Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Despite its incidence, the syndrome is poorly understood and remains underdiagnosed, and female patients are diagnosed with a delay. The heterogenous nature of this complex disorder results from the combined occurrence of genetic, environmental, endocrine, and behavioral factors. Primary clinical manifestations of PCOS are derived from the excess of androgens (anovulation, polycystic ovary morphology, lack of or scanty, irregular menstrual periods, acne and hirsutism), whereas the secondary manifestations include multiple metabolic, cardiovascular, and psychological disorders. Dietary and lifestyle factors play important roles in the development and course of PCOS, which suggests strong epigenetic and environmental influences. Many studies have shown a strong association between PCOS and chronic, low-grade inflammation both in the ovarian tissue and throughout the body. In the vast majority of PCOS patients, elevated values of inflammatory markers or their gene markers have been reported. Development of the vicious cycle of the chronic inflammatory state in PCOS is additionally stimulated by hyperinsulinemia and obesity. Changes in DNA methylation, histone acetylation and noncoding RNA levels are presented in this review in the context of oxidative stress, reactive oxygen species, and inflammatory signaling in PCOS. Epigenetic modulation of androgenic activity in response to inflammatory signaling is also discussed.

IntroductionIncisional surgical site infections (SSIs) occur in approximately 1.8–9.2% of patients undergoing cesarean section (CS) and contribute to prolonged hospitalization time and increased treatment costs. Dressings impregnated with dialkylcarbamoyl chloride (DACC) are an innovative approach to wound treatment based on a solely physical mechanism of action, and therefore can be used safely and without time restrictions in women during the puerperal and lactation period.Material and methodsA single-blinded randomized, controlled pilot study was conducted at the Mazovian Bródno Hospital, a tertiary care hospital, between December 2013 and March 2014, and it evaluated the presence of superficial and deep SSIs in patients during the first 14 days after a CS. Patients were randomly allocated to receive treatment with either a DACC dressing or a standard surgical dressing.ResultsOne hundred and forty-two patients after planned or emergency CS were enrolled in the study. No significant differences between the groups were observed with regard to patients’ basic demographic and perioperative characteristics. The rate of superficial and deep SSIs was 2.8% in the group of patients who received a DACC dressing compared to 9.8% in the group with a standard surgical dressing (p = 0.08). Patients with SSIs who received a standard surgical dressing required systemic antibiotic therapy significantly more frequently (p = 0.03). Based on the logistic regression model developed, the pre-pregnancy body mass index was the only statistically significant risk factor for SSI (p = 0.015).ConclusionsThe results of the pilot study indicate a decreasing tendency of the SSI rate in patients after a CS who received DACC impregnated dressings.

Electronic poster abstractssupplemented with MRI and CT scan. Surgery alone or in combination with chemotherapy is the proposed treatment of immature teratoma. P27.11Half a good diagnosis Guide the gynecologist on the type, origin and status of an adnexal mass is the fundamental role of transvaginal ultrasound. The Doppler mode in its various forms is an important auxiliary role in these cases. The following case shows a correct diagnosis in both the tumor type and its status, but also its mistake in the origin. The Images and videos we present are for a presumptive ultrasound diagnosis of uterine fibroid, subserosal pedunculated, with twisted pedicle (Whirlpool Sign with at least three turns on its axis), with preservation of flow. Although post-operative diagnosis corresponded to a fibroma with twisted pedicle, the true origin of the tumor corresponded to the ovary. Although the difference did not change diagnostic medical conduct, it was a partial misdiagnosis and a fail in our aim to achieve total accuracy in ultrasonographic diagnosis.Supporting information can be found in the online version of this abstract Department of Obstetrics, Gynecology and Oncology II Faculty of Medicine, Medical University of Warsaw, Warsaw, PolandObjectives: The aim of the study was to compare the diagnostic performance of the classic and modified RMI IV in the preoperative differentiation between malignant and non-malignant adnexal masses. Methods: 140 patients with adnexal masses were included in the study. An ultrasound examination was done for each patient. Formula of Yamamoto was used for calculation of risk of malignancy risk index RMI IV depending on the ultrasound score, menopause status and the serum concentration of CA125. The following ultrasound features were considered in the formula: the presence of multilocular cyst, presence of solid component, evidence of metastases in ultrasound scan, ascites, bilateral lesions and maximal diameter of the lesion. Serum concentration of CA125 was used directly in the classic formula. Menopause was defined as absence of menstruation for at least 12 months. Serum concentration of human epididymis protein HE4 was used directly in the modified formula instead of CA125. The definitive diagnosis of the adnexal pathology was confirmed by the pathological examination of the excised lesions. Results: Malignant disease was confirmed in 25 cases (17,86%) and non-malignant disease in 115 cases (82,14%). 59 patients (24,14%) were after menopause. The sensitivity of classic and modified RMI IV was 92% and 88% respectively. The specificity was 97,39% and 94,78% respectively. The positive predictive value was 88,46% and 78,57% respectively. The negative predictive value was 98,25% and 97,32% respectively. Conclusions:The classic RMI IV has higher sensitivity, specificity, positive and negative predictive values than the modified RMI IV. Replacing of CA125 by HE4 in the RMI IV formula does not improve the sensitivity, specificity, positive and predictive values of RMI IV. P27.13Comparison of the...

Objectives:To investigate the character of pelvic floor ultrasound in female patients with different classification of stress urinary incontinence. Methods: Pelvic floor ultrasound were performed in 67 female patients with I or II grade of stress urinary incontinence and 18 female patients with III or IV grade of stress urinary incontinence, the bladder neck movement degrees and urethral mouth funnel formation were observed in maximal Valsalva condition in two groups, the difference were compared between two groups. Objectives: To describe the effect of ulipristal acetate (UPA) on fibroids characteristics assessed with 3D ultrasound. Methods: A prospective observational study was designed in a university hospital, including premenopausal women with symptomatic uterine fibroids who received 12 weeks of 5 mg/24 h UPA treatment. A 3D ultrasound was performed pre and post UPA treatment by a single gynecologist (Voluson V750 Expert, GE). Variables considered were fibroids number, volume (using VOCAL™ software) and vascularisation of fibroids (subjective score 1-4), uterine volume, antral follicle count (AFC), endometrial type and endometrial thickness.