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Biomedical subjects

D Botsis

Publications and source records attributed to D Botsis.

At least 37 records · Page 2Linked to original sources
PubMed1997

Vaginal ultrasound of the endometrium in postmenopausal women with symptoms of urogenital atrophy on low-dose estrogen or tibolone treatment: a comparison.

OBJECTIVE: The objective of this study was to compare the efficacy of locally administered low-dose estrogens (0.625 mg of conjugated estrogens) and orally administered tibolone in postmenopausal women with symptoms and signs of atrophic vaginitis. Vaginal ultrasound was performed for the evaluation of endometrial or ovarian abnormalities. METHODS: A 6-month comparative randomised prospective study of women taking tibolone and locally administered low-dose estrogens. Seventy two postmenopausal women with symptoms of atrophic vaginitis were examined with vaginal ultrasound. The endometrial thickness, the endometrial volume, the uterus and the ovaries were measured before and after 6 months of treatment with low-dose estrogens or tibolone. RESULTS: In group A (low-dose estrogens treatment) the mean endometrial thickness, before and after treatment, was 3.0 +/- 0.1 mm and 2.9 +/- 0.8 mm, respectively. The mean ovarian volume was 3.9 ml. There were no changes in uterine volume during the treatment period. In group B (treated with tibolone) endometrial thickness was 3.2 +/- 0.3 mm and 3.2 +/- 0.7 mm, respectively. One women experienced vaginal bleeding. The volume of corpus uteri was unchanged after treatment. The volume of both ovaries was 4.2 ml and 3.9 ml, respectively. The overall acceptability of both types of administration was good. CONCLUSIONS: This study, using vaginal ultrasound, has shown that either hormone replacement therapy with tibolone or symptomatic treatment with low-dose estrogens, gives no sign of endometrial proliferation measured as endometrial thickness.

Administration, Intravaginal↗
PubMed1997

Transvaginal color Doppler and CA125 as tools in the differential diagnosis of postmenopausal ovarian masses.

OBJECTIVE: To evaluate whether transvaginal color Doppler and CA125 are valid in differentiating malignant from benign postmenopausal ovarian masses. METHODS: Sixty-two women with ovarian masses were studied with transvaginal color Doppler ultrasound before surgery. Serum CA125 levels were also measured. Resistance index (RI) and pulsatility index (PI) were calculated from the waveforms generated from blood flow within the ovary. RESULTS: Benign tumors had a significantly higher pulsatility index (mean 1.23 +/- 1.02; range 0.65-2.99) and resistive index (mean 0.78 +/- 0.22; range 0.5-1.1) than did malignant tumors. However some overlap in individual values for benign and malignant lesions was found. RI and PI sensitivity were significantly higher than those with CA125 (P < 0.05). Blood flow was detectable by color Doppler imaging in 95% of cases with malignant masses. CONCLUSION: Doppler sonographic evaluation of resistance and pulsatility indexes in the vessels of ovarian masses together with CA125 increased the sensitivity of prediction of malignancy for pelvic masses, but further work is needed before the validity of these factors is proved.

Aged↗
PubMed1997

A comparative study of an estradiol-releasing vaginal ring versus tibolone in postmenopausal women: a transvaginal color Doppler study.

OBJECTIVE: To evaluate endometrial blood flow characteristics in response to estrogen replacement therapy (ERT) and tibolone in postmenopausal women and to correlate the resistance index (RI) with plasma estradiol levels. MATERIALS AND METHODS: Transvaginal color Doppler ultrasound examinations were performed in 72 asymptomatic, postmenopausal women who demonstrated endometrial thickness < or = 5 mm. Thirty-six women receiving tibolone and 36 patients receiving ERT by a vaginal ring comprised the study groups. RESULTS: All postmenopausal women treated with tibolone or ERT showed continuous forward end-diastolic flow. The lowest RI was obtained in women with the vaginal ring inserted. The plasma concentrations of estradiol were found to be significantly higher in the vaginal ring group than those of tibolone. CONCLUSIONS: The data observed suggest that ERT and tibolone modify normal postmenopausal endometrial perfusion. Tibolone had a weaker estrogenic effect on endometrial blood flow resistance, and vaginal ring treatment enhanced endometrial blood perfusion through vasodilatation.

Anabolic Agents↗
PubMed1997

Hematological parameters of the mother and neonatal status during normal labor.

This study reviews the relationship between hematological parameters of the mother and the newborns status. Our material consisted of 180 pregnant women with singleton pregnancies who had an uncomplicated vaginal delivery. A negative relationship was noted between the pH and the maternal hemoglobin values both in the umbilical artery and vein (r = -0.27, p < 0.001, for the umbilical vein and r = -0.32, p < 0.0001, for the umbilical artery). A negative relationship was also noted between the umbilical vein pH and the maternal hematocrit, which was statistically significant (r = -0.28, p = 0.001). A similar negative correlation was observed between the umbilical artery pH and the maternal hematocrit (r = -0.32, p < 0.0001). In conclusion, maternal hematological parameters (hemoglobin, hematocrit) can affect the fetal acid-base balance.

Acid-Base Equilibrium↗
PubMed1997

Vaginal fluid and serum CEA, CA125 and SCC in normal conditions and in benign and malignant diseases of the genital tract.

Carcinoembryonic antigen (CEA), CA125, and squamous cell carcinoma antigen (SCC) were evaluated in paired vaginal fluid and serum samples from 69 women, mean age 40.6 (20-78) years. Fifteen of the subjects were normal females (controls), 12 were pregnant, 20 had benign gynecological diseases, 5 presented severe cervical dysplasias and 17 suffered from cancer of the genital tract. Highly elevated CEA, CA125 and SCC concentrations (median, range) were found in vaginal fluid: 186 ng/ml (12-5420); 890 U/ml (54-65000); 1600 ng/ml (27-13000) respectively, compared with those in the paired serum samples: 1 ng/ml (0.5-8.6); 12 U/ml (3.0-1590); 1 ng/ml (0.3-19). Vaginal fluid CEA, CA125 and SCC values were significantly different among the five studied groups (p < 0.0002; p < 0.02: p < 0.002 respectively), being significantly higher in the patients with benign gynecological diseases, compared with those in the patients with malignancies of the genital tract (p < 0.0001; p < 0.02; p < 0.005), and those in controls (p < 0.02; p < 0.007; p < 0.02 respectively). The results of this study suggest that: 1) CEA, CA125 and SCC seem to be normal constituents of vaginal fluid. 2) The distribution of CEA, CA125 and SCC between vaginal fluid and the circulation is affected by pregnancy, inflammation and cancer of the genital tract.

Adult↗
PubMed1997

Predictive factors used to justify hysterectomy after loop conization: increasing age and severity of disease.

OBJECTIVE: To determine the interpretability and significance of the traditional factors used to predict residual dysplasia in hysterectomy specimens after loop conization. MATERIALS AND METHODS: Loop electrosurgical cervical conization was performed on 372 patients. Ninety three women had a hysterectomy within 6 months of the loop conization. Residual disease was defined as cervical intraepithelial neoplasia or cancer in the hysterectomy specimen. RESULTS: Of the 93 patients having a subsequent hysterectomy, 36 (38.7%) has residual disease in their hysterectomy specimen. The mean age of the patients with residual disease in the post loop conization hysterectomy specimen was 42.22. The mean age of those free of residual disease was 29.42. By multivariate analysis, dysplasia involving the ectocervical margin (p = 0.34) and the endocervical margin (p = 0.35) was not predictive of disease in the hysterectomy specimens. Endocervical curettage (p = 0.005), glandular involvement (p = 0.01), loop conization pathology findings (p < 0.05) and cytological examination (p < 0.001) were predictive of residual dysplasia. CONCLUSIONS: Cytological reports, increasing age, severity of disease, gland involvement and endocervical curettage were the only factors that accurately predicted residual dysplasia. The presence or absence of dysplasia in the loop conization, ectocervical margin and endocervical margin was not predictive of residual dysplasia in post loop conization hysterectomy specimens.

Adult↗
PubMed1997

Vaginal intraepithelial neoplasia (VAIN) following hysterectomy in patients treated for carcinoma in situ of the cervix.

OBJECTIVE: To determine the number of patients with carcinoma in situ of the cervix treated by hysterectomy who proceeded to develop vaginal intraepithelial neoplasia (VAIN) and define whether the subsequent development of VAIN justifies intensive cytology and colposcopy follow-up. MATERIALS AND METHODS: Nine hundred and ninety-three women who were subjected to hysterectomy with CIN, (793 patients had completed 10 years of cytology and colposcopy follow-up) were identified. RESULTS: Forty-one patients with VAIN presented with CIN 3 after hysterectomy. The upper one half of the vagina was the area more affected. The middle age group developed VAIN in the shortest time. Atypical Cells (ASCUS) were found in 42% of these patients. Colposcopy revealed VAIN involving the vault angles of the suture line in 54% of the cases. In 51% of the cases the grade of vaginal abnormality was the same as that of the original lesion in the cervix. CONCLUSION: With such data we would propose screening over a 5-year period. Follow-up should also include colposcopic review during every examination.

Adult↗
PubMed1997

Transvaginal Doppler ultrasound with color flow imaging in the diagnosis of luteal phase defect (LPD).

OBJECTIVE: Our purpose was to determine whether color flow pulsed Doppler could predict a luteal phase defect (LDP). METHOD: Twenty-one women with regular menstrual cycles and at risk for luteal phase defect were examined by transvaginal color Doppler during the follicular and luteal phase of the menstrual cycle. Progesterone was measured on the day of the Doppler exam. Ovulation was determined from the lutenizing hormone (LH) surge. Endometrial biopsy during the late luteal phase was performed on each patient. RESULT: Six patients (28.5%) were diagnosed with luteal phase defect. Mean resistance index in patients with luteal phase defect was significantly higher only throughout the luteal phases (p = 0.02). Mean progesterone levels were significantly lower for patients with LPD than for normal women (p < 0.001). Mean pulsatility index in luteal phase deficient cycles was significantly higher throughout the follicular and luteal phases (p = 0.03). CONCLUSION: Color Doppler may aid in assessing luteal phase adequacy. Doppler indices of corpus luteum blood flow in combination to plasma progesterone may be a useful index of luteal function.

Corpus Luteum↗
PubMed1997

Is color Doppler necessary in the evaluation of tubal patency by hysterosalpingo-contrast sonography.

BACKGROUND: To evaluate the diagnostic efficacy of hysterosalpingo-contrast sonography (HyCoSy) and to establish whether, in doubtful cases, the additional use of transvaginal Color Doppler can improve the tubal diagnosis reached with gray scale imaging alone. STUDY DESIGN: Ninety-six cases of unknown tubal function with infertility complaints were included. Within four weeks after sonographic hydrotubation, hysterosalpingography was performed. The diagnostic efficacy of gray scale and Color Doppler were compared with each other and against HSG. RESULTS: We calculated a sensitivity value of 82.9% and a specificity value of 86.1% for both tubes. The concordance value was of 83.5%. The total number of Color Doppler examinations compared with those of HSG showed a sensitivity of 91% for the right tube and 93% for the left tube and a specificity of 100% for both tubes. CONCLUSIONS: HyCoSy provides reproducible findings for the evaluation of uterine abnormalities and tubal patency. The additional use of Color Doppler is recommended as a supplement to gray scale imagin in cases of suspected tubal occlusion.

Adult↗
PubMed1997

Smoking and preterm labor.

The aim of the present study was to investigate the role of maternal smoking during pregnancy in the occurrence of the premature rupture of the membranes (PROM) and premature labor . Our study consisted of 1,133 women of which 283 (group A) had premature labor (gestation < or = 37 weeks), while 850 (group B) had term labor (gestation > 37 weeks). The two groups did not differ in their socioeconomic status and did not include women with serious complications during pregnancy. There were no apparent effects of smoking on the length of gestation. However, our results showed that smoking had a marked effect on preterm labor of less than 32 weeks; we also found a statistically significant correlation between PROM in premature deliveries and smoking during pregnancy, but no gradient was observed between the number of cigarettes smoked per day and the risk for PROM, in cases of premature labor. We conclude that smoking during pregnancy raises the risk of delivery before the 32nd week, as well as the PROM in premature deliveries, independently of the number of cigarettes smoked per day.

Adult↗
PubMed1996

Transvaginal sonography in postmenopausal women treated with low-dose estrogens locally administered.

OBJECTIVE: The objective of this study was to determine the efficacy of low-dose estrogens, administered locally, in postmenopausal women with symptoms and signs of atrophic vaginitis. Transvaginal ultrasonography was performed for the evaluation of endometrial or ovarian abnormalities. MATERIALS AND METHODS: Fifty-six healthy postmenopausal women with symptoms of atrophic vaginitis due to estrogen deficiency were examined with transvaginal ultrasound. The endometrial thickness, the uterus and the ovaries were measured before and after 6 months of treatment with low-dose estrogens. RESULTS: The mean endometrial thickness, before and after treatment was 3.1 +/- 0.8 mm and 3.1 +/- 1.2 mm respectively. The mean ovarian volume before treatment was 4.5 ml and there was no difference after treatment. There were no changes in uterine thickness during the treatment period. CONCLUSIONS: Our study, using transvaginal ultrasonography, has shown that low-dose estrogens, administered locally, give no sign of endometrial proliferation, measured as endometrial thickness, and do not alter the ovarian volume in postmenopausal volume.

Atrophy↗
PubMed1995

Sonographic incidence of polycystic ovaries in a gynecological population.

The prevalence of polycystic ovaries in a large population of 1078 women of reproductive age was determined by pelvic ultrasonography. The ovarian ultrasonic appearance of 183 (17%) women met the morphological criteria of polycystic ovaries. Of these women, 147 (80.3%) had irregular cycles (group A) and 36 (19.7%) had normal cycles (group B). The remaining women constituted the control group. Ovarian volume was calculated in all women in whom at least one ovary was visualized. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were measured in 124 women from group A, 25 from group B and 50 controls. Mean ovarian volume was statistically higher in both group A (13.4 ml) and group B (11.8 ml) than in the control group (6.2 ml). Mean LH/FSH ratio and mean testosterone values were statistically higher in group A only (2.1 and 1.1 ng/ml, respectively) compared with the mean values in the control group (0.7 and 0.7 ng/ml, respectively). Obesity and hirsutism were more common in group A than in group B and the controls. Screening the ovaries in women of reproductive age and subsequent assessment of morphology in polycystic ovaries can aid in the diagnosis of this condition in patients who may have a varied clinical presentation.

Adolescent↗
PubMed1993

The tap test: a simple and inexpensive method for the diagnosis of fetal pulmonary maturity.

OBJECTIVE: To report our experience in the prediction of fetal lung maturity with the tap test. METHOD: Amniotic fluid was obtained from 207 pregnant women from 17-40 weeks' gestation and the tap test compared with the phospholipid profile. RESULTS: The predictive values for a mature tap test were 100%, 99.9% and 98.2% and for immature tap test were 45.8%, 50% and 56.4% at 2.5 and 10 min, respectively. CONCLUSION: The tap test is a reliable, rapid, easy, inexpensive and accurate method for detection of fetal lung maturity.

Amniotic Fluid↗
PubMed1992

Cystic hygromas associated with Turner's syndrome. Report of three cases.

Three cases of cystic hygromas are reported. Two of these were singleton pregnancies diagnosed at 20 weeks' gestation and the other was an affected fetus in a twin pregnancy at 19 weeks gestation. Amniocentesis was done and chromosomal analysis revealed Turner syndrome in all cases. The two singleton pregnancies were terminated by intrauterine installation of PgF2a. The affected fetus of the twin pregnancy died at 24 weeks' gestation and the pregnancy continued.

Abortion, Therapeutic↗
PubMed1992

Vaginal sonography of the endometrium in postmenopausal women.

The purpose of this study was to compare transvaginal ultrasound scanning and histology of the endometrium obtained by curettage. One hundred twenty women with postmenopausal bleeding were examined by vaginal sonography, before undergoing curettage. Endometrial thickness, as measured by vaginal sonography, was used as an indicator of endometrial abnormality. The mean endometrial thickness in those women with endometrial cancer was 16.6 +/- 5.4 mm as compared with 3.2 +/- 1.1 mm in those women with atrophic endometrium, and 9.5 +/- 2.3 in those with hyperplasia. If a cutoff limit of 5 mm had been used in this study, 82% of the curettage procedures could have been avoided, without missing a single case of serious endometrial pathology. We conclude that vaginal sonography is a reliable examination in the detection of endometrial abnormality in women with postmenopausal bleeding.

Aged↗
PubMed1991

Prenatal sonographic diagnosis of thanatophoric dwarfism.

A case of thanatophoric dwarfism is reported in a 35-year-old woman. The diagnosis was made at 34 weeks gestation by ultrasound. Marked shortening of the extremities, macrocephaly, narrow thorax and polyhydramnios were observed. The importance of routine ultrasound screening in pregnancy is emphasized, since such malformations can be detected prenatally.

Adult↗
PubMed1989

Culture of seminal fluid in infertile men and relationship to semen evaluation.

Bacterial flora of the seminal fluid and its influence on semen quality, was examined in 225 asymptomatic unselected men. Each semen sample was cultured aerobically, anaerobically, for genital mycoplasmas, and for Chlamydia trachomatis. Semen analysis was made according to standard methods recommended by the W.H.O. All 225 semen samples had microbial isolates. All isolates had colony counts of 10(2) colony forming units (cfu/ml). Thirty-three cases had greater than 10(2) cfu/ml, 85 cases had greater than 10(3) cfu/ml and 78 cases greater than 10(5) cfu/ml. The most common organisms isolated were Ureaplasma urealyticum in 86 samples and C. trachomatis in 26 samples. The most frequent abnormal parameters were viability (117 of 212, 52%), motility (85 of 212, 40%) and number of sperm cells (74 of 225, 32.8%). No significant correlation was found between abnormal semen parameters and presence of U. urealyticum, and C. trachomatis. We concluded that asymptomatic bacteriospermia (infection) in the semen did not significantly affect the count, motility or morphologic features of the specimen.

Bacteria↗