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Der Einfluss des mikrobiologischen Vaginalabstrichs auf den Ausgang der Kinderwunschbehandlung bei Frauen mit Sterilität Dissertation
Get PDFEinleitung: Das steigende Durchschnittsalter von Frauen bei Geburt ihres ersten Kindes, verbunden mit den modernen Möglichkeiten der Reproduktionsmedizin, trägt zur immer größer werdenden Relevanz der Kinderwunschbehandlungen bei. Der Erfolg einer solchen Behandlung hängt von vielen Faktoren ab. Durch Fortschritte in molekularen Techniken, die die Entschlüsselung des vaginalen Mikrobioms erlauben, ist dessen Einfluss auf das Ergebnis reproduktionsmedizinischer Behandlungen in den Fokus der Wissenschaft gerückt. Diese Arbeit soll den Einfluss der vaginalen Besiedlung, die mithilfe des mikrobiologischen Vaginalabstrichs identifiziert wurde, auf den Erfolg der Kinderwunschbehandlung untersuchen.
Methoden: Im Rahmen dieser Arbeit wurden retrospektiv die Daten von 397 Patientinnen ausgewertet, die sich von Januar 2018 bis August 2022 in der Kinderwunschambulanz der Klinik für Frauenheilkunde, Geburtsmedizin und Reproduktionsmedizin des Universitätsklinikums des Saarlandes vorstellten. Insgesamt wurden 1390 Kinderwunschbehandlungen ausgewertet. Die angewandten reproduktionsmedizinischen Verfahren waren der Verkehr zum Optimum (VZO), die intrauterine Insemination (IUI), die In-Vitro-Fertilisation (IVF), die intrazytoplasmatische Spermieninjektion (ICSI) und der Transfer kryokonservierter Embryonen, die vorher in einem der eben genannten Verfahren gewonnen wurden. Die vaginale Besiedlung wurde mithilfe des mikrobiologischen Vaginal- und Zervikalabstrichs und einer anschließenden kulturellen Anzucht und dem molekulargenetischen Verfahren der PCR nachgewiesen. Die statistische Auswertung der Daten erfolgte mit dem Statistikprogramm SPSS.
Ergebnisse: Das Vorliegen einer Dysbiose war, wenn auch statistisch nicht signifikant, mit einer niedrigeren Schwangerschaftsrate assoziiert. Die Schwangerschaftsrate bei auffälligem Abstrichergebnis betrug 8,6 %, wohingegen die Schwangerschaftsrate bei unauffälligem Abstrichergebnis bei 13,4 % lag. Darüber hinaus war das Vorliegen einer Endometriose signifikant mit einer niedrigeren Schwangerschaftsrate assoziiert (p = 0,006). Außerdem konnte eine, allerdings statistisch nicht signifikante, Assoziation zwischen Endometriose und Dysbiose festgestellt werden. Bei auffälligem Abstrichergebnis lag eine Endometriose häufiger vor als bei unauffälligem Abstrichergebnis (21,1 % vs. 17,7 %). Eine signifikante Assoziation bestand bei dem fehlenden Nachweis von Laktobazillen und Endometriose (p = 0,021). Darüber hinaus war ein Fehlen von Laktobazillen im Vaginalabstrich ebenfalls mit einer niedrigeren Schwangerschaftsrate assoziiert. Dieser Zusammenhang war knapp unter dem Signifikanzniveau, ab dem von einer statistischen Signifikanz gesprochen werden kann (p = 0,063).
Schlussfolgerung: Die Ergebnisse dieser Arbeit weisen darauf hin, dass bei Vorliegen einer Dysbiose mit einem geringeren Erfolg reproduktionsmedizinischer Verfahren zu rechnen ist. Das Vorliegen einer Endometriose ist ebenfalls mit Dysbiose und Infertilität assoziiert. In zukünftigen Studien sollte untersucht werden, inwieweit sich eine Transformation eines dysbiotischen Milieus in eine Eubiose auf das Ergebnis von Kinderwunschbehandlungen auswirkt.Introduction: The increasing average age of women at the birth of their first child, combined with the modern possibilities of reproductive medicine, contributes to the ever-increasing relevance of fertility treatments. The success of such treatment depends on many factors. Advances in molecular techniques that allow the decoding of the vaginal microbiome have brought its influence on the outcome of reproductive medicine treatments into scientific focus. This thesis aims to investigate the influence of vaginal colonisation, identified using the microbiological vaginal swab, on the success of fertility treatment.
Methods: In the context of this thesis, the data of 397 patients who were treated at the Clinic for Gynaecology, Obstetrics and Reproductive Medicine at Saarland University Hospital from January 2018 to August 2022 was retrospectively analysed. A total of 1390 fertility treatments were evaluated. The reproductive medicine procedures used were intercourse to optimum, intrauterine insemination (IUI), in-vitro-fertilisation (IVF), intracytoplasmic sperm injection (ICSI) and the transfer of cryopreserved embryos previously obtained in one of the procedures just mentioned. Vaginal colonisation was detected with the help of microbiological vaginal and cervical swabs and subsequent cultural cultivation and the molecular genetic procedure of polymerase chain reaction (PCR). The data was analysed using the statistical programme SPSS.
Results: The presence of dysbiosis was associated with a lower pregnancy rate. However, this association was not statistically significant. The pregnancy rate with a conspicuous swab result was 8.6%, whereas the pregnancy rate with an inconspicuous swab result was 13.4%. In addition, the presence of endometriosis was significantly associated with a lower pregnancy rate (p = 0.006). Furthermore, an association between endometriosis and dysbiosis was found, however not statistically significant. Endometriosis was more frequent with a conspicuous swab result than with an inconspicuous swab result (21.1 % vs. 17.7 %). The absence of lactobacilli was significantly associated with endometriosis (p = 0.021). In addition, the absence of lactobacilli in the vaginal swab was also associated with a lower pregnancy rate. However, with a p-value of 0.063, this association was just above the defined significance level at which statistical significance can be assumed.
Conclusion: The results of this thesis indicate that in the presence of dysbiosis a lower success rate of reproductive medicine procedures is to be expected. The presence of endometriosis is also associated with dysbiosis and infertility. Future studies should investigate the extent to which transformation of a dysbiotic environment into eubiosis affects the outcome of fertility treatments
Retrospective Evaluation of Bone Turnover Markers in Serum for the Prediction of Metastases Development in Breast Cancer Patients: A Cohort Study
No full textBackground: Serum bone turnover markers might play a role in the prediction of the development of bone metastases in breast cancer (BC) patients. We conducted a retrospective cohort study to address the association of serum bone turnover markers with oncologic outcomes. Methods: We included 80 women with BC, who were operated on at the Department of Gynecology, Obstetrics and Reproductive Medicine, Homburg/Saar, Germany. Serum samples were obtained prior to surgery and were used for estimation of the concentration of tumor and bone turnover markers using enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA). Results: At baseline, pyridinoline cross-linked carboxy-terminal telopeptide of type-1 collagen (ICTP) concentrations were higher in nodal positive vs. negative tumors (Mann–Whitney test p = 0.04). After a median follow-up of 79.4 months, 17 patients developed metastases, with 9 demonstrating, among other organs, osseous metastases. ICTP demonstrated the best area under the curve in the predection of osseous metastases in our cohort (AUC = 0.740, DeLong Test p = 0.005). Univariable Cox proportional hazard models failed to demonstrate significant associations between serum bone turnover markers and oncologic outcomes (progression-free survival, overall survival). Conclusions: Serum bone turnover markers (e.g., ICTP) were able to predict the development of osseous metastases but were not associated with oncologic outcomes. Further investigation and validation are required for the use of such markers in clinical practice
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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