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Article: Huge Fibroid in Pregnancy: A Case Presentation.

Petroulakis, Athanasios / Katsanevakis, Emmanouil / Tiong, Bing / Ajjawi, Sajida

2024 Volume 16, Issue 5, Page(s) e59566

Abstract: Uterine fibroid, widely known as leiomyoma, is one of the most common benign tumours of the female reproductive system. It is not uncommon for pregnancies to be complicated by uterine fibroids. Most commonly, the first line of large uterine fibroids ... ...

Abstract	Uterine fibroid, widely known as leiomyoma, is one of the most common benign tumours of the female reproductive system. It is not uncommon for pregnancies to be complicated by uterine fibroids. Most commonly, the first line of large uterine fibroids management in pregnancy is conservative, with myomectomy counselling after delivery if necessary. In this paper, we present a case of a very high-risk pregnancy, that was managed by delivery via caesarean section at 34 weeks of gestation, which was performed for a patient, with an 18 centimetres (cm) fibroid, first diagnosed during pregnancy. Interventional radiology involvement was critical in this case for minimizing the final blood loss and surgical complications. Bilateral internal iliac artery balloons were used. Maternal and foetal risks, the timing of delivery, and the options for the management of fibroids in pregnancy will be discussed.
Language	English
Publishing date	2024-05-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.59566
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Article ; Online: Is routine gastrointestinal endoscopy required in every woman with mucinous ovarian cancer? An analysis of survival rates and metastatic tumours in a cancer centre.

Katsanevakis, E / Addo-Yobo, W / Bharathan, B / Loona, A / Gan, C / Nunns, D / Gajjar, K

European journal of obstetrics, gynecology, and reproductive biology

2024 Volume 294, Page(s) 105–110

Abstract: Introduction: Mucinous ovarian cancer (MOC) represents a rare entity of ovarian malignant neoplasms. The true incidence could be as low as 3% of all ovarian cancers. The aim of this study is to compare and understand the clinicopathological ... ...

Abstract	Introduction: Mucinous ovarian cancer (MOC) represents a rare entity of ovarian malignant neoplasms. The true incidence could be as low as 3% of all ovarian cancers. The aim of this study is to compare and understand the clinicopathological characteristics of patients with mucinous ovarian cancer, report on the survival rates and evaluate the role of gastrointestinal (GI) endoscopy as part of the peri-operative investigations and the impact it has on the survival rates. Methodology: This is a retrospective data collection on patients with MOC operated in Nottingham gynaecological oncology centre over a 10-year period. Data were analysed using SPSS software. Results: 43 cases were included in the final analysis. The median maximal tumour diameter was 180 mm. 32 (74.5 %) and 11 (25.5 %) women presented with unilateral and bilateral tumours respectively. 30 patients (69.7 %) presented with stage 1 disease, 1 (2.3 %) presented with stage 2 disease, 7 women (16.4 %) had stage 3 disease and 1 woman (11.6 %) had stage 4 disease. 41 women had staging surgical procedures and 2 women had limited surgery due to poor performance status. After final histology, 5 cases found to have metastatic disease to the ovary rather than primary MOC. 14 women had GI endoscopy as part of their investigation. The total estimated cost of the endoscopies that have been performed is £5635. Primary GI cancer was diagnosed in 1 case during the endoscopy (1 case of gastric cancer). The 5-year overall survival of the women included in this study is 62.8 %. The 5-year overall survival of the women in the endoscopy and non-endoscopy groups was 60 % and 64.3 % respectively (p-value: 0.767). Conclusion: The findings of this study show that the survival rates of patients treated for mucinous ovarian cancer in our centre are similar to other published studies. Our findings do not support the routine use of GI endoscopy in the peri-operative investigations of every patient with MOC due to the non-statistically significant difference in the overall survival.
MeSH term(s)	Humans ; Female ; Male ; Retrospective Studies ; Survival Rate ; Carcinoma, Ovarian Epithelial/pathology ; Ovarian Neoplasms/pathology ; Adenocarcinoma, Mucinous/pathology ; Endoscopy, Gastrointestinal ; Neoplasm Staging
Language	English
Publishing date	2024-01-14
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2024.01.012
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Article ; Online: Implementation of Uterine Artery Doppler Scanning: Improving the Care of Women and Babies High Risk for Fetal Growth Restriction.

Ekanem, Emmanuel / Karouni, Faris / Katsanevakis, Emmanuoil / Kapaya, Habiba

Journal of pregnancy

2023 Volume 2023, Page(s) 1506447

Abstract: Introduction: While stillbirth rates have declined in many countries, these declines are less marked in the UK. Fetal growth restriction (FGR) affects about 3% to 7% of all pregnancies and is by far the single strongest risk factor for stillbirth. FGR ... ...

Abstract	Introduction: While stillbirth rates have declined in many countries, these declines are less marked in the UK. Fetal growth restriction (FGR) affects about 3% to 7% of all pregnancies and is by far the single strongest risk factor for stillbirth. FGR implies a pathological restriction of the genetic growth potential and is not synonymous with small-for-gestational age (SGA). The Royal College of Obstetricians and Gynaecologists (RCOG) defines SGA as an estimated fetal weight (EFW) or abdominal circumference (AC) less than the 10th centile. The likelihood of FGR is higher in severe SGA defined as an EFW or AC less than the 3rd centile. The second version of Saving Babies' Lives Care Bundle (SBLCBv2) recommends the second trimester uterine artery Doppler (UtAD) pulsatility index (PI) screening for pregnancies at high risk of FGR. This study was aimed at determining the prevalence of FGR and assess pregnancy outcomes following the implementation of UtAD at the United Lincolnshire Hospitals NHS Trust (ULHT). Methods: One-year retrospective cohort study (1st September 2020-31st August 2021) was conducted across both ULHT hospitals in the UK (Lincoln County Hospital in Lincoln and Pilgrim Hospital in Boston). Results: During the study period, 5197 women were booked at ULHT. Of 5197, 349 were identified as high risk for FGR. When numbers were compared for the two hospitals, FGR rate was higher in Lincoln 8.10% vs. 4.51% in Boston. In addition, an increased proportion of abnormal UtAD scans was observed in Lincoln (35.7%) vs. in Boston (22%) (
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Fetal Growth Retardation/diagnostic imaging ; Fetal Growth Retardation/epidemiology ; Stillbirth ; Retrospective Studies ; Uterine Artery/diagnostic imaging ; Ultrasonography, Prenatal ; Infant, Small for Gestational Age ; Fetal Weight ; Gestational Age
Language	English
Publishing date	2023-01-23
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2595413-1
ISSN	2090-2735 ; 2090-2735
ISSN (online)	2090-2735
ISSN	2090-2735
DOI	10.1155/2023/1506447
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Article: Prenatal Diagnosis of Williams-Beuren Syndrome Based on Suspected Fetal Hypotonia in Early Pregnancy.

Tsagkas, Nikolaos / Katsanevakis, Emmanouil / Karagioti, Natalia / Perdikaris, Panagiotis / Billis, Michail

Cureus

2023 Volume 15, Issue 2, Page(s) e34841

Abstract: In this report, we describe a rare case of prenatal diagnosis of Williams-Beuren syndrome (WBS). While the prenatal diagnosis of WBS is very rare, in the current case, WBS was diagnosed in early pregnancy. The key element was the detection of fetal hands ...

Abstract	In this report, we describe a rare case of prenatal diagnosis of Williams-Beuren syndrome (WBS). While the prenatal diagnosis of WBS is very rare, in the current case, WBS was diagnosed in early pregnancy. The key element was the detection of fetal hands hypotonia and generalized fetal hypotonia at 17 weeks of gestation. This led to the diagnosis of WBS by molecular karyotyping, specifically array comparative genomic hybridization (arrayCGH) of the fetal DNA. The genetic material was acquired by extraction from the fetal cells which are abundant in the amniotic fluid drawn by amniocentesis. Clinical hypotonia of the affected individuals is a clinical characteristic that is widely associated with WBS; however, fetal hypotonia has not been described as a diagnostic criterion for the prenatal diagnosis of WBS.
Language	English
Publishing date	2023-02-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.34841
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Article: Choriocarcinoma After Full-Term Pregnancy: A Case Report and Review of the Literature.

Katsanevakis, Emmanouil / Oatham, Alice / Mathew, Darly

Cureus

2022 Volume 14, Issue 2, Page(s) e22200

Abstract: Choriocarcinoma is a disease associated with uncontrollable proliferation and malignant change of cells of the placenta and belongs to the malignant end of the spectrum in gestational trophoblastic disease. These tumours are usually developed after molar ...

Abstract	Choriocarcinoma is a disease associated with uncontrollable proliferation and malignant change of cells of the placenta and belongs to the malignant end of the spectrum in gestational trophoblastic disease. These tumours are usually developed after molar pregnancies, and their incidence after full-term pregnancies is extremely rare. We present a very rare case of a 30-year-old lady, admitted with a five-month history of vaginal bleeding after a normal pregnancy. The human chorionic gonadotropin (hCG) was at a level of 209,566. A pelvic ultrasound scan revealed an endometrial thickness of 6 cm and the presence of an intra-uterine mass measuring 56 × 50 × 45 mm. After discussion with the regional gestational trophoblastic disease centre, we proceeded to a surgical evacuation of the uterus, which confirmed a post-partum choriocarcinoma (International Federation of Gynaecology and Obstetrics (FIGO) score 9). Care was continued in the specialised centre with multi-agent chemotherapy. The response was excellent, and the patient was subsequently discharged after 10 cycles of chemotherapy, and a 10-year follow-up was arranged. Choriocarcinomas after full-term pregnancies are a rare entity. Even when they happen, they are usually associated with pregnancy complications in the ante-natal period. The prognosis is usually very good, provided that prompt diagnosis and referral to a specialised centre are made. Low-risk patients are usually treated with methotrexate monotherapy, whereas high-risk women would normally require multi-agent chemotherapy. The diagnosis of choriocarcinoma might be proven challenging even for experienced clinicians. Women should be informed that the prognosis is usually excellent, provided that they receive the right treatment.
Language	English
Publishing date	2022-02-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.22200
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Article ; Online: Concerns about the reliability of a trial of oral progesterone for preterm birth included in a meta-analysis.

Gravesteijn, Benjamin Y / Thornton, Jim G / Katsanevakis, Emmanouil / Mol, Ben Willem

American journal of obstetrics & gynecology MFM

2022 Volume 4, Issue 5, Page(s) 100664

MeSH term(s)	Cervical Length Measurement ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Premature Birth/epidemiology ; Premature Birth/etiology ; Premature Birth/prevention & control ; Progesterone ; Progestins/adverse effects ; Reproducibility of Results
Chemical Substances	Progestins ; Progesterone (4G7DS2Q64Y)
Language	English
Publishing date	2022-05-30
Publishing country	United States
Document type	Letter ; Meta-Analysis ; Comment
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2022.100664
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Article ; Online: A study of recurrence, complication and survival rates in patients with early stage vulval cancer undergoing sentinel lymph node sampling: a single-centre experience.

Katsanevakis, Emmanouil / Joshi, Anuja / Ong, Zun Zhen / O'Connor, Richard / Nunns, David / Gajjar, Ketankumar

Archives of gynecology and obstetrics

2023 Volume 308, Issue 2, Page(s) 561–567

Abstract: Purpose: Groin sentinel lymph node (SLN) identification and removal has become a standard of care for women with clinical early stage vulval cancer. There is evidence to support safe detection of the SLN with minimal morbidity. The purpose of this study ...

Abstract	Purpose: Groin sentinel lymph node (SLN) identification and removal has become a standard of care for women with clinical early stage vulval cancer. There is evidence to support safe detection of the SLN with minimal morbidity. The purpose of this study is to report our experience of managing patients focusing on patient selection, adverse events, quality assurance of the procedure and any benefits and/or disadvantages to patients. Methods: This was a retrospective study of patients with clinical early stage vulval cancer in a cancer centre over 5 years. Notes and hospital data were reviewed including admissions to emergency departments. Statistical software was used for the statistical analysis and the Kaplan Meier survival curve was generated to present survival rates. Results: 61 cases were analysed. A total of 156 nodes have been removed and positive nodes were identified in 14 cases. In total, 9 women (14.75%) had disease recurrence within 5 years from primary surgery. Overall, 4 patients (6.5%) developed groin recurrence. In 3 of these patients there was isolated groin recurrence (4.9%). The median length of admission was 3 days and 6 cases were managed as day cases. Conclusions: Since the closure of the GROINNS-2 trial we have continued the procedure of SLN identification for women with clinical early stage vulval cancer. We have shown high level of adherence to our protocol and survival and complication rates comparable to other studies on the same field. There were a few patients managed as day-case which was of benefit to the patients.
MeSH term(s)	Humans ; Female ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy/adverse effects ; Sentinel Lymph Node Biopsy/methods ; Lymph Node Excision/methods ; Lymphatic Metastasis/pathology ; Retrospective Studies ; Survival Rate ; Vulvar Neoplasms/surgery ; Vulvar Neoplasms/pathology ; Neoplasm Recurrence, Local/pathology ; Lymph Nodes/surgery ; Lymph Nodes/pathology
Language	English
Publishing date	2023-02-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-023-06968-z
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Article ; Online: A question about the reliability of a recent trial of progesterone for preterm birth prevention, published in Acta.

Katsanevakis, Emmanouil / Mol, Ben W / Thornton, Jim

Acta obstetricia et gynecologica Scandinavica

2019 Volume 99, Issue 3, Page(s) 426

MeSH term(s)	Administration, Intravaginal ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Premature Birth ; Progesterone ; Progestins ; Reproducibility of Results
Chemical Substances	Progestins ; Progesterone (4G7DS2Q64Y)
Language	English
Publishing date	2019-12-08
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80019-3
ISSN	1600-0412 ; 0001-6349
ISSN (online)	1600-0412
ISSN	0001-6349
DOI	10.1111/aogs.13771
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Article: Fetal Hand Abnormalities in the First-Trimester Scan: A Report of Two Cases.

Katsanevakis, Emmanouil / Tzitzikalakis, Caterina / Karagioti, Natalia / Tziomaki, Maria / Perdikaris, Panagiotis / Papanikolaou, Anna / Gkogkos, Panagiotis / Tsagkas, Nikolaos

Cureus

2022 Volume 14, Issue 3, Page(s) e23189

Abstract: Two cases of fetal hand abnormalities are presented in this report. The first one is a case of unilateral fetal syndactyly detected in the first trimester routine scan, resulting in the early diagnosis of a severe genetic condition by invasive testing ... ...

Abstract	Two cases of fetal hand abnormalities are presented in this report. The first one is a case of unilateral fetal syndactyly detected in the first trimester routine scan, resulting in the early diagnosis of a severe genetic condition by invasive testing and early termination of pregnancy. By doing so, we ensured that the woman was managed in the most appropriate way. In the second case, we describe a fetus with bilateral hand polydactyly, which was combined with a cardiac defect - incompatible with extrauterine life. This was once again diagnosed during the first trimester scan. An uncomplicated termination of pregnancy was achieved in the first trimester of pregnancy.
Language	English
Publishing date	2022-03-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.23189
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Article: A novel method to precisely assemble loose nanofiber structures for regenerative medicine applications.

Beachley, Vince / Katsanevakis, Eleni / Zhang, Ning / Wen, Xuejun

Advanced healthcare materials

2013 Volume 2, Issue 2, Page(s) 343–351

Abstract: Polymer nanofibers are favorable for tissue engineering scaffolds because of their high surface-to-volume ratio and biomimicry of the extracellular matrix. Random and uniaxially oriented polymer nanofibers are easily fabricated by conventional ... ...

Abstract	Polymer nanofibers are favorable for tissue engineering scaffolds because of their high surface-to-volume ratio and biomimicry of the extracellular matrix. Random and uniaxially oriented polymer nanofibers are easily fabricated by conventional electrospinning techniques; however, control over fiber organization within nanofiber structures is limited when they are collected directly from an electrospinning jet. The regenerative medicine applications of electrospun scaffolds could be expanded by developing assembly methods that allow better control of fiber organization. Here, a novel technique is presented that utilizes parallel automated tracks to orient and collect nanofibers from an electrospinning jet. The stabilized fibers are then subsequently assembled into desirable structures. It is difficult to assemble complex structures directly from an electrospinning jet because of high electrical charge and velocities, so this technology adds an intermediate step where nanofibers are immobilized on automated tracks. The result is a continuous steady-state delivery of static stabilized nanofibers that provides a unique and promising platform for automated post processing into useful nanofiber structures. This technique also allows for an indefinite amount of time, as determined by design parameters, for fibers to dry or cool before they contact other nanofibers in the collection site, thus eliminating potential for fiber-to-fiber adhesions even with slow evaporating solvents or high-temperature melts. To demonstrate potential in regenerative medicine applications, several nanofiber structures were fabricated, including: 2D structures with well-controlled fiber density; 3D loosely assembled aligned nanofiber structures with good cell penetration properties; and, complex layer-by-layer 3D aligned fiber structures assembled by integration with post-processing techniques.
MeSH term(s)	Animals ; Biocompatible Materials/chemistry ; Cells, Cultured ; Humans ; Nanofibers ; Regenerative Medicine/methods ; Tissue Engineering/methods ; Tissue Scaffolds
Chemical Substances	Biocompatible Materials
Language	English
Publishing date	2013-02
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2649576-4
ISSN	2192-2659 ; 2192-2640
ISSN (online)	2192-2659
ISSN	2192-2640
DOI	10.1002/adhm.201200125
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