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Article ; Online: The clinically suspicious cervix--how often is it cancer?

Milingos, Dimitrios S / Harry, Vanessa N / Cruickshank, Margaret E

2010 Volume 14, Issue 3, Page(s) 196–199

Abstract: Objective: To evaluate the outcome of women referred to colposcopy with the clinical finding of suspected cancer ("clinically suspicious cervix").: Materials and methods: A prospective cohort study of women referred to a dedicated colposcopy clinic ... ...

Abstract	Objective: To evaluate the outcome of women referred to colposcopy with the clinical finding of suspected cancer ("clinically suspicious cervix"). Materials and methods: A prospective cohort study of women referred to a dedicated colposcopy clinic serving a regional population with a clinically suspicious cervix was conducted. All referral letters were reviewed, and women were identified prospectively when the letter stated "referral for a clinically suspicious cervix." Relevant data were collected subsequently by case note review. Results: One hundred four women were identified, and 95 attended for colposcopy from September 2006 to January 2008. Nine women defaulted. Seventy-six (80%) had a normal cervix or a benign cervical pathological result. Cervical intraepithelial neoplasia was detected in 15 patients (16%), and only 4 women (4%) had invasive cancer confirmed. Conclusions: We believe that women referred with a clinically suspicious cervix should be assessed in a general gynecology clinic rather than colposcopy because most will not have cancer. The small number of women with a clinical cancer can then be referred onto colposcopy, whereas women with benign pathological result can be treated appropriately in the general clinic.
MeSH term(s)	Adult ; Aged ; Cervical Intraepithelial Neoplasia/diagnosis ; Cervical Intraepithelial Neoplasia/epidemiology ; Cohort Studies ; Colposcopy/methods ; Early Detection of Cancer/methods ; Female ; Humans ; Middle Aged ; Prevalence ; Prospective Studies ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/epidemiology
Language	English
Publishing date	2010-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2041332-4
ISSN	1526-0976 ; 1089-2591
ISSN (online)	1526-0976
ISSN	1089-2591
DOI	10.1097/LGT.0b013e3181cb4c7d
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Article: Three surgically managed ipsilateral spontaneous ectopic pregnancies.

Milingos, Dimitrios S / Black, Mairead / Bain, Christine

Obstetrics and gynecology

2008 Volume 112, Issue 2 Pt 2, Page(s) 458–459

Abstract: Background: Recurrence of ectopic pregnancy is usually associated with assisted reproductive techniques, being less likely to occur after natural conception.: Case: We report the case of a patient who had three consecutive ectopic pregnancies on the ... ...

Abstract	Background: Recurrence of ectopic pregnancy is usually associated with assisted reproductive techniques, being less likely to occur after natural conception. Case: We report the case of a patient who had three consecutive ectopic pregnancies on the ipsilateral side after natural conception and was treated surgically in each case with partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, respectively. The contralateral normal tube was resected at the time of last operation. Conclusion: We indicate the high risk for tubal rupture and bleeding and the need for appropriate surgical intervention when managing recurrent ectopic pregnancies. Furthermore, care should be undertaken not to leave a long tubal stump when performing salpingectomy for ectopic pregnancy, to decrease risk of recurrence.
MeSH term(s)	Adult ; Fallopian Tubes/pathology ; Fallopian Tubes/surgery ; Female ; Humans ; Pregnancy ; Pregnancy, Tubal/pathology ; Pregnancy, Tubal/surgery ; Recurrence
Language	English
Publishing date	2008-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	207330-4
ISSN	1873-233X ; 0029-7844
ISSN (online)	1873-233X
ISSN	0029-7844
DOI	10.1097/AOG.0b013e31816baec0
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Article ; Online: Manual vacuum aspiration: a safe alternative for the surgical management of early pregnancy loss.

Milingos, D S / Mathur, M / Smith, N C / Ashok, P W

BJOG : an international journal of obstetrics and gynaecology

2009 Volume 116, Issue 9, Page(s) 1268–1271

Abstract: Manual vacuum aspiration (MVA) is an alternative to the standard surgical curettage, performed under local anaesthetic in the setting of a treatment room. The aim of our study was to assess the efficacy of MVA in the management of first trimester early ... ...

Abstract	Manual vacuum aspiration (MVA) is an alternative to the standard surgical curettage, performed under local anaesthetic in the setting of a treatment room. The aim of our study was to assess the efficacy of MVA in the management of first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. This was a retrospective study of 246 patients who were scheduled to undergo MVA for first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. One woman was excluded in the analysis because of the procedure being abandoned prior to MVA. Efficacy of the procedure was 94.7% (232/245). Incomplete uterine evacuation was seen in 5.3% (13/245) patients. Although not widely used in the UK, MVA could be considered routinely, thus avoiding general anaesthesia and the need for access to theatre.
MeSH term(s)	Abortion, Incomplete/therapy ; Adult ; Female ; Humans ; Length of Stay ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Retrospective Studies ; Vacuum Curettage/methods
Language	English
Publishing date	2009-08
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/j.1471-0528.2009.02223.x
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Article: Leptin in human reproduction.

Messinis, I E / Milingos, S D

Human reproduction update

1999 Volume 5, Issue 1, Page(s) 52–63

Abstract: The recent discovery of the obese (ob) gene has provided new insight into the mechanism which controls body fat mass. Leptin, a product of the ob gene, serves as the link between fat and the brain. This protein, by acting at the level of the hypothalamus, ...

Abstract	The recent discovery of the obese (ob) gene has provided new insight into the mechanism which controls body fat mass. Leptin, a product of the ob gene, serves as the link between fat and the brain. This protein, by acting at the level of the hypothalamus, decreases food intake and increases energy expenditure. Animals that lack leptin (ob/ob mice) develop profound obesity and become infertile. Treatment of these animals with leptin reduces food intake and restores normal fertility. Although leptin is important for the control of fat stores in certain species, the role of this substance in the development of human obesity remains obscure. However, it has been speculated that, in humans, obesity is related to leptin resistance. The relationship between fat and reproduction has been recognized for >20 years. This article discusses the relationship between leptin and human reproduction. In particular, recent knowledge about the possible role of leptin in various conditions such as puberty, polycystic ovary syndrome and pregnancy is reviewed. Also, the article discusses the possible role of leptin in ovarian function and the relationship of this protein with gonadal steroids. It is expected that future research will clarify the physiological importance of leptin in human reproductive function.
MeSH term(s)	Animals ; Female ; Humans ; Infant, Newborn ; Leptin ; Menstrual Cycle/physiology ; Obesity/physiopathology ; Polycystic Ovary Syndrome/physiopathology ; Pregnancy/physiology ; Proteins/metabolism ; Proteins/physiology ; Puberty/physiology ; Reproduction/physiology
Chemical Substances	Leptin ; Proteins
Language	English
Publishing date	1999-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1286738-x
ISSN	1460-2369 ; 1355-4786
ISSN (online)	1460-2369
ISSN	1355-4786
DOI	10.1093/humupd/5.1.52
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Article: Future use of clomiphene in ovarian stimulation. Clomiphene in the 21st century.

Messinis, I E / Milingos, S D

Human reproduction (Oxford, England)

1998 Volume 13, Issue 9, Page(s) 2362–2365

MeSH term(s)	Clomiphene/pharmacology ; Clomiphene/therapeutic use ; Female ; Fertility Agents, Female/pharmacology ; Fertility Agents, Female/therapeutic use ; Fertilization in Vitro ; Forecasting ; Humans ; Ovulation Induction
Chemical Substances	Fertility Agents, Female ; Clomiphene (1HRS458QU2)
Language	English
Publishing date	1998-09
Publishing country	England
Document type	Journal Article
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/13.9.2362
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Article: The epididymal factor--a diagnostic approach.

Milingos, S D

International journal of andrology

1985 Volume 8, Issue 6, Page(s) 417–420

MeSH term(s)	Carnitine/metabolism ; Epididymis/physiopathology ; Humans ; Infertility, Male/physiopathology ; Male ; Semen/metabolism ; Sperm Maturation
Chemical Substances	Carnitine (S7UI8SM58A)
Language	English
Publishing date	1985-12
Publishing country	England
Document type	Journal Article
ZDB-ID	413205-1
ISSN	1365-2605 ; 0105-6263
ISSN (online)	1365-2605
ISSN	0105-6263
DOI	10.1111/j.1365-2605.1985.tb00854.x
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Article: Urokinase-type plasminogen activator and insulin-like growth factor-binding protein 3 mRNA expression in endometriotic lesions and eutopic endometrium: implications for the pathophysiology of endometriosis.

Lembessis, Peter / Milingos, Spyros / Michalas, Stelios / Milingos, Dimitris / Creatsas, George / Sourla, Antigone / Koutsilieris, Michael

Annals of the New York Academy of Sciences

2003 Volume 997, Page(s) 223–228

Abstract: The peritoneal fluid of women with endometriosis contains an increased insulin-like growth factor 1 (IGF-1) bioavailability, which is produced by limited hydrolysis of urokinase-type plasminogen activator (uPA) on IGF-binding protein 3 (IGFBP-3). ... ...

Abstract	The peritoneal fluid of women with endometriosis contains an increased insulin-like growth factor 1 (IGF-1) bioavailability, which is produced by limited hydrolysis of urokinase-type plasminogen activator (uPA) on IGF-binding protein 3 (IGFBP-3). Recently, IGF-1 was shown to inhibit apoptosis of endometrial-like cells in vitro, suggesting that a microenvironment of increased IGF-1 bioavailability can optimize the survival of endometrial cells grown ectopically. Here the expression of mRNA of IGFBP-3 and uPA in tissue biopsies from eutopic endometrium and endometriotic lesions obtained at laparoscopy from women with endometriosis have been analyzed, and it is documented that both IGFBP-3 and uPA mRNA expression are increased from 3- to 10-fold in endometriotic lesions versus eutopic endometrium. Consequently, the necessary components (uPA and IGFBP-3 expression) of endocrine/autocrine/paracrine enhancement of local IGF bioavailability mediated by uPA hydrolysis of the IGFBP-3 were present in endometriotic lesions. These data possibly explain the origin of the increased content of uPA activity, IGF-1 bioavailability, and NH(2)-truncated forms of IGFBP-3 in the peritoneal fluid of women with endometriosis.
MeSH term(s)	Ascitic Fluid ; Biopsy, Needle ; Case-Control Studies ; Culture Techniques ; Endometriosis/genetics ; Endometriosis/pathology ; Female ; Gene Expression Regulation ; Genetic Markers ; Genetic Predisposition to Disease ; Humans ; Insulin-Like Growth Factor Binding Protein 3/analysis ; Insulin-Like Growth Factor Binding Protein 3/genetics ; Probability ; RNA, Messenger/analysis ; Reference Values ; Reverse Transcriptase Polymerase Chain Reaction/methods ; Risk Assessment ; Sensitivity and Specificity ; Urokinase-Type Plasminogen Activator/analysis ; Urokinase-Type Plasminogen Activator/genetics
Chemical Substances	Genetic Markers ; Insulin-Like Growth Factor Binding Protein 3 ; RNA, Messenger ; Urokinase-Type Plasminogen Activator (EC 3.4.21.73)
Language	English
Publishing date	2003-11
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	211003-9
ISSN	1749-6632 ; 0077-8923
ISSN (online)	1749-6632
ISSN	0077-8923
DOI	10.1196/annals.1290.025
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Article: Current and future status of ovulation induction in polycystic ovary syndrome.

Messinis, I E / Milingos, S D

Human reproduction update

1997 Volume 3, Issue 3, Page(s) 235–253

Abstract: Great progress had been achieved during the last 20 years in the field of ovulation induction in patients with polycystic ovary syndrome (PCOS). Clomiphene citrate remains the first line of treatment for all anovulatory women with PCOS, since in properly ...

Abstract	Great progress had been achieved during the last 20 years in the field of ovulation induction in patients with polycystic ovary syndrome (PCOS). Clomiphene citrate remains the first line of treatment for all anovulatory women with PCOS, since in properly selected patients the cumulative pregnancy rate approaches that in normal women. Human urinary gonadotrophins have been used extensively for ovulation induction, but the development of low-dose regimens has opened a new era in the management of anovulation related to PCOS. This article discusses the main advantages and disadvantages of the principal methods and regimens currently used for ovulation induction in patients with PCOS including clomiphene citrate, gonadotrophins, pulsatile gonadotrophin-releasing hormone (GnRH) and GnRH agonists. It also discusses new drugs discovered recently, particularly recombinant gonadotrophins and GnRH antagonists, and provides some thoughts regarding their use in future protocols. Finally, based on the discovery of new ovarian substances which specifically control luteinizing hormone (LH) secretion, this article develops assumptions on possible implications of these substances in the pathophysiology of PCOS and their potential use in the management of the syndrome.
MeSH term(s)	Anovulation/drug therapy ; Anovulation/etiology ; Clomiphene/therapeutic use ; Female ; Gonadotropin-Releasing Hormone/administration & dosage ; Gonadotropin-Releasing Hormone/agonists ; Gonadotropin-Releasing Hormone/therapeutic use ; Gonadotropins, Pituitary/therapeutic use ; Humans ; Ovulation Induction/methods ; Ovulation Induction/trends ; Polycystic Ovary Syndrome/complications ; Pregnancy ; Reproductive Techniques
Chemical Substances	Gonadotropins, Pituitary ; Clomiphene (1HRS458QU2) ; Gonadotropin-Releasing Hormone (33515-09-2)
Language	English
Publishing date	1997-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1286738-x
ISSN	1460-2369 ; 1355-4786
ISSN (online)	1460-2369
ISSN	1355-4786
DOI	10.1093/humupd/3.3.235
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Article: Hereditary angioedema and pregnancy: successful management of recurrent and frequent attacks of angioedema with C1-inhibitor concentrate, danazol and tranexamic acid - a case report.

Milingos, D S / Madhuvrata, P / Dean, J / Shetty, A / Campbell, D M

Obstetric medicine

2009 Volume 2, Issue 3, Page(s) 123–125

Abstract: Hereditary angioedema (HAE) is a rare but potentially life-threatening condition caused by deficiency of C1 esterase inhibitor. It is characterized by subcutaneous swelling in any part of the skin, gastrointestinal and respiratory tracts. We present the ... ...

Abstract	Hereditary angioedema (HAE) is a rare but potentially life-threatening condition caused by deficiency of C1 esterase inhibitor. It is characterized by subcutaneous swelling in any part of the skin, gastrointestinal and respiratory tracts. We present the case of a pregnant woman with known HAE that deteriorated during pregnancy with frequent attacks that were managed successfully with danazol, tranexamic acid and regular intravenous administration of C1 esterase inhibitor.
Language	English
Publishing date	2009-09-01
Publishing country	England
Document type	Case Reports
ZDB-ID	2612229-7
ISSN	1753-4968 ; 1753-495X
ISSN (online)	1753-4968
ISSN	1753-495X
DOI	10.1258/om.2009.090003
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Article: Insulin-like growth factor-1 isoform mRNA expression in women with endometriosis: eutopic endometrium versus endometriotic cyst.

Milingos, Dimitrios / Katopodis, Haralampos / Milingos, Spyros / Protopapas, Athanasios / Creatsas, George / Michalas, Stelios / Antsaklis, Aris / Koutsilieris, Michael

Annals of the New York Academy of Sciences

2006 Volume 1092, Page(s) 434–439

Abstract: Pathogenesis of endometriosis involves growth factors, which are synthesized locally. Insulin-like growth factor-1 (IGF-1) prevents apoptosis and has mitogenic action on endometrial cells. The IGF-1 gene undergoes alternative splicing and results in ... ...

Abstract	Pathogenesis of endometriosis involves growth factors, which are synthesized locally. Insulin-like growth factor-1 (IGF-1) prevents apoptosis and has mitogenic action on endometrial cells. The IGF-1 gene undergoes alternative splicing and results in three isoforms (IGF-1Ea, IGF-1Eb, and IGF-1Ec or MGF). We analyzed the mRNA expression of IGF-1 isoforms in tissue samples of eutopic endometrium and endometriotic cyst obtained during laparoscopy from women with endometriosis. We documented that all three IGF-1 isoforms are expressed in both eutopic endometrium and ovarian endometrioma. Furthermore, we documented a significant decrease in all IGF-1 isoform expression in endometriotic cyst compared to endometrium of women with endometriosis. The reduction may correlate with the disease status and presence of fibrotic inactive tissue found in late stages of the disease.
MeSH term(s)	Case-Control Studies ; Cysts/metabolism ; DNA Primers ; Endometriosis/metabolism ; Endometrium/metabolism ; Female ; Gene Expression Regulation ; Humans ; Insulin-Like Growth Factor I/analysis ; Insulin-Like Growth Factor I/genetics ; Polymerase Chain Reaction ; Protein Isoforms ; RNA, Messenger/analysis
Chemical Substances	DNA Primers ; Protein Isoforms ; RNA, Messenger ; Insulin-Like Growth Factor I (67763-96-6)
Language	English
Publishing date	2006-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	211003-9
ISSN	1749-6632 ; 0077-8923
ISSN (online)	1749-6632
ISSN	0077-8923
DOI	10.1196/annals.1365.042
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