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Biomedical subjects

G Creatsas

Publications and source records attributed to G Creatsas.

At least 109 records · Page 6Linked to original sources
PubMed1999

Improving reproductive sexual health: a primary goal at the beginning of the new millennium.

At the beginning of the millennium, it is important that experts and official organizations direct their strategic plans towards the improvement of reproductive sexual health. Adolescents represent the major target of these plans in an effort to improve their sexual behavior. Sexually transmitted diseases must be reduced since their prevalence is very high in certain eastern European countries. These plans should be considered together with the development of new fertility control methods which provide at the same time bactericidal and antiviral properties. Education, provided especially through the media, should be considered a tool for the improvement of the present situation.

Adolescent↗
PubMed1999

Ovarian tumors during childhood and adolescence. A clinicopathological study.

Ovarian tumors during the first two decades of life represent the most frequent tumors of the female genital tract at this age. Clinical and therapeutical particularities differentiate them from the same tumors of older women. During the period 1993-1997, 57 ovarian tumors were diagnosed and managed in the Divisions of Pediatric and Adolescent Gynecology of the 1st and 2nd Departments of Obstetrics and Gynecology, University of Athens. Benign tumors were found to be 77.2%, malignant 15.8% and borderline 7%. Germ cell tumors were the most common 49.1%, epithelial 35.1%, stromal 12.3%, lymphoma 1.75% and mixed tumors 1.75%. Of all the malignancies germ cell carcinomas consisted of 44.5%.

Adolescent↗
PubMed1999

Genital tumors during childhood and adolescence. A clinical and pathological study of 71 cases.

Genital tumors during the first two decades of life are not common and they constitute 5-10% of all tumors. During the period 1993-1997, 71 cases of genital tumors were diagnosed and managed in the Divisions of Pediatric and Adolescent Gynecology of the 1st and 2nd Departments of Obstetrics and Gynecology, University of Athens. Ovarian tumors were found to be the most common uterine tumors -16.9% and cervical -28%. From the ovarian tumors -80.3% of all tumors; -77.2% of cases were found to be benign; 15.8% malignant and 7% borderline. Malignant tumors were found to be germ cell -44.5%, epithelial -22.2%, stromal -11.1%, lymphoma 11.1%, and mixed -11.1%.

Adolescent↗
PubMed1999

Laparoscopic evaluation and management of chronic pelvic pain during adolescence.

Chronic pelvic pain (CPP) is a common symptom and a difficult condition to manage especially during adolescence. The aim of this study was to evaluate the role of laparoscopy in the diagnosis and treatment of CPP during this period of life. From January 1993 to December 1997, 98 patients, selected from a group of 180 patients who were referred to our clinic underwent laparoscopy. In most cases (60%) no abnormalities were observed. Endometriosis was found in 25% of cases, followed by ovarian cysts 7%, parovarian cysts 3%, pelvic inflammatory disease 3% and adhesions 2%. Laparoscopic treatment was performed as indicated by laparoscopic findings. We conclude that laparoscopy is a valuable and effective procedure in the diagnosis and management of CPP in a selected group of patients.

Adolescent↗
PubMed1999

Evaluation of combined endoscopic and pharmaceutical management of endometriosis during adolescence.

Laparoscopy is the most frequent surgical approach in gynecologic patients with acute or chronic pelvic pain. The symptomatology is frequently related to a specific gynecological pathology such as endometriosis or associated adhesive disease. During an eight year period, January 1990 to December 1997, 26 patients (aged 16-20 years) with endometriosis were diagnosed endoscopically and managed pharmaceutically in our clinic. The disease was evaluated and staged according to the American Society of Reproductive Medicine. The disease was evaluated as first stage in 16 patients (61.6%), as second stage in eight patients (30.8%), as third stage in one patient (3.8%) and as fourth stage in one patient (3.8%). Patients underwent adhesiolysis and management according to their laparoscopic findings. Postoperative pharmaceutical treatment (Danazol, GnRH analogues, Oral Contraceptives) was given. Patients were followed for the evaluation of the treatment. The efficacy of the combination of endoscopic and pharmaceutical management of the disease is discussed.

Adolescent↗
PubMed1999

Reproductive health issues in Greece.

OBJECTIVE: To evaluate reproductive health issues in Greece. METHODS: Analysis of hospital data and national registry reports. RESULTS: The rate of population growth in Greece is declining and is now 0.99% p.a. The maternal mortality ratio is approximately 3.6 per 100,000 live births, and perinatal and infant mortality are approximately 10/1,000 and 16/1,000 respectively. However, only 28-30% of sexually active women use contraception and approximately 300,000 terminations are performed each year. Sexually transmitted diseases are less common than in 1985: the incidence of syphilis is less than 4 per 100,000 population and that of gonorrhoea is less than 25/100,000. Between 1984 and September 1996, 1,421 cases of AIDS were reported; of these, 1,252 (88.1%) were in men and 169 (11.9%) in women. The incidence of human papilloma virus infection increased and at least 30% of sexually active women are infected. CONCLUSION: Good reproductive health is of major importance to women and health agencies but there are still significant obstacles to overcome in some regions.

Family Planning Services↗
PubMed1998

Results of the colposuspension operation in pre and postmenopausal incontinent women.

OBJECTIVE: To compare the results of Burch colposuspension in premenopausal and postmenopausal women with urinary stress incontinence (USI). METHODS: A total of 85 women with urodynamic diagnosis of genuine urinary stress incontinence were divided into two groups, according to their menstrual status (premenopausal and postmenopausal group). All of them underwent the Burch colposuspension procedure. Clinical and urodynamic data were compared preoperatively and postoperatively and between the two groups. RESULTS: Cure rate was significantly higher after Burch colposuspension in the premenopausal as compared to the postmenopausal patients (90.9 vs 73.1%, respectively, P < 0.01). A significant reduction of the diurnal and nocturnal frequency and urgency was noted in both groups postoperatively. The reduction of urgency was more prominent in the premenopausal women (P < 0.001). There were no statistically significant differences between the preoperative and postoperative values of bladder capacity, residual volume, maximal voiding pressure, peak flow rate, absolute urethral length, functional urethral length, urethral pressure and maximum urethral closure pressure both preoperatively and postoperatively within the groups and between the two groups. Comparing the two groups postoperatively, the pressure transmission ratios in the postmenopausal women were found to be significantly lower in the middle two quarters of the urethra as compared to the premenopausal patients (P < 0.001). CONCLUSION: Burch colposuspension for urinary stress incontinence has better cure rate in premenopausal than in postmenopausal women. Nevertheless, the above procedure remains an acceptable method for treatment of USI in postmenopausal patients.

Adult↗
PubMed1998

Detection of oestrogen receptor variants in endometrium, myometrium, leiomyoma and peripheral blood mononuclear cells: comparison to variants present in breast cancer.

Oestradiol has mitogenic and regulatory effects on various organs and cells, mediated mainly by its nuclear receptor (ER). The presence of aberrant ER forms in Oestrogen-dependent tumours has been discussed in correlation with tumour progression. ER variants, generated by alternative splicing, have been detected in human breast cancer, but also in normal mammary glands, therefore their role in tumorigenesis has been questioned. We have investigated, by the use of the reverse transcription polymerase chain reaction amplification technique, the possible existence of ER variants in other normal oestrogen target organs and cells, such as uterus (myometrium and endometrium), in peripheral blood mononuclear cells and in a benign uterus tumour (leiomyoma). We have detected variant ER in these samples and have compared the variant profile to that observed in breast cancer. All tissues and cells studied expressed both wild-type ER and variant species. Variant forms encompassed ER with deletions of exons 2, 5 and 7. Variants with exon 5 deleted were detected only in peripheral blood mononuclear cells and in breast cancer. Variants with exons 2 and 7 deleted were present in all specimens tested. These results corroborate previous findings that the presence of ER variants is not a characteristic of breast cancer. The physiological significance and possible clinical relevance of the variant ER forms remain to be elucidated.

Base Sequence↗
PubMed1998

Tenoxicam versus lynestrenol-ethinyl estradiol treatment of dysfunctional uterine bleeding cases during adolescence.

BACKGROUND: The purpose of this study was to compare the effectiveness of tenoxicam versus lynestrenol-ethinyl estradiol (L-EE) in the treatment of severe cases of dysfunctional uterine bleeding (DUB) during adolescence. METHODS: Forty-eight patients with objective DUB completed a randomized comparative trial of treatment with tenoxicam (20 mg daily, n = 23) or L-EE (1 tablet containing 0.05 mg + 2.5 mg, respectively, 3 times daily, n = 25). Treatment was given during menorrhagia until bleeding ceased. Mean age of the patients was 13.74 +/- 2.1 years (range, 11-18 years). RESULTS: A significantly higher level of hematocrit (35.9% v 32.6%, t = 2.1, P = 0.0217) and hemoglobin (11.5 v 10.4 g%, t = 1.7, P = 0.0495), and significantly less hospitalization (5.75 v 8.33 days, t = 2.45, P = 0.0106) was seen in the tenoxicam group in comparison to L-EE group after completion of the treatment. Three patients were submitted to curettage and seven to transfusion in the group receiving L-EE, but no patients in the tenoxicam group required these procedures. CONCLUSIONS: Tenoxicam is considered an effective medication for the management of DUB during adolescence.

Adolescent↗
PubMed1997

Sexually transmitted diseases and oral contraceptive use during adolescence.

Sexually transmitted diseases (STD) cause lower genital tract infections (cervicitis, vaginitis) or ascending infections of the fallopian tubes, and, possibly, pelvic inflammatory disease (PID). The syphilis bacterium, human immunodeficiency virus (HIV), and the hepatitis virus cause systematic disease. Although oral contraceptives (OCs) are the most reliable contraceptive method, they have limited anti-STD properties and their relationship with STDs remain unclear. Various mechanisms explain a protective role of OCs against STDs; however, in no way can OCs be considered a safe anti-STD contraceptive method, when compared to specific barrier methods, which provide both contraception and anti-STD protection. The above has been confirmed by a recent study performed in our institution where 10.3% and 6.9% of OC users presented a prevalence of Chlamydia trachomatis and Mycoplasma, respectively, when compared to 0% and 4.5% infection rates found among condom users. It is concluded that although OCs possess some anti-STD properties, mainly in the prevention of PID, they should be used in combination with a barrier method.

Adolescent↗
PubMed1997

Reconstruction of urethrovaginal fistula and vaginal atresia in an adolescent girl after an abdominoperineal-vaginal pull-through procedure.

OBJECTIVE: To report a rare case of urethrovaginal communication and vaginal atresia. DESIGN: To reconstruct the communication and the vaginal route. SETTING: Division of Pediatric and Adolescent Gynecology and Corrective Gynecological Surgery, University of Athens, and "Alexandra" Hospital. PATIENT(S): A 16-year-old girl with cyclic hematuria, periodic pelvic pain, and primary amenorrhea. INTERVENTION(S): Diagnostic studies, followed by an abdominoperineal-vaginal pull-through procedure. MAIN OUTCOME MEASURE(S): Reconstruction of the urethrovaginal fistula and vaginal route. RESULT(S): Normal menstruation through the vaginal route. CONCLUSION(S): A careful examination of every infant's external genitalia should be performed immediately after delivery. A urethrovaginal fistula should be corrected in time to facilitate menstrual flow and improve future reproductive potential.

Adolescent↗
PubMed1997

Improving adolescent sexual behavior: a tool for better fertility outcome and safe motherhood.

The consequences of increased adolescent sexuality worldwide include: an increased rate of adolescent pregnancies and abortions; a high prevalence of sexually transmitted diseases; and a significant number of psychosocial problems. Improvement of adolescent sexual behavior should be one of the primary goals of the 21st century. This includes development of new contraception techniques, providing protection from sexually transmitted diseases, improvement of contraception compliance and the correct use of mass media. As adolescents seek advice on sexual matters, it is our responsibility to provide them with accurate consultation as well as free family planning services in well organized adolescent units, where they may be counselled on the prevention of unwanted pregnancy, and sexually transmitted diseases. This will assist in a better fertility outcome and a safe motherhood.

Adolescent↗
PubMed1997

The GyneFix implant systems for interval, postabortal and postpartum contraception: a significant advance in long-term reversible contraception. International Study Group on Intrauterine Drug Delivery.

Intrauterine contraception has a number of important advantages over other forms of contraception and remains, therefore, an important method of birth control. However, side-effects and other drawbacks have reduced its overall acceptance. Also misconceptions and lack of updated scientific knowledge among the potential users and providers are major obstacles to the widespread use of intrauterine contraception. Ideally, an intrauterine device (IUD) should prevent pregnancy effectively, be well tolerated, not become displaced or expelled over time, cause a minimum of side-effects, be long-lasting, have a strictly local effect, and be easy to insert and remove. A group at the University of Ghent, Belgium, the International Study Group on Intrauterine Drug Delivery, has developed, since 1985, a totally new concept in order to improve current intrauterine contraceptive efficacy and enhance tolerance, by creating a harmonious relationship between the uterine cavity and the contraceptive 'foreign body'. The new concept (GyneFix) consists of a non-biodegradable suture thread made of surgical 00 monofilament polypropylene on which six copper tubes are threaded, providing a total surface area of 330 mm2. The upper and lower tubes are crimped onto the thread to keep the tubes in place. The upper extremity of the thread is provided with a knot which serves as an anchor. The knot is implanted in the myometrium of the uterine fundus with a specially designed insertion instrument, thereby permanently securing the device in the uterine cavity. Since the initial clinical investigations, over 10,000 woman years of experience and up to 10 years' follow-up in international multicenter, non-comparative and comparative clinical trials have been collected. The clinical material also included a large number of nulligravid and nulliparous women. Due to the design characteristics of the GyneFix and its anchoring in the uterine fundus, an optimal tolerance and almost complete absence of expulsion were obtained. The constant release of copper ions in the upper part of the uterine cavity results in the high effectiveness of the anchored device. The effectiveness is higher than in the high-load conventional copper IUDs which have a risk of becoming displaced, partially or totally expelled in 10% or more (nulliparous women), resulting in a significant number of accidental pregnancies. The absence of frame and, as a consequence, its flexibility, explain the low incidence of side-effects and the very low incidence of complications, such as pelvic inflammatory disease and ectopic pregnancies. This new concept could be a major step forward in the acceptance of intrauterine contraception worldwide and increase its popularity. This article reviews the experience with the new concept for interval, postabortal and postpartum contraception.

Abortion, Induced↗
PubMed1997

Effects of two combined monophasic and triphasic ethinylestradiol/gestodene oral contraceptives on natural inhibitors and other hemostatic variables.

OBJECTIVE: To evaluate the effects of two preparations of combined oral contraceptives (COCs), the monophasic COC containing 30 micrograms ethinylestradiol and 75 micrograms gestodene and the triphasic COC containing 30/40/30 ethinylestradiol and 50/70/100 micrograms gestodene on seven natural inhibitors and hemostatic variables. METHOD: Forty-four healthy young women, randomly allocated into two groups (A and B) received the two preparations of COCs, respectively. The following variables were tested in a basic examination and at 1-, 3- and 6-month intervals to evaluate the role of the above preparations on the hemostatic balance of prothrombin time, fibrinogen, antithrombin III activity, protein C activity, total protein S antigen, plasminogen activity and lupus anticoagulant. RESULTS: Group A women presented shorter prothrombin time at 6 months, an increased fibrinogen level at 3 months, no influence on the anticoagulant factors, antithrombin III, protein C and total protein S and an increased plasminogen activity at the 1st and 3rd months of treatment. On the other hand, group B women presented shorter prothrombin time at 3 months, no increase in fibrinogen, a decrease in antithrombin III activity and total protein S activity at the 6th month, whereas protein C and plasminogen activities were found to be increased at the 3rd and 1st, 3rd and 6th month, respectively. CONCLUSIONS: The study did not find differences between the two treatment groups, for the evaluated parameters. This finding is clearly important in the light of the recent epidemiological reports on third-generation COCs. However, differences were found among the various periods of administration of both COCs.

Adolescent↗