N. Koutlaki

Umbilical cord serum vascular endothelial growth factor (VEGF) levels in normal pregnancies and in pregnancies complicated by preterm delivery or pre-eclampsia

Objectives: The aim of this study was to determine whether increased levels of vascular endothelial growth factor (VEGF) are implicated in the pathogenesis of pre‐eclampsia and in preterm delivery. Methods: Umbilical cord serum VEGF levels from women with uncomplicated term pregnancies (control group, n=24), with pregnancies complicated by pre‐eclampsia (n=21), or with preterm delivery (n=29) were compared. Statistical analysis was performed using the Mann–Whitney U‐test, the t‐test, and Smirnoff–Kolmogorov test. Results: The mean VEGF concentration was significantly higher in the women with pre‐eclampsia than in women from the control group (P<0.01). There were also increased but not significantly higher VEGF concentrations in the preterm delivery group compared with the control group (P=0.16). Conclusions: Our study results support previous findings that raised umbilical cord serum VEGF levels might be correlated with the clinical development of pre‐eclampsia and, in some circumstances, of preterm delivery.

The role of cytokines IL-6 and IL-8 in the pathogenesis of spontaneous abortions

Objective. The aim of this study was to investigate the role of interleukin-6 and interleukin-8 in the spontaneous abortion of the first and second trimester of pregnancy and the possibility of IL-6 and IL-8 being used as markers for the pregnancy outcome. Method. The patients were divided into three groups: group 1, women at the time of first trimester miscarriage (n = 35); group 2, women at the time of second trimester miscarriage (n = 35); group 3 included the women without previous history of abortions submitted to hysterectomy (n = 10). Plasma levels of interleukin-6 and interleukin-8 were measured by bioassays method (ELISA). Mann–Whitney U test and Kruskal–Wallis test were used to assess differences between two or more groups of patients, respectively. Post hoc analysis was performed using Mann–Whitney U test with Bonferroni’s correction. Results. Interleukin 6 levels in women who had a second trimester abortion were statistically higher compared to those who had a first trimester abortion. Interleukin-8 levels in patients with second trimester abortion were also statistically higher compared to the control group. No significant differences between women with first trimester abortions and those without previous history of abortions were found. Conclusions. Our data suggest that IL-6 and IL-8 might be crucial factors which take part in the defensive reaction of maternal organization during the 2nd trimester of pregnancy.

Trends in epidemiology of preinvasive and invasive vulvar neoplasias

Abstract Objective: To describe the trends in incidence of preinvasive and invasive vulvar neoplasias in the rural area of Trace, as well as to check the hypothesis that patients found with these two distinct entities represent populations with different epidemiologic characteristics. Patients and Methods: We performed a retrospective study on 34 patients found with invasive vulvar cancer and vulvar intraepithelial neoplasia (VIN) (12 and 22 respectively), who referred to our department from 1986– 1998. Epidemiologic characteristics of the patients were abstracted from medical charts. To evaluate our results we used the direct standardization method (1995 Eur. Population) and χ2 test. Results: The age-adjusted incidence rates for VIN1–2, in situ cancer (CIS)-VIN3 and invasive vulvar cancer were 0.9\100,000, 1.6\100,000 and 1.8\100,000 respectively, while for the whole VIN lesions 2.5\100,000. There were statistically significant differences in most epidemiologic characteristics between the two study groups, one with invasive cancer patients and one with patients found with preinvasive vulvar neoplasia. Conclusions: The overall age-adjusted incidence rate for vulvar neoplasia in Thrace is comparable to the one reported in literature. Our study results confirm that patients with invasive and preinvasive vulvar neoplasia represent populations with different epidemiologic characteristics.

Differentiation in contraceptive behavior of the female population in Thrace, Greece

Objective To investigate the factors influencing the contraceptive practice of the female population in the rural area of Thrace, Greece. Methods We conducted a retrospective sociopsychological study on representatives of the two major religious subgroups in Thrace: 127 Orthodox Christians and 120 Muslims. The women were reasonably representative in terms of age, education, marital status and professional life. Interviews covered sexual history and contraceptive use in detail. Results We observed a significant preference of Christians for condoms, and of Muslims for coitus interruptus. The use of the male condom was significantly higher in younger, compared to older, Christians (p < 0.001). Muslim women aged 30–39 years showed a significant preference for coitus interruptus and intrauterine devices, as compared with Christians. Highly educated women of both subgroups did not present statistically significant differences concerning contraception. It was found that, the more intense the sexual activity, the more common the use of the condom for Christians and the more popular the choice of interrupted intercourse for Muslims. Muslims with a permanent sexual relationship preferred interrupted intercourse, while all Muslims with multiple sexual partners used the male condom. Conclusions There is an urgent need to promote information concerning the variety of modern contraceptive options in order to improve the prevalence of contraceptive use and reproductive health in the region of Thrace.

Attenuation of the oestrogen positive feedback mechanism with the age in postmenopausal women.

It has been reported that the positive feedback mechanism of oestrogens and progesterone is preserved, although attenuated, in late postmenopausal years. Whether this is also true for the positive feedback effect of oestrogens alone has not been investigated.

Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding

BackgroundThe amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women as well as in those who receive analgesia during labor and those who do not recieve.ObjectiveIn this study, we explored relations between stress during birth experience and lactogenesis of 100 women, who experienced vaginal delivery in Department of Obstetrics and Gynecology of University Hospital of Alexandroupolis.MethodStress hormones (cortisol and glucose) were measured in serum (cord and maternal blood) immediately after delivery. Moreover, breast-feeding frequency on day 4, the time when the subjects first felt fullness in the breasts, milk volume on day 4 postpartum and duration of labor were recorded. Also, we recorded maternal exhaustion score during labor and positive and negative affects, posttraumatic stress score and mother–infant bonding rate, with the use of questionnaires.ResultsThere were significant intercorrelations among the outcome variables. Mothers who experienced pain, exhaustion and negative feelings in a stressful and long labor had delayed onset of lactation.ConclusionsThese results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, negative affects and high score of posttraumatic stress are risk factors for delayed lactogenesis.

Attenuating activity of the ovary on LH response to GnRH during the follicular phase of the cycle

Oestradiol sensitizes the pituitary to GnRH, while gonadotrophin surge attenuating factor (GnSAF) may oppose this action. Using the LH response to GnRH during treatment with FSH as an in vivo bioassay for GnSAF, we tested the hypothesis that the augmented LH response to GnRH in the late follicular phase is related to reduced production of GnSAF from the ovulatory follicle.

Trends in epidemiology of cervical cancer in Thrace, Greece.

This retrospective study assessed the epidemiological trends of cervical cancer in Thrace Greece. The study examined 86 Christian Orthodox (n = 78) and Muslim (n = 8) patients treated in a clinic during 1986-98. The analysis was based on the distribution of tumor characteristics and certain sociodemographic factors between the two groups. The average annual age-adjusted incidence rate of cervical cancer was 10.0/100000 (9.1/100000 among Christians and 0.9/100000 among Muslims). Furthermore there was a decreasing incidence of invasive cancer (4.9-2.3/100000) and an increasing incidence of carcinoma (0.6-1.7/100000). A higher prevalence of adenocarcinoma as a histology type (p < 0.001) more skilled workers (p < 0.05) and better educational status (p < 0.05) were observed among Christian patients. On the other hand an advanced disease (p < 0.05) earlier sexual intercourse (p < 0.003) circumcised sexual partners (p < 0.001) and multiparity (p < 0.05) were observed among Muslim patients. The variations in risk factor profiles in the two groups did not provide a satisfactory explanation for the ethnic variation in the incidence of cervical cancer between Christians and Muslims.

Epidemiologic aspects of endometrial cancer in Thrace, Greece

To describe the epidemiologic characteristics of endometrial cancer in relation with certain risk factors affecting the two major ethnic groups (Christian Orthodox and Muslims) in the area of Thrace, Greece. We performed a cross‐sectional study of 166 consecutive patients, aged between 29 and 87 years, with documented endometrial cancer who were referred to our clinic for treatment from January 1986 to June 1998. Epidemiologic characteristics of the patients were abstracted from medical charts. To evaluate our results we used the direct standardization method (1995 Eur. Population) and χ2 test. The endometrial cancer incidence for the two study populations (Christian Orthodox and Muslims) was 16.96 and 3.16/100 000, respectively. We observed statistically significant differences in most epidemiologic characteristics between the two major ethnic groups in Thrace (Christian Orthodox and Muslims) regarding endometrial cancer. Our results confirm the increasing trend of endometrial cancer incidence as established in previous investigations.

Preimplantation Genetic Diagnosis

Abstract:  Preimplantion genetic diagnosis (PGD) is now used for identification of gene and chromosomal defects in embryos. In this article we describe its use primarily for identification of chromosomal defects in women with recurrent abortions, repeated in vitro fertilization (IVF) failure, and advanced maternal age. In all these situations there is increase in chromosomal defects. The identification of normal embryos and the elimination of abnormal embryos are argued to be helpful in increasing implantation and pregnancy rates in these women.