Tag: pubmed

Aust N Z J Obstet Gynaecol. 2022 Mar 22. doi: 10.1111/ajo.13519. Online ahead of print.

ABSTRACT

BACKGROUND: The higher burden of post-caesarean infection in the remote Kimberley region of Australia is intimately associated with poorer social determinants of health. This results in a confluence of environmental factors such as overcrowding and limited access to clean water and host factors such as diabetes mellitus and obesity which result in heightened susceptibility and vulnerability to infection.

AIM: To ascertain infection rates following caesarean section in Broome Hospital, before and after the implementation of evidence-based strategies intended to reduce bacterial load and mitigate the impact of poor underlying social determinants of health.

MATERIALS AND METHODS: This is a retrospective observational longitudinal audit study including women who underwent caesarean section in Broome Hospital between the time of 1 January 2019 and 1 May 2019 or 1 January 2021 and 1 May 2021. Files and theatre records were audited to determine demographic, surgical and post-partum infection in women who underwent caesarean section at Broome Hospital. The main outcome measure was infection within six weeks post-caesarean section.

RESULTS: This study found a statistically significant improvement in post-operative infection rates in women who underwent caesarean section at Broome Hospital (41.7% vs 11.6%, P = 0.002). The two groups were statistically similar in background.

CONCLUSION: The combination of various infection prevention initiatives targeted at reducing infection burden can result in clinical and statistically significant reductions in post-caesarean infections in high-risk populations with poor underlying social determinants of health.

PMID:35315054 | DOI:10.1111/ajo.13519

Ginekol Pol. 2022 Mar 22. doi: 10.5603/GP.a2021.0246. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of our study is to examine maternal serum Elabela levels in pregnancy with intrauterine growth retardation (IUGR). IUGR is one of the most important causes of perinatal mortality and morbidity. IUGR is also related future comorobidities such as diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease.

MATERIAL AND METHODS: Fifty pregnancies diagnosed as IUGR (Group 1) and fifty healthy pregnancies (Group 2) enrolled into the study. Obstetric and demographic characteristics of the patients, serum elabela levels, ultrasound parameters, cord pH value and APGAR scores of the newborns were recorded. In the study, which was planned as a prospective case-control study, an independent t test was used for the evaluation of continuous data and the Mann Whitney U test was used for the statistical evaluation of ordinal data. p < 0.05 was considered significant.

RESULTS: The mean gestational age of the cases at delivery was 36.35 ± 1.29 in Group 1 and 38.16 ± 0.94 weeks in Group 2 (p < 0.05). Mean serum Elabela levels were 15.05 ± 9.03 in Group 1 and 8.96 ± 4.33 ng/mL in Group 2 (p < 0.0001). Mean newborn weights were 2498.20 ± 465.92 in Group 1 and 3179.44 ± 387.99 gr. in Group 2 (p < 0.0001). Systolic and diastolic blood pressure measurements taken on the day of delivery were higher in Group 1, and diastolic blood pressure was 77.0 ± 9.53 in Group 1 and 72.60 ± 13.37 mmHg in Group 2 (p < 0.05). Bilateral uterine artery Pulsatile Index (PI) and umbilical artery PI value were significantly higher in Group 1 (p < 0.05), and middle cerebral artery PI and cerebroplacental ratio were significantly lower in Group 1 compared to Group 2 (p < 0.05). Although the cord pH value, 1st and 5th minute APGAR scores were lower in Group 1 compared to Group 2, no statistically significant difference was found (p > 0.05).

CONLUSIONS: In our study, it was found that serum Elabela levels increased significantly in pregnancies complicated by IUGR compared to the control group.

PMID:35315019 | DOI:10.5603/GP.a2021.0246

Ginekol Pol. 2022 Mar 22. doi: 10.5603/GP.a2021.0254. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the feasibility of clinical application of non-invasive prenatal screening to detect aneuploidy diseases.

MATERIAL AND METHODS: A total of 14,574 singleton pregnant women who underwent Non-invasive prenatal testing (NIPT) in the Southern Hospital from 2015 to June 2017 were selected, and 6471 pregnant women with twin pregnancy who underwent NIPT in the laboratory of Bei Rui He Kang Southern Hospital from June 2016 to October 2017 were included in this study. We analyzed NIPT screening efficiency (sensitivity, specificity) in twin pregnancies and singleton pregnancies, compared the positive detection rate of NIPT in patients with or without clinical symptoms. All NIPT high-risk results were validated by karyotyping, which were further verified by the follow-up physical examination of the neonatal.

RESULTS: A total of 68 cases of twin pregnancy abnormalities were detected by NIPT, including 18 cases of trisomy 21, 6 cases of trisomy 18, 1 case of trisomy 13, 39 cases of Spinocerebellar ataxias (SCAs), and 4 cases of other chromosomal abnormalities. The sensitivity for trisomy 21, 18, and 13 and sex chromosome abnormality was 100%; the specificity for trisomy 21, 18, and 13 and sex chromosome abnormality was 99.97%, 99.95%, 99.97%, and 99.91% respectively. The screening efficiency was similar to that of singleton pregnancy, indicating that the NIPT technology in our laboratory for screening for aneuploidy diseases in twin pregnancy has reached the accuracy level of singleton pregnancy screening. There was a statistical difference between the risk group and the non-risk group in pregnant women with singleton pregnancy. The screening efficiency of NIPT was higher in pregnant women in the risk group, which implies that the clinical application of NIPT is inclined to detect high-risk group.

CONCLUSIONS: Non-invasive prenatal testing (NIPT) is a rapid and safe screening method with high efficiency. Non-invasive prenatal testing (NIPT) is used for the screening of aneuploidy in twin pregnancy. The efficiency is similar to that of singleton pregnancy, indicating the feasibility of clinical application. However, the efficiency of NIPT screening tends to favor the detection in high-risk groups.

PMID:35315016 | DOI:10.5603/GP.a2021.0254

Ginekol Pol. 2022 Mar 22. doi: 10.5603/GP.a2021.0249. Online ahead of print.

ABSTRACT

OBJECTIVES: Newborns of diabetic mothers are at increased risk of abnormal nutritional status at birth, thus developing metabolic disorders. The aim of this study was to evaluate the anthropometric measurements and body composition of newborns born to mothers with gestational diabetes in comparison to newborns born to mothers with normal glucose tolerance in pregnancy, in the first week of their life. Maternal factors affecting the gestational period were also evaluated.

MATERIAL AND METHODS: The study included 70 participants: neonates born to mothers with gestational diabetes (GDM) and neonates born to healthy mothers (non-GDM). A set of statistical methods (e.g., ANOVA, Kruskal-Wallis test, Chi-square test, regression, cluster analysis) was used to compare data between the study groups and to find their association with maternal factors.

RESULTS: Our approach resulted in statistically significant classification (p < 0.05) by maternal history of hypothyroidism, weight gain during pregnancy and diagnosis of GDM. Newborns of mothers diagnosed with both GDM and hypothyroidism had lower birth weight and fat mass than newborns of mothers without GDM nor hypothyroidism (p < 0.05), however this finding might be associated with high incidence of excessive gestational weight gain among healthy mothers. No differences in body composition were found between the study groups on account of maternal GDM only (p > 0.05).

CONCLUSIONS: Thus, well-controlled gestational diabetes mellitus as an individual factor does not significantly affect neonatal anthropometric measurements and body composition.

PMID:35315018 | DOI:10.5603/GP.a2021.0249

Ginekol Pol. 2022 Mar 22. doi: 10.5603/GP.a2021.0247. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the importance of β-hCG values on the day of onset and on the fourth and seventh day after treatment in the effectiveness of treatment in tubal ectopic pregnancies treated with a single dose of methotrexate.

MATERIAL AND METHODS: One hundred sixty-two patients with tubal ectopic pregnancy treated with a single dose MTX treatment were retrospectively evaluated. β-hCG values and changes on Days 0, 4 and 7 of the MTX treatment successful group and the unsuccessful group were analyzed.

RESULTS: MTX treatment was successful in 125 (77.2%) and unsuccessful in 37. When the β-hCG values ​​on Days 0, 4 and 7 were compared in pairs, the differences between groups were statistically significant (p < 0.001). The mean β-hCG value was 783.0 in the MTX successful group and 1802.0 in unsuccessful group (p < 0.001). There was a 21.6% decrease in β-hCG values ​​between Days 0 and day 4 in the MTX successful group and a 25.7% increase in the MTX unsuccessful group (p < 0.001). On Days 0, 4 and 7, ROC curve analysis’s values are​​, respectively; 755/939/486 for cut off, 86.49/83.78/94.59% for sensitivity and 48.80/69.60/72.36% for specificity.

CONCLUSIONS: Success rates of single-dose MTX treatment increase in tubal ectopic pregnancies with low initial β-hCG value. Patients with a decrease in β-hCG value and/or a cut-off decrease of 20% or more on the fourth day of treatment can be called for weekly β-hCG monitoring without the need for close follow-up. The change in β-hCG between Day 0 and Day 4 can be used to predict the efficacy of treatment.

PMID:35315015 | DOI:10.5603/GP.a2021.0247

J Cancer Surviv. 2022 Mar 22. doi: 10.1007/s11764-022-01192-1. Online ahead of print.

ABSTRACT

PURPOSE: This study assessed the effects of 12-week supervised resistance training combined with home-based physical activity on physical fitness, cancer-related fatigue, depressive symptoms, health-related quality of life (HRQoL), and life satisfaction in female breast cancer survivors.

METHODS: A parallel-group, outcome assessor-blinded, randomized controlled trial included 60 female breast cancer survivors who had completed their core treatments within the previous 10 years. Through computer-generated simple randomization, participants were assigned to resistance training (RTG; two sessions/week for 12 weeks plus instructions to undertake ≥ 10,000 steps/d) or control (CG; ≥ 10,000 steps/d only). Outcomes were evaluated at baseline and week 12. Muscular strength was assessed with electromechanical dynamometry. A standardized full-body muscular strength score was the primary outcome. Secondary outcomes included cardiorespiratory fitness, shoulder mobility, cancer-related fatigue, depressive symptoms, HRQoL, and life satisfaction.

RESULTS: Thirty-two participants were assigned to RTG (29 achieved ≥ 75% attendance) and 28 to CG (all completed the trial). Intention-to-treat analyses revealed that the standardized full-body muscular strength score increased significantly in the RTG compared to the CG (0.718; 95% CI 0.361-1.074, P < 0.001, Cohen’s d = 1.04). This increase was consistent for the standardized scores of upper-body (0.727; 95% CI 0.294-1.160, P = 0.001, d = 0.87) and lower-body (0.709; 95% CI 0.324-1.094, P = 0.001, d = 0.96) strength. There was no effect on cardiorespiratory fitness, shoulder flexion, cancer-related fatigue, depressive symptoms, HRQoL, or life satisfaction. The sensitivity analyses confirmed these results.

CONCLUSION: and implication for cancer survivors. In female breast cancer survivors who had completed their core treatments within the past 10 years, adding two weekly sessions of supervised resistance training to a prescription of home-based physical activity for 12 weeks produced a large increase in upper-, lower-, and full-body muscular strength, while other fitness components and patient-reported outcomes did not improve.

TRIAL REGISTRATION NUMBER: ISRCTN14601208.

PMID:35314958 | DOI:10.1007/s11764-022-01192-1

Ginekol Pol. 2022 Mar 22. doi: 10.5603/GP.a2022.0001. Online ahead of print.

ABSTRACT

OBJECTIVES: Morcellation is an integral part of laparoscopic procedures related to uterine fibroids, which consist of the mechanical fragmentation of the tumor and its extraction outside the abdominal cavity. To avoid the risk of tissue dissemination, special extraction systems have been developed, which allow morcellation of the specimen under visual control and its removal without contact with the abdominal organs. The aim of the paper is to compare the two systems for laparoscopic morcellation.

MATERIAL AND METHODS: The study included 33 premenopausal women with symptomatic leiomyomas or adenomyosis, who were qualified for laparoscopic surgery with contained power morcellation. Patients were allocated alternately to a different tissue extraction system’s group. According to the study protocol, selected operative parameters were prospectively recorded. Finally, an assessment of bag use was performed. The data was statistically analyzed.

RESULTS: There were significant differences between the two tested systems in terms of introducing and positioning the bag, its removal from the peritoneal cavity, as well as optic trocar insertion and establishing the pseudo-peritoneum.

CONCLUSIONS: Despite the minor design differences and some ergonomic aspects, both presented systems proved to be safe and feasible tools for laparoscopic contained morcellation. This technique both reduces the risk of tissue dissemination and preserves the advantages of minimal invasiveness.

PMID:35315008 | DOI:10.5603/GP.a2022.0001

Diving Hyperb Med. 2022 Mar 31;52(1):2-6. doi: 10.28920/dhm52.1.2-6.

ABSTRACT

INTRODUCTION: Measurement of skin temperature with infrared thermometry has been utilised for assessing metabolic activity and may be useful in identifying patients with ulcers suitable for hyperbaric oxygen treatment and monitoring their treatment progress. Since oxygen promotes vasoconstriction in the peripheral circulation, we hypothesised that oxygen administration may lower skin temperature and complicate the interpretation of temperatures obtained. This pilot study investigated the effect of oxygen administration on lower limb skin temperature in healthy subjects and diabetic patients.

METHODS: Volunteers were recruited from healthy staff members (n = 10) and from patients with diabetic foot ulcers (n = 10) at our facility. Foot skin surface temperatures were measured by infra-red thermometry while breathing three different concentrations of oxygen (21%, 50% and 100%).

RESULTS: Skin temperature changes were observed with increasing partial pressure of oxygen in both groups. The mean (SD) foot temperatures of diabetic patients and healthy controls at air-breathing baseline were 30.1°C (3.6) versus 29.0°C (3.7) respectively, at FiO₂ 0.5 were 30.1°C (3.6) versus 28.5°C (4.1) and at FiO₂ 1.0 were 28.3°C (3.2) versus 29.2°C (4.3). None of these differences between groups were statistically significant.

CONCLUSIONS: Data from this small study may indicate a difference in thermal responses between healthy subjects and diabetic patients when inhaling oxygen; however, none of the results were statistically significant. Further investigations on a larger scale are warranted in order to draw firm conclusions.

PMID:35313366 | DOI:10.28920/dhm52.1.2-6

Med Sci Monit. 2022 Mar 21;28:e935879. doi: 10.12659/MSM.935879.

ABSTRACT

According to world statistics, men are more susceptible to the coronavirus disease 2019 (COVID-19) than are women. Considering the interconnection between infections and male infertility, investigation of the potential impact of COVID-19 on men’s reproductive health is now a particularly relevant topic. Published data indicate decreased sperm quality and orchitis development in patients with COVID-19, including reduced sperm count, decreased sperm motility, and elevated DNA fragmentation index. Although mass vaccination against COVID-19 is currently being carried out worldwide using available authorized vaccines, the effect of these vaccines on men’s reproductive health has not yet been investigated. There is currently no evidence that SARS-CoV-2 can be transmitted in semen, but available data suggest that it can infect spermatogonia, spermatids, Leydig cells, and Sertoli cells. Therefore, SARS-CoV-2 orchitis and reduced male fertility may be long-term complications of COVID-19, which requires further investigation. Currently, there is also no evidence that vaccines against SARS-CoV-2 have any pathological effects on spermatogenesis or male reproductive health. Thus, further studies are needed to determine the effects of COVID-19 and COVID-19 vaccines on men’s reproductive health, which will help to optimize the management and rehabilitation of these patients. This review aims to discuss recent studies on the impact of the COVID-19 and COVID-19 vaccines on men’s reproductive health. The article addresses various issues such as the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on testosterone biosynthesis, semen parameters, testicular tissue, and epididymis.

PMID:35313326 | DOI:10.12659/MSM.935879

Clin Oral Investig. 2022 Mar 21. doi: 10.1007/s00784-022-04457-2. Online ahead of print.

ABSTRACT

OBJECTIVES: Type 1 diabetes mellitus (T1DM), a chronic autoimmune disease characterized by insulin deficiency, is related to periodontal diseases in children and adolescents. Our aim was to profile salivary human beta-defensin (hBD)-2 and hBD-3 concentrations in relation to periodontal and T1DM status in children and adolescent populations.

MATERIAL AND METHODS: Unstimulated saliva samples were collected from 66 participants including periodontally healthy T1DM patients (T1DM + C; n = 18), T1DM patients with gingivitis (T1DM + G; n = 20), systemically and periodontally healthy individuals (SH + C: n = 15), and systemically healthy gingivitis patients (SH + G; n = 13). Full mouth plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded. Salivary hBD-2 and hBD-3 concentrations were evaluated by sandwich ELISA method. A p value of < 0.05 was considered statistically significant.

RESULTS: Salivary hBD-3 concentrations were lower in T1DM groups in comparison to systemically healthy counterparts (SH + G vs. T1DM + G; p < 0.001 and SH + C vs. T1DM + C; p < 0.001). Salivary hBD-2 levels did not differ between related groups. The difference in hBD-3 concentrations between T1DM and control groups was still significant (p = 0.008) after being adjusted for PI%, BOP%, and age.

CONCLUSION: In the limits of study, T1DM patients were found to have decreased salivary hBD-3 concentrations, regardless of their gingival inflammatory status.

CLINICAL RELEVANCE: Altered salivary hBD-3 concentration can partly explain why diabetic children are more prone to periodontal diseases.

PMID:35313357 | DOI:10.1007/s00784-022-04457-2