Female fertility has been a field of interest for the scientific community throughout the years. The contribution of proteomics in the study of female fertility as well as female infertility and in ...vitro fertilization (IVF) has been significant. Proteomics is a recently developed field, extensively applied to the identification and quantification of proteins, which could be used as potential biomarkers in a diagnostic, prognostic, or predictive manner in a variety of medical conditions.
The present review focuses on proteomic studies of the oocyte and endometrial environment as well as on conditions related to infertility, such as polycystic ovarian syndrome, endometriosis, obesity, and unexplained infertility. Moreover, this review presents studies that have been done in an effort to search for fertility biomarkers in individuals following the IVF procedure.
The comprehension of the molecular pathways behind female fertility and infertility could contribute to the diagnosis, prognosis, and prediction of infertility. Moreover, the identification of proteomic biomarkers for IVF cycles could predict the possible outcome of an IVF cycle, prevent an unsuccessful IVF, and monitor the IVF cycle in a personalized manner, leading to increased success rates. Figure: see text.
Preeclampsia represents a major pregnancy complication, associated with high rates of perinatal morbidity. The aim of this systematic review is to accumulate current literature evidence in order to ...examine the pattern of serum adipokine levels among preeclamptic women and asses their potential efficacy in the prediction of the disease.
Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were systematically searched from inception. All observational studies reporting serum adipokine values among preeclamptic and healthy pregnant women were held eligible.
A total of 163 studies were included, comprising 23,482 women. Leptin was evaluated in 91 studies and its values were found to be significantly elevated in preeclamptic women during all pregnancy trimester, independently of disease onset and severity. Preeclampsia was also associated with increased serum fatty acid binding protein-4 and chemerin levels, when measured both during the 1st and 3rd trimester. Data concerning the rest adipokines were either conflicting or limited to reach firm conclusions. Quality of evidence was evaluated to be high for leptin, moderate for serum fatty acid binding protein-4 and chemerin and low for the other adipokines.
The existing evidence suggests that preeclampsia is linked to increased levels of leptin, chemerin and fatty acid binding protein-4 in all pregnancy trimesters and forms of the disease. Inconsistent data currently exists concerning the role of the other adipokines. Large-scale prospective studies should longitudinally evaluate the serum concentration of novel adipokines and define the optimal threshold and timing of measurement to be widely applied in clinical practice.
•Current evidence suggests that leptin levels are higher in preeclamptic pregnancies.•Leptin increase is observed in all pregnancy trimesters and forms of the disease.•Serum fatty acid binding protein-4 and chemerin are increased in preeclampsia.•The existing evidence regarding the other adipokines is inconsistent.•Future cohorts should define the optimal thresholds to be widely applied.
•Chemotherapy response score is a valuable tool that helps determine patients at risk of earlier relapse and death.•The importance of debulking surgery remains significant even in those with minimal ...response to chemotherapy.•Survival differences of CRS 1-2 vs CRS 3 patients were similar to those of patients with platinum resistant vs sensitive disease.
The chemotherapy response score (CRS) has been widely adopted as a predictive tool for ovarian cancer survival. In the present study, we seek to define differences in survival rates among patients grouped in the traditionally established three-tiered system and those who have not been offered debulking surgery.
We designed a retrospective cohort study involving women treated with chemotherapy and offered interval or late debulking surgery for ovarian cancer. Twenty-eight women were not considered for a debulking procedure for various reasons. Of the 89 women who were finally offered interval debulking or late debulking surgery, 28 had a CRS 1 score, 34 had a CRS 2 score and 27 had a CRS 3 score.
Significant differences were noted in the progression-free survival (PFS) and overall survival (OS) of patients based on the CRS stratification, although survival rates were considerably longer for all three groups compared to those of patients who were not offered surgery. Cox regression univariate analysis revealed that suboptimal debulking and CRS 1 or no surgery had a significant negative impact on PFS and OS rates. The binary stratification of CRS (CRS 1–2 vs CRS 3) revealed comparable differences in the PFS and OS to those in the groups that were stratified as platinum resistant and platinum sensitive.
The chemotherapy response score is a significant determinant of ovarian cancer survival that helps evaluate the risk of early disease relapse and death and may soon be useful in guiding patient-tailored treatment.
Overproduction of fetal hemoglobin by the placenta leading to increased consumption of endogenous heme scavenging proteins has been recently implicated as a novel pathway in the pathogenesis of ...preeclampsia. The aim of the present systematic review was to evaluate maternal serum levels of fetal hemoglobin, haptoglobin, heme oxygenase-1, hemopexin and α1-microglobulin, as well as haptoglobin phenotypes among preeclamptic and healthy pregnant women and assess their predictive role in the disease.
Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were systematically searched from inception. All studies comparing levels of fetal hemoglobin or heme scavengers among preeclamptic and healthy pregnant controls were deemed eligible.
Twenty-three studies were included, with a total number of 7461 pregnant women. Quantitative synthesis was not conducted for the comparison of serum levels due to high heterogeneity. Current evidence suggests that preeclampsia is associated with increased levels of fetal hemoglobin and α1-microglobulin, as well as with lower levels of serum hemopexin. Data regarding serum haptoglobin and heme oxygenase-1 were conflicting, as the available evidence did not unanimously suggest a significant change of their levels in the disease. Network meta-analysis indicated no significant association for any of the haptoglobin phenotypes with preeclampsia development.
The present review suggests that preeclampsia may be associated with increased fetal hemoglobin and α1-microglobulin and decreased hemopexin levels, although inter-study heterogeneity was high. Future large-scale studies are needed to fully elucidate the predictive efficacy of these markers by introducing cut-off values and defining the optimal gestational age for sampling.
•Preeclampsia is linked to higher HbF, α1-microglobulin and lower hemopexin levels.•Haptoglobin phenotype does not alter preeclampsia risk.•Future cohort studies should define the optimum cut-offs to be widely used.•The most appropriate gestational age for sampling remains to be elucidated.
Several articles have implied that progestogen supplementation during pregnancy to reduce the risk of preterm birth may increase the risk for developing gestational diabetes mellitus.
The purpose of ...the present meta-analysis was to accumulate existing evidence concerning this correlation.
We searched Medline (1966–2019), Scopus (2004–2019), Clinicaltrials.gov (2008–2019), EMBASE (1980–2019), Cochrane Central Register of Controlled Trials CENTRAL (1999–2019), and Google Scholar (2004–2019) databases.
Randomized trials and observational studies were considered eligible for inclusion in the present meta-analysis. To minimize the possibility of article losses, we avoided language, country, and date restrictions.
The methodological quality of included studies was evaluated with the Cochrane risk of bias and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool. Meta-analysis was performed with the RevMan 5.3 and secondary analysis with the Open Meta-Analyst software. Trial sequential analysis was conducted with the trial sequential analysis program.
Overall, 11 studies were included in the present meta-analysis that recruited 8085 women. The meta-analysis revealed that women who received 17-alpha hydroxyprogesterone caproate had increased the risk of developing gestational diabetes mellitus (risk ratio, 1.73, 95% confidence interval, 1.32–2.28), whereas women who received vaginal progesterone had a decreased risk, although the effect did not reach statistical significance because of the unstable estimate of confidence intervals (risk ratio, 0.82, 95% confidence interval, 0.50–1.12). Meta-regression analysis indicated that neither the methodological rationale for investigating the prevalence of gestational diabetes mellitus (incidence investigated as primary or secondary outcome) (coefficient of covariance, –0.36, 95% confidence interval, –0.85 to 0.13, P = .154) nor the type of investigated study (randomized controlled trial/observational) (coefficient of covariance –0.361, 95% confidence interval, –1.049 to 0.327, P = .304) significantly altered the results of the primary analysis. Trial sequential analysis suggested that the meta-analysis concerning the correlation of 17-alpha hydroxyprogesterone caproate was of adequate power to reach firm conclusions, whereas this was not confirmed in the case of vaginal progesterone.
The results of the present meta-analysis clearly indicate that women who receive supplemental 17-alpha hydroxyprogesterone caproate for the prevention of preterm birth have an increased risk of developing gestational diabetes mellitus. On the other hand, evidence concerning women treated with vaginal progesterone remains inconclusive.
Neurofibromatosis type 1 is a dominantly inherited neurologic disorder that affects primarily the skin, bones, and peripheral nervous system. The disorder may be associated with a variety of clinical ...manifestations including both superficial and deep-seated lesions such as café-au-lait spots, skinfold freckling, Lisch nodules, and cutaneous, deeper, and visceral neurofibromas, Visceral involvement, in particular, rarely affects the genital tract, and isolated ovarian neurofibromas are extremely rare. Herein is reported a case of a solitary neurofibroma of the left ovary in a 24-year-old woman with chronic pelvic pain. The tumor was excised at laparoscopy, with complete resolution of symptoms. After 3 years of follow-up, the patient remains asymptomatic and free of any further visceral involvement.
Background
Preeclampsia is a leading cause of perinatal morbidity, although an optimal screening model is still under investigation. The aim of the present meta‐analysis is to accumulate current ...evidence and evaluate the diagnostic accuracy of CA‐125 in preeclampsia.
Materials and Methods
Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched. All studies reporting serum CA‐125 among preeclamptic and healthy pregnant women were selected.
Results
Nine studies involving 977 women were included. Meta‐analysis revealed significant differences among patients with preeclampsia and control pregnant women (MD 15.86 IU/mL, 95% CI, 9.03‐22.69). Patients with severe preeclampsia had significantly higher levels of CA‐125 compared to patients with mild preeclampsia (MD 13.21 IU/mL, 95% CI, 1.94‐24.49). Meta‐regression analysis revealed that gestational age <34 weeks could positively affect this association.
Conclusions
The present meta‐analysis suggests that serum CA‐125 levels are increased in preeclamptic women during the third trimester of pregnancy. This association should be interpreted with caution as there are concerns for significant selection bias. Future studies are needed to corroborate these findings and investigate the diagnostic accuracy of this biomarker during early pregnancy.
To evaluate the compliance of healthcare professionals with national guidelines and the hesitancy of pregnant women to be immunized against influenza and pertussis.
We conducted a two-stage study. ...The first stage of our study included all women (n = 197) who gave birth in Alexandra Maternity Hospital in Athens, Greece during a 3-month period (April–June) 2018. They completed a questionnaire regarding their immunization status against influenza and pertussis. If pertinent, they detailed their reasons for not getting immunized. During the second stage of our study, we actively recommended both vaccines to the outpatients of Alexandra Maternity Hospital (n = 195) between September 2018 and January 2019.
The majority of women (92.9%) were immunized during childhood according to Greek national immunization guidelines. Almost all the women (98%) stated that they will vaccinate their children. More than half (65.5%) responded that they would have been vaccinated during pregnancy if their doctor had recommended it, but in 73.6% of cases, their doctor did not do so. Only a small proportion of women (16.2%) were immunized against influenza during pregnancy while none of them (0%) received the Tdap vaccine. In most cases (65%), study participants stated they were not immunized because their doctor did not recommend vaccination. Additionally, 9.7% of participants feared possible side effects. During the second stage of our study 94.9% out of 195 women agreed to get vaccinated against influenza and 92.8% against pertussis.
It is apparent that the compliance with the immunization guidelines during pregnancy is surprisingly low. However, health professionals appear to be reluctant to recommend vaccination during pregnancy. Women appear to trust their doctors and usually agree with their recommendations.
The negative impact of perioperative blood transfusion on survival outcomes has been reported in several cancer types. The purpose of the present study is to summarize existing evidence in ovarian ...cancer patients. We searched the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases for observational and randomized trials that assessed the impact of perioperative blood transfusion on the disease-free survival (DFS) and overall survival (OS) of ovarian cancer patients that undergone debulking surgery were selected for inclusion. The methodological quality of the included studies was assessed by using the Newcastle-Ottawa Scale. Statistical meta-analysis was performed with the RevMan 5.3 software using the Der-Simonian Laird random effects model. Seven studies were identified which included 2341 ovarian cancer patients. Meta-analyses that were based on univariate and multivariate reporting revealed that perioperative blood transfusion had a significant negative impact on the patient`s OS rates (OR 1.78, 95 %CI 1.16, 2.74 and OR 1.31, 95 %CI 1.00, 1.71 respectively). Disease free survival rates were also influenced according to the results of the univariate analysis (OR 1.58, 95 %CI 1.14, 2.19), however, the effect was not significant in the multivariate analysis. The analysis that was based on propensity score matched populations did not reveal differences among transfused and non-transfused. Concluding, the findings of our meta-analysis suggest that transfusion of blood products during the perioperative period is not an independent factor that may affect survival outcomes of ovarian cancer patients. Nevertheless, it should be noted that patients that receive transfusion have several potential confounders that may affect their survival outcomes.
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