obstetric lacerations. Six to 18 months postpartum, they will complete an International Consultation on Incontinence Questionnaire Vaginal Symptoms Module (ICIQ-VS), a standardized questionnaire to quantify the mid-term impact of perineal lacerations on vaginal symptoms, prolapse symptoms, sexual problems and quality of life. Moreover, correlations between the anxiety scores and ICIQ-VS scores will be sought. Results. GraphPad Prism 8 was used for statistical analysis. Mann-Whitney test was used for comparisons among groups and Pearson coefficient was used for correlations. The women reported significantly higher anxiety scores correlated with childbirth perineal trauma during labor, compared to immediate postpartum (p=0.0008). Women receiving epidural analgesia reported higher anxiety scores compared to women without epidural, but the difference of scores did not reach the statistical significance (p=0.142). No statistically significant correlation was found between the age or Body Mass Index (BMI) of the included women and the reported anxiety scores (p=0.142 and p=0.494, respectively). Conclusions. Anxiety correlated with childbirth trauma is significantly higher during labor compared to the postpartum period in primiparous women. Patients with epidural analgesia did not report significantly different anxiety scores compared to patients without analgesia. In addition, demographic or anthropometric factors, such as age or BMI, did not significantly correlate with the anxiety scores in primiparous women. [ABSTRACT FROM AUTHOR]

Late first-stage or second-stage caesarean section is commonly associated with fetal head impaction, leading to maternal and neonatal complications. This situation requires safe delivery techniques, but the optimal management remains controversial. The aim of this meta-synthesis was to compare maternal and neonatal outcomes associated with delivery techniques via caesarean section. Methodology. An electronic search of three databases, from inception to June 2021, was conducted. Cohort and randomized comparative studies on maternal and neonatal outcomes associated with techniques to deliver an impacted fetal head during caesarean section were included. The methodological quality of the primary studies was assessed. Review Manager 5.4 was used for statistical analyses. Nineteen articles, including 2345 women, were analyzed. Results. Three fetal extraction techniques were identified. Meta-analyses showed that the “pull” technique carries lower risks as compared to the “push” technique, and that the Patwardhan technique is safer compared to the “push” or the “push and pull” technique. Nine out of 11 quality criteria of the included studies were fully met. The “push” and the “pull” techniques were investigated by most included studies. The “pull” technique showed lower risks of blood transfusion (p=0.03), extension of uterine incision (p<0.00001), infection (p=0.003) and pyrexia (p<0.00001) compared to the “push” method. Conclusions. In the absence of robust evidence to support the use of a specific technique, the choice of the obstetrician should be based on best available evidence. Our study suggests that the “pull”, as well as the Patwardhan technique represent safe options to deliver an impacted fetal head. [ABSTRACT FROM AUTHOR]