Papers by Anastasia Vatopoulou
Gynecological Endocrinology, Jun 2, 2020
Background: Gonadotropin-releasing hormone (GnRH) analogs represent the treatment of choice in pa... more Background: Gonadotropin-releasing hormone (GnRH) analogs represent the treatment of choice in patients with central precocious puberty (CPP). Recently, GnRH analogs that can be administered every 3 months have been developed and appear to be as safe and effective as one-monthly formulations. However, there are limited data regarding its long term safety and efficacy profile. We aimed to evaluate the long-term safety and efficacy treatment of CPP with GnRH analogs every 3 months. Methods: We prospectively studied all patients who were diagnosed with CPP in our center between January 2015 and December 2019. All patients were treated with intramuscular leuprolide acetate 11.25 mg every 3 months. Results: Twenty-four patients with CPP were included in the study. Mean follow-up was 3.1 years. Height gain ranged between 4 and 6 cm. Bone mineral density (BMD) was not affected. Body mass index (BMI) increased in all subjects but none was obese at the end of follow-up. Conclusions: Treatment of patients with CPP with GnRH analogs every 3 months induces substantial increases in height and does not affect BMI or BMD. Therefore, it represents an attractive option for these young patients.
Journal of Pediatric and Adolescent Gynecology, Apr 1, 2023
European Journal of Obstetrics & Gynecology and Reproductive Biology, Mar 1, 2022
European Journal of Obstetrics & Gynecology and Reproductive Biology, Jun 1, 2022
European Journal of Obstetrics & Gynecology and Reproductive Biology, Mar 1, 2022
Clinical and Experimental Obstetrics & Gynecology, 2020
The widespread use of vaginal ultrasound as an integral part of the gynecologic clinical examinat... more The widespread use of vaginal ultrasound as an integral part of the gynecologic clinical examination in many countries has led to the unexpected finding of adnexal mass. The implications of the finding of an adnexal mass in an asymptomatic postmenopausal woman can be serious if it is malignant and is not excised, because ovarian cancer has an indolent course and when it becomes symptomatic it is often fatal. The aim of the present review is to discuss the evaluation and management of incidental adnexal masses in postmenopausal women. Despite careful evaluation with ultrasound and biomarkers, a small number of patients will remain without a conclusive diagnosis. It is our opinion, based on empirical evidence discussed here, that conservative therapy with observation can be safely applied in the majority of these patients.
Journal of Turkish Society of Obstetric and Gynecology, 2014
Complete androgen insensitivity syndrome (CAIS) (testicular feminization) is the most common caus... more Complete androgen insensitivity syndrome (CAIS) (testicular feminization) is the most common cause of male pseudohermaphroditism. The underlying main pathology is an end organ resistance to androgen stimulation, and as a result, this impairs the differentiation of the body structures and systems which this hormone affects. Inheritance of this disorder is by means of an X-linked recessive gene that is responsible for the intracellular androgen receptors. CAIS may be observed in several members of a family. For this reason, the family members of the affected individual should be screened. In this article we present a case of three sisters diagnosed with CAIS after investigating the pedigree of one of them owing to an inguinal mass and diagnosing with CAIS.
European Journal of Obstetrics & Gynecology and Reproductive Biology
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
Background Paediatric and adolescent gynaecology is a special field of interest within general gy... more Background Paediatric and adolescent gynaecology is a special field of interest within general gynaecology and obstetrics. The care for children and young people differs from adults. In gynaecology, children should not be treated like little adults. Within Europe, there is great variability in the provision of care, availability of clinical networks and lack of national standards within paediatric and adolescent gynaecology. Therefore, this review aims to summarize the current evidence regarding best clinical practice within Europe. Methods: A search was performed in Embase and Medline from 1974 onwards. Inclusion criteria were paediatric and adolescent population, gynaecology or reproductive health, care provision and evidence based clinical guidelines. In most papers recommendations were made, so no outcome measures could be used. It was, therefore, not possible to perform a meta-analysis. The risk of bias of the studies was assessed according to the GRADE and AGREE-2 guidelines. Results: 91 papers were identified and a total of 7 papers were included in the final analysis.
Overweight and obesity in childhood and adolescence has been growing epidemic in the last 30 year... more Overweight and obesity in childhood and adolescence has been growing epidemic in the last 30 years, with 5%–25% affected young people in Europe. Body mass index plotted on percentile charts for age and sex is the gold standard diagnostic. According to World Health Organization, cutoff points are 85th–97th percentile for overweight and ≥97th percentile for obesity. Sedentary and poor eating habits are the main etiologic factors. Being overweight and obese at a young age stimulates early puberty, a premature adrenarche, and accelerates linear growth. Increase in leptin, sex steroids, insulin, insulin growth factor-1, insulin resistance and a reduction in sex hormone–binding globulin have been identified. Almost all the systems in the human body are affected by being overweight and obese. These conditions also worsen young people’s quality of life and are linked to various psychological and behavioral problems. The increase in pediatric obesity is alarming because of its association wi...
Children
Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adole... more Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours and the indications for operating on them, and to put subjective criteria for the management in elective or emergency presentations. Methods: Medical records of patients between the age of 12 and 20 years old that underwent surgery for ovarian teratomas at the Department of Obstetrics and Gynaecology in University Hospital of Ioannina, between January 2000 and August 2022, were reviewed. A medical database was searched between January 2000 and August 2022 with the following keywords: ovarian teratoma, paediatrics and adolescents. Results: We present the results of forty patients, with a mean age of 11.8 years of age. All patients had surgery, where three out of four underwent oophorectomy and only one out of four ...
Taiwanese Journal of Obstetrics and Gynecology
Inguinal endometriosis is a very rare entity with uncertain pathophysiology, that poses several d... more Inguinal endometriosis is a very rare entity with uncertain pathophysiology, that poses several diagnostic and therapeutic challenges. This study aimed to summarize published literature on the diagnosis and treatment of this condition. Thus, a systematic literature search was conducted in PubMed/MEDLINE, Scopus and the Cochrane Library. An effort was made to numerically analyze all parameters included in case reports and retrospective analyses, as well. The typical and atypical features of this condition, investigations used, type of treatment and histopathology were recorded. More specifications about the surgical treatment, such as operations previously performed, type of surgery and treatment after surgery have been acknowledged. Other sites of endometriosis, the presence of pelvic endometriosis and the follow-up and recurrence have been also documented. Overall, the search yielded 61 eligible studies including 133 cases of inguinal endometriosis. The typical clinical presentation includes a unilateral inguinal mass, with or without catamenial pain. Transabdominal or transvaginal ultrasound was typically used as the first line method of diagnosis. Groin incision and exploratory surgery was the treatment indicated by the majority of the authors, while excision of part of the round ligament was reported in about half of the cases. Chemotherapy and radiotherapy were initiated in cases of coexisting endometriosis-related neoplasia. Inguinal recurrence or malignant transformation was rarely reported. The treatment of inguinal endometriosis is surgical and a long-term follow-up is needed. More research is needed on the effectiveness of suppressive hormonal therapy, recurrence rate and its relationship with endometriosis-associated malignancies.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2021
PURPOSE The aim of the present study is to evaluate the concordance between preoperative endometr... more PURPOSE The aim of the present study is to evaluate the concordance between preoperative endometrial sampling histopathology performed by conventional dilatation and curettage (D&C) and final histopathological diagnosis after total hysterectomy concerning tumor grade and subtype in patients with endometrial cancer (EC). METHODS In this comparative retrospective study, 203 women with endometrial cancer were included who underwent at first dilatation and curettage and then total hysterectomy. The preoperative histopathological report obtained by dilatation and curettage was compared with the final histopathology after total hysterectomy to assess the accuracy of endometrial sampling. RESULTS Comparison of preoperative with postoperative histopathological results showed an overall 5.9% and 10.9% discordance regarding endometrial cancer histological subtype and grade, respectively. Six (4.9%) of the patients with preoperative grade 1 were grade 2 and 1 (0.8%) was found to be grade 3. Th...
Archives of Gynecology and Obstetrics, 2022
This study aimed at comparing survival outcomes between systematic axillary lymph node dissection... more This study aimed at comparing survival outcomes between systematic axillary lymph node dissection (ALND) vs sentinel lymph node and axillary lymph node dissection only if sentinel positive (SLN ± ALND) in early-stage, clinically node-negative breast cancer patients. A systematic review and meta-analysis adhered to PRISMA guidelines was performed. Included studies were prospective randomized controlled trials (RCTs) comparing survival outcomes of ALND vs. SLN ± ALND in early-stage, node-negative breast cancer patients. Patients enrolled were only those with tumor size lower than 4 cm, clinically negative nodes and treated with breast-conservative surgery. Primary endpoints were locoregional recurrence, overall death and cancer-related death. There were four studies included in the analysis, enrolling overall 2982 patients, of which 1494 in ALND arm and 1488 in the SLN ± ALND arm. No statistically significant difference was observed in locoregional recurrence, breast cancer-related death and overall death. Locoregional recurrence was observed in 2.8% (ALND) vs. 4.1% (SLND ± ALND), (RR 0.69, 95% CI 0.20–2.30). Overall death rate was 7.0% vs. 6.8% respectively, (RR 1.00, 95% CI 0.73–1.39, I2 = 28.7%). Breast cancer-related death was 3.6% vs. 3.5%, respectively (SLN ± ALND), (RR 1.11, 95% CI 0.70–1.78, I2 = 0%). No statistically significant difference was observed in any of secondary study outcomes. Systematic axillary axillary lymph node dissection provides no survival benefit compared with sentinel lymph node dissection for early-stage clinically node-negative breast cancer patients.
Journal of Obstetrics and Gynaecology, 2021
Journal of Obstetrics and Gynaecology, 2021
Acute vulvar ulceration in children and non-sexually active adolescents is rare and presents as s... more Acute vulvar ulceration in children and non-sexually active adolescents is rare and presents as single or multiple painful ulcers with necrotic margins that usually resolve without scarring. In addition to sexually transmitted infections (STIs), it can be caused by several conditions such as autoimmune diseases (Behçet’s disease (BD)), fixed drug reactions or Crohn’s disease. Infections by viruses, mycoplasma and toxoplasma have been implicated in some cases (Vismara et al. 2020). The Epstein-Barr virus (EBV) causes infectious mononucleosis, one of the commonest viral infections in humans (Masucci and Ernberg 1994). Most of the population in developed countries acquire immunity to EBV during childhood and adolescence (Schuster and Kreth 1992). Genital ulcerations have been associated with EBV infection and appear to represent a manifestation of a systemic viraemia (Sumaya 1986). We report the case of a patient with infectious mononucleosis who presented with genital ulceration in an...
Breast Care, 2020
Background: Adolescence is accompanied by a variety of changes in young breast development, which... more Background: Adolescence is accompanied by a variety of changes in young breast development, which greatly affects the adolescent’s psychology and socialization. Summary: PubMed, EMBASE, and the Cochrane Library were searched for studies relative to epidemiology, clinical characteristics, diagnosis, and management of all breast disorders in adolescence and their consequences. Development disorders are breast asymmetry, breast atrophy, breast hypoplasia, hypomastia, juvenile breast hypertrophy, and tuberous breast. Breast congenital abnormalities include athelia, amastia, accessory breast tissue, polymastia, polythelia, and congenital disorders of nipples. Breast infections are commonly caused from Gram-positive coccus rather than Gram-negative bacteria. Breast abscess occurs when breast infections are not promptly treated. Nipple discharge is caused by a variety of conditions and should be managed carefully. Fibrocystic changes, cysts, and fibroadenomas are the most common benign mas...
Handbook of Research on Oncological and Endoscopical Dilemmas in Modern Gynecological Clinical Practice, 2021
Ovarian cancer is the second most common malignant disease of the female genital tract, but the f... more Ovarian cancer is the second most common malignant disease of the female genital tract, but the first in mortality because it is usually diagnosed at an advanced stage. Options for early detection, diagnosis, and treatment are limited. Prevention of ovarian cancer relates to primary prevention by avoiding factors that are epidemiologically associated with an increased incidence of ovarian cancer and the adoption of protective habits. These include interventions to exclude the fallopian tubes and ovaries. Secondary prevention is related to early diagnosis. The chapter aims to summarize current evidence on prevention of ovarian cancer as well as role of surgery to prevent advanced-stage disease.
In Vivo, 2020
Background: In Greece the population-level impact of HPV vaccination is unknown due to lack of of... more Background: In Greece the population-level impact of HPV vaccination is unknown due to lack of official registries. This study presents in a pragmatic frame the comparison of cervical pathology data between HPVvaccinated and unvaccinated women referred for colposcopy. Patients and Methods: This is an observational prospective cohort study performed in 7 academic Obstetrics and Gynaecology Departments across Greece between 2009-2019. Cases were women that had completed HPV vaccination before coitarche and were referred for colposcopy due to abnormal cytology. For each vaccinated woman an unvaccinated matched control was selected. Results: A total of 849 women who had been vaccinated before coitarche and 849 unvaccinated controls were recruited. The combination of cytological, colposcopic and molecular findings necessitated treatment in only a single case among vaccinated (0.1%) and in 8.4% among unvaccinated. Conclusion: HPV vaccination at a proper age can markedly reduce development of severe cervical precancers and consequently the need for treatment, as well as their long-term related obstetrical morbidity.
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Papers by Anastasia Vatopoulou