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1.
BMC Womens Health ; 22(1): 33, 2022 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-35148732

RESUMO

BACKGROUND: This study aimed to compare the effect of ovarian suspension and hyaluronic acid gel to prevent re-adhesions after laparoscopic endometrioma surgery. METHODS: This randomized clinical trial was conducted at Rasoul-e-Akram and Pars Hospitals, Tehran, Iran, 2016-18. Fifty patients with bilateral endometrioma and pelvic adhesions, the candidates of laparoscopic surgery, were included. In each patient, at the end of ovarian cystectomy and adhesiolysis, one of the ovaries was randomly sutured to the abdominal wall, and the HYAcorp Endogel covered the other; the adhesion rate was compared between the groups by ultrasonography, three-month after surgery. RESULTS: Mean age of patients was 32.6 years. Presurgical variables were similar between right and left ovaries and the study groups (P > 0.05). Postsurgical ultrasonography showed that ovarian soft markers, including < 1/3 ovarian adhesions (minimal adhesions) in 80.5% of ovaries of the Endogel group and 35.5% of the ovarian suspension group (P < 0.001) with higher ovarian mobility in the Endogel group (65% vs. 22%) (P = 0.001). In addition, site-specific tenderness and ovarian fading margin were lower in the Endogel group (P < 0.001). Trial registration Clinical trial registry number: IRCT2015081723666N1, 12.19.2015, Date of registration: 01/02/2016; https://en.irct.ir/trial/20174?revision=20174 . Date and number of IRB: 2015, I.R.IUMS.REC.1394.24703. CONCLUSION: Hyaluronic acid gel can be more effective than ovarian suspension in preventing ovarian adhesions after laparoscopic treatment of endometriosis.


Assuntos
Endometriose , Laparoscopia , Adulto , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Ácido Hialurônico/uso terapêutico , Irã (Geográfico) , Ovário/patologia , Aderências Teciduais/etiologia , Aderências Teciduais/prevenção & controle
2.
Bull Emerg Trauma ; 9(3): 145-150, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34307705

RESUMO

OBJECTIVE: To evaluate the maternal and fetal outcomes of COVID-19 up to three months after the delivery in pregnant women. METHODS: This case series study was conducted on all pregnant women with COVID-19 hospitalized in Hazrat -E- Rasoul Akram Hospital, Tehran, Iran from March 8, 2020 to December 28, 2020. Data were included maternal age and gestational age (GA) which presenting signs and symptoms were collected at hospital admission. To confirm COVID-19 diagnosis, high-resolution computed tomography (HRCT) or reverse transcription-polymerase chain reaction (RT-PCR) tests were conducted. Both the mothers and the newborns were followed up to three months after delivery. RESULTS: Fourteen pregnant women with the median age of 31.5 were enrolled. HRCT was done in twelve mothers (85.7%), and eleven mothers (78.6%) were evaluated via RT-PCR; four of them (36.36%) were positive. Two mothers (14.28%) were admitted to ICU. The cesarean section (C/S) was done following fetal distress in only three mothers due to their concerns of vertical transmission. Two mothers were admitted to the intensive care unit (ICU), and one of them died of pneumomediastinum. Fortunately, no neonatal death was reported three months after the delivery. CONCLUSION: COVID-19 affects mothers more in the last trimester of the pregnancy. Although no fetal death was reported in the recent study, physicians should closely monitor pregnant women to reduce the adverse event .

3.
J Reprod Infertil ; 22(2): 125-132, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34041009

RESUMO

BACKGROUND: The newly emerging COVID-19 has caused severe anxiety around the world and it is infecting more people each day since there is no preventive measure or definite therapy for the diseases. The present study aimed to evaluate its effect on anxiety and stress of pregnant mothers during perinatal care. METHODS: Three-hundred pregnant mothers without COVID-19 infection who were referred to the hospitals affiliated to Iran University of Medical Sciences for delivery during April 2020, based on negative clinical symptoms and the results of polymerase chain reaction (rt-PCR) for COVID-19, were recruited by census method and asked to complete the Persian version of the perceived stress scale (PSS); participants views about their anxiety level and the role of COVID-19 as the source of their stress and worries were recorded. Women who refused to continue the study were excluded. The frequency of variables and mean scores were calculated using SPSS v. 21. RESULTS: Mean age of mothers was 30.20±16.19 years; 31.3% were primigravida and mean gestational age was 38.00±4.14 weeks. Moreover, 16.3% asked for earlier pregnancy termination and 39% requested Cesarean section (C/S). Assessing the mothers' anxiety revealed a high/very high level of anxiety in 51.3%. The majority felt worried and frustrated because of COVID-19 (86.4%). Social media had a great impact on the level of stress among these mothers (60.3%). CONCLUSION: COVID-19 pandemic is an important source for the increased anxiety and stress among healthy pregnant mothers.

4.
Int J Surg Case Rep ; 79: 421-423, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33529821

RESUMO

INTRODUCTION: Abdominal pregnancy though scarce is associated with considerable morbidity and mortality. Few cases till now have been diagnosed or managed by laparoscopy. CASE PRESENTATION: In this study, a case of an abdominal pregnancy in a woman with intrauterine contraceptive device (IUD) in situ and a history of cesarean section is described. CLINICAL DISCUSSION: Our case was a brief description of a broad ligament pregnancy as a subcategory of abdominal pregnancy .It was located medial to the pelvic sidewall, lateral to the uterus, inferior to the fallopian tube and superior to the pelvic floor. CONCLUSION: The pregnancy was in the location of the left broad ligament which was diagnosed on laparoscopic evaluation.

5.
Gynecol Endocrinol ; 37(7): 640-645, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33508990

RESUMO

BACKGROUND: To our knowledge, data on the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis are limited. This study was conducted to determine the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis. METHODS: The current randomized, double-blind, placebo-controlled trial was conducted among 60 patients (aged 18-40 years old) with endometriosis. Participants were randomly allocated into two groups (30 participants each group) to receive either 50,000 IU vitamin D or placebo each 2 weeks for 12 weeks. RESULTS: Vitamin D supplementation significantly decreased pelvic pain (ß - 1.12; 95% CI, -2.1, -0.09; p=.03) and total-/HDL-cholesterol ratio (ß - 0.29; 95% CI, -0.57, -0.008; p=.04) compared with the placebo. Moreover, vitamin D intake led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (ß - 0.64 mg/L; 95% CI, -0.97, -0.30; p<.001) and a significant increase in total antioxidant capacity (TAC) (ß 47.54 mmol/L; 95% CI, 19.98, 75.11; p=.001) compared with the placebo. CONCLUSIONS: Overall, our study demonstrated that vitamin D intake in patients with endometriosis resulted in a significant improvement of pelvic pain, total-/HDL-cholesterol ratio, hs-CRP and TAC levels, but did not affect other clinical symptoms and metabolic profiles.


Assuntos
Endometriose/tratamento farmacológico , Dor Pélvica/fisiopatologia , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Adulto , Antioxidantes/metabolismo , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Constipação Intestinal/fisiopatologia , Método Duplo-Cego , Dismenorreia/fisiopatologia , Dispareunia/fisiopatologia , Endometriose/metabolismo , Endometriose/fisiopatologia , Feminino , Glutationa/sangue , Humanos , Insulina/sangue , Malondialdeído/sangue , Resultado do Tratamento , Triglicerídeos/sangue
6.
J Obstet Gynaecol ; 41(6): 966-971, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33243036

RESUMO

We aimed to investigate the effect of superior hypogastric plexus (SHP) block on pain relief and quality of life of patients with refractory endometriosis. Sixteen patients with refractory endometriosis underwent SHP block. The outcome measures included visual analogue scale (VAS) for chronic pelvic pain, VAS for dysmenorrhoea, and VAS for dyspareunia. The short-form endometriosis health profile (EHP-5) was used to measure quality of life. All the outcome measures were evaluated at weeks 0, 1, 4, 12 and 24. The mean baseline VAS scores significantly improved after the SHP block (p < .001 for all). The mean overall EHP-5 score also significantly improved from 54.3 ± 18.2 to 24.6 ± 13.3 (p < .001). The positive effects of SHP were not diminished over time. No serious adverse effect was noticed in any of the patients. Preliminary results suggest that SHP block could be used as an effective method in pain control and improvement of quality of life in refractory endometriosis.IMPACT STATEMENTWhat is already known on this subject? Safety and efficacy of SHP block in the treatment of CPP has been revealed in earlier investigations. However, the efficacy of SHP block for pain management in patients with refractory endometriosis has not been investigated in earlier investigations.What do the results of this study add? SHP block is an effective method for pain control and improvement of quality of life in patients with refractory endometriosis. The positive effects of this treatment did not diminish over 24-weeks follow-up of the study. No serious adverse effect was noticed in any of the patients.What are the implications of these findings for clinical practice and/or further research? Preliminary results suggest that SHP block could be used safely and effectively for controlling pain and improvement of quality of life in patients with refractory endometriosis.


Assuntos
Dor Crônica/tratamento farmacológico , Endometriose/complicações , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pélvica/tratamento farmacológico , Adulto , Dor Crônica/etiologia , Dismenorreia/etiologia , Dispareunia/etiologia , Feminino , Humanos , Plexo Hipogástrico , Medição da Dor , Dor Pélvica/etiologia , Qualidade de Vida , Resultado do Tratamento
7.
Gynecol Obstet Invest ; 85(5): 396-404, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32937634

RESUMO

BACKGROUND AND OBJECTIVES: A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy. MATERIALS AND METHODS: In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (n = 46) or a non-tourniquet group (n = 35). Serum levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis. RESULTS: Demographic, obstetric, and myoma characteristics were similar in the 2 groups (p > 0.05). The mean baseline values of AMH and FSH did not differ between groups (p > 0.05). After surgery, only FSH was higher in the control group (p = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (p < 0.001). Blood loss was higher in the control group (p = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (p = 0.002). Blood loss was significantly associated with the duration of surgery (r = 0.523, p < 0.001). CONCLUSION: The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy.


Assuntos
Perda Sanguínea Cirúrgica , Leiomioma/cirurgia , Reserva Ovariana , Torniquetes , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia , Adulto , Hormônio Antimülleriano/sangue , Método Duplo-Cego , Feminino , Hormônio Foliculoestimulante/sangue , Hemoglobinas/metabolismo , Humanos , Duração da Cirurgia , Período Pós-Operatório , Período Pré-Operatório
8.
ACS Biomater Sci Eng ; 6(11): 6285-6298, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33449643

RESUMO

The human amniotic membrane (HAM) has been viewed as a potential regenerative material for a wide variety of injured tissues because of its collagen-rich content. High degradability of HAM limits its wide practical application in bone tissue engineering. In this study, the natural matrix of the decellularized amniotic membrane was developed by the double diffusion method. The results confirmed a reduction of the amniotic membrane's degradability because of the deposition of calcium and phosphate ions during the double diffusion process. Real-time PCR results showed a high expression of osteogenesis-related genes from adipose-derived mesenchymal stem cells (ADMSCs) cultured on the surface of the developed mineralized amniotic membrane (MAM). Further in vivo experiments were conducted using an MAM preseeded with ADMSCs and a critical-size rat calvarial defect model. Histopathological results confirmed that the MAM + cell sample has excellent potential in bone regeneration.


Assuntos
Âmnio , Engenharia Tecidual , Animais , Biomimética , Regeneração Óssea , Diferenciação Celular , Humanos , Ratos
9.
J Cell Physiol ; 234(11): 19384-19392, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31004368

RESUMO

Endometriosis is a frequent and chronic illness in young women which could be defined by the existence of endometrial stroma and glands outside of the normal site of the lining of the uterus. It has painful symptoms. The advanced stage of endometriosis may lead to gynecological malignancies, such as ovarian cancer, and other complications, including infertility. However, its exact physiopathology is not well known. Recent studies have shown the possible roles of inflammation along with oxidative stress. Additionally, angiogenesis and apoptosis dysregulation contribute to endometriosis pathophysiology. Therapeutic strategies and continuing attempts, to conquer endometriosis should be done regarding molecular signaling pathways. Thus, the present review summarizes current studies and focuses on molecular mechanisms.


Assuntos
Endometriose/genética , Inflamação/genética , Neovascularização Patológica/genética , Estresse Oxidativo/genética , Apoptose/genética , Endometriose/patologia , Endometriose/terapia , Endométrio/metabolismo , Endométrio/patologia , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Inflamação/patologia , Inflamação/terapia , Terapia de Alvo Molecular , Neovascularização Patológica/patologia , Neovascularização Patológica/terapia , Transdução de Sinais/genética
10.
Artigo em Inglês | MEDLINE | ID: mdl-30610398

RESUMO

The affiliation of the 6th author Dr. Abolfazl Mehdizadehkashi was incorrect. It has been corrected to Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.

11.
Rev Physiol Biochem Pharmacol ; 176: 107-129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29728868

RESUMO

The development of resistance toward current cancer therapy modalities is an ongoing challenge in gynecological cancers, especially ovarian and cervical malignancies that require further investigations in the context of drug- and irradiation-induced resistance. In this regard, curcumin has demonstrated beneficial and highly pleiotropic actions and increased the therapeutic efficiency of radiochemotherapy. The antiproliferative, anti-metastatic, anti-angiogenic, and anti-inflammatory effects of curcumin have been extensively reported in the literature, and it could also act as a chemopreventive agent which mitigates the out-of-target harmful impact of chemotherapeutics on surrounding normal tissues. The current review discussed the modulating influences of curcumin on some cell and molecular features, including the cell signaling and molecular pathways altered upon curcumin treatment, the expression of target genes involved in the progression of gynecological cancers, as well as the expression of genes accountable for the development of resistance toward common chemotherapeutics and radiotherapy. The cell molecular targets implicated in curcumin's resensitizing effect, when used together with cisplatin, paclitaxel, and irradiation in gynecological cancers, are also addressed. Finally, rational approaches for improving the therapeutic benefits of curcumin, including curcumin derivatives with enhanced therapeutic efficacy, using nanoformulations to advance curcumin stability in physiological media and improve bioavailability have been elucidated.


Assuntos
Antineoplásicos/farmacologia , Curcumina/farmacologia , Neoplasias dos Genitais Femininos/tratamento farmacológico , Disponibilidade Biológica , Cisplatino , Resistencia a Medicamentos Antineoplásicos , Feminino , Humanos , Paclitaxel , Tolerância a Radiação , Radiossensibilizantes/farmacologia
13.
Arch Iran Med ; 21(2): 61-66, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29664656

RESUMO

BACKGROUND: Adverse pregnancy outcome are frequent in developing countries. Pregnancy outcomes are influenced by numerous factors. It seems that maternal anthropometric indices are among the most important factors in this era. The aim of this study was to determine any association between maternal anthropometric characteristics and adverse pregnancy outcomes in Iranian women and provide a predictive model by using factors affecting birth weight (BW) via the pathway analysis. METHODS: This study was performed in Alborz province between September 2014 and December 2016. In this cross-sectional study, 1006 pregnant women who had the study criteria were selected from 1500 pregnant women. The data were collected in 2 phases: at their first prenatal visit and during the postpartum period. Demographic data, history of previous pregnancy, fundal height (FH), gestational weight gain (GWG), and abdominal circumference (AC) were recorded. Pathway (path) analysis was used to assess effective factors on pregnancy outcomes. RESULTS: The mean and standard deviation of participant age at delivery was 25.97 ± 5.71 years. Overall, 4.6% of infants were low BW (LBW) and 5.8% had macrosomia. The final model, with a good fit accounting for 22% of BW variance, indicated that AC and FH (both P < 0.001), and pre-pregnancy body mass index (BMI) (P = 0.01) had positive direct effect on BW, while pre-pregnancy BMI and GWG (both P < 0.001) affected BW indirectly through their effect on FH and AC. CONCLUSION: Based on the path analysis model, FH and AC of neonates with the greatest impact on BW, could be predicted by mother's BMI before pregnancy and weight gain during pregnancy. Therefore, close observation during prenatal care can reduce the risk of abnormal BW.


Assuntos
Peso ao Nascer , Estatura , Índice de Massa Corporal , Resultado da Gravidez , Adolescente , Adulto , Estudos Transversais , Feminino , Ganho de Peso na Gestação , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Irã (Geográfico) , Masculino , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Análise de Regressão , Adulto Jovem
14.
J Minim Invasive Gynecol ; 24(1): 114-123, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27693809

RESUMO

STUDY OBJECTIVE: To evaluate the pelvic peritoneum under chromoendoscopy by scanning electron microscopy (SEM) as well as light microscopy with hematoxylin and eosin staining and immunohistochemistry (IHC) assays in patients with chronic pelvic pain (CPP) associated with subtle endometriosis. DESIGN: Case series study (Canadian Task Force classification II). SETTING: A referral academic community tertiary medical center. PATIENTS: Three women aged 29 to 37 years were referred to the obstetrics and gynecology clinic of the tertiary university hospital with CPP. They were suspicious for endometriosis, were not responding to medical treatments, and had undergone previous pelvic laparoscopy to determine the stage of endometriosis and preparation of peritoneal samples under the guidance of staining with methylene blue in 0.25% dilution. INTERVENTIONS: Comparison of stained and unstained pelvic peritoneal samples after the instillation of 0.25% methylene blue into the pelvic cavity. MEASUREMENTS AND MAIN RESULTS: In 3 patients, laparoscopic examination showed minimal endometriosis. A total of 18 samples (9 stained and 9 unstained) from the 3 patients were prepared for SEM. Ten of the samples (55.6%) showed microstructural peritoneal destruction (7 of 9 stained [77.7%] and 3 of 9 [33.4%] unstained). Eighteen samples (9 stained and 9 unstained) from the 3 patients were also prepared for IHC. Six of these samples (33.3%) were S-100-positive, including 4 of 9 (44.4%) stained samples and 2 of 9 (22.2%) unstained samples. CONCLUSIONS: In general, in the context of CPP and endometriosis, there is no established relationship between the severity of pain and stage of endometriosis. In the pathophysiology of CPP associated with endometriosis, ultrastructural changes can play a significant role. Under methylene blue staining, some destroyed areas were detected, but the stained areas do not necessarily correlate with increased microstructural peritoneal destruction.


Assuntos
Doenças dos Anexos/diagnóstico , Endometriose/diagnóstico , Laparoscopia/métodos , Dor Pélvica/diagnóstico , Peritônio/diagnóstico por imagem , Coloração e Rotulagem/métodos , Doenças dos Anexos/patologia , Doenças dos Anexos/cirurgia , Adulto , Doença Crônica , Dor Crônica/diagnóstico , Dor Crônica/patologia , Dor Crônica/cirurgia , Endometriose/complicações , Endometriose/patologia , Endometriose/cirurgia , Amarelo de Eosina-(YS)/farmacologia , Feminino , Hematoxilina/farmacologia , Humanos , Período Intraoperatório , Azul de Metileno/farmacologia , Microscopia Eletrônica de Varredura , Microscopia de Polarização , Dor Pélvica/patologia , Dor Pélvica/cirurgia , Pelve/diagnóstico por imagem , Pelve/patologia , Pelve/cirurgia , Peritônio/cirurgia , Peritônio/ultraestrutura
15.
Iran Red Crescent Med J ; 18(4): e33892, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27330834

RESUMO

INTRODUCTION: Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner's criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English. CASE PRESENTATION: In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma. CONCLUSIONS: Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy.

16.
J Pregnancy ; 2014: 675792, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25328705

RESUMO

In this research, we represent the changes in visual acuity during pregnancy and after delivery. Changes as myopic shift start during second trimester and will be stopped after delivery; however it is obtained that women will have the same refractive error as what they had in the first trimester, after postpartum. So, any change in their spectacle prescription during this period is forbidden. As a result, not only changing in hormones can cause myopic shift in vision, but also overweight has its retributive role. What we are trying to do is to notify gynecologists and optometrists to be aware of these changes, so as to leave spectacle prescription writing to the session after postpartum period.


Assuntos
Período Pós-Parto/fisiologia , Gravidez/fisiologia , Acuidade Visual/fisiologia , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Miopia/epidemiologia , Miopia/etiologia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/fisiopatologia
18.
J Reprod Infertil ; 15(1): 57-60, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24696796

RESUMO

BACKGROUND: Ovarian fibroma is the most common benign solid tumor of the ovary, which is often difficult to diagnose preoperatively. The choice treatment for ovarian fibroma is surgical removal, but discussions for the operative approach, laparoscopic or open, in the literature seem to be scant. CASE PRESENTATION: We presented a unique clinical experience of laparoscopic approach to a case of 15 cm unilateral ovarian fibroma in a 24 year old patient, with a successful and complete resection of the tumor beside ovarian tissue preservation in December 2012 in Rasoul-e-Akram hospital, Tehran, Iran. CONCLUSION: In conclusion, we should not forget the role of laparoscopy as a diagnostic procedure even in suspicious cases of ovarian fibroma with solid tumor, ascites, and pleural effusion.

19.
J Reprod Infertil ; 14(4): 197-201, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24551574

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS), a common endocrine disorder, is associated with infertility, menstrual dysfunction, hirsutism and frequent miscarriages. Insulin resistance, as a major cause of PCOS, represents a disorder with increase in inflammatory markers and risk of type 2 diabetes. We aimed to investigate whether inflammatory markers, including C-reactive protein and C3 (Complement), are related and altered in polycystic ovary syndrome. METHODS: A case-control study including forty-two women diagnosed with PCOS, according to Rotterdam criteria, and forty-two healthy controls, matched for body mass index (BMI) and age, was conducted in 2012. C-Reactive protein (CRP) and C3 were assessed as possible determinants of the homeostasis model assessment (HOMA) index. Independent-sample t-test was used to compare the means of the groups in age, BMI, C3, FBS and BS 2hpp (2 hr postprandial glucose) and for CRP, Fasting Insulin and 2 hr Plasma Insulin and HOMA index. Mann-Whitney test and Pearson correlation were used for analyzing the data. The p<0.05 was considered as statistically significant. RESULTS: Levels of plasma CRP (p=0.039), 2 hr pp (p=0.045), Fasting Insulin (p=0.002), 2 hr Plasma Insulin (p=0.002) and HOMA index (p=0.002) were significantly higher in PCOS patients. But C3 was not significantly higher in cases (p=0.885). There was no significant correlation between C3 and CRP with HOMA index. CONCLUSION: CRP increased significantly in patients with PCOS and was associated with insulin resistance, the most probable cause of PCOS. However, such an association was not found in C3.

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