Search

There is evidence that chemotherapy has a significant impact on women's reproductive function, ovarian failure and infertility being currently mentioned as specific side effects and depending, among other things, on the chemotherapeutic agent involved. Cyclophosphamide (CP) is an antineoplastic agent which generates reactive oxygen species (ROS), deeply influencing and affecting not only physiological, but also numerous pathologic processes. The controversial aspect of using antioxidants along with chemotherapy is still to be investigated; their correlation must be done not only to improve survival, but also to preserve fertility. Our study investigates the effects of a common antioxidant, vitamin E, on CP-induced oxidative stress in female rats. Material and methods: 24 female Wistar were randomly divided into 3 groups: a control group, injected with saline, CP group (150mg/kg by intraperitoneal injection) and CP-Vitamin E group (CP-150mg/kg, vitamin E-100mg/kg, orally). After 4 weeks, samples of ovarian and uterine tissue were fixed in buffered formaldehyde for histologic exam. Superoxide dismutase (SOD) and catalase (CAT) activity were determined. Results: Compared to control group, whereas no significant alterations can be observed in uterine tissue, the ovarian failure is present as a result of CP administration; on the other hand, when vitamin E added, these ovarian alterations diminished. Conclusions: antioxidants as vitamin E may improve cancerrelated infertility, but further studies have to explore their complete effects and intractions with chemotherapy. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis is a chronic neuroinflammatory disorder associated with important chronic pelvic pain, affecting approximately 6-10% of women of reproductive age. The diagnosis of endometriosis is often delayed because symptoms such as pelvic pain and/ or infertility are associated with other disorders. The identification of biomarkers and endometriosis-specific noninvasive diagnostic tests represents a goal of the entire scientific community. The present paper aims to harmonize the results of these studies in the research for new promising perspectives regarding early diagnosis. Materials and method. The analysis of articles published in literature for evaluating new biomarkers that play a part in early identification of patients with endometriosis, but also in evaluating the response to the treatment. Results. The majority of the studies focused on a panel of biomarkers, rather than focusing on a single biomarker, and they couldn’t identify at least one biomolecule or biomarker panel with enough specificity and sensibility in endometriosis. Recently, promising data regarding the utilization of blood micro-RNA as biomarker have appeared, although this domain has been previously underestimated by poor reproducibility between studies. The differential expression of miR-145 has been reported in the highest number of studies (six articles). Using saliva and vaginal fluid samples to identify miRNA could be a potential noninvasive test for overcoming the current barriers in endometriosis diagnosis. Conclusions. Various lines of evidence support the potential role of many biomolecules or panels of biomolecule but, for the moment, none of them are showing the proven sensibility and specificity of the test. Therefore, they can only complete the diagnosis of this pathology, alongside imagistic techniques or laparoscopic surgery. [ABSTRACT FROM AUTHOR]

Introduction/objective. The infection with SARSCoV-2, after approximatively two years from its debut, continues to be a major public health problem, not only due to the high number of new cases admitted to intensive care unit, but also due to the number of deaths recorded on a global level. The pregnancy has been reported to be an independent risk factor in respect to the side effects associated to the infection with SARSCoV-2, especially in the case of pregnant women with associated pathology, such as gestational diabetes or preeclampsia. More reports have pointed to a high risk of placental lesions, caused by hypoperfusion and inflammation of women infected by SARS-CoV-2. The eventual association between the infection with SARSCoV-2 and the affliction of placental functionality are crucial, because they could lead to fetal decompensation and to an implicitly greater risk of perinatal mortality. Methodology. We searched and analyzed the articles published in the specialized literature in order to evaluate the risk of placental thrombosis associated with SARS-CoV-2. Results. The majority of the studies have reported the presence of maternal vascular malperfusion in a proportion of approximatively 30% in the cases of the analyzed patients infected with SARSCoV-2. At the same time, fetal vascular malperfusion has been observed in 27% of the studied cases. As a histopathological mechanism, the perivillous fibrin growth has been reported in proportion of 32%, while intervillous thrombosis has been observed in 14% of the cases. Discussion and conclusions. A significant proportion of placentas have presented histopathological modifications, suggesting hypoperfusion and placental inflammation amongst pregnant women infected by SARS-CoV-2. Nonetheless promising, the available evidence is based on a restricted number of clinical studies. Therefore, multicenter prospective blinded studies are needed in order to corelate these placental lesions to the pregnancy results. [ABSTRACT FROM AUTHOR]

Introduction. Endometriosis is a chronic neuroinflammatory disorder associated with important chronic pelvic pain, affecting approximately 6-10% of women of reproductive age. The diagnosis of endometriosis is often delayed because symptoms such as pelvic pain and/ or infertility are associated with other disorders. The identification of biomarkers and endometriosis-specific noninvasive diagnostic tests represents a goal of the entire scientific community. The present paper aims to harmonize the results of these studies in the research for new promising perspectives regarding early diagnosis. Materials and method. The analysis of articles published in literature for evaluating new biomarkers that play a part in early identification of patients with endometriosis, but also in evaluating the response to the treatment. Results. The majority of the studies focused on a panel of biomarkers, rather than focusing on a single biomarker, and they couldn’t identify at least one biomolecule or biomarker panel with enough specificity and sensibility in endometriosis. Recently, promising data regarding the utilization of blood micro-RNA as biomarker have appeared, although this domain has been previously underestimated by poor reproducibility between studies. The differential expression of miR-145 has been reported in the highest number of studies (six articles). Using saliva and vaginal fluid samples to identify miRNA could be a potential noninvasive test for overcoming the current barriers in endometriosis diagnosis. Conclusions. Various lines of evidence support the potential role of many biomolecules or panels of biomolecule but, for the moment, none of them are showing the proven sensibility and specificity of the test. Therefore, they can only complete the diagnosis of this pathology, alongside imagistic techniques or laparoscopic surgery. [ABSTRACT FROM AUTHOR]

Introduction/objective. The infection with SARSCoV- 2, after approximatively two years from its debut, continues to be a major public health problem, not only due to the high number of new cases admitted to intensive care unit, but also due to the number of deaths recorded on a global level. The pregnancy has been reported to be an independent risk factor in respect to the side effects associated to the infection with SARSCoV- 2, especially in the case of pregnant women with associated pathology, such as gestational diabetes or preeclampsia. More reports have pointed to a high risk of placental lesions, caused by hypoperfusion and inflammation of women infected by SARS-CoV-2. The eventual association between the infection with SARSCoV- 2 and the affliction of placental functionality are crucial, because they could lead to fetal decompensation and to an implicitly greater risk of perinatal mortality. Methodology. We searched and analyzed the articles published in the specialized literature in order to evaluate the risk of placental thrombosis associated with SARS-CoV-2. Results. The majority of the studies have reported the presence of maternal vascular malperfusion in a proportion of approximatively 30% in the cases of the analyzed patients infected with SARSCoV- 2. At the same time, fetal vascular malperfusion has been observed in 27% of the studied cases. As a histopathological mechanism, the perivillous fibrin growth has been reported in proportion of 32%, while intervillous thrombosis has been observed in 14% of the cases. Discussion and conclusions. A significant proportion of placentas have presented histopathological modifications, suggesting hypoperfusion and placental inflammation amongst pregnant women infected by SARS-CoV-2. Nonetheless promising, the available evidence is based on a restricted number of clinical studies. Therefore, multicenter prospective blinded studies are needed in order to corelate these placental lesions to the pregnancy results. [ABSTRACT FROM AUTHOR]

Highly vascularized and deeply involved in the protection of the eyeball and eyelids, conjunctiva seems to be a very sensitive structure to oxidative stress. Despite opinions that sustain oxidative imbalance does not interfere with conjunctiva profile and functions, we incline to consider that oxidative stress affects conjunctival components. Material and methods: 42 adult male Wistar rats were randomly distributed in 6 groups: control/light deprivation/continuous light exposure/induced diabetes mellitus/diabetes mellitus+light deprivation/diabetes mellitus+continuous light exposure, as forms of oxidative stress. After a month, blood for antioxidant enzymes catalase (CAT) and malondialdehyde (MDA) assessment was taken, the rats were euthanasized and conjunctival samples were taken from all the rats used in experiment. The tissues were prepared for paraffin embedding and H&E staining. Results: The number of goblet cells dispersed among epithelial cells were sensible reduced in rat conjunctiva exposed to oxidative stress, sustained by significant alterations of specific biomarkers of oxidative stress, CAT and MDA. Conclusions: there is evidence on conjunctiva alterations in different forms of induced oxidative stress. [ABSTRACT FROM AUTHOR]

Endometriosis is considered a benign condition, in which endometrial tissue can be observed outside the uterine cavity; the chronic pelvic pain is frequently associated with infertility and may cause significant reproductive functional disorders. Animal experimental models represent an alternative for clinical studies, as a useful resource in deciphering the pathogenic mechanisms of endometriosis. MATERIAL AND METHODS: 25 adult Wistar female rats were assigned to a control group and an experimental group. A laparatomy was performed to experimental group of rats, the uterine horns were exposed and fragments from left horn were prelevated and implanted in extraperitoneal space, as ectopic implants. RESULTS: We detected the viable implant, visible as an endometriotic cyst on the abdominal wall, multiple epiploic adhesions, neovascularization areas. CONCLUSIONS: Murine model can be used with benefits for experimental research and understanding of endometriosis. [ABSTRACT FROM AUTHOR]

Introduction/objective. Vaginal atrophy is a disease associated with menopause caused by a definite decrease in ovarian hormones, with a negative impact on patients’ quality of life. Systemic and local hormone replacement therapy is the current treatment for vaginal atrophy. The adoption of new long-term therapeutic strategies such as injection of materials into the vaginal wall (plateletrich plasma [PRP], autologous fat graft [AFG], hyaluronic acid [HA], botulinum toxin [BTX] and collagen) is an alternative therapy, in order to suppress the painful symptoms and to control the other symptoms associated with vaginal atrophy. Methodology. We performed a search and analysis of articles published in the literature to evaluate new treatment options in vaginal atrophy and the rate of suppression of symptoms. Results. The effectiveness of treatment in vaginal atrophy is currently limited. Therefore, it is necessary to explore new therapeutic strategies to minimize the adverse effects of the current hormonal treatments. Recently, two studies in the literature demonstrate the role of regenerative medicine in the local treatment of urogenital atrophy by single local injection of autologous microfragmented adipose tissue. This could be a new viable solution for these patients, as it not only helps to relieve symptoms, but also counteracts the mechanisms that lead to menopausal genitourinary atrophy. Discussion and conclusions. Although promising, the available evidence is based on a limited number of well-conducted clinical trials. Therefore, properly constructed clinical trials are required to obtain more conclusive results on the promising role of autologous and microfragmented adipose tissue as a safe, feasible and effective therapeutic approach for the treatment of postmenopausal urogenital atrophy. [ABSTRACT FROM AUTHOR]

Introduction/objective. Vaginal atrophy is a disease associated with menopause caused by a definite decrease in ovarian hormones, with a negative impact on patients’ quality of life. Systemic and local hormone replacement therapy is the current treatment for vaginal atrophy. The adoption of new long-term therapeutic strategies such as injection of materials into the vaginal wall (plateletrich plasma [PRP], autologous fat graft [AFG], hyaluronic acid [HA], botulinum toxin [BTX] and collagen) is an alternative therapy, in order to suppress the painful symptoms and to control the other symptoms associated with vaginal atrophy. Methodology. We performed a search and analysis of articles published in the literature to evaluate new treatment options in vaginal atrophy and the rate of suppression of symptoms. Results. The effectiveness of treatment in vaginal atrophy is currently limited. Therefore, it is necessary to explore new therapeutic strategies to minimize the adverse effects of the current hormonal treatments. Recently, two studies in the literature demonstrate the role of regenerative medicine in the local treatment of urogenital atrophy by single local injection of autologous microfragmented adipose tissue. This could be a new viable solution for these patients, as it not only helps to relieve symptoms, but also counteracts the mechanisms that lead to menopausal genitourinary atrophy. Discussion and conclusions. Although promising, the available evidence is based on a limited number of well-conducted clinical trials. Therefore, properly constructed clinical trials are required to obtain more conclusive results on the promising role of autologous and microfragmented adipose tissue as a safe, feasible and effective therapeutic approach for the treatment of postmenopausal urogenital atrophy. [ABSTRACT FROM AUTHOR]

Introduction. Fetal aortic coarctation still represents a challenge even for the best sonographers, especially in the early forms of appearence. Case presentation. A secundipara, with a previous healthy child, presents for the first assesement with a 32-week pregnancy. The ecography showed: IUGR of minus 3 weeks, a significant discrepancy between the right and left ventricule, fibroelastosis of the wall in right ventricule, and a suspicion of aortic coarctation. The aortic isthmal diameter was measured immediately proximal to the insertion of the arterial duct in the transverse (three vessel and trachea) and sagittal view, and the ductal diameter was measured immediately before it entered the descending aorta in the same view. Conclusions. The Z-scores for the fetal aortic isthmus and arterial duct are measured in the three vessels and trachea view and for the isthmus in the sagittal plane. In suspected coarctation, these Z-scores and the isthmal to ductal ratio may help in longitudinal assessment of the aortic arch and help at the prenatal diagnosis of coarctation. [ABSTRACT FROM AUTHOR]

Introduction. The incidence of pregnancy on the uterine scar is 1/1800-1/2500 pregnancies, increasing in the last 20 years, with the increase of the caesarean section. Case presentation. A 34-year-old patient, at her fifth pregnancy, with four births by caesarean section in the past (the last one seven months ago), presented at the emergency room with reduced genital bleeding and hypogastric pain. Transvaginal ultrasound established the diagnosis of pregnancy on uterine scar, and a 5-week embryo with present cardiac activity. Methotrexate 1 mg/kg intramuscular was administered, the patient being reviewed after five days, when the cardiac activity was absent, with the persistence of peripheral vascularization at the level of the uterine scar. Uterine dilatation and curettage were performed, and the trophoblastic fragments were extracted under ultrasound control. Two days later there were confirmed the HCG regression and the ultrasound evacuation of the pregnancy from the level of the uterine scar. The risk factors for pregnancy on the uterine scar are: thin uterine segment below 5 mm, the ultrasound visualization of a gestational sac that protrudes into the bladder-vaginal space, and a history of irregular vaginal bleeding. Discussion. The early diagnosis allows for conservative treatment with better results, and the subsequent follow-up by early ultrasound on a new pregnancy is important. There is no consensus on the most effective treatment, the options including: administration of methotrexate, either locally, in the sac, or by systemic intramuscular treatment, uterine artery embolization, uterine and hemostatic uterine bleeding, or hysteroscopic excision that offers minimal complication rates. Conclusions. Pregnancies on the uterine scar are rare, but with increasing incidence, having a major impact on the woman's subsequent fertility. [ABSTRACT FROM AUTHOR]