Publications by authors named "Kostova E"

Objective: To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes.

Design: Systematic review and meta-analysis.

Data Sources: Major databases between December 2019 and January 2023.

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Article Synopsis
  • Pregnant women infected with SARS-CoV-2 face increased risks, including preterm birth and higher rates of stillbirth or neonatal admissions, highlighting ongoing concerns even after the WHO declared an end to the COVID-19 pandemic in May 2023.
  • A systematic review was performed to analyze the prevalence of early pregnancy loss in women with SARS-CoV-2 and compare these results to those of non-infected pregnant women.
  • The review included various studies that reported pregnancy losses before 20 weeks, as well as data on ectopic pregnancies and pregnancy terminations, ensuring a comprehensive examination of the impact of SARS-CoV-2 on early pregnancy outcomes.
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Infections with certain pathogens can lead to perinatal complications. Several infections have been also associated with an increased likelihood of miscarriage. This manuscript discusses these infections, their modes of transmission, the evidence linking them to an increased risk of miscarriage, and whether prevention or treatment strategies are available.

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Article Synopsis
  • - The review investigates the effectiveness and safety of statins in women with polycystic ovary syndrome (PCOS) who are not trying to conceive, focusing on possible benefits like lowering testosterone levels and improving menstrual regularity.
  • - The authors analyzed randomized controlled trials (RCTs), comparing statin treatments against placebos or other agents, by collecting data on menstrual regularity, ovulation, and other factors like acne and hirsutism.
  • - Six RCTs involving a total of 396 women were included, with varying treatment durations, and the analysis was conducted using standard Cochrane methods to evaluate the certainty of the findings.
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Background: The number of frozen embryo transfers (FET) has increased dramatically over the past decade. Based on current evidence, there is no difference in pregnancy rates when natural cycle FET (NC-FET) is compared to artificial cycle FET (AC-FET) in subfertile women. However, NC-FET seems to be associated with lower risk of adverse obstetric and neonatal outcomes compared with AC-FET cycles.

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Study Question: Does the addition of hyaluronic acid (HA) to embryo transfer medium improve pregnancy outcomes in both autologous and oocyte donation IVF cycles?

Summary Answer: The best available evidence indicates that the addition of HA to embryo transfer medium is clinically beneficial in cycles with autologous oocytes.

What Is Known Already: There is a known clinical benefit of HA addition to embryo transfer media but it is not known if HA affects donor and autologous oocyte cycles differently.

Study Design, Size, Duration: A systematic review with meta-analysis was performed.

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Objectives: To assess the rates of SARS-CoV-2 positivity in babies born to mothers with SARS-CoV-2 infection, the timing of mother-to-child transmission and perinatal outcomes, and factors associated with SARS-CoV-2 status in offspring.

Design: Living systematic review and meta-analysis.

Data Sources: Major databases between 1 December 2019 and 3 August 2021.

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Background: In subfertile couples, couples who have tried to conceive for at least one year, intrauterine insemination (IUI) with ovarian hyperstimulation (OH) is one of the treatment modalities that can be offered. When IUI is performed a second IUI in the same cycle might add to the chances of conceiving. In a previous update of this review in 2010 it was shown that double IUI increases pregnancy rates when compared to single IUI.

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Introduction: Rapid, robust and continually updated evidence synthesis is required to inform management of COVID-19 in pregnant and postpartum women and to keep pace with the emerging evidence during the pandemic.

Methods And Analysis: We plan to undertake a living systematic review to assess the prevalence, clinical manifestations, risk factors, rates of maternal and perinatal complications, potential for mother-to-child transmission, accuracy of diagnostic tests and effectiveness of treatment for COVID-19 in pregnant and postpartum women (including after miscarriage or abortion). We will search Medline, Embase, WHO COVID-19 database, preprint servers, the China National Knowledge Infrastructure system and Wanfang databases from 1 December 2019.

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Study Question: Can the priorities for future research in infertility be identified?

Summary Answer: The top 10 research priorities for the four areas of male infertility, female and unexplained infertility, medically assisted reproduction and ethics, access and organization of care for people with fertility problems were identified.

What Is Known Already: Many fundamental questions regarding the prevention, management and consequences of infertility remain unanswered. This is a barrier to improving the care received by those people with fertility problems.

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Study Question: Can consensus definitions for the core outcome set for infertility be identified in order to recommend a standardized approach to reporting?

Summary Answer: Consensus definitions for individual core outcomes, contextual statements and a standardized reporting table have been developed.

What Is Known Already: Different definitions exist for individual core outcomes for infertility. This variation increases the opportunities for researchers to engage with selective outcome reporting, which undermines secondary research and compromises clinical practice guideline development.

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Background: In in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI), selection of the most competent embryo(s) for transfer is based on morphological criteria. However, many women do not achieve a pregnancy even after 'good quality' embryo transfer. One of the presumed causes is that such morphologically normal embryos have an abnormal number of chromosomes (aneuploidies).

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Objective: To determine the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed coronavirus disease 2019 (covid-19).

Design: Living systematic review and meta-analysis.

Data Sources: Medline, Embase, Cochrane database, WHO COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 6 October 2020, along with preprint servers, social media, and reference lists.

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Article Synopsis
  • Metformin is being studied as a potentially safer and more effective long-term treatment option compared to oral contraceptive pills (OCP) for women with polycystic ovary syndrome (PCOS), as outlined in a Cochrane Review update focusing solely on metformin.
  • The objectives were to evaluate the effectiveness and safety of metformin against the OCP in improving clinical and hormonal symptoms, as well as metabolic issues related to PCOS.
  • The review included 44 randomized controlled trials, totaling 2,253 women, but noted low to very low evidence quality due to risks of bias and inconsistency in results, making it difficult to draw definitive conclusions about the effectiveness of metformin compared to the OCP.
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Background: Ovulation induction with follicle stimulating hormone (FSH) is a second-line treatment in women with polycystic ovary syndrome (PCOS) who do not ovulate or conceive on clomiphene citrate.

Objectives: To compare the effectiveness and safety of gonadotrophins as a second-line treatment for ovulation induction in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS), and women who do not ovulate or conceive after clomiphene citrate.

Search Methods: In January 2018, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, the World Health Organisation clinical trials register, Clinicaltrials.

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Familial hemophagocytic lymphohistiocytosis type 5 (FHL-5) is a rare genetic disorder caused by mutations in STXBP2/Munc18-2. Munc18-2 plays a role in the degranulation machinery of natural killer cells and cytotoxic T lymphocytes. Mutations in STXBP2/Munc18-2 lead to impaired killing of target cells by natural killer cells and cytotoxic T lymphocytes, which in turn results in elevated levels of the inflammatory cytokine interferon γ, macrophage activation, and hemophagocytosis.

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Even though red blood cell (RBC) vesiculation is a well-documented phenomenon, notably in the context of RBC aging and blood transfusion, the exact signalling pathways and kinases involved in this process remain largely unknown. We have established a screening method for RBC vesicle shedding using the Ca(2+) ionophore ionomycin which is a rapid and efficient method to promote vesiculation. In order to identify novel pathways stimulating vesiculation in RBC, we screened two libraries: the Library of Pharmacologically Active Compounds (LOPAC) and the Selleckchem Kinase Inhibitor Library for their effects on RBC from healthy donors.

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Introduction: This study was conducted to analyze the reliability of clinical diagnosis in ACL tear injuries.

Material And Methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 73 were arhroscopicaly diagnosed ACL tears.

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The aim of this study was to compare findings from clinical examinations, MRI scans and arthroscopy in ACL injury of the knee in order to assess the diagnostic significance of both examination findings. This study was conducted to manage the reliability of clinical diagnosis in ACL tear injuries. All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment.

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This study was initiated to refine and characterize a nongenetic experimental model of type 2 diabetes mellitus and to follow up various metabolic parameters up to six weeks after diabetes induction. Male Wistar rats were divided into 4 groups: CON group--consumed standard rat chow and served as control; HFD group--consumed high-fat diet (45% calories as fat); STZ group-was injected once intraperitoneally with streptozotocin (35 mg/kg) on day 14, and DM-2 group--consumed high-fat diet and was injected with streptozotocin. The metabolic parameters were measured one week after streptozotocin injection (week 3) and at the end of the study (week 9).

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Macrophages tightly control the production and clearance of red blood cells (RBC). During steady state hematopoiesis, approximately 10(10) RBC are produced per hour within erythroblastic islands in humans. In these erythroblastic islands, resident bone marrow macrophages provide erythroblasts with interactions that are essential for erythroid development.

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Background/aim: Matrix metalloproteinases (MMPs) are perceived to play a key role in tumor invasion and metastasis by their capacity to degrade basement membranes and extracellular matrix proteins. The aim of this study was to investigate the expressions of MMP-2, MMP-7 and MMP-9 in tumor tissue and their relation to clinicopathologic features in patients with colorectal cancer.

Methods: Specimens of resected colorectal cancer and surrounding normal tissue of 82 patients were immunohistochemically stained for MMP-2, MMP-7 and MMP-9.

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During storage, erythrocytes undergo changes that alter their clearance and function after transfusion and there is increasing evidence that these changes contribute to the complications observed in transfused patients. Stored erythrocytes were incubated overnight at 37°C to mimic the temperature after transfusion. After incubation, several markers for erythrocyte damage were analysed.

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Parasitic nematodes cause serious diseases in humans, animals, and plants. They have limited lipid metabolism and are reliant on lipid-binding proteins to acquire these metabolites from their hosts. Several structurally novel families of lipid-binding proteins in nematodes have been described, including the fatty acid- and retinoid-binding protein family (FAR).

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