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Biomedical subjects

O Gregoriou

Publications and source records attributed to O Gregoriou.

At least 19 recordsLinked to original sources
PubMed2005

First-trimester pregnancy termination with 800 microg of vaginal misoprostol every 12 h.

The objective of the study was to evaluate the efficacy and safety of 800 microg of misoprostol every 12 h, for a period of 36 h for pharmacological abortion. A group of 162 volunteer women with gestations between 50 and 63 days received misoprostol every 12 h up to a maximum of three doses for abortion. Outcome measures assessed included: successful abortion (complete abortion without requiring surgery), side effects, and a decrease in hemoglobin, mean time of vaginal bleeding, mean expulsion time and mean time of returning of menses. Complete abortion occurred in 148 of 162 (91%, 95% confidence interval 87.95) patients. The mean decrease in hemoglobin was statistically significant (p = 0.001). Vaginal bleeding lasted 8.0 +/- 3.2 days, spotting 8.0 +/- 3.5 days, and total bleeding 16 +/- 4.0 days. The mean expulsion time was 8.5 +/- 4.0 h. According to the observed outcomes, 800 microg of misoprostol vaginally could be a valid method to terminate pregnancies up to 9 weeks of gestation.

Abortifacient Agents, Nonsteroidal↗
PubMed2001

Long term effects of Tibolone on postmenopausal women with uterine myomas.

OBJECTIVES: The aim of the present study is to evaluate the long term effects of Tibolone (Livial) on uterine myomas volume as well as on uterine arteries pulsatility index (PI) in postmenopausal women. METHODS: This study included 66 naturally menopausal women. Twenty of them (group A) had no uterine myomas; 23 of them (group B) had a single, asymptomatic, intramural or subserous myoma of a maximum diameter less or equal than 2 cm; 23 of them (group C) had a single, asymptomatic, intramural or subserous myoma of a maximum diameter between 2 and 5 cm. The volume of the myomas as well as the pulsatility index of the uterine arteries was assessed by transvaginal ultrasonography every 6 months after administration of Tibolone (2.5 mg daily). RESULTS: No statistically significant difference on myomas volume was found after a 3-year period of Tibolone administration. The uterine artery basal PI was significantly higher in group A compared to that of groups B and C. After 6 months of Tibolone administration the PI in group A was significantly lower compared to the basal one whereas in groups B and C was significantly higher compared to the basal value. CONCLUSIONS: Our results suggest that treating postmenopausal woman with Tibolone on a long-term basis: (a) does not increase the volume of uterine myomas and (b) has an early effect on uterine haemodynamics (decrease of PI in women without myomas and increase of PI in women with myomas).

Antineoplastic Agents, Hormonal↗
PubMed2000

Bone mineral density in women with idiopathic hirsutism.

Idiopathic hirsutism is relatively uncommon, affecting approximately 6% of hirsute women. In the present study we compared the bone mineral density (BMD) of women with idiopathic hirsutism with controls. A group of 20 women diagnosed with idiopathic hirsutism was evaluated with respect to BMD and the findings were compared to those of a control group consisting of 10 normal women. Hirsutism was graded according to the Ferriman-Gallwey score and threshold was considered to be a score more than 4. There was no statistically significant difference with respect to patients' mean age, BMI and body fat composition. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), androstenedione, testosterone, free testosterone, 17 alpha-hydroxyprogesterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG) and estradiol were assessed in both groups and no statistically significant differences were found. There was no statistically significant difference with respect to bone turnover--which was evaluated by determining the serum levels of parathyroid hormone, calcium, alkaline phosphatase and osteocalcin as well as the urinary secretion of calcium and hydroxyproline, corrected for the creatinine values--between the two groups. Statistical analysis was performed using the t test for unpaired data to compare age, BMD and biochemical data, and Wilcoxon's rank test was used to compare physical activity and calcium intake. Statistical significance was defined as p < 0.05. The BMD at the level of the 2nd to 4th lumbar vertebrae (L2-L4) and the total BMD were higher in women with idiopathic hirsutism compared to those in the control group, suggesting a possible direct effect of androgens on the osseous tissue of hirsute women.

17-alpha-Hydroxyprogesterone↗
PubMed2000

The effect of combined oral contraception with or without spironolactone on bone mineral density of hyperandrogenic women.

We studied the effect of treatment with combined oral contraception (COC) with or without spironolactone on the bone mineral density (BMD) of hyperandrogenic women. A group of 22 women (group 1) was treated with ethinylestradiol plus desogestrel for 21 days each month for 12 months, while another group of 21 patients (group 2) was treated with ethinylestradiol and desogestrel for 21 days each month plus spironolactone daily for 12 months. There was no statistically significant difference with respect to mean age, body mass index (BMI) and BMD between the two groups of patients before the treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), androstenedione, total testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), prolactin and estradiol were assessed in both groups and no statistically significant difference was found before treatment. Nor was there any statistically significant difference in bone turnover between the two groups. Statistical analysis was performed using the Student's t test for unpaired data to compare age, BMD and biochemical data, and statistical significance was defined as p < 0.05. The BMD before and after 12 months of treatment showed no statistically significant difference between the patients of group 1 and those of group 2, suggesting that both ethinylestradiol plus desogestrel, and ethinylestradiol and desogestrel plus spironolactone daily for 12 months at the given doses do not affect the BMD of the treated women, while the addition of spironolactone improves the efficacy of hirsutism treatment.

Adult↗
PubMed1998

Clinical value of creatinine kinase in the diagnosis of ectopic pregnancy.

The role of creatinine kinase (CK) in the diagnosis of ectopic pregnancy was studied. We selected 56 patients divided into 4 groups. Group A consisted of 10 patients with asymptomatic tubal pregnancy, group B consisted of 11 patients with symptomatic tubal pregnancy whereas groups C and D consisted of 20 and 15 patients with normal and threatened intrauterine pregnancy, respectively. Serum samples of CK were taken from all patients on admission. No significant difference was observed in the median CK value of cases with normal pregnancy (58.5 +/- 7.24 U/1, mean +/- SE) as well as threatened abortion (73 +/- 11.43 U/1) compared to that of cases with asymptomatic 58.5 +/- 12.42 U/1) or symptomatic tubal pregnancy (59 +/- 10.08 U/1). We conclude that serum CK is not a useful biochemical marker in the diagnosis of ectopic pregnancy.

Abortion, Threatened↗
PubMed1998

Evaluation of ovarian cysts following GnRH-a treatment in patients with polycystic ovarian syndrome.

The aim of this study was to evaluate the ovarian cysts appearing during GnRH-a/hMG treatment in patients with polycystic ovarian syndrome (PCOS). A total of 35 women with PCOS were included in the study. All women received 3.75 mg IM of long-acting leuprolide acetate on the first day of the menstrual cycle. On the 15th day of the menstrual cycle, transvaginal ultrasound examination (US) and determination of serum E2 were done. A total of 90 cycles were studied in this way and during these cycles, 14 (15.5%) ovarian cysts with a diameter of >/= 20 mm developed. According to the serum E2 levels, 11 cases (group A) had E2 concentrations > 35 pg/ml and 3 (group B) had serum E2 levels < 35 pg/ml. Group A patients attained a significantly larger mean size of ovarian cyst than group B patients (42 +/- 7.3 vs. 24.2 +/- 3.2 mm, p < 0.001). When the serum E2 concentrations were < 35 pg/ml, the ovarian cysts were disregarded and ovarian stimulation with gonadotropins was initiated. In case that serum E2 levels were > 35 pg/ml, the initiation of the ovarian stimulation with hMG was postponed until serum E2 levels indicated down-regulation, which was achieved after 5.8 +/- 2.9 days. In both groups the ovarian stimulation resulted in ovulatory cycles, while four pregnancies in group A and one in group B were achieved. In conclusion, our results indicate that in patients with PCOS the GnRH-a administration may cause follicular cysts at an incidence of 15.5%. These cysts do not constitute a contraindication for ovarian stimulation provided that serum E2 levels are low.

Adult↗
PubMed1998

Gonadotropin ovulation induction and pregnancies in women with Kallmann's syndrome.

Only 17 cases of pregnancy in women with Kallmann's syndrome have been reported in the literature, eight as case reports. In our clinic, we diagnosed seven women with complete Kallmann's syndrome in a 16-year period. In five cases (unprimed patients) the diagnosis was established for the first time, while in the other two cases diagnosis had been established earlier. The five unprimed patients received hormone therapy (HRT) immediately after diagnosis. The other two patients had already been on HRT. Four patients wanted to bear children. Follicular evolution and maturation was induced with daily human menopausal gonadotropin (hMG) administration. The results were monitored through plasma estradiol (E2) determinations and ultrasonography. Ovulation was induced with hCG administration. Five pregnancies were achieved in three patients, resulting in four healthy neonates. Two women achieved a second pregnancy. Nausea and vomiting did not occur in any of our five pregnancies. We found no significant differences between the total hMG dose needed for ovulation induction, the number of stimulation days, estradiol plasma concentrations and the number of follicles with diameter > or = 17 mm, in either conceptional or non-conceptional cycles. In fact, the total hMG dose administered was lower and the days of stimulation were significantly fewer in women on their second pregnancy. There was no difference in plasma estradiol concentrations and the number of follicles with diameter > or = 17 mm. In conclusion, ovulation induction and pregnancy in women with complete Kallmann's syndrome is not such a difficult procedure as was believed in the past. A previous pregnancy seemed to augment ovarian sensitivity to gonadotropins.

Adult↗
PubMed1997

Effect of tibolone on postmenopausal women with myomas.

OBJECTIVE: The aim of this study is to assess the effect of Tibolone (Livial) on uterine fibroids in postmenopausal women. METHODS: This study included 40 naturally postmenopausal women with at least one uterine fibroid measuring > 20 mm. All of theme were scanned by transvaginal ultrasonography. Patients were randomized into two groups. Group A (n = 20) were treated with Tibolone 2.5 mg daily for 1 year and group B (n = 20) did not received therapy. The size of the uterine fibroids was reevaluated on the end of the treatment. RESULTS: No statistically significant difference was found in the mean volume of fibroids before and after treatment with Tibolone. The administration of Tibolone resulted in an increase of fibroid volume in three patients, whereas it remained constant in the majority of the patients (70%) and decreased in three patients. CONCLUSIONS: Our results suggest that treating menopausal symptoms with Tibolone does not affect preexisting asymptomatic uterine fibroids.

Anabolic Agents↗
PubMed1997

Receptor scintigraphy of non-neuroendocrine cancers with In-111 pentetreotide.

Somatostatin receptors (SR) are surface markers characterizing not only APUDomas associated with neuroendocrine identities but also malignancies without neuroendocrine expression. Recently, the somatostatin analog pentetreotide was labeled with In-111 (OctreoScan 111, Mallinckrodt Medical BV, Petten, Holland) and introduced for the in vivo visualization in man of SR-positive tissues. In the present report, SR-specific scintigraphy is evaluated as a clinical tool for tissue characterization in correlation with histological and radiological examinations. Scintigraphy was focused and performed in cancer types without neuroendocrine tissue expression such as brain (n = 6) and breast tumors (n = 9) and lymphomas (n = 5). Scintigraphy was performed for comparison at 6 and 22 h after i.v. application of 111 MBq (3 mCi) of In-111-Pentetreotide. In the breast cancer group, the primary tumor was visualized in all 9 women as well as in all 4 cases with palpable axillary lymph nodes. Three women with a negative axillary node scan and impalpable nodes had positive biopsy. In two cases, mediastinal lymph node involvement was observed. So far the role of SR-positive breast cancer (BC) scans remains unknown. It is tempting to speculate that in resected women who are histologically and scintigraphically SR positive, it might be of value in the early detection of symptom-free recurrences. High densities of SR were present within both meningiomas, the high-grade astrocytoma and the craniopharyngioma. Differentiation of low- and high-grade astrocytomas could not be successfully achieved because both grades showed intense radioactivity uptake, even though high-grade tumors lack SR. The latter might be due to the damaged blood-brain barrier and the poor radioactivity washout observed in high-grade astrocytomas. All five lymphomas could be detected due to the presence of activated lymphocytes and macrophages that express SR at a sufficient density. In conclusion, SR scintigraphy in non-neuroendocrine malignancies does not seem to be reliable for an initial tumor staging but rather more suitable for a tissue characterization and extremely useful for monitoring changes of SR expression after treatment.

Adolescent↗
PubMed1996

Pregnancy rates in gonadotrophin stimulated cycles with timed intercourse or intrauterine insemination for the treatment of male subfertility.

OBJECTIVE: To compare the pregnancy rates achieved by intrauterine insemination or timed intercourse in gonadotrophin stimulated cycles in couples whose only detectable abnormality was poor sperm quality. DESIGN: Sixty-two couples with primary or secondary infertility due to male factor entered the study. The 62 couples were randomly equally divided into two groups. Each group began one of the two treatment modalities (controlled ovarian hyperstimulation in conjunction with timed intercourse or intrauterine insemination) for three consecutive cycles and then switched to the alternative treatment after one rest cycle, if pregnancy was not achieved. RESULTS: Five pregnancies (3.9%) were achieved after 128 cycles with timed intercourse and 15 pregnancies (11.5%) after 130 cycles with intrauterine insemination. The difference was found to be statistically significant (P < 0.05). CONCLUSION: We suggest that intrauterine insemination during hMG stimulated cycles improves the pregnancy rates of couples whose only detectable abnormality is poor sperm quality.

Adult↗
PubMed1995

Controlled ovarian hyperstimulation with or without intrauterine insemination for the treatment of unexplained infertility.

OBJECTIVE: To evaluate whether there are any benefits from intrauterine insemination (IUI) as opposed to timed intercourse (TI) in stimulated ovarian cycles in couples with longstanding, unexplained infertility. METHODS: Forty-six couples with diagnoses of unexplained infertility were evaluated in a crossover study after a total of 141 cycles. Sixty-seven cycles were with IUI after controlled ovarian hyperstimulation (COH) while 74 cycles were after COH and TI. RESULTS: The pregnancy rate after COH/TI was 16.7% and after COH/IUI 45.2%. Cycle fecundity however was 8.9% after COH/TI and 25.7% after COH/IUI, which is a statistically significant difference (P < 0.05). CONCLUSIONS: A trial of human menopausal gonadotropin and IUI is justified in couples with prolonged infertility of unknown cause.

Adult↗
PubMed1995

Fallopian tube sperm perfusion has no advantage over intra-uterine insemination when used in combination with ovarian stimulation for the treatment of unexplained infertility.

In this prospective randomized study we treated 60 couples with unexplained infertility with a combination of ovarian stimulation and either intrauterine insemination (IUI) or fallopian sperm perfusion (FSP). In the IUI we used a volume of 0.5 ml of inseminate and in the FSP a volume of 4 ml. The demographic characteristics of the patients, the stimulation parameters and the sperm data were not statistically different between the two groups. The pregnancy rate per cycle was 16.2% in the IUI group and 14.5% in the FSP group and the pregnancy rate per woman was 40 and 36.7%, respectively (not statistically different). We conclude that IUI and FSP are equally effective in the treatment of couples with unexplained infertility.

Adult↗
PubMed1994

Immune dysfunction in patients with unexplained repeated abortions.

OBJECTIVES: To examine the immunological profiles by antiphospholipid antibodies IgG, IgM, IgA immunoglobulins ACA, as well as C3, C4 complement component levels. METHODS: A group of 44 women with a history of three or more consecutive pregnancy losses was compared with 34 normal women. RESULTS: Our results showed lower levels of IgG immunoglobulins for the patient group (P < 0.001) while the C3, C4 complement component levels remained unaltered. Anticardiolipin antibodies were positive in ten patients for IgG or IgM isotypes or for both presenting a prevalence of 22.7% while none of the control subjects had ACA positive titers. The lupus anticoagulant was not detected in either group. Ten patients (22.7%) presented positive autoantibody tests as compared with only 3 (8.8%) of the control group. No statistical differences were found between the two groups when the frequency of each autoantibody's positive tests were examined separately. CONCLUSIONS: An inconsistent immune derangement seems to be present in recurrent aborters with the presence of anticardiolipin antibodies as the stronger representative marker of immune alteration.

Abortion, Habitual↗
PubMed1993

A randomized comparison of intrauterine and intraperitoneal insemination in the treatment of infertility.

OBJECTIVE: To compare the pregnancy rates (PRs) between intrauterine insemination (IUI) and intraperitoneal insemination (IPI) in women receiving comparable ovarian stimulation in couples who were infertile for various infertility conditions. METHOD: Fifty-four couples were treated. Of these, 25 were diagnosed as having unexplained infertility, 21 as having male infertility and 8 as having cervical mucus hostility. RESULT: Nine pregnancies occurred with 89 cycles of IUI and 6 pregnancies with 85 cycles of IPI, giving an overall PR of 28%. Twelve of the 15 pregnancies occurred during the first treatment cycle and three during the second treatment cycle. There was no significant difference in the (PRs) between the IUI and IPI (P > 0.25). CONCLUSION: Both procedures combined with superovulation proved to be simple, inexpensive safe and worthwhile for infertile couples with unexplained infertility, male infertility and cervical mucus hostility.

Adult↗
PubMed1993

The tap test: a simple and inexpensive method for the diagnosis of fetal pulmonary maturity.

OBJECTIVE: To report our experience in the prediction of fetal lung maturity with the tap test. METHOD: Amniotic fluid was obtained from 207 pregnant women from 17-40 weeks' gestation and the tap test compared with the phospholipid profile. RESULTS: The predictive values for a mature tap test were 100%, 99.9% and 98.2% and for immature tap test were 45.8%, 50% and 56.4% at 2.5 and 10 min, respectively. CONCLUSION: The tap test is a reliable, rapid, easy, inexpensive and accurate method for detection of fetal lung maturity.

Amniotic Fluid↗
PubMed1993

Immunoglobulins IgG, IgA, IgM, complement C3, C4 and ferritin and transferrin levels in serum and follicular fluid in IVF patients.

Serum and follicular fluid immunoglobulin (IgG, IgA, IgM) and complement (C3, C4), as well as transferrin and ferritin concentrations were measured in 82 consecutive IVF patients (Pregnant: Group A, and non pregnant: Group B). Higher serum concentrations were observed in complement in all Immunoglobulins but IgM which was found to be significantly lower in follicular fluid in both groups. Also there were no statistically significant differences observed for transferrin and ferritin levels in either compartment or among the groups. No correlation was found for the above parameters and the in vitro fertilization outcome in terms of oocytes retrieved, fertilized and embryos implanted.

Adult↗
PubMed1993

Treatment of idiopathic infertility with testosterone undecanoate. A double blind study.

This study refers to 50 couples treated for subfertility. Twenty five of these patients were treated with TU (Testosterone Ur econoate), the remaining 25 received placebo. Sperm characteristics, including ejaculate volume, pH, sperm density, morphology, motility, total testosterone, FSH, LH, DHT and E2 were evaluated both before and after treatment. A statistically significant increase of DHT levels was noticed after TU administration, whereas a marginally significant improvement of sperm morphology was present. Serum FSH concentrations, decreased significantly in the TU group whereas serum LH presented a slight but not statistically significant decrease; 4 pregnancies were achieved by the TU group whereas none were achieved by the patients belonging to the placebo group. The administration of TU per os to patients with idiopathic oligospermia presents a demonstrably positive effect.

Administration, Oral↗