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Konstantinos Dinas, Leonidas Zepiridis,
Olga Arvanitidou,
George Mavromatidis,
Maria Nasioutziki,
Panagiotis Loufopoulos,
Angelos Daniilidis,
Apostolos Mamopoulos,
Konstantinos Pantazis,
Dimitrios Dovas,
Theodoros Theodoridis,
Aristoteles Loufopoulos
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ABSTRACT: We aimed to evaluate the knowledge about chlamydial infection of Greek midwives and midwifery students. An appropriately designed, self-administered, anonymous questionnaire was distributed to 107 midwives and 29 graduating midwifery students. Perceived awareness of chlamydial infection was similar in midwives and students (p=0.083). However, midwives were more aware than students that Chlamydia are acquired through sexual contact (84.1% vs 58.7%; p=0.004) and that chlamydial infection is frequently asymptomatic (72.9% vs 37.9%; p=0.001). Knowledge of the consequences was poor in both groups, but it was relatively better in midwives; only 7.5% of the midwives did not know any of the potential sequelae of chlamydial infection compared with 24.1% of the students (p=0.006). In contrast, the majority of both midwives and students were aware that when chlamydial infection is diagnosed in a woman, both she and her partner should receive treatment (90.7% vs 93.2%; p = 0.901). In conclusion, an important proportion of midwifery students ignore important aspects of chlamydial infection. Therefore, it is important to improve the educational curriculum in midwifery schools in order to maximize the contribution of midwives to decrease the prevalence of chlamydial infection and of its complications.
Scandinavian Journal of Infectious Diseases 04/2010; 42(4):249-53. · 1.72 Impact Factor
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ABSTRACT: The aims of this study was (a) to compare the diagnostic accuracy of ultrasound examination with laparoscopic findings and both with the gold standard (histology) in the management of benign ovarian lesions, and (b) to assess the feasibility of laparoscopy in their diagnosis and management.
Prospective, comparative study (Canadian Task Force Classification II-2). A total of 117 women 15-59 years old were examined at outpatient department and had transvaginal ultrasound assessment. Ninety-eight women (three postmenopausal) with 105 cystic ovarian lesions met inclusion criteria and underwent operative laparoscopy. Histology was performed in all cases.
Although laparoscopy showed an overall higher performance compared to transvaginal ultrasound, statistically significant difference was found only in the detection of endometriomas compared to ultrasound (P = 0.004 for sensitivity and P = 0.046 for specificity).
Laparoscopy exhibits higher diagnostic accuracy, especially in endometriomas, compared to transvaginal scan. Laparoscopic diagnosis appears to be safe and accurate. Conservative laparoscopic management of benign adnexal masses is safe and with low morbidity.
Archives of Gynecology 04/2009; 280(5):767-73. · 0.91 Impact Factor
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ABSTRACT: We conducted a pilot study in female dental school students in Northern Greece in order to assess their awareness and practice of contraception.
The study population consisted of 88 female graduating students of the dental school. A self-administered, anonymous questionnaire was designed to explore students' awareness and use of contraceptive methods.
Condoms were the most widely used contraceptive method (they were used by 52.3% of the students); 20.5% of the students were using condoms in alternation or together with coitus interruptus, and 6.8% were using only coitus interruptus. The oral contraceptive pill (OC) was used as the only contraceptive method by 4.5% of the students and in combination with condoms by 9.1% of them. The majority (53.4%) considered condoms as the most effective contraceptive method; 9.1% of the students answered "sterilization" and the same percentage stated "intrauterine contraceptive device (IUD)." Overall, 20.5% of the students believed that the OC increases the risk of cancer, and 36.4% did not know if there is an association between OC use and risk of cancer. Among students not using OC, the respective percentages were 23.7% and 42.1%. among the students, 59.1% had asked their gynecologist about contraception. The contraceptive method used and the perception regarding the most effective contraceptive method did not differ significantly between those who had consulted their gynecologist and those who had not.
Dental school students in Greece appear to have inaccurate knowledge on important contraceptive issues, and this is reflected in their contraceptive practices. There is a pressing need to provide scientifically based sexual education if we are to avoid unwanted pregnancies.
Journal of Women s Health 04/2009; 18(3):387-91. · 1.57 Impact Factor
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ABSTRACT: Mesenteric cysts are rare intra-abdominal lesions with variable clinical symptoms and signs that make pre-operative diagnosis difficult. Optimal treatment is surgical excision of the cyst with laparotomy or laparoscopy. We present a case of mesenteric cyst that was misdiagnosed as para-ovarian cyst and managed laparoscopically by gynaecologists.
Cases Journal 03/2009; 2:132.
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ABSTRACT: Wilson's disease is a rare genetic disorder of copper metabolism that causes primary hepatic cirrhosis, secondary menstrual abnormalities and infertility. Following the appropriate therapy patients are asymptomatic and pregnancy may be achieved. We present a case of placental abruption in a pregnant woman with Wilson's disease and we review the management dilemmas and treatment options of pregnant women with Wilson's disease.
Cases Journal 01/2009; 2:8699.
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ABSTRACT: The amniotic band syndrome has a scarce prevalence and intrauterine death as a result of amniotic bands formation is extremely rare.
We present an illustrative case of intrauterine death of an embryo in the 24th gestational week in an 30-year old primigravida. The death was ascribed to the twisting of the umbilical cord around the left upper extremity, causing a strangulation of the umbilical cord in a very impressive way.
Constriction of the umbilical cord by an amniotic band is extremely rare and very hard, if not impossible, to diagnose with antenatal sonography.
Cases Journal 01/2009; 2:9108.
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ABSTRACT: To present a series of six consecutive women with adenomyomas who were successfully managed with a standard treatment strategy to elucidate the feasibility and the effectiveness of laparoscopic treatment of adenomyomas.
Cross-sectional case series.
Obstetrics and gynecology department of a tertiary academic hospital and endoscopic unit of a private hospital.
The six cases described in this report were nonpregnant women of reproductive age (mean age, 34.8 years old; range, 29-38 years) who presented in the outpatient gynecological clinic for yearly routine visit (one patient), dysmenorrhea and menorrhagia (three patients), and history of pregnancy loss (two patients).
Laparoscopic excision of uterine adenomyomas.
Feasibility and effectiveness of laparoscopic management of adenomyomas.
The average operating time was 100.5 minutes, and the average estimated blood loss was 163 mL. No event complicated the intraoperative and the postoperative course of these cases, and no case was converted to laparotomy. The mean follow-up was 13.7 months, with complete regression of the symptoms.
Excision of adenomyomas presents intraoperative peculiarities involving difficulties in their dissection and manipulation. Laparoscopic management of these lesions appears to be safe and feasible with good follow-up results and limited recurrence rates.
Fertility and sterility 05/2008; 89(4):953-61. · 3.97 Impact Factor
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ABSTRACT: Recent studies have shown that gingivitis and periodontal infection during pregnancy represent an independent risk factor for pre-term birth. However, little is known about the prevalence and correlates of dental attendance during pregnancy.
During the first 3 days postpartum, an anonymous questionnaire was administered to 425 women in order to explore their dental condition and utilisation of dental health services during pregnancy, as well as their perceptions on the potential associations between dental care during pregnancy and pregnancy outcomes.
Almost half of the respondents (46.8%) reported symptoms of gingivitis during their pregnancy. Pregnancy gingivitis was independently associated with non-Greek ethnicity (p=0.008), multiparity versus primiparity (p<0.005), lower economic class versus middle and upper classes (p=0.001), and the lack of routine primary dental care (p=0.005). Some 27.3% reported a visit to the dentist during their pregnancy. The majority (72.2%) believed that dental treatment during pregnancy might have a negative affect on pregnancy outcome. The presence of pregnancy gingivitis and the belief that dental treatment during pregnancy is safe were both independently associated with visiting a dentist during pregnancy (p<0.0005 for both).
Despite the increased prevalence of dental problems among pregnant women, few women seek dental services in this population, which can be primarily attributed to women's erroneous beliefs regarding the safety of dental examination. Therefore, there is an imperative need to offer oral health education and develop preventive programs for women of reproductive age.
Acta Obstetricia Et Gynecologica Scandinavica 01/2007; 86(8):938-44. · 1.77 Impact Factor
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ABSTRACT: To explore the possible relationship between sperm quality and embryo development, pregnancy and implantation rates, in patients undergoing intracytoplasmic sperm injection (ICSI).
Fertilization and cleavage rates, quality of embryos, blastocyst development, pregnancy and implantation rates were analyzed in 1020 embryos from 219 couples undergoing first ICSI treatment cycle. The couples were allocated in five groups, according to semen parameters: Group 1: patients with normal semen parameters, Group 2: patients with mild oligo-astheno-teratozoospermia, Group 3: patients with severe oligo-astheno-teratozoospermia, Group 4: patients with obstructive azoospermia, Group 5: patients with non-obstructive azoospermia.
Fertilization and cleavage rates, quality of embryos as well as blastocyst development rates were significantly reduced, as semen quality decreased. However, no significant differences were observed in clinical pregnancy and implantation rates.
Overall, a negative relationship was observed between semen quality and embryo development, even before activation of the embryonic genome, suggesting that sperm can affect embryogenesis from a very early stage.
Journal of Assisted Reproduction and Genetics 03/2006; 23(2):69-74. · 1.84 Impact Factor
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ABSTRACT: This article describes the laparoscopic management of unicornuate uterus with a non-communicating rudimentary horn in three women who presented with lower abdominal pain and dysmenorrhoea. The patients were managed with laparoscopic removal of the rudimentary horn along with the ipsilateral salpinx. No complications were noted intraoperatively and the patients remain asymptomatic.
Reproductive biomedicine online 02/2006; 12(1):128-30. · 2.04 Impact Factor
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ABSTRACT: Interstitial pregnancy is a rare but life-threatening condition. A case of a 28-year-old woman with a partially ruptured interstitial pregnancy treated with operative laparoscopy is presented. A laparoscopic cornual resection and a left salpingectomy were performed uneventfully. Serum beta-human chorionic gonadotrophin concentrations were measured serially at weekly intervals until resolved on day 20 postoperatively. It seems, therefore, that laparoscopic treatment is still an effective option for management even in ruptured interstitial pregnancy, preserving the anatomical integrity of the uterus and future fertility, and that rupture of interstitial ectopic pregnancy is not a contra-indication for laparoscopy.
Reproductive biomedicine online 11/2004; 9(4):447-51. · 2.04 Impact Factor
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ABSTRACT: Fertility, defined as the ability to achieve a pregnancy, declines gradually over the woman's lifespan. Although this decline seems to begin from the age of 30 years, it is more obvious between 35 and 40 and increases dramatically thereafter. The age of 41 is considered to be the point when fertility stops and sterility starts. The actual menopause occurs approximately 10 years after the substantial loss of conception potential. Thus, the biological rather than the chronological age of the woman can predict more accurately her fertility potential. This decline in female reproductive potential correlates with ovarian factors, although a slight contribution from the uterus itself and from the neuroendocrine axis cannot be excluded. The ovarian reserve decreases with advancing age, while a parallel decrease in the quality of the oocytes is present, as indicated by the increased incidence of oocyte aneuploidy. The endocrine function of the ovary also declines with age, the later becoming unable to sustain its normal function in the neuroendocrine axis. Additionally, the role of the various endometrial factors remains controversial. On the other hand, exposure to toxic factors and the increased prevalence of infertility-related diseases like endometriosis and PID, may also contribute. Spontaneous conception rates are minimal in perimenopausal women, mainly due to a qualitative and quantitative loss of female gametes. In the rare case of spontaneous conception achievement, complications are more likely. The application of classic ovulation induction and IVF may serve some selected cases, where the woman's ovarian biological age does not correspond to her chronological one. However, the implantation, clinical pregnancy, and live birth rates in women of advanced age undergoing IVF treatment, show very poor results. On the other hand, preimplantation genetic diagnosis is an accurate diagnostic tool for exclusion of genetically deficient embryos prior to embryo transfer. Oocyte donation seems to be the most reliable option of the perimenopausal woman, since the cumulative birth rates after four treatment cycles is approximately 80%. Cryopreservation of ovarian tissue may be an alternative in nulliparas women <40 years of age who want to have children in the future or women with the same desire who, unfortunately, have had pelvic radiotherapy, chemotherapy, oophorectomy, or premature menopause. This technique has given encouraging results in animals, but has not achieved pregnancies in humans. In the future, the use of drugs to block oocyte depletion as well as recent techniques, such as cytoplasmic or germinal vesicle transfer, will be more widely tested and may offer an option to the perimenopausal woman who wishes to conceive.
Annals of the New York Academy of Sciences 11/2003; 997:93-104. · 3.15 Impact Factor
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Journal of Minimally Invasive Gynecology 12(6):469. · 1.74 Impact Factor
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ABSTRACT: To evaluate the efficacy of a Levonorgestrel-releasing Intrauterine System (LNG-IUS) in controlling menorrhagia in comparison with endometrial thermal rollerball ablation.
Seventy-nine consecutive patients with menorrhagia underwent either LNG-IUS insertion (n=42) or hysteroscopical endometrial thermal rollerball ablation (n=37) in a prospective, observational, comparative study. Women reported duration of uterine bleeding in days prior to, and six and 12 months after each intervention. Prior to each intervention, endometrial, cervical or other pathological conditions of the genital tract were excluded. GnRH analogues for endometrial suppression were given for ten weeks before endometrial ablation but not prior to LNG-IUS insertion.
There were no differences in duration of uterine bleeding before each intervention in the two groups. The duration of uterine bleeding was lower in the LNG-IUS group as compared with endometrial ablation at six (p<0.001) and 12 months (p<0.001) after each intervention. Furthermore, the effect on reduction of bleeding was stronger in the LNG-IUS group as compared with the endometrial ablation group at six (p<0.001) and 12 months (p<0.001).
The LNG-IUS was more efficacious than endometrial thermal ablation in reducing duration of uterine bleeding at six and 12 months post-intervention.
Hormones (Athens, Greece) 8(1):60-4. · 2.44 Impact Factor
