Psychological stress is an important factor involved in disease manifestations of human papillomavirus (HPV) infection, and it can participate in HPV-associated carcinogenesis. The impact or effect ...which stress can have (exert) depends on a person’s genetic pool, experiences and behaviors. Due to inconsistencies in some study results, this issue remains a subject of research. Concerning the course of HPV manifestations, it has been observed that a higher number of life stressors in at least the previous 6 months, the absence of social support and the types of personal coping mechanisms employed, all influence HPV progression. In women with cervical dysplasia, a connection between greater stress experiences and dysregulation of specific immune responses has been observed. Once HPV enters a cell via the α6 integrin there are three possible sequences: latent infection, subclinical infection, and clinically manifest disease. HPV proliferation in differentiated epithelial cells induces morphologically cytopathic changes (koilocytosis, epidermal thickening, hyperplasia, hyperkeratosis). Oncogenic transformation requires the integration of the virus genome into the host genome. In doing so, DNA in the E1 region of E2 breaks down, leading to transcription disorders of E6 and E7. For the formation of irreversible malignancy, the following sequence is necessary: initial expression of E6 and E7 genes followed by suppression of apoptosis and the stabile expression of E6 and E7 proteins that protect transformed cells from apoptosis. A successful immune response is characterized by a strong, local cell-mediated immune response. Several factors are important for the regression of HPV manifestation/infection, among which is psychological stress which can prolong the duration and severity of HPV disease. Stress hormones may reactivate latent tumor viruses, stimulate viral oncogene expression, and inhibit antiviral host responses. In the regression of HPV infection, increased activity of Th1 cells was observed. However, during psychosocial stress, a decrease in the Th1 type of immune response is seen, and there is a shift towards a Th2 response. Understanding perceived stress and biological changes in stress, as well as the evaluation of immune parameters, gives researchers a better picture of how stress influences HPV infections and how to improve disease management and outcomes.
The aim of the study was to explore the relationship between educational level, employment status and sexual activity after delivery. The study was conducted on 286 women with experience of vaginal ...delivery who completed the questionnaire about age, education, employment, and health status for themselves and partners. Time of the first intercourse and its frequency in the first year after childbirth was observed. Relationship between the variables observed was explored by using multiple linear regression. The mean pregnancy duration was 39 weeks. The mean age of participants was 29.9 (16 to 44) years. Most women had high education (n=170, 59.4%), 114 (39.9%) had secondary, and 2 (0.7%) had primary educational level. Although there were significant differences in the time of the first intercourse and maternal educational level (p=0.013872), partner’s employment status (p=0.007403) and maternal age (p= 0.01107), as well as differences in the frequency of intercourse in the first year following delivery and partner’s educational level (p=0.016929), multiple correlation coefficients indicated a very weak correlation. According to study results, the correlation of educational level, employment status and sexual activity after childbirth is weak.
Injury of the rectum with intact anal sphincter is an extremely rare but very serious complication of vaginal delivery. It is also called a "buttonhole" tear.
We present two cases of "buttonhole" ...tear/injury.
In one case, the injury was recognized at the time of delivery and adequately treated. In the other case the injury was not diagnosed on time and the patient was treated for complications on the 6th postpartal day.
The consequences for the wellbeing of young mothers with perineal injury can be serious and affect social and sexual aspects of their lives. Adequate surgical treatment and postoperative care assure optimal results and prevent long term complications such as fistulas or fecal incontinence.
Postponing assisted reproductive technology treatment can cause pronounced mental health problems. The aim of this study was to examine the level of depression, anxiety, stress, and overall ...infertility-related distress experienced by infertile couples during the pandemic, as well as the differences between men and women in the examined variables and the correlations between them.
A total of 131 participants were included in the study, 65 men and 66 women. They were selected based on their responses in the Fertility Problems Inventory (FPI); the Depression, Anxiety, and Stress Scale-21 (DASS-21); and a general data questionnaire provided to them at the time of IVF.
The levels of depression, anxiety, and stress in women and men resided within the normal range. Depression (p<0.05), anxiety (p<0.01), stress (p<0.01), and social concern (p<0.05) were more pronounced among women. Significant correlations were found between depression, anxiety, stress, and global stress and its three dimensions: social concern, sexual concern, and relationship concern.
During the pandemic, women undergoing assisted reproductive technology treatment experienced significantly higher levels of depression, anxiety, stress, and overall infertility-related stress than men. Furthermore, depression, anxiety, and stress were apparently correlated with overall infertility-related stress.
Ureteral triplication is a very rare anomaly found in the upper urinary tract. This condition can be connected with a higher incidence of congenital anomalies and predisposition for urinary ...infections. Operative procedure is considered in cases where symptoms reduce the patient's quality of life. The type of surgical treatment depends on symptom manifestation. The risk of renal failure is usually a deciding factor, which can be found in conditions such as vesicoureteral reflux, obstruction, ureteral ectopy and recurrent infections. Simultaneous treatment of upper and lower urinary tract can be performed. We report a case of a 38-year-old female patient diagnosed with cervical carcinoma, where ureteral triplication was detected incidentally during a radical operative procedure. Keywords: Ureteral triplication; Cervical carcinoma; Congenital anomalies
The objective of this study was to assess the relationship between women's age and risk of pregnancy-related complications. The study was a retrospective cohort analysis of the pregnancy-related ...complications and outcomes between two age groups of parturient women. Categorical data were expressed as absolute and relative frequencies. Statistical analysis was performed using chi square-test. The incidence of gestational diabetes was higher in the 40-47 age group as compared with the 20-24 age group. The rates of hypertension, preeclampsia, intrahepatic cholestasis of pregnancy and hypothyroidism did not differ between the two groups. The rates of labor induction, oxytocin use, vaginal delivery, and need for episiotomy were higher in younger age group. Dystocia and breech presentation as indications for cesarean section were more common among younger women. According to study results, the risk of gestational diabetes and rates of cesarean delivery increased with advanced maternal age. Key words: Maternal age; Pregnancy; Risk factors; Delivery
Uterine rupture during pregnancy is a critical obstetric complication associated with maternal and fetal mortality and morbidity. The risk is increased in patients with a history of previous uterine ...surgery including cesarean section, myomectomy, salpingectomy, as well as uterine and placental anomalies and polyhydramnios. It can also occur spontaneously. We present a case of uterine rupture in the early third trimester in a woman who had undergone previous laparoscopic removal of the left fallopian tube due to sactosalpinx and laparotomic removal of left uterine horn due to ectopic pregnancy. Key words: Pregnancy; Third trimester; Uterine rupture; Cornual resection; Salpingectomy
With advancement of medicine in the field of diagnostics and treatment of women suffering from certain genetic disorders, more and more women have attained reproductive age and desired fertility. ...Maintaining pregnancy, as well as bringing it to an end poses a real challenge not only for obstetricians, but also for anesthesiologists involved in the procedure. In our case report, we describe anesthetic management of a female patient suffering from myotonic dystrophy type 2 and suspected von Willebrand's disease, and undergoing elective cesarean section. It is acknowledged that both diseases have their own peculiarities and specificities related to anesthesia and require careful consideration when it comes to selecting it. Bearing in mind the advantages and disadvantages of certain types of anesthesia, we believe that in this case, general anesthesia was a better choice compared to the regional techniques of anesthesia.
Purpose
Previously, pain treatment following episiotomy has relied on non-steroid anti-inflammatory drugs as analgesics, whose use during breastfeeding remains controversial due of their transfer to ...the child.
Methods
This was a pilot randomized parallel single-center study aiming to evaluate the effects of auricular acupuncture on pain relief after episiotomy. The primary outcome was reduction of pain intensity using visual analogue scale (VAS) scores during the first three postpartum days. The patients were allocated to either of the groups by using a heads–tails binary result coin toss method and the allocation was not masked. The study was completed after including 60 healthy women that underwent mediolateral episiotomy performed during vaginal delivery, with 29 receiving acupuncture therapy and 31 not receiving acupuncture therapy for pain relief. Oral analgesic therapy was made available per request for all patients.
Results
This study showed that subjective experience of pain was significantly reduced in the acupuncture group on the second and third postpartum days (
P
= 0.004,
P
= 0.005,
P
= 0.22). There were no adverse effects of acupuncture noted.
Conclusions
Our findings confirm that auricular acupuncture therapy may be a valuable adjunct to analgesic therapy in patients undergoing episiotomy during vaginal delivery. The results prompt a question whether our current ‘best practice’ may yet be improved.
- Cervical ripening can be promoted in many ways, but mechanical methods are among the oldest. Like all other methods, this one also has its pros and cons. Disadvantages compared to pharmacological ...methods include some maternal discomfort upon manipulation of the cervix, a theoretical increase in the risk of maternal and neonatal infection from the introduction of a foreign body, potential disruption of a low-lying placenta, and increase in the need of oxytocin induction of labor. The aim of the study was to evaluate the effect of using cervical ripening balloon in preinduction on the mode of delivery. This was a longitudinal, cohort, intervention, non-randomized one center study. Inclusion criteria were term pregnancies with gestational diabetes, oligohydramnios, intrauterine growth restriction, gestational hypertension/preeclampsia and pregnancies after 41 weeks of pregnancy. Preinduction of labor was performed in term pregnancies at Sestre milosrdnice University Hospital Center. Results in the first 150 women having undergone labor preinduction with cervical ripening balloon were included. Two-sided p values <0.05 were considered significant. Statistical analysis was done using SPSS Version 20.0. The study included 150 women; one woman was excluded from further analyses due to conversion of fetal presentation (head to breech). Indications for labor preinduction were as follows: gestational diabetes, oligohydramnios, intrauterine growth restriction, gestational hypertension/preeclampsia and pregnancies after 41 weeks of pregnancy. Women with normal vaginal delivery (96/149) had lower rates of gestational diabetes and oligohydramnios and used epidural analgesia more frequently. Women with dystocia (32/53) had a significantly longer labor duration and higher neonatal birth weight. In multivariate analysis, multiparity, greater cervical dilatation after balloon removal and use of epidural analgesia were associated with a decreased risk of cesarean section, while the presence of gestational diabetes and oligohydramnios was associated with an increased risk of cesarean section. We found this preinduction method safe and efficient, with a potential to increase the rate of vaginal deliveries.
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