Objective:The aim of our study is to assess the risk factors for medical treatment failure and to predict the patients who will require the surgical therapy as well as to predict the factors affecting treatment success. Material and Methods:This was a cross-sectional study including 76 women with tubo-ovarian abscesses (TOA) who were either conservatively or surgically treated and were admitted to two gynecology units over a 4-year period. The demographic characteristics of the patients, gynecologic and obstetric histories, size and localization of abscesses were recorded. Gentamicin plus clindamycin treatment protocol was implemented for all patients. Ampicillin treatment was added in three patients with the positive culture of Actinomyces. Response to treatment was evaluated after 48-72 h. Patients who fail to respond to medical treatment required surgery or percutaneous drainage. We compared clinical and laboratory factors between the groups. Results:In surgery group, patients were significantly older than the others (44.9±5.4 versus 39.1±7.6 years). Fifty-six patients (74%) responded to antibiotics and 20 of the patients required surgical intervention. Patients treated with antibiotics were hospitalized for an average of 6.32±2.8 days versus 12.75±5.6 days for those who required surgery (p=0.021). Patients who were surgically treated had a mean size of TOA of 67.9±11.2 mm versus 53.6±9.4 mm for those treated with antibiotics alone (p=0.036). There were no significant differences between groups in laboratory parameters, except for initial white blood cell (WBC) counts. The complications of surgery included in descending order of frequency blood transfusions, surgical wound infections, bowel injury, and bladder injury. Conclusion:An increased size of pelvic mass, higher initial WBC counts, advanced age, and smoking were all associated with failed response to conservative treatment. It is important to identify the risk factors to distinguish patients who will respond to antibiotic therapy and those who will need a surgical treatment. Thus, the required early intervention can result in a reduction in the morbidity associated with TOA. (J Turk Ger Gynecol Assoc 2015; 16: 226-30) Keywords: Antibiotic therapy, pelvic abscess, surgery, tubo-ovarian abscesses Received: 01 July, 2015 Accepted: 06 August, 2015 Available Online Date: 02 November, 2015 The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses Material and MethodsThis was a cross-sectional study including 76 women with TOA who were either treated conservatively (group 1) and surgically (group 2) and were admitted to two gynecology units over a 4-year period. The study was subject to local ethics committee's approval, and written informed consent was obtained from patients who participated in this study. All authors and the study protocol have complied with the World Medical Association Declaration of Helsinki regarding the ethical conduct of research involving human subjects. In this study, some of t...

disease. The secretory activity includes interleukin 6, tumor necrosis factor alpha, angiotensin II, plasminogen activator, omentin, and nerve growth factor [6, 7]. Moreover, EF tissue also secretes anti-inflammatory and antiaterogenic adipokins such as adiponectin and adrenomedullin [8]. To our knowledge, echocardiographic epicardial fat thickness (EFT) measurement in adults was first attempted by Iacobellis et al. [9, 10] and was reported to vary between 1-23 mm [10]. Becaue EFT measurement seems to be unaffected by variations in skin and muscular tissue layers, it may show lipoidosis much more accurate than waist measurement [11]. Previous data from adult subjects indicate that EFT measured during echocardiography is in close relation with abdominal fat

The recurrence of myoma was relatively low following CM. Subsequent pregnancy is protective for recurrence of myoma without increased adhesion formation and obstetric complications.

MS during pregnancy was not associated with adverse maternal and perinatal outcomes except UTI, low 1-min Apgar scores, and decreased breastfeeding rates.

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