bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Bangladesh Rolling towards Debt Stress? An Exploration of Debt Sustainability in the Context of Recent External Financial Flows
Authors: Bhattacharya Debapriya , Ashraf Zeeshan 
Published: September 2018

This article examines the sustainability of public debt in Bangladesh under alternative future scenarios based on simulation exercises for the period of FY2017 to FY2026. It adopts the debt-stabilizing primary balance approach (DPSBA) and International Monetary Fund/World Bank Debt Sustainability Framework (DSF). The findings of the former indicate that Bangladesh will be able to service its increasing public debt as long as its economic growth rate remains higher than the real interest rate payable on debt. Public debt also appears to be sustainable according to variables tested under the DSF. However, findings indicate that Bangladesh has been and would continue allocating an increasing share of its revenue to external debt repayment, creating a trade-off with investment in growth-oriented sectors. JEL Classification: H63, H68, H69, H81, G28
Decreased Concentrations of AMH in Follicular Fluid of Women with Endometriosis: A Hypothetical New Marker of Oocyte Quality
Authors: Garcia-Velasco Juan A. , Motta Laura , Rodriguez Sara , Toribio Monica , Martinez-Salazar Javier , Pacheco Alberto 
Published: September 2018

Introduction Anti-müllerian hormone (AMH) has been recently introduced as a new marker of ovarian reserve with a high sensitivity and with the added value of being independent of cycle day. Some authors have claimed that it may also provide information regarding oocyte quality. As endometriosis is a disease that mainly affects the ovary and thus, egg quality, we decided to evaluate AMH follicular fluid concentrations in three clinical groups: a) women with endometriosis and a visible endometrioma at ultrasound in one of the ovaries, b) same women with endometrioma-free contralateral ovary, and c) women without endometriosis. Material and Methods From August to December 2007, 28 women undergoing an IVF/ICSI cycle in whom an endometrioma > 2cm was clearly visible at ultrasound in one of the ovaries and not in the other, and 28 fertile egg donors as controls entered the study. Follicular fluid from the largest follicle of each ovary (with endometrioma and without endometrioma) was individually collected prior to the rest of the follicular aspiration at the time of egg retrieval, and similarly in the control group. After cumulus identification and short centrifugation to remove cells, fluids were stored at -80°C until assayed. AMH was evaluated by a commercially available ELISA. Kolmorov-Smirnov test was performed to test for normality, as well as a one-way ANOVA with Tukey test to evaluate differences among groups. Significance was set at 0.05. Results AMH follicular fluid concentrations were significantly lower in women with endometriosis versus control (4.5 ± 2.6 vs 6.2 ± 3.0 ng/mL, p=0.02). Interestingly, when the three groups were evaluated individually, the concentration of AMH in follicular fluid obtained from the ovaries where a large endometrioma was present was significantly lower than in the other two groups – a) 4.1 ± 2.7 ng/mL in the ovaries with the endometrioma, b) 4.9 ± 2.6 ng/mL in the contralateral ovary in the same patients, and c) 6.2 ± 3.0 ng/mL in control patients; (p=0.039). Conclusions AMH concentration in follicular fluid is diminished in women with endometriosis. The presence of the endometrioma itself may reduce even further AMH concentration in the surrounding follicles. These results may reflect oocyte quality and could be useful when counselling patients regarding their reproductive outcome.
Surface-Enhanced Laser Desorption/Ionization Mass Spectrometry of Peritoneal Fluid Identifies Potential Biomarkers for Endometriosis
Authors: Wölfler Monika M. , Henkel Corinna , Hornung Daniela , Knüchel Ruth , Rath Werner , Maass Nicolai , Schwamborn Kristina 
Published: September 2018

Purpose Several markers for diagnosis of endometriosis that have been tested in clinical approaches so far lack in both sensitivity and specificity. Therefore, it is conceivable that a need exists to perform a cluster analysis in which the attributes of different markers are considered. Methods In this study, protein pattern profiling by surface-enhanced laser desorption/ionization time of flight (SELDI-TOF) mass spectrometry was performed to reveal differentially expressed pathognomonic proteins for endometriosis in peritoneal fluid samples of 106 symptomatic patients. Results At laparoscopy, 46 out of 106 (43.4%) patients exhibited endometriosis and 60 (56.6%) were proven disease-free. Using anionic affinity surfaces and a genetic algorithm for data analysis, 16 significantly different protein peaks were identified that allow for the prediction of endometriosis, with an overall recognition capability of 85.2%, exhibiting a sensitivity of 70.6% and a specificity of 80.8%. Conclusions Although lacking in sensitivity, this study provides highly significant information about differentially regulated proteins in endometriosis which might play a key role in the pathogenesis of this disease.
Pain Symptoms and Peritoneal Fluid Cytokine and Marker Concentrations in Women with and without Endometriosis
Authors: Bersinger Nick A. , McKinnon Brett , Kuhn Annette , Santi Alessandro , Mueller Michael D. 
Published: September 2018

Purpose Endometriosis is not only associated with infertility, it is also a common cause of pain in women, leading to work absenteeism and a reduced quality of life. The objective of this study was to confirm the increased peritoneal fluid (PF) concentration of several cytokines in endometriosis patients, to investigate their association with pain levels, and to identify new biological markers in the PF which are neurostimulatory and thus responsible for the appearance and severity of different types of pain. Methods Our sample group included 111 patients with histologically confirmed endometriosis and 47 controls undergoing laparoscopy for reasons of abdominal pain or infertility. They rated their pain during menstruation, during sexual intercourse and general lower abdominal pain prior to undergoing surgery in our clinic using a visual analogue scale. During laparoscopy, PF was aspirated. Marker cytokine concentrations were measured by immunoassay and correlated to the Revised American Fertility Society (rAFS) stage of endometriosis and to the pain level using non-parametric methods. Results Differences were found between the correlations of the peritoneal fluid levels of many cytokines with dysmenorrhea or lower abdominal pain, and with the presence of severe endometriosis (rAFS III+IV). Glycodelin and osteoprotegerin (OPG) show the strongest associations with menstrual pain, while IL-8, MCP-1 and OPG were correlated to the stage of endometriosis. Low density cytokine protein arrays did not contribute to finding new markers for endometriosis and pain. Conclusions These findings illustrate the large variation of cytokine levels between patients. Glycodelin, IL-8 and OPG are the most likely targets for further investigations towards their future clinical use.
Adolescent Physical Activity and Endometriosis Risk
Authors: Vitonis Allison F. , Maruti Sonia S. , Hankinson Susan E. , Hornstein Mark D. , Missmer Stacey A. 
Published: September 2018

Background In the one study examining the relationship, adolescent physical activity was not associated with risk for endometriosis. Case-control studies have shown 40–80% reductions in risk for adult activity, while only an 11% reduction in endometriosis risk was observed in a recent prospective analysis. Methods Using data collected from the Nurses’ Health Study II, a prospective cohort study of premenopausal US nurses that began in 1989, we have attempted to clarify this relation. Data are updated every 2 yrs with follow-up for these analyses through to 2001. Women reported the average amount of time per week spent in moderate and strenuous recreational activity during three age periods: ages 12–13, ages 14–17, and ages 18–22. A metabolic equivalent (MET) score was assigned to each activity and these were summed to estimate total activity. Results During 637,747 person-years of follow-up, 1,481 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. After adjusting for age, calendar time, birth weight, age at menarche, parity, oral contraceptive use, and body mass index (BMI), we observed a 16% increase in the risk for endometriosis comparing the greatest amount of activity (≥80 MET-h/wk) with the least (<20 MET-h/wk) during ages 12–13 (RR=1.16, 95% CI=0.98–1.37, p-value test for trend=0.02), and no associations for ages 14–17 or ages 18–22. In analyses of the individual activity types within each time period, only strenuous activity during ages 12–13 was associated with endometriosis. Conclusions We did not find evidence of a beneficial association between adolescent physical activity and laparoscopically confirmed endometriosis, but in fact found a small increase in risk.
Sentinel Lymph Node Labeling of Patients with Deep Infiltrating Rectovaginal Endometriosis – Does this Make Sense?
Authors: Riedlinger Wolfram F. J. , Weichbrodt Miriam , Gericke Jessica , Gericke Christine , Schneider Achim , Köhler Christhard , Mechsner Sylvia 
Published: September 2018

Purpose Deep infiltrating endometriosis is a chronic disease of largely unresolved pathogenesis. Lymphatic dissemination of endometriotic cells has been shown in incidentally removed mesorectal lymph nodes (ILNs) and in pelvic sentinel lymph nodes (SLNs) but its significance is unknown. To evaluate this observation further, we compared occurrences and morphology of endometriotic lesions (EM-lesions) within pelvic SLNs with those within ILN. Methods From 18 patients, 58 pelvic SLNs and from additional 23 patients 105 ILNs, found in the resection specimens, were excised. All lymph nodes were examined for possible endometriotic lesions. Detection of endometriotic lesions were performed by immunohistochemical analysis of possible expression of estrogen and progesterone-receptors as well as CD10 and cytokeratin. Furthermore, two dimensional sizes of endometriotic lesions were measured. Results Endometriotic lesions were found in 14 patients: in 6 patients of the SLN-group (33%) and in 8 patients of the group of incidentally removed lymph nodes (28%). EM-lesions of the SLN-group were significantly larger than those of incidentally removed regional LN (size A: p= 0.014; size B: p=0.006). Conclusion Detection of endometriotic lesions in SLNs and in ILNs has demonstrated lymphatic dissemination of endometriosis. In comparison to the incidentally excised lymph nodes of patients with rectovaginal endometriosis, the sentinel lymph node concept is much more suitable for detection of potentially affected lymph nodes. Therefore, we postulate use of this system in future studies to evaluate the clinical significance of lymphatic dissemination of endometriotic cells. (Journal of Endometriosis 2010; 2: 33–40)
Endometriosis Index: A Software-Derived Score to Predict the Presence and Severity of the Disease
Authors: Fasciani Alessandro , Repetti Felice , Binda Gian Andrea , Puntoni Matteo , Meroni Mario Giuseppe , Bocci Guido 
Published: September 2018

Objective To develop a clinical index that will positively predict the presence of endometriosis. Design Prospective single-center observational study. Setting: A hospital-based institute. Patients 120 patients affected by chronic pelvic pain, infertility or with clinical suspicion of endometriosis. Interventions: Electronic processing of clinical data with software-assistance at the end of each consultation and digital video recording of surgeries. Main Outcome Measures Endometriosis Index (EI), the score calculated using clinical parameters correlated with macroscopic/microscopic presence or absence of endometriosis. Results Endometriosis was staged and treated in 95 cases, the remaining 25 women presented benign pathology with no endometriosis. Patients with positive operative findings of endometriosis had a mean (± standard deviation) pre-operative EI score of 22 ± 12, while mean EI value of patients with no operative findings of endometriosis was 8 ± 6 (p 28 (75th percentile value) versus women with EI score ≤ 28; with EI score > 28 this noninvasive test was predictive of DIE with a sensitivity of 72.4% and a specificity of 90.1%. Conclusions These data suggest that a dedicated Endometriosis Index is effective in identifying patients who would benefit from early surgical management. We propose the use of this non-invasive tool to reduce the delay between the onset of symptoms and a surgical diagnosis of endometriosis.
Assessment of Oocyte and Embryo Quality in Women with Endometriosis
Authors: Matalliotakis Ioannis , Cakmak Hakan , Sakkas Denny , Matalliotaki Charikleia , Arici Aydin 
Published: September 2018

Objective The aim was to determine the number and the grade of oocyte-corona-cumulus complex (OCCC) and the most viable embryos for transfer in women with endometriosis compared to those with tubal factor infertility. Study methods Patients underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at the Yale IVF program. The endometriosis group of 135 patients was monitored in 262 consecutive cycles. The controls consisted of 103 patients with tubal factor infertility undergoing 203 consecutive assisted reproductive technology (ART) cycles. All the patients underwent laparoscopy before IVF treatment. Response to gonadotropins, the oocyte and embryo grade, fertilization, cleavage, implantation, pregnancy, delivery and abortion rates were noted. Results Oocyte-corona-cumulus complex (OCCC), two-pronuclear (2PN) oocytes, and the grade 1 and 2 embryos on days 2 and 3 were lower in women with endometriosis compared to those with tubal factor infertility. Higher total gonadotropin requirements, fewer mature follicles, lower peak E2, a lower number of oocytes collected, and higher cancellation rates were found with the endometriosis group compared to controls. However, no differences were found in fertilization, cleavage, implantation, pregnancy, miscarriage, and delivery rates between the endometriosis and tubal factor groups. Conclusions Despite the lesser quality of oocytes and embryo grading and diminished ovarian reserve, the presence of endometriosis does not affect implantation and delivery rates in patients undergoing ART procedures.
Endometriosis: Diagnosis and Management
Authors: Leyland Nicholas , Casper Robert , Laberge Philippe , Singh Sukhbir S. , Allen Lisa , Arendas Kristina , Leyland Nicholas , Allaire Catherine , Awadalla Alaa , Best Carolyn , Contestabile Elizabeth , Dunn Sheila , Heywood Mark , Leroux Nathalie , Potestio Frank , Rittenberg David Allan , Singh Sukhbir S. , Soucy Renée , Wolfman Wendy Lynn , Senikas Vyta 
Published: September 2018

Objective To improve the understanding of endometriosis and to provide evidence-based guidelines for the diagnosis and management of endometriosis. Outcomes Outcomes evaluated include the impact of the medical and surgical management of endometriosis on women's experience of morbidity and infertility. Methods Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology background. The committee reviewed all available evidence in the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. Results This document provides a summary of up-to-date evidence regarding diagnosis, investigations, and medical and surgical management of endometriosis. The resulting recommendations may be adapted by individual health care workers when serving women with this condition. Conclusions Endometriosis is a common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle modifications, medications, and allied health services should be used to limit the impact of this condition on activities of daily living and fertility. In some circumstances surgery is required to confirm the diagnosis and provide therapy to achieve the desired goal of pain relief or improved fecundity. Women who find an acceptable management strategy for this condition may have an improved quality of life or attain their goal of successful pregnancy. Evidence Medline and Cochrane databases were searched for articles in English and French on subjects related to endometriosis, pelvic pain, and infertility from January 1999 to October 2009 in order to prepare a Canadian consensus guideline on the management of endometriosis. Values The quality of evidence was rated with use of the criteria described by the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described by the Task Force. See Table 1. Benefits, harms, and costs Implementation of the guideline recommendations will improve the care of women with pain and infertility associated with endometriosis.
Brain-Derived Neurotrophic Factor in Plasma of Women with Endometriosis
Authors: Giannini Andrea , Bucci Fiorella , Luisi Stefano , Cela Vito , Pluchino Nicola , Merlini Sara , Casarosa Elena , Russo Marinella , Cubeddu Alessandra , Daino Diana , Artini Paolo G. , Genazzani Andrea R. 
Published: September 2018

Purpose Endometriosis is one of the most common benign gynecological diseases affecting women of reproductive age; it is characterized by the presence and growth of ectopic endometrial tissue outside the endometrial cavity. This complex disease is frequently associated with infertility and pelvic pain. Given the relationship and the apparent importance of the role that neurotrophins play in the reproductive system, and in particular brain-derived neurotrophic factor (BDNF) which is involved in both the central and peripheral pain pathways, we were interested in determining whether the presence of endometriosis is associated and correlated with plasma and follicular fluid variation of BDNF. Methods We determined BDNF level in plasma and in follicular fluid from infertile women with endometriosis and fertile women without the disease. Results BDNF plasma levels were significantly higher in endometriotic patients than in control women (p<0.001). After surgery this level decreased significantly (p<0.001), ranging within the values of control women in follicular phase. In follicular fluid, BDNF values were significantly lower in infertile women for endometriosis than in infertile women for male factors (p<0.001). Conclusion These data raise the possibility that neuroinflammatory reactions in endometriosis could have a neuroprotective effect and support the hypothesis that BDNF represents an important link in the networks of human homeostasis, thus providing an early marker for patients affected by endometriosis. Moreover, low BDNF levels in follicular fluid may refect an altered ovary production and may be a marker of poor oocyte quality and poor fertility in women suffering from endometriosis.
Predicting Pregnancy after Surgery for Pelvic Endometriosis: A Multivariate Analysis Based on Objective Clinical Data
Authors: Reis Fernando M. , Luisi Stefano , Calonaci Francesco , Carneiro Márcia M. , Razzi Sandro , Petraglia Felice 
Published: September 2018

Background Endometriosis is a common disorder in women of reproductive age and is a major cause of pelvic pain and infertility. Counseling women with endometriosis about their reproductive future remains a difficult task. Because many women are diagnosed with endometriosis before any attempt to conceive, they still are not considered infertile and therefore a thorough investigation of fertility parameters is not advisable at that time. The aim of the present study was to evaluate clinical factors that are promptly available upon diagnosis, to see which of them might predict a subsequent pregnancy in women with endometriosis. Methods Surgical and clinical data were obtained from 71 women who underwent laparoscopy for endometriosis in two tertiary medical centers and responded to a follow-up interview after an average of 18 months. Data were analyzed with multivariate logistic regression. Results The only independent predictors of becoming pregnant during the follow-up period were age (adjusted odds ratio for age >30 y=0.063, 95% confidence interval [CI] 0.015–0.262, p Conclusions While women reporting acyclic pelvic pain are less likely to achieve pregnancy after endometriosis surgery, age remains the only independent, strong predictor of time to pregnancy and of becoming pregnant.
Natural Killer Cells and Telomerase in the Endometrium of Patients with Endometriosis
Authors: Petta Carlos A. , Peloggia Alessandra , Salamonsen Lois , De Angelo Andrade Liliana , Zhang Jin , Bahamondes Luis 
Published: September 2018

Background Although endometriosis is a common cause of pelvic pain and infertility, the pathogenesis of the disease remains poorly understood. Several theories have been proposed to explain the mechanisms involved in the development of this disease, including the role of the immunological system. Objectives To evaluate the percentage of endometrial natural killer (eNK) cells and telomerase expression in the endometrium of patients with and without endometriosis. Materials and methods Endometrium samples were obtained during the mid-secretory phase from two groups of women: 12 women with endometriosis diagnosed by laparoscopy and confirmed by histological evaluation of the lesion, and 13 fertile women (control group) who underwent tubal sterilization at the same institution and in whom no signs of endometriosis were detected at surgery. Specific antibodies were used for the immunohistochemical assessment of eNK and telomerase. Results: eNK cells were significantly higher in the group of women without endometriosis (p<0. 0001); however, telomerase expression in the endometrium was similar in the two study groups. Conclusions: Significantly fewer eNK cells were observed in the endometrium of women with endometriosis; however, there was no difference in telomerase expression. The finding of fewer eNK cells supports the hypothesis of a deficiency in the immune system facilitating the implantation of endometriotic tissue or interfering with implantation after fertilization.