Biomedical subjects

C Papadias

Publications and source records attributed to C Papadias.

At least 19 recordsLinked to original sources

PubMed1998

Clinical value of creatinine kinase in the diagnosis of ectopic pregnancy.

The role of creatinine kinase (CK) in the diagnosis of ectopic pregnancy was studied. We selected 56 patients divided into 4 groups. Group A consisted of 10 patients with asymptomatic tubal pregnancy, group B consisted of 11 patients with symptomatic tubal pregnancy whereas groups C and D consisted of 20 and 15 patients with normal and threatened intrauterine pregnancy, respectively. Serum samples of CK were taken from all patients on admission. No significant difference was observed in the median CK value of cases with normal pregnancy (58.5 +/- 7.24 U/1, mean +/- SE) as well as threatened abortion (73 +/- 11.43 U/1) compared to that of cases with asymptomatic 58.5 +/- 12.42 U/1) or symptomatic tubal pregnancy (59 +/- 10.08 U/1). We conclude that serum CK is not a useful biochemical marker in the diagnosis of ectopic pregnancy.

Abortion, Threatened↗

PubMed1998

Evaluation of ovarian cysts following GnRH-a treatment in patients with polycystic ovarian syndrome.

The aim of this study was to evaluate the ovarian cysts appearing during GnRH-a/hMG treatment in patients with polycystic ovarian syndrome (PCOS). A total of 35 women with PCOS were included in the study. All women received 3.75 mg IM of long-acting leuprolide acetate on the first day of the menstrual cycle. On the 15th day of the menstrual cycle, transvaginal ultrasound examination (US) and determination of serum E2 were done. A total of 90 cycles were studied in this way and during these cycles, 14 (15.5%) ovarian cysts with a diameter of >/= 20 mm developed. According to the serum E2 levels, 11 cases (group A) had E2 concentrations > 35 pg/ml and 3 (group B) had serum E2 levels < 35 pg/ml. Group A patients attained a significantly larger mean size of ovarian cyst than group B patients (42 +/- 7.3 vs. 24.2 +/- 3.2 mm, p < 0.001). When the serum E2 concentrations were < 35 pg/ml, the ovarian cysts were disregarded and ovarian stimulation with gonadotropins was initiated. In case that serum E2 levels were > 35 pg/ml, the initiation of the ovarian stimulation with hMG was postponed until serum E2 levels indicated down-regulation, which was achieved after 5.8 +/- 2.9 days. In both groups the ovarian stimulation resulted in ovulatory cycles, while four pregnancies in group A and one in group B were achieved. In conclusion, our results indicate that in patients with PCOS the GnRH-a administration may cause follicular cysts at an incidence of 15.5%. These cysts do not constitute a contraindication for ovarian stimulation provided that serum E2 levels are low.

Adult↗

PubMed1998

Gonadotropin ovulation induction and pregnancies in women with Kallmann's syndrome.

Only 17 cases of pregnancy in women with Kallmann's syndrome have been reported in the literature, eight as case reports. In our clinic, we diagnosed seven women with complete Kallmann's syndrome in a 16-year period. In five cases (unprimed patients) the diagnosis was established for the first time, while in the other two cases diagnosis had been established earlier. The five unprimed patients received hormone therapy (HRT) immediately after diagnosis. The other two patients had already been on HRT. Four patients wanted to bear children. Follicular evolution and maturation was induced with daily human menopausal gonadotropin (hMG) administration. The results were monitored through plasma estradiol (E2) determinations and ultrasonography. Ovulation was induced with hCG administration. Five pregnancies were achieved in three patients, resulting in four healthy neonates. Two women achieved a second pregnancy. Nausea and vomiting did not occur in any of our five pregnancies. We found no significant differences between the total hMG dose needed for ovulation induction, the number of stimulation days, estradiol plasma concentrations and the number of follicles with diameter > or = 17 mm, in either conceptional or non-conceptional cycles. In fact, the total hMG dose administered was lower and the days of stimulation were significantly fewer in women on their second pregnancy. There was no difference in plasma estradiol concentrations and the number of follicles with diameter > or = 17 mm. In conclusion, ovulation induction and pregnancy in women with complete Kallmann's syndrome is not such a difficult procedure as was believed in the past. A previous pregnancy seemed to augment ovarian sensitivity to gonadotropins.

Adult↗

PubMed1997

Effects of nasal administration of calcitonin in oophorectomized women: 2-year controlled double-blind study.

OBJECTIVE: The aim of this study was to assess the effects of nasal salmon calcitonin (SCT) administration on bone turnover in ovariectomized women. METHODS: Patients who had undergone bilateral ovariectomy 7 days previously, received either calcium supplementation (1000 mg/day, together with nasal SCT (100 IU/day) (n = 19) or the same calcium supplementation together with a placebo intranasal spray daily (n = 19), for 2 years. RESULTS: In the calcium-only-treated subjects, lumbar bone mineral density (BMD) was found to have decreased significantly (P < 0.001), 6 months after surgery and remained at this level until the end of the study. In the SCT-treated group, BMD remained stable during the 1st year and then decreased gradually, reaching a statistically significant level in the 2nd year. Mean serum osteocalcin concentration was unchanged during the 1st year of SCT treatment but was significantly elevated during the 2nd year (P < 0.01). The observed rise in serum osteocalcin concentration and urinary hydroxyproline excretion during the 2nd year of treatment with SCT was accompanied by a significant rise in serum calcitonin levels (P < 0.001 after 18 months and P < 0.01 after 24 months). CONCLUSION: This study shows that continuous treatment with intranasal SCT is able to prevent the bone loss that follows ovariectomy.

Administration, Intranasal↗

PubMed1997

Effect of tibolone on postmenopausal women with myomas.

OBJECTIVE: The aim of this study is to assess the effect of Tibolone (Livial) on uterine fibroids in postmenopausal women. METHODS: This study included 40 naturally postmenopausal women with at least one uterine fibroid measuring > 20 mm. All of theme were scanned by transvaginal ultrasonography. Patients were randomized into two groups. Group A (n = 20) were treated with Tibolone 2.5 mg daily for 1 year and group B (n = 20) did not received therapy. The size of the uterine fibroids was reevaluated on the end of the treatment. RESULTS: No statistically significant difference was found in the mean volume of fibroids before and after treatment with Tibolone. The administration of Tibolone resulted in an increase of fibroid volume in three patients, whereas it remained constant in the majority of the patients (70%) and decreased in three patients. CONCLUSIONS: Our results suggest that treating menopausal symptoms with Tibolone does not affect preexisting asymptomatic uterine fibroids.

Anabolic Agents↗

PubMed1996

Pregnancy rates in gonadotrophin stimulated cycles with timed intercourse or intrauterine insemination for the treatment of male subfertility.

OBJECTIVE: To compare the pregnancy rates achieved by intrauterine insemination or timed intercourse in gonadotrophin stimulated cycles in couples whose only detectable abnormality was poor sperm quality. DESIGN: Sixty-two couples with primary or secondary infertility due to male factor entered the study. The 62 couples were randomly equally divided into two groups. Each group began one of the two treatment modalities (controlled ovarian hyperstimulation in conjunction with timed intercourse or intrauterine insemination) for three consecutive cycles and then switched to the alternative treatment after one rest cycle, if pregnancy was not achieved. RESULTS: Five pregnancies (3.9%) were achieved after 128 cycles with timed intercourse and 15 pregnancies (11.5%) after 130 cycles with intrauterine insemination. The difference was found to be statistically significant (P < 0.05). CONCLUSION: We suggest that intrauterine insemination during hMG stimulated cycles improves the pregnancy rates of couples whose only detectable abnormality is poor sperm quality.

Adult↗

PubMed1996

Corticosteroid treatment does not improve the results of intrauterine insemination in male subfertility caused by antisperm antibodies.

AIM: To determine whether corticosteroid immunosuppression (CS) administered to the male partner together with intrauterine insemination (IUI) is preferable compared to IUI alone in treating male autoimmune subfertility. MATERIALS AND METHODS: Thirty-six couples with proven male immunological subfertility were randomly assigned to begin CS + IUI (n = 18) or IUI (n = 18) treatment and progressed alternatively to receiving each treatment modality for three cycles unless pregnancy occurred. Each couple served as their own control. The administered corticosteroid was soluble prednisolone. RESULTS: Five pregnancies were achieved with 77 cycles of CS + IUI and seven pregnancies with IUI alone. The pregnancy rates per cycle were 6.5% with CS + IUI and 9.21% with IUI, while the pregnancy rates per couple were 16.13% with CS + IUI and 21.2% with IUI alone. These rates do not differ to a statistically significant degree (P > 10%). CONCLUSIONS: The addition of corticosteroid immunosuppression does not seem to significantly enhance the pregnancy rate in couples with male autoimmune subfertility treated with IUI as compared to the treatment with IUI alone. Considering the possible side-effects of corticosteroid intake, we conclude that IUI alone might be preferable to the combination of IUI with corticosteroid administration.

Adult↗

PubMed1996

Transvaginal sonography of the endometrium in women with postmenopausal bleeding.

OBJECTIVE: The purpose of this study was to determine the value of screening transvaginal ultrasonography for the evaluation of endometrial abnormalities in women with postmenopausal bleeding. MATERIALS AND METHODS: 250 women with postmenopausal bleeding underwent transvaginal ultrasonographic examinations before undergoing dilatation and curettage. Women who had any pelvic symptoms or were on hormone replacement therapy were excluded. RESULTS: In 151 women, the histologic diagnosis was atrophic endometrium. In these patients, the mean endometrial thickness was 3.4 +/- 1.2 mm. In 24 patients with endometrial carcinoma, the mean endometrial thickness was 16.5 +/- 6.2 mm. The measurement included both endometrial layers (i.e. double layer). Thirty six cases of other pelvic pathologic conditions were discovered on ultra sonography. CONCLUSIONS: We believe that is reasonable to have a cutoff limit for normal postmenopausal endometrium at 5 mm. Endovaginal ultrasound is a valuable diagnostic instrument, as sensitive as dilatation and curettage, for detecting pathological conditions in the uterine mucosa.

Adult↗

PubMed1996

Comparison of flutamide and cyproterone acetate in the treatment of hirsutism: a randomized controlled trial.

The objective of this study was to compare the efficacy of flutamide and cyproterone acetate in the treatment of hirsutism. Twenty-two women with idiopathic hirsutism were randomized to receive either flutamide or cyproterone acetate. Each patient underwent a complete gynecological examination as well as an endocrinological profile and hematological, hepatic and renal function analyses. Hirsutism scores were determined using a modified Ferriman-Gallwey scoring system. These tests were then repeated at 3 and 9 months of therapy. Eleven patients received 250 mg of flutamide twice daily and 11 patients received 100 mg of cyproterone acetate on days 5-14 of the menstrual cycle. Ferriman-Gallwey scores were decreased significantly in both groups at the end of 9 months. There was a trend towards a better response with flutamide, that did not achieve significance. Another significant difference was the increased sex hormone-binding globulin in both groups. A statistically significant decrease was also observed for the levels of testosterone on both drugs. No subject withdrew from the study due to a side-effect. The data suggest that both flutamide and cyproterone acetate were similarly effective in treatment of hirsutism, and that the pure antiandrogen flutamide is a safe, well-tolerated and effective alternative in treatment.

Adolescent↗

PubMed1995

Controlled ovarian hyperstimulation with or without intrauterine insemination for the treatment of unexplained infertility.

OBJECTIVE: To evaluate whether there are any benefits from intrauterine insemination (IUI) as opposed to timed intercourse (TI) in stimulated ovarian cycles in couples with longstanding, unexplained infertility. METHODS: Forty-six couples with diagnoses of unexplained infertility were evaluated in a crossover study after a total of 141 cycles. Sixty-seven cycles were with IUI after controlled ovarian hyperstimulation (COH) while 74 cycles were after COH and TI. RESULTS: The pregnancy rate after COH/TI was 16.7% and after COH/IUI 45.2%. Cycle fecundity however was 8.9% after COH/TI and 25.7% after COH/IUI, which is a statistically significant difference (P < 0.05). CONCLUSIONS: A trial of human menopausal gonadotropin and IUI is justified in couples with prolonged infertility of unknown cause.

Adult↗

PubMed1995

Fallopian tube sperm perfusion has no advantage over intra-uterine insemination when used in combination with ovarian stimulation for the treatment of unexplained infertility.

In this prospective randomized study we treated 60 couples with unexplained infertility with a combination of ovarian stimulation and either intrauterine insemination (IUI) or fallopian sperm perfusion (FSP). In the IUI we used a volume of 0.5 ml of inseminate and in the FSP a volume of 4 ml. The demographic characteristics of the patients, the stimulation parameters and the sperm data were not statistically different between the two groups. The pregnancy rate per cycle was 16.2% in the IUI group and 14.5% in the FSP group and the pregnancy rate per woman was 40 and 36.7%, respectively (not statistically different). We conclude that IUI and FSP are equally effective in the treatment of couples with unexplained infertility.

Adult↗

PubMed1993

A randomized comparison of intrauterine and intraperitoneal insemination in the treatment of infertility.

OBJECTIVE: To compare the pregnancy rates (PRs) between intrauterine insemination (IUI) and intraperitoneal insemination (IPI) in women receiving comparable ovarian stimulation in couples who were infertile for various infertility conditions. METHOD: Fifty-four couples were treated. Of these, 25 were diagnosed as having unexplained infertility, 21 as having male infertility and 8 as having cervical mucus hostility. RESULT: Nine pregnancies occurred with 89 cycles of IUI and 6 pregnancies with 85 cycles of IPI, giving an overall PR of 28%. Twelve of the 15 pregnancies occurred during the first treatment cycle and three during the second treatment cycle. There was no significant difference in the (PRs) between the IUI and IPI (P > 0.25). CONCLUSION: Both procedures combined with superovulation proved to be simple, inexpensive safe and worthwhile for infertile couples with unexplained infertility, male infertility and cervical mucus hostility.

Adult↗

PubMed1993

Treatment of idiopathic infertility with testosterone undecanoate. A double blind study.

This study refers to 50 couples treated for subfertility. Twenty five of these patients were treated with TU (Testosterone Ur econoate), the remaining 25 received placebo. Sperm characteristics, including ejaculate volume, pH, sperm density, morphology, motility, total testosterone, FSH, LH, DHT and E2 were evaluated both before and after treatment. A statistically significant increase of DHT levels was noticed after TU administration, whereas a marginally significant improvement of sperm morphology was present. Serum FSH concentrations, decreased significantly in the TU group whereas serum LH presented a slight but not statistically significant decrease; 4 pregnancies were achieved by the TU group whereas none were achieved by the patients belonging to the placebo group. The administration of TU per os to patients with idiopathic oligospermia presents a demonstrably positive effect.

Administration, Oral↗

PubMed1991

Intrauterine insemination as a treatment of infertility in women with antisperm antibodies.

Twenty-four women with infertility caused by antisperm antibodies were treated by homologous intrauterine insemination. Initially, all the women had timed intrauterine insemination by washed spermatozoa for three cycles. The pregnancy rate per couple was 4.20%. The remaining 23 patients received a combined treatment of chlomiphene citrate and intrauterine insemination for three cycles, which did not increase the pregnancy rate per couple and per cycle (4.3% and 1.4% respectively). Thereafter, the remaining 22 patients received a combined treatment of hMG and intrauterine insemination for another three cycles which resulted in a pregnancy rate per cycle (6.1%) and per couple (18.20%) that was significantly greater (P less than 0.01). We conclude that infertile women with antisperm antibodies can benefit after a trial of induction of multiple follicular development with hMG in combination with intrauterine insemination.

Adult↗

PubMed1990

Clinical efficacy of LH-color: a new home ovulation test.

In this study we evaluate the efficacy of a new home ovulation test to identify LH surge (LH-Color, Organon). Fifty-five spontaneously ovulating women were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound and BBT charts. In 39 (70.91%) of the 55 patients, ovulation occurred within 24 h after the decoloration of the LH-Color. Follicular collapse as visualized by ultrasonography, took place in all patients within 36 h after the decoloration of the LH-Color. Thus a good correlation was found between urinary LH surge and ultrasound. We conclude that the rapid LH test was able to predict impending ovulation.

Adult↗

PubMed1989

The role of chlamydial serology in fertile and subfertile men.

The incidence of serum antibodies to Chlamydia trachomatis and the possible association of a positive serology on semen parameters in 120 subfertile men were studied. The findings were compared with those of 120 fertile volunteers fathering two or more children. The two groups were divided into those without and those with a history of genito-urinary infection. There was no significant difference (p greater than 0.1) in the prevalence of antibody testing between the subgroups of fertile population. A statistically significant difference in the incidence of antibodies was found between the two subgroups of subfertile population. No significant difference was noted in the semen parameters between Chlamydia-positive and Chlamydia-negative fertile and subfertile patients.

Adult↗

PubMed1988

Sexually transmitted diseases in women with urethral syndrome.

Frequency of micturition and dysuria were prominent symptoms in 135 (57%) of 237 women with urethral syndrome. Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis were the principal organisms associated with the urethral syndrome (38.41%, 28.14% and 11.11%, respectively). Escherichia coli was cultured from four patients and Herepes genitalis and Neisseria gonorrhoea were isolated from five patients. Infections with more than one organism were frequent. Thirty-one of 135 patients were infected by two organisms, 27 by three and 4 patients by four microorganisms. Vaginitis due to Garnerella vaginalis, Candida spp. and Trichomonas vaginalis was discovered in 52 (39%) of 135 patients.

Adult↗

PubMed1976

Pyometra.

Thirteen cases of pyometra without preoperative diagnosis in which vaginal or abdominal surgery was performed, are analysed in the present paper. The histologic examination revealed endocervicitis in all cases, while positive cultures for bacteria were found preoperatively in only eight of the above cases, thus, pyometra was considered to be a symptom of obstruction of the cervical canal.

Female↗