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  • 1
    Online Resource
    Online Resource
    Maternal HPV Infection and the Estimated Risks for Adverse Pregnancy Outcomes—A Systematic Review
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 6 ( 2022-06-15), p. 1471-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 6 ( 2022-06-15), p. 1471-
    Abstract: Background: Human Papilloma Virus (HPV) represents the most prevalent genital infection in young women of reproductive age. Objective: This systematic review aims to estimate the effect of HPV infection during pregnancy and assess the correlation between HPV and adverse pregnancy outcomes. Materials and methods: The search strategy has been developed based on the PICOS framework: Population (pregnant women infected with HPV), Intervention (HPV infection confirmed by molecular tests), Comparator (pregnant women without HPV infection), Outcomes (adverse pregnancy outcomes) and Study design (observational studies). We searched PubMed, Web of Science, and Scopus databases on 8 January 2022 by using the following keywords: “HPV”, “prematurity”, “preterm birth”, “miscarriage”, “premature rupture of membranes”, “adverse pregnancy outcome”, “low birth weight”, “fetal growth restriction”, “pregnancy-induced hypertensive disorders”, “preeclampsia”. Selection criteria were HPV infection confirmed within maximum 2 years before pregnancy with a molecular test and adverse pregnancy outcomes. (Results: Although numerous studies are conducted on this topic, data are still controversial regarding identifying maternal HPV infection as a risk factor for adverse pregnancy outcomes. More prospective large cohort studies are needed to prove a causative relationship.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12061471
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 2
    Online Resource
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    Fetal Pancreatic Hamartoma Associated with Hepatoblastoma—An Unusual Tumor Association
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 3 ( 2022-03-20), p. 758-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 3 ( 2022-03-20), p. 758-
    Abstract: Abdominal tumor masses are a very rare disease in the fetus. The authors present the first reported case of neonatal multicystic adenomatoid hamartoma of the pancreas associated with well-differentiated fetal epithelial subtype hepatoblastoma and reveal clinical, histologic, and imagistic aspects. Case presentation: A 36-week-old female newborn in whom a 25-week ultrasound showed a relatively homogeneous pancreatic echogenic mass (34 × 30 × 55 mm) with compression of the inferior vena cava and retrograde dilation. Postnatal CT showed a giant pancreatic tumor mass (113 × 70 × 60 mm), with areas enhancing contrast and cystic/necrotic areas and a hypodense, hypocaptive nodule of 8 × 6 mm located at segment IV of the liver; thrombosis of the subhepatic segment of the inferior vena cava and both renal veins. Histopathological and immunohistochemical studies confirmed the diagnosis of multicystic pancreatic adenomatoid hamartoma and well-differentiated fetal epithelial subtype hepatoblastoma. Conclusions: Pancreatic hamartoma can be difficult to diagnose (especially prenatal), with or without nonspecific symptoms. The synchronous presence of hepatoblastoma complicated the therapeutic conduct and prognosis of this case, with the diagnosis being confirmed histopathologically and immunohistochemically after liver biopsy.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12030758
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 3
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    Online Resource
    Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 5 ( 2022-02-24), p. 1221-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 5 ( 2022-02-24), p. 1221-
    Abstract: Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11051221
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 4
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    Online Resource
    Taurine and Its Derivatives: Analysis of the Inhibitory Effect on Platelet Function and Their Antithrombotic Potential
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 3 ( 2022-01-27), p. 666-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 3 ( 2022-01-27), p. 666-
    Abstract: Taurine is a semi-essential, the most abundant free amino acid in the human body, with a six times higher concentration in platelets than any other amino acid. It is highly beneficial for the organism, has many therapeutic actions, and is currently approved for heart failure treatment in Japan. Taurine has been repeatedly reported to elicit an inhibitory action on platelet activation and aggregation, sustained by in vivo, ex vivo, and in vitro animal and human studies. Taurine showed effectiveness in several pathologies involving thrombotic diathesis, such as diabetes, traumatic brain injury, acute ischemic stroke, and others. As human prospective studies on thrombosis outcome are very difficult to carry out, there is an obvious need to validate existing findings, and bring new compelling data about the mechanisms underlying taurine and derivatives antiplatelet action and their antithrombotic potential. Chloramine derivatives of taurine proved a higher stability and pronounced selectivity for platelet receptors, raising the assumption that they could represent future potential antithrombotic agents. Considering that taurine and its analogues display permissible side effects, along with the need of finding new, alternative antithrombotic drugs with minimal side effects and long-term action, the potential clinical relevance of this fascinating nutrient and its derivatives requires further consideration.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11030666
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 5
    Online Resource
    Online Resource
    Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 1 ( 2021-01-04), p. 147-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 1 ( 2021-01-04), p. 147-
    Abstract: Anabolic androgenic steroids (AAS), simply called “androgens”, represent the most widespread drugs used to enhance performance and appearance in a sporting environment. High-dosage and/or long-term AAS administration has been associated frequently with significant alterations in the cardiovascular system, some of these with severe endpoints. The induction of a prothrombotic state is probably the most life-threatening consequence, suggested by numerous case reports in AAS-abusing athletes, and by a considerable number of human and animal studies assessing the influence of exogenous androgens on hemostasis. Despite over fifty years of research, data regarding the thrombogenic potential of exogenous androgens are still scarce. The main reason is the limited possibility of conducting human prospective studies. However, human observational studies conducted in athletes or patients, in vitro human studies, and animal experiments have pointed out that androgens in supraphysiological doses induce enhanced platelet activity and thrombopoiesis, leading to increased platelet aggregation. If this tendency overlaps previously existing coagulation and/or fibrinolysis dysfunctions, it may lead to a thrombotic diathesis, which could explain the multitude of thromboembolic events reported in the AAS-abusing population. The influence of androgen excess on the platelet activity and fluid–coagulant balance remains a subject of debate, urging for supplementary studies in order to clarify the effects on hemostasis, and to provide new compelling evidence for their claimed thrombogenic potential.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10010147
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 6
    Online Resource
    Online Resource
    Technical Tips and Tricks after 10 Years of HyFoSy for Tubal Patency Testing
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 19 ( 2022-10-08), p. 5946-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 19 ( 2022-10-08), p. 5946-
    Abstract: Background: Hysterosalpingo-foam sonography (HyFoSy) has gained popularity in the last decades, as it represents a feasible, well-tolerated, and minimally invasive method of evaluation of tubal patency in cases of infertility. The purpose of this study was to communicate the technical tips and tricks based on our experience in performing HyFoSy, with the aim to improve the feasibility, to reduce the pain, and to evaluate pregnancy-obtaining rate after procedure. Methods: Our observational study includes 672 patients from infertile couples who underwent HyFoSy for tubal patency evaluation. During HyFoSy, tubal pathway and patency as well as the level of pain were evaluated. A telephonic questionnaire was conducted in order to assess the pregnancy obtaining rate in the first 3 months and more than 3 months after the procedure. Results: The median age in our group was 33.5 years. Most of our patients (61.16%) underwent HyFoSy in the 8–10 days of the menstrual cycle. Tubal patency was present bilaterally in 86% cases, unilaterally in 11% of patients, and was absent in 3% of cases; 75% of patients related absent or tolerable pain, 17% described HyFoSy as a painful procedure, and 8% experienced extreme pain. After HyFoSy, pregnancy was naturally obtained in 10.86% of cases within the first 3 months after HyFoSy. Conclusions: HyFoSy represents a useful, easy to use, and painless tool in female infertility evaluation and should be considered as a complementary method of the transvaginal ultrasonography, completing the genital tract imaging with information about the hidden part of the standard examination: tubal patency. HyFoSy provides information about patency, caliber regularity, pathway, and occlusion location of the fallopian tubes; therefore, it should be introduced along with transvaginal ultrasound as a first-line infertility exploration method.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11195946
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 7
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    Online Resource
    Ultrasound Pitfalls in a Complex Fetal Cardiac Malformation—Case Report of a New Arteriovenous Central Communication
    MDPI AG ; 2021
    In:  Diagnostics Vol. 11, No. 12 ( 2021-12-20), p. 2398-
    Details
    In: Diagnostics, MDPI AG, Vol. 11, No. 12 ( 2021-12-20), p. 2398-
    Abstract: Cardiac and cardiovascular malformations are of real interest in terms of definition, epidemiology, and means of early diagnosis by imaging. Although ultrasound examination reaches exceptional performance nowadays, unusual pathologies are still exposed to the risk of either incorrect acquired image or misinterpretation by the specialist in a routine scan. Herein, we present a case of a 20-week-old fetus (from an apparently low-risk pregnancy) with complex cardiac and vascular abnormalities, including an arteriovenous malformation along with ventricular septal defect, ductal coarctation of the aorta, aneurysm of a brachiocephalic vein, and dilation of the entire neck and upper mediastinum venous system, and the limitations that were encountered in the process of diagnosis and management of the case.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics11122398
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 8
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    Online Resource
    The Necessity of Magnetic Resonance Imaging in Congenital Diaphragmatic Hernia
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 7 ( 2022-07-17), p. 1733-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 7 ( 2022-07-17), p. 1733-
    Abstract: This is a retrospective study investigating the relationship between ultrasound and magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is a rare cause of pulmonary hypoplasia that increases the mortality and morbidity of patients. Inclusion criteria were: patients diagnosed with CDH who underwent MRI examination after the second-trimester morphology ultrasound confirmed the presence of CDH. The patients came from three university hospitals in Bucharest, Romania. A total of 22 patients were included in the study after applying the exclusion criteria. By analyzing the total lung volume (TLV) using MRI, and the lung to head ratio (LHR) calculated using MRI and ultrasound, we observed that LHR can severely underestimate the severity of the pulmonary hypoplasia, even showing values close to normal in some cases. This also proves to be statistically relevant if we eliminate certain extreme values. We found significant correlations between the LHR percentage and herniated organs, such as the left and right liver lobes and gallbladder. MRI also provided additional insights, indicating the presence of pericarditis or pleurisy. We wish to underline the necessity of MRI follow-up in all cases of CDH, as the accurate measurement of the TLV is important for future treatment and therapeutic strategy.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12071733
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 9
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    Online Resource
    The Effect of Plant-Based Nutrition Diets on Plasma Lipids Profile—A Study Case in Romania
    MDPI AG ; 2022
    In:  Sustainability Vol. 14, No. 2 ( 2022-01-17), p. 1008-
    Details
    In: Sustainability, MDPI AG, Vol. 14, No. 2 ( 2022-01-17), p. 1008-
    Abstract: Diet is an important tool in managing dyslipidemic disorders, thus contributing to the prophylaxis of cardiovascular morbidity. Research has shown that a plant-based diet could have positive effects through many pathways. We conducted a study on a group of 38 plant-based individuals from Romania who have adopted the diet for at least one year. The aim of the research was to evaluate eventual changes in their lipid profile. We analyzed to what extent the values of different markers significantly changed following the dietary transition. Improvements were obtained for body mass index (BMI) and all lipid markers, with the exception of high-density lipoprotein cholesterol (HDL-C). Results showed that 75.0% of persons with elevated TGs (triglycerides) succeeded in normalizing them, as well as individuals with high low-density lipoprotein cholesterol (LDL-C) levels, where 72.7% from the borderline elevated became optimal. The total cholesterol (TC)/HDL-C ratio shifted from elevated to optimum in 78.6% of cases. Results were poor in three participants with presumed familial hypercholesterolemia, which were later successfully managed by using lipid-lowering medication. In conclusion, although dyslipidemias are only a surrogate marker for cardiovascular morbidity, the actions by which a plant-based diet can influence cardiovascular diseases are multiple, and we consider that our study confirms its positive effect.
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su14021008
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518383-7
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  • 10
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    Online Resource
    Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 2 ( 2022-01-19), p. 236-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 2 ( 2022-01-19), p. 236-
    Abstract: Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12020236
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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