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Koensgen D.,University of Greifswald | Oskay-Oezcelik G.,Charite University Hospital | Katsares I.,Clinic of Gynecology and Obstetrics | Walle U.,Charite University Hospital | And 6 more authors.
Supportive Care in Cancer | Year: 2010

Goals of work: Quality of life (Qol) represents a relevant end point in the clinical management of advanced ovarian cancer (AOC). However, there exist only a few specific instruments which have been designed for patients with ovarian cancer. The aim of this study was to develop a systematic checklist (Berlin Symptom Checklist Ovary (BSCL-O)) as an instrument of Qol for patients with AOC and to discriminate between the frequency and the importance of symptoms. Patients and methods: The main symptoms were identified in a phase I study via free interviews of five patients with ovarian cancer (OC) as well as five medical doctors, family dependants, and care workers. In the phase II study, the capability of BSCL-O was evaluated by questionnaire-guided interviews of 200 patients with primary OC, recurrent OC, metastasized breast cancer, and benign ovarian tumors. Main results: In phase I, 36 main symptoms were identified. In phase II, 7,200 answers from 98.5% of all patients were evaluable. Of the 36 symptoms of the BSCL-O, 23 revealed clinical relevance. There was a correlation of frequency and importance of symptoms (p<0.05). The symptoms of the BSCL-O were deemed twice as strenuous in patients with recurrent OC. Conclusions: The BSCL-O can measure Qol of patients with OC. The BSCL-O is being validated in a phase III study. © Springer-Verlag 2009.

Dobrosavljevic A.,Private Practice | Dobrosavljevic B.,Private Practice | Raznatovic S.J.,University of Belgrade | Vranes B.,Clinic of Gynecology and Obstetrics
Clinical and Experimental Obstetrics and Gynecology | Year: 2013

Prenatal diagnosis of vein of Galen aneurysmatic malformation (VGAM) is made with the use of color Doppler, while in B-mode it is seen as a centrally placed supratentorial cystic structure. 3D-power Doppler (3D-PD) is a method that enables precise visualization of the vascular anatomy of this complex malformation. In our case, VGAM was detected in the 33rd week of gestation with power Doppler, and the use of 3D-PD enabled better visualization of the angioarchitecture and detection of feeding and drainage vessels of aneurysmatic widening. The diagnosis was confirmed postnatally with the use of MRI. A prenatal study of the angioarchitecture could have prognostic significance as well as being important in the therapeutic approach during the postnatal period.

Wolf N.,University of Duisburg - Essen | Yang W.,University of Duisburg - Essen | Dunk C.E.,Womens and Infants Health | Gashaw I.,Schering | And 5 more authors.
Endocrinology | Year: 2010

It is known that a hypoxic environment is critical for trophoblast migration and invasion and is fundamental for appropriate placental perfusion. Because cysteine-rich 61 (CYR61, CCN1) and nephroblastoma overexpressed (NOV, CCN3) are expressed in the extravillous trophoblast and expression levels are deregulated in preeclampsia, we investigated their regulation properties in first-trimester placental explants and in JEG3 choriocarcinoma cells upon a physiological low oxygen tension of 1-3%. In placental explants, both proteins were expressed in the extravillous trophoblast cells and were increased upon hypoxia. JEG3 cells revealed a significant up-regulation of CYR61 and NOV intracellular as well as secreted protein upon hypoxic treatment accompanied by the stabilization of the hypoxia-inducible factor-1α (HIF-1α). Treatment with dimethyloxalylglycine to mimic hypoxia and silencing of HIF-1α using small interfering RNA revealed that only the increase in intracellular protein expression seems to be dependent on HIF-1α but obviously not the secretion process. Moreover, recombinant TGF-β3 was able to further enhance the amount of intracellular CCN proteins as well as secreted CYR61 levels under hypoxia. These results indicate that low oxygen levels trigger elevation of intracellular as well as secreted CYR61 and NOV protein probably in two independent pathways. Addition of recombinant CYR61 and NOV proteins increases migration as well as invasion properties of JEG3 trophoblast cells, which strengthen their role in supporting trophoblast migration invasion properties. In summary, CYR61 and NOV are regulated by HIF-1α and TGF-β3 in the trophoblast cell line JEG3, and their enhanced secretion could be implicated in appropriate placental invasion. Copyright © 2010 by The Endocrine Society.

Janosevic D.R.,Clinic of Gynecology and Obstetrics | Popovic J.,Clinic of Gynecology and Obstetrics | Krstic M.,Institute of Pathology | Pavlovic A.T.,Clinic of Gynecology and Obstetrics | And 2 more authors.
Vojnosanitetski Pregled | Year: 2016

Background/Aim. Recurrent or habitual missed abortions (RMA) are defined as three or more consecutive abortions. In the first trimester of pregnancy habitual missed abortions occur in about 1% of population. The aim of this immuno-histochemical study of decidua in RMA of unknown etiology was to identify subpopulations of decidual lymphocytes in recurrent miscarriages and compare the distribution of immunocompetent cells in artificial abortions and RMA. Methods. The study included 30 women with at least 2 consecutive miscarriages in the first trimester of pregnancy. Curettements of the third missed abortion were immunohistochemically analyzed. The control group consisted of 20 women without loaded reproductive anamnesis, with the abortion for social reasons. Criteria for exclusion from the study were diagnosed uterine anomalies, positive screening for thrombophilia and women who suffered from diabetes mellitus and disorders in the function of the thyroid gland. Immunophenotyping was performed by immuno-alkaline phosphatase (APAAP) using monoclonal antibodies: CD 30, CD 45 RO, CD 56 and CD 57, CD 68. Results. The number of missed abortions (1,223) was on the average 9.7% of all deliveriies during the test period. Among them RMA were registered in 52 (4.2%) patients and in 30 (57%) the exact etiology of abortions was not determined. RMA was most common in the 25–34 years of age group. The largest number of RMA showed the ultrasound characteristics of missed abortion in 60% of cases and was in nulliparous patients (76.7%). The number of natural killer (NK) CD56 positive cells did not differ significantly between the types of abortion. In the decidual tissue, a number of NK CD57 positive cells was significantly higher in missed abortions compared to artificial interruptions (p < 0.01). In artificial termination of pregnancy there was an absolute predominance of CD45RO lymphocyte subpopulations, whereas in the RMA group there was slightly greater predominance of CD30 positive cells. The completed analysis showed a significantly higher number of CD68 positive macrophages in a decidual tissue of RMA pregnancy (p < 0.01). Conclusion. The number and phenotypic structure of NK cells are significantly different in normal pregnancy decidua and in RMA. The NK cell dominance is present in the RMA group, in favor of CD56+ and CD 57 of subpopulations with increased CD30 of T lymphocyte subpopulations. Macrophages are more numerous in the decidua of pregnancies ended in abortion, so the cause of RMA of unknown etiology in a number of cases could be disregulation of immunocompetent cells. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Yavuzsen H.T.,Clinic of Gynecology and Obstetrics | Vupa Cilengirolu O.,Dokuz Eylul University
Turkiye Klinikleri Jinekoloji Obstetrik | Year: 2015

Objective: To evaluate the burnout and to determine the relationship demographic characteristics and burnout levels between physicians and nurses working in 3 different obstetrics/gynecology clinics. Material and Methods: This is an observational cross-sectional study and included in 47 physicians and 90 nurses. We used to quantitative survey to assess burnout levels using a Turkish version of the Maslach Burnout Inventory. Results: Results showed that the women perceived lower personal sense of accomplishment compared to the men for physicians (p=0.013), and the single demonstrated lower personal sense of accomplishment compared to the married physicians (p=0.003). Two government hospitals created differences according to emotional exhaustion and depersonalization levels (p=0.046, p=0.034). The mean age of physicians was higher than that of nurses (p=0.036). The working hour per-day for nurses was higher than physicians (p=0.000). Physicians showed higher levels of burnout in emotional exhaustion, depersonalization, and lower level of personal sense of accomplishment subscales compared to the nurses. However there was a statistical difference between nurses and physicians for depersonalization and personal sense of accomplishment subscales (p=0.000, p=0.013). Correlation analyses in physicians showed that age was significantly negatively correlated with depersonalization (p=0.006). Increasing age among nurses was found when the level of depersonalization subscale is decreasing like physicians (p=0.012). Conclusion: The levels of burnout have been shown high in the obstetric gynecology physicians. The burnout syndrome was observed more in female gender, single ones, and younger age both of healthcare workers. Further researches should be evaluated the interrelationships among the burnout, job career satisfaction, and psychosocial health in the obstetric gynecologic physicians. Copyright © 2015 by Türkiye Klinikleri.

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