Olga M Fajardo, Ekaterina Grebenyuk, Katherine F Chaves, Zhiguo Zhao, Tan Ding, Howard L Curlin, Lara F B Harvey
{"title":"Impact of trainees involvement on surgical outcomes of abdominal and laparoscopic myomectomy.","authors":"Olga M Fajardo, Ekaterina Grebenyuk, Katherine F Chaves, Zhiguo Zhao, Tan Ding, Howard L Curlin, Lara F B Harvey","doi":"10.1080/01443615.2024.2330697","DOIUrl":"10.1080/01443615.2024.2330697","url":null,"abstract":"<p><strong>Background: </strong>To determine the association of trainees involvement with surgical outcomes of abdominal and laparoscopic myomectomy including operative time, rate of transfusion, and complications.</p><p><strong>Methods: </strong>A retrospective cohort study of 1145 patients who underwent an abdominal or laparoscopic myomectomy from 2008-2012 using the American College of Surgeons National Surgical Quality Improvement Program database (Canadian Task Force Classification II-2).</p><p><strong>Results: </strong>Overall, 64% of myomectomies involved trainees. Trainees involvement was associated with a longer operative time for abdominal myomectomies (mean difference 20.17 minutes, 95% Confidence Interval (CI) [11.37,28.97], <i>p</i> < 0.01) overall and when stratified by fibroid burden. For laparoscopic myomectomy, there was no difference in operative time between trainees vs no trainees involvement (mean difference 4.64 minutes, 95% CI [-18.07,27.35], <i>p</i> = 0.67). There was a higher rate of transfusion with trainees involvement for abdominal myomectomies (10% vs 2%, <i>p</i> < 0.01; Odds Ratio (OR) 5.62, 95% CI [2.53,12.51], <i>p</i> < 0.01). Trainees involvement was not found to be associated with rate of transfusion for laparoscopic myomectomy (4% vs 5%, <i>p</i> = 0.86; OR 0.82, 95% CI [0.16,4.14], <i>p</i> = 0.81). For abdominal myomectomy, there was a higher rate of overall complications (15% vs 5%, <i>p</i> < 0.01; OR 2.96, 95% CI [1.77,4.93], <i>p</i> < 0.01) and minor complications (14% vs 4%, <i>p</i> < 0.01; OR 3.71, 95% CI [2.09,6.57], <i>p</i> < 0.01) with no difference in major complications (3% vs 2%, p = 0.23). For laparoscopic myomectomy, there was no difference in overall (6% vs 10% <i>p</i> = 0.41; OR 0.59, 95% CI [0.18,2.01], <i>p</i> = 0.40), major (2% vs 0%, <i>p</i> = 0.38), or minor (5% vs 10%, <i>p</i> = 0.32; OR 0.52, 95% CI [0.15,1.79], <i>p</i> = 0.30) complications.</p><p><strong>Conclusion: </strong>Trainees involvement was associated with increased operative time, rate of transfusion, and complications for abdominal myomectomy, however, did not impact surgical outcomes for laparoscopic myomectomy.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2330697"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigation of the relationship between air pollution and gestational diabetes.","authors":"Sima Nazarpour, Afshin Shokati Poursani, Maryam Mousavi, Fahimeh Ramezani Tehrani, Samira Behboudi-Gandevani","doi":"10.1080/01443615.2024.2362962","DOIUrl":"https://doi.org/10.1080/01443615.2024.2362962","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) can have negative effects on both the pregnancy and perinatal outcomes, as well as the long-term health of the mother and the child. It has been suggested that exposure to air pollution may increase the risk of developing GDM. This study investigated the relationship between exposure to air pollutants with gestational diabetes.</p><p><strong>Methods: </strong>The present study is a retrospective cohort study. We used data from a randomised community trial conducted between September 2016 and January 2019 in Iran. During this period, data on air pollutant levels of five cities investigated in the original study, including 6090 pregnant women, were available. Concentrations of ozone (O<sub>3</sub>), nitric oxide (NO), nitrogen dioxide (NO<sub>2</sub>), nitrogen oxides (NOx), sulphur dioxide (SO<sub>2</sub>), carbon monoxide (CO), particulate matter < 2.5 (PM<sub>2.5</sub>) or <10 μm (PM<sub>10</sub>) were obtained from air pollution monitoring stations. Exposure to air pollutants during the three months preceding pregnancy and the first, second and third trimesters of pregnancy for each participant was estimated. The odds ratio was calculated based on logistic regression in three adjusted models considering different confounders. Only results that had a <i>p</i> < .05 were considered statistically significant.</p><p><strong>Results: </strong>None of the logistic regression models showed any statistically significant relationship between the exposure to any of the pollutants and GDM at different time points (before pregnancy, in the first, second and third trimesters of pregnancy and 12 months in total) (<i>p</i> > .05). Also, none of the adjusted logistic regression models showed any significant association between PM<sub>10</sub> exposure and GDM risk at all different time points after adjusting for various confounders (<i>p</i> > .05).</p><p><strong>Conclusions: </strong>This study found no association between GDM risk and exposure to various air pollutants before and during the different trimesters of pregnancy. This result should be interpreted cautiously due to the lack of considering all of the potential confounders.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2362962"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction of outcomes after chemoradiotherapy for cervical cancer by neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.","authors":"Jing Yu, Longzhang Huang, Ting Dong, Lihua Cao","doi":"10.1080/01443615.2024.2361858","DOIUrl":"https://doi.org/10.1080/01443615.2024.2361858","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer ranks as the second most fatal tumour globally among females. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been widely applied to the diagnosis of cancers.</p><p><strong>Methods: </strong>The clinicopathologic data of 180 patients with stage IB2-IIB cervical cancer who underwent radical concurrent chemoradiotherapy from January 2018 to December 2019 were retrospectively analysed. Receiver operating characteristic (ROC) curves were plotted to analyse the optimal cut-off values of NLR and PLR for predicting the therapeutic effects of concurrent chemoradiotherapy. The associations of PLR and other clinicopathological factors with 1-year survival rates were explored through univariate analysis and multivariate Cox regression analysis, respectively.</p><p><strong>Results: </strong>NLR was significantly associated with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 2.89, area under the ROC curve (AUC) of 0.848 (95% confidence interval [CI]: 0.712-0.896), sensitivity of 0.892 (95% CI: 0.856-0.923) and specificity of 0.564 (95% CI: 0.512-0.592). PLR had a significant association with the therapeutic effects of neoadjuvant therapy, with the optimal cut-off value of 134.27, AUC of 0.766 (95% CI: 0.724-0.861), sensitivity of 0.874 (95% CI: 0.843-0.905) and specificity of 0.534 (95% CI: 0.512-0.556). Lymphatic metastasis ([95% CI: 1.435-5.461], [95% CI: 1.336-4.281], depth of invasion ([95% CI: 1.281-3.546], [95% CI: 1.183-3.359]) and tumour size ([95% CI: 1.129-3.451], [95% CI: 1.129-3.451]) were independent factors influencing the overall survival and disease-free survival (DFS) of patients with cervical cancer. NLR (95%CI: 1.256-4.039) and PLR (95%CI:1.281-3.546) were also independent factors affecting DFS.</p><p><strong>Conclusion: </strong>NLR and PLR in the peripheral blood before treatment may predict DFS of patients with stage IB2-IIB cervical cancer.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2361858"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Meta-analysis of efficacy and safety of pembrolizumab for the treatment of advanced or recurrent cervical cancer.","authors":"Xue Zhang, Wen-Jie Yin, Ai-Li Zhang, Xiao-Xiao Zhang, Li-Juan Ding, Jiao Zhang, Shu-Ting He, Jie-Ping Yan","doi":"10.1080/01443615.2024.2390564","DOIUrl":"10.1080/01443615.2024.2390564","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis seeks to assess the efficacy and safety of pembrolizumab in individuals with advanced or recurrent cervical cancer.</p><p><strong>Methods: </strong>Databases from PubMed, Embase, and the Cochrane Library were all thoroughly searched for pertinent research. Outcomes include complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), overall response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse events (AEs) were retrieved for further analysis.</p><p><strong>Results: </strong>Ten trials with 721 patients were included in this meta-analysis. The pooled results for patients with cervical cancer receiving pembrolizumab were as follows: CR (0.06, 95%CI: 0.02-0.10), PR (0.15, 95%CI: 0.08-0.22), SD (0.16, 95%CI: 0.13-0.20), PD (0.50, 95%CI: 0.25-0.75), ORR (0.26, 95%CI: 0.11-0.41) and DCR (0.42, 95%CI: 0.13-0.71), respectively. Regarding survival analysis, the pooled mPFS and mOS were 3.81 and 10.15 months. Subgroup analysis showed that pembrolizumab in combination was more beneficial in CR (0.16 vs. 0.03, <i>p</i> = 0.012), PR (0.24 vs. 0.08, <i>p</i> = 0.032), SD (0.11 vs. 0.19, <i>p</i> = 0.043), ORR (0.42 vs. 0.11, <i>p</i> = 0.014), and mPFS (5.54 months vs. 2.27 months, <i>p</i> < 0.001) than as single agent. The three most common AEs were diarrhoea (0.25), anaemia (0.25), and nausea (0.21), and the incidence of grade 3-5 AEs was significantly lower, rarely surpassing 0.10.</p><p><strong>Conclusions: </strong>For patients with advanced or recurrent cervical cancer, this systematic review and meta-analysis demonstrated that pembrolizumab had a favourable efficacy and tolerability. Future research will primarily focus on optimising customised regiments that optimally integrate pembrolizumab into new therapies and combination strategies. Designed to maximise patient benefit and efficiently control adverse effects while maintaining a high standard of living.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2390564"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qing Hao, Lan Feng, Dandan Chen, Xia Fan, Lei Wei, Zhaojun Cui, Jing Zhang, Lin Wang, Dan Zhang, Xinxin Zhan, Wenping Yang
{"title":"Application of WeChat-based cognitive behavioural stress management for early-stage cervical cancer patients: a randomised controlled study.","authors":"Qing Hao, Lan Feng, Dandan Chen, Xia Fan, Lei Wei, Zhaojun Cui, Jing Zhang, Lin Wang, Dan Zhang, Xinxin Zhan, Wenping Yang","doi":"10.1080/01443615.2024.2410858","DOIUrl":"10.1080/01443615.2024.2410858","url":null,"abstract":"<p><strong>Background: </strong>This randomised controlled study was aimed at investigating the effects of WeChat-based cognitive behavioural stress management (WB-CBSM) on the mental health of patients with early-stage cervical cancer treated with surgical resection.</p><p><strong>Methods: </strong>A total of 184 patients with early-stage cervical cancer were randomised to receive either WB-CBSM (<i>n</i> = 92) or normal care (NC) (<i>n</i> = 92) for 8 weeks.</p><p><strong>Results: </strong>Compared with the NC group, the WB-CBSM group exhibited reduced Hospital Anxiety and Depression Scale (HADS)-anxiety scores at months (M)1 (<i>t</i> = 2.022, <i>P</i> = 0.045), M3 (<i>t</i> = 2.575, <i>P</i> = 0.011), and M6 (<i>t</i> = 2.709, <i>P</i> = 0.007); anxiety rates at M3 (<i>χ<sup>2</sup></i> = 4.834, <i>P</i> = 0.028) and M6 (<i>χ<sup>2</sup></i> = 5.182, <i>P</i> = 0.023); HADS-depression scores at M3 (<i>t</i> = 2.069, <i>P</i> = 0.040) and M6 (<i>t</i> = 2.449, <i>P</i> = 0.015); and depression rates at M6 (<i>χ<sup>2</sup></i> = 4.268, <i>P</i> = 0.039). Moreover, the WB-CBSM group showed increased Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale scores at M1 (<i>t</i> = -2.001, <i>P</i> = 0.047), M3 (<i>t</i> = -2.281, <i>P</i> = 0.024), and M6 (<i>t</i> = -3.501, <i>P</i> = 0.001); the Quality of Life Questionnaire-Core 30 (QLQ-C30) global health score at M3 (<i>t</i> = -2.034, <i>P</i> = 0.043) and M6 (<i>t</i> = -2.426, <i>P</i> = 0.016); and QLQ-C30 function score at M3 (<i>t</i> = -2.009, <i>P</i> = 0.046). However, the groups exhibited decreased EuroQol-5 dimension scores at M3 (<i>t</i> = 2.056, <i>P</i> = 0.041) and M6 ((<i>t</i> = 2.242, <i>P</i> = 0.026) and QLQ-C30 symptom scores at M1 (<i>t</i> = 2.026, <i>P</i> = 0.044) and M3 (<i>t</i> = 2.210, <i>P</i> = 0.028).</p><p><strong>Conclusion: </strong>WB-CBSM reduced anxiety and depression and improved the spiritual well-being and quality of life of patients with early-stage cervical cancer treated with surgical resection.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2410858"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prophylactic norepinephrine infusion to treat hypotension after spinal anaesthesia during caesarean section: a meta-analysis.","authors":"Chunli Zhang, Jie Qiu, Yuyuan Huang, Renkang Tan","doi":"10.1080/01443615.2024.2393379","DOIUrl":"10.1080/01443615.2024.2393379","url":null,"abstract":"<p><strong>Background: </strong>Spinal anaesthesia is a common anaesthetic method for caesarean sections but often results in hypotension, posing potential risks to maternal and neonatal health. Norepinephrine, as a vasopressor, may be effective in preventing and treating this hypotension. This systematic review and meta-analysis aims to systematically evaluate the efficacy and safety of prophylactic norepinephrine infusion for the treatment of hypotension following spinal anaesthesia in caesarean sections.</p><p><strong>Methods: </strong>Literature searches were conducted in PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases for relevant studies on prophylactic administration of norepinephrine for the treatment of hypotension after spinal anaesthesia in caesarean delivery. Reference lists of included articles were also searched. The latest search update was on March 20, 2024. Meta-analysis was conducted using R software. The methods recommended by the Cochrane Handbook, Begge's and Egger's tests were used for risk of bias evaluation of the included literature.</p><p><strong>Results: </strong>Nine studies were finally included in this study. The results showed that prophylactic administration of norepinephrine was superior to the control group in four aspects of treating hypotension after spinal anaesthesia in caesarean delivery: the incidence of hypotension was reduced [RR = 0.34, 95%CI (0.27-0.43), <i>P</i> < 0.01]; the incidence of severe hypotension was reduced [RR = 0.32, 95%CI (0.21-0.51), <i>P</i> < 0.01]; and maternal blood pressure was more stable with MDPE [MD = -5.00, 95%CI (-7.80--2.21), <i>P =</i> 0.06] and MDAPE [MD = 4.11, 95%CI (1.38-6.85), <i>P</i> < 0.05], the incidence of nausea and vomiting was reduced [RR = 0.52, 95%CI (0.35-0.77), <i>P</i> < 0.01]. On the other hand, the incidence of reactive hypertension was higher than the control group [RR = 3.58, 95%CI (1.94-6.58), <i>P</i> < 0.01]. There was no difference between the two groups in one aspects: newborn Apgar scores [MD = -0.01, 95%CI (-0.10-0.09, <i>P</i> = 0.85)].</p><p><strong>Conclusion: </strong>Prophylactic administration of norepinephrine is effective in treating hypotension after spinal anaesthesia in caesarean delivery patients; however, it does not provide improved safety and carries a risk of inducing reactive hypertension.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2393379"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of normal reference intervals for renal function in pregnancy: a secondary analysis of clinical trial data.","authors":"Zandile Legoabe, Motshedisi Sebitloane, Carl Lombard, Megeshinee Naidoo, Glenda Gray, Dhayendre Moodley","doi":"10.1080/01443615.2024.2361445","DOIUrl":"https://doi.org/10.1080/01443615.2024.2361445","url":null,"abstract":"<p><strong>Background: </strong>Due to its potential nephrotoxicity, screening for pre-existing renal function disorders has become a routine clinical assessment for initiating Tenofovir diphosphate fumarate (TDF)-containing antiretroviral treatment (ART) or pre-exposure prophylaxis (PrEP) in pregnant and non-pregnant adults. We aimed to establish reference values for commonly used markers of renal function in healthy pregnant women of African origin.</p><p><strong>Methods: </strong>Pregnant women ≥18 years, not living with HIV, and at 14-28 weeks gestation were enrolled in a PrEP clinical trial in Durban, South Africa between September 2017 and December 2019. Women were monitored 4-weekly during pregnancy until six months postpartum. We measured maternal weight and serum creatinine (sCr) at each visit and calculated creatinine clearance (CrCl) rates using the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae. Reference ranges for sCr and CrCl by CG and MDRD calculations were derived from the mean ± 2SD of values for pregnancy and postdelivery.</p><p><strong>Results: </strong>Between 14--and 40 weeks gestation, 249 African women not exposed to TDF-PrEP contributed a total of 1193 renal function values. Postdelivery, 207 of these women contributed to 800 renal function values. The normal reference range for sCr was 30-57 and 32-60 umol/l in the 2<sup>nd</sup> and 3<sup>rd</sup> trimesters of pregnancy. Normal reference ranges for CrCl using the MDRD calculation were 129-282 and 119-267 ml/min/1.73m<sup>2</sup> for the 2<sup>nd</sup> and 3<sup>rd</sup> trimesters, respectively. Using the CG method of calculation, normal reference ranges for CrCl were 120-304 and 123-309 ml/min/1.73m<sup>2</sup> for the 2<sup>nd</sup> and 3<sup>rd</sup> trimesters respectively. In comparison, the normal reference range for sCr, CrCl by MDRD and CG calculations postpartum was 40-77 umol/l, 92-201, and 90-238 ml/min/1.73m<sup>2</sup>, respectively.</p><p><strong>Conclusions: </strong>In African women, the Upper Limit of Normal (ULN) for sCr in pregnancy is approximately 20% lower than 6 months postnatally. Inversely, the Lower Limit of Normal (LLN) for CrCl using either MDRD or CG equation is approximately 35% higher than 6 months postnatally. We provide normal reference ranges for sCr and CrCl for both methods of calculation and appropriate for the 2<sup>nd</sup> and 3<sup>rd</sup> trimesters of pregnancy in African women.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2361445"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nana Tian, Chunhui Liu, Zhihui Cai, Junrong Shi, Pin Li, Shasha Bai, Xiaoxin Du, Gaoyuan Liu, Min Geng, Peishan Weng
{"title":"The impact of heterotopic ovarian tissue transplantation with varied volumes on reproductive endocrine function in oophorectomized rats.","authors":"Nana Tian, Chunhui Liu, Zhihui Cai, Junrong Shi, Pin Li, Shasha Bai, Xiaoxin Du, Gaoyuan Liu, Min Geng, Peishan Weng","doi":"10.1080/01443615.2024.2362416","DOIUrl":"https://doi.org/10.1080/01443615.2024.2362416","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the effects of different volumes of ovarian tissue transplantation on the reproductive endocrine function of rats after oophorectomy.</p><p><strong>Methods: </strong>Female rats were selected to establish a castration model and then underwent different volumes of ovarian tissue transplantation. Group I served as the sham operation group. The transplantation group was divided into five subgroups based on the calculated ratio of ovarian weight to body weight in normal female rats, δ = (2.52 ± 0.17) ×10<sup>-4</sup>: Group II: transplanted ovarian volume was δ; Group III: 0.75δ; Group IV: 0.5δ; Group V: 0.25δ; Group VI: without ovarian transplantation. The post-transplant oestrous cycle recovery was observed, and blood samples were collected every 2 weeks to measure serum hormone levels. Histological evaluation was performed at the end of the observation period.</p><p><strong>Results: </strong>Rats in Group V exhibited disrupted oestrous cycles after transplantation, which were significantly longer than those in Group I. Rats in Groups II, III, and IV showed no cyclic changes. At 6 weeks post-transplantation, rats in Group V had lower E2 and AMH levels and higher FSH levels compared to Group I. The uterine wet weight and the number of normal follicles in Group V were significantly lower than those in Group I, but the number of atretic follicles was higher than in Group I.</p><p><strong>Conclusion: </strong>The larger ovarian tissue transplantation resulted in a faster recovery with a higher survival rate of the uterus and normal follicles, compared to smaller ovarian tissue transplantation.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2362416"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The predictors of successful methotrexate treatment of tubal ectopic pregnancy.","authors":"Eiman Abdelfattah-Arafa, Hager Farag Abdussalam, Mohamed Omar Saad, Walid El Ansari","doi":"10.1080/01443615.2024.2361456","DOIUrl":"https://doi.org/10.1080/01443615.2024.2361456","url":null,"abstract":"<p><strong>Background: </strong>The pre-treatment characteristics of the patient and ectopic pregnancy to determine the patients who are likely to successfully respond to methotrexate (MTX) therapy remain controversial. This study investigated the outcomes of ectopic pregnancy after one and two MTX doses and their independent predictors.</p><p><strong>Methods: </strong>Retrospective cross-sectional study of women who consented to MTX treatment in 2017-2018 at our institution (<i>N</i> = 317). Of these, patients with Caesarean scar pregnancies were excluded because they require different treatment protocols (<i>n</i> = 25). All patients were treated according to our institution's protocol based on international guidelines and standardised across the three hospitals included in the current study. We retrieved patients' demographics, laboratory, ultrasonography, and clinical characteristics from our hospital database. Serum β-human chorionic gonadotropin (β-hCG) was measured using electrochemiluminescence immunoassay; ectopic pregnancy was diagnosed using ultrasonography (transvaginal probe).</p><p><strong>Results: </strong>Two ninety-two patients were included in the current analysis. Age, pre-treatment β-hCG levels, sonographic presence of yolk sac, presence of foetal cardiac activity, and pelvic pain were significantly different between patients with successful and unsuccessful outcomes. Younger age (adjusted odds ratio [aOR] 2.33, 95% confidence interval (CI) 1.16-4.66, <i>p</i> = .017), no pelvic pain (aOR 2.65, 95%CI 1.03-6.83, <i>p</i> = .043), lower initial β-hCG level (aOR 1.32, 95%CI 1.08-1.59, <i>p</i> = .005), and absence of foetal cardiac activity (aOR 12.63; 95% CI 1.04-153.6; <i>p</i> = .047) were independently associated with success. Treatment failure odds were >2 folds higher for each 10-year age increase (<i>p</i> = .017), 32% higher for each 1000 IU/L increase in initial β-hCG level (<i>p</i> = .005), and >2 folds higher in presence of pelvic pain (<i>p</i> = .043).</p><p><strong>Conclusions: </strong>MTX is effective in most patients, averting invasive surgery, which might affect fertility. Pre-treatment β-hCG levels, age, pelvic pain, and foetal cardiac activity was independently associated with outcomes. Research should assess the relationship between the ectopic pregnancy size and treatment outcomes and refine β-hCG titres where treatment would be ineffective.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2361456"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peining Dou, Feng Fang, Rongqiu Qin, Jingsong Nie, Xiaoyan Chen, Xiaoyan Yin, Yiding Wang, Shengying Shi
{"title":"Vaginal flora in HPV infection: a cross‑sectional analysis.","authors":"Peining Dou, Feng Fang, Rongqiu Qin, Jingsong Nie, Xiaoyan Chen, Xiaoyan Yin, Yiding Wang, Shengying Shi","doi":"10.1080/01443615.2024.2361847","DOIUrl":"https://doi.org/10.1080/01443615.2024.2361847","url":null,"abstract":"<p><strong>Objective: </strong>The vaginal flora has been reported to be associated with human papillomavirus (HPV) infection. The purpose of this study was to investigate the characteristics of the cervical microbiota in patients with HPV infection and to analyse the changes in the vaginal flora and enzyme profiles in females with HPV infection.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving 206 participants who underwent HPV genotyping, sexually transmitted diseases pathogen testing, cytology examination, and microbiome analysis. Additionally, we collected 115 HPV-negative samples and 48 HPV-positive samples for 16S rRNA amplicon sequencing. The vaginal microbial communities of both groups were analysed for diversity and differences to explore their association with HPV infection.</p><p><strong>Results: </strong>The abundance of <i>Lactobacillus</i> was found to be reduced, while <i>Gardnerella vaginalis</i> was significantly more prevalent in the HPV + group. In terms of alpha diversity indices, the Shannon index (<i>P</i> = .0036) and Simpson index (<i>P</i> = .02) were higher in the HPV + group compared to the HPV - group, indicating greater community diversity in the HPV + group. Among the 10 sexually transmitted diseases pathogens analysed, Uup3 and Uup6 were significantly associated with HPV infection. Statistically significant differences were observed in Nugent scores and bacterial vaginosis between the two groups (<i>P</i> < .05). In functional analysis, 11 proteins and 13 enzymes were found to be significantly altered in the HPV + group.</p><p><strong>Conclusion: </strong>Our study demonstrates that disruptions in the vaginal flora are associated with HPV infection. Reduced levels of <i>Lactobacillus</i>, increased prevalence of <i>Gardnerella</i>, and abnormal enzyme profiles are closely linked to HPV infection.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"44 1","pages":"2361847"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}