Complications of oxidised regenerated cellulose at Caesarean section: A report of two cases.

Two patients underwent surgical deliveries within four months of one another at a single maternity unit. Both patients had complications of infection-like symptoms such as offensive vaginal discharge and pyrexia, months following their caesarean sections resulting in further surgery. The incidents were thought to be secondary to woven oxidised regenerated cellulose (ORC) use. ORC must be used according to its relevant product literature which can vary between brands. Surgeons must keep abreast of changes to the haemostatic material provided to them and therefore the properties of each type, especially when faced with bleeding not suitable for suturing or electrocautery.

Rapidly progressive primary undifferentiated ovarian carcinoma: presentation of a rare case.

Ovarian cancer is the second most common gynecologic malignancy and is one of the leading causes of death among women. The disease course and the accurate diagnosis are correlated with the early detection of the lesion. About 5% of ovarian cancers are poorly differentiated and difficult to be classified, and are referred to as undifferentiated carcinomas. They are usually large, solid with haemorrhage and necrosis, bilateral, and very difficult to be histologically classified. Generally, cases with undifferentiated components are very rare. The authors present a case of a young female patient with a rapidly progressive undifferentiated ovarian carcinoma and a final unfortunate clinical result.

Vulvar melanoma presenting as postmenopausal bleeding: a case report.

Primary melanomas of the vulva are extremely rare, creating obstacles in the differential diagnosis of other epithelial and non-epithelial malignancies. Due to their rarity, there are only approximately 250 cases reported in the current literature. Vulvar melanomas tend to relapse locally, as well as develop locoregional and distant metastasis through lymph node and haematic dissemination. The authors describe a case of an 84-year-old Caucasian female patient, presenting with postmenopausal bleeding, consistent with primary vulvar melanoma cause, which was successfully diagnosed and treated accordingly.

Bioethical issues on the role of contemporary gynecologists concerning HPV vaccination.

UNLABELLED: Debate is heating up whether or not to require girls to be vaccinated against the human papillomavirus (HPV), a leading cause of cervical cancer (CC). Prolepsis against this plague is mainly focused on early detection with Pap test (screening) and recently with administrating HPV vaccines in youths. OBJECTIVE: To discuss the increased bioethical role of contemporary gynecologist in the young population, with the aim to contribute to the decrease of this malignancy. MATERIALS AND METHODS: The authors searched the web (data-warehouse: articles, forums, etc., and data-mining: sequence analysis and classification) for HPV vaccination and related bioethical issues. RESULTS: HPV vaccines have already caused debates on whether they must be mandatory and on whether they cause a pseudo-safeness mental state, making youths "forget" necessary annual Pap tests or even worse, urging them in promiscuity, resulting in an increased occurrence of CC. CONCLUSIONS: Greece, in order to appropriately apply the Constitutional Law 5 Section 5 (All persons have the right to the protection of their health...), needs to train contemporary gynecologists in adequate youth consultation and proper family approaches regarding HPV vaccination issues. Enhancing the gynecologist's role, vaccination's effectiveness (sensitivity and specificity) will be increased and on the other hand, a rule of social law will be established in the country.

Comparison of transvaginal 3D sonohysterography with outpatient hysteroscopy in the evaluation of abnormal uterine bleeding.

OBJECTIVE: To compare transvaginal three-dimensional sonohysterography (3D SHSG) and outpatient hysteroscopy with regards to diagnostic accuracy, procedure time, and patient discomfort with a prospective randomized controlled cohort study in a teaching hospital in London. The study included a population group of 49 women with abnormal uterine bleeding from varied ethnic backgrounds, of which 44 completed the study. Subjects with pregnancies, pelvic infections, large uteruses, suspicious or diagnosed pelvic malignancies, and who did not meet the criteria for day surgery, were excluded. MATERIALS AND METHODS: Patients were randomized into two groups: group 1 had hysteroscopy followed by SHSG while group 2 had SHSG followed by hysteroscopy. Diagnostic accuracy, procedure time, and patient discomfort of SHSG in comparison to hysteroscopy were studied. RESULTS: A total of 44 patients completed the study. The average age of the study population was 44.8 years and the mean parity was 1.8. Nulliparas represented 34.03% of the study population and the average duration of symptoms was 14.8 months. CONCLUSION: In the investigation of women with abnormal bleeding in an outpatient setting, both hysteroscopy and SHSG are comparable in the diagnosis of intracavity lesions, pain rating, and procedure time. However patient acceptability of SHSG was significantly more when compared to outpatient hysteroscopy.

Uncorrected tetralogy of Fallot and pregnancy: a case report.

We report a case of pregnancy in a 34-year-old woman with uncorrected tetralogy of Fallot (TOF). There are more risks in patients without surgical correction. In our case, haemoglobin and haematocrit were higher, oxygen saturation was lower, and right ventricular enlargement was observed. Pregnancy was resolved successfully by caesarean section. Improvement of fetomaternal outcome may be related to corrective procedures before conception to achieve better functional heart capacity. Delicate multidisciplinary medical management is essential for these limited cases to achieve optimal prognosis.

Contraceptive consciousness and sexual behavior in three different female age groups in Greece: a retrospective study of the evolution during the last three decades.

The aim of the study is to describe the evolution of contraceptive and sexual behavior within our Greek society. MATERIALS, MEASURES AND METHODS: We interviewed 508 females and made a statistical analysis of their answers. CONCLUSION: We tried to underline a strategy for the best promotion of the values in question. General, sexual and contraceptive education as well as the use and type of contraception are the weapons that will lead our endeavors to decreased involuntary pregnancy and towards responsible sexual behavior.

The role of oral contraception use in the occurrence of breast cancer. A retrospective study of 405 patients.

UNLABELLED: The investigation of potential predisposing factors of breast cancer, a disease accounting for almost one-third of malignancies in women, is necessary in order to reduce the incidence. MATERIALS AND METHOD: We interviewed 405 female patients who had been diagnosed with breast cancer and who also reported having used oral contraceptive pills before. They were categorized into two groups (group A < 7 years OC use and group B > 7 years OC use). RESULTS: Statistical analysis revealed a small (p < 0.02) but significant increased risk of the disease to BRCA mutation carriers, as well as to the women with a significant medical or family history of breast, ovarian or colon cancer who had also previously used oral contraceptive pills for more than seven years. DISCUSSION: Breast cancer seems to be positively dependent on prolonged oral contraceptive use. CONCLUSION: More research is needed to establish the hypothesis that the human genome is vulnerable to oral contraceptives.

The slow levonorgestrel-releasing intrauterine system (LNG-IUS) 20 mcg/day: a literature review.

The aim of the study is to present the mechanisms of action, indications, complications, contraindications and the necessary tests before the insertion of a levonorgestrel-releasing intrauterine system (Mirena). After a literature search in Pubmed, a narrative review in the field is presented.

Unwanted pregnancy and induced abortion among young women 16-22 years old in Greece: a retrospective study of the risk factors.

UNLABELLED: Unwanted pregnancies and the subsequent induced abortions are common problems of our youths in modern Greece. The aim of this study was to recognize the risk factors of the problem in an effort to find the best possible solution out of this social dead end. MATERIALS AND METHOD: We interviewed 1,320 young female individuals and analyzed their answers using statistical analysis. RESULTS: Several useful conclusions were reached concerning the forces that are involved in unwanted pregnancy/induced abortions. DISCUSSION: We have tried to underline the strategy to combat the problem. CONCLUSION: Sexual education and the proper use of contraception remain the essential tools in this effort.